No abstract available.
Catheters* ; Cystic Adenomatoid Malformation of Lung, Congenital* ; Fetal Therapies* ; Lung*

No abstract available.

Kawasaki disease(KD) is an acute febrile vasculitis with various clinical manifestations and the most common cause of acquired coronary arterial lesion in pediatric population. Occasionally, KD can be presented with some kind of unusual associations. of these, cases associated with autoimmune hemolytic anemia(AIHA) have been rarely reported worldwide. We report a case of KD associated with AIHA in the acute stage of disease and Parvovirus B19 infection, in a 4-month-old infant.
Anemia, Hemolytic, Autoimmune* ; Humans ; Infant ; Mucocutaneous Lymph Node Syndrome* ; Parvovirus ; Vasculitis

BACKGROUND: To achieve tight glycemic control in the poorly controlled type 2 diabetic patients with oral hypoglycemic agent, it maybe beneficial to initiate insulin treatment at the early stage. Many patients with type 2 diabetes are often reluctant to begin insulin therapy despite poor glycemic control with oral hypoglycemic agents, this little known phenomenon, often termed 'psychological insulin resistance (PIR)'. This study investigates psychological insulin resistance in Korean patients with type 2 diabetes. METHOD: This study examined a total of 76 type 2 diabetic patients with poor glycemic control during period of April to July 2006. Through questionnaire and telephone survey, total 24 questions were asked about various attitudes on insulin therapy including psychological barriers and patients' acceptance of this treatment. Subjects were asked to allocate points in 5-point scale (from 5 points for 'very true' to 1 point for 'very untrue'). RESULTS: The means of psychological rejection, injection-related anxiety and fear of insulin side effects such as hypoglycemia and weight gain were 3.65 +/- 0.92, 3.17 +/- 0.98 and 2.8 +/- 1.02, respectively. Unwillingness was common in insulin therapy, 67% of patient rejected or was unwilling to take insulin. Main reasons of patients most frequently endorsed beginning insulin indicate that disease is worsening, permanence (once you start insulin you can never quit) and sense of personal failure. Furthermore, study indicates that patients' reasons for avoiding insulin therapy were mainly psychological rejection, which extended far beyond a simple injection related anxiety. CONCLUSION: PIR was psychological reluctance rather than injection related anxiety. To overcome these psychological barriers to insulin treatment, it is necessary to address appropriate diabetes education including training and counseling with excellent interactive communications between patients and clinicians.
Anxiety ; Counseling ; Humans ; Hypoglycemia ; Hypoglycemic Agents ; Insulin ; Insulin Resistance ; Rejection (Psychology) ; Telephone ; Weight Gain ; Surveys and Questionnaires

BACKGROUND: A allele, A(var), characterized by a 784G>A polymorphism (Asp262Asn) has been identified only in Korean A(weak)B donors. This study evaluated the serological and genetic characteristics of thirteen samples with newly identified A(var) allele. METHODS: This study examined 10 samples with the A(var) allele including 4 members from a family, who were randomly obtained from blood donors recruited at Gwangju-Chonnam Red Cross Blood Center, and patients at the Chonnam National University Hospital. Routine ABO serologic tests, ABO genotyping using an allele specific polymerase chain reaction (AS-PCR), and the sequencing of exon 6 and 7 of ABO gene were performed on all samples. In addition, sequencing of exon 1~5 of the ABO gene was carried out on two randomly selected samples. RESULTS: The A(var) allele was identified in nine A(weak)B and one O (II-1 of the family study) sample. Eight of these nine individuals showed 1+ agglutination with the monoclonal anti-A reagents on forward typing but one sample showed no agglutination. Weak anti-A was detected in all sera. From the family study, the A(var) allele, which was transmitted from the propositus through her descendant (II-1, II-3 and III-1), produced either the weak A phenotype when inherited with a B allele or the O phenotype when inherited with an O allele. CONCLUSION: A(var) erythrocytes showed different agglutination patterns to anti-A. Different expressions (possible allelic enhancement) were observed depending on the co-inherited ABO alleles from samples with the A(var) allele.
Agglutination ; Alleles* ; Blood Donors ; Erythrocytes ; Exons ; Humans ; Indicators and Reagents ; Jeollanam-do ; Phenotype ; Polymerase Chain Reaction ; Red Cross ; Serologic Tests ; Tissue Donors

OBJECTIVE: To describe the angiographic embolization as a safe and an effective alternative treatment in the management of obstetrical hemorrhage and in preserving fertility. METHODS: Between March 1999 and May 2003, 43 patients at Asan Medical Center underwent angiographic embolization for the management of obstetrical hemorrhage. All cases received arterial embolization because of obstetrical hemorrhage unresponsive to conservative management or prophylaxis for massive obstetrical hemorrhage. Medical records were reviewed and detailed to collect adequate clinical data such as clinical status, underlying conditions, amount of transfusion, embolization sites, materials of embolization, duration of the procedure, complications associated with embolization, hospital stay, and the success rate. Patients were contacted by telephone to obtain long-term outcome for menstruation, desire for conception, and subsequent pregnancies. RESULTS: We have experienced the clinical successful embolization in 37 (86.0%) of 43 patients of obstetrical hemorrhage resulting from various causes. The main cause of hemorrhage was atony of uterus (n=17), followed by abnormal placentation (n=6), genital tract laceration (n=5). The average amount of blood transfusion was 7.0 units (range; 0-36 units). The average length of the time for the procedure was 68.2 minutes (range; 30-150 minutes). The average duration of hospitalization was 6.4 days (range; 3-20 days). The main complication after embolization was numbness and pain on right lower extremities in 5 cases and vessel dissection occurred in 1 case. But there was no major complication related to the procedure. We were able to follow up 28 patients. In all cases menses resumed spontaneously soon after the procedure. Seven cases of long-term follow-up became pregnant, and 3 cases of them completed gestations giving birth to healthy babies. CONCLUSION: The results suggest that angiographic embolization is a relatively noninvasive and highly effective method for the management of obstetrical hemorrhage and a useful technique for preserving fertility.
Blood Transfusion ; Chungcheongnam-do ; Female ; Fertility ; Fertilization ; Follow-Up Studies ; Hemorrhage* ; Hospitalization ; Humans ; Hypesthesia ; Lacerations ; Length of Stay ; Lower Extremity ; Medical Records ; Menstruation ; Parturition ; Placentation ; Pregnancy ; Telephone ; Uterus

Before the exact location of its chromosomal abnormality was identified, 22q11.2 deletion syndrome was described as many different names depending on its presenting clinical features. Patients with this syndrome have a wide range of findings such as cardiac anomaly, abnormal face, thymic hypoplasia, cleft palate, and hypocalcemia. Cardiac involvement is a prominent feature and most of the patients have a conotruncal heart defect. 22q11.2 deletion is the most common chromosomal cause of congenital heart defect after trisomy 21. Familial transmission accounts for about 8 per cent of cases and most of the cases develop sporadically. Even in cases where this syndrome is inherited, the parents' chromosomal abnormalities are often discovered only after the deletion is suspected in their children. We describe two prenatal cases in which this syndrome was suspected by ultrasonogram and confirmed by fluorescent in situ hybridization (FISH). In both cases, there was no known prior family history of cardiac abnormalities or chromosomal abnormality. In one case, autopsy following termination further confirmed the diagnosis. In the other case, the mother was also found to have 22q11.2 deletion.
Autopsy ; Child ; Chromosome Aberrations ; Cleft Palate ; Diagnosis ; DiGeorge Syndrome* ; Down Syndrome ; Heart ; Heart Defects, Congenital ; Humans ; Hypocalcemia ; In Situ Hybridization, Fluorescence ; Mothers ; Prenatal Diagnosis* ; Ultrasonography

PURPOSE: Although home renovation exposure during childhood has been identified as a risk factor for the development of allergy, there is limited information on the association between prenatal exposure to home renovation and cord blood (CB) IgE response. The aims of this study were to identify the effect of prenatal exposure to home renovation on CB IgE levels, and to investigate whether this exposure interacts with neonatal genes and whether the effect can be modified by maternal atopy. METHODS: This study included 1,002 mother-neonate pairs from the COhort for Childhood Origin of Asthma and allergic diseases (COCOA). Prenatal environmental factors were collected using a questionnaire. The levels of CB IgE were measured by the ImmunoCAP system, and DNA was extracted from CB. RESULTS: Exposure to home renovation during the prenatal period was associated with significantly higher levels of CB IgE only in neonates from atopic mothers, and the effect of renovation exposure on CB IgE levels persisted from 31 months before birth. Furthermore, prenatal exposure to home renovation increased the risk of CB IgE response interacting with polymorphisms of NRF2 and GSTP1 genes only in neonates from atopic mothers. CONCLUSIONS: Maternal atopy modified the effect of prenatal exposure to home renovation on CB serum IgE response as well as the interaction between the exposure and neonatal genes involved in the oxidative stress pathway. These findings suggest that the genetically susceptible offspring of atopic mothers may be more vulnerable to the effect of prenatal exposure to home renovation on the development of allergy.
Asthma ; Cohort Studies ; DNA ; Fetal Blood* ; Gene-Environment Interaction ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Infant, Newborn ; Mothers ; Oxidative Stress ; Parturition ; Polymorphism, Single Nucleotide ; Reactive Oxygen Species* ; Risk Factors