Background: Hearing loss (HL) in children may adversely affect their development. HL is more prevalent in patients with chronic kidney disease (CKD) than in the general population.This study evaluated the prevalence of HL and its underlying diseases in patients with childhood-onset in CKD. Methods: In this retrospective study of a tertiary referral center, childhood-onset CKD patients (stage 2–5, age at onset of renal symptom < 18 years) were recruited. We referred to the “renal” syndromic HL as cases with genetic or syndromic diseases, or extra-renal anomalies in addition to HL and CKD. Results: A total of 421 patients (male:female = 279:142) were reviewed according to the causes of CKD: congenital anomalies of the kidney and urinary tract (CAKUT; n = 184, 43.7%), glomerulopathies (GP; n = 105, 24.9%), cystic kidney diseases (CYST; n = 39, 9.3%), perinatal problems (PP; n = 29, 6.9%), and others (n = 64, 15.2%). HL was detected in 82 (19.5%) patients, including 51 (12.1%) patients with sensorineural hearing loss (SNHL), 30 (7.1%) with conductive hearing loss (CHL), and 1 patient with mixed HL. The prevalence of HL in each group was as follows: 16.8% in the CAKUT group, 28.6% in the GP group, 12.8% in the CYST group, 24.1% in the PP group, and 14.1% in the others group. HL was more common in higher CKD stages, especially CHL in end-stage renal disease. SNHL was more prevalent in CKD from GP. Of the 82 patients with HL, 50% had renal syndromic HL: 58.8% of SNHL and one-third of CHL were renal syndromic HL. Conclusion One-fifth of the childhood-onset CKD had HL. Collectively, renal syndromic HL comprised half of the HL in this study. To improve the quality of life in patients with childhood-onset CKD, we suggest that HL should be considered, requiring surveillance, and if necessary, early intervention.

OBJECTIVES: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a side effect of bisphophonate therapy that has been reported in recent years. Osteoclastic inactivity by bisphosphonate is the known cause of BRONJ. Bone morphogenetic protein-2 (BMP-2) plays an important role in the development of bone. Recombinant human BMP-2 (rhBMP-2) is potentially useful as an activation factor for bone repair. We hypothesized that rhBMP-2 would enhance the osteoclast-osteoblast interaction related to bone remodeling. MATERIALS AND METHODS: Human fetal osteoblast cells (hFOB 1.19) were treated with 100 microM alendronate, and 100 ng/mL rhBMP-2 was added. Cells were incubated for a further 48 hours, and cell viability was measured using an MTT assay. Expression of the three cytokines from osteoblasts, receptor activator of nuclear factor-kappaB ligand (RANKL), osteoprotegerin (OPG), and macrophage colony-stimulating factor (M-CSF), were analyzed by real-time polymerase chain reaction and enzyme-linked immunosorbent assay. RESULTS: Cell viability was decreased to 82.75%+/-1.00% by alendronate and then increased to 110.43%+/-1.35% after treatment with rhBMP-2 (P<0.05, respectively). OPG, RANKL, and M-CSF expression were all decreased by alendronate treatment. RANKL and M-CSF expression were increased, but OPG was not significantly affected by rhBMP-2. CONCLUSION: rhBMP2 does not affect OPG gene expression in hFOB, but it may increase RANKL and M-CSF gene expression.
Alendronate ; Bisphosphonate-Associated Osteonecrosis of the Jaw ; Bone Remodeling ; Cell Survival ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; Humans ; Macrophage Colony-Stimulating Factor ; Osteoblasts* ; Osteoclasts ; Osteoprotegerin ; RANK Ligand ; Real-Time Polymerase Chain Reaction

BACKGROUND/AIMS: Several rescue therapies have been recommended to eradicate Helicobacter pylori infection in patients with a failure of first-line eradication therapy, but they still fail in more than 20% of cases. The aim of this study was to evaluate the efficacy and safety of levofloxacin, metronidazole, and lansoprazole (LML) triple therapy relative to quadruple therapy as a second-line treatment. METHODS: In total, 113 patients who failed first-line triple therapy for H. pylori infection were randomly assigned to two groups: LML for 7 days and tetracycline, bismuth subcitrate, metronidazole and lansoprazole (quadruple) for 7 days. RESULTS: According to intention-to-treat analysis, the infection was eradicated in 38 of 56 patients (67.9%) in the LML group and 48 of 57 (84.2%) in the quadruple group (p=0.042). Per-protocol analysis showed successful eradication in 38 of 52 patients (73.1%) from the LML group and 48 of 52 (92.3%) from the quadruple group (p=0.010). There were no significant differences in the adverse effects in either treatment group. CONCLUSIONS: LML therapy is less effective than quadruple therapy as a second-line treatment for H. pylori infection. Therefore, quadruple therapy should be considered as the primary second-line strategy for patients experiencing a failure of first-line H. pylori therapy in Korea.
2-Pyridinylmethylsulfinylbenzimidazoles ; Bismuth ; Helicobacter ; Helicobacter pylori ; Humans ; Korea ; Metronidazole ; Ofloxacin ; Organometallic Compounds ; Tetracycline

OBJECTIVES: Our goal is to validate diagnosing and characterizing epilepsy based on a medical record survey by external reviewers. METHODS: We reviewed medical records from 80 patients who received antiepileptic drugs in 2009 at two hospitals. The study consisted of two steps; data abstraction by certified health record administrators and then verification by the investigators. The gold standard was the results of the survey performed by the epileptologists from their own hospital. RESULTS: The specificity was more than 90.0% for diagnosis and activity, and for new-onset seizures. The sensitivity was 97.0% or more for diagnosis and activity and 66.7-75.0% for new-onset epilepsy. This method accurately classified epileptic syndromes in 90.2-92.9% of patients, causes in 85.4-92.7%, and age of onset in 78.0-81.0%. Kappa statistics for inter-rater reliability and test-retest reliability ranged from 0.641-0.975, which means substantial to near-perfect agreement in all items. CONCLUSIONS: Our data suggest that epilepsy can be well identified by external review of medical records. This method may be useful as a basis for large-scale epidemiological research.
Administrative Personnel ; Age of Onset ; Anticonvulsants ; Epilepsy ; Humans ; Medical Records ; Reproducibility of Results ; Research Personnel ; Seizures ; Sensitivity and Specificity

Intramural hematoma of the gastrointestinal tract is an uncommon occurrence with the majority being localized to the esophagus or duodenum. Hematoma of the gastric wall is very rare, and has been reported most commonly in association with coagulopathy, trauma, hematologic disease, and therapeutic endoscopy. Here we describe a case of intramural gastric hematoma after epinephrine injection therapy for a gastric ulcer with underlying liver cirrhosis that was successfully managed with conservative therapy.
Duodenum ; Endoscopy ; Epinephrine ; Esophagus ; Gastrointestinal Tract ; Hematologic Diseases ; Hematoma ; Hemorrhage ; Hemostasis, Endoscopic ; Humans ; Liver ; Liver Cirrhosis ; Stomach Ulcer

PURPOSE: Iron deficiency anemia (IDA) is one of the most common nutritional deficiencies in children on a weaning diet. We investigated weaning practices in infants and children, as well as their mothers' knowledge about weaning. METHODS: We investigated 129 children with IDA and 166 without IDA (aged 6-36 months) who had visited 10 university hospitals between March 2006 and July 2007. We investigated the hematologic values of both groups. A questionnaire on weaning was answered by the mothers of these children. RESULTS: The hematologic values in the IDA group showed a significant difference from those in the comparison group (P<0.05). Children who were solely breastfed until 6 months of age were 85%, 34% (P<0.05), and weaning was started by 6.3, 6.4 months, respectively (P>0.05). Rice gruel, boiled rice, and fruit juice accounted for approximately 8 0% of the starting foods in both groups (P>0.05). Only 40% of the children in the IDA group had a balanced diet within a month, versus 38% in the comparison group. In response to questions about the necessity of iron-fortified foods for breast-fed infants, less than 50% of mothers in both groups answered correctly. In the IDA group, 42% showed serum ferritin less than 10 ng/ mL, while 92% showed serum MCV less than 72 fL. CONCLUSION: In conclusion, collection of information on history should be thorough for feeding and selective examinations for IDA in high-risk groups. Considering the adaptation period, we suggest beginning children on a weaning diet at 45 months. In addition, we need to educate mothers on weaning practice, especially on the necessity of iron-fortified foods for breast-fed infants.
Anemia, Iron-Deficiency ; Child ; Diet ; Ferritins ; Fruit ; Hospitals, University ; Humans ; Infant ; Iron ; Malnutrition ; Mothers ; Surveys and Questionnaires ; Weaning

OBJECTIVE: The purpose of this study is to determine the prevalence of sinus disease and abnormalities in patients scheduled for dental implant in maxillary posterior area using cone beam CT. PATIENTS AND METHOD: One hundred five maxillary sinuses in eighty-seven patients who underwent cone beam CT for dental implant in maxillary posterior area were included. Any patients who had previous history of sinus operations were not included. The sinus abnormalities were classified as follows ; normal (membrane thickness <2 mm), mucosal thickening (membrane thickness > or = 2 mm and <6 mm), partial opacification (membrane thickness >6 mm but not full), full opacification and mucous retention cyst. The relationship between the remaining bone height, sinus symptoms and maxillary sinus abnormality was statistically surveyed. RESULTS: Of 105 maxillary sinuses in 87 patients, 80 (76%) maxillary sinuses showed abnormalities ; 4 of 4 symptomatic patients and 76 of 101 asymptomatic patients. Mucosal thickening was the most common sinus abnormality. Only 3 (4%) of 80 maxillary sinus abnormalities were caused by the odontogenic origin. The prevalence of maxillary sinus abnormalities was higher in the symptomatic group than asymptomatic one (p<0.05). CONCLUSION: Maxillary sinus abnormalities were very common in the patients who were planning implantation in maxillary posterior areas. This result supports that thorough evaluation for maxillary sinus is recommended when implant treatment is planned for those areas.
Cone-Beam Computed Tomography ; Dental Implants ; Humans ; Maxillary Sinus ; Prevalence ; Retention (Psychology)

OBJECTIVE: The purpose of this study is to determine the prevalence of sinus disease and abnormalities in patients scheduled for dental implant in maxillary posterior area using cone beam CT. PATIENTS AND METHOD: One hundred five maxillary sinuses in eighty-seven patients who underwent cone beam CT for dental implant in maxillary posterior area were included. Any patients who had previous history of sinus operations were not included. The sinus abnormalities were classified as follows ; normal (membrane thickness <2 mm), mucosal thickening (membrane thickness > or = 2 mm and <6 mm), partial opacification (membrane thickness >6 mm but not full), full opacification and mucous retention cyst. The relationship between the remaining bone height, sinus symptoms and maxillary sinus abnormality was statistically surveyed. RESULTS: Of 105 maxillary sinuses in 87 patients, 80 (76%) maxillary sinuses showed abnormalities ; 4 of 4 symptomatic patients and 76 of 101 asymptomatic patients. Mucosal thickening was the most common sinus abnormality. Only 3 (4%) of 80 maxillary sinus abnormalities were caused by the odontogenic origin. The prevalence of maxillary sinus abnormalities was higher in the symptomatic group than asymptomatic one (p<0.05). CONCLUSION: Maxillary sinus abnormalities were very common in the patients who were planning implantation in maxillary posterior areas. This result supports that thorough evaluation for maxillary sinus is recommended when implant treatment is planned for those areas.
Cone-Beam Computed Tomography ; Dental Implants ; Humans ; Maxillary Sinus ; Prevalence ; Retention (Psychology)

In this study, we observed the alteration of choline signal intensity in hippocampus region of the depressive rat model induced by forced swimming test (FST). The purpose of this study was to evaluate the antidepressant efficacy in the depressive animal model using MR spectroscopy. Fourteen experimentally naive male Sprague-Dawley rats weighting 160~180 g were used as subjects. Drug injection group was exposed to the FST except for control group. The drugs were administered subcutaneously (SC) in a volume equivalent to 2 ml/kg. And three injections were administered 23, 5, and 1 h before beginning the given test. 1H MR spectra were obtained with use of a point resolved spectroscopy (PRESS) localization sequence performed according to the following parameters: repetition time, 2500 ms; echo time, 144 ms; 512 average; 2048 complex data points; voxel dimensions, 1.5x2.5x2.5 mm3; acquisition time, 25 min. There were no differences in NAA/Cr and Cho/Cr ratio between the right and the left hippocampus both normal control rats and antidepressant-injected rats. Also, no differences were observed in NAA/Cr and Cho/Cr ratio between the normal control rats and the antidepressant-injected rats both the right and the left hippocampus. In this study, we found the recovery of choline signals in the depressive animal model similar to normal control groups as injecting desipramine-HCl which was antidepressant causing anti-immobility effects. Thus, we demonstrated that MR spectroscopy was able to aid in evaluating the antidepressant effect of desipramine-HCl.
Animals ; Choline ; Hippocampus ; Humans ; Magnetic Resonance Spectroscopy ; Male ; Models, Animal ; Protons ; Rats ; Rats, Sprague-Dawley ; Spectrum Analysis ; Swimming

PURPOSE: To investigate the 3-bond and spatial connectivity of human brain metabolites by scalar coupling and dipolar nuclear Overhauser effect/enhancement (NOE) interaction through 2D- correlation spectroscopy (COSY) and 2D- NOE spectroscopy (NOESY) techniques. MATERIALS AND METHODS: All 2D experiments were performed on Bruker Avance 500 (11.8 T) with the zshield gradient triple resonance cryoprobe at 298 K. Human brain metabolites were prepared with 10% D2O. Two-dimensional spectra with 2048 data points contains 320 free induction decay (FID) averaging. Repetition delay was 2 sec. The Top Spin 2.0 software was used for post-processing. Total 7 metabolites such as N-acetyl aspartate (NAA), creatine (Cr), choline (Cho), glutamine (Gln), glutamate (Glu), myo-inositol (Ins), and lactate (Lac) were included for major target metabolites. RESULTS: Symmetrical 2D-COSY and 2D-NOESY spectra were successfully acquired: COSY cross peaks were observed in the only 1.0-4.5 ppm, however, NOESY cross peaks were observed in the 1.0-4.5 ppm and 7.9 ppm. From the result of the 2-D COSY data, cross peaks between the methyl protons (CH3(3)) at 1.33 ppm and methine proton (CH(2)) at 4.11 ppm were observed in Lac. Cross peaks between the methylene protons (CH2(3,H alpha)) at 2.50ppm and methylene protons (CH2,(3,HB)) at 2.70 ppm were observed in NAA. Cross peaks between the methine proton (CH(5)) at 3.27 ppm and the methine proton (CH(4,6)) at 3.59 ppm, between the methine proton (CH(1,3)) at 3.53 ppm and methine proton (CH(4,6)) at 3.59 ppm, and between the methine proton (CH(1,3)) at 3.53 ppm and methine proton (CH(2)) at 4.05 ppm were observed in Ins. From the result of 2-D NOESY data, cross peaks between the NH proton at 8.00 ppm and methyl protons (CH3) were observed in NAA. Cross peaks between the methyl protons (CH3(3)) at 1.33 ppm and methine proton (CH(2)) at 4.11 ppm were observed in Lac. Cross peaks between the methyl protons (CH3) at 3.03 ppm and methylene protons (CH2) at 3.93 ppm were observed in Cr. Cross peaks between the methylene protons (CH2(3)) at 2.11 ppm and methylene protons (CH2(4)) at 2.35 ppm, and between the methylene protons(CH2 (3)) at 2.11 ppm and methine proton (CH(2)) at 3.76 ppm were observed in Glu. Cross peaks between the methylene protons (CH2 (3)) at 2.14 ppm and methine proton (CH(2)) at 3.79 ppm were observed in Gln. Cross peaks between the methine proton (CH(5)) at 3.27 ppm and the methine proton (CH(4,6)) at 3.59 ppm, and between the methine proton (CH(1,3)) at 3.53 ppm and methine proton (CH(2)) at 4.05 ppm were observed in Ins. CONCLUSION: The present study demonstrated that in vitro 2D-COSY and NOESY represented the 3-bond and spatial connectivity of human brain metabolites by scalar coupling and dipolar NOE interaction. This study could aid in better understanding the interactions between human brain metabolites in vivo 2DCOSY study.
Aspartic Acid ; Brain ; Choline ; Creatine ; Glutamic Acid ; Glutamine ; Humans ; Lactic Acid ; Protons ; Spectrum Analysis