Noroviruses have been recognized as the leading cause of epidemic and sporadic gastroenteritis since the advent of molecular diagnostic technique. They have been documented in 5-31% of pediatric patients hospitalized with gastroenteritis. Although norovirus gastroenteritis is typically mild and self-limited, it causes severe, but sometimes fatal, conditions in the vulnerable population such as immunocompromised patients, young children, and the elderly. Bowel perforation due to norovirus infection is rare. We report a case of small bowel perforation with norovirus gastroenteritis in the infant with Down syndrome during the hospitalization with pneumonia. Severe dehydration may cause bowel ischemia and could have triggered bowel perforation in this case. Physicians should be alert to the potential surgical complications followed by severe acute diarrhea, especially in high risk groups.
Aged ; Child ; Dehydration ; Diarrhea ; Down Syndrome ; Gastroenteritis* ; Hospitalization ; Humans ; Immunocompromised Host ; Infant* ; Ischemia ; Molecular Diagnostic Techniques ; Norovirus* ; Pneumonia ; Vulnerable Populations

PURPOSE: The current study was undertaken to examine the trend in gallbladder cancer (GBC) incidenceand survival in Korea. MATERIALS AND METHODS: GBC incidence data by histologic typewere obtained from the Korea Central Cancer Registry.Age-standardized incidence rates were calculated using the mid-year Korean population of2000 as a standard population, and a joinpoint regression model was used to calculate theannual percent change (APC) in incidence rates. Incidence by Surveillance, Epidemiology and End Results (SEER) summary stage and by geographical areas and female-to-male incidencerate ratios was also described. RESULTS: The number of new GBC cases increased between 1999 and 2013. Nevertheless, the agestandardizedincidence rate decreased by 0.5% per year in men (p < 0.01), whereas theincidence rate in women did not change significantly over the same period (APC, –0.2;p=0.59). The most common histologic type was adenocarcinoma in both sexes. Based onthe SEER stage, the distant stage was the most frequent stage (41%), followed by theregional stage (37%). Ulsan (4.31/100,000 for men and 4.09/100,000 forwomen in 2009-2013) and Gyeongsangnam-do (4.15/100,000 for men and 3.54/100,000 for women)showed the highest GBC incidence, whereas the lowest incidence was observed in Seouland Gyeonggi-do. There were no significant sex differences in the incidence of GBC (femaleto-maleincidence rate ratio, 0.96). CONCLUSION: The overall incidence of GBC in Korea did not change significantly over the 15-year period.Incidence for men and women was similar. However, geographical variation was found.
Adenocarcinoma ; Epidemiology ; Female ; Gallbladder Neoplasms* ; Gallbladder* ; Gyeonggi-do ; Gyeongsangnam-do ; Humans ; Incidence* ; Korea* ; Male ; Sex Characteristics ; Ulsan

Thyrotoxic periodic paralysis (TPP) occurs in 2% of the asian patients with hyperthyroidism and is characterized by bilateral flaccid paralysis of the extremity, especially lower limbs. It is well-known that hypokalemia is usually accompanied by TPP. However, hypophosphatemia is usually mild and well neglected. Although paralysis is generally recovered without treatment, in some cases, patients with TPP may die due to cardiopulmonary complications, such as cardiac arrhythmia. Therefore, proper and rapid replacement of potassium is essential. But it should be acknowledged that replacement may cause a rebound. TPP is often unrecognized and over-treated in the emergency room due to its non-specific symptoms. This is why clinicians must be familiar with this disease and its diagnostic clues such as Echocardiography change and clinical features. This is a case report of a 29-year-old male presenting with TPP accompanied by hypokalemia, hypophosphatemia and second degree atrioventricular block, who showed rebound hyperkalemia and hyperphosphatemia after rapid replacement of electrolytes. EKG changed to the normal sinus rhythm in the end after the correction of the electrolytes.
Adult ; Arrhythmias, Cardiac ; Asian Continental Ancestry Group ; Atrioventricular Block ; Echocardiography ; Electrocardiography ; Electrolytes ; Emergencies ; Extremities ; Humans ; Hyperkalemia ; Hyperphosphatemia ; Hyperthyroidism ; Hypokalemia ; Hypophosphatemia ; Lower Extremity ; Male ; Paralysis ; Potassium

The aim of this study was to estimate internal radiation doses and lifetime cancer risk from food ingestion. Radiation doses from food intake were calculated using the Korea National Health and Nutrition Examination Survey and the measured radioactivity of 134Cs, 137Cs, and 131I from the Ministry of Food and Drug Safety in Korea. Total number of measured data was 8,496 (3,643 for agricultural products, 644 for livestock products, 43 for milk products, 3,193 for marine products, and 973 for processed food). Cancer risk was calculated by multiplying the estimated committed effective dose and the detriment adjusted nominal risk coefficients recommended by the International Commission on Radiation Protection. The lifetime committed effective doses from the daily diet are ranged 2.957-3.710 mSv. Excess lifetime cancer risks are 14.4-18.1, 0.4-0.5, and 1.8-2.3 per 100,000 for all solid cancers combined, thyroid cancer, and leukemia, respectively.
Adolescent ; Adult ; Cesium Radioisotopes/chemistry ; Child ; Child, Preschool ; *Eating ; Food Contamination, Radioactive/*analysis ; Humans ; Infant ; Infant, Newborn ; Iodine Radioisotopes/chemistry ; Neoplasms, Radiation-Induced/*etiology ; Nutrition Surveys ; Radiation Dosage ; Republic of Korea ; Young Adult

Radon is a naturally occurring radioactive material formed by the slow decay of uranium and thorium found in the earth's crust or construction materials. Internal exposure to radon accounts for about half of the natural background radiation dose to which humans are exposed annually. Radon is a carcinogen and is the second leading cause of lung cancer following smoking. An association between radon and lung cancer has been consistently reported in epidemiological studies on mine workers and the general population with indoor radon exposure. However, associations have not been clearly established between radon and other diseases, such as leukemia and thyroid cancer. Radiation doses are assessed by applying specific dose conversion coefficients according to the source (e.g., radon or thoron) and form of exposure (e.g., internal or external). However, regardless of the source or form of exposure, the effects of a given estimated dose on human health are identical, assuming that individuals have the same sensitivity to radiation. Recently, radiation exceeding the annual dose limit of the general population (1 mSv/yr) was detected in bed mattresses produced by D company due to the use of a monazite-based anion powder containing uranium and thorium. This has sparked concerns about the health hazards for mattress users caused by radiation exposure. In light of this event, this study presents scientific information about the assessment of radon and thoron exposure and its human implications for human health, which have emerged as a recent topic of interest and debate in society.
Background Radiation ; Beds ; Carcinogens ; Construction Materials ; Epidemiologic Studies ; Humans ; Korea ; Leukemia ; Lung Neoplasms ; Miners ; Radiation Exposure ; Radon ; Smoke ; Smoking ; Thorium ; Thyroid Neoplasms ; Uranium

Radon is a naturally occurring radioactive material formed by the slow decay of uranium and thorium found in the earth's crust or construction materials. Internal exposure to radon accounts for about half of the natural background radiation dose to which humans are exposed annually. Radon is a carcinogen and is the second leading cause of lung cancer following smoking. An association between radon and lung cancer has been consistently reported in epidemiological studies on mine workers and the general population with indoor radon exposure. However, associations have not been clearly established between radon and other diseases, such as leukemia and thyroid cancer. Radiation doses are assessed by applying specific dose conversion coefficients according to the source (e.g., radon or thoron) and form of exposure (e.g., internal or external). However, regardless of the source or form of exposure, the effects of a given estimated dose on human health are identical, assuming that individuals have the same sensitivity to radiation. Recently, radiation exceeding the annual dose limit of the general population (1 mSv/yr) was detected in bed mattresses produced by D company due to the use of a monazite-based anion powder containing uranium and thorium. This has sparked concerns about the health hazards for mattress users caused by radiation exposure. In light of this event, this study presents scientific information about the assessment of radon and thoron exposure and its human implications for human health, which have emerged as a recent topic of interest and debate in society.
Background Radiation ; Beds ; Carcinogens ; Construction Materials ; Epidemiologic Studies ; Humans ; Korea ; Leukemia ; Lung Neoplasms ; Miners ; Radiation Exposure ; Radon ; Smoke ; Smoking ; Thorium ; Thyroid Neoplasms ; Uranium

Radon is a naturally occurring radioactive material formed by the slow decay of uranium and thorium found in the earth's crust or construction materials. Internal exposure to radon accounts for about half of the natural background radiation dose to which humans are exposed annually. Radon is a carcinogen and is the second leading cause of lung cancer following smoking. An association between radon and lung cancer has been consistently reported in epidemiological studies on mine workers and the general population with indoor radon exposure. However, associations have not been clearly established between radon and other diseases, such as leukemia and thyroid cancer. Radiation doses are assessed by applying specific dose conversion coefficients according to the source (e.g., radon or thoron) and form of exposure (e.g., internal or external). However, regardless of the source or form of exposure, the effects of a given estimated dose on human health are identical, assuming that individuals have the same sensitivity to radiation. Recently, radiation exceeding the annual dose limit of the general population (1 mSv/yr) was detected in bed mattresses produced by D company due to the use of a monazite-based anion powder containing uranium and thorium. This has sparked concerns about the health hazards for mattress users caused by radiation exposure. In light of this event, this study presents scientific information about the assessment of radon and thoron exposure and its human implications for human health, which have emerged as a recent topic of interest and debate in society.

PURPOSE: This study was to evaluate temporal changes in the expressions of the phosphorylated extracellular-regulated kinase1/2 (pERK1/2), the phosphorylated MAPK/ERK kinase1/2 (pMEK1/2) and the cFos proteins in the hippocampus of rats following transient global ischemia. METHODS: Transient global ischemia was induced in the forebrains of Sprague-Dawley rats by using a 4-vessel occlusion for 20 min under anesthetic condition. Hematoxyline-eosin staining showed typical microscopic findings that represented neuronal cell death in hippocampal CA1 regions 5 days after transient global ischemia. Four-vessel occlusion-reperfusion produced ischemic injury in major forebrain structures, such as the striatum, the cortex and the hippocampus, in the finding of triphenyltetrazolium chloride (TTC) staining. RESULTS: A high density of pERK1/2 immunoreactivity existed in the pyramidal-cell layers of the CA2-3 regions and in the granular-cell layers of the dentate gyrus 5 min after ischemia. Following ischemia, expression of the pMEK1/2 protein showed temporal changes similar to that of the pERK1/2 protein. A significant expression of the cFos protein was noted in the pyramidal-cell layers of the CA2-3 regions and in the granular-cell layers of the dentate gyrus 2 hours after global ischemia. CONCLUSION: Intracellular signaling cascades of the ERK or the cFos protein take part in early cellular events in the hippocampus of rats in response to ischemic insult.
Animals ; CA1 Region, Hippocampal ; Cell Death ; Dentate Gyrus ; Hippocampus* ; Ischemia ; Neurons ; Prosencephalon ; Rats* ; Rats, Sprague-Dawley ; Reperfusion Injury*

Self expandable metal stent can be used both as palliative treatment for malignant colorectal obstruction and as a bridge to surgery in patients with potentially resectable colorectal cancer. Here, we report a case of successful relief of malignant stomal obstruction using a metal stent. A 56-year-old man underwent loop ileostomy and was given palliative chemotherapy for ascending colon cancer with peritoneal carcinomatosis. Eight months after the surgery, he complained of abdominal pain and decreased fecal output. Computed tomography and endoscopy revealed malignant stomal obstruction. Due to his poor clinical condition, we inserted the stent at the stomal orifice, instead of additional surgery, and his obstructive symptoms were successfully relieved. Stent insertion is thought to be a good alternative treatment for malignant stomal obstruction, instead of surgery.
Abdominal Pain ; Carcinoma ; Colon ; Colon, Ascending ; Colonic Neoplasms ; Colorectal Neoplasms ; Endoscopy ; Humans ; Ileostomy ; Middle Aged ; Palliative Care ; Stents

Gardners syndrome is a single gene disorder with variable manifestations associated with the adenomatous polyposis coli (APC) gene; including gastrointestinal polyposis and osteomas associated with a variety of benign soft tissue tumors and other extraintestinal manifestations. Infrequently associated tumors include papillary carcinoma of the thyroid, biliary neoplasia and adrenal neoplasia, both benign and malignant. It is classified as a variant of classic familial adenomatous polyposis (FAP) and is an autosomal dominant disease. The incidence of incidentaloma in FAP patients is known to be higher than general population. The occurrence of an adrenal carcinoma could affect a patient's prognosis with Gardners syndrome. Increased awareness of this lesion is important in patients with Gardners syndrome who have extended lifespan after prophylactic colectomy. We report a 37 year old case of Gardners syndrome associate with adrenal adenoma.
Adenoma* ; Adenomatous Polyposis Coli ; Adrenal Gland Neoplasms ; Adult ; Carcinoma, Papillary ; Colectomy ; Gardner Syndrome* ; Humans ; Incidence ; Osteoma ; Prognosis ; Thyroid Gland