PURPOSE: Most of childhood MCNS has a long disease course with frequent relapses. This study was designed to analyze the long-term clinical course of childhood MCNS, focusing at relapsing pattern, treatment response and complications. Mothods : The medical records of 137 children with biopsy-proven MCNS observed during 1976 ti 1996 were analyzed retrospectively. They were classified as initial responders (111 patients, 81%) and nonresponders (26 patients, 19%) according to the response to initial oral prednisolone (60mg/m2/d) for 4 weeks. The detailed clinical courses were obtained in 126 patients. RESULTS: The incidences of hematuria, hypertension and azotemia were more frequent in initial responders than nonresponders. During follow-up, the proportion of patients with sustained remission increased gradually with decreasing rate of relapse. At the last follow-up, 77 patients (61%) revealed sustained remission, 36 (29%) repeated relapses, 9 (7%) persistent proteinuria, 3 (2%) renal failure, and 1 (1%) death. The responses to secondary drugs such as first and second course of cyclophosphamide, cyclosporin, levamisole and methylprednisolone pulse were 80%, 85.7%, 70%, 75%, and 40%, respectively. Major complications were infections including peritonitis (29 patients) and acute renal failure (10) patients.CONCLUSION: Long-term prognosis of childhood MCNS is determined by clinical courses rather than renal pathology. Although majority of childhood MCNS reveal good long-term prognosis, patients did well, few patients do not so. Early detection and more aggressive therapy of such patients are very helpful.
Acute Kidney Injury ; Azotemia ; Child* ; Cyclophosphamide ; Cyclosporine ; Follow-Up Studies* ; Hematuria ; Humans ; Hypertension ; Incidence ; Levamisole ; Medical Records ; Methylprednisolone ; Nephrosis, Lipoid* ; Pathology ; Peritonitis ; Prednisolone ; Prognosis ; Proteinuria ; Recurrence ; Renal Insufficiency ; Retrospective Studies

Histiocytosis-X is a term used to define three diseases with similar morphologic characteristics : Letterer-Siwe diseae, Hand-Schuller-Christian disease and Eosinophilic granuloma. In general, they differ in terms of their age of onset, severity of clinical course and site of involvement. Eosinophilic granuloma typically is seen in young adults. Eosinophilic granuloma is diagnosed in the presense of diffuse pulmonary infiltrate, bony involvement. However, the Pulmonary radiologic findings of eosinophilic granuloma are variable accordinary to stage of disease. therefore pathologic diagnosis of involving site is essential for confirmative diagnosis of eosinophilic grananuloma. Pathologically. the three disease are characterized by granulomatous infiltration of alveolar septa and bronchial walls and often involvement of bone. The hallmark of this disease is proliferation of the Langerhans' cell. The identifying feature is the X-body or Birbeck granule that is present in Langerhans' cells and histiocytic cells found in the lung of EG patient. We report a case of bilateral, recurrent and spontaneous pneumothoraces in a 21 year old man with pulmonary histiocytosis-X which is confined by eosinophilc granuloma in bone marrow biopsy and ultrastructural examination in cells obtained from BAL.
Age of Onset ; Biopsy ; Bone Marrow ; Diagnosis ; Eosinophilic Granuloma ; Eosinophils ; Granuloma ; Histiocytosis, Langerhans-Cell* ; Humans ; Lung ; Pneumothorax* ; Young Adult

PURPOSE: This study aimed to determine the relationships between particulate matter risk perception, knowledge, and perceived barriers and health-promoting behaviors among college students. METHODS: Data for this cross-sectional study were collected from September 1 to 30, 2017. The study sample consisted of 85 students from a university, Seoul. Students not living in the Seoul metropolitan area during the spring 2017 semester were excluded from participation. Pearson's correlation coefficient was used to identify relationships among study variables. RESULTS: A significant positive correlation existed between particulate matter risk perception and health-promoting behaviors related to particulate matter (r=.51, p < .001). Among the risk perception subdomains, attention (r=.47, p < .001) and health effect (r=.55, p < .001) showed strong positive relationships with health-promoting behaviors. No significant relationships were found between knowledge (r=.12, p=.288) or perceived barriers (r=−.12, p=.264) and health-promoting behaviors related to particulate matter. CONCLUSION: Based on the study results, strategies for enhancing particulate matter risk perception are needed to increase the level of health-promoting behaviors related to particulate matter among college students.
Cross-Sectional Studies ; Health Promotion ; Humans ; Particulate Matter ; Seoul

Objective: The Clinical Data Interchange Standards Consortium (CDISC) proposed outcome measures for clinical trials on Alzheimer’s disease (AD) in the Therapeutic Area User Guide for AD (TAUG-AD). To investigate how well the clinical trials on AD registered in the ClinicalTrials.gov complied with the recommendations on outcome measures by the CDISC. Methods: We compared the outcome measures proposed in the TAUG-AD version 2.0.1 with those employed in the protocols of clinical trials on AD registered in ClinicalTrials.gov. Results: We analyzed 101 outcome measures from 305 protocols. The TAUG-AD listed ten scales for outcome measures of clinical trials on AD. The scales for cognition, activities of daily living, behavioral and psychological symptoms of dementia, and global severity listed in TAUG-AD were most frequently employed in the clinical trials on AD. However, TAUG-AD did not include any scale on quality of life. Also, several scales such as Montreal Cognitive Assessment, Alzheimer’s Disease Cooperative Study–Activities of Daily Living, and Cohen- Mansfield Agitation Inventory not listed in the TAUG-AD were commonly employed in the clinical trials on AD and changed over time. Conclusion To properly standardize the data from clinical trials on AD, the gap between the TAUG-AD and the measures employed in real-world clinical trials should be filled.

A new sesquiterpenoid, 11-hydroxy-valenc-1(10),3(4)-dien-2-one (3), two chemically synthesized but first isolate from nature, 3-oxocedran-8β-ol (1) and valenc-1(10),3(4),11(12)-trien-2-one (2) along with four known compounds, sugiol (4), (+)-nootkatone (5), 11-hydroxy-valenc-1(10)-en-2-one (6), and clovandiol (7), were isolated from the heartwood of Juniperus chinensis. All chemical structures were elucidated using extensive spectroscopic analysis including 1D and 2D NMR spectroscopy. Valenc-1(10),3(4),11(12)-trien-2-one (2) exhibited significant inhibitory activity against butyrylcholinesterase with an IC₅₀ value of 68.45 µM.
Acetylcholinesterase ; Butyrylcholinesterase ; Juniperus ; Magnetic Resonance Spectroscopy

After the trauma of frontoethmoidal sinus, post-traumatic mucocele may occur. Surgical removal of the lesions rarely produces cerebrospinal fluid (CSF) leakage and even delayed tension pneumocephalus. We experienced a case of fronto-ethmoid mucocele complicated with peri-operative CSF leakage and post-operative tension pneumocephalus which was improved by conservative treatment. It is imperative to take into account the potential for tension pneumocephalus when a patient suffers from severe headache after sinus surgery.
Cerebrospinal Fluid Leak* ; Cerebrospinal Fluid* ; Ethmoid Sinus ; Frontal Sinus ; Headache ; Humans ; Mucocele ; Pneumocephalus*

BACKGROUND: Keloids are characterized by excessive collagen deposition in the dermis, in which transforming growth factor β (TGF-β)/Smad signaling plays an important role. Low-level light therapy (LLLT) is reported as effective in preventing keloids in clinical reports, recently. To date, studies investigating the effect of LLLT on keloid fibroblasts are extremely rare. OBJECTIVE: We investigated the effect of LLLT with blue (410 nm), red (630 nm), and infrared (830 nm) light on the collagen synthesis in keloid fibroblasts. METHODS: Keloid fibroblasts were isolated from keloid-revision surgery samples and irradiated using 410-, 630-, 830-nm light emitting diode twice, with a 24-hour interval at 10 J/cm². After irradiation, cells were incubated for 24 and 48 hours and real-time quantitative reverse transcription polymerase chain reaction was performed. Western blot analysis was also performed in 48 hours after last irradiation. The genes and proteins of collagen type I, TGF-β1, Smad3, and Smad7 were analyzed. RESULTS: We observed no statistically significant change in the viability of keloid fibroblasts after irradiation. Collagen type I was the only gene whose expression significantly decreased after irradiation at 410 nm when compared to the non-irradiated control. Western blot analysis showed that LLLT at 410 nm lowered the protein levels of collagen type I compared to the control. CONCLUSION: LLLT at 410 nm decreased the expression of collagen type I in keloid fibroblasts and might be effective in preventing keloid formation in their initial stage.
Blotting, Western ; Collagen Type I ; Collagen* ; Dermis ; Fibroblasts* ; Humans* ; In Vitro Techniques* ; Keloid* ; Low-Level Light Therapy* ; Polymerase Chain Reaction ; Reverse Transcription ; Transforming Growth Factors

Anemia is a common and significant complication of chronic kidney disease (CKD). However, its prevalence and current management status has not been studied thoroughly in Korea. We examined the prevalence of anemia, its association with clinical and laboratory factors, and utilization of iron agents and erythropoiesis stimulating agents using the baseline data from the large-scale CKD cohort in Korea. We defined anemia when hemoglobin level was lower than 13.0 g/dL in males and 12.0 g/dL in females, or received by erythropoiesis stimulating agents. Overall prevalence of anemia was 45.0% among 2,198 non-dialysis CKD patients from stage 1 to 5. Diabetic nephropathy (DN) as a cause, CKD stages, body mass index (BMI), smoking, leukocyte count, serum albumin, iron markers, calcium, and phosphorus concentration were identified as independent risk factors for anemia. Considering the current coverage of Korean National Health Insurance System, only 7.9% among applicable patients were managed by intravenous iron agents, and 42.7% were managed by erythropoiesis stimulating agents.
Anemia* ; Body Mass Index ; Calcium ; Cohort Studies* ; Diabetic Nephropathies ; Female ; Hematinics ; Humans ; Iron ; Korea ; Leukocyte Count ; Male ; National Health Programs ; Phosphorus ; Prevalence* ; Renal Insufficiency, Chronic* ; Risk Factors ; Serum Albumin ; Smoke ; Smoking

OBJECTIVE: This study aims at investigating the incidence, clinical nature and associated clinical characteristics of the clozapine-induced fever. METHODS: Retrospective review of hospital records was performed for 56 inpatients who had started to take clozapine and stayed at the hospital for four or more weeks after the initiation of clozapine treatment. RESULTS AND CONCLUSION: Clozapine-induced fever was developed in 31% of the patients. The mean peak temperature was 39degrees C and the mean duration of the fever was 3 days. Fever was developed average of 11 days after the initiation of clozapine treatment. All the patients were recovered without discontinuation of clozapine. Demographic variables, the clinical response to clozapine, other drugs administered with clozapine, and the presence of other adverse effects of clozapine were not associated with the clozapine-induced fever.
Clozapine* ; Fever* ; Hospital Records ; Humans ; Incidence* ; Inpatients ; Retrospective Studies ; Schizophrenia

OBJECTIVES: Delirium of hospitalized patients is common and it is significantly associated with increased mortality rate. Misdiagnosis rates of delirium are reported in a range of 36.7 to 63% in clinical setting. We aimed to identify the clinical features and symptomatic characteristics associated with misdiagnosis of delirium. METHODS: Subjects were 256 inpatients who were referred for psychiatric consultation and diagnosed with delirium by a psychiatrist at a university hospital between January 1 and June 30, 2012. Clinical data were obtained with retrospective chart review. Patients were divided into misdiagnosed group and correct diagnosed group, after reviewing the reason which were described in the consultation request form. RESULTS: Sixty nine(27%) subjects of the 256 patients were referred for other reasons(mood, substance, anxiety, dementia etc.) than "delirium/confusion" by clinician(misdiagnosed group). In misdiagnosed group, use of antipsychotics was more common. There were no differences between the two groups in age, gender, and department of referring clinician. Fluctuation score of DRS-R-98 was higher in the correct diagnosed group. CONCLUSIONS: In this study, the risk of misdiagnosis was higher when the patients have taken antipsychotics or less symptom fluctuation. Careful clinical attention is needed for diagnosis for delirium in these patients.
Antipsychotic Agents ; Anxiety ; Delirium* ; Dementia ; Diagnosis ; Diagnostic Errors ; Humans ; Inpatients ; Mortality ; Psychiatry ; Retrospective Studies