OBJECTIVE: To evaluate the safety and potential efficacy of "recombinant human growth hormone (rhGH)" on the functional recovery of completed stroke patients. METHOD: Completed stroke patients were recruited. All participants were randomly assigned to the GH group (rhGH injection and rehabilitative therapy) or the control group (only rehabilitative therapy). Above all, they were closely monitored for safety. Further, for the efficacy measurement, Korean Modified Barthel Index (K-MBI), Manual Muscle strength Test (MMT), and Fugl-Meyer assessment (FMA) were assessed to determine the changes of functional recovery during 6-months of the study period. Along with it, diffusion tensor image was taken as the baseline, and a followed-up study to observe the changes in diffusion tensor tractography (DTT), during the period, and one patient in the GH group was also examined with functional MRI (fMRI). Index of fatigue on 5 point scale for the study period was also assessed. RESULTS: Twenty-two patients were enrolled, and 15 completed the study and were included in the analysis. No harmful adverse events were observed in the GH group. By comparison between the groups, the GH group showed more improvement in K-MBI than the control group (p<0.05). DTT showed less decrement of fibers in the GH group than in the control group, without statistical significance. fMRI showed an increment in the activated area. Patients in the GH group expressed no fatigue at all, during the study period (p=0.00). CONCLUSION: The administration of rhGH in long term resulted in the improvement in K-MBI, and subjectively less tiredness during the injection period.
Diffusion ; Fatigue ; Growth Hormone ; Human Growth Hormone ; Humans ; Insulin-Like Growth Factor I ; Magnetic Resonance Imaging ; Muscle Strength ; Stroke

Shigella is a common cause of bacterial enteritis worldwide. Shigella sonnei accounts for 90% of Shigella infections and Shigella flexneri is rarely reported in Korea. Although the incidence of Shigella infection has decreased, the incidence of organisms with antibiotic resistance has gradually increased in Korea. An outbreak of extended-spectrum β-lactamase (ESBL)-producing S. sonnei in children was reported in Korea; however, ESBL-producing S. flexneri has not yet been reported. We report the first two cases of multidrug-resistant CTX-M-14-producing S. flexneri infections in Korean children.
beta-Lactamases ; Child* ; Drug Resistance, Microbial ; Enteritis ; Humans ; Incidence ; Korea* ; Shigella flexneri* ; Shigella sonnei ; Shigella*

PURPOSE: Abdominal computed tomography (CT) is a widely recognized method to diagnose patients with acute abdominal pain in the emergency departments (EDs). We aimed to investigate the current state and interpretations of abdominal CT performed in the ED of a tertiary university hospital. METHODS: This was a retrospective study based on an abdominal CT database and medical records of patients over 15 years of age, who had visited our ED between January 1 and December 31, 2013. The data collected included CT types, final interpretations, characteristics of the patients, and location of pain at the time of CT. RESULTS: A total of 1,978 abdominal CTs were performed among 1,923 patients during the research period. The most frequent organs involved in the major diagnosis were those in the urinary system, followed by the appendix, liver, large intestine, and gallbladder. The most frequently interpreted diagnoses in these organs were in the order of urinary stone, appendicitis, liver cirrhosis, infectious colitis, and acute cholecystitis. The most frequent location of pain was the right lower quadrant (429 cases, 21.7%), and the most frequently performed CT types were contrast-enhanced abdominal and pelvic CT (1,260 cases, 63.7%). CONCLUSION: Various interpretations were derived based on the abdominal CTs, ranging from critical to mild diseases and from common to rare diseases. Based on this study, we have developed a preliminary interpretation checklist for abdominal CTs.
Abdominal Pain ; Appendicitis ; Appendix ; Checklist* ; Cholecystitis, Acute ; Colitis ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Gallbladder ; Humans ; Intestine, Large ; Liver ; Liver Cirrhosis ; Medical Records ; Methods ; Rare Diseases ; Retrospective Studies ; Tomography, X-Ray Computed ; Urinary Calculi

OBJECTIVE: To investigate the prognostic value of cross-sectional areas (CSA) of paraspinal (multifidus and erector spinae) and psoas muscles on magnetic resonance imaging (MRI) in chronicity of low back pain. METHOD: Thirty-eight subjects who visited our hospital for acute low back pain were enrolled. Review of their medical records and telephone interviews were done. Subjects were divided into two groups; chronic back pain group (CBP) and a group showing improvement within 6 months after onset of pain (IBP). The CSA of paraspinal and psoas muscles were obtained at the level of the lower margin of L3 and L5 vertebrae using MRI. RESULTS: CSA of erector spinae muscle and the proportion of the area to lumbar muscles (paraspinal and psoas muscles) at L5 level in the CBP group were significantly smaller than that of the IBP group (p<0.05). The mean value of CSA of multifidus muscle at L5 level in the CBP group was smaller than that of the IBP group, but was not statistically significant (p>0.05). CSA of psoas muscle at L5 level and all values measured at L3 level were not significantly different between the groups (p>0.05). CONCLUSION: CSA of erector spinae muscle at the lower lumbar level and the proportion of the area to the lumbar muscles at the L5 level can be considered to be prognostic factors of chronicity of low back pain.
Back Pain ; Interviews as Topic ; Low Back Pain ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Medical Records ; Muscles ; Organothiophosphorus Compounds ; Psoas Muscles ; Spine

OBJECTIVE: To obtain reliability and applicability of the Korean version Bayley Scale of Infant Development-II (BSID-II) in evaluating the developmental status of children with cerebral palsy (CP). METHODS: The inter-rater reliability of BSID-II scores from 68 children with CP (46 boys and 22 girls; mean age, 32.54+/-16.76 months; age range, 4 to 78 months) was evaluated by 10 pediatric occupational therapists. Patients were classified in several ways according to age group, typology, and the severity of motor impairment by the level of the Gross Motor Function Classification System (GMFCS). The measures were performed by video analysis, and the results of intraclass correlation (ICC) were obtained for each of the above classifications. To evaluate the clinical applicability of BSID-II for CP, its correlation with the Gross Motor Function Measure (GMFM), which has been known as the standard motor assessment for CP, was investigated. RESULTS: ICC was 0.99 for the Mental scale and 0.98 for the Motor scale in all subjects. The values of ICC ranged from 0.92 to 0.99 for each age group, 0.93 to 0.99 for each typology, and 0.99 to 1.00 for each GMFCS level. A strong positive correlation was found between the BSID-II Motor raw score and the GMFM total score (r=0.84, p<0.001), and a moderate correlation was observed between the BSID-II Mental raw score and the GMFM total score (r=0.65, p<0.001). CONCLUSION: The Korean version of BSID-II is a reliable tool to measure the functional status of children with CP. The raw scores of BSID-II showed a great correlation with GMFM, indicating validity of this measure for children with CP on clinical basis.
Cerebral Palsy ; Child ; Child Development ; Humans ; Infant

Purpose: Isoform 2 of tight junction protein claudin-18 (CLDN18.2) is a potential target for gastric cancer treatment. A treatment targeting CLDN18.2 has shown promising results in gastric cancer. We investigated the clinical significance of CLDN18.2 and other cell-adherens junction molecules (Rho GTPase-activating protein [RhoGAP] and E-cadherin) in metastatic diffuse-type gastric cancer (mDGC). Materials and Methods: We evaluated CLDN18.2, RhoGAP, and E-cadherin expression using two-plex immunofluorescence and quantitative data analysis of H-scores of 77 consecutive mDGC patients who received first-line platinum-based chemotherapy between March 2015 and February 2017. Results: CLDN18.2 and E-cadherin expression was significantly lower in patients with peritoneal metastasis (PM) than those without PM at the time of diagnosis (P=0.010 and 0.013, respectively), whereas it was significantly higher in patients who never developed PM from diagnosis to death than in those who did (P=0.001 and 0.003, respectively). Meanwhile, CLDN18.2 and E-cadherin expression levels were significantly higher in patients with bone metastasis than in those without bone metastasis (P=0.010 and 0.001, respectively).Moreover, we identified a positive correlation between the expression of CLDN18.2 and E-cadherin (P<0.001), RhoGAP and CLDN18.2 (P=0.004), and RhoGAP and E-cadherin (P=0.001). Conversely, CLDN18.2, RhoGAP, and E-cadherin expression was not associated with chemotherapy response and survival. Conclusions CLDN18.2 expression was reduced in patients with PM but significantly intactin those with bone metastasis. Furthermore, CLDN18.2 expression was positively correlated with other adherens junction molecules, which is clinically associated with mDGC and PM pathogenesis.