PURPOSE: H. pylori infection was recently reported to be associated with unexplained iron-deficiency anemia(IDA) in children and adolescents. H. pylori-related IDA was thought to occur due to GI blood loss, scavenging of iron by H. pylori and iron malabsorption. The aim of this study was to examine how the status of H. pylori infection and age of children affected RBC indices, serum iron level and TIBC. METHODS: We performed esophagogastroduodenoscopy, and examined RBC indices, serum iron and TIBC on 178 pediatric patients with recurrent abdominal pain. H. pylori infection was assessed by CLO test and silver stain of gastric biopsy specimen. RESULTS: H. pylori infection was found in 42 of 178 patients(23.6%). In children with H. pylori infection, the prevalence of iron deficiency(ID) and IDA(39.0% and 10.3%, respectively) was higher than in children without H. pylori infection(29.6% and 4.1%, respectively), but there was no statistically significant difference. Serum iron level was lower(69.5+/-32.7 vs 77.3+/-34.1g/dL; P= 0.08) and TIBC was higher(380.8+/-50.4 vs 366.9+/-47.0g/dL; P=0.09) in children with H. pylori infection than in children without H. pylori infection. All RBC indices and iron saturation were lower in children with H. pylori infection than in children without H. pylori infection, but there was no significant difference between the two groups. In correlation analysis, serum iron, Hgb, Hct, MCV and MCH were significantly increased by age in children without H. pylori infection (P<0.05), but MCH and MCHC were decreased significantly(P<0.05) by age in children with H. pylori infection. In multiple regression analysis, the change of serum iron, MCH and MCHC by age was significantly influenced by the status of H. pylori infection(P<0.05). CONCLUSION: H. pylori infection decreases RBC indices and serum iron and increases TIBC in children. These changes become prominent as age increases. This age effect rnay be related to the duration of H. pylori infection. (J Korean Pediatr Soc 2000;43:755-762)
Abdominal Pain ; Adolescent ; Anemia, Iron-Deficiency ; Biopsy ; Child* ; Endoscopy, Digestive System ; Erythrocytes* ; Helicobacter pylori* ; Helicobacter* ; Humans ; Iron* ; Prevalence ; Silver

Background: There have been many reports on microbial contamination of antiseptics and disinfectant used in the hospitals. Mid to low level disinfectants such as chlorhexidine gluconate, quaternary ammonium, phenols and benzalkonium are reported to be the one with high risk of microbial contamination. We investigated microbial contamination of 0.05% chlorhexidine gluconate solution used in our hospital. Methods: 0,05% chlorhexidine gluconate solution and 0.05% chlorhexidine gluconate cotton balls used in the general ward and intensive care unit were randomly collected for microbial culture. Also, sterile water, 20% chlorhexidine gluconate and staining solution, which is mixed in the preparation room to make 0,05% chlorhexidine gluconate solutions, were collected for bacterial culture to evaluate the focus of microbial contamination. Results: Total of 31 chlorhexidine gluconate samples was randomly collected from general wards. intensive care unit and preparation room for microbial culture. Seven of thirteen 0.05% chlorhexidine gluconate solution and 5 of twelve 0.05% chlorhexidine soaked cotton balls kept in a canister were contaminated by Burkholderia cepacia. Sterile water used for dilution of 20% chlorhexidine gluconate to make 0.05% chlorhexidine and originally purchased 20% chlorhexidine gluconate were not contaminated by microorganism. But staining solution that is used as an additive to differentiate from other diluted disinfectants was contaminated by Bukholderia cepacia. 0.05% chlorhexidine gluconate solutions that were mixed in the preparation room were also contaminated by same organism. Source of contamination was thought to be staining solution. All the previously made chlorhexidine. solutions and staining solution were discarded. Staining solution was not used afterward. Several processes in the handling of chlorthexidine solution were corrected and no microbial contamination was found afterward. Conclusion: Diluted chlorthexidine gluconate solutions are always under a risk of microbial contamination if any of the process in the handling is overlooked. Staining solution as an additive to disinfectants should be used carefully.
Ammonium Compounds ; Anti-Infective Agents, Local ; Benzalkonium Compounds ; Burkholderia cepacia ; Chlorhexidine* ; Disinfectants ; Intensive Care Units ; Patients' Rooms ; Phenol ; Phenols ; Water

Although many kinds of operation for rectal prolapse exist, generally they could be divided into the transabdominal and transperineal approach. The former has low recurrence rate as compared with the latter, but needs laparotomy. Unfortunately, many patients with rectal prolapse are old and debilitated. So they are not suitable candidates for a major abdominal operation. For those patient, a transperineal method may be proper, but the recurrence rate may be high and continence is not always achieved. We reviewed 12 patients who were older than 70 years of age and treated by the Thiersch operation among the 52 cases of rectal prolapse from Feb. 1992 to Mar. 1997 at Kwangju Christian Hospital. The results were summarized as follows; 1) The male to female ratio was 1 : 1.4. 2) Durations of rectal prolapse were distributed from 6 months to 30 years. Seven cases had duration of longer than 10 years. 3) The preoperative incidence of incontience was 8 (67%) of 12 cases. Among the 8 patients with incontinence, the male was 3 (37.5%) and female was 5 (62.5%). 4) Postoperative review of incontinence revealed complete disappearance in 4 cases (50%), improvement in 3 cases (37.5%), and no improvement in 1 case (12.5%). 5) After the Thiersch operation, rectal prolapse recurred in only 1 of the 12 cases (8.3%), a wound infection developed in 1 case (8.3%), defecation difficulty due to the small Thiersch ring was present in 3 cases (25%). The results of this study show that the Thiersch operation may be an effective method in treating rectal prolapse, especially in patient who are old or have poor general condition and manifested incontinence.
Defecation ; Female ; Gwangju ; Humans ; Incidence ; Laparotomy ; Male ; Rectal Prolapse* ; Recurrence ; Wound Infection

Although it is not certain when malaria began to appear in the Korean peninsula, it is believed to have had been an endemic disease until 1984. Vivax malaria reemerged in the Republic of Korea (ROK) in 1993. In the early period most of the cases occurred among soldiers stationed in the DMZ and the adjacent region. In order to cope with malaria, the soldiers at risk received chemoprophylaxis with chloroquine and primaquine. The regimen for the treatment of vivax malaria in Korea was established in 1950's. Primaquine was introduced in 1951, and the field testing during the Korean War demonstrated that the combination of three days of chloroquine administration with fourteen days of primaquine reliably prevented the recurrence of vivax malaria. The regimen has been used since then, but there were some controversies as to whether or not to start chloroquine and primaquine on the same day. Most of the current treatment guidelines recommend the use of primaquine for fourteen days to overlap with blood schizonticide agents such as chloroquine and routine tests for G-6-PD deficiency before use. Previous data showed that the G-6-PD deficiency rate has been found very low among Koreans. Thus, it is not always necessarily mandatory to test for G-6-PD deficiency among Korean patients.
Chemoprevention ; Chloroquine ; Endemic Diseases ; Glucosephosphate Dehydrogenase ; Humans ; Korea* ; Korean War ; Malaria ; Malaria, Vivax* ; Military Personnel ; Primaquine ; Recurrence ; Republic of Korea

No abstract available.
Glycogen Storage Disease Type I*

The majority of patients with medulloblastoma present with hydrocephalus. It has been reported, however, that not all medulloblastoma patients will continue to have hydrocephalus after the tumor is resected, and in fact, only selected patients need permanent shunts. To retrospectively identify the prognostic factors indicating this requirement, we analysed several charateristics in patients without preoperative shunts suffering from medulloblastoma combined with hydrocephalus. We studied 32 patients and divided them into two groups: those requiring shunts within 4 weeks of surgery, and those not shunted. Nine patients(28%) required a permanent shunt. We found that these patients were younger(4.8+/-4.3 vs. 9.6+/-7.4 years; p<0.05), had more extensive tumors (Chang's stage T2 vs. T3; p<0.050), and that postoperatively, some tumor remained(p<0.05). However, with regard to gender, symptoms of increasedintracranial pressure(ICP), the duration of these symptoms, positive cerebrospinal fluid(CSF) cytology, perioperative external ventricular drainage, and degree of preoperative hydrocephalus, there were no differences between the groups. It was thus concluded that younger patients with extensive preoperative tumors and tumors remaining after surgery may benefit from postoperative CSF diversion. It was thought that patients not fitting the above criteria can probably be managed with perioperative corticosteroids alone.
Adrenal Cortex Hormones ; Drainage ; Humans ; Hydrocephalus* ; Medulloblastoma* ; Retrospective Studies

No abstract available.
Aspergillosis*

Pancreatic cancer is a disease with poor prognosis mainly due to low resection rates and late diagnosis. To increase resectability and improve survival rates, a better understanding of pancreatic cancer pathogenesis and more effective screening techniques are required. New methods, such as genetic and molecular alterations, may suggest novel approaches for pancreatic cancer diagnosis and treatment. We immunohistochemically investigated 44 formalin-fixed, paraffin-embedded specimens of pancreatic ductal adenocarcinoma using monoclonal anti-p16 antibodies and monoclonal anti-p53 antibodies. The expressions of p16 and p53 proteins were compared using the Chi-square test with SPSS. Disease-free survival was analyzed using the Kaplan-Meier method, verified by the Log- Rank test. Loss of p16 expression was noted in 20 (45.5%) cases and aberrant p53 protein expression was detected in 14 (31.8%) cases. Loss of p16 expression was associated with a higher incidence of lymph node metastasis (p=0.040) and a more advanced stage (p=0.015), although there was no significant correlation between p16 expression and survival. Aberrant p53 protein expression correlated with histologic grade (p= 0.038). Disease-free survival rate was significantly lower in the aberrant p53 protein positive group compared to the negative group (p=0.029). From our results, we suggest that p53 is not a prognostic factor; however, p16 and p53 genes do play important roles in the progression of pancreatic ductal adenocarcinoma.
Adult ; Aged ; Female ; Genes, p16 ; Genes, p53 ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Neoplasm Staging ; Pancreatic Neoplasms/*chemistry/genetics/mortality/pathology ; Protein p16/*analysis ; Protein p53/*analysis ; Sex Characteristics

Proliferative vitreoretinopathy (PVR) is the main cause of failure in retinal reattachment surgery, Vitrectomy combined with pharmacologic therapy to inhibit proliferating and contracting epiretinal membranes appears to be a promismg approach in the management of PVR. We investigated the inhibitory effect of intravitreal 5-fluorouracil (5-FU) on experimental PVE induced by intravitreal injection of homologous dermal fibroblast in pigmented rabbits. At 6 weeks after intravitreal injection, Goup I (fibroblast only), Group II (early treatment with 1mg of 5-FU), and Group Ill (delayed treatment with 1mg of 5-FU) developed the retinal detachment in 85.7%, 33.3%, and 58.3% respectively. The rate of retinal detachment was lower in treatment groups than in non-treatment group, but there was a statistically significant difference only between non-treatment group (Group I) and early-treatment group (Group II) (p<0.05). In the group that only 5-FU was injected (Group IV), the retinas were preserved in normal clinically and pathologically. These results show that 5-FU may exert a significant anti proliferative effect on intraocular proliferative disorders including PVR especially if the drug is administered more earlier.
Epiretinal Membrane ; Fibroblasts ; Fluorouracil* ; Intravitreal Injections ; Rabbits ; Retina ; Retinal Detachment ; Retinaldehyde ; Vitrectomy ; Vitreoretinopathy, Proliferative*

OBJECTIVES: To confirm the HAVS in workers exposed to hand-arm vibration with using the objective diagnostic methods METHODS: Several tests were used to help substantiate a clinical diagnosis of HAVS. Some other diseases were excluded by a medical interview, hematologic assessment, urinalysis, X-rays. The hand-arm vibration acceleration level of the grinder was evaluated for considering HAVS. Peripheral vascular changes were examined by a cold provocation test. An electromyography was implemented to ascertain the peripheral neural changes. RESULTS: 8 workers with symptoms in hands & fingers, exposed to hand-arm vibration were examined. Some other diseases(primary Raynauds disease, secondary Raynauds disease in not occupational origin) were excluded by a medical interview, hematologic assessment, urinalysis, X-rays. The hand-arm vibration acceleration level of the grinder was 7. 9 m/sec2. The recovery time of a skin temperature followed finger cooling was significantly prolonged in 6 workers with HAVS. The nerve conduction velocity was reduced in 6 workers with HAVS. CONCLUSIONS: So we report 6 cases of HAVS in grinding workers exposed to hand-arm vibration diagnosed objectively by an exclusion of some other disease, handarm vibration acceleration level, cold provocation test, electromyography.
Acceleration ; Diagnosis ; Electromyography ; Fingers ; Hand* ; Hand-Arm Vibration Syndrome* ; Neural Conduction ; Raynaud Disease ; Skin Temperature ; Urinalysis ; Vibration*