PURPOSE: Over the past several decades, the survival rates of low birth weight(LBW; birth weight <2,500 g) infants have been improving. Many of these infants have had bronchial asthma(BA) at childhood and aldolescence. The aim of this study is to investigate whether LBW influenced the severity of BA in prealdolescent children and aldolescence by a retrospective case control study. METHODS: 15 LBW children(1,500 g Adolescent ; Asthma* ; Birth Weight ; Case-Control Studies ; Child* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant ; Infant, Low Birth Weight* ; Infant, Newborn ; Methacholine Chloride ; Parturition ; Reference Values ; Retrospective Studies ; Risk Factors ; Survival Rate

BACKGROUND: Unlike its use during stable conditions, central venous pressure (CVP) monitoring from a peripherally inserted central venous catheter (PICC) has not often been used in surgeries with significant hemodynamic alterations. The aim of this study was to evaluate the feasibility of measuring PICC pressure (PICCP) as an alternative to measuring centrally inserted central catheter pressure (CICCP) in adult liver transplantation (LT) patients. METHODS: We measured PICCP and CICCP simultaneously during each main surgical period in adult LT. Statistical analysis was performed using simple linear regression analysis to observe whether changes in PICCP paralleled by simultaneous changes in CICCP. Correlation analysis and Bland-Altman analysis were used to determine the degree of agreement between the two devices. Differences were considered statistically significant when P values were less than 0.05. RESULTS: A total of 1342 data pairs were collected from 35 patients. The PICCPs and CICCPs were highly correlated overall (r = 0.970, P < 0.001) as well as at each period measured. The differences among each period were not clinically significant (0.33 mmHg for pre-anhepatic, 0.32 mmHg for anhepatic, -0.15 mmHg for reperfusion, and -0.10 mmHg for neohepatic periods). The overall mean difference was 0.14 mmHg (95% confidence interval: 0.09-0.19) and PICCP tended to give a higher reading by between 0.09 and 0.19 mmHg overall. The limit of agreement was -1.74 to 2.02 overall. CONCLUSIONS: These findings suggest that PICCP can be a reasonable alternative to CICCP in situations of dynamic systemic compliance and preload, as well as under stable hemodynamic conditions.
Adult ; Catheters ; Central Venous Catheters ; Central Venous Pressure ; Compliance ; Hemodynamics ; Humans ; Jugular Veins ; Linear Models ; Liver ; Liver Transplantation ; Reperfusion

PURPOSE: Long-acting beta2 agonists (LABA) may mask ongoing bronchial inflammation, leaving asthmatic patients at greater risk of severe complications. The aim of this study was to compare the effect of combination therapy using low-dose inhaled corticosteroids (ICS) plus LABA on airway inflammation in asthma to the effect of medium-dose ICS alone. METHODS: Twenty-four patients with asthma not controlled by low-dose (400 microg per day) budesonide alone were enrolled in this prospective crossover study. Patients were randomized into 2 treatment phases: one receiving medium-dose (800 microg per day) budesonide (ICS phase), and the other receiving a combination therapy of low-dose budesonide/formoterol (360 microg/9 microg per day) delivered by a single inhaler (LABA phase). Each treatment phase lasted for 6 week, after which patients were crossed over. Asthma symptoms, lung function, and airway inflammation were compared between the 2 phases. RESULTS: Twenty-three patients completed the study; adequate sputum samples were collected from 17 patients. Asthma symptoms and lung function remained similar between the 2 phases. However, the mean sputum eosinophil percentage was higher in the LABA phase than in the ICS phase (5.07+/-3.82% vs. 1.02+/-1.70%; P<0.01). Sputum eosinophilia (> or =3%) was more frequently observed in the LABA phase than in the ICS phase (six vs. two). CONCLUSION: Addition of LABA may mask airway eosinophilic inflammation in asthmatic patients whose symptoms are not controlled with low-dose ICS.
Adrenal Cortex Hormones ; Asthma* ; Budesonide ; Cross-Over Studies ; Eosinophilia ; Eosinophils* ; Humans ; Inflammation* ; Lung ; Masks* ; Methods ; Nebulizers and Vaporizers ; Prospective Studies ; Sputum

PURPOSE: To report a case of malignant glaucoma in an eye vitrectomized 5 years previously due to endophthalmitis. CASE SUMMARY: A 55-year-old male visited clinic due to a painful right eye 2 days in duration. Five years ago, he suffered endophthalmitis in his right eye and underwent pars plana vitrectomy. On slit-lamp examination, shallow anterior chamber depth of 2 central corneal thickness and corneal edema were observed along with remnant cortical lens material behind the intraocular lens. Intraocular pressure was 68 mm Hg measured using applanation tonometry. Maximal medical treatment failed to lower the intraocular pressure on the first day of visit. The very next day, anterior chamber became shallower less than 0.5 central corneal thickness and intraocular pressure was 70 mm Hg. Posterior capsular syndrome was suspected on anterior optical coherence tomography and neodymium:yttrium-aluminum-garnet laser posterior capsulotomy was performed, however, normal anterior chamber could not be restored. Despite continuous medical therapy for 3 weeks, the patient's symptoms worsened and intraocular pressure increased over 99 mm Hg and therefore, the Ahmed glaucoma valve was implanted. One day after the operation, intraocular pressure decreased to 10 mm Hg and anterior chamber depth became deeper with the depth of over 5 central corneal thickness. At the final visit 4 months postoperatively, intraocular pressure and normal anatomy of the anterior segment were well maintained. CONCLUSIONS: Malignant glaucoma syndrome can occur even in vitrectomized eyes and capsular block syndrome can initiate this. Malignant glaucoma syndrome in a vitrectomized eye resistant to maximal medical treatment can be treated with Ahmed valve implantation.
Anterior Chamber ; Corneal Edema ; Endophthalmitis ; Glaucoma* ; Humans ; Intraocular Pressure ; Lenses, Intraocular ; Male ; Manometry ; Middle Aged ; Posterior Capsulotomy ; Tomography, Optical Coherence ; Vitrectomy

PURPOSE: To report a case of pigment dispersion syndrome and reverse pupillary block secondary to the implantation of implantable collamer lens (ICL) with a central hole (AQUA ICL®) that was treated with ICL removal and laser peripheral iridotomy (LPI). CASE SUMMARY: A 29-year-old woman with myopia in both eyes underwent implantation of AQUA ICL®. Four weeks postoperatively, the intraocular pressure (IOP) increased to 34 mm Hg and the patient showed pigment dispersion syndrome in both eyes. Since the IOP did not reduce with the maximum tolerable medical therapy, the ICLs were removed 8 weeks after implantation. The pigment dispersion subsided and IOP reduced shortly after ICL removal. However, 4 weeks after removal of ICL, posterior iris bowing and reverse pupillary block occurred in the right eye and the IOP increased to 46 mm Hg. LPI was performed in the right eye, and the reverse pupillary block was dissolved after a reduction in pigment dispersion. The IOP subsequently normalized to 13 mm Hg. Two weeks later, prophylactic LPI was performed in the left eye. Four weeks after prophylactic LPI, selective laser trabeculoplasty was performed on both eyes. As a result, the IOP was 11 mm Hg in the right eye and 12 mm Hg in the left eye after 4 weeks of treatment with topical IOP-lowering medications. CONCLUSIONS: The present case indicates that implantation of ICL with a central hole can lead to early postoperative pigment dispersion syndrome. When this condition persists and is accompanied by reverse pupillary block after ICL removal, LPI can be partially effective.
Adult ; Female ; Humans ; Intraocular Pressure ; Iris ; Myopia ; Trabeculectomy

PURPOSE: Drug rash with eosinophilia and systemic symptoms (DRESS) and the Stevens-Johnson syndrome (SJS) are both severe drug reactions. Their pathogenesis and clinical features differ. This study compared the causes and clinical features of SJS and DRESS. METHODS: We enrolled 31 patients who were diagnosed with DRESS (number=11) and SJS (number=20). We retrospectively compared the clinical and laboratory data of patients with the two disorders. RESULTS: In both syndromes, the most common prodromal symptoms were itching, fever, and malaise. The liver was commonly involved in DRESS. The mucosal membrane of the oral cavity and eyes was often affected in SJS. The most common causative agents in both diseases were antibiotics (DRESS 4/11 (37%), SJS 8/20 (40%)), followed by anticonvulsants (DRESS 3/11 (27%), SJS 7/20 (35%)). In addition, dapsone, allopurinol, clopidogrel, sulfasalazine and non-steroidal anti-inflammatory drugs (NSAIDs) were sporadic causes. CONCLUSIONS: The most common causes of DRESS and SJS were antibiotics, followed by anticonvulsants, NSAIDs and sulfonamides. The increase in the use of antibiotics in Korea might explain this finding.
Allopurinol ; Anti-Bacterial Agents ; Anti-Inflammatory Agents, Non-Steroidal ; Anticonvulsants ; Dapsone ; Drug Hypersensitivity ; Eosinophilia ; Exanthema ; Eye ; Fever ; Humans ; Korea ; Liver ; Membranes ; Mouth ; Prodromal Symptoms ; Pruritus ; Retrospective Studies ; Stevens-Johnson Syndrome ; Sulfasalazine ; Sulfonamides ; Ticlopidine

PURPOSE: Drug rash with eosinophilia and systemic symptoms (DRESS) and the Stevens-Johnson syndrome (SJS) are both severe drug reactions. Their pathogenesis and clinical features differ. This study compared the causes and clinical features of SJS and DRESS. METHODS: We enrolled 31 patients who were diagnosed with DRESS (number=11) and SJS (number=20). We retrospectively compared the clinical and laboratory data of patients with the two disorders. RESULTS: In both syndromes, the most common prodromal symptoms were itching, fever, and malaise. The liver was commonly involved in DRESS. The mucosal membrane of the oral cavity and eyes was often affected in SJS. The most common causative agents in both diseases were antibiotics (DRESS 4/11 (37%), SJS 8/20 (40%)), followed by anticonvulsants (DRESS 3/11 (27%), SJS 7/20 (35%)). In addition, dapsone, allopurinol, clopidogrel, sulfasalazine and non-steroidal anti-inflammatory drugs (NSAIDs) were sporadic causes. CONCLUSIONS: The most common causes of DRESS and SJS were antibiotics, followed by anticonvulsants, NSAIDs and sulfonamides. The increase in the use of antibiotics in Korea might explain this finding.
Allopurinol ; Anti-Bacterial Agents ; Anti-Inflammatory Agents, Non-Steroidal ; Anticonvulsants ; Dapsone ; Drug Hypersensitivity ; Eosinophilia ; Exanthema ; Eye ; Fever ; Humans ; Korea ; Liver ; Membranes ; Mouth ; Prodromal Symptoms ; Pruritus ; Retrospective Studies ; Stevens-Johnson Syndrome ; Sulfasalazine ; Sulfonamides ; Ticlopidine

Objective: This study is to measure the high sensitivity C-reactive protein (hs-CRP) value in acute myocardial infarction (AMI) patients who arrive within 6 hours of the symptom manifestation and see how the resulting value affects the short term prognosis in AMI patients. Methods: This study was conducted on 118 patients who had less than 6 hours of onset-to-door time among 149 patients who were diagnosed with myocardial infarction in emergency room and undergo percutaneous coronary intervention (PCI) for 2 years from September 2017. The group including main adverse cardiovascular outcomes were compared in the patients according to the blood test figures (hs-CRP on admission [CRP1], CRP velocity [CRPv], post-PCI hs-CRP [CRP2], and CRP difference values [CRP2-1]). Results: In this study, the average of the hs-CRP values of AMI patients arriving within 6 hours of the symptom manifestation was 2.2±2.3 mg/L. CRP velocity that corrected the CRP value to the elapsed time after the onset of symptoms and N-terminal probrain natriuretic peptide (NT-proBNP) appeared to be significantly correlated with the occurrence of main adverse cardiovascular outcomes (P=0.03). Conclusion The hs-CRP values of AMI patients arrived within 6 hours of the symptom manifestation showed the mean risk group. CRPv and NT-proBNP showed a significant casual relationship with main adverse cardiovascular outcomes.

PURPOSE: The aims of this study were to investigate the incidence of rehospitalization for very low birth weight (VLBW) infants due to respiratory illness during the first year of life, and to examine the association between rehospitalization with respiratory distress syndrome (RDS) and duration of mechanical ventilation. METHODS: Twenty-three VLBW infants admitted to neonatal intensive care unit (NICU) at Dae-Dong Hospital from January 1996 to December 2002 were studied. Twenty-three of full-term infants born from January 2001 to December 2002 at Dae-Dong Hospital were studied as control group. Parental questionnaire were collected and hospital records of VLBW infants and control group were reviewed retrospectively. RESULTS: The rate of rehospitalization for respiratory illness in VLBW infants (16/23, 69%) was greater than that of term infants (6/23, 26%) (P< 0.05). Ventilated group with RDS (14/ 19, 73%) in VLBW infants had more rehospitalization compared to non-ventilated group (2/4, 50%) (P< 0.05). Those with ventilator care longer than 7 days (7/7, 100%) had more rehospitalization than those with ventilator care less than seven days (7/12, 58%) (P< 0.05). Fifty nine percent of rehospitalization occurred from December to March. Sixty five percent of rehospitalized infants required admissions between 5 and 8 months after NICU discharge. CONCLUSION: VLBW infants are more likely to have rehospitalization with respiratory illness during first year, especially VLBW infants with RDS and prolonged care of mechanical ventilation. It is important to prevent these susceptible infants from respiratory infections and to follow-up them periodically because VLBW infants tend to show decreased pulmonary function subsequently.
Follow-Up Studies ; Hospital Records ; Humans ; Incidence ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Parents ; Surveys and Questionnaires ; Respiration, Artificial ; Respiratory Tract Infections ; Retrospective Studies ; Ventilators, Mechanical

The familial environment may also play an important role in the epidemiology of HCV infection through vertical and horizontal transmission by infected household members. However, it is still controversial whether familial clustering of HCV occurs. We experienced a case of familial clustering of hepatitis C virus. A 10-year old girl presented with nausea, vomiting and anorexia for a month was diagnosed as hepatitis C. Her mother, grandmother, a maternal aunt and her daughter had contracted with HCV. Her laboratory findings showed AST/ALT 63/122 IU/L, positive anti-HCV Ab and HCV RNA (3.54 x 10(5) copies/mL). Pathologic findings of the liver biopsy revealed chronic hepatitis with minimal lobular activity, mild porto-periportal activity and mild portal fibrosis. After treatment with interferon-alpha 2b for 6 months, the clinical symptoms and laboratory findings were normalized.
Anorexia ; Biopsy ; Child ; Cluster Analysis* ; Epidemiology ; Family Characteristics ; Female ; Fibrosis ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Interferon-alpha ; Liver ; Mothers ; Nausea ; Nuclear Family ; RNA ; Vomiting