OBJECTIVE: We investigated the effect of preeclampsia, birth weight, fetal sex, maternal body mass index(BMI) on cord blood leptin concentrations. This study is to test whether leptin would be increased in preeclampsia and to test cord leptin concentrations for correlation with maternal leptin concentrations. METHOD: Maternal blood samples were obtained from 56 normal pregnancies and 24 preeclampsia women prior to delivery. Umbilical cord blood were obtained from the all cases studied immediately after delivery. The total leptin levels were determined by radioimmunoassay. RESULTS: Mean maternal leptin level was 16.4+/-6.4ng/ml in normal pregnancy and was 19.4+/-7.9 ng/ml in preeclampsia. Mean cord leptin level was 5.4+/- 3.4ng/ml in normal pregnancy and 4.6+/-3.2ng/ml in preecalmpsia. Mean cord blood leptin level in female fetus was 6.6+/-3.7ng/ml and 4.8+/-2.8ng/ml in male fetus. CONCLUSION: This study shows that there are correlation with leptin level and fetal birth weight, body mass index, and fetal gender. Furthermore, physiologic role and mechanism of leptin of maternal serum and umbilical cord would be studied.
Birth Weight ; Body Mass Index ; Female ; Fetal Blood ; Fetus ; Humans ; Leptin* ; Male ; Plasma* ; Pre-Eclampsia ; Pregnancy* ; Radioimmunoassay ; Umbilical Cord*

BACKGROUND: The study aimed to determine the type of capsular insertion and the extent of capsular elongation in anterior shoulder instability by quantitatively evaluating their computed tomography arthrographic (CTA) findings, and to investigate the correlation of these parameters with surgical outcomes. METHODS: We retrospectively reviewed 71 patients who underwent CTA and arthroscopic capsulolabral reconstruction for anterior shoulder instability between April 2004 and August 2008. The control group comprised 72 patients diagnosed as isolated type II superior labrum anterior to posterior (SLAP) lesion during the period. Among the 143 patients, 71 were examined with follow-up CTA at an average 13.8 months after surgery. It was measured the capsular length and cross-sectional area at two distinct capsular regions: the 4 and 5 o'clock position of the capsule. RESULTS: With regards to the incidence of the type of anterior capsular insertion, type I was more common in the control group, whereas type III more common than in the instability group. Anterior capsular length and cross-sectional area were significantly greater in the instability group than in the control group. Among patients of the instability group, the number of dislocations and the presence of anterior labroligamentous periosteal sleeve avulsion lesion were significantly associated with anterior capsular redundancy. Postoperatively, recurrence was found in 3 patients (4.2%) and their postoperative capsular length and cross-sectional area were greater than those of patients without recurrence. CONCLUSIONS: Capsular insertion type and capsular redundancy derived through CTA may serve as important parameters for the management of anterior shoulder instability.
Arthrography* ; Dislocations ; Follow-Up Studies ; Humans ; Incidence ; Joint Instability ; Recurrence ; Retrospective Studies ; Shoulder*

Familial hyperkalemic periodic paralysis (HYPP) is an autosomaldominant channelopathy characterized by transient and recurrent episodes of paralysis with concomitant hyperkalemia. Mutations in the skeletal muscle voltage-gated sodium channel gene SCN4A have been reported to be responsible for this disease. Here, we report the case of a 16-year-old girl with HYPP whose mutational analysis revealed a heterozygous c.2111C>T substitution in the SCN4A gene leading to a Thr704Met mutation in the protein sequence. The parents were clinically unaffected and did not have a mutation in the SCN4A gene. A de novo SCN4A mutation for familial HYPP has not previously been reported. The patient did not respond to acetazolamide, but showed a marked improvement in paralytic symptoms upon treatment with hydrochlorothiazide. The findings in this case indicate that a de novo mutation needs to be considered when an isolated family member is found to have a HYPP phenotype.
Acetazolamide ; Adolescent ; Channelopathies ; Humans ; Hydrochlorothiazide ; Hyperkalemia ; Muscle, Skeletal ; Paralysis ; Paralysis, Hyperkalemic Periodic ; Parents ; Phenotype ; Sodium ; Sodium Channels

Familial hyperkalemic periodic paralysis (HYPP) is an autosomaldominant channelopathy characterized by transient and recurrent episodes of paralysis with concomitant hyperkalemia. Mutations in the skeletal muscle voltage-gated sodium channel gene SCN4A have been reported to be responsible for this disease. Here, we report the case of a 16-year-old girl with HYPP whose mutational analysis revealed a heterozygous c.2111C>T substitution in the SCN4A gene leading to a Thr704Met mutation in the protein sequence. The parents were clinically unaffected and did not have a mutation in the SCN4A gene. A de novo SCN4A mutation for familial HYPP has not previously been reported. The patient did not respond to acetazolamide, but showed a marked improvement in paralytic symptoms upon treatment with hydrochlorothiazide. The findings in this case indicate that a de novo mutation needs to be considered when an isolated family member is found to have a HYPP phenotype.
Acetazolamide ; Adolescent ; Channelopathies ; Humans ; Hydrochlorothiazide ; Hyperkalemia ; Muscle, Skeletal ; Paralysis ; Paralysis, Hyperkalemic Periodic ; Parents ; Phenotype ; Sodium ; Sodium Channels

No abstract available.
Child* ; Humans ; Scrub Typhus*

PURPOSE: The objective of this study was to assess and investigate the epidemiology of pertussis in infants under 6 months of age. METHODS: A prospective study was conducted between October 1, 2011 and April 30, 2013 in CHA Bundang Medical Center, Seongnam, South Korea. Polymerase chain reaction (PCR) or culture was used to detect Bordetella pertussis in nasopharyngeal aspirates from case patients who were hospitalized for acute lower respiratory tract infection (LRTI). In addition, multiplex real-time PCR assays were also performed to detect 6 etiologic viruses, including adenovirus, human metapeumovirus, influenza virus, parainfluenza virus, respiratory syncytial virus and rhinovirus. RESULTS: Of the 79 enrolled case patients, whose median age was 2 months of age, the most common diagnoses uncovered in this study were acute bronchiolitis (60%) and pneumonia (28%). B. pertussis infection was found in 13 cases (16%), in which 7 (53%) was coinfected with respiratory syncytial virus and 1 (7%) with influenza A virus. Of the 13 patients with B. pertussis infection, 6 (46%) were not vaccinated with the diphtheria, tetanus toxoid, and acellular pertussis vaccine, while 6 (46%) received 1 dose, and 1 (8%) received 2 doses. CONCLUSION: B. pertussis infection was present in 16% of under 6 month-old infants, who were hospitalized for acute LRTI. Therefore, a nationwide epidemiological surveillance of pertussis, including institutions that cater to infants under 6 months of age is necessary and needed.
Adenoviruses, Human ; Bordetella pertussis ; Bronchiolitis ; Diagnosis ; Diphtheria ; Epidemiology ; Gyeonggi-do ; Humans ; Infant* ; Influenza A virus ; Korea ; Orthomyxoviridae ; Paramyxoviridae Infections ; Pertussis Vaccine ; Pneumonia ; Polymerase Chain Reaction ; Prospective Studies ; Real-Time Polymerase Chain Reaction ; Respiratory Syncytial Viruses ; Respiratory Tract Infections ; Rhinovirus ; Tetanus Toxoid ; Vaccination ; Whooping Cough*

Bcl-2 is a proto-oncogene initially described in follicular lymphoma, associated with chromosomal translocation(14;18). Recent studies have shown the presence of Bcl-2 in nonhematolymphoid tissue, especially in hormonally responsive tissue. The endometrium is an attractive model for studying the hormone dependent regulation of Bcl-2 expression. We have studied the immunoreactivity of Bcl-2 oncoprotein in relation to the immunoreactivity of estrogen receptors(ER) and progesterone receptors(PR) by immunohistochemistry in 52 human endometrial carcinomas, according to nuclear grade. The results obtained are summarized as followings, 1) Immunohistochemical grade of Bcl-2 showed a significant inverse correlation with nuclear grade. 2) Immunohistochemical grades of ER and PR also showed a significant inverse correlation with nuclear grade, and were well correlated with each other. 3) Immunohistochemical grades of Bcl-2 and hormone receptors showed a strongly significant correlation. On the basis of the above results, we suggest that Bcl-2 expression may be under hormone dependent control and that it can be used in prognosis and choice of hormonal therapy in the presence of hormone receptor.
Humans

The Acknowledgements was published incorrectly.

PURPOSE: The purpose of this study was to identify the relationship between response to violence, resilience and burnout and to investigate the factors that affect burnout in emergency room nurses. METHODS: Data from 237 nurses in 15 emergency rooms were collected using a structured questionnaire. Data were analyzed using SPSS 23.0, and the analyses included descriptive statistics, t-test, Mann-Whitney test, ANOVA, Kruskall Wallis test, Pearson correlation, and hierarchical multiple regression. RESULTS: Burnout was positively correlated with response to violence and negatively correlated with resilience in emergency room nurses. Response to violence (β=.466, p<.001), resilience (β=−.308, p<.001), and religion (β=−.131, p=.011) were significant predictors of burnout, and they explained 39.9% of emergency room nurses' burnout. CONCLUSION: Response to violence and resilience were identified as significant factors affecting burnout in emergency room nurses. Therefore, it is necessary to develop strategies to cope effectively with violence and to develop programs that can strengthen resilience.
Emergencies ; Emergency Service, Hospital ; Exposure to Violence ; Violence

We present an incidentally detected case of bilateral sub-internal limiting membrane (ILM) hemorrhage secondary to typical hemolytic uremic syndrome (HUS) along with a literature review. A 4-year-old girl presented to our emergency department with bloody diarrhea, abdominal pain, fever, and oliguria. HUS was suspected based on clinical symptoms and laboratory findings suggestive of hemolytic anemia, thrombocytopenia, and acute kidney injury. Supportive management, including intermittent dialysis, was provided during admission. However, the patient exhibited central nervous system involvement and presented with a seizure. Despite the absence of visual symptoms, a fundus examination revealed unexpected bilateral sub-ILM hemorrhages and a cotton wool spot in the right eye. Blood dyscrasia improved with repeated hemodialysis and red blood cell transfusions. The sub-ILM hemorrhage gradually resolved, as observed on consecutive fundus photographs. Multimodal retinal imaging revealed healthy capillary structures without evidence of macular ischemia or fibrosis. Typical HUS can be accompanied by a sub-ILM hemorrhage without preceding symptoms. The absence of visual symptoms, despite significant retinal abnormalities, emphasizes the importance of immediate and routine fundus examinations in patients with typical HUS. This proactive approach improves early detection of ocular involvement, enabling prompt intervention to manage potential visual complications, and ultimately improving patient outcomes.