Herpes simplex esophagitis can occur in those with normal immune function, but is more often seen in those who are immunocompromised. In one series, 5 percent of post-kidney transplant recipients had herpes esophagitis. We experienced a case of herpes simplex esophagitis, following renal transplantation in a 9 year old male. He complained of epigastric pain, nausea and blood-tinged vomiting. Endoscopic examination showed volcano ulcer, mucosal friability and multiple confluent ulcers covered by whitish exudates on elevated margin in the middle and lower esophagus. Microscopic findings revealed multinucleated giant cells, margination of chromatin, intense nonspecific inflammation and strong positive for herpes simplex virus immunohistochemical staining. Esophageal lesions and symptoms improved after acyclovir therapy.
Acyclovir ; Child* ; Chromatin ; Esophagitis ; Esophagus ; Exudates and Transudates ; Giant Cells ; Herpes Simplex* ; Humans ; Inflammation ; Kidney Transplantation ; Male ; Nausea ; Simplexvirus* ; Transplantation ; Ulcer ; Vomiting

Human rotavirus has now been established as the leading cause of gastroenteritis in young children worldwide. At least fourteen serotypes of group A rotavirus have been identified on the basis of antibody responses to major neutralizing glycoprotein, VP7 (G type for glycoprotein), present in the outer capsid of the virus. Serotype 1, 2, 3 and 4 are the most highly prevalent in human. In Korea, rotavirus is also the principal cause of severe nonbacterial diarrhea requiring hospitalization in infants and young children, which is commonly detected by EIA method. The epidemiology of rotavirus infection has been monitored by only serologic methods without electropherotyping in Korea. This study shows seasonal and age related variations .of rotavirus infection in Korea according to the genotype using the reverse transcription polymerase chain reaction (RT-PCR). Fecal specimens were obtained from 39 children hospitalized with acute watery diarrhea and gastroenteritis in Ewha Womans University MokDong Hospital in Seoul from Jan. to Dec. of 1996. All four (1, 2, 3, 4) major G serotypes were identified by amplification of segment of the gene for VP7 using RT-PCR. Rotavirus Gl 749 bp, G2 653 bp, G3 374 bp and G4 583bp were shown on 2.9 or 3.3% NuSieve agar gel. Results were as follows: 1) Rotavirus was detected at 53.8% (21/39) by EIA and 89.7% (35/39) by RT-PCR. 2) Serotype Gl, G2, G3, G4 when detected by RT-PCR accounted for 80.0% (28/35), 14.3% (5/35), 2.9% (1/35) and 2.9% (1/35), respectively. 3) Thirty five strains of rotavirus were detected at the frequency of 17.1% (6/35) in Oct., 20.0% (7/35) in Nov. and 20.0% (7/35) in Dec. 4) As for the age range, children affected by rotavirus were mostly under 1 years.
Agar ; Antibody Formation ; Capsid ; Child ; Child, Hospitalized* ; Diarrhea* ; Epidemiology ; Female ; Gastroenteritis ; Genotype* ; Glycoproteins ; Hospitalization ; Humans* ; Infant ; Korea ; Polymerase Chain Reaction* ; Reverse Transcription* ; Rotavirus Infections ; Rotavirus* ; Seasons ; Seoul

PURPOSE: The purpose of this study is to detect viral coproantigens in children who were hospitalized with acute diarrhea and to compare its association with clinical symptoms. METHODS: Seventy-four stool samples were collected from children admitted to Ewha Mokdong Hospital from March 1996 to December 1999. The samples were frozen and analyzed for rotavirus, adenovirus, enterovirus, astrovirus, and calicivirus by enzyme immunoassay (EIA) with monoclonal antibody. 53 stool samples were collected from patients with diarrhea (diarrheal group) and 21 stool samples from patients hospitalized for reasons other than diarrhea (control group). Clinical features and laboratory findings were reviewed in both groups. RESULTS: Among 74 stool samples, virus antigens were detected in 60 samples. Of the 60 virus-positive stool samples, 47 enterovirus, 26 rotavirus, 16 adenovirus, 11 astrovirus, and 11 calicivirus antigens were detected by EIA. Of the 60 virus-positive stool samples, 28 samples have one viral antigen, 30 samples have 2 or more viral antigens, and 2 samples showed a simultaneous infection of Salmonella group B and enterovirus. There was no relationship between the detected virus and clinical features. CONCLUSION: In this study, viral coproantigen and clinical symptoms were not associated. In the future, further larger scale studies are necessary.
Adenoviridae ; Antigens, Viral* ; Child ; Child, Hospitalized* ; Diarrhea ; Enterovirus ; Humans ; Immunoenzyme Techniques ; Rotavirus ; Salmonella

Astrovirus is frequently associated with diarrhea in children. It can not be readily isolated by cell culture, and an electronmicroscope is usually used for detection of this agent. Recently in 1995 a combined method of reverse transcription-polymerase chain reaction (RT-PCR) was designed for easier detection of astrovirus, which is based on the conserved sequence in 3'-end of genomes of the 7 known serotypes of human astrovirus. As of yet there has not been any report of astrovirus data in Korea using the RT-PCR methods. The purpose of this study was to detect astrovirus incidence, severity of symptoms, seasonal variation and coinfection rate with rotavirus in Korean children inpatients with diarrhea. Fecal specimens from 61 young children hospitalized with gasteroenteritis Korea from Jan. 1996 through Mar. 1997. They were examined for astroviurs infection by RT-PCR method. Results are as follows: 1. Astrovirus was detected at 9.8% (6/61) from fecal specimens of children with severe diarrhea by EIA using monoclonal antibody coated plates. 2. Astorvirus was detected at 29.5% (18/61) from fecal specimens of children with severe diarrhea by RT-PCR. 3. The age of the 18 children affected by astrovirus ranged from 2 monthes to 7 years with mean of 3.0 years. 4. Mean hospital stay of the 1S children was 6.1 days. 5. Five (27.8%) astrovirus RT-PCR positive strains were confirmed in November and in December, respectively out of 18 specimens in total. 6. Astrovirus coinfection with rotavirus type G1 was confirmed in 15/16 specimens (93.8%), and with type G2 was in 1/16 specimens (6.3%).
Cell Culture Techniques ; Child* ; Coinfection ; Conserved Sequence ; Diarrhea ; Feces* ; Genome ; Humans ; Incidence ; Inpatients ; Korea ; Length of Stay ; Mamastrovirus ; Polymerase Chain Reaction* ; Reverse Transcription* ; Rotavirus ; Seasons

To determine the perinatal mortality and morbidity of fetuses with absent end-diastolic velocities (AEDV) of the umbilical artery in severe pre-eclampsia and eclampsia, the outcome of 5 fetuses with AEDV was compared with that of 35 fetuses with positive end-diastolic velocities (PEDV). The study population comprised 38 cases of severe pre-eclampsia and 2 cases of eclampsia with structurally normal singletons, who had had umbilical artery Doppler velocimetry weekly from admission to delivery. The Doppler velocimetry result was not used for the clinical management. Perinatal death and neonatal morbidity from both groups were further examined in gestational age category to control the influence of preterm births. The incidence of AEDV of the umbilical artery Doppler velocimetry in severe pre-eclampsia and eclampsia was 12.5% (5/40). The AEDV group had a significantly higher incidence than the PEDV group in terms of ceasarean section due to fetal distress (60% : 17%), Apgar score < 7 at 5 minutes (60% : 14%), perinatal death (25% : 0%) and assisted mechanical ventilation (67% : 9%) both at 32-36 weeks. Time intervals from the detection of AEDV to delivery of live neonates varied from the day to 15 days. In conclusion, AEDV in the umbilical artery might be of clinical value in routine surveillance of pregnancies complicated by severe pre-eclampsia and eclampsia, and predict hypoxic fetal condition which needs operative interventions before or during labor and mechanical ventilation after birth.
Apgar Score ; Cesarean Section ; Dystocia ; Eclampsia* ; Female ; Fetal Distress ; Fetus ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Maternal Death ; Mortality ; Parturition ; Parturition* ; Perinatal Mortality ; Pre-Eclampsia* ; Pregnancy ; Premature Birth ; Respiration, Artificial ; Rheology ; Trial of Labor ; Umbilical Arteries* ; Uterine Rupture

BACKGROUND: The main source of carbohydrate in the Korean diet is rice, which is usually served in a rice bowl. This study investigated the impact of a meal plan using smaller rice bowls on dietary energy intake and macronutrient composition in overweight or obese patients with type 2 diabetes mellitus. METHODS: A total of 67 women with type 2 diabetes were enrolled in our study. We divided these participants into three groups: a normal-weight group (NW; body mass index [BMI] < 23 kg/m2; n = 17), an overweight group (OW; 23 < or = BMI < 25 kg/m2; n = 24) and an obese group (OB; BMI > or = 25 kg/m2; n = 26). Three-day dietary records were analyzed for total energy intake (TEI) and macronutrient composition both before enrollment and two weeks after patients received instruction in a dietary plan based on using a small (200 mL) rice bowl. RESULTS: After the intervention, TEI decreased in the OW and OB groups. Decreased carbohydrate (NW, -4 +/- 5%; OW, -4 +/- 5%; OB, -3 +/- 6%) and increased fat intakes were found in all three groups, which complies with Korean Diabetes Association recommendations. The protein proportion of TEI significantly increased only in the OW group. Body weight decreased both in the OW and OB groups. CONCLUSION: A short-term, small-rice-bowl-based meal plan was effective for body weight control and macronutrient balance in overweight or obese women in Korea with type 2 diabetes.
Body Mass Index ; Body Weight ; Diabetes Mellitus, Type 2 ; Diet, Diabetic ; Diet ; Diet Records ; Energy Intake ; Female ; Humans ; Korea ; Meals ; Overweight

BACKGROUND: The regular meal pattern with consistent day-to-day calorie and carbohydrate intake is one of the most important determinants of good glycemic control in diabetes. This study was aimed to investigate the meal pattern and their relationships with total energy intake, nutrients intake and glycemic and lipid profile in type 2 diabetes. METHODS: 1,084 subjects were divided according to glycemic status into three groups: the diabetes (DM), dysglycemia (DG) and normal (N). The meal frequency (MF), meal interval (MI) and daily intake of total energy, macronutrient and micronutrient were estimated with the 24 hours dietary recall from the Korean National Health and Nutrition Examination Survey (KNHANES) in 2001 and Eulji hospital. For analysis of meal pattern and it's relations with the nutrients intake, we regrouped into meal skipper (G1), non-meal skipper with unreasonable MI (G2), and non-meal skipper with reasonable MI (G3). RESULTS: 17.5% of DM, 21.8% of DG, 23.3% of N skipped at least one meal a day without significant difference across the groups. 55.9% of non-meal skipper had unreasonable MI. Meal was more regular in older age, lower educated person, employee, and female. G1 took higher fat, and more calories form snack and less micronutrient density, compared with G3 (P < 0.05). HbA1c, total cholesterol and triglyceride values were higher in G1 compared with other two groups (P < 0.05). CONCLUSION: Many type 2 diabetics had the irregular meal patterns, which was associated with poor glycemic control, lipid profiles and less micronutrient density. This suggested that another treatment strategy might be required for those who had irregular lifestyle.
Cholesterol ; Energy Intake ; Female ; Humans ; Life Style ; Meals ; Micronutrients ; Nutrition Surveys ; Snacks

BACKGROUND: The Korean National Health and Nutrition Examination Surveys reported 65% of daily energy intake (EI) as carbohydrate (CHO) in the Korean population and main source of CHO was cooked rice. We used a standardized-small sized rice bowl for diet education and investigated its effectiveness on body weight, glucose and lipid, compared to the conventional food exchange system in type 2 diabetes obese women. METHODS: Type 2 diabetic women with body mass index > or = 23 kg/m2 were randomly assigned to small rice bowl-based meal plan (BM) and food exchange-based meal plan (ExM) group. Both groups were asked to reduce their EI by 500 kcal/day for 12 weeks. The macronutrient composition was instructed: 55 to 60% of EI as CHO, 15 to 20% as protein, and 20 to 25% as fat. BM group received only a simple instruction for application of the rice bowl. Nutrient intake was estimated with the 3-day dietary records. RESULTS: Finally, 44 subjects finished the study. The percent reduction of body weight was significant both BM group (-5.1 +/- 2.6%) and ExM group (-4.8 +/- 2.8%) after 12 weeks (P < 0.001) but there was no difference between the groups. There was no difference in the proportional change of CHO, protein and fat in EI between the groups. Additionally, the change of HbA1c and low density lipoprotein-cholesterol were not significantly different between the two groups. CONCLUSION: The BM group was as effective as ExM for body weight and glucose control in type 2 diabetes obese women.
Body Mass Index ; Body Weight ; Diabetes Mellitus, Type 2 ; Diet, Diabetic ; Diet ; Diet Records ; Energy Intake ; Female ; Glucose ; Humans ; Meals ; Obesity ; Weight Loss

BACKGROUND: Obese type 2 diabetic subjects are recently increasing in Korea, indicating the importance of insulin resistance rather than insulin secretory defects in the pathophysioloy of type 2 diabetes. The purpose of this study is to evaluate the safety and efficacy of fixed dose rosiglitazone/metformin combination therapy in poorly controlled subjects with type 2 diabetes mellitus. METHODS: 12 type 2 diabetic subjects who had a HbA1c > 11% or fasting plasma glucose > 15 mmol/L were included. After a 2 week screening period, the subjected took the fixed does rosiglitazone/metformin for 24 weeks. The treatment with rosiglitazone/metformin began at week 0 with an initial dose of 4 mg/1000 mg and, unless tolerability issues arose, subjects would be increased to 6 mg/1500 mg at week 4 and at week 8 to the maximum dose of 8 mg/2000 mg. The primary object of this study was to characterize the magnitude of HbA1c reduction from baseline after 24 weeks of rosiglitazone and metformin treatment in poorly controlled type 2 diabetics. RESULTS: The mean age of the subjects was 48.9 +/- 10.6 years old, body mass index was 25.0 +/- 3.5 kg/m2, HbA1c was 12.0 +/- 1.0%, and fasting plasma glucose was 16.3 +/- 3.1 mmol/L. HbA1c was reduced to 7.54 +/- 1.45% and fasting plasma glucose reduced to 7.96 +/- 2.38 mmol/L at week 24. The proportion of HbA1c responder who showed the reduction from baseline of > or = 0.7% or HbA1c < 7% was 11 among 12 subjects (91.7%). 41% of the subjects (5 among 12 subjects) achieved HbA1c level < 7.0% and 75% (9 among 12 subjects) achieved HbA1c level < 8.0%. CONCLUSIONS: In this study, rosiglitazone and metformin combination therapy was effective in glycemic control in poorly controlled subjects with type 2 diabetes mellitus.
Body Mass Index ; Diabetes Mellitus, Type 2 ; Fasting ; Glucose ; Insulin ; Insulin Resistance ; Korea ; Mass Screening ; Metformin ; Plasma ; Thiazolidinediones

Holoprosencephaly(HPE), a common developmental defect affecting the forebrain and cranioface, is etiologically heterogenous. Teratogen, chromosomal anomalies, genetic syndrome, or genetic disorder of non-syndromic HPE are usually accepted as etiology. But the severity of brain and craniofacial malformation are not associated with etiology. Individuals with microform of HPE, who usually have normal cognition and brain imaging, are at the risk of having children with HPE. Several studies on the basis of HPE gene have been performed, which shed valuable insight on normal brain development. As additional HPE genes are identified, more accurate recurrent risk counseling can be given. We experienced a case of recurrent HPE diagnosed by transabdominal ultrasound examinations at 22 weeks' gestation.
Brain ; Child ; Cognition ; Counseling ; Holoprosencephaly* ; Humans ; Microfilming ; Neuroimaging ; Pregnancy ; Prosencephalon ; Ultrasonography