PURPOSE: Mycoplasma pneumoniae pneumonia is one of the most common community- acquired pneumonias in childhood. Recently, it has tended to occur at a young age. We reviewed clinical manifestations of M. pneumoniae pneumonia in the young. METHODS: A total of 378 children who were admitted to the Bundang Jesaeng Hospital due to M. pneumoniae pneumonia from 2003 to 2006 were retrospectively analyzed. M. pneumoniae infection was confirmed by mycoplasma antibody titer >1:320 or four-fold increase of titer. The children were divided into an infant group (Group A, 0-4 years) and an older children group (Group B, 4-14 years). We analyzed the differences between the two groups according to incidence, clinical manifestations, laboratory and radiologic findings. RESULTS: The number of patients in Group A was 147 (38.9%) and in Group B, 231 (61.1%), respectively. Seasonal distribution showed the highest frequency in autumn and the lowest frequency in spring in both groups. The most common symptom was cough (98.6% and 96.5%, respectively) and fever (85.7% and 91.3%, respectively). The most common physical findings were crackle (72.8% and 73.3%, respectively). The common radiologic findings were lobar pneumonia in both groups (55% and 76.1%, respectively), followed by bronchopneumonia (29.2% and 11.6%, respectively). Group A had a lower incidence of high antimycoplasma antibody titer (>1:5,120) and severe pulmonary complication than Group B. CONCLUSION: Group A had the more incidence of sputum production, leukocytosis, bronchopneumonia and duration of fever less than 7days. Group B had the more incidence of weak breathing sound, lobar pneumonia and duration of fever more than 7days.
Bronchopneumonia ; Child ; Cough ; Fever ; Humans ; Incidence ; Infant ; Leukocytosis ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma* ; Respiratory Sounds ; Retrospective Studies ; Seasons ; Sputum

BACKGROUND: The level of physical adaptation through active lifestyle can result in changes in appetite; and caused by physical activity and exercise, physical adaptation may change carbohydrate and fat metabolism during exercise. This study investigated the differences in carbohydrate and fat metabolism after moderate treadmill running and the difference in appetite response before and after exercise in active, regularly exercising individuals and those inactive. METHODS: We analyzed the effects of moderate physical activity (70% of oxygen uptake reserve, 30 minutes on the treadmill) on free fatty acids, glucose, growth hormone, insulin and an appetite visual analogue scale (VAS). Our subjects included 28 healthy males who were divided into two groups, the activity group (n=14) and the inactivity group (n=14) according to the International Physical Activity Questionnaire (IPAQ). The serum samples and VAS were collected at pre, post and 30 min post-exercise. RESULTS: The results of the serum analysis showed no significant effects on free fatty acids, glucose, growth hormone and insulin between the groups, but showed significant changes in free fatty acids and growth hormone between points of measurement. Significant increases in VAS were seen with moderate exercise in both groups, with the inactivity group expressing greater hunger than the activity group. CONCLUSIONS: This study found that inactive persons were hungrier than active persons after moderate exercise. This information might be useful to staff and participants of weight loss programs.
Appetite ; Energy Metabolism ; Exercise ; Fatty Acids, Nonesterified ; Glucose ; Growth Hormone ; Humans ; Hunger ; Insulin ; Life Style ; Male ; Motor Activity ; Oxygen ; Running ; Weight Reduction Programs ; Surveys and Questionnaires

A prominent mandibular angle is considered to be unattractive in the Orient. With recent increase of angle reduction via intraoral approach, it also has risks of injuries on the surrounding structures, especially vessels and nerve. We herein describe a simple method using intravenous tube rubber for prevention of bleeding in mandible angle ostectomy. After elevation of the periosteum, an intravenous tube rubber sutured with 2-0 nylon on one or both side was positioned deeply along the inferior border of mandible, and planned ostectomy was performed. The rubber was removed easily by pulling out the string. We experienced 21 cases of the mandible angle ostectomy using intravenous tube rubber from November 2008 to June 2009 and found no major complications. Intravenous tube rubber can cheaply and easily be obtained in the hospital. During ostectomy, the rubber protects the facial vessels and nerve from saw blade, and provides better visual field. Therefore, intravenous tube protection of facial vessel is a simple method to prevent massive bleeding or nerve injury in mandibular angle ostectomy.

There are frequently limitations to general wound dressing in some cases. Dermabond(R) has been available as a skin closure alternative. The purpose of this study was to apply this topical skin adhesive in postoperative wound management. Dermabond(R) was used for postoperative dressing in total 62 cases; group A includes wounds of the perineum & anus, which have greater chance of contamination(N=16), group B includes wounds located in hairy areas, which are difficult to cover up (N=21), group C includes wounds in children or bed-ridden patients, who have poor compliance (N=6), and group D includes wounds in patients who underwent free flap operations(N=19). There were no infections in group A by separating the wounds from infection sources. Dressings in group B were done much more simply and comfortable. There was increased compliance of patients in group C, as patients could wash around the wound. It was possible to carry out real time monitoring in group D as the simply coverage of the wound. Using Dermabond(R) after primary closure was found to be efficient in the management of wounds near areas with greater chance of being contaminated, wounds which are hard to cover up with dressing materials, wounds in patients with poor compliance, and wounds requiring frequent observation.
Child ; Male ; Female ; Humans

Cytomegalovirus (CMV) is the most common agent of congenital infections and opportunistic infections in an immunocompromised host. CMV in an immunocompetent host has inapparent infections, which are usually asymptomatic or cause mild mononucleosis-like symptoms. However, severe CMV diseases, such as pneumonia, hepatitis, gastrointestinal disease, often occur in a healthy infant. The association of CMV pneumonia with the development of pneumothorax has rarely been reported. We experienced a case of CMV pneumonia presenting as pneumothorax in a 4-month-old healthy infant, who was successfully treated with supportive care. CMV was confirmed by using CMV polymerase chain reaction of tracheal aspirates. This case suggested that CMV should be considered as a cause of viral pneumonia during the infant period.

BACKGROUND: PTCA is often unsuccessful in a patient with chronic total occlusion of coronary arteries with success rates varying from 60 to 70%. Success rates are related to the duration of total occlusion, longer occlusions being associated with lower success rates. Chronic total occlusion may be associated with thrombi superimposed on the stenotic lesion. We used an intra-coronary bolus of urokinase followed by a prolonged urokinase infusion in an attempt to lyse the lesion and allow for passage of the PTCA wire during subsequent angioplasty. The purpose of prolonged durokinase infusion was to reduce the clot sufficiently to recanalize the coronary artery and make it more amenable to PTCA. METHODS: Study patients: We were included six patients who developed total occlusion for more than 3 weeks and good collateral channels of Grade 2 or more and previous attempts at angioplaty had failed. Procedures: All patients underwent dual catheter system and incremental dose protocol of intracoronary urokinase infusion. RESULTS: The mean duration of occlusion was calculated to be 65.3+/-2.7 weeks and urokinase dose ranged from 130,000 to 200,000U/hr and treatment lasted 21.7+/-1.4 hours in our study. The prolonged urokinase infusion resulted in reperfusion of the occluded dvessel in 5 of the 6 patients(83%), with or without the complementary balloon inflation. One patient failed to recanalize the occluded vessel because cardiac tamponade was developed during the prolonged urokinase infusion. CONCLUSION: We concluded that the prolonged urokinase infusion in occluded coronary artery appeared to increase the likelihood of successful PTCA in patients with chronic total occlusion of coronary arteries.Also, in carefully selected patients, prolonged urokinase infusion in occluded coronary artery was relatively safe and well tolerated.
Angioplasty ; Cardiac Tamponade ; Catheters ; Coronary Vessels* ; Humans ; Inflation, Economic ; Reperfusion ; Urokinase-Type Plasminogen Activator*

Metformin, commonly prescribed for type 2 diabetes, is considered safe with minimal side-effect. Acute pancreatitis is rare but potentially fatal adverse side-effect of metformin. We report a patient on hemodialysis with metformin-related acute pancreatitis and lactic acidosis. A 62-year-old woman with diabetic nephropathy and hypertension presented with nausea and vomiting for a few weeks, followed by epigastric pain. At home, the therapy of 500 mg/day metformin and 50 mg/day sitagliptin was continued, despite symptoms. Laboratory investigations showed metabolic acidosis with high levels of lactate, amylase at 520 U/L (range, 30-110 U/L), and lipase at 1,250 U/L (range, 23-300 U/L). Acute pancreatitis was confirmed by computed tomography. No recognized cause of acute pancreatitis was identified. Metformin was discontinued. Treatment with insulin and intravenous fluids resulted in normalized amylase, lipase, and lactate. When she was re-exposed to sitagliptin, no symptoms were reported.
Acidosis ; Acidosis, Lactic* ; Amylases ; Diabetes Mellitus ; Diabetic Nephropathies ; Female ; Humans ; Hypertension ; Insulin ; Lactic Acid ; Lipase ; Metformin* ; Middle Aged ; Nausea ; Pancreatitis* ; Renal Dialysis* ; Sitagliptin Phosphate ; Vomiting

Percutaneous nephrostomy was done in 18 cases for ureteral obstruction secondary to advanced pelvic malignancy from Jan.1990 to Apr.1993. The most common site of the primary malignancy was cervix ( 77% ). The mean survival time after diversion was 4.2 months ; 22.2% (4/18) of the patients lived more than 6 months, and 1 patient is alive at 4 months. In 4 patients the renal function was not improved, whose mean survival time was 1.4 months. We consider that close. periodic follow-up is mandatory to detect the ureteral obstruction in patients With malignant pelvic tumor and early management may improve the survival time. The patients who had previously urinary diversion for unilateral ureteral obstruction should be evaluated periodically for contralateral renal function. However, the exact criteria for the selection of patients for urinary diversion is, not obvious.
Cervix Uteri ; Female ; Follow-Up Studies ; Humans ; Nephrostomy, Percutaneous* ; Pregnenolone Carbonitrile ; Survival Rate ; Ureter* ; Ureteral Obstruction* ; Urinary Diversion

PURPOSE: The purpose of this study is to evaluate the prognostic significance of the tumor volume reduction rate (TVRR) measured during adaptive definitive radiation therapy (RT) for nasopharyngeal cancer (NPC). MATERIALS AND METHODS: We reviewed the RT records of 159 NPC patients treated with definitive RT with or without concurrent chemotherapy between January 2006 and February 2013. Adaptive re-planning was performed in all patients at the third week of RT. The pre- and mid-RT gross tumor volumes (GTVs) of the primary tumor and the metastatic lymph nodes were measured and analyzed for prognostic implications. RESULTS: After a median follow-up period of 41.5 months (range, 11.2 to 91.8 months) for survivors, there were 43 treatment failures. The overall survival and progression-free survival (PFS) rates at 5 years were 89.6% and 69.7%, respectively. The mean pre-RT GTV, mid-RT GTV, and TVRR were 45.9 cm3 (range, 1.5 to 185.3 cm3), 26.7 cm3 (1.0 to 113.8 cm3), and -41.9% (range, -87% to 78%), respectively. Patients without recurrence had higher TVRR than those with recurrence (44.3% in the no recurrence group vs. 34.0% in the recurrence group, p=0.004), and those with TVRR > 35% achieved a significantly higher rate of PFS at 5 years (79.2% in TVRR > 35% vs. 53.2% in TVRR ≤ 35%; p < 0.001). In multivariate analysis, TVRR was a significant factor affecting PFS (hazard ratio, 2.877; 95% confidence interval, 1.555 to 5.326; p=0.001). CONCLUSION: TVRR proved to be a significant prognostic factor in NPC patients treated with definitive RT, and could be used as a potential indicator for early therapeutic modification during the RT course.
Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Lymph Nodes ; Multivariate Analysis ; Nasopharyngeal Neoplasms* ; Radiotherapy ; Recurrence ; Survivors ; Treatment Failure ; Tumor Burden*

OBJECTIVE: Lethality of the chosen method during a suicide attempt is a strong risk factor for completion of suicide. We examined whether annual changes in the pattern of suicide methods is related to annual changes in suicide rates among older adults in South Korea and Japan. METHODS: We analyzed annual the World Health Organization data on rates and methods of suicide from 2000 to 2011 in South Korea and Japan. RESULTS: For Korean older adults, there was a significant positive correlation between suicide rate and the rate of hanging or the rate of jumping, and a significant negative correlation between suicide rate and the rate of poisoning. Among older adults in Japan, annual changes in the suicide rate and the pattern of suicide methods were less conspicuous, and no correlation was found between them. CONCLUSION: The results of the present study suggest that the increasing use of lethal suicide methods has contributed to the rise in suicide rates among older adults in South Korea. Targeted efforts to reduce the social acceptability and accessibility of lethal suicide methods might lead to lower suicide rate among older adults in South Korea.
Adult* ; Humans ; Japan* ; Korea* ; Methods* ; Poisoning ; Risk Factors ; Suicide* ; World Health Organization