Typhoid fever is an acute systemic febrile disease caused by Salmonella Typhi, characterized by persistent fever, headache, abdominal pain, diarrhea and rose spots. Salmonella infection can lead to diffuse organ involvement including bone, lung, thyroid, kidney, liver, spleen, heart, intestine and skin. While a variety of complications may be seen in typhoid fever, sensorineural hearing loss or pancreatitis has been rarely observed. Recently, we experienced a case of typhoid fever complicated by sensorineural hearing loss, acute pancreatitis and hepatitis in a 21-year-old female patient, who was improved with ceftriaxone and ciprofloxacin administration and supportive care. We report this case with a review of the literature.
Abdominal Pain ; Ceftriaxone ; Ciprofloxacin ; Diarrhea ; Female ; Fever ; Headache ; Hearing Loss, Sensorineural* ; Heart ; Hepatitis* ; Humans ; Intestines ; Kidney ; Liver ; Lung ; Pancreatitis* ; Salmonella Infections ; Salmonella typhi ; Skin ; Spleen ; Thyroid Gland ; Typhoid Fever* ; Young Adult

BACKGROUND: It has been reported that younger patients with lung cancer have characteristic features that differ from those in older patients. The prognosis for young patients with this disease is controversial. This study aimed to determine the clinicopathological characteristics, the survival rate, and the risk factors associated with the overall survival rate in younger patients with lung cancer. METHODS: The records of 120 young(age≤40) patients with histologically confirmed lug cancer in the Korea Cancer Center Hospital(KCCH) between Jan. 1992 to 1998, 120 older(age>40) patients were randomly selected as the controls. RESULTS: More female patients(45.0% vs. 20.0%, p<0.001) and more adenocarcinoma cases(64.2% vs. 38.3%, p<0.001) were found in the younger group, when compared to the older patients. In NSCLC, advanced disease(stage III B and IV) was more common in the younger patients(90.2%) than in the older patients(62.7%) (p<0.001). The Median survival was 8.6 months in the younger patients and 12.2 months in the older(p=0.003). In a multivariate analysis, only the advanced-stage was an independent negative prognostic factor. CONCLUSION: Lung cancer in the younger age group presents with a more advanced stage resulting in a poor survival rate, which suggests that lung cancer in this population is more aggressive than in older patients.
Adenocarcinoma ; Female ; Humans ; Korea ; Lung Neoplasms* ; Lung* ; Multivariate Analysis ; Prognosis ; Risk Factors ; Survival Rate

The purpose of the present study was to investigate cardiac damage biomarkers after a triathlon race in elite and non-elite athlete groups. Fifteen healthy men participated in the study. Based on performance, they were divided into elite athlete group (EG: n=7) and non-elite athlete group (NEG: n=8). Participants' blood samples were obtained during four periods: before, immediately, 2 hours and 7 days after finishing the race. creatine kinase (CK), creatine kinase-myoglobin (CK-MB), myoglobin, and lactate dehydrogenase (LDH) were significantly increased in both groups immediately after, and 2 hours after finishing the race (p<.05). CK, CK-MB, and myoglobin were completely recovered after 7 days (p<.05). Hematocrit (Hct) was significantly decreased in both groups (p<.05) 7 days after the race. LDH was significantly decreased in the EG (p<.05) only 7 days after the race. Homoglobin (Hb) was significantly decreased in the NEG (p<.05) only 2 hours after the race. Although cardiac troponin T (cTnT) was significantly increased in the EG but not in the NEG 2hours after the race (p<.05), there was no group-by-time interaction. cTnT was completely recovered in both groups 7 days after the race. In conclusion, cardiac damage occurs during a triathlon race and, is greater in elite than in non-elite. However, all cardiac damage markers return to normal range within 1 week.
Athletes ; Biomarkers* ; Continental Population Groups ; Creatine ; Creatine Kinase ; Hematocrit ; Humans ; L-Lactate Dehydrogenase ; Male ; Myoglobin ; Reference Values ; Troponin T

BACKGROUND: We had undergone this study to investigate clinical progress of this disease and to decide the role of aggressive diagnostic approaches, the efficacy of treatments and prognoses. METHODS: A retrospective study was done on 113 patients who had been diagnosed to metastatic adenocarcinoma of pleura by pleural fluid cytology (106 cases) or pleural needle biopsy(22 cases), at Presbyterian Medical Center, from Jan. 1990 to Dec. 1994. RESULTS: 1) The patients were composed of 59 males(52.2%) and 54 females(47.8%), and the mean age distribution was 57.4 +/- 12.1 years. 2) The site of origin was lung cancer 46.9%(53/l 13), stomach cancer 20.4%(23/113), breast cancer 11.5%(13/113), and unknown primary site 6.2%(7/113 cases), as a whole. In male, lung cancer was 55.9%(33/59), stomach cancer was 28.8%(17/59), and in female, lung cancer was 37% (20/54), breast cancer was 24.1% (13/54) of cases. 3) The cardinal symptoms were dyspnea(69%), cough(61%), chest pain(50%), weight loss(50%), anorexia(49%), sputum(43%), malaise(30%). 4) The pleural fluid findings were exudative in 94.4%(102/108), serosanguinous or bloody in 36~53%, unilateral involvement in 74.3%(84/l 13) of cases, and lymphocyte predominance (71 +/- 27%) in differential count of WBC. 5) CEA levels in pleural fluid or plasma were over 10ng/ml in 60.6% (40/66), and ADA levels in pleural fluid were under 40U/L in 95% (57/60) of cases. 6) The patients were managed by various methods, but the efficacy of treatment was uncertain. 7) The mean survival time was 12.7 +/- 13.5 weeks. CONCLUSION: It seems to be no effective treatment methods yet and the prognosis was very poor in this disease, so the objectives of diagnostic approaches and treatment methods should be directed to early diagnosis, treatment and prevention of curable disease. And we must make our best endeavors to lengthen the survival time and improve the quality of patients' life.
Adenocarcinoma* ; Age Distribution ; Breast Neoplasms ; Early Diagnosis ; Female ; Humans ; Lung Neoplasms ; Lymphocytes ; Male ; Needles ; Plasma ; Pleura* ; Prognosis ; Protestantism ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate ; Thorax

Food-dependent exercise-induced anaphylaxis (FDEIAn) is induced by different types and various intensities of physical activity, and is distinct from food allergies. It has been shown that consumption of allergenic food followed by exercise causes FDEIAn symptoms. Intake of allergenic food or medication before exercise is a major predisposing factor for FDEIAn. Urticaria and severe allergic reactions are general symptoms of FDEIAn. Dermatological tests and serum IgE assays are the typical prescreening methods, and have been used for several decades. However, these screening tests are not sufficient for detecting or preventing FDEIAn. It has been found that exercise may stimulate the release of mediators from IgE-dependent mast cells that can result in FDEIAn when a certain threshold level has been exceeded. Mast cell degradation might be a major factor to induce FDEIAn but this has not been determined. A number of foods have been reported to be involved in the onset of FDEIAn including wheat, eggs, chicken, shrimp, shellfish, nuts, fruits, and vegetables. It is also known that aspirin increases the occurrence of type I allergy symptoms when combined with specific foods. Moreover, high intensity and frequent exercise are more likely to provoke an attack than low intensity and less frequent exercise. In this paper, we present the current views of the pathophysiological mechanisms underlying FDEIAn within the context of exercise immunology. We also present a detailed FDEIAn definition along with etiologic factors and medical treatment for cholinergic urticaria (UC) and exercise-induced anaphylaxis (EIA).
Anaphylaxis ; Aspirin ; Chickens ; Eggs ; Food Hypersensitivity ; Fruit ; Hypersensitivity ; Immunoglobulin E ; Mass Screening ; Mast Cells ; Motor Activity ; Nuts ; Ovum ; Shellfish ; Triticum ; Urticaria ; Vegetables

PURPOSE: Enterovirus infection is a type of viral infection that occurs relatively frequently in children during summer. It has clinical symptoms of non-specific fever, aseptic encephalomeningitis, gastrointestinal diseases, skin rash and, hand-foot-mouth disease. However, it can also occcaisionally, result in fatal symptoms like myocarditis, epicardial inflammation, transverse myelitis, quadriplegia and etc. There have been epidemic enterovirus studies, but not in the Chungnam area. Therefore, we undertook this study in order to comprehend the cause viruses in this area. Methods: We enlisted 157 children hospitalized with enteroviral infections at Soonchunhyang University hospital in Cheonan between May and August 2005. Cerebrospinal fluids or feces were collected during the acute phase after hospitalization, and observed the cytopathic effects caused by enterovirus and using reverse transcription polymerase chain reaction (RT-PCR). RESULTS: The number of children hospitalized due to possible enteroviral infection during the period of study was 157. The number of children who tested positive with the reverse transcription polymerase chain reaction totalled 32 cases (20.4 percent). Among the children with entroviral diseases, 20 were male and 12 were female, thus the sex ratio of male to female was 1.67:1. Their clinical symptoms included fever most frequently (93.7 percent), was followed by headaches (90.0 percent), meningeal irritation signs (65.0 percent), and abdominal pain (30.0 percent). As for the type of isolated enterovirus, there were 17 cases of echovirus 18 and 6 cases of coxsackievirus B5. Furthermore, there were 2 cases of echovirus 9, 1 case of coxsackievirus A6 and coxsackievirus B3, respectively. But 5 cases were not determined by genotype. CONCLUSION: Echovirus 18 is circulating in Korea. We reported on identified enteroviruses, including echovirus 18, using RT-PCR in the Chungnam area during the summer of 2005.
Abdominal Pain ; Cerebrospinal Fluid ; Child* ; Chungcheongnam-do* ; Echovirus 9 ; Enterovirus ; Enterovirus B, Human ; Enterovirus Infections ; Exanthema ; Feces ; Female ; Fever ; Gastrointestinal Diseases ; Genotype ; Headache ; Hospitalization ; Humans ; Inflammation ; Korea ; Male ; Meningoencephalitis ; Myelitis, Transverse ; Myocarditis ; Polymerase Chain Reaction ; Quadriplegia ; Reverse Transcription ; Sex Ratio

BACKGROUND: A peptide nucleic acid (PNA) probe-based real-time PCR (PNAqPCR(TM) TB/NTM detection kit; PANAGENE, Korea) assay has been recently developed for the simultaneous detection of Mycobacterium tuberculosis complex (MTBC) and nontuberculous mycobacteria (NTM) in clinical specimens. The study was aimed at evaluation of the performance of PNA probe-based real-time PCR in respiratory specimens. METHODS: To evaluate potential cross-reactivity, the extracted DNA specimens from Mycobacterium species and non-mycobacterial species were tested using PNA probe-based real-time PCR assay. A total of 531 respiratory specimens (482 sputum specimens and 49 bronchoalveolar washing fluid specimens) were collected from 230 patients in July and August, 2011. All specimens were analyzed for the detection of mycobacteria by direct smear examination, mycobacterial culture, and PNA probe-based real-time PCR assay. RESULTS: In cross-reactivity tests, no false-positive or false-negative results were evident. When the culture method was used as the gold standard test for comparison, PNA probe-based real-time PCR assay for detection of MTBC had a sensitivity and specificity of 96.7% (58/60) and 99.6% (469/471), respectively. Assuming the combination of culture and clinical diagnosis as the standard, the sensitivity and specificity of the new real-time PCR assay for detection of MTBC were 90.6% (58/64) and 99.6% (465/467), respectively. The new real-time PCR for the detection of NTM had a sensitivity and specificity of 69.0% (29/42) and 100% (489/489), respectively. CONCLUSIONS: The new real-time PCR assay may be useful for the detection of MTBC in respiratory specimens and for discrimination of NTM from MTBC.
Bronchoalveolar Lavage Fluid/microbiology ; DNA Probes/chemistry/metabolism ; DNA, Bacterial/*analysis ; Humans ; Molecular Typing/*methods ; Mycobacterium tuberculosis/*genetics/isolation & purification ; Nontuberculous Mycobacteria/*genetics/isolation & purification ; Nucleic Acid Hybridization ; Peptide Nucleic Acids/chemistry/*metabolism ; *Real-Time Polymerase Chain Reaction ; Respiratory System/*microbiology ; Sputum/microbiology

Rapid and accurate detection of norovirus is essential for the prevention and control of norovirus outbreaks. This study compared the effectiveness of a new immunochromatographic assay kit (SD BIOLINE Norovirus; Standard Diagnostics, Korea) and real-time reverse transcription-PCR (RT-PCR) for detecting norovirus in fecal specimens. Compared with real-time RT-PCR, the new assay had sensitivity, specificity, positive predictive value, and negative predictive value of 76.5% (52/68), 99.7% (342/343), 98.1% (52/53), and 95.5% (342/358), respectively. The sensitivity of the assay was 81.8% (18/22) for GII.3 and 75.7% (28/37) for GII.4. None of the 38 enteric virus-positive specimens (3 for astrovirus, 5 for enteric adenovirus, and 30 for rotavirus) tested positive in the cross-reactivity test performed by using this assay. The new immunochromatographic assay may be a useful screening tool for the rapid detection of norovirus in sporadic and outbreak cases; however, negative results may require confirmatory assays of greater sensitivity.
Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Caliciviridae Infections/*diagnosis ; Child ; Child, Preschool ; Feces/*virology ; Gastroenteritis/*diagnosis/virology ; Humans ; *Immunoassay ; Infant ; Middle Aged ; Norovirus/*genetics/isolation & purification ; RNA, Viral/analysis ; Reagent Kits, Diagnostic ; Reverse Transcriptase Polymerase Chain Reaction ; Sensitivity and Specificity

BACKGROUND: Norovirus is one of the most prevalent pathogens causing acute gastroenteritis in children. We compared the clinical features of noroviral gastroenteritis to those of rotaviral gastroenteritis and analyzed the noroviruses' genotype frequencies. MATERIALS AND METHODS: Stool samples were obtained form 433 children hospitalized with acute gastroenteritis from May 2008 through February 2009 at Soonchunhyang University Cheonan Hospital and examined for the presence of norovirus or rotavirus. We then analyzed the clinical features of noroviral gastroenteritis in comparison with rotaviral gastroenteritis and observed the capsid protein gene sequences from the isolated norovirus for genotyping. RESULTS: Norovirus was isolated from 69 patients (16.4%) and rotavirus from 49 patients (11.6%). The noroviral gastroenteritis patients experienced vomiting (77.4%), diarrhea (73.2%), and respiratory symptoms (53.6%); the rotaviral gastroenteritis patients experienced diarrhea (71.4%), dehydration (69.3%), and vomiting (65.3%). Dehydration in patients with noroviral gastroenteritis (43.4%) was rare compared with rotavirus (69.3%) (P=0.008). The isolated norovirus belonged primarily to the GII.4 genogroup (85.5%). Our phylogenetic analysis of the GII.4 isolates revealed 3 clusters, including novel cluster C. CONCLUSIONS: Vomiting was the most common symptom in noroviral gastroenteritis patients. Dehydration in noroviral gastroenteritis patients was less common compared with rotavirus gastroenteritis patients. The majority of the norovirus strains isolated from children with acute gastroenteritis belonged to the GII.4 genogroup.
Capsid Proteins ; Child ; Child, Hospitalized ; Dehydration ; Diarrhea ; Gastroenteritis ; Genotype ; Humans ; Norovirus ; Rotavirus ; Vomiting

BACKGROUND: Dapagliflozin, a selective sodium-glucose co-transporter 2 (SGLT2) inhibitor, lowers blood glucose by reducing glucose reabsorption at the proximal renal tubule in an insulin-independent manner. We aimed to evaluate the efficacy and safety of dapagliflozin and to identify the risk factors of adverse drug events in patients with type 2 diabetes. METHODS: As an institutional pharmacovigilance review activity, we reviewed data from medical records of 455 patients with type 2 diabetes who received dapagliflozin therapy from July 2014 to August 2015 in Seoul National University Hospital. We analyzed the changes in laboratory data and examined the characteristics of dapagliflozin users who showed adverse effects. RESULTS: Mean changes in HbA1c and fasting serum glucose level from baseline to second visit were −0.42% (8.07 ± 1.51% to 7.65 ± 1.31%, P < 0.001) and −22.9 mg/dL (167.8 ± 48.5 mg/dL to 144.9 ± 37.6 mg/dL, P < 0.001), respectively. Adverse drug events observed during this study were lower urinary tract symptoms (7.7%), dehydration-related symptoms (6.1%), ketonuria (3.4%), hypoglycemia (3.4%), and urogenital infection (4.2%). Thiazide use, age, insulin use, number of anti-diabetic drugs, gender and history of urogenital infection were the risk factors for adverse drug events (P < 0.05). CONCLUSION: Dapagliflozin significantly improved hyperglycemia in patients with type 2 diabetes without serious adverse drug events. The incidences of adverse drug events were was similar to those ofthat in the previous studies.
Blood Glucose ; Diabetes Mellitus ; Drug-Related Side Effects and Adverse Reactions ; Fasting ; Glucose ; Humans ; Hyperglycemia ; Hypoglycemia ; Incidence ; Insulin ; Ketosis ; Kidney Tubules, Proximal ; Lower Urinary Tract Symptoms ; Medical Records ; Pharmacovigilance* ; Risk Factors ; Seoul