PURPOSE: Many diagnostic modalities have been used for diagnosis of gastroesophageal reflux disease (GERD). Feeding materials during esophageal pH monitoring may interfere the result of examination and esophageal pH monitoring can not diagnose GER in case of alkaline reflux. The purpose of our study is to evaluate whether scintigraphy can substitiute 24 hr pH monitoring in children with GERD. METHODS: From March 2002 to June 2003, 23 patients (12 boys and 11 girls, mean age 27 months) who have been admitted to Hanyang University Hospital presented with GER symptoms (recurrent vomiting, cough, chest pain, irritability) were included in the study. Scintigraphy and 24 hr pH monitoring were performed in all patients. RESULTS: Six out of the 23 patients (26.1%) had evidence of GER on 24 hr pH monitoring, whereas nine of 23 patients (39.2%) exhibited GER by scintigraphy. Two out of the 23 patients could not be tested because of irritability. Three (14.3%) patients had evidence of GER on both 24 hr pH monitoring and scintigraphy, three (14.3%) patients on only 24 hr pH monitoring, six (28.6%) patients on only scintigraphy, and nine (42.9%) patients had no evidence of GER on both methods. No correlation was observed between 24 hr pH monitoring and scintigraphic results by Fisher's exact test (p=0.523) or Kendal's tau (t=0.678). CONCLUSION: The results of this study demonstrated that there was no correlation between 24 hr pH monitoring and scintigraphy. Therefore these modalities could be used as complementary tests to diagnose GERD.
Chest Pain ; Child* ; Cough ; Diagnosis ; Esophageal pH Monitoring ; Female ; Gastroesophageal Reflux* ; Humans ; Hydrogen-Ion Concentration* ; Radionuclide Imaging ; Vomiting

PURPOSE: The current study was undertaken to examine the trend in gallbladder cancer (GBC) incidenceand survival in Korea. MATERIALS AND METHODS: GBC incidence data by histologic typewere obtained from the Korea Central Cancer Registry.Age-standardized incidence rates were calculated using the mid-year Korean population of2000 as a standard population, and a joinpoint regression model was used to calculate theannual percent change (APC) in incidence rates. Incidence by Surveillance, Epidemiology and End Results (SEER) summary stage and by geographical areas and female-to-male incidencerate ratios was also described. RESULTS: The number of new GBC cases increased between 1999 and 2013. Nevertheless, the agestandardizedincidence rate decreased by 0.5% per year in men (p < 0.01), whereas theincidence rate in women did not change significantly over the same period (APC, –0.2;p=0.59). The most common histologic type was adenocarcinoma in both sexes. Based onthe SEER stage, the distant stage was the most frequent stage (41%), followed by theregional stage (37%). Ulsan (4.31/100,000 for men and 4.09/100,000 forwomen in 2009-2013) and Gyeongsangnam-do (4.15/100,000 for men and 3.54/100,000 for women)showed the highest GBC incidence, whereas the lowest incidence was observed in Seouland Gyeonggi-do. There were no significant sex differences in the incidence of GBC (femaleto-maleincidence rate ratio, 0.96). CONCLUSION: The overall incidence of GBC in Korea did not change significantly over the 15-year period.Incidence for men and women was similar. However, geographical variation was found.
Adenocarcinoma ; Epidemiology ; Female ; Gallbladder Neoplasms* ; Gallbladder* ; Gyeonggi-do ; Gyeongsangnam-do ; Humans ; Incidence* ; Korea* ; Male ; Sex Characteristics ; Ulsan

The purpose of this article is to introduce a simple appliance that uses a setup model and a nickel-titanium (Ni-Ti) wire for correcting the mesial rotation and drift of the permanent maxillary first molar. The technique involves bonding a Ni-Ti wire to the proper position of the target tooth on a setup model, followed by the fabrication of the transfer cap for indirect bonding and its transfer to the patient's teeth. This appliance causes less discomfort and provides better oral hygiene for the patients than do conventional appliances such as the bracket, pendulum, and distal jet. The treatment time is also shorter with the new appliance than with full-fixed appliances. Moreover, the applicability of the new appliance can be expanded to many cases by using screws or splinting with adjacent teeth to improve anchorage.
Humans ; Molar* ; Oral Hygiene ; Splints ; Tooth ; Tooth Movement

Coronary artery aneurysms are uncommon, are usually associated with atherosclerosis, and rarely involve all three major coronary arteries. The present report describes a rare case of a young female patient presenting with acute myocardial infarction (AMI). Coronary angiography revealed multiple severe aneurysmal and stenotic changes. Based on clinical feature and angiographic findings, it was strongly suspected that the patient had polyarteritis nodosa (PAN) complicated by AMI. The patient was treated with standard cardiac medications and immunosuppressive agents and has remained stable without further complications during a follow-up period of 6 months.
Aneurysm ; Atherosclerosis ; Coronary Aneurysm ; Coronary Angiography ; Coronary Vessels ; Female ; Follow-Up Studies ; Humans ; Immunosuppressive Agents ; Myocardial Infarction ; Polyarteritis Nodosa ; Vasculitis

PURPOSE: This study aimed to evaluate the clinical features of juvenile polyp and the usefulness of polypectomy with entire colonoscopy in children. METHODS: We retrospectively reviewed the medical records of 83 children who were diagnosed with having juvenile polyps. RESULTS: The mean age of the patients was 6.5+/-3.7 (range 1.3-14.5 years) years. The male to female ratio was 2.1 : 1. Eighty one patients (97.6%) had hematochezia, of which the observed characteristics included red stool (74.1%), blood on wipe (13.6%). The time interval between the 1st episode of hematochezia and colonoscopy was 8.9+/-20.4 (ranged 0.1-48.0) months. The most proximal regions of colonoscopic approach were terminal ileum (96.4%). Sixty three patients (75.9%) had a solitary polyp and 20 patients (24.1%) had multiple polyps. The sites of the polyps were rectum (61.4%), sigmoid colon (23.5%). Eighteen polyps (15.1%) were found more proximal locations than rectosigmoid. The polyp size ranged from 0.3 to 5 cm. After the polypectomy, hematochezia recurred in 9 patients. Endoscopic hemostasis was performed in 2 patients due to severe bleeding. All procedures were carried out without using general anesthesia. CONCLUSION: Juvenile polyp occurred in a wide range locations and had variable sizes and numbers, suggesting that colonoscopy on the entire colon is necessary. Colonoscopic polypectomy is a simple and useful therapeutic method in children with juvenile polyp.
Child ; Colon ; Colon, Sigmoid ; Colonoscopy ; Female ; Gastrointestinal Hemorrhage ; Hemorrhage ; Hemostasis, Endoscopic ; Humans ; Ileum ; Male ; Medical Records ; Polyps ; Rectum ; Retrospective Studies

Dendritic cells (DCs), which are regarded as the most potent antigen-presenting cells, are involved in innate and adaptive immunity. Upon uptake of pathogens, DCs express cell surface markers and secrete cytokines. In this study, we analyzed production of cytokines and found that interleukin (IL)-10 and transforming growth factor (TGF)-beta production significantly increased in bone marrow-derived DCs and a mouse DC line, DC2.4, after treatment with crude antigen (CA) from liver fluke, Clonorchis sinensis. However, expression patterns of several activation molecules did not change. In addition, following treatment of DC2.4 cells with antigen from the lung fluke, Paragonimus westermani, production of IL-10 and TGF-beta significantly increased compared with groups treated with other parasite antigens, Spirometra erinacei plerocercoid CA and Echinococcus granulosus hydatid cystic fluid. We also found that treatment of DC2.4 cells with C. sinensis CA resulted in rapid and significant phosphorylation of extracellular signal-regulated kinase 1/2, a mitogen-activated protein kinase. Following treatment of DC2.4 cells with C. sinensis CA, treatment with an inhibitor specific to an extracellular signal-regulated kinase inhibited production of IL-10 and TGF-beta. Our results suggest that CA from C. sinensis has a role in the anti-inflammatory function of DC cells by inducing IL-10 and TGF-beta through activation of extracellular signal-regulated kinase 1/2.
Animals ; Antigens, Helminth/*pharmacology ; Cells, Cultured ; Clonorchis sinensis/*immunology ; Dendritic Cells/drug effects/*metabolism ; Interleukin-10/genetics/*metabolism ; MAP Kinase Signaling System ; Mice ; Transforming Growth Factor beta/genetics/*metabolism

Chronic active Epstein-Barr virus (CAEBV) infection is characterized by persistent infectious mononucleosis-like symptoms, an unusual pattern of Epstein-Barr virus (EBV) antibodies, detection of the EBV genome in affected tissues or peripheral blood, and chronic illness that cannot be attributed to any other known disease. This is the first reported Korean case of an immunocompetent adult with CAEBV-associated interstitial pneumonitis. A 28-year-old female was admitted with a fever that persisted for 3 weeks. She had multiple lymphadenopathy, hepatosplenomegaly, pancytopenia, and elevated serum aminotransferase levels. Serology for antibodies was positive and chest computed tomography showed diffuse ground glass opacities in both lungs. Histopathology of the lung tissue showed lymphocyte infiltration, and EBV DNA was detected in those lymphocytes using in situ hybridization with an EBV-encoded RNA probe. After 1 month of hospitalization, she improved without specific treatment.
Adult ; Chronic Disease ; Epstein-Barr Virus Infections/complications/*pathology/radiography ; Female ; *Herpesvirus 4, Human ; Humans ; Immunocompetence ; Lung Diseases/etiology/pathology ; Lung Diseases, Interstitial/etiology/*pathology/radiography

Chondrosarcoma is a rare entity of malignant tumor which arises from cartilaginous tissue, and the literatures on this disease are scarce. The first-line of treatment for cardiac chondrosarcoma is surgery. Due to early local recurrence and distant metastasis, the prognosis is poor even after complete surgical excision. We present a case of chondrosarcoma in the left atrium causing functional mitral stenosis which required urgent surgical intervention, and the successful treatment outcome.
Chondrosarcoma* ; Heart Atria ; Heart Neoplasms ; Heart* ; Mitral Valve Stenosis ; Neoplasm Metastasis ; Neoplasms, Connective Tissue ; Prognosis ; Recurrence ; Treatment Outcome

PURPOSE : Aberrant DNA methylation patterns have been commonly associated with human cancers. We have investigated the frequency of DNA hypermethylation in promoter regions from adenocarcinomas of the lung and then attempted to detect the same epigenetic changes from patient serum samples. MATERIALS AND METHODS : We collected tissues from 72 cases of lung adenocarcinomas. The cancer and normal lung tissues were tested for DNA hypermethylation using methylation-specific PCR (MSP). The genes investigated were DAPK, RARbetaP2 and p16. We selected 12 patients where promoter hypermethylation was present for all three genes and four patients where hypermethylation was not seen for any of the three genes. Serum-free DNA was extracted and was tested for promoter hypermethylation. The status of serum-free DNA methylation was analyzed; the hypermethylation status was compared to clinical variables and cancer outcomes. RESULTS : DNA hypermethylation was observed in 32% of samples for DAPK, 63% of samples for RARbetaP2 and 83% of samples for p16 from the cancer tissues. Among the 12 matched serum samples where the primary tumor showed hypermethylation in all three gene promoter regions, we were able to detect five incidences of serum DNA hypermethylation in four patients. The four patients had TNM stage II or higher disease. None of the patients with stage I disease showed serum-free DNA hypermethylation. CONCLUSION : Aberrant promoter hypermethylation was frequently observed in surgically resected adenocarcinoma of the lung. Concurrent serum-free DNA hypermethylation was detected in 34% of patients where the primary tumor showed hypermethylation in all three gene promoter regions. The findings suggest that the serum-free DNA methylation status might be used as a potential target for the diagnosis of lung cancer. However, the low sensitivity should be improved for use in a clinical application
Adenocarcinoma ; DNA ; DNA Methylation ; Epigenomics ; Humans ; Incidence ; Lung ; Lung Neoplasms ; Polymerase Chain Reaction ; Promoter Regions, Genetic

Endovascular stent graft placement in Stanford type B aortic dissection has increased as a result of the demonstration of its safety and efficacy. Despite the advantage of reduced mortality and morbidity, the mid-to long-term prognosis and possible complications associated with the procedure are a source of concern. Among the many possible complications, retrograde type A dissection after stent grafting for type B dissection is considered rare; however, this life-threatening event appears to be underrecognized. Here, we report a case that converted to open surgery due to a retrograde type A dissection after endovascular stent graft placement for a Stanford type B dissection. This is the first report of a retrograde type A dissection after endovascular stent graft placement in Korea.
Aortic Diseases ; Imidazoles ; Korea ; Nitro Compounds ; Prognosis ; Stents ; Transplants