PURPOSE: This study was conducted to evaluate the association between H. pylori infection and socioeconomic status and to determine the current prevalence of H. pylori infection in Korean adolescents. METHODS: A structured questionnaire was sent to the children's parents to obtain demographic information on the parents and environmental information. Of the 532 questionnaires sent out, 375 (70.5%; 170girls and 205boys) were returned. Their ages ranged from 10 to 15 years (mean, 12.9 years). After collecting blood samples, we measured serum IgG antibody to H. pylori using ELISA method. The association of risk factors such as age, sex, socioeconomic class, type of house, and crowding index with H. pylori infection were analyzed by multiple regression analysis. Socioeconomic status was estimated from the parents'education and occupation using a modified Hollingshead index. RESULTS: The prevalence rate of H. pylori infection was 16.8% (63/375). It increased with age (10.3% at 10~11 years, 15.9% at 12~13 years, and 20.7% at 14~15 years). The H. pylori infection was inversely related to the socioeconomic class (6.3% for the upper class, 16.0% for the middle class, and 20.0% for the lower class). Crowding condition and type of house did not affect significantly on seroprevalence of H. pylori infection. After logistic regression, we found that the odds ratio for age was 2.2 (95% confidence interval 0.9~5.4), and for socioeconomic status, 3.6 (95% confidence interval 0.5~28.9). CONCLUSION: The prevalence of H. pylori infection in Korean adolescents was 16.8%. It related inversely to socioeconomic status but was not statistically significant. Socioeconomic status based on parents' education and occupation seemed to affect more on H. pylori seroprevalence than crowding or type of house did.
Adolescent* ; Crowding ; Education ; Enzyme-Linked Immunosorbent Assay ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G ; Logistic Models ; Occupations ; Odds Ratio ; Parents ; Prevalence ; Surveys and Questionnaires ; Risk Factors ; Seroepidemiologic Studies ; Social Class*

Previous reported ocular complications of interferon alfa administration are extremely rare. These include oculomotor palsy, corneal allograft rejection, retinal hemorrhage and cotton wool patches. A 15-year-old boy with chronic hepatitis B was treated with interferon alpha for six months, and then developed glaucoma. After the interferon therapy had been discontinued the glaucoma improved. Accordingly, we report a case of glaucoma development during the course of interferon alpha therapy for chronic hepatitis B.
Adolescence ; Case Report ; Glaucoma/chemically induced* ; Hepatitis B, Chronic/drug therapy* ; Human ; Interferon-alpha/adverse effects* ; Male

No abstract available.
Arteriovenous Malformations*

PURPOSE: Previously reported ocular complications of interferon alfa administration are extremely rare. We experienced a 15-year-old boy with chronic hepatitis B who developed glaucoma after interferon alfa therapy. The purpose of this prospective study was to evaluate the possible development of glaucoma after interferon alfa therapy for chronic hepatitis B. METHODS: Nine patients with chronic hepatitis B who visited Inha university hospital between February 1998 and July 1999 received interferon alfa therapy. We measured visual acuity, intraocular pressure, C/D ratio, and visual field examination at pre-interferon therapy, three and six months after therapy, respectively. RESULTS: The total number of patients was 9 (4 boys and 5 girls). Mean age was 11.7±4.1 years. The duration of therapy was 6 months and mean dosage of interferon was 5 million units. Compared with visual acuity, intraocular pressure, and C/D ratio at pre-therapy, those parameters at 3 months and 6 months after therapy showed no significant differences and none showed visual field defect after therapy. CONCLUSION: Our prospective study showed no evidence of development of glaucoma after interferon therapy. However, it is necessary to be concerned about the possibility of developing glaucoma or other ophthalmologic diseases after interferon therapy in chronic hepatitis B.
Adolescent ; Glaucoma ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Interferon-alpha ; Interferons ; Intraocular Pressure ; Male ; Prospective Studies ; Visual Acuity ; Visual Fields

Familial adenomatous polyposis(FAP) is an autosomal dominant disease characterized by numerous adenomas in the colorectum. Patients with FAP are always at risk of malignant transformation, so that colectomy is unavoidable. NSAID, such as sulindac, and selective COX-2 inhibitor, such as celecoxib, have shown a positive effect on FAP by causing polyp regression in some patients. We report a case of FAP in a 9-year-old female whose polyposis regressed markedly after six months-treatment with celecoxib.
Adenoma ; Adenomatous Polyposis Coli* ; Child* ; Colectomy ; Female ; Humans ; Polyps ; Sulindac ; Celecoxib

PURPOSE: Antivenin is a standard therapy in snakebite victims. While the required antivenin dose can be easily estimated, based on the initial symptoms, this strategy may be unsuccessful if the initial symptoms progressively worsen. The purpose of this study was to identify the progression rate of the initial symptoms following snakebite and its associated factors. METHODS: The medical records of 44 patients treated for snakebite from give the actual dates of the study period were retrospectively examined. Thirty-two of these patients were enrolled. Demographic data, local wound grade and local effect score at initial presentation (G-0 and LES-0, respectively) and 12 hours after admission (G-12 and LES-12, respectively) were reviewed, along with laboratory data. RESULTS: The 32 patients had an average age of 54.0+/-14.5 years and were predominantly male (n=26) and presented mainly during summer. Compared to G-0 and LES-0, re-evaluated G-12 and LES-12 were significantly increased despite initial administration of proper antivenin dosage (p=0.001 and p=0.000, respectively). Total amounts of antivenin correlated with LES-12 (correlation co-efficiency 0.558, p<0.05). However, factors associated with symptom progression were not revealed. CONCLUSION: Initial snakebite symptoms might progressively worsen within hours despite acceptable initial antivenin therapy. Therefore, re-evaluation within several hours must be considered if when the initial snakebite symptoms are minimal or mild.
Antivenins ; Chronology as Topic ; Disease Progression ; Humans ; Male ; Medical Records ; Retrospective Studies ; Snake Bites

Intestinal neuronal dysplasia(IND) is a disease characterized clinically by symptoms of intestinal obstruction and pathologically by hyperplasia of the submucosal and myenteric plexuses with formation of giant ganglia. Chronic intestinal pseudo-obstruction is a clinical diagnosis, composed of myopathic form and neuropathic form, and normal intestinal histology. Intestinal neuronal dysplasia is a neuropathic form of chronic intestinal pseudo-obstruction. The clinical presentation and the course of IND is very variable. We experienced a case of intestinal neuronal dysplasia in a 5 year-old boy who had suffered from recurrent abdominal pain and vomiting for 3 years. Small bowel series showed multiple intestinal dilatations and delayed excretion of contrast media. He underwent exploratory laparotomy. However no mechanical causes for markedly dilated intestine were found and he received loop ileostomy. However, he suffered from recurrent vomiting and abdominal pain. So, he received repair-operaton. The pathology of surgical specimen showed hyperplasia of the submucosal and myenteric plexuses with giant ganglia. We report this case with a brief review of the related literatures.
Abdominal Pain ; Child, Preschool ; Contrast Media ; Diagnosis ; Dilatation ; Ganglia ; Humans ; Hyperplasia ; Ileostomy ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction ; Intestines ; Laparotomy ; Male ; Myenteric Plexus ; Neurons* ; Pathology ; Vomiting

Wilson's disease is a treatable autosomal recessive inherited disorder of copper metabolism due to mutation of the copper transporting gene. The basic strategy of treatment is to reduce the amount of copper in the liver and other tissues by administering both a low copper diet and copper-chelating agents. D-penicillamine is the first choice as a copper-chelating agent. Some serious side effects could occur in 3~5% of all patients following D-penicillamine therapy. We report a 19 year-old male with Wilson's disease who developed nephrotic syndrome 6 months after the initiation of D-penicillamine therapy. Prednisolone was administered to control nephrotic syndrome and D-penicillamine was switched to trientine. Urinary remission was achieved within a week and maintained thereafter. Nephrotic syndrome was proven to be MCNS by kidney biopsy.
Biopsy ; Copper ; Diet ; Hepatolenticular Degeneration* ; Humans ; Kidney ; Liver ; Male ; Metabolism ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Penicillamine* ; Prednisolone ; Trientine ; Young Adult

BACKGROUND AND OBJECTIVES: Modern endoscopes provide a direct access into the hidden recesses of the middle ear using a minimally invasive approach. The authors employed endoscopes in a transcanal tympanoplasty and analyzed the results for the further application of these endoscopic procedures to various otologic surgeries. MATERIALS AND METHOD: 15 ears with chronic otitis media and 2 ears with congenital cholesteatoma were operated under local anesthesia using 2.7 mm and 4 mm rigid endoscopes, a camera, and a monitor. RESULTS: The structures in the posterior tympanum were directly visualized with 0 endoscope in all cases without removal of the overlying bone. The attic was visualized with 70 endoscope after removal of the incus. 15 tympanoplasties were performed in 14 cases of chronic otitis media and in 1 congenital cholesteatoma. Staged tympanoplasties were performed for the other 2 cases. The intraoperative aid postoperative courses were uneventful in all cases. All cases showed closure of' the perforation and 15 cases showed favorable hearing results postoperatively. CONCLUSION: The endoscopes directly visualized the structures in the posterior tympanum and the transcanal endoscopic tympanoplasties showed closure of the perforation and favorable hearing results postoperatively. With the employment of these endoscopes, minimally invasive otologic surgeries will be possible on the ears with narrow canal, adhesive otitis, ossicular abnormalities, and other abnormalities.
Adhesives ; Anesthesia, Local ; Cholesteatoma ; Ear ; Ear, Middle ; Employment ; Endoscopes ; Hearing ; Incus ; Otitis ; Otitis Media ; Tympanoplasty*

PURPOSE: Procalcitonin (PCT) is a good marker of infection but is still not routinely used. Here, we assessed the usefulness of a semi-quantitative procalcitonin test kit (PCT-Q(R)), a rapid and simple test for evaluating sepsis in the emergency department. METHODS: We recruited 80 patients who visited the emergency center and with systemic inflammatory response syndrome (SIRS). Patients were classified into 4 groups according to PCT levels using PCT-Q[Ed-Trademark signs only have to be given one time in a document]. Mortality rate, bacteremia, severity score, and severity of sepsis (SIRS/sepsis/severe sepsis/septic shock) were assessed with the criteria of the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference. We calculated a receiver operating characteristic curve (ROC curve), cut-off value, and the related diagnostic parameters of each cut-off value. RESULTS: Higher PCT levels were significantly associated with increased mortality, bacteremia, and severity scores. PCT levels could discriminate between sepsis and severe sepsis at a threshold of 2 ng/ml. CONCLUSION: PCT-Q is a prognostic marker of infectious disease, but low levels do not always indicate a good prognosis. PCT levels increase with aggravation of sepsis, especially at values greater than 2 ng/ml for severe sepsis.
Bacteremia ; Calcitonin ; Communicable Diseases ; Consensus ; Critical Care ; Emergencies ; Emergency Medicine ; Humans ; Prognosis ; Protein Precursors ; Reagent Strips ; ROC Curve ; Sepsis ; Systemic Inflammatory Response Syndrome ; Thorax