PURPOSE: Ghrelin stimulates the secretion of growth hormone and other pituitary hormones, and has orexigenic effects. It may have a physiologic role in fetal and neonatal growth. Leptin secreted by the adipocytes reflects fat mass in infants as well as adults. The aim of this study was to evaluate the relation of cord blood ghrelin and leptin levels to body weight(BW), body mass index(BMI), insulin-like growth factor-I(IGF-I) and insulin-like growth factor binding protein-3(IGFBP-3) levels in appropriate for gestational age(AGA) newborns. METHODS: Sixty healthy AGA newborns(31 males and 29 females, gestational age[GA] 34-42 weeks) were included in this study, whose BW and BMI were measured at delivery. Umbilical cord venous blood samples were withdrawn, and ghrelin and leptin were measured by radioimmunoassay. Cord blood IGF-I and IGFBP-3 were determined by immunoradiometric assay. RESULTS: The mean levels of ghrelin were inversely correlated with BW(r=-0.29, P<0.05) and GA (r=-0.28, P<0.05), but were not affected by gender. The mean levels of leptin levels showed positive correlation with BW(r=0.44, P<0.01), GA(r=0.36, P<0.01), and BMI(r=0.28, P<0.05). The leptin levels of females were higher than those of males. There was no gender difference in leptin levels in neonates under GA 37 weeks. However, the leptin levels of females were higher than those of males (P<0.01) in newborns with GA 37 weeks or over. There was no correlation between ghrelin and leptin levels. Ghrelin and leptin levels showed no relations to cord blood IGF-I and IGFBP-3 levels. CONCLUSION: These data suggest that cord blood ghrelin may have an inverse correlation with BW in AGA newborns, and leptin levels are positively correlated with BW and fat mass. Further study of ghrelin concentrations in cord blood is necessary to elucidate the physiological and pathological roles of ghrelin during the fetal and neonatal periods.
Adipocytes ; Adult ; Anthropometry* ; Female ; Fetal Blood* ; Gestational Age* ; Ghrelin* ; Growth Hormone ; Humans ; Immunoradiometric Assay ; Infant ; Infant, Newborn* ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Leptin* ; Male ; Pituitary Hormones ; Radioimmunoassay ; Umbilical Cord

OBJECTIVES: We have analyzed the correlation between the House-Brackmann (HB) scale and Facial Nerve Grading System 2.0 (FNGS 2.0) in patients with Bell palsy, and evaluated the usefulness of the new grading system. METHODS: Sixty patients diagnosed with Bell palsy from May 2009 to December 2010 were evaluated using the HB scale and FNGS 2.0 scale during their initial visit, and after 3 and 6 weeks and 3 months. RESULTS: The overall intraclass correlation coefficient (ICC) was 0.908 (P=0.000) and the Spearman correlation coefficient (SCC) was 0.912 (P<0.05). ICC and SCC displayed differences over time, being 0.604 and 0.626, respectively, at first visit; 0.834 and 0.843, respectively, after 3 weeks; 0.844 and 0.848, respectively, after 6 weeks; and 0.808 and 0.793, respectively, after 3 months. There was a significant difference in full recovery, depending on the scale used (HB, P=0.000; FNGS 2.0, P<0.05). The exact agreements between regional assessment and FNGS 2.0 for the mouth, eyes, and brow were 72%, 63%, and 52%, respectively. CONCLUSION: FNGS 2.0 shows moderate agreement with HB grading. Regional assessment, rather than HB grading, yields stricter evaluation, resulting in better prognosis and determination of grade.
Bell Palsy ; Eye ; Facial Nerve ; Humans ; Mouth ; Prognosis

OBJECTIVES: Otitis media (OM) is an infectious disease that affects all age brackets. Aural discharge is a typical symptom, occurring in all subtypes of OM. We have compared the identity and antibiotic sensitivity of bacteria isolated from aural discharges of adults and children with various types of OM, including acute OM (AOM), OM with effusion (OME), chronic OM (COM), and cholesteatomatous OM (CSOM). METHODS: The study involved 2,833 patients who visited five tertiary hospitals between January 2001 and December 2010 and were diagnosed with AOM, OME, COM, or CSOM. The patients were divided into a pediatric group and an adult group, and the distribution of cultured bacteria and their antibiotic sensitivity were compared in the two groups. RESULTS: Bacterial detection rates were higher in adults than in children with OME and COM (P=0.000 each). The majority of the bacteria cultured from patients with AOM and OME bacteria were methicillin-susceptible Staphylococcus aureus (MSSA) and Streptococcus pneumoniae. Bacteria cultured from children were more susceptible to antibiotics (P=0.002) and had higher antibiotic sensitivity (P=0.001) than were bacteria cultured from adults. The majority of bacteria culture from patients with COM and CSOM were MSSA and pathogenic Pseudomonas aeruginosa. The frequency of methicillin-resistant Staphylococcus aureus was significantly higher in adults than in children, and more strains of bacteria isolated from adults were sensitive to the antibiotics septrin, vancomycin, and teicoplanin. CONCLUSION: Bacteria cultured from children were more susceptible to antibiotics and had higher antibiotic sensitivity than did bacteria cultured from adults.
Adult* ; Anti-Bacterial Agents ; Bacteria ; Bacteriology ; Child* ; Communicable Diseases ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Otitis Media* ; Pseudomonas aeruginosa ; Staphylococcus aureus ; Streptococcus pneumoniae ; Teicoplanin ; Tertiary Care Centers* ; Vancomycin ; Trimethoprim, Sulfamethoxazole Drug Combination

BACKGROUND/AIMS: HBeAg-negative chronic hepatitis B (CHB) has a poor long-term prognosis. Since no precise clinically relevant HBV thresholds are known in HBeAg-negative CHB, the decision to treat is difficult. The aim of this study was to evaluate the levels of serum HBV DNA and transaminase and to investigate the correlation of these values in patients with HBeAg-negative CHB. METHODS: The study analyzed the sera from 82 patients with HBeAg-negative CHB, 61 men and 21 women. The mean age was 45 years. The patients were divided into two groups according to serum ALT levels: the patients with lower ALT level (n=52, UNL < ALT < 2 X UNL) and higher level (n=30, ALT >or= 2 X UNL). The level of serum HBV DNA was determined by the Cobas Amplicor HBV Monitor(TM) (Roche). RESULTS: The median serum HBV DNA level was 2.7 X 10(5) copies/mL in patients with HBeAg-negative CHB. The median serum HBV DNA level of patients with a higher ALT level (1.0 X 10(6) copies/mL) was significantly higher than that of patients with a lower ALT level (5.6 X 10(4) copies/mL)(p<0.001). The serum ALT level was correlated with serum HBV DNA levels in patients with HBeAg-negative CHB (r=0.416, p<0.001). The serum level of HBV DNA in patients with cirrhosis (median 2.0 X 10(5) copies/mL) did not differ from patients without cirrhosis (median 4.7 X 10(5) copies/mL). CONCLUSIONS: The level of serum HBV DNA was higher in patients with higher serum ALT level than it was in patients with lower serum ALT, and it was closely correlated with serum ALT levels in HBeAg-negative CHB.
Alanine Transaminase/*blood ; DNA, Viral/*blood ; English Abstract ; Female ; Hepatitis B e Antigens/*blood ; Hepatitis B virus/*genetics/isolation & purification ; Hepatitis B, Chronic/blood/diagnosis/*virology ; Humans ; Lamivudine/*therapeutic use ; Male ; Middle Aged

PURPOSE: This study aimed to evaluate the autonomic imbalance in syncope by comparing the baseline heart rate variability (HRV) between healthy children and those with vasovagal syncope. METHODS: To characterize the autonomic profile in children experiencing vasovagal syncope, we evaluated the HRV of 23 patients aged 7-18 years and 20 healthy children. These children were divided into preadolescent (<12 years) and adolescent groups. The following time-domain indices were calculated: root mean square of the successive differences (RMSSD); standard deviation of all average R-R intervals (SDNN); and frequency domain indices including high frequency (HF), low frequency (LF), normalized high frequency, normalized low frequency, and low frequency to high frequency ratio (LF/HF). RESULTS: HRV values were significantly different between healthy children and those with syncope. Student t test indicated significantly higher SNDD values (60.46 ms vs. 37.42 ms, P=0.003) and RMSSD (57.90 ms vs. 26.92 ms, P=0.000) in the patient group than in the control group. In the patient group, RMSSD (80.41 ms vs. 45.89 ms, P=0.015) and normalized HF (61.18 ms vs. 43.19 ms, P=0.022) were significantly higher in adolescents, whereas normalized LF (38.81 ms vs. 56.76 ms, P=0.022) and LF/HF ratio (0.76 vs. 1.89, P=0.041) were significantly lower in adolescents. In contrast, the control group did not have significant differences in HRV values between adolescents and preadolescents. CONCLUSION: The results of this study indicated that children with syncope had a decreased sympathetic tone and increased vagal tone compared to healthy children. Additionally, more severe autonomic imbalances possibly occur in adolescents than in preadolescents.
Adolescent* ; Child* ; Heart Rate* ; Humans ; Syncope ; Syncope, Vasovagal*

This study evaluated the surgical outcome and complications of phacoemulsification and the implantation of an acryl foldable intraocular lens (IOL) with a squared edge in dogs with cataracts. Thirty-two eyes from 26 dogs were examined. The mean follow up period was 75.9 days ranging from 23 to 226 days. The complications after phacoemulsification were posterior capsular opacity (PCO) around the IOL (n = 11), ocular hypertension (n = 4), focal posterior synechia (n = 4), hyphema (n = 3) and corneal ulcer (n = 2). The complications associated with the IOL were decenteration of the optic (n = 2) and ventral haptic displacement (n = 1). Most cases of PCO were found only around the margin of the IOL, and all eyes had vision during the observation period. In conclusion, the implantation of an acryl-foldable lens with a squared edge at the time of phacoemulsification is an effective method for preserving the central visual field of dogs with cataract.
Animals ; Cataract/*veterinary ; Dog Diseases/*surgery ; Dogs/*surgery ; Female ; Lens Implantation, Intraocular/adverse effects/*veterinary ; Male ; Phacoemulsification/adverse effects/*veterinary ; Retrospective Studies

Acute A viral hepatitis is a mild, self-limiting disease of liver and acute renal failure (ARF) is a rare complication. We report two cases of chronic renal failure (CRF) in nonfulminant acute A viral hepatitis and ARF. A 40-year-old man was admitted with ARF and acute A viral hepatitis, and underwent temporary hemodialysis therapy. The renal biopsy showed acute tubular necrosis with tubulointerstitial nephritis. At 13 months after discharge serum creatinine was 1.33 mg/dL and protein-creatinine ratio of spot urine was 0.47 (mg/mg Cr). The second case was a 28-year-old man and was managed conservatively. At discharge the serum creatinine was 3.14 mg/dL and the urinalysis showed hematuria, and protein-creatinine ratio 0.56 (mg/mg Cr). Thirty-nine months after discharge, the creatinine was 1.23 mg/dL, the urinalysis showed persistent nephritis findings and the protein-creatinine ratio 1.28. Kidney biopsy revealed the membranous glomerulopathy with mild tubulointerstitial nephritis, and all of findings suggested the systemic disease-associated secondary glomerulopathy. To our knowledge our case is the first one of chronic glomerulapathy that is confirmed by kidney biopsy.
Acute Kidney Injury ; Adult ; Biopsy ; Creatinine ; Glomerulonephritis ; Glomerulonephritis, Membranous ; Hematuria ; Hepatitis ; Humans ; Kidney ; Kidney Failure, Chronic ; Liver ; Necrosis ; Nephritis ; Nephritis, Interstitial ; Renal Dialysis ; Urinalysis

BACKGROUND: Altered airway mucosal osmolarity is an underlying mechanism of bronchoconstrictive response to both exercise and hypertonic saline (HS). The purpose of this study was to examine whether the osmotic challenge test using HS could predict the exercise-induced bronchospasm (EIB) in asthma. METHODS: Thirty-six consecutive young male patients with asthma visited Chonnam National Univertisy Hospital underwent bronchial challenge tests using 4.5% HS, exercise (>24 hours later), and methacholine (MCh). The relationship in the responses between HS and exercise was observed in comparison with that between MCh and exercise. RESULTS: The maximal fall in forced expiratory volume in one second following exercise was significantly higher in the HS-responders (n=19) than that in the HS-nonresponders (n=17)(35.9 +/- 4.1% vs. 17.9 +/- 2.7%, p<0.001). There was a significant correlation between the severity of EIB and HS-airway hyperresponsiveness (AHR). Compared with the MCh-AHR test in diagnosing for EIB, the HS-AHR test showed a higher specificity (71.4% vs. 42.9%), but a lower sensitivity (58.6% vs. 89.7%) and a lower negative predictive value (29.4% vs. 50.0%). At the cutoff value for moderate AHR, the MCh-AHR test had specificity comparable with and predictive values higher than those of the HS-AHR test. CONCLUSION: The HS-AHR test was more specific than the MCh-AHR test, but less sensitive and had poor negative predictive value precluding from use of it as a screening test for EIB. The MCh-AHR test at the cutoff value for moderate AHR may be more useful in predicting EIB in asthma.
Asthma ; Asthma, Exercise-Induced ; Bronchial Provocation Tests ; Bronchoconstriction* ; Forced Expiratory Volume ; Humans ; Jeollanam-do ; Male ; Mass Screening ; Methacholine Chloride ; Osmolar Concentration ; Sensitivity and Specificity

BACKGROUND: Changes in airway mucosal osmolarity are an underlying mechanism of bronchoconstrictive responses to exercise and hypertonic saline (HS). The purpose of this study was to examine whether an osmotic challenge test using HS can predict exercise-induced bronchospasm (EIB) in asthma patients. METHODS: Thirty-six young male asthmatic patients underwent bronchial challenge tests based on 4.5% HS, exercise (> 24h later), and methacholine (MCh) at the Chonnam National University Hospital. The relationships between responses to HS and exercise, and between MCh and exercise were evaluated. RESULTS: The maximal fall in forced expiratory volume in one second following exercise was significantly higher in the HS-responders (n=19) than in the HS-nonresponders (n=17, 35.9+/-4.1% vs. 17.9+/-2.7%, p< 0.001), and there was a significant correlation between the severity of EIB and HS-airway hyperresponsiveness (AHR). When compared with the MCh-AHR test in terms of predicting EIB, the HS-AHR test showed higher specificity (71.4% vs. 42.9%), but a lower sensitivity (58.6% vs. 89.7%) and negative predictive value (29.4% vs. 50.0%). At the moderate AHR cutoff value, the MCh-AHR test had a specificity that was comparable with and predictive values that were higher than those of the HS-AHR test. CONCLUSIONS: The HS-AHR test was more specific than the MCh-AHR test, but was less sensitive and had a poorer negative predictive value, which in combination preclude the use of the HS-AHR test as a screening tool for EIB. The MCh-AHR test had a cutoff value for moderate AHR that may be more useful for predicting EIB in asthmatic patients.
Saline Solution, Hypertonic/*diagnostic use ; Predictive Value of Tests ; Methacholine Chloride/diagnostic use ; Male ; Humans ; Bronchoconstrictor Agents/diagnostic use ; Bronchial Provocation Tests/*methods ; Bronchial Hyperreactivity/*diagnosis ; Asthma, Exercise-Induced/*diagnosis ; Adult ; Adolescent

BACKGROUND: This study aimed to evaluate the quality of surgical antibiotic prophylaxis (SAP) in a tertiary hospital. METHODS: Medical, anesthetic, and nursing records from the 27,320 procedures conducted in a tertiary hospital during 2012 were retrospectively reviewed. Three clinical performance indicators of SAP (selection of antibiotic, timing of the first administration, duration of prophylaxis) were included as part of the National Hospital Evaluation Program (NHEP) of the Health Insurance Review and Assessment Service. In addition, 2 other parameters were assessed according to recent guidelines (weight-based initial dosing for obesity, intraoperative re-dosing for excessive blood loss, and prolonged duration of procedures). RESULTS: Prophylactic antibiotics were administered in 19,637 (71.8%) of 27,320 total procedures. Quality of the 3 performance indicators was higher in the types of operations included in NHEP than in other procedures. However, additional doses were administered in 15 (1.2%) of 1,299 surgical procedures that lasted more than twice the half-life of the antibiotic used, and in 9 (3.3%) of 273 procedures with excessive blood loss greater than 1,500 mL. NHEP and non-NHEP results did not differ significantly. CONCLUSION: Three SAP quality indicators showed more improvement in NHEP surgical procedures than in non-NHEP, but the other parameters did not perform well regardless of NHEP assessment. Therefore, more measures to improve the appropriateness of SAP should be developed.
Anti-Bacterial Agents ; Antibiotic Prophylaxis* ; Half-Life ; Insurance, Health ; Nursing Records ; Obesity ; Quality Indicators, Health Care ; Retrospective Studies ; Tertiary Care Centers*