BACKGROUND: Peripheral T cell lymphoma (PTCL), a prevalent form of non Hodgkin lymphomas in East Asia, can manifest fever, hepatomegaly, lymphadenopathy, pancytopenia and hemophagocytic histiocytosis (HPH). Similar clinicopathologic findings are also frequently encountered in reactive hemophagocytic syndrome (HPS) and malignant histiocytosis (MH) , thus diagnoses could be confused among them. With recent advancement of immunohistochemlal techniques, diagnostic accuracies have been improved and most cases of MH could have been reclassified as PTCL. In this study, we intended to delineate the lineage of atypical malignant cells in bone marrow of subjects which were previously diagnosed as MH or HPS with immunohlstochemical analysis and characterize clinlcophathologic findings of PTCL associated with HPH in the bone marrow. METHODS: Five cases dignosed as HPS, 3 as MH, 3 as presumed MH, and 7 as PTCL on bone marrow examination were enrolled in this study. We performed immunohistochemical stain for CD45, CD3, CD43, CD2O and CD68, then revised the diagnoses and summarized the clinical and morphologic features of PTCL associated with HPH. RESULTS: Eleven out of 18 cases were confirmed as PTCL which were previously diagnosed as MH(1), presumed MH(3) and PTCL(7). Eight cases of 11 PTCL showed HPH mimicking MH with infiltration of the atypical malignant cells, even if the proportion of atypical malignant cells was small on bone marrow aspirates. They manifested fever and hepatomegaly but didn't have lymphadenopathy at the early stage of disease. Subtypes of PTCL with HPH were PTCL, unspecifed (3), angioimmunoblastic T cell lymphoma (1) and undetermined (4). They showed poorer outcome in 3-month survival rate (25%) than in those with PTCL without HPH(100%). CONCLUSION: These results suggest that PTCL associated with HPH should be excluded from MH by immunohistochemical analysis. Considering that prognosis of PTCL with HPH is very poor, accurate and rapid diagnosis is needed for prompt treatment.
Bone Marrow ; Bone Marrow Examination ; Diagnosis ; Far East ; Fever ; Hepatomegaly ; Histiocytic Sarcoma* ; Histiocytosis* ; Lymphatic Diseases ; Lymphohistiocytosis, Hemophagocytic ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral* ; Pancytopenia ; Prognosis ; Survival Rate

No abstract available.
Diabetic Neuropathies ; Humans

PURPOSE: To evaluate diagnostic usefulness of ultrasonography(US) in pediatric patient with urinary tract infection. MATERIALS AND METHODS: Fifty-five children with urinary tract infection underwent renal ultrasonography and voiding cystourethrography(VCUG). The imaging findings were analyzed retrospectively. RESULTS: Renal sonograms were normal in 34 of 55 children(62%). Five of 34 patients with normal sonogram had vesicoureteral reflux of grade I to III on VCUG. Renal sonograms were abnormal in 21 of 55 children(38%). Sonographic findings included hydronephrosis, hyperechoic kidney, nephromegaly, atrophic kidney, renal abscess, and duplex ureter. Eleven of 21 patient with abnormal SOhogram had vesicoureteral reflux of grade I to IV on VCUG. CONCLUSION: Ultrasonography is an useful and reliable initial screening examination in the investigation of children with UTI. Unfortunately US is neither sufficiently sensitive nor specific for detecting VUR. VCUG provides confirmative and valuable information about vesicoureteral reflux, and VCUG should be considered as a next modality for UTI. The combined use of sonography and VCUG provides more valuable information in urinary tract infection.
Abscess ; Child* ; Humans ; Hydronephrosis ; Kidney ; Mass Screening ; Retrospective Studies ; Ultrasonography* ; Ureter ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

PURPOSE: The purpose of this study was to develop a protocol that would help prevent accidents, apply physical restraints properly, and reduce the use of physical restraints in nursing homes. METHOD: A review of the literature and analysis of existing statutes and regulations were used to develop the preliminary protocol. To test the validity of this preliminary protocol, ten experts were selected from academia and clinical practice to review the protocol. The initial protocol was finalized after it had been reviewed by experts and tested for clinical validity in five different nursing homes. RESULT: The protocol consists of objectives, definitions and accident probability assessment, principle of using physical restraints, monitoring and documentation of physical restraints. CONCLUSION: The findings of this study can be used as guidelines to focus on preventing accidents arising out of use of physical restraints, assessing the probability of accidents, and reducing the use of physical restraints through preventive interventions. This will be helpful to prevent ethical, physical, or psychological problems arising from use of physical restraints and to protect the rights of elderly people in nursing homes.
Aged ; Human Rights ; Humans ; Nursing Homes* ; Nursing* ; Restraint, Physical* ; Social Control, Formal

We evaluated the prevalence of vitamin B12 deficiency and associated factors in type 2 diabetes patients using metformin. A total of 799 type 2 diabetes patients using metformin was enrolled. Vitamin B12 and folate levels were quantified by chemiluminescent enzyme immunoassay. Vitamin B12 deficiency was defined as vitamin B12 < or = 300 pg/mL without folate deficiency (folate > 4 ng/mL). The prevalence of vitamin B12 deficiency in metformin-treated type 2 diabetes patients was 9.5% (n = 76), and the mean vitamin B12 level was 662.5 +/- 246.7 pg/mL. Vitamin B12 deficient patients had longer duration of metformin use (P < 0.001) and higher daily metformin dose (P < 0.001) than non-deficient patients. Compared with daily metformin dose of < or = 1,000 mg, the adjusted odds ratio for 1,000-2,000 mg, and > or = 2,000 mg were 2.52 (95% CI, 1.27-4.99, P = 0.008) and 3.80 (95% CI, 1.82-7.92, P < 0.001). Compared with metformin use of < 4 yr, the adjusted odds ratios for 4-10 yr, and > or = 10 yr were 4.65 (95% CI, 2.36-9.16, P < 0.001) and 9.21 (95% CI, 3.38-25.11, P < 0.001), respectively. In conclusion, our study indicates that patients with type 2 diabetes treated with metformin should be screened for vitamin B12 deficiency, especially at higher dosages (> 1,000 mg) and longer durations (> or = 4 yr) of treatment.
Aged ; Area Under Curve ; Diabetes Mellitus, Type 2/complications/diagnosis/*drug therapy ; Female ; Folic Acid/blood ; Humans ; Hypoglycemic Agents/adverse effects/*therapeutic use ; Immunoassay ; Male ; Metformin/adverse effects/*therapeutic use ; Middle Aged ; Odds Ratio ; Patients ; Prevalence ; ROC Curve ; Time Factors ; Vitamin B 12/blood ; Vitamin B 12 Deficiency/diagnosis/epidemiology/*etiology

No abstract available.
Humans ; Mentors*

A 9-year-old Korean boy with lissencephaly was found dead at home. He had previously been diagnosed with lissencephaly that presented with infantile spasm on the basis of magnetic resonance imaging and electroencephalogram results. Antemortem chromosomal banding revealed a normal karyotype. A legal autopsy was requested to eliminate the possibility of neglect or abuse by his parents. The autopsy findings revealed type I lissencephaly with the associated microcephaly. No external wounds or decubitus ulcers were noted. Postmortem fluorescence in situ hybridization for the LIS1 locus and nucleotide sequence analysis of the whole coding regions of the LIS1 gene did not reveal any deletions. The antemortem and postmortem findings revealed that lissencephaly syndrome was associated with isolated lissencephaly sequence. External causes of death were excluded by the full autopsy and toxicology test results. Because patients with mental retardation are frequently victimized and suffer neglect or abuse, thorough external and internal examinations should be conducted at the time of autopsy.
Autopsy ; Base Sequence ; Cause of Death ; Child ; Child Abuse ; Classical Lissencephalies and Subcortical Band Heterotopias ; Clinical Coding ; Electroencephalography ; Fluorescence ; Forensic Pathology ; Humans ; In Situ Hybridization ; Infant ; Infant, Newborn ; Intellectual Disability ; Karyotype ; Lissencephaly ; Magnetic Resonance Imaging ; Microcephaly ; Parents ; Pressure Ulcer ; Spasms, Infantile ; Toxicology

No abstract available.
Hemolytic-Uremic Syndrome*

OBJECTIVES: The purpose of this study is to investigate the characteristics of drinking patterns and the prevalence of hazardous drinking and alcohol use disorder with the assessment of alcohol policy needs in community population of urban city in Korea. METHODS: Data was collected from 1,000 residents in a single urban city in Korea, from June 1 to July 31, 2011 by a questionnaire. As research tools, socio-demographic characteristics composed of variables based on study purpose, alcohol problems and alcohol use disorder state scales composed with Alcohol Use Disorder Identification Test(AUDIT) and Cut down, Annoyed, Guilty, Eye-opener(CAGE), and the assessment of alcohol policy needs in community population questions were used. RESULTS: The lifetime experience of alcohol drinking was 97.4%. For the frequency of drinking, 21.9% of population responded 2 to 4 times per weekly. 24.4% of male had one time or more high risk drinking, defined as having four or more drinks in a sitting, per week. 51.6% experienced the first time drinking of alcohol in adolescence. The lifetime prevalence of hazardous drinking and alcohol use disorder were 14.9% and 3.3%, respectively using AUDIT. Alcohol use disorder were 9.6% with the CAGE scale. Problem drinking were 8.4% in this study. They requested the program such as prevention education(57.2%), construction of liaison system to treatment facilities( 50.1%), alcohol counseling and intervention(41.7%), and rehabilitation program(39.8%). CONCLUSIONS: These results demonstrate that alcohol problem and alcohol use disorder were much prevalent, and these problem started in the earlier age. It is necessary to develop an effective alcohol prevention program or policy with considering the needs in community population.
Adolescent ; Alcohol Drinking ; Counseling ; Drinking ; Humans ; Korea ; Male ; Prevalence ; Questionnaires ; Weights and Measures

No abstract available.
Child ; Humans ; Kidney Failure, Chronic ; Peritoneal Dialysis, Continuous Ambulatory*