Kawasaki disease (KD) is an immune-mediated disease which is a leading cause of acquired cardiovascular disease in developed country. Recently, tumor necrosis factor-alpha (TNF-alpha) blocker, infliximab has been considered a promising option for patients with refractory KD. Although chronic use of a TNF-alpha blocker could increase risk of opportunistic infections, a few studies have documented that use of infliximab was safe without serious adverse effects in patients with KD. We observed serious bacterial infection after infliximab treatment in an infant with refractory KD. Our patient was a 5-month-old male infant diagnosed with KD who did not respond to repeated doses of intravenous immunoglobulin. We effectively treated him with a single infusion of infliximab (5 mg/kg), but gram-negative (Acinetobacter lwoffii) septicemia developed after infliximab infusion. Therefore, we report a case of serious septicemia after treatment with infliximab, and suggest considering the risk of severe infection when deciding whether to prescribe infliximab to an infant with refractory KD.
Bacterial Infections ; Cardiovascular Diseases ; Developed Countries ; Humans ; Immunoglobulins ; Infant* ; Male ; Mucocutaneous Lymph Node Syndrome* ; Opportunistic Infections ; Sepsis* ; Tumor Necrosis Factor-alpha ; Infliximab

BACKGROUND: This study aimed to empirically investigate the determinants on oxygen free radical degree which causes biological damage focusing on smoking habit and health behaviors in daily life. METHODS: In this cross-sectional study, the subjects were adult males who submitted free radical tests among the examinees of the comprehensive medical testings at an university hospital in Suwon from 2008 to 2010. Total 497 samples were used in analyses for clarifying the relations of free radical degree to age, smoking, obesity, and other health behaviors. RESULTS: First, the degree of oxygen free radical increases by 0.164 as the age group increases (P<0.05). Second, the degree of oxygen free radical increases by 0.547 as the smoking habit increases (P<0.001). Third, the degree of oxygen free radical increases by 0.087 as the exposure to hazardous factors in workplace increases (P<0.001). CONCLUSIONS: The findings of the study imply that the smoking habit has more great influence on the increase of oxygen free radical in body than any other health behaviors. The causality of free radical to smoking and health behavior was not identified due to the limit of the cross-sectional study so it needs to be studied prospectively in the future.
Adult ; Cross-Sectional Studies ; Free Radicals ; Health Behavior ; Humans ; Male ; Obesity ; Oxygen ; Smoke ; Smoking

PURPOSE: The purpose of this study was to examine the degree of self-care, symptom experience and disease state among the patients with liver cirrhosis and to identify its correlation. METHODS: The subjects were 220 patients with liver cirrhosis who were treated in D-university hospital in Busan. The instruments used for study were the self-care inventory, the symptom experience inventory and modified childpugh classification scale. RESULTS: The average points of the patient's self-care performance, symptom experience, and disease status were 3.67, 29.10 and 6.12 respectively. Their self care was negatively correlated to symptom experience, and symptom experience was positively correlated to disease state. CONCLUSION: This research findings suggested that active self-care by patients with liver cirrhosis might contribute to reduce various symptoms they can undergo and to prevent aggravation of disease state. Therefore, patients with liver cirrhosis have to carry out self care actively in daily life and discreet nursing intervention should be offered to facilitate their self-care.
Busan ; Classification ; Humans ; Liver Cirrhosis* ; Liver* ; Nursing ; Self Care*

PURPOSE: The purpose of this study was to identify the effects of structured information provided on self care knowledge, self care performance, and functional status. METHOD: The data were collected using self care knowledge and performance assessment tool, and functional status assessment tool from both group hospitalized patients at D hospital in Busan. RESULTS: There was a significant improvement(p=.032) in self care knowledge in experimental group compared to the control group. But there were not improvement in self care performance and functional status in experimental group compared to the control group. But comparing to pretest and posttest in experimental group, There were significant improvement in self care performance (p=.003) and functional status(p=.013). CONCLUSION: Structured information provided showed increased in the degree of knowledge, self care performance, and functional status. But the effect size of program which had been developed in this study was estimated small, so there is needed to modify this program and to research repeatedly.
Busan ; Humans ; Liver Cirrhosis* ; Liver* ; Self Care*

Purpose: Hydroxychloroquine is widely used for long-term treatment of rheumatic diseases, but the drug can trigger irreversible toxic retinopathy. We studied the prevalence of, and the risk factors for, hydroxychloroquine retinopathy in rheumatic patients with dry eye symptoms and we introduce a representative case. Methods: We retrospectively studied a cohort of 133 rheumatological patients who had taken hydroxychloroquine for at least 12 months and who visited our ophthalmology clinic with dry eye symptoms from April 2016 to December 2021. Hydroxychloroquine retinopathy was diagnosed via fundus photography, spectral-domain optical coherence tomography, the Humphrey visual field test, autofluorescence fundus photography, and multifocal electroretinography. The principal outcomes were the prevalence of retinopathy at the first screening and the risk factors. Results: Of the 133 patients, hydroxychloroquine retinopathy was diagnosed in seven (5.2%) at the first screenings. The Mann-Whitney U-test revealed that older age; higher daily doses; longer dosing duration; greater cumulative doses; and higher daily and cumulative doses/kg were statistically significant in terms of retinopathy development. On multivariate logistic regression analysis, the average daily dose (odds ratio [OR] 6.02; 95% confidence interval [CI] 1.64-22.12, 100 mg increments) and duration of dosing (OR 3.39; 95% CI 1.19-9.62, 5 years increments) remained statistically significant (P = 0.021, P = 0.007 respectively) Conclusions Ophthalmologists should enquire about any history of hydroxychloroquine therapy, and perform a retinal examination, when encountering dry eye in patients with rheumatic disease. Early detection of hydroxychloroquine retinopathy followed by discontinuation of hydroxychloroquine is the only way to prevent visual loss. High daily drug doses and long dosing durations are risk factors for retinopathy.

Apert syndrome is an uncommon congenital disorder characterized by malformation of the skull, most often acrocephaly or oxycephaly, in association with symmetrical syndactyly of both hands and feet. It is due to a disturbance in the growth of bone and soft tissue, affecting principally the head, hands, and feet. Recently we experienced a typical Apert syndrome expressed only in one neonate of dizygotic twin.
Acrocephalosyndactylia* ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Craniosynostoses ; Foot ; Hand ; Head ; Humans ; Infant, Newborn* ; Skull ; Syndactyly ; Twins, Dizygotic*

Pneumocystis carinii causes serious pulmonary infection in immunosuppressed patients. This study was undertaken to observe the cytoskeletal proteins of P. carinii by immuno-electron microscopy. P. carinii infection was experimentally induced by immunosuppression of Sprague-Dawley rats for seven weeks, and their lungs were used for the observations of this study. The gold particles localized actin, tropomyosin, and tubulin. The actin was irregularly scattered in the cytoplasm of the trophic forms but was much more concentrated in the inner space of the cell wall of the cystic forms called the inner electron-lucent layer. No significant amount of tropomyosin was observed in either trophic forms or cystic forms. The tubulin was distributed along the peripheral cytoplasm and filopodia of both the trophic and cystic forms rather than in the inner side of the cytoplasm. Particularly, in the cystic forms, the amount of tubulin was increased and located mainly in the inner electron-lucent layer of the cell wall where the actin was concentrated as well. The results of this study showed that the cell wall of P. carinii cystic forms is a structure whose inner side is rich in actin and tubulin. The location of the actin and tubulin in P. carinii suggests that the main role of these proteins is an involvement in the protection of cystic forms from the outside environment by maintaining rigidity of the cystic forms.
Actins/analysis ; Animals ; Cytoskeletal Proteins/*analysis ; Fungal Proteins/*analysis ; Histocytochemistry ; Microscopy, Immunoelectron ; Pneumocystis/*chemistry/cytology ; Rats ; Rats, Wistar ; Support, Non-U.S. Gov't ; Tropomyosin/analysis ; Tubulin/analysis

PURPOSE: Cytokines are known to play a major role in mediating many of the immunological and pathological findings of allergic disease. Many studies on allergen-specific T cell clones isolated from atopic individuals have shown that these cells produce cytokines of the Th2 phenotype. The purpose of the present study was to investigate cytokine patterns of T lymphocyte induced by Dermatophagoides pteronyssinus in atopic asthma. METHODS: Freshly isolated peripheral blood mononuclear cells of Dp(+) asthmatic children, Dp(-) asthmatic children, nonasthmatic children, and normal adults were stimulated with Dp antigen and examined for the induction of IFN-gamma, IL-2, IL-4, and IL-5 mRNA using RT-PCR. RESULTS: The lymphoproliferative response to crude Dp antigen was maximized at Dp concentration of 2.5 microgram/mL. The lymphoproliferative response was low in children including Dp(+) asthmatics, Dp(-) asthmatics and nonasthmatics, but that of normal adults was high. The expression of IFN-gamma was not so different in each group, but the expression of IL-4 was least in adults, and that of IL-5 was most prominent in Dp(+) asthmatic children. In adult healthy group, IFN-gamma expression without IL-4 and IFN-gamma without IL-5 was significantly higher than those in children. IL-5 expression with or without IFN-gamma was the highest in Dp(+) asthmatic children. IL-4 and IL-5 or IL-5 without IL-4 expression were observed more frequently in Dp(+) asthmatic children than in any other groups. Th2 response was most prominent in Dp(+) asthmatics, and Th1 response was most prominent in normal adult group. CONCLUSION: In conclusion, we observed significantly prominent Th2 response in Dp(+) asthmatic children, especially that of IL-5.
Adult ; Asthma ; Child ; Clone Cells ; Cytokines* ; Dermatophagoides pteronyssinus* ; Gene Expression* ; Humans ; Interleukin-2 ; Interleukin-4 ; Interleukin-5 ; Lymphocytes ; Negotiating ; Phenotype ; Pyroglyphidae* ; RNA, Messenger

OBJECTIVES: This study aimed to confirm the efficacy of the urinary fluoride concentration/creatinine ratio for monitoring fluorine intake in fluoridated and non-fluoridated communities. METHODS: The correlations among the fluoride concentration in drinking water and that in the urine and fingernails of 52 preschool children (age, 60-72 months) from fluoridated and non-fluoridated communities were analyzed. RESULTS: The urinary fluoride concentration/creatinine ratio had a relatively high correlation with the fluoride concentration in drinking water (Pearson's correlation coefficient, 0.606; P<0.05). Further, this ratio was significantly positively correlated with the urinary fluoride concentration (Pearson's correlation coefficient, 0.374; P<0.01). However, there was no significant correlation between this ratio and the fluoride concentration in fingernails (Pearson's correlation coefficient, 0.145; P>0.05). CONCLUSIONS: The findings of this study suggest that the urinary fluoride concentration/creatinine ratio in children can be utilized as an index for monitoring excess fluoride intake in fluoridated communities.
Child ; Child, Preschool ; Drinking ; Drinking Water ; Fluoridation ; Fluorides ; Fluorine ; Humans ; Nails

Congenital bronchoesophageal fistula (BEF), congenital communication between esophagus and bronchus, is a rare malformation. Benign BEF shows only nonspecific symptoms that may delay a correct diagnosis and proper treatment. This is a case of a 3-year-old boy presenting congenital BEF with imperforate anus and atrial septal defect. He had recurrent pneumonia in the right lower lobe since he was 5 months old. A barium swallow examination showed a communicating fistula between the lower esophagus and the right lower lobe bronchus. Computed tomography scan supported to delineate the course of the fistula. He underwent resection surgery of the fistula and lobectomy of the right lower lobe. He recovered without any postoperative complications.
Anus, Imperforate ; Barium ; Bronchi ; Child ; Esophagus ; Fistula ; Heart Septal Defects, Atrial ; Humans ; Pneumonia ; Postoperative Complications