Cyclic vomiting syndrome (CVS) is a paroxysmal, recurrent vomiting disorder of unknown pathophysiology and target organ. It has been hypothesized that CVS shares the same mechanism as migraine. We describe here a 5-year-old boy with CVS characterized by episodic vomiting attacks. These recurrent vomiting episodes began at 3 years of age, occurred every month and lasted for 5 days at a time. At the time of admission, no abnormal physical or neurological findings were observed and laboratory findings, including brain MRI and endoscopic examination, revealed nothing specific. The vomiting episodes were self-limited but recurrent and severely interrupted his daily life. When this patient was treated with topiramate, he showed a marked increase of symptom-free periods.
Brain ; Child ; Child, Preschool ; Humans ; Magnetic Resonance Imaging ; Male ; Migraine Disorders ; Vomiting*

PURPOSE: This study was conducted to investigate dietary habits related to weight reduction and snack intake habits of 4th to 5th grade elementary students located in Jeju-si, Jeju, South Korea. METHODS: The 4(th) and 5(th) grade elementary school students (total n = 234, equally matched numbers of normal weight children and overweight/obese children (n = 117/group)) were surveyed using a questionnaire and a 24-hour dietary recall method in Oct 2015. RESULTS: The percentage of students who experienced reduced food intake to control weight was 26.3% in the normal weight group (NG) and 77.6% in the obese group (OG). Most frequently answered meal for reduced intake was snacks in the NG and dinner in the OG. Percentages of daily calorie intake among subjects were 17.2% for breakfast, 33.8% for lunch, 29.7% for dinner, and 19.3% for snacks. Frequency of snack intake was 2.1 times a week in NG and 1.6 times a week in OG, which showed a statistical difference between body weight groups. Types of snack foods were distinctly different depending on where children consumed them, although no difference was observed between NG and OG. In addition, snack intake level of low energy and nutrient-dense foods was significantly lower in the OG compared to the NG, whereas snack intake level of energy dense and low-nutritive foods was not different between the OG and NG. CONCLUSION: Taken together, snack intake level with consideration of frequency and amount of snack intake showed that children in the OG consumed significantly less low energy and nutrient-dense foods compared to the NG. Therefore, nutritional education for choosing healthy snack foods for children regardless of body weight status is crucial based on family-school links.
Body Weight ; Breakfast ; Case-Control Studies ; Child ; Eating ; Education ; Food Habits ; Humans ; Korea ; Lunch ; Meals ; Methods ; Obesity ; Snacks* ; Weight Loss

No abstract available.
Sparganosis*

We evaluated the long-term outcome of vagus nerve stimulation (VNS) in 28 children with refractory epilepsy. Of these 28 children, 15 (53.6%) showed a >50% reduction in seizure frequency and 9 (32.1%) had a >75% reduction. When we compared seizure reduction rates according to seizure types (generalized vs. partial) and etiologies (symptomatic vs. cryptogenic), we found no significant differences. In addition, there was no correlation between the length of the stimulation period and treatment effect. The seizure reduction rate, however, tended to be inversely related to the seizure duration before VNS implantation and age at the time of VNS therapy. VNS also improved quality of life in this group of patients, including improved memory in 9 (32.1%), improved mood in 12 (42.9%), improved behavior in 11 (39.3%), improved altertness in 12 (42.9%), improved achievement in 6 (21.4%), and improved verbal skills in 8 (28.6%). Adverse events included hoarseness in 7 patients, dyspnea at sleep in 2 patients, and wound infection in 1 patient, but all were transient and successfully managed by careful follow-up and adjustment of parameters. These results indicate that VNS is a safe and effective alternative therapy for pediatric refractory epilepsy, without significant adverse events.
Adolescent ; Child ; Child, Preschool ; Electric Stimulation Therapy/*methods ; Epilepsy/*therapy ; Female ; Humans ; Korea ; Male ; Quality of Life ; Seizures/therapy ; Time Factors ; Treatment Outcome ; Vagus Nerve/*pathology

PURPOSE: This study aimed to reveal the benefits and the safety of surgical treatment in children with refractory epilepsy by reviewing our experiences on a case-by-case basis. METHODS: Twenty one patients who underwent epilepsy surgeries from September, 2003 to March, 2005 at Sanggye Paik Hospital were included. Data including clinical features and surgical outcomes were filed up through 2 years. RESULTS: The profiles of the 15 patients who underwent curative epilepsy surgeries were as follows. Characteristically, one patient had dual epilepsy including mesial temporal lobe epilepsy. Two patients had infantile spasms with cortical dysplasia, both of whom underwent epilepsy surgeries in early infancy. Also, there is a patient who underwent a re-operation, while another one patient had an epileptic focus in the insular lobe. Two patients were diagnosed Sturge-Weber syndrome, and three patients had nonlesional or lesional multilobar epilepsies. Furthermore, the surgical outcomes can be classified such as Engel class I in 10(66.7%) patients, class II in 3(20.0%) patients while one patient failed to obtain any seizure reduction after surgical treatment. In addition, palliative total corpus callosotomies were tried in 6 patients. But only one patient showed seizure reduction of more than 90%, while 4 patients exhibited 50-75% seizure reduction and the other one did not have any changes in seizure frequency. We also experienced various kinds of unwanted events such as memory deterioration (1), vascular infarction (1), hypoxic insult (1), transient hemiparesis (2), dysinhibition (1) and visual field defects (3). Most of neuroimaging studies were highly concordant to the ictal scalp and intracranial EEGs. CONCLUSION: Epilepsy surgery can be an effective therapeutic modality in localization related intractable childhood epilepsies. However, we should consider various surgical complications and carefully evaluate the epileptogenic and functionally eloquent areas.
Child ; Electroencephalography ; Epilepsy* ; Epilepsy, Temporal Lobe ; Humans ; Infant ; Infant, Newborn ; Infarction ; Malformations of Cortical Development ; Memory ; Neuroimaging ; Paresis ; Scalp ; Seizures ; Spasms, Infantile ; Sturge-Weber Syndrome ; Visual Fields

BACKGROUND AND OBJECTIVES: Local wide split double potentials are used as a parameter to determine complete conduction block during cavotricuspid isthmus ablation in patients with isthmus dependent atrial flutter. However, delayed slow conduction in that region can sometimes be very difficult to differentiate from complete block. Flutter cycle length (FCL) can be used to confirm isthmus conduction block, because FCL is a measure of conduction time around the tricuspid annulus (TA). This study was designed to determine which degree of splitting of the local electrograms is adequate to confirm complete isthmus block, using FCL as a reference. SUBJECTS AND METHODS: Cavotricuspid isthmus (CTI) ablation was performed in fifty consecutive patients. The interval between the pacing stimulus on the lateral side of the CTI and the first component of the double potentials on the block line (SD1) corresponded to the counterclockwise conduction time. The interval between the pacing stimulus and second component (SD2) represented the clockwise conduction time to the contralateral side of the ablation line. SD1 and SD2 were measured before and after complete isthmus block. RESULTS: An SD1+SD2 reaching 90% of the FCL identified the counterclockwise isthmus conduction block with 94% sensitivity and 100% specificity. CONCLUSION: If the sum of SD1 and SD2 following isthmus ablation was close to the FCL, complete conduction block was predicted with high diagnostic accuracy and positive predictive value for at least counterclockwise conduction.
Atrial Flutter ; Catheter Ablation ; Humans ; Sensitivity and Specificity ; Syndactyly

OBJECTIVES: This clinical study aimed to investigate if dentifrices containing policresulen would help to control dental plaque and gingivitis. METHODS: Seventy-eight eligible adults participated in this double-blind and randomized clinical study after an initial oral examination, calculus removal, and tooth prophylaxis. Two weeks after the procedure, the participants were assigned to three groups using the following dentifrices: (1) a dentifrice containing 0.22% NaF (control group); (2) a dentifrice containing 0.22% NaF and 100 ppm policresulen (policresulen group); and (3) a dentifrice containing 0.22% NaF, 100 ppm policresulen, and 1.00% bamboo salt (policresulen/bamboo group). The participants used only the provided dentifrice (for 1 min, twice a day, over 8 weeks) when brushing their teeth and followed their normal brushing habits. Dental plaque accumulation and gingivitis measurements were conducted using the Turesky modification of the Quigley-Hein plaque index (PI), the Loe and Silness gingival index (GI), and the percent bleeding on probing (%BOP) to obtain baseline data and 4- and 8-week data after grouping. RESULTS: A total of 73 participants aged 35.92+/-11.46 years (mean+/-SD) completed the study. The results after 8 weeks demonstrated statistically significant group-by-time interactions for PI, GI, and %BOP (P<0.001). The PI observed in the control groups increased over time up to 6%, while that observed in the dentifrice groups containing policresulen decreased by 5% (P<0.001). For GI and %BOP, the control group exhibited significantly higher values after 8 weeks, while the policresulen and the policresulen/bamboo groups revealed similar index values as the baseline after 4 and 8 weeks. The changes in all indices were significantly different between the control and the two experimental groups. There were no significant differences in the results obtained from the policresulen/bamboo group and the results obtained from the policresulen group. CONCLUSIONS: Use of dentifrices containing policresulen over 8 weeks demonstrated anti-plaque and anti-gingivitis efficacy compared to a control dentifrice.
Adult ; Calculi ; Dental Plaque Index ; Dental Plaque* ; Dentifrices* ; Diagnosis, Oral ; Gingival Hemorrhage ; Gingivitis* ; Hemorrhage ; Humans ; Periodontal Index ; Tooth

PURPOSE: The main treatment for stage IV breast cancer is currently systemic therapy. Surgical resection of the primary tumor is usually done for treating the tumor-related complications. Recent studies have suggested that surgery may improve the long-term survival of stage IV breast cancer patients. We evaluated the impact of the primary surgical resection site on the survival of stage IV breast cancer patients. METHODS: We reviewed the records of the stage IV breast cancer patients who were treated at Seoul University Hospital between April 1992 and December 2007. The tumor and clinical characteristics, the type of treatments and the overall survival were compared between the surgically versus nonsurgically treated patients. RESULTS: Of the 198 identified patients, 110 (55.8%) received surgical excision of their primary tumor and 88 (44.2%) did not. The mean survival was 67 months vs. 42 months for the surgically treated patients vs. the patients without surgery, respectively (p=0.0287). On a multivariate analysis with using the Cox model and after adjusting for the estrogen receptor status, visceral metastases, the number of metastatic sites and trastuzumab treatment, surgery was an independent factor for improved survival (hazard ratio, 0.55; 95% confidence interval, 0.31-0.97; p=0.041). CONCLUSION: Surgical resection of the primary tumor in stage IV breast cancer patients was independently associated with improved survival. Randomized prospective trials are needed to firmly recommend surgical resection of the primary tumor in stage IV breast cancer patients.
Antibodies, Monoclonal, Humanized ; Breast ; Breast Neoplasms ; Estrogens ; Humans ; Multivariate Analysis ; Neoplasm Metastasis ; Trastuzumab

PURPOSE: The main treatment for stage IV breast cancer is currently systemic therapy. Surgical resection of the primary tumor is usually done for treating the tumor-related complications. Recent studies have suggested that surgery may improve the long-term survival of stage IV breast cancer patients. We evaluated the impact of the primary surgical resection site on the survival of stage IV breast cancer patients. METHODS: We reviewed the records of the stage IV breast cancer patients who were treated at Seoul University Hospital between April 1992 and December 2007. The tumor and clinical characteristics, the type of treatments and the overall survival were compared between the surgically versus nonsurgically treated patients. RESULTS: Of the 198 identified patients, 110 (55.8%) received surgical excision of their primary tumor and 88 (44.2%) did not. The mean survival was 67 months vs. 42 months for the surgically treated patients vs. the patients without surgery, respectively (p=0.0287). On a multivariate analysis with using the Cox model and after adjusting for the estrogen receptor status, visceral metastases, the number of metastatic sites and trastuzumab treatment, surgery was an independent factor for improved survival (hazard ratio, 0.55; 95% confidence interval, 0.31-0.97; p=0.041). CONCLUSION: Surgical resection of the primary tumor in stage IV breast cancer patients was independently associated with improved survival. Randomized prospective trials are needed to firmly recommend surgical resection of the primary tumor in stage IV breast cancer patients.
Antibodies, Monoclonal, Humanized ; Breast ; Breast Neoplasms ; Estrogens ; Humans ; Multivariate Analysis ; Neoplasm Metastasis ; Trastuzumab

BACKGROUND: Several methods have been reported to induce asthmatic reactions in mice but few studies have compared their efficiency. We evaluated the efficiency of the protocols frequently used in the literature. METHODS: BALB/c mice were sensitized to ovalbumin (OVA) by intraperitoneal injection; 1] Once a week for two weeks using OVA with alum (IPOA-2) or without (IPO-2), and provocation on days 28-30 by 1% OVA inhalation; 2] seven times for two weeks by OVA with alum (IPOA-7) or without (IPO-7) and provocation by 1% OVA inhalation on days 42-44. 3] Sensitization by 1% OVA inhalation for ten days (IHO-10) and provocation by 1% OVA inhalation on days 28-30. After the last challenge, airway hyperresponsiveness was measured with single chamber plethysmography 24 hours later and mice were sacrificed 48 hours later. RESULTS: Airway hyperresponsiveness, BALF eosinophilia, airway inflammation, and OVA-specific IgE and IgG1 production were effectively induced in IPOA-2, IPOA-7, and IPO-7. However, these phenotypes were not induced in IPO-2 (except for increased BALF eosinophils) or IHO-10 (except for an increased OVA-specific IgG1 level). CONCLUSION: The intraperitoneal injections of OVA with alum once a week for two weeks proved to be the most efficient sensitization method of inducing an asthmatic reaction in mice.
Administration, Inhalation ; Animals ; Antibodies, Anti-Idiotypic/blood ; Asthma/diagnosis/*genetics/immunology ; *Bronchial Provocation Tests ; Comparative Study ; Disease Models, Animal ; Female ; Immunoglobulin G/immunology ; Injections, Intraperitoneal ; Lung/pathology ; Mice ; Mice, Inbred BALB C ; Ovalbumin/administration & dosage/*diagnostic use/immunology ; *Phenotype ; Research Support, Non-U.S. Gov't