PURPOSE: This study was conducted to analyze the change in the obesity index in girls receiving a gonadotropin-releasing hormone agonist (GnRHa), based on treatment duration, and to aid in nutritional counseling by investigating dietary habits and lifestyle. METHODS: Anthropometric examinations were conducted on 62 girls treated with GnRHa from January 2010 through July 2014. Parents were asked to fill out questionnaires on patient dietary habits and lifestyle. RESULTS: The group taking GnRHa for over 1 year had a higher rate of obesity increase than the group taking GnRHa for less than 1 year, but they had common habits related to obesity, which should be corrected. In addition, 69.2% of the normal weight group taking GnRHa for over 1 year gained weight, and needed more intensive programs, which include physical exercise and nutritional education. Although girls with precocious puberty showed a decrease in the intake of high-calorie foods with nutritional intervention regardless of treatment duration, they still had problems that needed improvement, such as shorter meals and lack of exercise. CONCLUSION: Girls with precocious puberty and their parents should emphasize maintenance of proper body weight, especially when treatment for over 1 year is anticipated. Consistent education in nutrition, ways to increase intensity and duration of physical activity, and the need to slow down mealtimes are important in managing obesity; doctors need to perform regular checkups and provide nutritional counseling.
Body Weight ; Counseling ; Education ; Exercise ; Female* ; Food Habits* ; Gonadotropin-Releasing Hormone ; Humans ; Life Style* ; Meals ; Motor Activity ; Obesity ; Parents ; Puberty, Precocious*

Although an association of Kawasaki disease (KD) with infectious agents has been suggested, none have been proven to cause KD. In this case study, we present a case of KD with concurrent onset of influenza and Mycoplasma pneumoniae (MP) infections. A 27-month-old boy presented with prolonged fever, cough, and rhinorrhea. During the initial testing, influenza A infection was identified, and he was treated with oseltamivir. Despite the antiviral therapy, the fever persisted, and he had cervical lymph node enlargement, bilateral conjunctival injection, fissured red lips, strawberry tongue, and erythematous skin lesions on the Bacillus Calmette-Guérin vaccination site. Thus, the patient was diagnosed with KD and was treated with intravenous immunoglobulin (IVIG). The result of the initial antimycoplasma immunoglobulin M (IgM) antibody testing and was positive, and an increased IgM titer from baseline was found in a repeat test. We reviewed the hypotheses on pathogens known to be associated with KD and the etiology of KD. Based on our findings, we suspect that symptoms of KD and coronary artery lesions can occur from various infections besides those caused by Mycoplasma species and influenza viruses.
Bacillus ; Child, Preschool ; Coronary Vessels ; Cough ; Fever ; Fragaria ; Humans ; Immunoglobulin M ; Immunoglobulins ; Influenza A virus* ; Influenza, Human* ; Lip ; Lymph Nodes ; Male ; Mucocutaneous Lymph Node Syndrome* ; Mycoplasma pneumoniae* ; Mycoplasma* ; Orthomyxoviridae ; Oseltamivir ; Pneumonia, Mycoplasma* ; Skin ; Tongue ; Vaccination

Neoplasm from the accessory parotid glands (APG) rarely occurs, and its malignancy rate is higher than other salivary glands. The B-cell lymphoma from APG is rare, with less than 2% of all malignancy in APG. The mucosa-associated lymphoid tissue (MALT) lymphoma, a subtype of B-cell lymphoma, tends to be a localized disease with an indolent clinical course. It is very rare for MALT lymphoma to develop bilaterally in the APG and the parotid glands without an autoimmune disease. A 43-year-old male presented with superficial masses in the bilateral infra-zygomatic regions, and was pathologically confirmed as MALT lymphoma by excisional biopsy. We report this very rare and interesting case with a brief literature review.

BACKGROUND: Home therapy has merits, enabling rapid treatment thereby reducing complications, but difficulty with venous access is a barrier to treatment. There is a paucity of data on this. This study investigated the current status of home therapy for patients with hemophilia, and examined problems and potential solutions.METHODS: Patients and their families who were performing home therapy and who attended the camp of the Korea Hemophilia Association in 2014 were asked to complete questionnaires. The questionnaires pertained to complications of infusion and whether (or not) factor infusion was properly performed. Responses were scored on a scale from 1-5, with a high frequency of complications and adequate performance of infusion being allocated relatively higher scores.RESULTS: The mean score of complications arising from infusion was 1.56±0.46. This was relatively low and was not correlated with the factor infusion training method. The performance of home therapy obtained a relatively high score: 4.46±0.56. The performance score was significantly higher for patients who had practiced infusion with medical personnel, an injection simulator or a video clip.CONCLUSION: Although most patients properly performed home therapy, further improvement is needed in training of infusion and keeping records of bleeds. It is essential to establish guidelines on home therapy, develop a standardized patient and family training program, and reinforce the role of hemophilia treatment centers in educating patients and their families.
Education ; Hemophilia A ; Humans ; Korea ; Methods

Central neurogenic hyperventilation (CNH) is a rare condition that characterized by an increase in the rate and depth of respiration to an extent that produces advanced respiratory alkalosis due to various central nervous disorder. The mechanism of CNH remains unclear. We reported a case of CNH in patients with progressive ischemic stroke in pons, including parabrachial nucleus, which is thought to have disrupted inhibitory impulses to the medullary respiratory center.

Central neurogenic hyperventilation (CNH) is a rare condition that characterized by an increase in the rate and depth of respiration to an extent that produces advanced respiratory alkalosis due to various central nervous disorder. The mechanism of CNH remains unclear. We reported a case of CNH in patients with progressive ischemic stroke in pons, including parabrachial nucleus, which is thought to have disrupted inhibitory impulses to the medullary respiratory center.

Central neurogenic hyperventilation (CNH) is a rare condition that characterized by an increase in the rate and depth of respiration to an extent that produces advanced respiratory alkalosis due to various central nervous disorder. The mechanism of CNH remains unclear. We reported a case of CNH in patients with progressive ischemic stroke in pons, including parabrachial nucleus, which is thought to have disrupted inhibitory impulses to the medullary respiratory center.

Central neurogenic hyperventilation (CNH) is a rare condition that characterized by an increase in the rate and depth of respiration to an extent that produces advanced respiratory alkalosis due to various central nervous disorder. The mechanism of CNH remains unclear. We reported a case of CNH in patients with progressive ischemic stroke in pons, including parabrachial nucleus, which is thought to have disrupted inhibitory impulses to the medullary respiratory center.

PURPOSE: Urinary tract infection (UTI) is a common disease in the emergency department (ED). In general, UTI could be treated easily without complication. However, UTI with bacteremia can progress to sepsis or severe sepsis and delay of appropriate treatment can result in worse prognosis. Increased serum procalcitonin level in the bacterial infection of ED patients has been proven. The purpose of this study is to examine the clinical utility of procalcitonin as a predictor for bacteremia in UTI patients in the ED setting. METHODS: This is a retrospective cohort study. UTI Patients admitted through the ED of three academic teaching hospitals from January 2010 to December 2012 were enrolled. We investigated demographic characteristics, hemodynamic variables, and laboratory results including serum procalcitonin level at presentation to the ED according to the presence of bacteremia. ROC curve was obtained and multivariate regression analysis was performed to test the predictive value of serum procalcitonin level for bacteremia in UTI patients. RESULTS: A total of 334 patients were enrolled. Bacteremia was proven in 135 UTI patients. UTI patients with bacteremia had significantly higher serum level of procalcitonin (0.830 vs. 6.860, p<0.0001). In multivariable logistic regression analysis, level of procalcitonin and platelet count showed statistical significance (Odds Ratio=1.018, (1.007-1.028), 0.995, (0.992-0.998), 95% CI). Area under the curve for procalcitonin was 0.729, and cut off value was 2.52 ng/ml. CONCLUSION: Serum procalcitonin level could be used as a valuable predictor for the presence of bacteremia in UTI patients visiting the ED.
Bacteremia* ; Bacterial Infections ; Calcitonin ; Cohort Studies ; Emergency Service, Hospital ; Hemodynamics ; Hospitals, Teaching ; Humans ; Logistic Models ; Platelet Count ; Prognosis ; Retrospective Studies ; ROC Curve ; Sepsis ; Urinary Tract Infections*

BACKGROUND: For the effective management of hypertension, drug adherence and life style modification are important. We investigated the effects of mobile phone text-message reminders on compliance and life style modification in patients with hypertension. METHODS: The study was performed at family medicine outpatient clinics at 15 hospitals in South Korea from July 2008 to June 2010. Study subjects included 1,449 patients who were all prescribed candesartan cilexetil. Patients were randomly divided into two groups- mobile phone text-message reminder group and control group. In the reminder group, contents of text messages were recommendations for antihypertensive adherence, exercise, low salt diet, and reduction of weight and alcohol. In the control group, the date of next visit was sent at 10 week. Mobile phone text-messages were sent at 2, 4, 6, 8 and 10 weeks by the coordinating center. Thereafter, they were followed up for 12 weeks. Chi-square test was performed to compare compliance and performance indexes of the two groups. RESULTS: The reminder group had 719 (49.6%) patients vs. 730 (50.4%) patients in the control group. Attendance rate were 92.8% for the reminder group and 94.7% for the control group (P=0.14). 94.7% of the reminder group and 94.0% of the control group took their medication regularly (P=0.59). The target blood pressure was attained in 75.8% of the reminder group and 75.4% of the control group (P=0.87). Similarly, rates of weight loss, decreased alcohol use, increased physical activity and a low salt diet showed no significant differences between the two groups. CONCLUSIONS: In our study, mobile phone text reminders did not show to have any significant positive effect on the management of hypertension.
Ambulatory Care Facilities ; Blood Pressure ; Cellular Phone* ; Compliance* ; Diet ; Humans ; Hypertension ; Korea ; Life Style ; Motor Activity ; Text Messaging ; Weight Loss