BACKGROUND AND OBJECTIVES: In addition to diagnostic criteria, a broad range of nonspecific clinical features can be found in patients with Kawasaki disease. This lack of specificity may cause confusion with other febrile illnesses and delay the diagnosis of Kawasaki disease. The purpose of this study is to describe common associated symptoms and their clinical significances in children affected with Kawasaki disease. SUBJECTS AND METHODS: As a retrospective study, we reviewed the medical records of 121 children who were treated for Kawasaki disease at Presbyterian medical center from January 2005 to June 2010. All clinical symptoms, laboratory data and echocardiographic findings in patients with KD were collected and analyzed. RESULTS: We found that there are 9 associated symptoms, namely cough, rhinorrhea, sputum, abdominal pain, vomiting, diarrhea, arthralgia, headache and seizure, which occur in patients with Kawasaki disease. Among the study group, there were only 32 children with no associated symptoms (26.4%). Patients with abdominal pain and headache had an older mean age than those without such symptoms. The incidence of seizure was significantly higher in incomplete Kawasaki disease patients compared with those with complete Kawasaki disease. Vomiting was highly associated with IVIG non-responder group. CONCLUSION: To decrease the incidence of serious coronary complications due to delayed diagnosis, physicians need to be aware of the manifestations of Kawasaki disease and the possibility of associated symptoms, which, being unspecific, may otherwise not raise any red flags.
Abdominal Pain ; Arthralgia ; Child ; Cough ; Delayed Diagnosis ; Diarrhea ; Headache ; Humans ; Immunoglobulins, Intravenous ; Incidence ; Medical Records ; Mucocutaneous Lymph Node Syndrome ; Protestantism ; Retrospective Studies ; Seizures ; Sensitivity and Specificity ; Sputum ; Vomiting

Infectious diseases of immigrant populations have recently become important issues for the health of both Korean nationals and foreigners living in Korea. This case report of general paresis is intended to raise awareness about re-emerging neurosyphilis in Korea as a possible etiology of psychotic disorders. A 68-year-old male Chinese resident came to Korea in 2019 with disorientation, auditory hallucination, persecutory delusion, and aggressive behavior, and was admitted to a psychiatric ward for further evaluation and treatment via the emergency department. He was confirmed to have neurosyphilis by serum test, analysis of cerebrospinal fluid, and brain magnetic resonance imaging. After treatment with antibiotics, including intravenous penicillin, in combination with atypical antipsychotics for 6 weeks, his disorientation, auditory hallucination, delusion, and aggressive behavior had attenuated.Neurosyphilis should still be included as a possible etiology of psychotic disorders in Korea.At the initial evaluation, syphilis screening serum tests are recommended for psychotic patients, especially those with pleomorphic symptoms and cognitive dysfunction.

PURPOSE: To determine changes in the degree of pseudomyopia and convergence in patients with spasm of the near reflex. METHODS: In 5 patients with spasm of the near reflex, we checked following: UCVA/BCVA, the degree of pseudomyopia revealed through manifest and cycloplegic refraction tests, pupil size, limitation of EOM, the amount of convergence defined by the alternate prism cover test, and slit lamp and funduscopic exams. RESULTS: Of the 5 patients with spasm of near reflex, 3 had accommodative spasm alone and 2 had accommodative spasm, convergence spasm and miosis. The patients' degrees of pseudomyopia and convergence were -8.0D and 14PD on the average. which disappeared after an average of 10.8 months but recurred in 1 of the 3 patients with accommodative spasm. As for spasm of the near reflex, 1 patient showed improvement in convergence but worsening pseudomyopia during the follow-up period, and another patient showed recurrence. CONCLUSIONS: The most common clinical feature of spasm of the near reflex is accommodative spasm. Patients with accommodative spasm alone showed better prognosis among all patients with spasm of the near reflex in terms of recurrence and the disease course.
Follow-Up Studies ; Humans ; Miosis ; Prognosis ; Pupil ; Recurrence ; Reflex* ; Spasm*

PURPOSE: The purpose of this study was to construct a fetal animal model of congenital diaphragmatic hernia in a lamb under domestic environments. METHODS: Left-sided diaphragmatic hernias were created in seven fetal lambs at about 85 days' gestation (experimental group). Three other fetal lambs did not receive any surgical procedure and served as control group. Four of these lambs (3 in the experimental group and 1 in the control group) were delivered after a sufficient intrauterine period. The morphological changes of lung development were compared between the two groups. RESULTS: Creation of diaphragmatic hernia resulted in marked hypoplasia in fetal lung development. In this experiment, the maternal mortality was 33.3%, and the fetal mortality was 60% which are relatively high as compared with previous reports. CONCLUSION: From this data, the authors concluded that experimental fetal diaphragmatic hernia can be established although the technique for the measurement of gestational age, anesthesia and postoperative care should be improved to overcome domestic inexperience in using the lamb as an experimental animal.
Anesthesia ; Animals ; Fetal Mortality ; Gestational Age ; Hernia, Diaphragmatic* ; Lung ; Maternal Mortality ; Models, Animal ; Postoperative Care ; Pregnancy

PURPOSE: There is no standard targeted therapy for the treatment of triple-negative breast cancer (TNBC). Therefore, its management heavily depends on adjuvant chemotherapy. Using core needle biopsy, this study evaluated the histological factors of TNBC predicting the response to chemotherapy. METHODS: One hundred forty-three TNBC patients who received single-regimen neoadjuvant chemotherapy (NAC) with the combination of doxorubicin, cyclophosphamide, and docetaxel were enrolled. The core needle biopsy specimens acquired before NAC were used to analyze the clinicopathologic variables and overall performance of the predictive model for therapeutic response. RESULTS: Independent predictors of pathologic complete response after NAC were found to be higher number of tumor infiltrating lymphocytes (p=0.007), absence of clear cytoplasm (p=0.008), low necrosis (p=0.018), and high histologic grade (p=0.039). In the receiver operating characteristics curve analysis, the area under curve for the combination of these four variables was 0.777. CONCLUSION: The present study demonstrated that a predictive model using the above four variables can predict therapeutic response to single-regimen NAC with the combination of doxorubicin, cyclophosphamide, and docetaxel in TNBC. Therefore, adding these morphologic variables to clinical and genomic signatures might enhance the ability to predict the therapeutic response to NAC in TNBC.
Area Under Curve ; Biopsy, Large-Core Needle ; Chemotherapy, Adjuvant ; Cyclophosphamide ; Cytoplasm ; Doxorubicin ; Drug Therapy* ; Humans ; Lymphocytes, Tumor-Infiltrating ; Necrosis ; Neoadjuvant Therapy ; ROC Curve ; Treatment Outcome ; Triple Negative Breast Neoplasms*

Purpose: We report the clinical outcomes of Korean patients who were diagnosed with orbital malignancies and underwent orbital exenteration. Methods: We retrospectively reviewed the tumor origins, histopathological diagnoses, local/regional recurrences, distant metastases, surgical margin clearances, overall and event-free survivals, and adjuvant chemotherapy or radiation therapy statuses of 14 patients who underwent orbital exenteration in our center from February 2009 to March 2020. Results: We enrolled seven men and seven women of mean age at the time of exenteration of 68 years (range, 37 to 80 years). The mean follow-up period was 44.6 months (range, 10 to 133 months). Most tumors had arisen in the eyelid (seven cases, 50.0%). The most common pathological diagnosis was malignant melanoma (five cases, 35.7%). We observed no local or regional recurrence after exenteration, but distant metastases developed in seven cases, of which four were malignant melanomas (80% of all melanomas). Positive surgical margins were observed in six cases (42.9%). The distant metastasis rate was 42.9%; the overall survival rate was 60%. The 1-year overall survival rate was 100%, the 2-year survival rate was 81.8%, and the 5-year survival rate was 56.1%. The 1-year event-free survival (EFS) rate was 100%, the 2-year EFS rate was 72.7%, and the 5-year EFS rate was 49.9%. Nine patients received adjuvant radiation or chemotherapy and six patients received combined chemoradiation. Conclusions Patients underwent orbital exenteration to treat orbital malignancies and received postoperative chemotherapy and/or radiation exhibited differences in clinical outcomes and survival rates depending on the tumor type.

Several outbreaks of Getah virus (GETV) have been reported in horses and pigs, causing large economic losses. However, there have been no reports describing serological survey for GETV in South Korea pigs. The present study conducted serological survey of GETV in South Korean pigs. A total of 670 whole blood samples were collected from domestic pigs. The overall seropositive rate was 26.4%, higher than the rates observed in racehorses in 2013–2014. Preparations for epidemics of novel diseases caused by climate change should include regular serological survey for these diseases, including GETV, and the development of vaccines against novel pathogens.

BACKGROUND: Disability of Activities of daily living (ADL) is the most important factor for care of dementia patients. So Korean Dementia Association has prepared the survey for current state and cognition of active daily living in Korean dementia patients. METHODS: A total of 100 subjects were interviewed. Structured open and closed questions about ADL for dementia were asked. They are main caregivers of dementia patients who working over 5hours per day. Assessments included age, sex, education level, economic status, severity of dementia patients, pattern of the care-giving, current state and cognition of ADL, and needs of the caregivers. RESULTS: The cognition of ADL was very low (51%) and this is correlated with economic status. Increasing of care-giving time is the most stressful for caregivers, they frequently suffered from disability of outgoing and personal hygiene. Dementia patient's ADL disability causes serious economic losses, need of the caregivers about guide lines or education program was very high. CONCLUSION: Considering these results, we should design more detailed study about dementia patient's ADL disability and prepare guide line or program for it.
Activities of Daily Living ; Caregivers ; Cognition ; Dementia ; Humans ; Hygiene

Background: Fluorescent antibody virus neutralization (FAVN) test is a standard assay for quantifying rabies virus-neutralizing antibody (VNA) in serum. However, a safer rabies virus (RABV) should be used in the FAVN assay. There is a need for a new method that is economical and time-saving by eliminating the immunostaining step. Objectives: We aimed to improve the traditional FAVN method by rescuing and characterizing a new recombinant RABV expressing green fluorescent protein (GFP). Methods: A new recombinant RABV expressing GFP designated as ERAGS-GFP was rescued using a reverse genetic system. Immuno-fluorescence assay, peroxidase-linked assay, electron microscopy and reverse transcription polymerase chain reaction were performed to confirm the recombinant ERAGS-GFP virus as a RABV expressing the GFP gene. The safety of ERAGS-GFP was evaluated in 4-week-old mice. The rabies VNA titers were measured and compared with conventional FAVN and FAVN-GFP tests using VERO cells. Results: The virus propagated in VERO cells was confirmed as RABV expressing GFP.The ERAGS-GFP showed the highest titer (108.0TCID50/mL) in VERO cells at 5 days postinoculation, and GFP expression persisted until passage 30. The body weight of 4-week-old mice inoculated intracranially with ERAGS-GFP continued to increase and the survival rate was 100%. In 62 dog sera, the FAVN-GFP result was significantly correlated with that of conventional FAVN (r = 0.95). Conclusions We constructed ERAGS-GFP, which could replace the challenge virus standard-11 strain used in FAVN test.

Feline panleukopenia virus (FPV) causes leukopenia and severe hemorrhagic diarrhea, killing 50% of naturally infected cats. Although intact FPV can serve as an antigen in the hemagglutination inhibition (HI) test, accidental laboratory-mediated infection a concern. A non-infectious diagnostic reagent is required for the HI test. Here, we expressed the viral protein 2 (VP2) gene of the FPV strain currently prevalent in South Korea in a baculovirus expression system; VP2 protein was identified by an indirect immunofluorescence assay, electron microscopy (EM), Western blotting (WB), and a hemagglutination assay (HA). EM showed that the recombinant VP2 protein self-assembled to form virus-like particles. WB revealed that the recombinant VP2 was 65 kDa in size. The HA activity of the recombinant VP2 protein was very high at 1:215. A total of 143 cat serum samples were tested using FPV (HI-FPV test) and the recombinant VP2 protein (HI-VP2 test) as HI antigens. The sensitivity, specificity, and accuracy of the HI-VP2 test were 99.3%, 88.9%, and 99.3%, respectively, compared to the HI-FPV test. The HI-VP2 and HI-FPV results correlated significantly (r = 0.978). Thus, recombinant VP2 can substitute for intact FPV as the serological diagnostic reagent of the HI test for FPV.