We have recently encountered a case of Kasabach-Merritt syndrome which was characterized by hemangioma, thrombocytopenia, and Disseminated Intravascular Coagulation. The baby was delivered at 35 weeks gestation. A large hemangioma covered right forearm. He received interferon alfa-2a for 120 days after 20 day steroid treatment failure. Blood platelet count increased to acceptable range (>20,000/mm3) after 8weeks of interferon alfa-2alpha treatment and the size of hemangioma decreased.
Disseminated Intravascular Coagulation ; Forearm ; Hemangioma ; Interferons* ; Kasabach-Merritt Syndrome* ; Platelet Count ; Pregnancy ; Thrombocytopenia ; Treatment Failure

Pseudohypoaldosteronism is a disorder in which synthesis of aldosterone is normal but unresponsiveness of the target to the aldosterone activates angiotensin-renin system which in turn elevates levels of renin and aldosterone. This salt-losing syndrome causes life-threatening hyponatremia and hyperkalemia. Despite of the normal renal and adrenal function, due to deficiency of aldosterone function, reabsorption of sodium and excretion of potassium in the kidney is impaired. Sodium loss not only from the kidney but also from sweat gland, salivary gland and colon may occur in some cases. We experienced two cases of pseudohypoaldosteronism in a 3-day-old male and 6-month-old female. The hyponatremia, hyperkalemia, elevation of plasma renin activity and aldosterone concentration were observed without renal and adrenal dysfunction. Brief review and related literatures were also presented.
Aldosterone ; Colon ; Female ; Humans ; Hyperkalemia ; Hyponatremia ; Infant ; Kidney ; Male ; Plasma ; Potassium ; Pseudohypoaldosteronism* ; Renin ; Salivary Glands ; Sodium ; Sweat Glands

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

OBJECTIVE: To determine whether ACE insertion/deletion (I/D) polymorphism is associated with the ossification of the posterior longitudinal ligament (OPLL) of the spine in the Korean population. METHODS: A case-control study was conducted to investigate the association between I/D polymorphism of the angiotensin I converting enzyme (peptidyl-dipeptidase A) 1 (ACE) gene and OPLL. The 95 OPLL patients and 274 control subjects were recruited. Polymerase chain reaction for the genotyping of ACE I/D polymorphism was performed. The difference between the OPLL patients and the control subjects was compared using the contingency chi2 test and the logistic regression analysis. For statistical analysis, SPSS, SNPStats, SNPAnalyzer, and Helixtree programs were used. RESULTS: The genotype and allele frequencies of ACE I/D polymorphism showed significant differences between the OPLL patients and the control subjects (genotype, p<0.001; allele, p=0.009). The frequencies of D/D genotype and D allele in the OPLL group were higher than those in the control group. In logistic regression analysis, ACE I/D polymorphism was associated with OPLL (dominant model; p=0.002; odd ratio, 2.20; 95% confidence interval, 1.33-3.65). CONCLUSION: These results suggest that the deletion polymorphism of the ACE gene may be a risk factor for the development of OPLL in the Korean population.
Alleles ; Angiotensin I* ; Angiotensins* ; Case-Control Studies ; Gene Frequency ; Genotype ; Humans ; Logistic Models ; Longitudinal Ligaments* ; Peptidyl-Dipeptidase A* ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Risk Factors ; Spine

Background: There has been no comparison of the determinants of admission route between acute ischemic stroke (AIS) and acute myocardial infarction (AMI). We examined whether factors associated with direct versus transferred-in admission to regional cardiocerebrovascular centers (RCVCs) differed between AIS and AMI. Methods: Using a nationwide RCVC registry, we identified consecutive patients presenting with AMI and AIS between July 2016 and December 2018. We explored factors associated with direct admission to RCVCs in patients with AIS and AMI and examined whether those associations differed between AIS and AMI, including interaction terms between each factor and disease type in multivariable models. To explore the influence of emergency medical service (EMS) paramedics on hospital selection, stratified analyses according to use of EMS were also performed. Results: Among the 17,897 and 8,927 AIS and AMI patients, 66.6% and 48.2% were directly admitted to RCVCs, respectively. Multivariable analysis showed that previous coronary heart disease, prehospital awareness, higher education level, and EMS use increased the odds of direct admission to RCVCs, but the odds ratio (OR) was different between AIS and AMI (for the first 3 factors, AMI > AIS; for EMS use, AMI < AIS). EMS use was the single most important factor for both AIS and AMI (OR, 4.72 vs. 3.90). Hypertension and hyperlipidemia increased, while living alone decreased the odds of direct admission only in AMI;additionally, age (65–74 years), previous stroke, and presentation during non-working hours increased the odds only in AIS. EMS use weakened the associations between direct admission and most factors in both AIS and AMI. Conclusions Various patient factors were differentially associated with direct admission to RCVCs between AIS and AMI. Public education for symptom awareness and use of EMS is essential in optimizing the transportation and hospitalization of patients with AMI and AIS.