PURPOSE: Atopy is a state of allergic response, mediated by IgE, to common environmental allergens. In recent decades, there has been an increase in prevalence of atopic disorders in children in developed countries. The factor associated with the rise of atopy incidence may be declining exposure to some infection opportunities. The aim of this study is to determine if the immune response to Mycobacterium tuberculosis can suppress atopy by investigating the association between tuberculin responses and serum IgE. METHODS: We divided the patients into two groups according to tuberculin skin test. Group A showed positive response (induration diameter > or =10mm), while Group B showed negative response (induration diameter< l0mm). A comparison was made between the two groups in terms of age, sex, serum total IgE and allergen-specific IgE. RESULTS: Twenty-one patients comprised Group A and 72 comprised Group B. The mean serum total IgE concentration and the number of patients showing positive MAST in Group B was significantly higher than that of Group A (P<0.05). CONCLUSION: In our study, there was an inverse association between delayed hypersensitivity to Mycobacterium tuberculosis and atopy.
Allergens ; Child ; Developed Countries ; Humans ; Hypersensitivity, Delayed ; Immunoglobulin E* ; Incidence ; Mycobacterium tuberculosis ; Prevalence ; Skin Tests ; Tuberculin*

Alternating hemiplegia of childhood(AHC) is a rare but clinically distinct syndrome characterized by onset before 18 months of age, frequent attacks of alternating paralysis, nystagmus transient ocular palsies, other autonomic dysfunction, and the development of cognitive impairment and a choreoathetotic movement disorder. The case is a 13 month-old boy who has presented repeated episodes of alternating hemiplegia from the age of 6 months at a frequency of several times per month, which was lasting for two or three days. Ths diagnosis was based on clinical features. Frequently such hemiplegic attacks were accompanied by irratability. He had mental retardation, neurodevelopmental delay, and seizure attacks. EEG, brain MRI, brain MR angiography, and Tc-99m HMPAO-brain single photon emission computed tomography(SPECT) failed to reveal any significant abnormal finding during the hemiplegic attacks. We tried calcium-entry block and flunarizine to relieve the hemiplegic attacks, but the frequency and severity of the hemiplegic attacks were not decreased by flunarizine therapy.
Angiography ; Brain ; Diagnosis ; Electroencephalography ; Flunarizine ; Hemiplegia* ; Humans ; Infant ; Intellectual Disability ; Magnetic Resonance Imaging ; Male ; Movement Disorders ; Paralysis ; Seizures

PURPOSE: Febrile seizure is the most common type of seizure affecting 3-4% of children. The recurrence rate of febrile seizure is approximately 33%. About 16% of children with a febrile seizure during the febrile illness have a recurrent seizure attack within 24 hours. This study aimed to investigate the optimum dose of diazepam to reduce the recurrence of febrile seizures in children who have had a febrile seizure attack. METHODS: The children with febrile seizure who were admitted to the Maryknoll hospital for in vestigation and treatment were retrospectively reviewed. The study group compromised 306 children. The febrile seizure was defined as seizure attack with fever(above 38degreeC) without evidence of intracranial infection or defined cause in children aged 6 months to 5 years. The children were divided into four groups according to dose of diazepam. Group I, 72 patients, received no diazepam therapy. Group II, 78 patients, received oral diazepam in a dose of 0.1 mg/kg every eight hours during the febrile illness, Group III, 87 patients, 0.2 mg/kg, and Group IV, 69 patients, 0.3 mg/kg, respectively. RESULTS: The seizure attack rate and the duration of admission were reduced in both Group III and Group IV. However, there was no difference in the side effects of the diazepam between group III and IV. CONCLUSION: Oral diazepam in a dose of 0.2 mg/kg effectively decreases both the seizure attack rate and the duration of admission.
Child ; Diazepam* ; Humans ; Recurrence ; Retrospective Studies ; Seizures* ; Seizures, Febrile*

PURPOSE: Thyroxine is the hormone indispensible to the growth and development of infants. We made this study to confirm the influence of temporary depression of serum thyroxine levels on the development of intelligence. METHODS: I adopted as the study group 14 patients diagnosed with depression at the pediatrics department of Pusan National University Hospital from April of 1991 to October of 1997, and selected as the control group 24 infants born with normal functioning of thyroid glands in the same period. From August 18 to September 3 2003, a clinical psychologist carried out Korean Wechsler Intelligence Scale for Children on the patient group and the control group. According to the guidelines, they conducted 12 small tests, gave them marks and expressed the intelligent quotients by the conversion grade in seven articles. RESULTS:The patient group had meaningfully lower grades than the control group in three(similarity, vocabulary, digit scan) out of six articles of the small test of verbal scales, and the former had meaningfully lower grades in two(picture completion, object assembly) out of six articles of the small test of performance scales by K-WISC-III. The I.Q. shows the group of patients was meaningfully depressed in six(verbal IQ, performance IQ, global IQ, verbal comprehension, perceptional organization, working memory) out of seven articles; out of the six articles, the working memory was most depressed. CONCLUSION: Transient hypothyroidism can bring the mental retardation of children, so we think that there should be further studies for appropriate thyroid hormone replacement therapy on these patients.
Busan ; Child ; Comprehension ; Congenital Hypothyroidism* ; Depression ; Growth and Development ; Hormone Replacement Therapy ; Humans ; Hypothyroidism ; Infant ; Intellectual Disability ; Intelligence ; Memory, Short-Term ; Pediatrics ; Psychology ; Thyroid Gland ; Thyroxine ; Vocabulary ; Weights and Measures

PURPOSE: We studied to know the effect of early feeding on the course and the recovery of acute diarrheal disease. METHODS: The study was conducted on 76 patients who admitted to the Soonchunhyang university hospital for acute diarrhea. We divided 76 patients into 3 dietary groups (whole milk group (WMG): 35, diluted milk group (DMG): 29, breast milk group (BMG): 12). We compared three groups by numbers of diarrhea, numbers of vomiting, calory intake, weight increments, and duration of diarrhea. RESULTS: 1) The mean age was 16.45+/-18.20, 11.53+/-9.80, 5.38+/-5.01 months for WMG, DMG, and BMG, respectively. The mean weight was 9 kg and the mean duration of diarrhea was 2.29 days. 2) The numbers of diarrhea during admission was not significantly different in the three groups. 3) The calory intake during admission was significantly low in DMG. 4) The weight increments during admission was significantly low in DMG. 5) The duration of diarrhea during admission was not significantly different in the three gourps. CONCLUSION: Early refeeding with whole milk or breast milk did not prolong or worsen the course or symptoms of diarrhea compared with gradual reintroduction with diluted milk. But there were advantages of improved nutrition and weight increments. Futher study is necessary to demonstrate the effect of diet according to the causative organisms.
Diarrhea ; Diet Therapy* ; Diet* ; Humans ; Milk ; Milk, Human ; Vomiting

PURPOSE: Fibrous dysplasia is related to the mutation of gene encoding the alpha-subunit of a signal-transducing G-protein and has variable clinical course. Operation can be performed to prevent functional disorder or structural deformity. After curettage, autologous bone graft were used to fill the defects after curettage. The aim of this study is to compare the result of autogenous cancellous bone grafting and allogenic bone grafting for fibrous dysplasia. MATERIALS AND METHODS: Among the patients who visit our hospital during the period of April, 1997 to October, 2013, we selected 34 patients who diagnosed fibrous dysplasia and visited our clinic over 1 year. There were 13 males and 21 females. Average age was 26.4 (range 2 to 57) years old. Autogenous bone graft (group I) in 5 cases, Non-autogenous bone graft (group II) in 30 cases. Iliac bone is used in all cases of autogenous bone graft. There were no significant difference in age, follow-up period, preoperational laboratory finding between two groups. Radiographic image was done to evaluate the recurrence of fibrous dysplasia or secondary degeneration. RESULTS: There were four cases in recurrence (group I: 1 case, group II: 3 cases, p=0.554). In all recurrent cases, reoperations were done using curettage and autogenous iliac bone graft. There was no re-recurrence after reoperation. One case of secondary aneurysmal bone cyst was confirmed (group II) and 1 cases of pathologic fractures had developed (group I: 0 case, group II: 1 cases, p=0.559). No malignant change occurred. CONCLUSION: There were no significant difference between autogenous bone graft group and non-autogenous bone graft group. Our result suggested that autogenous bone graft seems to be good method to treat fibrous dysplasia, in the case of small volume of tumor lesion or non-weight bearing portion.
Aneurysm ; Bone Cysts ; Bone Transplantation* ; Congenital Abnormalities ; Curettage ; Female ; Follow-Up Studies ; Fractures, Spontaneous ; GTP-Binding Proteins ; Humans ; Male ; Recurrence ; Reoperation ; Transplants

Teaching both English in medical field and bioethics to medical students in Korea is becoming more and more important. We have investigated the present status of medical English and bioethics lectures in medical schools in Korea. We have taught bioethics in medical English class and investigated its effect through questionnaire. Less than two thirds of the 35 medical schools in Korea have medical English and /or bioethics lectures. Mainly English medical terms were taught in premedical course in most of the school which needs to be improved. Evaluation of the bioethics lecture in medical English class was responded favorably by the students. In conclusion, teaching bioethics in medical English class in English appears to be an effective way of teaching both English and bioethics in medical field at the same time and a good way of saving time by teaching both simultaneously.
Bioethics* ; Humans ; Korea ; Lectures ; Schools, Medical ; Students, Medical ; Surveys and Questionnaires

Death by drowning is one of the most common cause of death worldwide, and the diagnosis of fatal drowning through postmortem examination is not always confirmative. Although many autopsy findings of drowning have been described so far, all these macroscopical signs are non-specific and moreover disappear quite rapidly in the process of decomposition. The combination of autopsy findings and diatom test can provide useful indication for the tentative diagnosis of drowning, but the value of the diatom analysis is still argued. The aim of the present study is to investigate the diagnostic usefulness of diatom test for the drowning death in Korea. The authors reviewed the result of 87 cases of diatom test in the autopsy file and analyzed it by parameters of the common diatom species, monthly frequency, the difference between sea and land water, and the correlation between the test result and the decision of cause of death. The result revealed no definite seasonal variation of diatom detection or no species difference between sea water cases and fresh water cases. The detection rate of diatoms in systemic organs of all cases was 11.49% and that of drowning cases was 9.43%.
Autopsy ; Cause of Death ; Diatoms ; Drowning ; Fresh Water ; Korea ; Seasons ; Seawater ; Water

PURPOSE: Hemophagocytic lymphohistiocytosis (HLH) is an important differential diagnosis in infants and children who present with prolonged fever, hepatosplenomegaly, marked hypertriglyceridemia and cytopenia. HLH is currently curable with immunomodulatory therapy, chemotherapy and stem cell transplantation. We evaluated the clinical characteristics and treatment outcomes in patients with HLH. METHODS: We reviewed retrospectively the medical records of 22 children with HLH from January 1996 to June 2003 at Catholic University St. Mary's Hospital. RESULTS: Among the 22 patients, 11 patients were male and the others were female. The median age of onset was 5.5 (0.6~14.4) years including 6 cases presenting before 2 years of age. Family history of suspicious HLH was observed in 3 patients and Epstein Barr virus (EBV) was demonstrated in 10 patients. The most frequent manifestation was fever and the median duration of fever at diagnosis was 18 (6~46) days. Common laboratory findings were neutropenia, anemia, thrombocytopenia, hypertriglyceridemia, hypofibrinogenemia and abnormal liver function tests. Bone marrow examinations showed significant hemophagocytic lymphohistiocytosis in all of these patients. No treatment was needed in 3 patients and 6 patients were treated with high dose immunoglobulin and antiviral agents, 9 cases with chemotherapy and 4 patients were transplanted with sibling bone marrow or unrelated cord blood. The causes of death were refusal to treatment in 1 patient, disease progression in 6 and pulmonary hemorrhage in 1. CONCLUSION: If the disease is familial or relapsing, progressive or persistent even without family history, hematopoietic stem cell transplantation from the best available donor is strongly recommended. In less severe secondary HLH cases, either no treatment or a short duration of therapy might suffice, but future studies are necessary to define these subsets, possibly with additional genetic markers.
Age of Onset ; Anemia ; Antiviral Agents ; Bone Marrow ; Bone Marrow Examination ; Cause of Death ; Child ; Diagnosis ; Diagnosis, Differential ; Disease Progression ; Drug Therapy ; Female ; Fetal Blood ; Fever ; Genetic Markers ; Hematopoietic Stem Cell Transplantation ; Hemorrhage ; Herpesvirus 4, Human ; Humans ; Hypertriglyceridemia ; Immunoglobulins ; Immunomodulation ; Infant ; Liver Function Tests ; Lymphohistiocytosis, Hemophagocytic* ; Male ; Medical Records ; Neutropenia ; Refusal to Treat ; Retrospective Studies ; Siblings ; Stem Cell Transplantation ; Thrombocytopenia ; Tissue Donors

BACKGROUND: Both gemcitabine and vinorelbine are effective anticancer drugs with mild toxicity on non-small cell lung cancer, and monotherapy of these drugs are effective as a second-line chemotherapy. The aim of this trial was to assess the response and toxicity of a combination of gemcitabine and vinorelbine in patients of previously treated for non-small cell lung cancer. MATERIALS AND METHODS: 24 patients, initial stage III A/B,IV and previously treated with platinium and taxane based regimens, were enrolled from June 2000 to March 2004. The regimens consisted of vinorelbine 25mg/m2 followed by an infusion of gemcitabine 1000mg/m2 on day 1 and day 8 every three weeks. This course was repeated more than twice. RESULTS: Twenty-four patients were analyzed for the response, survival rate, and toxicities. The overall response was 17% with a complete remission rate of 4%. The median time-to progression (TTP) was 3.1 months (95%, CI 1-10months), and the survival time was 8.2 months (95%, CI 1-23 months). The grade 3/4 toxicities encountered were neutropenia (12.5%), anemia (0%), thrombocytopenia (0%). Non-hematological 3/4 toxicities were not observed. CONCLUSION: A combination of gemcitabine and vinorelbine in patients previously treated for non-small cell lung cancer provides a relatively good response rate, and a low toxicity profile. However, further study will be needed to confirm its effectiveness.
Anemia ; Carcinoma, Non-Small-Cell Lung* ; Drug Therapy* ; Humans ; Neutropenia ; Survival Rate ; Thrombocytopenia