Hand-foot-and-mouth disease (HFMD) is a viral illness with a distinct clinical presentation of oral and characteristic distal extremity lesions. It is caused by members of the enterovirus genus, namely, coxsackievirus A16 or enterovirus 71. HFMD is more severe in infants and children than adults, but generally, the disease has a mild course and is self-limiting. However, in recent epidemiology of HFMD in Asia, severe cases with complications have been reported. Enterovirus 71 may cause myocarditis, pneumonia, and severe neurological complications such as brainstem encephalitis, aseptic meningitis, acute flaccid paralysis, meningoencephalitis, meningomyeloencephalitis, and even death. A large outbreak of HFMD in Taiwan and Singapore caused by enterovirus 71 had a high mortality rate; the deaths resulted from pulmonary hemorrhage, interstitial pneumonitis, or brainstem encephalitis. HFMD was also epidemic in Korea in the spring of 2010. Severe cases with complications including neurological complications and death have been reported in HFMD patients, thus it has become a public health issue. We report five children who had severe HFMD caused by enterovirus 71 with meningomyeloencephalitis which caused a disturbance in consciousness, motor weakness, strabismus, and voiding difficulty. There was no mortality, and no patients exhibited sequelae.
Adult ; Asia ; Brain Stem ; Child ; Consciousness ; Encephalitis ; Enterovirus ; Extremities ; Foot ; Hand ; Hemorrhage ; Humans ; Infant ; Korea ; Lung Diseases, Interstitial ; Meningitis, Aseptic ; Meningoencephalitis ; Mouth ; Mouth Diseases ; Myocarditis ; Paralysis ; Pneumonia ; Public Health ; Singapore ; Strabismus ; Taiwan

PURPOSE: Precocious puberty (PP) is associated with psychological and behavioral problems. This study aimed to evaluate the perception of body image and depression in girls with PP receiving gonadotropin-releasing hormone (GnRH) analogue therapy. METHODS: From March to August 2013, 82 girls with PP receiving GnRH analogue therapy were enrolled. Height, weight, body mass index, and stages of pubertal development were assessed. Participants completed a series of questionnaires on their body image perception and pubertal self-assessment. The depression score was calculated using the Korean Kovacs' Children's Depression Inventory. RESULTS: The patients perceived their body to be more obese than the controls did. The mean depression score did not differ between the patients and controls. The mean depression scores according to Tanner stages (1: prepubertal, 2: early pubertal, and 3–5: mid to late pubertal stage) by self-assessment were 5.2±3.6, 6.8±4.9, and 11.4±10.1 (P<0.05), respectively. The perception of overall body build and figure (%) and the mean depression scores in patients were: dissatisfied (25.6%, 9.7±7.8) and satisfied (74.4%, 5.5±3.4) (P<0.05). In multiple linear regression analysis, self-T3 (Tanner stage 3–5 by self-awareness) and dissatisfaction about overall body build and figure were found to significantly affect the depression score(P<0.05). CONCLUSION: The perception of pubertal status and satisfaction about height or weight are unrelated to objective physical findings. Patients with PP are prone to distorted perception about their body image and breast development. Such incorrect body image seems to contribute to depression score.
Body Image* ; Body Weight ; Breast ; Depression* ; Female* ; Gonadotropin-Releasing Hormone* ; Humans ; Linear Models ; Problem Behavior ; Puberty, Precocious* ; Self-Assessment ; Somatotypes

PURPOSE: Precocious puberty (PP) is associated with psychological and behavioral problems. This study aimed to evaluate the perception of body image and depression in girls with PP receiving gonadotropin-releasing hormone (GnRH) analogue therapy. METHODS: From March to August 2013, 82 girls with PP receiving GnRH analogue therapy were enrolled. Height, weight, body mass index, and stages of pubertal development were assessed. Participants completed a series of questionnaires on their body image perception and pubertal self-assessment. The depression score was calculated using the Korean Kovacs' Children's Depression Inventory. RESULTS: The patients perceived their body to be more obese than the controls did. The mean depression score did not differ between the patients and controls. The mean depression scores according to Tanner stages (1: prepubertal, 2: early pubertal, and 3–5: mid to late pubertal stage) by self-assessment were 5.2±3.6, 6.8±4.9, and 11.4±10.1 (P<0.05), respectively. The perception of overall body build and figure (%) and the mean depression scores in patients were: dissatisfied (25.6%, 9.7±7.8) and satisfied (74.4%, 5.5±3.4) (P<0.05). In multiple linear regression analysis, self-T3 (Tanner stage 3–5 by self-awareness) and dissatisfaction about overall body build and figure were found to significantly affect the depression score(P<0.05). CONCLUSION: The perception of pubertal status and satisfaction about height or weight are unrelated to objective physical findings. Patients with PP are prone to distorted perception about their body image and breast development. Such incorrect body image seems to contribute to depression score.
Body Image* ; Body Weight ; Breast ; Depression* ; Female* ; Gonadotropin-Releasing Hormone* ; Humans ; Linear Models ; Problem Behavior ; Puberty, Precocious* ; Self-Assessment ; Somatotypes

PURPOSE: Expression of bel-2 is associated with inhibition of apoptosis and extension of cell survival. We investigated the expression of bel-2 oncoprotein in human bladder tumor. MATERIALS AND METHODS: The expression of bel-2 oncoprotein was investigated immunohistochemically in formalin-fixed and paraffin-embedded tissue specimens from 43 patients with primary transitional cell carcinoma in urinary bladder. Thirty four were superficial bladder tumors and nine were invasive bladder tumors. In histology grade according WHO grading there were 9 grade 1,21 grade II and 13 grade III. RESULTS: Strong positive staining was 5(11.62%), positive staining 13(30%) and negative staining 25(58%). Random distribution through the cancerous epithelium presented in 3 tumors but the other 15 tumors demonstrated cystoplasmic staining restricted to basal epithelial cells. Positive immunoreaction for bel-2 was found in 3 out of 9 invasive bladder tumors, while 15 of 34 superficial tumors showed positive staining. There was no significant correlation between bel-2 expression and tumor stage(p=0.56). 6 of grade I, 9 of grade II and 3 of grade III bladder tumors showed positive staining. There was no significant correlation between bcl-2 expression and tumor grade(p=0.12). CONCLUSIONS: The findings suggest that no clear relationship was found between tumor grade, stage and bel-2 expression.
Apoptosis ; Carcinoma, Transitional Cell ; Cell Survival ; Epithelial Cells ; Epithelium ; Humans ; Negative Staining ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Fifteen cases of genital warts were examined for the presence of human papillomavirus (HPV) using polymerise chain reaction (PCR). HPV6/11 DNA were found in all cases of genital warts. The PCR based methods described here provide a sensitive, accurate means of detecting genital HPVs.
Condylomata Acuminata ; DNA ; Humans* ; Papillomaviridae* ; Polymerase Chain Reaction*

Platyspondylic lethal skeletal dysplasia, Torrance type (PLSD-T), is one of the phenotypes of type II collagenopathy and is characteristic of severe bone growth disorder. This phenotype may limit the growth and expansion of the lungs, which is known to cause death from respiratory failure during or shortly after birth, but in few less severe cases, patients have been reported to have survived to adulthood. We have experienced a case of PLSD-T in a preterm infant who was delivered via cesarean section at the gestational age of 29 weeks 3 days, with a birth weight of 1.15 kg. Physical examination of the infant revealed characteristic findings of short arms and legs, small thorax, distended abdomen, and cleft palate. On the basis of the subsequent genetic testing, the patient had a heterozygous mutation in the encoded c-propeptide region of collagen, type II, alpha 1 (COL2A1), c.4335G>A (p.Trp1445*) in exon 52. This is the first case of PLSD-T diagnosed in Korea, and we hereby report the case.
Abdomen ; Arm ; Birth Weight ; Bone Development ; Cesarean Section ; Cleft Palate ; Collagen Type II ; Exons ; Female ; Genetic Testing ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Korea ; Leg ; Lung ; Parturition ; Phenotype ; Physical Examination ; Pregnancy ; Respiratory Insufficiency ; Thorax

Evidence for involvement of the central nervous system (CNS) in the regulation of glucose metabolism dates back to the 19th century, although the majority of the research on glucose metabolism has focused on the peripheral metabolic organs. Due to recent advances in neuroscience, it has now become clear that the CNS is indeed vital for maintaining glucose homeostasis. To achieve normoglycemia, specific populations of neurons and glia in the hypothalamus sense changes in the blood concentrations of glucose and of glucoregulatory hormones such as insulin, leptin, glucagon-like peptide 1, and glucagon. This information is integrated and transmitted to other areas of the brain where it eventually modulates various processes in glucose metabolism (i.e., hepatic glucose production, glucose uptake in the brown adipose tissue and skeletal muscle, pancreatic insulin and glucagon secretion, renal glucose reabsorption, etc.). Errors in these processes lead to hyper- or hypoglycemia. We here review the current understanding of the brain regulation of glucose metabolism.

Purpose: This study examined the impact of a virtual reality intervention program based on psychological needs on behavioral and psychological symptoms, apathy, and quality of life (QOL) in patients with dementia or mild cognitive impairment living in nursing facilities. Methods: This study is nonequivalent control group pretest-posttest design of quasi-experimental study. The study collected data from November 18, 2020 to July 24, 2021 from patients with dementia or mild cognitive impairment (30 in the experimental group and 30 in the control group) at three nursing facilities in G city using self-reporting and caregiver-informant reporting methods. The analysis employed the chi-square test, Fisher’s exact test, paired t-test, independent t-test, Wilcoxon signed rank test, Mann–Whitney U, repeated measures ANOVA, GEE, using SPSS/WIN 27.0. Results: The severity of behavioral and psychological symptoms (Wald χ2 = 2.68, p = .102) and the care burden of caregivers (Wald χ2 = 1.72, p = .190) were not significant and was no significant time and group interaction effect (Wald χ2 = 0.63, p = .426, Wald χ2 = 0.52, p =. 471). The difference in apathy and QOL score were statistically significant for the group-time interaction (F = 43.65, p < .001; F = 4.35, p= .041). Conclusion The virtual reality intervention program of this study shows a positive effect on the apathy reduction and QOL of patients with dementia or mild cognitive impairment residing in nursing facilities.

Hydrops fetalis is a condition characterized by an accumulation of fluid, or edema, in at least two fetal compartments. Only a small percentage (less than 10%) of hydrops fetalis cases are related to immune hydrops caused by variant antigens present the surface of the red blood cells (RBCs), depending on blood groups, such as ABO, Rh (C, D, E, c, e), I, P, Kell, etc. The Rh (E) antigen generally does not cause fetal anemia; however, in rare cases, it can be lethal, leading to stillbirth. We report a case of a preterm infant born at 28 weeks gestational age with severe hydrops fetalis caused by anti-E alloimmunization.
Anemia ; Anemia, Hemolytic ; Blood Group Antigens ; Edema* ; Erythrocytes ; Gestational Age ; Humans ; Hydrops Fetalis* ; Infant, Newborn ; Infant, Premature ; Stillbirth