PURPOSE: Minimal change esophagitis (MCE) is a reflux disease without mucosal breaks, known to be partially associated with abnormal gastric motor function. Electrogastrography (EGG) is commonly applied to assess gastric motor function in a noninvasive fashion. We aimed to determine the relationship between MCE and gastric myoelectrical activity (GME) recorded on EGG in children. METHODS: We retrospectively assessed the records of 157 children without underlying disease who underwent both EGG and upper gastrointestinal endoscopy at Gachon University Gil Medical Center between January 2010 and June 2015. The children were stratified according to the appearance of the esophagus (normal vs. MCE). Between-group differences in EGG parameters and their correlation with each MCE finding were statistically analyzed. RESULTS: Only the power ratio, one of the EGG parameters analyzed, differed significantly between the two groups (MCE, 1.68±3.37 vs. normal, 0.76±1.06; p < 0.05), whereas the other parameters, such as dominant frequency, dominant power, and the ratio of abnormal rhythm, showed no differences. Among children with MCE, significant correlations were noted between erythema and power ratio (p < 0.05), friability and postprandial dominant frequency (p < 0.05), and edema and/or accentuation of mucosal folds and pre-prandial frequency (p < 0.05). Helicobacter pylori infection correlated with postprandial arrhythmia (MCE, 33.59±15.52 vs. normal, 28.10±17.23; p < 0.05). EGG parameters did not differ between children with normal esophagus and those with biopsy-proven chronic esophagitis. CONCLUSION: In children with MCE, gastric dysmotility may affect the development of MCE, manifesting as EGG abnormalities. H. pylori infection may also affect GME. However, larger prospective investigations are needed to confirm these findings.
Arrhythmias, Cardiac ; Child ; Edema ; Endoscopy ; Endoscopy, Gastrointestinal ; Erythema ; Esophagitis ; Esophagus ; Helicobacter pylori ; Humans ; Ovum ; Prospective Studies ; Retrospective Studies

PURPOSE: The aim of this study is to investigate the association between elevated alanine aminotransferase (ALT) and urosepsis in children with acute pyelonephritis (APN). METHODS: We retrospectively identified all children who were managed in our hospital with APN during a decade period. In our study a diagnosis of APN was defined as having a positive urine culture and a positive (99m)Tc-dimercaptosuccinic acid scintigraphy. We compared those with elevated ALT and those with normal ALT according to the following variables: age, gender, duration of fever prior to admission, presence of hypotension, C-reactive protein (CRP), creatinine, presence of anemia, white blood cells count, platelet count, blood culture result, and grades of vesicoureteral reflux. In addition, the correlation between elevated ALT and positive blood culture was analyzed in detail. RESULTS: A total of 996 children were diagnosed with APN, of which 883 were included in the study. ALT was elevated in 81 children (9.2%). In the analysis of demographic characteristics, the number of children with elevated ALT was higher in children between 0 to 3 months, boys, and in those with positive blood culture (p=0.002, 0.036, and 0.010, respectively). In multivariate analysis of variables associated with positive blood culture, age younger than 3 months, elevated ALT, elevated CRP, and elevated creatinine showed statistical significance (p=0.004, 0.030, 0.043, and 0.044, respectively). CONCLUSION: Our study demonstrates the association between elevated ALT and increased prevalence of urosepsis in addition to elevated CRP, elevated creatinine, and age younger than 3 months in children with APN.
Alanine Transaminase* ; Alanine* ; Anemia ; C-Reactive Protein ; Child* ; Creatinine ; Diagnosis ; Fever ; Humans ; Hypotension ; Infant ; Leukocytes ; Multivariate Analysis ; Platelet Count ; Prevalence ; Pyelonephritis* ; Radionuclide Imaging ; Retrospective Studies ; Vesico-Ureteral Reflux

PURPOSE: Chlamydia pneumoniae is a common intracellular bacterial pathogen and plays an important role in acute respiratory infections. The purpose of this study was to investigate clinical presentations of C. pneumoniae in children with acute respiratory infections. METHODS: We examined the medical records of pediatric patients (age<18 years) admitted with acute respiratory infections of C. pneumoniae to Gachon University Gil Medical Center between March 1, 2011 and August 31, 2014. We compared the clinical features of C. pneumoniae infection with that of Mycoplasma pneumoniae infection. RESULTS: We confirmed acute respiratory infections of C. pneumoniae in 110 patients out of 2,156 patients (5.1%) admitted with acute respiratory infections. The mean age was 37.2+/-30.1 months. More than half of them (54.5%) had coinfection. C. pneumoniae infection had mild and subacute courses. The mean duration of symptoms prior to admission was 8.5+/-13.8 days. There were remarkable seasonal variations and prevalence was higher in December and April (P=0.03 and P=0.02, respectively). Although rhinorrhea and pharyngeal injection were more common in C. pneumoniae infection (P<0.05), clinical signs and symptoms were similar between C. pneumoniae and M. pneumoniae. Extrapulmonary manifestations such as skin lesion, Gastrointestinal symptoms, hepatitis, and neurologic symptoms were common (41.0%) in C. pneumoniae infection and, had similar incidence in M. pneumoniae infection. CONCLUSION: C. pneumoniae is an important infectious agent of acute respiratory infections in children. Clinical pictures of C. pneumoniae are similar to M. pneumoniae, even in extrapulmonary manifestations. C. pneumoniae should be taken into consideration in differential diagnosis of acute respiratory infection in children.
Child* ; Chlamydia* ; Chlamydophila pneumoniae* ; Coinfection ; Diagnosis, Differential ; Hepatitis ; Humans ; Incidence ; Medical Records ; Mycoplasma pneumoniae ; Mycoplasma* ; Neurologic Manifestations ; Pneumonia ; Pneumonia, Mycoplasma* ; Prevalence ; Respiratory Tract Infections* ; Seasons ; Skin

PURPOSE: Mycoplasma pneumoniae (MP) infection is a major cause of respiratory infection in school-aged children. Extrapulmonary manifestations of MP infection are common, but liver involvement has been rarely reported. The aim of this study was to determine the clinical characteristics of MP-associated hepatitis. METHODS: This prospective study included 1,044 pediatric patients with MP infection diagnosed serologically with MP IgM at one medical center from January 2006 to December 2012. Eighty of these patients had elevated levels of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT), each greater than 50 IU/L, without any other specific liver disorder and were compared with the 964 children without liver disorders. RESULTS: In total, 7.7% of patients with MP infection had a diagnosis of hepatitis, especially in fall and winter. The ratio of male to female patients was 1.7:1, and the mean age of the patients was 5 years and 5 months. The most common symptoms were cough, fever, and sputum. Anorexia was the most common gastrointestinal symptom, followed by nausea/vomiting, diarrhea, and abdominal pain. Mean levels of AST and ALT were 100.65 IU/L and 118.73 IU/L, respectively. Serum AST/ALT level was normalized within 7.5 days on average without complications. The mean duration of hospitalization (11.3 days) was longer for children with hepatitis than for those without hepatitis (P=0.034). CONCLUSION: MP-associated hepatitis is not uncommon and has a relatively good prognosis. Therefore, clinicians should be concerned about liver involvement in MP infection but avoid further unnecessary evaluation of hepatitis associated with MP.
Abdominal Pain ; Alanine Transaminase ; Anorexia ; Aspartate Aminotransferases ; Child* ; Cough ; Diagnosis ; Diarrhea ; Female ; Fever ; Hepatitis* ; Hospitalization ; Humans ; Immunoglobulin M ; Liver ; Macrolides ; Male ; Mycoplasma pneumoniae* ; Pneumonia, Mycoplasma* ; Prognosis ; Prospective Studies* ; Sputum

BACKGROUND: Medical skin care is essential for the treatment of skin diseases all over the world. Medical skin care is also part of medical practice and this must be differentiated from the simple skin care that is given for normal healthy skin. OBJECTIVE: We wanted to discuss medical skin care and the related medical devices and legal issues. METHODS: We reviewed the related laws and regulations, we consulted experts and associations and we analyzed the result of the survey. RESULTS: Legally, medical skin care and simple skin care are well classified. However, many illegal procedures are still performed by non-medical personnel and many adverse effects have been reported as a result. Furthermore, there are no legal restrictions for the performer based on the grade of each medical skin care procedure. CONCLUSION: For the best results and safe procedures, medical skin care must be performed by approved medical equipment under the supervision of a physician or medical personnel. Continuous control and guidance by the government is strongly needed.
Jurisprudence ; Organization and Administration ; Skin ; Skin Care ; Skin Diseases ; Social Control, Formal

BACKGROUND: The abuse, misuse, and adverse effects to topical drugs have been widespread in Korea due to lack of awareness of seriousness of drug abuse and misuse, and improper designation of prescription and non-prescription drugs. OBJECTIVE: This study was conducted to bring Korean people to an awareness of the abuse, misuse, and adverse effects of topical drugs, and to stress the importance of proper designation of non-prescription drugs. METHODS: A multicenter, prospective, clinico-epidemiologic evaluation was made from patients with adverse effects to topical drugs who visited 31 dermatologic departments in university hospitals or private clinics nationwide from march, 2002 to December, 2002. RESULTS: The diagnostic incidence of adverse effects from topical drugs are abuse and misuse (40%), dermatophytosis incognito (29%), bacterial infection (14%), contact dermatitis (9%), acne (2.5%), skin atrophy (1.4%), telangiectasia (1%). Erghty three percent of adverse effects are caused by topical corticosteroids, and betamethasone valerate, prednicarbate and triamcinolone acetonide are commonly used topical corticosteroids that induce adverse effects frequently. The most common way to obtain topical drugs is purchase directly from pharmacist without prescriptions. CONCLUSION: From this study, we confirmed that adverse effects to topical corticosteroids are very common even after the enforcement of designation of prescription drugs and non-prescription drugs. The proper designation of prescripton drugs should be reevaluated and based on the safety of patients to protect people from adverse effects of topical drugs.
Acne Vulgaris ; Adrenal Cortex Hormones ; Atrophy ; Bacterial Infections ; Betamethasone Valerate ; Dermatitis, Contact ; Hospitals, University ; Humans ; Incidence ; Korea ; Nonprescription Drugs ; Pharmacists ; Prescription Drugs ; Prescriptions ; Prospective Studies ; Skin ; Substance-Related Disorders ; Telangiectasis ; Tinea ; Triamcinolone Acetonide

BACKGROUND AND OBJECTIVES: Ideal treatment for vocal cord paralysis is to restore normal movement of the vocal cord and to bring back the natural voice. Pulsed electromagnetic stimulation (PEMS)has been known to bring early nerve regeneration as well as better functional recovery. The purpose of this investigation is to learn the effect of PEMS on regeneration of the recurrent laryngeal nerve. MATERIALS AND METHOD: Using 36 healthy male Sprague-Dawley rats, we made transections on their left recurrent laryngeal nerves and performed primary anastomosis under the operating microscope. Rats were divided into an experimental group and a control group, each having 18 rats by random sampling. For the experimental group, PEMS was carried out three hours a day and five days a week for twelve weeks. For the control group, PEMS was not given while other conditions were kept the same as in the experimental group. The extent of functional recovery was observed for each group by performing videostroboscopic examination once every week. After twelve weeks, a test for the functional recovery was performed electrophysiologically through laryngeal electromyography during respiration. RESULTS: After the twelve-week experiment, 14 out of 18 rats survived in the group which received PEMS while 8 out of 18 rats stayed alive in the control group. Ten rats (71%)in the PEMS performed group and 3 rats (38%)in the control group showed recovery of vocal cord movement, but it did not reveal any significant difference statistically. However, the time it took for functional recovery was 3.93+/-0.27 weeks and 7.87+/-0.85 weeks for the PEMS performed group and the control group, respectively. And the difference was statistically significant. CONCLUSION: This investigation confirmed the efficacy of PEMS on the early functional recovery in rats with surgically transected and reanastomosed recurrent laryngeal nerve. Further studies to understand the mechanism of action of these effects as well as the local stimulation rather than the total body stimulation seem to be necessary.
Animals ; Electromyography ; Humans ; Magnets* ; Male ; Nerve Regeneration ; Rats* ; Rats, Sprague-Dawley ; Recurrent Laryngeal Nerve ; Regeneration ; Respiration ; Vocal Cord Paralysis ; Vocal Cords ; Voice

Chronic actinic dermatitis is a rare disease worldwide and also in Korea. However there has been no clinicohistologic and photobiological analysis of chronic actinic dermatitis in Korea. We examined 11 patients who were diagnosed as chronic actinic dermatitis and the results of this study were compared with previous reports. Most patients were elderly men who had erythematous papules or lichenified plaques on sun-exposed areas such as the face, neck, and dorsum of the hands with severe itching sensation. All patients had severe sensitivity to UVB and biopsied specimens showed findings of chronic eczema. Five patients had positive photopatch test materials. The patients were treated with systemic and topical steroid, cyclosporine and antihistamine.
Adult ; Aged ; Chronic Disease ; Female ; Human ; Male ; Middle Age ; Photosensitivity Disorders/pathology ; Photosensitivity Disorders/etiology* ; Photosensitivity Disorders/drug therapy ; Ultraviolet Rays/adverse effects

We report a case of primary cutaneous adenoid cystic carcinoma in a 39-year-old male patient. It was a slightly erythematous hard nodule on left chin and composed of cribriform and tubular masses of basaloid cells. Lumina formed by neoplastic cells contained mucin and hyalin, and similar constituents were located between neoplastic cell masses and adjacent dermis. Immunohistochemically, the neoplastic cells stained only focally with S-100 protein and negative with carcinoembryonic antigen(CEA). Therapy should employ wide surgical excision that extends well beyond the clinical confines of the neoplasm.
Adenoids* ; Adult ; Carcinoma, Adenoid Cystic* ; Chin ; Dermis ; Humans ; Hyalin ; Male ; Mucins ; S100 Proteins

BACKGROUND: Vitiligo was divided into two types, segmental and non-segmental vitiligo. OBJECTIVE: The purpose of our study is to investigate the clinical differences of segmental and non-segmental vitiligo. METHODS: A cross-sectional study, using standard questionnaire items on 1190 cases of vitiligo was performed. RESULTS: The results were summarized as follows 1. The non-segmental vitiligo was 2.4fold more common than segmental vitiligo. 2. The mean age of onset was older in non-segmental vitiligo than in segmental vitiligo. 3. The mean duration was longer in non-segmental vitiligo. 4. The depigmented area was larger in non-segmental vitiligo. 5. The incidences of Koebner phenomenon, progressiveness and mucosal involvement were more common in non-segmental vitiligo. 6. There were no differences about sex ratio, blood typing, family history, and associated disorders. CONCLUSION: Segmental and non-segmental vitiligo differ substantially in various clinical manifestations, which suggests that two types of vitiligo have different pathogenic mechanism.
Age of Onset ; Blood Grouping and Crossmatching ; Cross-Sectional Studies ; Humans ; Incidence ; Sex Ratio ; Vitiligo* ; Surveys and Questionnaires