We present a case of autoimmune chronic pancreatitis in a previously healthy child without any history of autoimmune disease. A 12-year-old boy was admitted to the hospital with abdominal pain. The serum amylase, lipase, and IgG levels were elevated and autoantibodies (antinuclear antibody, antineutrophil antibody) were detected. An abdominal CT (computed tomographic) scan revealed diffuse enlargement of the pancreas. ERCP (endoscopic retrograde cholangiopancreaticography) demonstrated an irregular stricture of the main pancreatic duct in the pancreas tail. After two years of oral steroid and immunosuppressive drug therapy, the clinical, laboratory and radiological findings were improved. The patient has been symptom-free for 18 months after the discontinuation of medication.
Abdominal Pain ; Amylases ; Autoantibodies ; Autoimmune Diseases ; Child* ; Cholangiopancreatography, Endoscopic Retrograde ; Constriction, Pathologic ; Drug Therapy ; Humans ; Immunoglobulin G ; Lipase ; Male ; Pancreas ; Pancreatic Ducts ; Pancreatitis, Chronic* ; Tomography, X-Ray Computed

Hepatic subcapsular steatosis is a rare and unique form of fatty change in the liver. It is a specific finding in diabetic patients receiving continuous ambulatory peritoneal dialysis (CAPD) and intraperitoneal insulin treatment. Intraperitoneal administration of insulin and high glucose cause a unique pattern of fatty infiltration in the subcapsular location of the liver. We report a case of hepatic subcapsular steatosis in a diabetic CAPD patient who has not received intraperitoneal insulin. A 63-year-old diabetic woman on CAPD presented with uncontrolled blood glucose. The patient received a total amount of 44 units of NPH via subcutaneous injection. Her initial blood chemistry showed mildly increased serum lipid profiles. Abdominal CT scan images and MRI revealed characteristic findings consistent with hepatic subcapsular steatosis. We report a case of hepatic subcapsular steatosis in a diabetic patient not taking intraperitoneal insulin who recovered through strict blood sugar control without changing dialysis modality.
Blood Glucose ; Diabetes Mellitus ; Dialysis ; Fatty Liver ; Female ; Glucose ; Humans ; Injections, Subcutaneous ; Insulin ; Liver ; Middle Aged ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory

Alagille syndrome is a autosomal dominant disorder characterized by intrahepatic bile duct paucity and resultant chronic cholestasis in combination with cardiac(mainly peripheral pulmonary stenosis), skeletal, ocular, and facial abnormalities. In addition to the pulmonary stenosis, in large series, anecdotal reports of vascular lesions have concerned the renal artery, aorta, hepatic artery, carotid artery, celiac artery or subclavian artery. Theses diffuse vascular abnormalities, which appear to be a feature of Alagille syndrome, suggest Notch signaling pathway defects affect angiogenesis. The associations of Alagille syndrome with moyamoya disease, the chronic cerebrovascular occlusive disease, were reported and suggested as additional evidence of vasculopathy of Alagille syndrome. We report another 25 month-old Alagille syndrome girl who presented with acute left hemiparesis and was diagnosed with moyamoya disease through the cerebral angiographic study.
Child ; Male ; Female ; Humans

Kimura's disease is a rare chronic inflammatory disorder mimicking a malignant tumor. It usually occurs in the head and neck regions, but occasionally shows up in the groin. A gray-scale groin sonograph showed a lobulated hypoechoic mass. Color Doppler sonography revealed the paucity of blood vessels within the mass.
Blood Vessels ; Groin ; Head ; Neck

OBJECTIVES: We conducted this study to investigate the relationship between sleep duration and body mass index (BMI), in Korean children. METHODS: We performed a cross-sectional analysis of data collected on 3,639 boys and girls (aged 7-12) in Daegu, Korea. The data included each child's age, sex, weight, height, extracurricular activities, bedtime, wake-up time, sleep latency, total sleep duration, parents' occupations, and parents' educational levels. The relationship between sleep duration and each variable was examined via analysis of variance (ANOVA). RESULTS: The analysis showed an association between short sleep duration and high BMI. Boys showed a graded inverse relationship between sleep duration and BMI. However, there was no significant corresponding result for girls. In the total sample, hours of computer use, time when the computer was turned off, time when the television was turned off, mother's bedtime, and hours of extracurricular activity were associated with longer sleep duration. No association was found between sleep duration and hours of watching television, child's wake-up time, or educational level of the parents. CONCLUSION: The results of this study show an inverse relationship between a child's sleep duration and BMI;thus, children with shorter sleep duration tend to have higher BMIs.
Body Mass Index ; Child ; Cross-Sectional Studies ; Humans ; Korea ; Occupations ; Television

Systemic lupus erythematosus (SLE) is a multisystem disorder where the etiology is not clearly known. Symptomatic chronic interstitial pneumonitis is an uncommon manifestation, with a reported prevalence of 3~13%. Achalasia is rare disease that presents with failure in the relaxation of the esophagus sphincter. A 22-year-old woman was admitted to our hospital because of fever, cough and dyspnea. The patient had a history of pericardial effusion and Raynaud's phenomenon. The results of laboratory tests indicated the presence of lymphopenia and included positive antibody tests for antinuclear antibody and anti Sm antibody. A chest X-ray demonstrated the presence of peribronchial infiltration on both lung fields. A Chest CT image showed interlobar septal thickening, ground-glass opacity and a honeycomb appearance in both lung fields and esophageal dilatation with air fluid level. An esophagogram showed the presence of dilated esophagus ends that represented the non-relaxed lower esophageal sphincter. Manometry demonstrated incomplete sphincter relaxation. The case was diagnosed as systemic lupus erythematosus associated with interstitial pneumonia and achalasia.
Antibodies, Antinuclear ; Cough ; Dilatation ; Dyspnea ; Esophageal Achalasia ; Esophageal Sphincter, Lower ; Esophagus ; Female ; Fever ; Humans ; Lung ; Lung Diseases, Interstitial ; Lupus Erythematosus, Systemic ; Lymphopenia ; Manometry ; Pericardial Effusion ; Prevalence ; Rare Diseases ; Relaxation ; Thorax ; Young Adult

Globally, the incidence of communicable diseases has decreased compared to non-communicable diseases. However, chronic communicable diseases such as HIV/AIDS and tuberculosis persist worldwide. Furthermore, emerging new infections such as H1N1 influenza pose a new threat to public health. However, most studies have focused on non-communicable diseases because of their increasing incidence, with fewer studies investigating communicable diseases. Therefore, we estimated the burden of communicable diseases in Korea using national representative 2012 data. To estimate the disability-adjusted life years (DALY), we used cause of death data from the Statistics Korea to estimate the years of life lost (YLL), applied the Korean garbage code algorithm, and used national claims data from the National Health Insurance Service (NHIS) to estimate years lived with disability (YLD). In 2012, the total DALYs of communicable disease were 445 per 100,000, with 129 YLLs per 100,000 and 316 YLDs per 100,000. The total DALYs in men were 468 per 100,000, greater than the 422 per 100,000 DALYs seen in women. The DALYs of lower respiratory infections were the highest value among communicable diseases at 143/100,000 DALYs followed by tuberculosis and upper respiratory infections. The 40-49 years old age group had the largest number of total DALYs. In contrast, the over 80 years old age group had the largest number of total DALYs per 100,000 followed by the 70-79 and 0-9 years old age groups. These results enable the prioritization of interventions related to communicable diseases and can be used for evidence-based public health policies.
Cause of Death ; Communicable Diseases* ; Female ; Garbage ; Humans ; Incidence ; Influenza, Human ; Korea ; Male ; National Health Programs ; Public Health ; Respiratory Tract Infections ; Tuberculosis

PURPOSE: This study examined the recovery of the dentin-resin bonding strength, and the difference in the bonding strength after applying pH hemostatic agents at various pH. MATERIALS AND METHODS: Bosmin, Hemodent, Astregedent, and Visine were used as the hemostatic agents in this study. The Bosmin, Hemodent, and Astrigedent hemostatic agents are acidic, and the Visine hemostatic agent is neutral and is used as a decongestant. Ninety human molar teeth were used as the specimen. The teeth were sectioned using a diamond wheel until the dentin was exposed and wet ground by silica paper. The specimens were divided into two groups according to the hemostatic agent used. The specimens were then subdivided into 9 groups according to the application of re etching (R group) or rinsing only (N group). A commonly used resin bonding procedure was used in the control group. The resin bonding procedure was managed dentin using celluloid capsule. In addition, the shear bond strength was measured using an Instron. RESULTS: In general, samples with the applied hemostatic agent, with the exception of Visine, had a slightly weak bond that was similar to the control group. In addition, the rinsing only (N) group had slightly weak bond that was similar to the re etching (R) group. CONCLUSION: The application of a hemostatic agent on the dentin surface does not affect the shear bond strength after application for a short time. In addition, rinsing only can recover the shear bond strength making other management procedures redundant, particularly re etching.
Dentin ; Dentin-Bonding Agents ; Diamond ; Humans ; Hydrogen-Ion Concentration ; Imidazoles ; Molar ; Silicon Dioxide ; Tooth

BACKGROUND: Combined modality therapy is standard treatment of unresectable, locally advanced stage III non-small cell lung cancer (NSCLC). However, the optimal chemotherapy regimen and duration of chemotherapy remain a matter of debate. We evaluated the efficacy and feasibility of concurrent chemoradiation therapy (CCRT) in patients with locally advanced NSCLC. METHODS: PS 0-2 patients with histologically proven inoperable stage III NSCLC were eligible for this trial. The patients received paclitaxel (60mg/m2) on days 1, 8, 15, 22, 29, 36 with a concurrent radiotherapy (5days/week, 1.8Gy/day) starting day 1 with a total dose of 63 Gy. After CCRT, four cycles of consolidation chemotherapy with paclitaxel (140mg/m2) and carboplatin (AUC 5) was administered to patients with a partial, complete remission or stable disease. RESULTS: Twenty eight patients with locally advanced NSCLC enrolled in this study. The median age of the patients was 60 years. Of the 28 patients, 19 received scheduled CCRT. Overall response rate was 71.4% including 5 complete responses and 15 partial responses. Grade 3 or 4 pulmonary complication was observed in 7 patients and 3 patients died of pneumonitis. The median overall survival was 17.5 months (95% CI, 12.5-22.5). The median progression free survival was 8.0 months (95% CI, 4.1-11.9). CONCLUSIONS: CCRT including paclitaxel in patients with locally advanced NSCLC led to an encouraging response rate and survival, but resulted in high incidence of severe pulmonary complication.
Carboplatin ; Carcinoma, Non-Small-Cell Lung* ; Combined Modality Therapy ; Consolidation Chemotherapy ; Disease-Free Survival ; Drug Therapy ; Humans ; Incidence ; Paclitaxel* ; Pneumonia ; Radiotherapy

Esophageal stenosis due to tracheobronchial remnants is a rare cause of congenital esophageal stenosis. The cause is thought to be esophageal sequestration of tracheobronchial remnants during embryonic separation. Errors in diagnosis are common and high index of suspicion is required for accurate diagnosis, and resection of primary site with anastomosis is recommanded. Although a rare entity, esophageal stenosis due to tracheobronchial remnants should be considered in patients with esophageal stenosis, when esophageal stenosis fails to respond to standard therapy including bougienage and balloon dilatation, and esophagoscopy shows normal mucosa on the stenotic segment. Four cases of congenital esophageal stenosis due to tracheobronchial remnants were reported, the first case without accompanied anomaly, the second case accompanied by tracheoesophageal fistula, the third case accompanied by Down syndrome, and the last case accompanied by tracheoesophageal fistula and congenital heart disease.
Diagnosis ; Dilatation ; Down Syndrome ; Esophageal Stenosis* ; Esophagoscopy ; Heart Defects, Congenital ; Humans ; Mucous Membrane ; Tracheoesophageal Fistula