Fluoroquinolones are an important class of antibiotics that are widely used in adult patients because of their broad spectrum of activity, good tissue penetration, and oral bioavailability. However, fluoroquinolone use in children is limited because juvenile animals developed arthropathy in previous experiments on fluoroquinolone use. Indications for fluoroquinolone use in patients younger than 18 years, as stated by the U.S. Food and Drug Administration, include treatment of complicated urinary tract infections and postexposure treatment for inhalation anthrax. In Korea, the systemic use of fluoroquinolones has not been approved in children younger than 18 years. Although concerns remain regarding the adverse musculoskeletal effects of fluoroquinolones in children, their use in the pediatric population has increased in many circumstances. While pediatricians should be aware of the indications and adverse effects of fluoroquinolones, recent studies have shown that the risk for musculoskeletal complications in children did not significantly increase following fluoroquinolone treatment. In addition, fluoroquinolones may be particularly helpful in treating multidrug-resistant infections that have not responded to standard antibiotic therapy in immunocompromised patients. In the present article, we provide an updated review on the safety and current recommendations for using fluoroquinolones in children.
Adult ; Animals ; Anthrax ; Anti-Bacterial Agents ; Biological Availability ; Child ; Fluoroquinolones ; Humans ; Immunocompromised Host ; Inhalation ; Joint Diseases ; Korea ; Respiratory Tract Infections ; United States Food and Drug Administration ; Urinary Tract Infections

Extramedullary plasmacytoma involves organs outside the bone marrow, but involvement of the pancreas is very rare. We present the imaging findings of extramedullary plasmacytoma of the pancreas in a patient with multiple myeloma. Mixed echogenecity was noted at US, and marked enhancement at CT and MR.
Bone Marrow ; Humans ; Multiple Myeloma ; Pancreas* ; Plasmacytoma*

PURPOSE: To evaluate the relevant clinical and radiographical findings for the diagnosis of an arteriovenous fistula after a lumbar discectomy. MATERIALS AND METHODS: Five patients with an arteriovenous fistula following a lumbar discectomy were preoperatively diagnosed and treated. We retrospectively evaluated the level of surgery, injured vessels, clinical symptoms, physical findings, and the interval between surgery and treatment. Effective and fast diagnostic methods for determining the presence of a postoperative arteriovenous fistula were evaluated. RESULTS: All of the arteriovenous fistulas resulted from operative injuries of the iliac arteries and veins. They were diagnosed after a mean time of 22 months (range 2 months-4 years) in spite of various symptoms and signs shortly after surgery. The arteriovenous fistulas were confirmed with angiography and were treated by surgery for 3 patients and by insertion of a stent-graft in 2 patients. Postoperative CT angiography showed the complete occlusion of the fistula tract and the normal blood flow. CONCLUSION: Essential clinical information and radiological examination, especially CT angiography with 3D reconstruction, is necessary to obtain to diagnose an arteriovenous fistula after a lumbar discectomy.
Angiography ; Arteriovenous Fistula* ; Diagnosis* ; Diskectomy* ; Fistula ; Humans ; Iliac Artery ; Retrospective Studies ; Veins

BACKGROUND: It has been found that parental role is essential for obesity management in childhood. However, there are few studies concerning parental perception on childhood obesity in Korea. Parental perception on childhood obesity according to weight status in elementary school children was examined. METHODS: The subjects were 3,996 elementary school children and their parents in Busan. The surveys which included socioeconomic characteristics, children's eating habits and activities, parental weight and height, parental perception on childhood obesity, were filled out by parents. Children's body mass index (BMI) were calculated using the height and weight measured in school children were classified into the obese group (BMI 95 Percentile) , the high risk group (85 percentile BMI <95 percentile) and the normal weight group (85 percentile) according to BMI gender and age. The analyses were done using x2_ test and ANOVA. RESULTS: Parental BMI in the obese group was higher than the normal weight group in boys a girls (P<0.001) . Participation in regular exercise was higher among the obese group compared to the normal weight group regardless of sex, but daily exercise time was lesser among the obese group only in boys (P <0.001) . Daily TV watching time was not different according to weight status in both sex. The parents with obese children perceived their children's weight as an appearance problem or a health problem about 7-18 times more likely than the parents of children with normal weight. 70% of obese children have tried weight control. The proportion of parental understanding on childhood obesity as a disease was not different among boys, but different among girls (P<0.001) . Eighty five percents of the parents perceived childhood obesity as a disease or a risk factor. But, their perception for the association of hypertension, fatty liver, sleep apnea syndrome with obesity was relative low. CONCLUSION: Most parents with obese children perceived childhood obesity as an appearance problem, a health problem and as a disease or a risk factor.
Body Mass Index ; Busan* ; Child* ; Eating ; Fatty Liver ; Female ; Humans ; Hypertension ; Korea ; Obesity ; Parents* ; Pediatric Obesity* ; Risk Factors ; Sleep Apnea Syndromes

PURPOSE: Hematopoietic cell transplantation (HCT) recipients are vulnerable to invasive infection by Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae (Sp). This study was performed to evaluate immune responses after Hib and Sp vaccination in Korean pediatric HCT recipients. METHODS: Patients were prospectively enrolled at Samsung Medical Center during 2009-2011. ELISA tests to detect anti-PRP IgG antibody and antibodies to Sp serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F were performed at the Center for Vaccine Evaluation and Study, Ewha Medical Research Institute. RESULTS: Ten patients (two allogeneic, eight autologous recipients) with median age 5.4 years (range 2.7-12.2 years) were enrolled. Before Hib vaccination, 60% of patients' anti-PRP IgG titers were below 0.15 microg/mL. After vaccination, 100% of patients' anti-PRP IgG titers increased above 0.15 microg/mL (cut-off value for detection) and 1.0 microg/mL (cut-off value for seroprotection). For pneumococcus, in 2-5 year-old patients, pre-vaccination geometric mean concentrations (GMCs) of IgG for six serotypes (4, 6B, 9V, 14, 18C, and 23F) were below 0.35 microg/mL and at 5 months post-vaccination GMCs of IgG for all seven serotypes increased to above 0.35 microg/mL. In patients older than 5 years, pre-vaccination GMCs of IgG for four serotypes (4, 9V, 14, and 23F) were below 0.35 microg/mL and at 3 months post-vaccination GMCs of IgG for all seven serotypes increased to above 0.35 microg/mL. CONCLUSION: Most HCT recipients had low or no protective antibodies to Hib and Sp before vaccination, but showed good immune responses to protective levels after vaccination.
Academies and Institutes ; Antibodies ; Antibody Formation* ; Cell Transplantation* ; Enzyme-Linked Immunosorbent Assay ; Haemophilus influenzae type b* ; Humans ; Immunoglobulin G ; Prospective Studies ; Streptococcus pneumoniae* ; Transplants* ; Vaccination*

Verruciform xanthoma is a rare benign lesion characterized by verrucous epidermal hyperplasia with aggregates of foam cells in dermal papillae. The pathogenesis is still unknown. Although most verruciform xanthoma tend to occur as isolated lesions, several have been associated with other conditions including squamous cell carcinoma and epidermal atypia. We describe a case of verruciform xanthoma associated with epidermal atypia.
Carcinoma, Squamous Cell ; Foam Cells ; Hyperplasia ; Xanthomatosis*

The intramedullary nailing for humeral shaft fractures has become popular fixation method. It affords less invasive procedure, good stability and early rehabilitation. However many complications were reported such as nonunion, pain and motion limitation of shoulder. We managed 33 patients using interlocking intramedullary nail for the humeral shaft fractures, and nonunion occurred in 9 patients. We reviewed these 9 cases and analyzed the relationship between the nonunions and the fracture sites as well as fracture types. The results were as follows; 1. Nonunion occurred in 9 patients of 25 patients treated closed reduction, but did not occur in 8 patients treated open reduction. 2. The union was obtained in all 6 patients with proximal one third fracture. But nonunion occurred in 6 patients of 19 patients with middle one third fracture and in 3 patients of 8 patients with distal one third fracture. 3. Nonunion after interlocking nails for humeral shaft fractures did not occur in all 6 spiral fracture patients. Nonunion occurred in 5 patients of 8 comminuted fracture patients, in 3 patients of 6 transverse fracture patients and in 1 patient of 3 oblique fracture patients with below the middle one third of humerus. Our study showed that the high rate of nonunion occurred in the comminuted, transverse and oblique fracture below the middle one third of humerus. On the basis of these findings, we recommend that closer attention should be paid when choose the fixation method in these types of the humeral shaft fractures.
Fracture Fixation, Intramedullary ; Fractures, Comminuted ; Humans ; Humerus ; Rehabilitation ; Shoulder

Objectives: . In extracorporeal septoplasty (ECS), the entire septal cartilage is harvested, and a neo-L strut is built extracorporeally. Thus, ECS can simultaneously achieve septum straightening and tip projection. This study evaluated the functional and esthetic outcomes of the ECS technique for rhinoplasty in Asian patients. Methods: . We conducted a retrospective review of 64 patients who underwent rhinoplasty using ECS between January 2016 and March 2018. Subjective patient satisfaction was assessed and objective surgical outcomes were evaluated. Improvement in nasal obstruction was rated using a visual analog scale (VAS). Anthropometric changes were compared between preoperative and postoperative facial photographs. Complications and revisions were also analyzed. Results: . The participants comprised 64 patients (48 males and 16 females, with a mean age of 29.3 years). The mean operative time was 89.3 minutes. In total, 61 patients were satisfied with the esthetic outcome, and the overall objective rhinoplasty outcome score was 3.45. Preoperative nasal obstruction symptoms (7.9±1.2 on VAS) improved postoperatively (3.1±1.3, P<0.001), and significant improvements were also observed in the nasofrontal angle (152.3° to 148.1°, P<0.001), nasolabial angle (88.8° to 92.0°, P<0.001), and nasal tip projection (0.62 to 0.66, P<0.033). Recurrent deviation of the nasal septum and external nose or tip deprojection did not occur in any patients, and there were no cases of revision during the mean follow-up period of 13.3 months. Conclusion . ECS might be an esthetically and functionally satisfactory alternative rhinoplasty technique for Asian patients with a shortage of septal cartilage.

Familial adenomatous polyposis (FAP) is an autosomal dominantly inherited colon cancer-predisposing disorder, characterized by the development of innumerable adenomas in the large intestine. Polyps are present in the upper gastrointestinal tract in almost all FAP patients and there is a peculiar predilection for adenomatous change in the duodenum. Colonic adenomas in FAP are commonly observed as polyps but nonpolypoid adenomas can also be seen in the upper gastrointestinal tract. Careful endoscopic examination is needed for detecting such nonpolypoid lesions. At present, the adenoma-carcinoma sequence is thought to exist also in the duodenum, and malignancy of the duodenum represents one of the most common causes of mortality among patients with FAP. Therefore, careful periodic follow-up of upper intestinal endoscopies are recommended in patients with this disease, in consideration to the possible development of duodenal nonpolypoid adenomatous lesions. A case involving an experience of antral and duodenal nonpolypoid adenomas in a patient with FAP is herein reported.
Adenoma* ; Adenomatous Polyposis Coli* ; Colon ; Duodenum ; Follow-Up Studies ; Humans ; Intestine, Large ; Mortality ; Polyps ; Pyloric Antrum ; Upper Gastrointestinal Tract

It is very important to be aware of occurrence and distinctive histologic features of gastric glomus tumor because its clinical presentation and endoscopic ficdings are indistinguishable from other gastric tumors. A 58-year-old man was admitted because of intermittent epigastric pain and indigestion for 2 months. Physical examination and laboratory findings revealed within normal limits. Upper gastroendoscopy demonstrated a submucosal mass near the antrum with central mucosal depressionand peripheral multiple erosions. Endoscopic ultrasonography revealed a circumscribed mass that continued to the third and fourth layers which demonstrated a heterogeneous low echo pattern mixed with internal high echo spots. Histologically, the tumor cells have uniform small nuclei with inconspicuous nucleoli. Immunochemical analysis on the tumor cells expressed alpha 1 smooth muscle actin and the tumor cells are enveloped by reticulin fiber, individually or grouped. A case of glomus tumor of the stomach is herein reported with a review of literature.
Actins ; Dyspepsia ; Endosonography ; Glomus Tumor* ; Humans ; Middle Aged ; Muscle, Smooth ; Physical Examination ; Reticulin ; Stomach*