PURPOSE: The aim of this study was to evaluate the clinical manifestations, contact history, and status of tuberculosis contact investigations in school-age children and adolescents with pulmonary tuberculosis (TB) at two centers. METHODS: This study was conducted with 54 patients in the age ranging from 10 to 18 years, who were diagnosed with pulmonary TB at the Pusan National University Hospital and Pusan National University Children's Hospital, January 2008 to December 2012. We retrospectively reviewed the medical records of the patients. RESULTS: The median age of the patients was 16 years old; 11 patients were aged 10 to 14 and 43 patients were aged 15 to 18. Among 54 patients, 19 had history of contact with pulmonary TB, 10 had contact with house members (household), and remaining 9 had contact with classmates (non-household). One out of 10 patients who had household contacts and 6 out of 9 patients who had non-household contacts were evaluated with contact investigation after the exposure to pulmonary TB. Among 7 patients who were evaluated with contact investigation, 3 were diagnosed with active pulmonary TB, 1 had latent tuberculosis infection (LTBI), and 3 had no evidence of TB or LTBI. The median period of diagnosis after the exposure to active pulmonary TB was 2 years in patients with household contacts and 0.23 years in patients with non-household contacts. CONCLUSION: This study suggested that if the contact investigation conducted properly, it would be helpful for early diagnosis and prevention of pulmonary TB.
Adolescent* ; Busan ; Child* ; Diagnosis ; Early Diagnosis ; Family Characteristics ; Humans ; Latent Tuberculosis ; Medical Records ; Retrospective Studies ; Tuberculosis* ; Tuberculosis, Pulmonary*

PURPOSE: Many surgical methods for reconstruction of orbital floor fracture have been reported, which include subciliary approach, transconjunctival approach, transantral and transnasal endoscopic approach, etc. The purpose of this study is to demonstrate a surgical technique and analyze the results of transnasal endoscopic approach with Foley catheter ballooning without implantation of artificial surgical material through subciliary approach. METHODS: Between February 2007 and November 2010, 29 orbital floor fracture patients, who had no herniated muscles through bone fragments, were treated through transnasal endoscopic approach with Foley catheter ballooning. Under the endoscopic view, the operator identified the opening of maxillary sinus. After widening of the opening using forceps, the operator reduced the fragmented bone with curved suction tip. Thereafter, 18-Fr Foley catheter was inserted. Four weeks after the operation, the catheter was removed. RESULTS: Preoperatively, 6 patients had diplopias, 4 patients had limitations of extraocular motions and 3 patients had enophthalmos. After removal of the Foley catheter 4 weeks after the operation, 2 patients had diplopias, 1 patient had a limitation of extraocular motion, 1 patient has an enophthalmos and 1 patient had numbness on the cheek. These symptoms were resolved about 6 months after the surgery. CONCLUSION: The operative technique of Foley catheter ballooning through transnasal endoscopic approach without implantation of the artificial surgical material through subciliary approach can be considered one of the appropriate techniques for orbital floor fracture.
Catheters ; Cheek ; Diplopia ; Endoscopy ; Enophthalmos ; Floors and Floorcoverings ; Humans ; Hypesthesia ; Maxillary Sinus ; Muscles ; Orbit ; Orbital Fractures ; Suction ; Surgical Instruments

No abstract available.
Adult* ; Humans ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Tomography, Emission-Computed, Single-Photon* ; Urinary Tract Infections* ; Urinary Tract*

OBJECTIVES: Rapidly progres s ive glomerulonephritis (RPGN) is a clinico- pathologic entity characterized by extens ive crescent formation(usually involving 50% or more of glomeruli) as the principal his tologic finding and a rapid deterioration of kidney function, which can lead to end s tage renal disease within a few weeks. T he etiology and incidence of RPGN has been well defined in Europe and North America, however, there has been no report of a large series in Korea. T he aim of the present s tudy was to analyze the etiology and clinico- pathologic features of 26 patients with RPGN, seen during 1983-1997. METHODS: T wenty-six patients with RPGN(crescents in > 50% of glomeruli) were obs erved during a period of las t 14 years. Male to female ratio was 1:1.4, and the mean age was 30(6-75) years. Mean time from the initial symptoms to the ESRD was 3.1 months . RESULTS: The incidence of RPGN in our series was 2.1% of primary glomerulonephritis. Immunecomplex mediated disease was presented in 14 cases (54%), including 6 sys temic lupus erythematos us, 3 post- streptococcal glomerulonephritis, 3 Henoch- Schonlein purpura, and 2 IgA nephropathy. Pauci- immune disease was presented in 12 cases (46%), including 3 Wegener' s granulomatos is, one necrotizing crescentic glomerulonephritis, and 8 idiopathic crescentic glomerulonephritis. However, there was none of anti-GBM- mediated disease in our s tudy. ANCA were found in 6 patients. All 3 patients with WG were C- ANCA pos itive, whereas one patient with PSGN, necrotizing cres centic GN, and idiopathic crescentic GN were P- ANCA pos itive, respectively. Initial clinical and laboratory features included edema(80%), hypertens ion(72%), oliguria(68%), a decreased renal function(serum creatinine > 5mg/dL, 35%), and gros s hematuria(36%). Renal biopsy showed large crescents more than 80% of the glomeruli in 14 cases (54%) which were predominantly fibrocellular. Fifteen patients (58%) were treated with prednis olone alone, and 12 of them received puls e doses of corticosteroids. Five patients were treated with prednisolone and cyclophos phamide IV pulse. Two cases received plasma exchange. During the mean follow-up of 31+/-37 months, 18 patients (69%) developed inexorable progression of renal failure, three(12%) showed recovery of renal function, and two(8%) showed partial improvement, which is followed by varying degrees of renal insufficiency. During follow-up, three patients died : two from res piratory failure with severe pulmonary hemorrhage and one from opportunistic pulmonary infection during immunosuppressive therapy. Poor prognos is is as sociated with hypertension, increased serum creatinine level at the time of diagnosis, large crescents more than 85% of glomeruli, and glomerular scleros is . CONCLUSION: We conclude that an earlier diagnos is including kidney biopsy and the more aggressive treatment are essential in the management of RPGN.
Adrenal Cortex Hormones ; Antibodies, Antineutrophil Cytoplasmic ; Biopsy ; Creatinine ; Diagnosis ; Europe ; Female ; Follow-Up Studies ; Glomerulonephritis* ; Glomerulonephritis, IGA ; Hemorrhage ; Humans ; Hypertension ; Immune System Diseases ; Incidence ; Kidney ; Kidney Failure, Chronic ; Korea ; Male ; North America ; Plasma Exchange ; Prednisolone ; Purpura ; Renal Insufficiency ; Systemic Vasculitis

OBJECTIVES: The purpose of this study was to examine the automatic attentional bias to disease/body-related stimuli in individuals exhibiting somatization tendencies using Event-Related Potential (ERP). METHODS: The participants were classified according to somatization and control groups based on the somatization symptom scales of the Symptom Checklist-90-Revised and Somatosensory Amplification Scale scores. ERP were recorded in the somatization and control groups while participants were performing the task to respond with neutral (standard stimuli) or disease/body-related words (target stimuli). We compared N100, P200, and P300 ERP components between the two groups. RESULTS: In the somatization group, the reaction times to disease/body-related words were faster than for neutral words. In ERP analysis, N100 to standard stimuli was not observed in the somatization group. The somatization group showed higher P200 and P300 amplitudes to target stimuli than standard stimuli. On the contrary, in the control group, no difference in P200 and P300 amplitudes was observed between target and standard stimuli. CONCLUSION: It is suggested that individuals exhibiting somatization tendencies have automatic attentional bias to disease/body-related stimuli and interpret disease/body-related stimuli as self-relevant stimuli.
Bias (Epidemiology)* ; Evoked Potentials* ; Reaction Time ; Weights and Measures

No abstract available.
DNA* ; Herpesvirus 4, Human* ; Nasopharyngeal Neoplasms* ; Polymerase Chain Reaction*

Purpose: In 2007, the American Society of Clinical Oncology and the College of American Pathologists had established a human epidermal growth factor receptor 2 (HER2) testing guideline, which was updated in 2013 and subsequently in 2018. We assessed the clinical impact of the recent update by comparing the in situ hybridization (ISH) results based on the 2007, 2013, and 2018 guidelines. Methods: We assessed 2 cohorts. The first cohort included 1,161 primary invasive breast cancer (IBC) samples including 18 bilateral IBC cases, with both immunohistochemistry (IHC) and silver-enhanced ISH (SISH) results available for the HER2 status. The second cohort included 160 IBC cases with equivocal HER2 IHC, assessed using SISH. We retrospectively evaluated and compared the HER2 SISH results. Results: There were 22 (1.9%) and 20 (12.5%) cases with altered SISH results according to the 2013 guidelines in cohorts 1 and 2, respectively. As per the 2018 guidelines, final HER2 statuses of 16 (1.4%) and 14 (8.5%) cases changed in cohorts 1 and 2, respectively. The 2013 guidelines increased the positive rate compared to the 2007 guidelines, in both cohorts (0.6% and 6.2%, respectively). Most equivocal cases in cohorts 1 (92.3%) and 2 (100%) as per the 2013 guidelines were reclassified as HER2-negative according to the 2018 guidelines.The 2018 guidelines increased the negative rates (1.3% in cohort 1 and 8.7% in cohort 2) and slightly decreased the positive rates (−0.2% in cohort 1 and −3.1% in cohort 2), compared to the 2013 guidelines. With each update, minor changes in the positive and negative rates were observed in whole breast cancer samples (cohort 1). However, the 2018 guidelines affected previously defined HER2-positive IBC with equivocal IHC results. Conclusion Under the 2013 guidelines, the positive and equivocal cases increased. However, the 2018 guidelines eliminated ambiguous cases by reclassifying them as HER2-negative.

Necrotizing enterocolitis(NEC) is considered to be the leading cause of intestinal perforation in extremely low birth weight infants. We have seen an infant with intestir 1 perforation whose clinical, surgical and histopathological features were different from the presenting features of NEC. A male infant, the 995 gm product of 29-week gestation revealed intermittent abdominal distension which was managed conservatively with fluid and antibiotics. On the nineteenth day of life, free peritoneal air was seen on radiograph, and laparotorny was performed. At surgery, a discrete perforation was found in the terminal ileum. The intestine surrounding the perforation appeared normal without evidence of NEC. Biopsy specimen at the site of perforation was noted to have Candida invading the bowel wall. All blood cultures obtained before surgery were subsequently negative.
Anti-Bacterial Agents ; Biopsy ; Candida* ; Humans ; Ileum ; Infant ; Infant, Extremely Low Birth Weight* ; Infant, Low Birth Weight ; Infant, Newborn ; Intestinal Perforation* ; Intestines ; Male ; Pregnancy

PURPOSE: To assess the prevalence, lesion sites and characteristics of MR findings in patients with mild head injury and the relationship between MR findings and the postconcussion syndrome. MATERIALS AND METHODS: Our study involved 26 patients with mild head injury (Glasgow Coma Scale, 13 to 15 ; no subsequent deterioration ; loss ofconsciousness < 30 minutes). Prospective CT and MR Imaging was performed and the prevalence rate of abnormalities, sites and characteristics of lesions were evaluated, as well as the relationship between MR findings and the postconcussion syndrome. RESULTS: In 17 of 26 patients(65%) there were abnormal findings on MR, and in 8 of the 26(31%), abnormal findings were seen on CT. Abnormalities consisted of cerebral contusion in nine patients, diffuse axonal injury in six and small thin extracerebral hematomas in nine. MR is more sensitive than CT, especially when the lesion is non-hemorrhagic and is closer to the cranial vault. In 16 patients who wereclinically followed up, the prevalence rate of postconcussion syndrome was higher in those with abnormal MR than in those with normal MRI. CONCLUSION: The greater sensitivity of MR makes it a better indicator than CT for the presence and extent of injuries and thus potentially a better predictor of outcome, even in patients with mildhead injuries. Positive MR findings are an objective predictors for the evaluation of patients with postconcussion syndrome after mild head injury.
Axons ; Coma ; Contusions ; Craniocerebral Trauma* ; Head* ; Hematoma ; Humans ; Magnetic Resonance Imaging ; Prevalence ; Prospective Studies

The vanilloid receptor TRPV1 has been suggested to play an important role in thermal nociception and inflammatory hyperalgesia. In our previous study, we examined the expression of TRPV1 and colocalization of TRPV1 with substance P (SP) and calcitonin gene related peptide (CGRP) through fluorescence immunocytochemistry. Here, we investigated ultrastructural characteristics of TRPV1 immunoreactive fibers in the human tooth pulp through preembedding immunocytochemistry. TRPV1 immunoreactivity was present in the unmyelinated nerve fibers in the tooth pulp. There were two types of TRPV1 IR nerve fibers identified in the human tooth pulp: one containing clear round vesicles and many dense-cored vesicles, the other containing clear round vesicles and few dense-cored vesicles. TRPV1 immunoreactive fibers were constant in diameter without swellings along the length. Boutons en passant and boutons terminaux usually observed in the CNS were not observed in the TRPV1 immunoreactive fibers. Many vesicles were accumulated in the TRPV1 immunoreactive fibers, however synaptic structure was not found. It is known that dense-cored vesicles contain neuropeptides such as SP and CGRP and clear round vesicles contain neurotransmitter such as glutamate. Taken together, our results suggest that TRPV1 immunoreactive fibers showing distinct ultrastructructural features may be involved in inflammatory hyperalgesia and thermal nociception in the tooth pulp.
Calcitonin Gene-Related Peptide ; Fluorescence ; Glutamic Acid ; Humans* ; Hyperalgesia ; Immunohistochemistry ; Nerve Fibers ; Nerve Fibers, Unmyelinated ; Neuropeptides ; Neurotransmitter Agents ; Nociception ; Substance P ; Tooth*