The effect of NDMA after oral administration (17 mg/ml) on the glycoconjugates of lingual von Ebner's gland and mucous gland were investigated with lectin histochemical methods. For lectin histochemical studies, the biotinylated lectins (DBA, PNA, SBA, BSL -1, sWGA, RCA -1, LCA, UEA -1, and ConA) were applied. Lectin binding patterns of glycoconjugates of lingual von Ebner's gland showed the decreased affinity for DBA, PNA, BSL -1 and sWGA in NDMA -treated group compared with control group. The remarkable decrease of binding affinity of NDMA -treated group was observed in PNA for 12 and 24 hours, DBA for 96 hours, BSL -1 for 72 hours, and sWGA for 3 hours, while the striking decrease of BSL -1 and sWGA binding was observed in NDMA -treated group for 12 hours. But these decreases of binding were tended to recover in PNA and sWGA after 72 hours of NDMA treatment, and in DBA after 120 hours. The binding affinity of SBA and RCA -1 was decreased in NDMA -treated group for 3 hours, while the other NDMA -treated group showed an increased affinity. Especially, the increase of SBA binding was remarkable. There was a little change in binding affinity of UEA -1, LCA and Con A in NDMA -treated group. Lectin binding patterns of glycoconjugates of lingual mucous gland showed decreased affinities for SBA, sWGA and UEA -1 in NDMA -treated group. The striking decreases of binding affinity for NDMA -treated group was observed in SBA and sWGA for 3 hours, and UEA -1 for 3 and 24 hours. And the remarkable decreases of binding affinity for NDMA -treated group was found in SBA for 24 and 48 hours, sWGA for 48, 72 and 96 hours, and UEA -1 for 48 hours. These decreases of binding affinity of NDMA -treated group were tended to recover in SBA and UEA -1 after 96 hours and in sWGA after 120 hours. The binding affinity for PNA and ConA showed a little but not remarkable increase in NDMA - treated group, and LCA binding showed a little decrease following a little increase in NDMA - treated group. The affinity of DBA binding was decreased in NDMA -treated group for 12 hours and 24 hours, while the other NDMA -treated group showed an increased affinity. Especially, there was a remarkable increase in NDMA -treated group for 96 hours. From these results, it is suggested that the toxicity of NDMA may be related with the carcinogen of the rat tongue, and glycoconjugates are concerned with the repaire of the destruction of the lingual mucous acini.
Administration, Oral ; Animals ; Dimethylnitrosamine* ; Glycoconjugates* ; Lectins ; Rats* ; Salivary Glands* ; Strikes, Employee ; Tongue ; von Ebner Glands

Gastroesophageal reflux disease (GERD) has a chronicity and its symptoms wax and wane by proton pump inhibitor (PPI) therapy. Chronic consumption of PPI in the patients with GERD is common, and we can cope with a PPI failure or refractory GERD. Therefore, we review various alternative modalities for chronic PPI treatment and an approach for refractory GERD. PPI has a potential for side effects. Many studies have been published the side effects of long-term PPI using. Mostly clinical level of evidence is weak and the absolute risk is low, however we may discuss the patients who need long-term PPI therapy about the controversial side effects, and manage those appropriately.
Gastroesophageal Reflux ; Humans ; Phosphatidylethanolamines ; Prescriptions ; Proton Pump Inhibitors ; Proton Pumps ; Protons ; Safety Management

PURPOSE: To investigate the clinical effects of a single high dose intravenous immunoglobulin (IVIG) combined with initial dexamethasone as a primary treatment on Kawasaki disease (KD). MATERIALS AND METHODS: Between January 2008 and December 2010, we reviewed the medical records of 216 patients with complete KD patients that were admitted to a single medical center. 106 patients were treated with a single high dose of IVIG (2 g/kg) alone and 110 patients received IVIG and dexamethasone (0.3 mg/kg per day for three days). RESULTS: The combined IVIG plus dexamethasone patient group had a significantly shorter febrile period and duration of hospital stay (1.4+/-0.7 days vs. 2.0+/-1.2 days, p<0.001; 5.8+/-1.7 days vs. 6.9+/-2.5 days, p<0.001, respectively) than the IVIG alone group. The combined IVIG plus dexamethasone group required IVIG retreatment significantly less than the IVIG only group (12.7% vs. 32%, p=0.003). After completion of the initial IVIG, C-reactive protein levels in the combined IVIG plus dexamethasone group were significantly lower than those in the IVIG only group (2.7+/-4.0 mg/dL vs. 4.6+/-8.7 mg/dL, p=0.03). In the combined IVIG plus dexamethasone group, the incidence of coronary artery lesions tended to be lower without worse outcomes at admission after initial infusion of IVIG and in follow-up at two months; however, the differences were not significant (8.2% vs. 11.3%, p=0.22; 0.9% vs. 2.8%, p=0.29). CONCLUSION: Initial combined therapy with dexamethasone and a single high-dose of IVIG resulted in an improved clinical course, in particular a shorter febrile period, less IVIG retreatment, and shorter hospital stay without worse coronary outcomes.
Child, Preschool ; Dexamethasone/administration & dosage/adverse effects/*therapeutic use ; Female ; Fever/drug therapy ; Glucocorticoids/administration & dosage/adverse effects/*therapeutic use ; Humans ; Immunoglobulins, Intravenous/administration & dosage/adverse effects/therapeutic use ; Immunologic Factors/administration & dosage/adverse effects/*therapeutic use ; Infant ; Length of Stay ; Male ; Mucocutaneous Lymph Node Syndrome/*drug therapy ; Treatment Outcome

Eosinophilic esophagitis, as a new emerging disease during the last decade, is a clinicopathologic disorder of the esophagus, and it is characterized by dense esophageal eosinophilic infiltrations and typical esophageal symptoms. These patients usually present with dysphagia, food impaction or refractory reflux symptoms, and biopsy of the esophagus shows more than 15 eosinophils per high-power field. The typical findings on endoscopy are linear furrows, ringed esophagus, mucosal nodularities, whitish plaques and/or stricture. It is essential to exclude the known causes of tissue eosinophilia such as gastroesophageal reflux disease, eosinophilic gastroenteritis, infections, drug, hypersensitivity, Crohn's disease or malignancy. The majority of these patients have an atopy or allergic disorders, so other causes of eosinphilia should be evaluated. The therapeutic options include acid suppression, steroids, dietary modification, endoscopic dilatation, etc. Eosinophilic esopahgitis has recently been reported in Korea. Future schematic studies about this new disease are needed.
Biopsy ; Constriction, Pathologic ; Crohn Disease ; Deglutition Disorders ; Dilatation ; Endoscopy ; Enteritis ; Eosinophilia ; Eosinophilic Esophagitis ; Eosinophils ; Esophagus ; Food Habits ; Gastritis ; Gastroenteritis ; Gastroesophageal Reflux ; Humans ; Hypersensitivity ; Korea ; Steroids

Clopidogrel prevent atherothrombotic complications following acute coronary syndromes by inhibiting platelet aggregation. However, in case of concomitant use of clopidogrel and proton pump inhibitor (PPI) for prophylaxis of gastrointestinal (GI) bleeding, the anti-clotting of clopidogrel will be decreased because PPI inhibit competitively cytochrome P450 enzymes, especially CYP2C19. Through several pharmacodynomic studies, omeprazole, but not other PPIs, worsens surrogate markers (e.g., platelet reactivity index) of clopidogrel efficacy. And many observational studies show concomitant use of clopidogrel and PPI have increased the risks of cardiovascular (CV) events (hazard/odds ratios = 1.25-1.5). However, only one prospective randomized trial (COGENT trial) of omeprazole vs. placebo in clopidogrel users show no difference in CV events (hazard ratio = 1.02) and decrease the risk of GI bleeding (hazard ratio = 0.13). Further well designed research will need to determine whether a pharmacodynamic effect of clopidogrel affected by PPI will be changed clinical CV events. Clinical decisions about concomitant use of PPI and clopidogrel must be balance overall risks and benefits, considering both CV and GI complications.
Acute Coronary Syndrome ; Biomarkers ; Blood Platelets ; Cytochrome P-450 Enzyme System ; Drug Interactions ; Hemorrhage ; Omeprazole ; Platelet Aggregation ; Proton Pump Inhibitors ; Proton Pumps ; Protons ; Risk Assessment ; Ticlopidine

Helicobacter pylori infection is the main cause of chronic atrophic gastritis, peptic ulcer disease, gastric carcinoma, and mucosal associated lymphoid tumor. Recently, Helicobacter pylori infection has been reported in the association with several extragastric diseases such as idiopathic thrombocytopenic purpura (ITP), iron deficiency anemia (IDA), cardiovascular disease, respiratory disease, autoimmune disease, chronic urticaria and growth retardation, but the evidence of data has not been complete and is not widely known. According to up-to-date ideas, H. pylori eradication should be treated in the case of ITP and IDA. Here, we reviewed the extragastric diseases presumpted with the association of Helicobacter pylori infection, but the evidences need further investigation.
Anemia, Iron-Deficiency ; Autoimmune Diseases ; Cardiovascular Diseases ; Chronic Disease ; Gastritis, Atrophic ; Helicobacter pylori* ; Helicobacter* ; Peptic Ulcer ; Purpura, Thrombocytopenic, Idiopathic ; Stomach Diseases ; Urticaria

PURPOSE: The purpose of this study was to develop an online education on death, 'successful life, and beautiful death' for university students and to evaluate students' changes regarding perception of self and death. METHOD: A quasi-experimental design was used with one experimental group pre-post test. Subjects were 154 students who enrolled for online education about death for 16 weeks. SPSS/WIN 12 was used for analyzing data. RESULT: The results of the study clearly indicated this class had positive effects on students' perception of death-related concepts, attitudes toward death, and self-concept, showing statistically significant higher scores in post-tests than in pre-tests. In addition, the result of class evaluations showed a positive response, CONCLUSION: Findings suggested that this online education about death was effective to change students' perceptions of death related knowledge, attitude toward death, and self-concept. Recommendations for further studies were provided.
Adult ; *Attitude to Death ; Data Collection ; Data Interpretation, Statistical ; Female ; Humans ; Internet ; Male ; Models, Educational ; Perception ; Self Concept ; Students/*psychology

BACKGROUND: The use of ambulatory blood pressure monitoring (ABPM) in childhood hypertension has been in great advance. ABPM has been able to detect significantly high blood pressure (BP) and also helpful for identifying white coat hypertension. METHODS: Between March 2007 and December 2009, we evaluated individuals aged from 7 to 19 years who were referred as high BP with ABPM, echocardiogram, and abdominal computerized tomography, calculation of body mass index (BMI) at Ajou University Hospital. ABPM was performed using the Tonoport V monitors and SpaceLab 90217 monitors. Seventy were evaluated with 55 boys and 5 girls. The mean age of them was 13.1 +/- 2.8 years (mean +/- standard deviation). RESULTS: Forty of seventy (57.1%) were diagnosed as hypertension in ABPM and 8 of 40 were diagnosed as secondary hypertension with underline diseases such as hyperthyroidism, chronic renal disease, Takayasu's arteritis, coarctation of aorta. The mean BMI in 40 was 24.8 +/- 4.72 kg/m2. Twenty-three of seventy (32.8%) were obese with higher prevalence than in general population. White coat hypertension was diagnosed in 30 of 70 (42.9%). CONCLUSIONS: ABPM could provide more detailed data including mean values of BP, load, and night dip in assessment of children's BP. According to increasing children's obesity, use of ABPM was thought to be necessary for evaluation of their risk of hypertension and useful for diagnosis of masked hypertension and white coat hypertension. Further more study of ABPM in children and adolescents would be needed for absolute standards of ABPM.
Adolescent ; Aged ; Aortic Coarctation ; Blood Pressure Monitoring, Ambulatory ; Body Mass Index ; Child ; Humans ; Hypertension ; Hyperthyroidism ; Masked Hypertension ; Obesity ; Prevalence ; Renal Insufficiency, Chronic ; Takayasu Arteritis ; White Coat Hypertension

PURPOSE: The purpose of this study was to analyze death attitudes of students majoring in the human service area, such as nursing science, education, and social welfare. METHOD: The Q-methodology which provides a method of analyzing the subjectivity of each item was used. The 38 selected Q-statements from each of 42 subjects were classified into a shape of normal distribution using a 9 point scale. The collected data was analyzed using a QUANL PC program. RESULT: Four types of death attitudes for research subjects in nursing, education, and social welfare areas were identified. Type I is fatalistic admission, Type II is pursuit of existential life, Type III is uncertainty of life after death, and Type IV is separation-connection between life and death. CONCLUSION: The results of the study indicate that different approaches of death educational programs are recommended based on the four types of death attitudes.
Teaching ; Students, Nursing/*psychology ; Students/*psychology ; Social Work/*education ; Male ; Humans ; Female ; *Attitude to Death ; Adult

PURPOSE: We investigated the causative organism and its antibiotic susceptibility of community acquired urinary tract infection (UTI) in children at a secondary hospital to test the adequacy of the current guidelines. METHODS: Children diagnosed with UTI at the Department of Pediatrics, Kwandong University Myongji Hospital by pyuria and bacterial growth of greater than 1.0x10(5) CFU/mL on clean catch midstream urine from January 2005 to December 2008 were studied retrospectively. The epidemiologic data, causative organism, and the antibiotic susceptibility were analyzed. RESULTS: Sixty two children were diagnosed with sixty four cases of UTI's. Two bacteria were isolated in one case and thus data on 65 urine cultures were analyzed. The male:female ratio was 1.6:1 and 78.1% were less than 12 months of age. Escherichia coli was the predominant cause consisting of 53 cases (82.8%) of the cases. K. pneumoniae (5), Enterobacter (4), Enterococcus (1), beta-streptococcus (1), Diphtheroides (1) were isolated. The antibiotic resistance of E. coli were as follows; ampicillin 69.8%, cefotaxime 1.9%, gentamicin 15.1%, amikacin 0.0%, levofloxacin 1.9%, and trimethoprim/sulfamethoxazole 26.4%. Only one case of the E. coli was extended spectrum beta-lactamase (ESBL) positive. CONCLUSION: Compared to prior reports from other tertiary hospitals in Korea, E. coli was the predominant cause in childhood UTI and the rate of ESBL positivity was low. The antibiotic resistance was also different compared to prior reports. We conclude that a difference in the cause and antibiotic resistance of childhood UTI exists between centers and this should be taken into consideration when prescribing antibiotics for childhood UTIs.
Amikacin ; Ampicillin ; Anti-Bacterial Agents ; Bacteria ; beta-Lactamases ; Cefotaxime ; Child ; Drug Resistance, Microbial ; Enterobacter ; Enterococcus ; Escherichia coli ; Gentamicins ; Humans ; Korea ; Ofloxacin ; Pediatrics ; Pneumonia ; Pyuria ; Retrospective Studies ; Tertiary Care Centers ; Urinary Tract ; Urinary Tract Infections