PURPOSE: Steroids have anti-inflammatory effects which reduces inflammation and edema of the tissue. Thus, corticosteroids have been used for treatment of croup. The aim this study is to compare and assess the effects of intramuscularly injected dexamethasone and nebulized budesonide in treatment of moderate or severe croup. METHODS: Between July 1995 to June 1996, we have assessed 44 inpatients with croup syndrome, of which 20 patients have been treated by intramuscularly injected dexamethasone and 24 patients by nebulized budesonide. We measured the croup symptom scores and arterial oxygen saturation at initial, at 4 hours, 12 hours and 24 hours after treatment. RESULTS: The sex ratio and mean age of patients were 2.3:1 and 18.7 +/- 9.1 months in budesonide treatment group and 3:1 and 22.3 +/- 13.1 months in dexamethasone treatment group, respectively. There was no significant difference (P>0.05) among the two groups. In budesonide treatment group, the symptom scores were 7.5 +/- 4.5 at initial and 4.5 +/- 1.3 at 4 hours after treatment. These were statistically significant (P<0.005). In the dexamethansone treatment group, the symptom scores were 7.6 +/- 1.2 at initial and 5.1 +/- 1.2 at 4 hours after treatment. They were statistically significant (P<0.005). Arterial oxygen saturations were significantly different (P<0.005) between initial and 4 hours after treatment in both groups. There were no side effects in the budesonide treatment group. CONCLUSION: Nebulized budesonide has the same effects with intramuscularly injected dexamethasone in treatment of croup whether the severity is moderate or extreme. Therefore it should provide an effective means of treatment for moderate or severe croup patients without systemic side effects.
Adrenal Cortex Hormones ; Budesonide* ; Croup* ; Dexamethasone* ; Edema ; Humans ; Inflammation ; Inpatients ; Oxygen ; Sex Ratio ; Steroids

BACKGROUNDS: Standardization of nucleic acid amplification techniques (NAT) which can be achieved by the use of standard to validate reproducibility and sensitivity in each assay run is necessary before the introduction of such methods for routine screening of blood and blood products for viral contaminants. The objective of this study was to analyze the serological and genotypic characteristics of HCV positive plasmas and to manufacture the HCV RNA national standard candidate. METHODS: We obtained three plasmas from Blood Transfusion Research Institute, Korea, with highly positive HCV RNA plasmas (#37, #40, #46) and with normal plasma for dilution. All the plasmas were confirmed by enzyme immunoassay (EIA) test for anti-HIV, HBsAg, anti-HCV and by polymerase chain reaction(PCR) for HBV DNA, HIV RNA, HCV RNA. The genotypes of those were confirmed by INNO-LiPA HCV II. HCV RNA national standard candidate was manufactured by dispensing the diluted plasma into about 2,000 vials. Each vial was rapidly frozen using liquid nitrogen and was kept in refrigerator at -70 degrees C. RESULTS: All plasmas were identified as anti-HIV, HBsAg, HBV DNA, and HIV RNA negative plasmas. The genotypes of those were confirmed as 1b for #37, 1b or 2 for #40 and 2a or 2c for #46, respectively. Sample #37 was selected as the candidate material. After manufacturing, we obtained 1,944 vials for the candidate. CONCLUSION: In this study, we analyzed HCV positive plasmas and manufactured the HCV RNA national standard candidate. In near future, this material would be established for national standard to increase in the safety of blood and blood products in Korea.
Academies and Institutes ; Blood Transfusion ; DNA ; Genotype ; Hepacivirus ; Hepatitis B Surface Antigens ; HIV ; Immunoenzyme Techniques ; Korea ; Mass Screening ; Nitrogen ; Nucleic Acid Amplification Techniques ; Plasma* ; RNA*

OBJECTIVE: The aim of this study was to examine whether polymorphic variation in GSTs confers susceptibility to Endometriosis in Korean populations. METHODS: The GSTM1, GSTT1, and GSTP1 genotypes were determined in 124 patients with Endometriosis (stage 3, 4) and 155 healthy control subjects at Ewha woman's university Mok-dong hospital from 1996 to 2003. RESULTS: The homozygous wild allele in GSTP1 gene was most common genotypes both Endometriosis and healthy control groups (69.4% vs. 64.5%). Neither the heterozygous nor homozygous mutant allele in GSTP1 gene differed in frequency between the two groups (30.6% vs 35.5%). When null mutations in GSTM1, GSTT1 were combined with GSTP1 polymorphism, there was no evidence of increase in the risk of endometriosis, as the number of high risk alleles of the GST family increased. CONCLUSION: Our findings suggest that GSTP1 genetic polymorphism may not be associated with development of Endometriosis in Korean populations. There is no evidence of a trend in increasing risk with the number of putative high risk alleles of the GST family carried.
Alleles ; Endometriosis* ; Female ; Genotype ; Humans ; Polymorphism, Genetic*

Treatment modalities for lower gastrointestinal bleeding are thermal methods, injections, and mechanical devices. Every methods have advantages and disadvantages. The width of selection for the patients with risk factors (liver disease, coagulopathy, or ingestion of anticoagulant or NSAID) is narrow. We experienced a patient with severe bleeding from a sigmoid colonic huge mass. He had hepatic encephalopathy and bleeding tendency associated with liver cirrhosis. Endoscopic ligation using detachable snare was performed successfully. Fortunately, the patient was recovered from hepatic encephalopathy and had a good chance for liver transplantation.
Colon, Sigmoid* ; Eating ; Hemorrhage* ; Hepatic Encephalopathy ; Humans ; Ligation ; Liver Cirrhosis* ; Liver Transplantation ; Liver* ; Risk Factors ; SNARE Proteins*

Among the bronchogenic carcinomas, especially squamous cell carcinoma and large cell carcinoma frequently present with cavitation, which may result from tumor necrosis. Cavitary lesions of the tumor are occasionally associated with infection and misdiagnosed as benign lung abscess owing to the partial responsiveness to antibiotics. It is very difficult to distinguish the carcinomatous abscess from the benign lung abscess, because of their similar clinical and radiologic features. Delay in diagnosis of underlying lung cancer may result in poor outcome. Therefore, clinicians should remember that the patients with highly suspicious carcinoma of the lung should undergo further precise examinations to find out malignant cells.
Abscess ; Anti-Bacterial Agents ; Carcinoma, Bronchogenic ; Carcinoma, Large Cell ; Carcinoma, Squamous Cell ; Humans ; Liver Abscess ; Lung ; Lung Abscess ; Lung Neoplasms ; Necrosis

PURPOSE: To date, the risk factors for central venous port-related bloodstream infection (CVP-BSI) in solid cancer patients have not been fully elucidated. We conducted this study in order to determine the risk factors for CVP-BSI in patients with solid cancer. MATERIALS AND METHODS: A total of 1,642 patients with solid cancer received an implantable central venous port for delivery of chemotherapy between October 2008 and December 2011 in a single center. CVP-BSI was diagnosed in 66 patients (4%). We selected a control group of 130 patients, who were individually matched with respect to age, sex, and catheter insertion time. RESULTS: CVP-BSI occurred most frequently between September and November (37.9%). The most common pathogen was gram-positive cocci (n=35, 53.0%), followed by fungus (n=14, 21.2%). Multivariate analysis identified monthly catheter-stay as a risk factor for CVP-BSI (p=0.000), however, its risk was lower in primary gastrointestinal cancer than in other cancer (p=0.002). Initial metastatic disease and long catheter-stay were statistically significant factors affecting catheter life span (p=0.005 and p=0.000). Results of multivariate analysis showed that recent transfusion was a risk factor for mortality in patients with CVP-BSI (p=0.047). CONCLUSION: In analysis of the results with respect to risk factors, prolonged catheter-stay should be avoided as much as possible. It is necessary to be cautious of CVP-BSI in metastatic solid cancer, especially non-gastrointestinal cancer. In addition, avoidance of unnecessary transfusion is essential in order to reduce the mortality of CVP-BSI. Finally, considering the fact that confounding factors may have affected the results, conduct of a well-designed prospective controlled study is warranted.
Case-Control Studies* ; Catheter-Related Infections ; Catheters ; Drug Therapy ; Fungi ; Gastrointestinal Neoplasms ; Gram-Positive Cocci ; Humans ; Mortality ; Multivariate Analysis ; Risk Factors*

BACKGROUND/AIMS: Pneumatic dilation is the most effective non-surgical treatment option for the patients with achalasia. The aim of this study was to determine the predictors of outcome after pnematic dilation in patients with primary achalasia. METHODS: Thrity-five patients with primary achalasia between May 1996 and April 2001 were included. They were divided into two groups; responder and nonresponder. Esophageal manometry, scintigraphy and barium esophagogram was performed before dilation and 4 weeks after dilation. RESULTS: Seven patients having symptomatic relapse were treated with repeated pneumatic dilation. Remaining 28 patients (83%) had no recurrence during follow-up period (mean duration 16 month, range 6~43 month). Among the factors evaluated in the initial examination, only young age affected outcome (p=0.039). The post treatment retention fraction at 5, 20 minutes were the most valuable factors for predicting the clinical response (p<0.05). CONCLUSIONS: Older patients are more likely to have sustained response. Radionuclide esophageal emptying test remains a useful objective study evaluating esophageal transit before and after pneumatic dilation in the patients with achalasia and may have an important role in the follow-up evaluation of treatment for achalasia.
Barium ; Esophageal Achalasia* ; Follow-Up Studies ; Humans ; Manometry ; Radionuclide Imaging ; Recurrence

Pancreatic ascites is an exudative which is an amylase-rich accumulation of intraperitoneal fluid and occurs in association with rupture of a pseudocyst or disruption of the pancreatic duct. Characteristically the patient presents with increasing abdominal girth, weight loss, and varying degrees of abdominal pain. Conservative medical management, including withholding of oral feeding, total parenteral nutrition, and large volume paracentesis has led to successful resolution of pancreatic ascites in less than 50% of cases. Recently octreotide injection and endoscopic transpapillary pancreatic duct stenting have made a major impact on the conservative treatment of pancreatic ascites. We describe the case of a patient with chronic pancreatitis and pancreatic ascites who was treated by endoscopic pancreatic duct stenting and octreotide injection.
Abdominal Pain ; Ascites* ; Humans ; Octreotide* ; Pancreatic Ducts* ; Pancreatitis, Chronic ; Paracentesis ; Parenteral Nutrition, Total ; Rupture ; Stents* ; Weight Loss

BACKGROUND: There have been few clinical studies on 10 mg atorvastatin as a starting dosage for treatment of hypercholesterolemia in type 2 diabetes mellitus (T2DM) patients. This retrospective study aims to evaluate the efficacy of 10 mg dosage of atorvastatin in clinical setting. METHODS: One hundred five enrolled patients with high levels of low density lipoprotein cholesterol (LDL-C, > 100 mg/dL) took 10 mg atorvastatin. After 6 months, they were divided into 'Responder group' (LDL-C < 100 mg/dL) and 'Non-responder group' (LDL-C > or = 100 mg/dL), and the response rate was calculated. Thereafter, we subdivided the 'Responder group' into Maintenance (10 mg), Reduced dosage (5 mg), and Discontinuance group (0 mg). The 'Non-Responder group' was subdivided into Maintenance (10 mg) and Double dosage group (20 mg). After consecutive 6 months, the response rates of each 10 mg Maintenance groups were compared to those of the other groups, respectively. RESULTS: Following the first 6 months, the response rate of 10 mg fixed dosage was 74.3%. In the 'Responder group', response rates of 10 mg, 5 mg and Discontinuance groups following 6 months were 52.6%, 53.1%, and 12.5%, respectively. In the 'Non-responder group', response rates of 10 mg and 20 mg groups were 28.6% and 50.0%. Baseline LDL-C levels and body mass index (BMI) of 'Responder group' were significantly lower than those of 'Non-responder group' (P = 0.004, respectively). CONCLUSION: Hypercholesterolemia treatment with 10 mg, fixed dosage of atorvastatin was effective in three quarters of the subjects during the first 6-month treatment; however, a significant number of patients with high LDL-C levels and/or BMI require higher starting and maintenance dosage.
Body Mass Index ; Cholesterol ; Cholesterol, LDL ; Diabetes Mellitus, Type 2 ; Heptanoic Acids ; Humans ; Hypercholesterolemia ; Lipoproteins ; Pyrroles ; Retrospective Studies ; Atorvastatin Calcium

No abstract available.
Diabetes Mellitus, Type 2 ; Heptanoic Acids ; Humans ; Hypercholesterolemia ; Pyrroles ; Retrospective Studies ; Atorvastatin Calcium