No abstract available.
Child* ; Humans ; Kidney Failure, Chronic* ; Renal Insufficiency*

The beneficial effects of sunlight and ultraviolet light for the treatment, of psoriasis vulgaris has long been recognized. Parrish et al were the first to introduce a controlled light source, which allowed the delivery of a known quantity of light energy to the patients skin after the patient had ingested a photosensitizer, 8-methoxypsoralen (methoxsalen) two hours previous to UVA exposure. This successful treatment has become known as PUVA (psoralen and UVA). PUVA photochernotherapy denotes a systemic approach that is based on the interaction of light and a photoactive drug. Parrish et al have described successful treatment of psoriasis with PUVA and other investigators alI over the world have confirmed their beneficial results. The rationale of photochemotherapy in psoriasis is the inhibition of the increased DNA synthesis within the psoriatic lesions by the interaction of psoralen molecule and light energy in the UVA range(320-400nm). The present study was undertaken to evaluate the therapeutic effectiveness of PUVA photochernotherapy combining orally administered methoxsalen and UAA exposure using Dermatron UVA phototherapy system in patients with wi5espread psoriasis. A total of 15 patients with psoriasis over more than 30% of their bodies were selected at the department of dermatology, National Medical Center through March 1978 to September 1978. Oral administration of methoxsalen, 20 to 50 mg doses according to body weight, was followed by exposure to a high-intensity longwave ultraviolet light emitting a continuous spectrum between 320 and 400nm (peak emission, 350 - 365nm). Initial UVA exposure times were based on each patients minimal phototoxicity dose (MPD) and exposure times were increased at each treatment by 1 - 2 minutes to maintain minimal erythema. Frequency of treatment was two to three times weekly. Once the psoriatic lesions had, cleared completely the patient was placed on a maintenance schedule. If psoriasis recurred the frequency of treatment was increased. The results were as follows: l. 5 patients were dropped out due to unknown reasons. 2. 7 cases showed clearing of over 95, of the lesions (Response 5'). Mean number of PU VA therapy was 16. 7. During 1 4 months follow-up period, 4 cases remained free of psoriasis but 3 cases couldn't be followed. 3. Immediate side effects of PUVA were temporary and generally mild. No significant changes in laboratory screenings were noted. Side effects of therapy included transient nausea(33.3%), dizziness(26.7%), erythema.(66.7%), pruritus (60%), increased pigrnentation(100 %). 4. Comparison of pre-and post-PUVA therapy in biopsy specimens by light microscopy revealed histologic improvement evidenced by diminished acanthosis and parakeratosis, and regeneration of granular layers in all of 8 cases. Glycogen accumulation in the affected epiderrnis was significantly decreased or absent after PUVA therapy in all cases.
Administration, Oral ; Appointments and Schedules ; Biopsy ; Body Weight ; Dermatitis, Phototoxic ; Dermatology ; DNA ; Erythema ; Ficusin ; Follow-Up Studies ; Glycogen ; Humans ; Mass Screening ; Methoxsalen ; Microscopy ; Parakeratosis ; Photochemotherapy* ; Phototherapy ; Pruritus ; Psoriasis* ; PUVA Therapy ; Regeneration ; Research Personnel ; Skin ; Sunlight ; Ultraviolet Rays

Plesiomonas shigelloides is known to cause diarrhea in human. It is a facultatively anaerobic gram-negative rod belonging to the family Vibrionaceae. We isolated P. shigelloides from two patients with diarrhea, a 62-year-old woman with steroid therapy and a 4-year-old boy with no predisposing factor. The organisms were isolated on enteric agars as a nonlactose fermenter and were identified by oxidase, indole, and other biochemical characteristics. The isolates were susceptible to commonly used antimicrobial agents with the exception of ampicillin. P. shigelloides infection is rarely reported in our country, but appears to be a significant cause of diarrhea that responds to antimicrobial therapy. Therefore we suggest the need for correctly identifying P. shigelloides.
Agar ; Ampicillin ; Anti-Infective Agents ; Causality ; Child, Preschool ; Diarrhea ; Female ; Humans ; Male ; Middle Aged ; Oxidoreductases ; Plesiomonas* ; Vibrionaceae

BACKGROUND: Rotavirus activity in Korea has been reported beginning in October, peak in November, continuing in winter and ending in spring. But the peak month and the incidence of rotavirus seems to be changed recently. So we investigated the trends of rotavirus activity for the last 10 years in Hanyang University Hospital (HUH). Also latex agglutination test was compared with automated enzyme-linked fluorescent immunoassay for the detection of rotavirus in stool specimens. METHODS: Stool specimens (3,636 from HUH, 1989-1998; 1,171 from Hanyang University Kuri hospital, HUKH, 1996-1998) from pediatric patients with acute diarrhea were tested for rotavirus,. Sixty specimens were tested by latex agglutination test (Sliders Rota-kit 2, bioMerieux Vitek, France) and enzyme-linked fluorescent immunoassay (VIDAS Rotavirus, bioMerieux Vitek, France) according to the instructions from the manufacturer. RESULTS: The annual incidence of rotavirus diarrhea from 1989 to 1998 was 47%, 32%, 33%, 25%, 26%, 24%, 24%, 17%, 17%, 14%, respectively. Positive rate of rotavirus was 25% for the 10year period in HUH, 20% for the recent 3 years in HUKH. Peak month was November (46%) in the first 5 year, but November incidence decreased to 17% in the last 5 year, and the peak moved to January, February, and March (34%, 35%, 33%, respectively). Epidemic period was from October to February during the first 5 year, but from December to April during the last 5 year period. The agreement rate of the two methods was 90% and VIDAS Rotavirus showed significantly higher sensitivity compared to Sliders Rota-kit 2. CONCLUSIONS: The incidence of rotavirus diarrhea decreased gradually for the last 10 years and the peak month of rotavirus activity was changed from November to January, February, and March. The VIDAS Rotavirus was more sensitive than the Sliders Rota-kit 2 for the detection of rotavirus in stool.
Diarrhea ; Epidemiology ; Gastroenteritis* ; Humans ; Immunoassay ; Incidence ; Korea* ; Latex Fixation Tests ; Rotavirus*

Bacillus cereus meningitis can show unusual presentation and very rapid progression associated with high mortality and unusual MRI findings. We report a 77-year-old man with fever and altered mentality after epidural neuroplasty for chronic lumbar spinal pain. Symptoms rapidly progressed over the 12 hours following surgery. He was diagnosed with meningoencephalitis by Bacillus cereus confirmed by CSF culture and DNA sequencing. He improved with antibiotics slowly although his mental state did not completely revert to his prior level. This case demonstrates the rapid and fulminant clinical picture produced by Bacillus cereus associated with neuroplasty. It also shows peculiar frontal white matter changes with hydrocephalus on MRI

PURPOSE: Efforts to predict the progression of chronic renal failure (CRF) in children, using mathematical models based on transformations of serum creatinine (Scr) concentration, have failed. Error may be introduced by age-related variations in creatinine production rate. Height (Ht) is a reliable reference for creatinine production in children. Thus, Scr, factored for Ht, could provide a more accurate predictive model. We examined this hypothesis. METHODS: The progression of CRF was detected in 63 children who proceeded to end-stage renal disease. Derivatives of Scr, including 1/Scr, log Scr and Ht/Scr, were defined for the period Scr was between 2 and 5 mg/dl. Regression equation were used to predict the time, in months, to Scr > 10 mg/dl. The prediction error (PE) was defined as the predicted time minus actual time for each Scr transformation. RESULT: The PE for Ht/Scr was lower than the PE for either 1/Scr or log Scr (median: -0.01, -2.0 and +10.6 mos respectively; p < 0.0001). For children with congenital renal diseases, the PE for Ht/Scr was also lower than for the other two transformations (median: -1.2, -3.2 and +8.2 mos respectively; p < 0.0001). However, the PE's for children with glomerular diseases was not as clearly different (median: +0.9, +0.5 and +9.9 respectively). In children <13 yrs, PE for Ht/Scr was the lowest, while in older children, 1/Scr provided the lowest PE, but not significantly different from that for Ht/Scr. The logarithmic transformation tended to predict a slower progression of CRF than actually occurred. CONCLUSION: Scr, factored for Ht, appears to be a useful model to predict the rate of progression of CRF, particularly in the prepubertal child with congenital renal disease.
Child ; Creatinine* ; Humans ; Kidney Failure, Chronic* ; Models, Theoretical

No abstract available.
Korea*

BACKGROUND: Chlamydia trachomatis (C. trachomatis) is an obligatory intracellular parasite which causes trachoma, inclusion conjunctivitis, pneumonia in infants, nongonococcal urethritis, epididymitis, cervicitis, and salpingitis. Salpingitis frequently produces tubal damage and infertility. The micro-immunofluorecence (MIF) test is the standard method for chlamydial serology and is highly sensitive and specific. This study aimed to evaluate the prevalence of C. trachomatis antibodies in healthy individuals and patients with various diseases as well as the clinical value of chlamydial serology by MIF testing. METHODS: A total of 692 serum samples were collected. Of these, 388 samples were obtained from healthy individuals (male 209, female 179). Cord blood samples were collected from 38 healthy babies. Serum samples of 53 female patients with infertility due to PID (group 1), 107 patients with respiratory diseases (group 2; pneumonia, bronchitis, etc.), and 106 patients with cardiovascular diseases (group 3; angina pectoris, acute myocardial infarction, etc.) who were admitted to Hanyang University Hospital from March 1995 to June 1998 were enrolled in this study. Serological diagnosis of a previous infection was made when IgG antibody titers to C. trachomatis were 1:32 or higher. A single titer of antibody of > or =1:512 for IgG or > or =1:16 for IgM was considered to indicate a recent infection. RESULTS: The IgG antibody detection rate in healthy individuals was 27%, broken down by age as follows: < or =10 year old, 36%; 11 to 20 years old, 17%; 21 to 30 years old, 28%; 31 to 40 years old, 36%; 41 to 50 years old, 25%; 51 to 60 years old, 26%; > or =61 years old, 24%. For cord blood, the antibody was detected in 29% of the samples. There were 1 case (0.3%) of recent infection with C. trachomatis by IgG, and 6 cases (1.5%) for IgM. The incidence of IgG antibodies to C. trachomatis in the disease group was 70%, 28%, and 19% for group 1, group 2, and group 3, respectively. There were 3 cases of recent infection detected by IgG and 4 cases by IgM in group 1. Recent infection with C. trachomatis was detected by IgG in 1 case of group 2 and by IgM in another case of group 3. CONCLUSIONS: In healthy individuals, the prevalence of antibodies to C. trachomatis was highest in those between the ages of 21-40 years. Patients with infertility due to PID showed a significantly higher positive rate (P=0.000 by Chi-square test) and more cases of recent infection to C. trachomatis than others. The results suggest that a positive chlamydial serology indicates a higher risk for infertility due to PID.
Adult ; Angina Pectoris ; Antibodies ; Bronchitis ; Cardiovascular Diseases ; Chlamydia trachomatis* ; Chlamydia* ; Conjunctivitis, Inclusion ; Diagnosis ; Epididymitis ; Female ; Fetal Blood ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Infant ; Infertility ; Male ; Middle Aged ; Myocardial Infarction ; Parasites ; Pneumonia ; Prevalence ; Salpingitis ; Serologic Tests* ; Trachoma ; Urethritis ; Uterine Cervicitis ; Young Adult

BACKGROUND: The conventional anticardiolipin antibody (aCL)-ELISA test that has been widely used to diagnose antiphospholipid syndrome (APS) has drawbacks in that false-positive reactions can occur. There have been considerable controversy as to the exact nature of the epitopes to which antiphosholipid antibodies (a PL) are directed. Almost all investigators now agree that the actual antigen to which aPL derived from patient with APS is directed, is beta2-glycoprotein I (beta2GPI). Therefore, we thought that anti-beta2GPI antibodies (abeta2GPI) might be a more specific marker for APS, and attempted to evaluate the usefulness of abeta2GPI test. METHODS: ELISA tests for a CL-IgG and abeta2GPI-IgG were performed simultaneously using the sera from 70 patients with clinically suspected APS and 10 healthy volunteers. The results of abeta2GPI were compared with those of aCL and evaluated clinically by reviewing the medical records. RESULTS: The correlation coefficient between the two was 0.54 (p<0.005). Twelve of 70 patients were abeta2GPI-positive and they were also positive for aCL (mean 45GPL). Forty of 58 abeta2GPI- negative patients were aCL-positive, and many of them were diagnosed to have APS clinically. There was no case showing aCL-negative but abeta2GPI-positive result. CONCLUSIONS: According to our results, abeta2GPI test seems specific but too insensitive to differentiate APS by itself, so it has no additional diagnostic value superior to aCL test. We believe that a study which includes more cases and various test methods will be needed for the precise assessment of abeta2GPI test.
Antibodies ; Antibodies, Anticardiolipin ; Antiphospholipid Syndrome* ; beta 2-Glycoprotein I ; Diagnosis* ; Enzyme-Linked Immunosorbent Assay ; Epitopes ; Healthy Volunteers ; Humans ; Medical Records ; Research Personnel

PURPOSE: This retrospective study was performed to identify the clinical characteristics of influenza B infection and compare to influenza A infection. METHODS: Medical records of patients diagnosed with influenza using a multiplex PCR test, admitted to Seoul St. Mary's Hospital, during the 2011-2012 influenza season were analyzed. Clinical and laboratory characteristics of influenza B patients were investigated and compared with those of influenza A patients. RESULTS: A total of 145 influenza patients were enrolled during this study period. Among these, 66 and 78 patients were diagnosed with influenza A and B, respectively, and 1 patient was diagnosed with co-existing influenza A and B. Cough (88.2%), rhinorrhea (77.1%) and sputum (60.4%) were the most common symptoms among these influenza patients, and most were diagnosed with upper respiratory infection (31.9%) or lower respiratory infection (49.3%). In comparison to influenza A patients, influenza B patients were older (4.7+/-4.1 years vs. 3.3+/-2.5 years, P=0.016), and the number of fever days before hospitalization were longer (3.0 days vs. 2.5 days, P=0.043). While sore throat (10.3% vs. 1.5%, P=0.039) and vomiting (20.5% vs. 6.1%, P=0.012) were more common in influenza B patients than in influenza A patients, other clinical and laboratory characteristics were not significantly different between the two groups. CONCLUSIONS: No significant differences in clinical and laboratory perspectives were manifested in influenza A and B infections. Preventive measures should be emphasized over treatment in influenza B due to prolonged fever duration before admission.
Child ; Cough ; Fever ; Hospitalization ; Humans ; Influenza B virus ; Influenza, Human ; Medical Records ; Multiplex Polymerase Chain Reaction ; Pharyngitis ; Retrospective Studies ; Seasons ; Sputum ; Vomiting