Allergic bronchopulmonary aspergillosis(ABPA) is an inflammatory disease which causes a hypersensitivity to Aspergillus spores growing in the bronchi. The clinical syndrome is characterized by asthma, recurrent pulmonary infiltrations or mucoid impaction, eosinophilia, and central bronchiectasis. A 12-year-old boy was admitted to our hospital because of right lower chest pain and cystic mass-like shadows on a chest X-ray film. He had asthma as an infant, but had no asthmatic symptoms on admission. Chest CT scan showed low density cystic mass of the right lower lobe. The total eosinophil count and IgE level were abnormally high. Test for immediate skin reaction to Aspergillus fumigatus was positive but precipitating antibody to Aspergillus antigen was negative. After steroid treatment, he became asymptomatic. Radiologic abnormalities including mass-like shadows were resolved by two months after the start of treatment and a follow-up high resolution CT scan obtained after clinical improvement revealed central saccular bronchiectasis. We report one case of ABPA with review of literature.
Aspergillosis, Allergic Bronchopulmonary* ; Aspergillus ; Aspergillus fumigatus ; Asthma ; Bronchi ; Bronchiectasis ; Chest Pain ; Child ; Eosinophilia ; Eosinophils ; Follow-Up Studies ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant ; Male ; Skin ; Spores ; Thorax ; Tomography, X-Ray Computed ; X-Ray Film

PURPOSE: Little research has been conducted on adverse drug reactions in neonates, particularly in Korea, where no studies have been reported. METHODS: We conducted a retrospectively study using medical records in a neonatal intensive care unit from August 1, 2013 to July 31, 2014. The adverse drug reactions were evaluated according to the Naranjo algorithm, World Health Organization-Uppsala Monitoring Centre, and the Korean adverse drug reaction algorithm. RESULTS: Of the 410 infants hospitalized during the study period, 57 cases of adverse drug reactions were reported in 40 infants (9.8%). The average gestational age was 28.4+/-4.3 weeks, the average birth weight was 1,184.1+/-622.0 g, and the adverse drug reactions were reported at an average of 21.0+/-29.7 days after birth. Causative agents were identified as electrolytes (36.8%), respiratory medication (14.0%), total parenteral nutrition (12.3%), lipid emulsion (10.5%), antibiotics (7.0%), non-steroidal anti-inflammatory drugs (NSAIDs, 7.0%), sedatives (7.0%), vaccine (3.5%), and an antiviral medication (1.8%). Of the 57 cases, 55 (96.5%) cases demonstrated meaningful adverse drug reactions, defined as those given a score of "possible or above" in all 3 adverse drug reaction algorithms. CONCLUSION: More emphasis is warranted in the field of neonatal adverse drug reactions.
Anti-Bacterial Agents ; Birth Weight ; Drug-Related Side Effects and Adverse Reactions* ; Electrolytes ; Gestational Age ; Humans ; Hypnotics and Sedatives ; Infant ; Infant, Newborn ; Intensive Care, Neonatal* ; Korea ; Medical Records ; Parenteral Nutrition, Total ; Parturition ; Retrospective Studies ; World Health

Most inflammatory, neoplastic and vascular disorders manifest bowel wall thickening on computed tomography (CT). Therefore, it is very important to understand the patterns of bowel wall involvement (degree, length, symmetry and contrast enhancement patterns) in each category to make a correct diagnosis. Observing extraluminal changes also help to classify the primary causes of pathological conditions involving the gastrointestinal tract. Adequate CT examinations with optimal opacification of the gastrointestinal tract are essential not only to avoid false positive findings but also to detect subtle or minimal lesions. If findings for establishing a diagnosis are equivocal, the use of combined findings increases the diagnostic accuracy of CT.
Gastrointestinal Diseases/radiography* ; Gastrointestinal Diseases/diagnosis* ; Human ; Tomography, X-Ray Computed/methods*

PURPOSE: Leptin is a protein encoded by the ob gene that is expressed in adipocytes. It regulates eating behavior by the action to the satiety centers in the hypothalamus. In ob/ob mouse, adipocytes can not produce leptin because of a mutation in the ob gene which results in obesity. Whereas, leptin concentrations were elevated in obese adults, and leptin levels in obese children has not been studied much until now. The purpose of this study is to evaluate leptin concentrations in obese children and to find out correlating factors with leptin. METHODS: Thirty-six obese childrens whose weight is above 97 percentile of korean weight standard and 39 children with average weight were included. Height, weight, waist to hip ratio, fat weight and lean body mass were measured. The serum levels of leptin, insulin, cholesterol and triglyceride were measured. RESULTS: Mean age was 10.8 +/- 2.5 years in obese group and 10.6 +/- 2.6 years in control group. Obesity percent was 51.6 +/- 18.8% in obese and 8.8 +/- 10.2% in control group. Body mass index (BMI) was 26.3 +/- 5.8kg/m2 in obese group and 17.3 +/- 1.9kg/m2 in control group. Leptin levels of obese group (13.7 +/- 5.4ng/ml) were significantly higher than that of the control group (3.6 +/- 3.3ng/ ml). Leptin levels showed no significant difference by gender and by pubertal development. Leptin levels significantly correlated with BMI, obesity percent, fat weight, and serum cholesterol level but showed no significant correlation with lean body mass, serum fasting insulin and triglyceride levels. CONCLUSION: Serum leptin levels of obesity group were significantly higher than that of the control group, and they were correlated with BMI, obesity percent and fat weight. Additional research is necessary to assess the mechanism of leptin resistance in obese children.
Adipocytes ; Adult ; Animals ; Body Mass Index ; Child* ; Cholesterol ; Fasting ; Feeding Behavior ; Humans ; Hypothalamus ; Insulin ; Leptin* ; Mice ; Obesity ; Triglycerides ; Waist-Hip Ratio

PURPOSE: Leptin is a protein encoded by the ob gene that is expressed in adipocytes. It regulates eating behavior by the action to the satiety centers in the hypothalamus. In ob/ob mouse, adipocytes can not produce leptin because of a mutation in the ob gene which results in obesity. Whereas, leptin concentrations were elevated in obese adults, and leptin levels in obese children has not been studied much until now. The purpose of this study is to evaluate leptin concentrations in obese children and to find out correlating factors with leptin. METHODS: Thirty-six obese childrens whose weight is above 97 percentile of korean weight standard and 39 children with average weight were included. Height, weight, waist to hip ratio, fat weight and lean body mass were measured. The serum levels of leptin, insulin, cholesterol and triglyceride were measured. RESULTS: Mean age was 10.8 +/- 2.5 years in obese group and 10.6 +/- 2.6 years in control group. Obesity percent was 51.6 +/- 18.8% in obese and 8.8 +/- 10.2% in control group. Body mass index (BMI) was 26.3 +/- 5.8kg/m2 in obese group and 17.3 +/- 1.9kg/m2 in control group. Leptin levels of obese group (13.7 +/- 5.4ng/ml) were significantly higher than that of the control group (3.6 +/- 3.3ng/ ml). Leptin levels showed no significant difference by gender and by pubertal development. Leptin levels significantly correlated with BMI, obesity percent, fat weight, and serum cholesterol level but showed no significant correlation with lean body mass, serum fasting insulin and triglyceride levels. CONCLUSION: Serum leptin levels of obesity group were significantly higher than that of the control group, and they were correlated with BMI, obesity percent and fat weight. Additional research is necessary to assess the mechanism of leptin resistance in obese children.
Adipocytes ; Adult ; Animals ; Body Mass Index ; Child* ; Cholesterol ; Fasting ; Feeding Behavior ; Humans ; Hypothalamus ; Insulin ; Leptin* ; Mice ; Obesity ; Triglycerides ; Waist-Hip Ratio

BACKGROUND: A range of well characterized materials are needed for validating the performance of hepatitis B surface antigen (HBsAg) immunoassays. These materials are purchased currently from overseas manufacturers at a high cost and with limited quantity. This study was conducted to establish an HBsAg low titer performance panel for use as a national standard for validation of HBsAg immunoassays in Korea. METHODS: 476 plasma units reactive on blood donor screening were collected HBsAg was tested using 3 enzyme immunoassays (EIA) and 1 chemiluminescence immunoassay (CIA). Units reactive on the CIA assay or on 2 or more immunoassays were subjected to hepatitis B virus (HBV) DNA quantification, HBV genotyping and subtyping. Units reactive on HBV DNA quantification were confirmed for HBsAg by neutralization. Candidates for the panel were subjected to a collaborative study performed at 7 laboratories using 7 immunoassays. RESULTS: Eleven HBsAg positive units were selected for the low titer performance panel based on HBsAg immunoassay, HBV DNA quantification, HBV genotyping and subtyping results. The range of the HBsAg concentration of the panel members was 0.05~1.28 IU/mL. Two HBsAg negative units were also included as negative controls. CONCLUSION: As a result of this study, a low titer performance panel [KFDA standard (08/028); HBsAg low titer performance panel (BTRL HBV/LP)] for validation of HBsAg immunoassays has been established as a Korean national standard. Use of this panel will improve performance assessment of HBsAg immunoassays. Because the performance of immunoassays cannot be assessed properly with a limited number of panels, continuous efforts are needed to develop a range of performance panels.
Blood Donors ; DNA ; Hepatitis ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Humans ; Immunoassay ; Immunoenzyme Techniques ; Luminescence ; Mass Screening ; Plasma

OBJECTIVE: To compare the usefulness of magnetic resonance cholangiopancreatography (MRCP) and MR angiography (MRA) in differentiating malignant from benign intraductal papillary mucinous tumors of the pancreas (IPMTs), and to determine the findings which suggest malignancy. MATERIALS AND METHODS: During a 6-year period, 46 patients with IPMT underwent MRCP. Morphologically, tumor type was classified as main duct, branch duct, or combined. The diameter of the main pancreatic duct (MPD), the extent of the dilated MPD, and the location and size of the cystic lesion, septum, and communicating channel were assessed. For all types of IPMTs, enhanced mural nodules and portal vein narrowing were evaluated at MRA. RESULTS: Combined-type IPMTs were more frequently malignant (78%) than benign (42%) (p < 0.05). Compared with benign lesions, malignant lesions were larger, and the caliber of the communicating channel was also larger (p < 0.05). Their dilated MPD was more extensive and of greater diameter (p < 0.05), and the presence of mural nodules was more frequent (p < 0.001). CONCLUSION: Combined MRCP and MRA might be useful for the differential diagnosis of malignant and benign IPMTs of the pancreas.

OBJECTIVE: To describe the anatomical variation occurring in intrahepatic bile ducts (IHDs) in terms of their branching patterns, and to determine the frequency of each variation. MATERIALS AND METHODS: The study group consisted of 300 consecutive donors for liver transplantation who underwent intraoperative cholangiography. Anatomical variation in IHDs was classified according to the branching pattern of the right anterior and right posterior segmental duct (RASD and RPSD, respectively), and the presence or absence of the first-order branch of the left hepatic duct (LHD), and of an accessory hepatic duct. RESULTS: The anatomy of the intrahepatic bile ducts was typical in 63% of cases (n=188), showed triple confluence in 10% (n=29), anomalous drainage of the RPSD into the LHD in 11% (n=34), anomalous drainage of the RPSD into the common hepatic duct (CHD) in 6% (n=19), anomalous drainage of the RPSD into the cystic duct in 2% (n=6), drainage of the right hepatic duct (RHD) into the cystic duct (n=1), the presence of an accessory duct leading to the CHD or RHD in 5% (n=16), individual drainage of the LHD into the RHD or CHD in 1% (n=4), and unclassified or complex variation in 1% (n=3). CONCLUSION: The branching pattern of IHDs was atypical in 37% of cases. The two most common variations were drainage of the RPSD into the LHD (11%) and triple confluence of the RASD, RPSD and LHD (10%).

The pleural and lesser omental effusion were commonly seen on acute or chronic recurrent pancreatitis complication. But pericardial effusion is rare complication of recurrent pancreatitis and may result to tamponade. We report a case with literature on alcoholic acute recurrent pancreatitis complicated by development of pericardial and pleural effusion, which resolved after catheter drainage.
Alcoholics ; Catheters ; Drainage ; Humans ; Pancreatitis* ; Pericardial Effusion* ; Pleural Effusion

Although a metastasis to the gastrointestinal tract (GI) is rare in patients with hepatocellular carcinoma (HCC), it can occur by hematogenous or lymphatic spread, or by direct invasion of a tumor. A 61-year old woman who had a progressing large primary liver cancer presented with upper gastrointestinal (UGI) bleeding. UGI endoscopy showed a large duodenal submucosal tumor-like mass with a central ulcer and adherent blood clots. Endoscopic biopsy and coagulation using argon plasma probe were performed. The microscopic examination revealed a HCC. We report this unusual case of HCC with direct invasion of the duodenum.
Argon ; Biopsy ; Carcinoma, Hepatocellular* ; Duodenum* ; Endoscopy ; Female ; Gastrointestinal Tract ; Hemorrhage* ; Humans ; Liver Neoplasms ; Middle Aged ; Neoplasm Metastasis ; Plasma ; Ulcer