Epidemiological evidence suggests that the severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is lesser and morbidity and mortality rates are lower in children than in adults. Although respiratory viral infections are major triggers of asthma exacerbations in children, the association between asthma and SARS-CoV-2 infection remains unclear. We describe a previously healthy 13-year-old male adolescent who developed severe acute asthma exacerbation following coronavirus disease 2019 (COVID-19) infection. This case report describes new-onset asthma as severe exacerbation following COVID-19 infection and highlights the importance of ongoing surveillance of the wide spectrum of COVID-19 manifestations in children.

BACKGROUND: Bile acids have anti-cancer properties in a certain types of cancers. We determined anticancer activity and its underlying molecular mechanism of ursodeoxycholic acid (UDCA) in human DU145 prostate cancer cells. METHODS: Cell viability was measured with an MTT assay. UDCA-induced apoptosis was determined with flow cytometric analysis. The expression levels of apoptosis-related signaling proteins were examined with Western blotting. RESULTS: UDCA treatment significantly inhibited cell growth of DU145 in a dose-dependent manner. It induced cellular shrinkage and cytoplasmic blebs and accumulated the cells with sub-G1 DNA contents. Moreover, UDCA activated caspase 8, suggesting that UDCA-induced apoptosis is associated with extrinsic pathway. Consistent to this finding, UDCA increased the expressions of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) receptor, death receptor 4 (DR4) and death receptor 5 (DR5), and TRAIL augmented the UDCA-induced cell death in DU145 cells. In addition, UDCA also increased the expressions of Bax and cytochrome c and decreased the expression of Bcl-xL in DU145 cells. This finding suggests that UDCA-induced apoptosis may be involved in intrinsic pathway. CONCLUSIONS: UDCA induces apoptosis via extrinsic pathway as well as intrinsic pathway in DU145 prostate cancer cells. UDCA may be a promising anti-cancer agent against prostate cancer.
Apoptosis* ; Bile Acids and Salts ; Blister ; Blotting, Western ; Caspase 8 ; Cell Death ; Cell Survival ; Cytochromes c ; Cytoplasm ; DNA ; Humans ; Necrosis ; Prostate* ; Prostatic Neoplasms* ; Receptors, TNF-Related Apoptosis-Inducing Ligand ; Ursodeoxycholic Acid*

BACKGROUND: Orthognathic surgery is required in 25% to 35% of patients with a cleft lip and palate, for whom functional recovery and aesthetic improvement after surgery are important. The aim of this study was to examine maxillary and mandibular changes, along with concomitant soft tissue changes, in cleft patients who underwent LeFort I osteotomy and sagittal split ramus osteotomy (two-jaw surgery). METHODS: Twenty-eight cleft patients who underwent two-jaw surgery between August 2008 and November 2013 were included. Cephalometric analysis was conducted before and after surgery. Preoperative and postoperative measurements of the bone and soft tissue were compared. RESULTS: The mean horizontal advancement of the maxilla (point A) was 6.12 mm, while that of the mandible (point B) was -5.19 mm. The mean point A-nasion-point B angle was -4.1degrees before surgery, and increased to 2.5degrees after surgery. The mean nasolabial angle was 72.7degrees before surgery, and increased to 88.7degrees after surgery. The mean minimal distance between Rickett's E-line and the upper lip was 6.52 mm before surgery and 1.81 mm after surgery. The ratio of soft tissue change to bone change was 0.55 between point A and point A' and 0.93 between point B and point B'. CONCLUSIONS: Patients with cleft lip and palate who underwent two-jaw surgery showed optimal soft tissue changes. The position of the soft tissue (point A') was shifted by a distance equal to 55% of the change in the maxillary bone. Therefore, bone surgery without soft tissue correction can achieve good aesthetic results.
Cleft Lip ; Humans ; Lip ; Mandible ; Maxilla ; Orthognathic Surgery ; Osteotomy ; Osteotomy, Le Fort ; Osteotomy, Sagittal Split Ramus ; Palate

BACKGROUND: Cisplatin (cis-diaminedichloroplatinum, CDDP) is a widely used chemotherapeutic agent for the treatment of many cancers. However, initial resistance to CDDP is a serious problem in treating these cancers. Vitis coignetiae Pulliat (Meoru in Korea) have shown anti-nuclear factor kappa B and anti-epidermal growth factor receptor activities in cancer cells. METHODS: In this study, in order to seeking an approach to increase the anti-cancer effects of CDDP with natural products. Here, we investigated anthocyanins isolated from Vitis coignetiae Pulliat (anthocyanidins isolated from meoru, AIMs) can enhance anti-cancer effects of cisplatin (CDDP) in stomach cancer cells. The cell viability of SNU-1 and SNU-16 cells after treated with AIMs and CDDP were analyzed by MTT assay. The expressions of Akt and X-linked inhibitor of apoptosis protein (XIAP) proteins were examined by western blot in AIMs- and CDDP-treated cells. RESULTS: We found that AIMs enhanced anticancer effects of CDDP, which activity was additive but not synergistic. AIMs suppressed Akt activity of the cancer cells activated by CDDP. AIMs also suppressed in XIAP an anti-apoptotic protein. CONCLUSIONS: This study suggests that the anthocyanins isolated from fruits of Vitis coignetiae Pulliat enhanced anti-cancer effects of CDDP by inhibiting Akt activity activated by CDDP.
Anthocyanins* ; Biological Products ; Blotting, Western ; Cell Survival ; Cisplatin* ; Fruit* ; Humans* ; Stomach Neoplasms* ; Vitis* ; X-Linked Inhibitor of Apoptosis Protein

PURPOSE: To compare a new extramedullary femoral alignment guide system with the conventional intramedullary alignment guide system for femoral component alignment in total knee arthroplasty(TKA). MATERIALS AND METHODS: From November 2004 to June 2005, a newly developed extramdullary technique was applied in 80 cases (EM group), which was compared to another 80cases (IM group) in which conventional intramedullary technique was used. Standing long leg anteroposterior (AP) radiographs were evaluated at postoperative 2 months to compare the alignment between the groups. And surgery time between two groups was compared. RESULTS: Femoral component alignment was 1.7+/-1.3degrees in EM group and 1.3+/-1.2degrees in IM group (p=0.025). Clinically acceptable femoral component alignment(<+/-3degrees) was achieved in 92% of EM group and 93% in IM group. The femoral component flexion angle was 3.9+/-2.3degrees delta in EM group and 5.5+/-2.7degrees delta in IM group (p<0.0001). The surgery time was 69+/-11.5 min in EM group and 68+/-11.7 min in IM group(p= 0.516). CONCLUSION: By using our EM technique, we could achieve a accurate alignment and similar surgery time compared with conventional IM technique, although it is not superior to IM technique. We think that our new extramedullary technique is a useful surgical method decreasing the complications of intramedullary canal injury.
Knee ; Leg

PURPOSE: To compare the accuracy of implantation by radiologic results between 3D Linker and navigation guided total knee arthroplasty. MATERIALS AND METHODS: Between February 2004 and April 2005, total knee arthroplasties were done in 25 knees with balanced gap-resection technique (group A) and 25 using kinematic navigation system(group B) by a single surgeon. All patients had standing long anteroposterior (AP) radiographs of the lower extremities and supine lateral radiographs of the knees at 6 weeks postoperatively. Mechanical axis deviation, alpha and beta, angles were measured on standing long leg AP views and alpha and beta angles on supine knee lateral views. Results were classified according to the deviation from the reference line and graded as excellent, good, and poor. The result was regarded as satisfactory when all five angles were excellent or good. RESULTS: The mean mechanical axis deviation was 1.11degrees in group A and 1.36degrees in group B and all were excellent in both groups. Regarding alpha.angles, 19 cases were excellent and, 6 good in group A and, 21 excellent and 4 good in group B. Regarding., angles, 22 cases were excellent and, 3 good in group A and, 23 excellent and 2 good in group B. Regarding.,, angles, 15 cases were excellent, 8 good and 2 poor in group A and, 15 excellent, 9 good, and 1 poor in group B. Regarding beta angles, 19 cases were excellent, 3 good and 3 poor in group A and, 23 excellent, and 2 poor in group B. There were no statistical differences between two groups in all five angles (p>0.05). An excellent implantation in all five angles was obtained in 28% in group A and 60% in group B (p<0.05). There were 80% of satisfactory cases in group A and 84% in group B with no statistical difference (p>0.05). CONCLUSION: Radiological results (mechanical axis and component angles) of total knee arthroplasty were satisfactory in 80% with balanced gap-resection technique and 84% with kinematic navigation system and showed no statistical difference.
Arthroplasty* ; Axis, Cervical Vertebra ; Humans ; Knee* ; Leg ; Lower Extremity

PURPOSE: To compare the clinical outcomes of bilateral total knee arthroplasty (TKA) performed simultaneously by two teams or sequentially by one team under a single anesthesia, with those of staged bilateral TKA performed during separate hospitalizations. MATERIALS AND METHODS: We retrospectively analyzed 83 patients (166 knees) who underwent bilateral TKA. Group I comprised 25 patients receiving simultaneous bilateral TKA. Group II comprised 31 patients receiving sequential bilateral TKA. Group III comprised 27 patients receiving staged bilateral TKA spaced an average of 8.9 weeks apart. Data including complication rate, length of hospital stay, and allogenic blood transfusion rate were evaluated. RESULTS: Complication rate for group I, II, and III was 12%, 19.4%, and 25.9%, respectively, but there was no significant difference. Allogenic blood transfusion rate was 28%, 29%, and 11.1%, respectively, but there was no significant difference. The average hospital stay was 8.4 days, 8.9 days, and 14.5 days, respectively, and group I and II showed significantly shorter hospitalization compared with group III. CONCLUSION: Simultaneous or sequential bilateral TKA is a safe and efficient procedure that can shorten hospital stay without increasing complication rate and allogenic blood transfusion rate, compared with staged bilateral TKA.
Anesthesia ; Arthroplasty* ; Blood Transfusion ; Hospitalization ; Humans ; Knee* ; Length of Stay ; Retrospective Studies

BACKGROUND AND OBJECTIVES: The prevalence of coronary disease in Korea, with the consequent morbidity and mortality, has rapidly risen during the last two decades. This study aimed to describe the changing pattern in the demographic composition during the 1990s of patients presenting with acute myocardial infarction (AMI) in Korean metropolitan cities. SUBJECTS AND METHODS: Data from the medical record of patients with AMI, admitted to five University Hospitals in Busan and Daegu between January 1990 and December 1999, were sorted according to their age (<30, 3044, 4559, 6074, >75 years) and gender. RESULTS: During the last decade, the number of cases of AMI increased from 283 in 1990, to 988 by 1999 (ratio of AMI/medical patients admitted; 1.68% in 1990 to 2.52% in 1999). The most prevalent age group was 6074 yrs (46.1%), followed by 4559 yrs (34.2%). Generally, the male cases were twice as prevalent as female (68.2% : 31.8%), but the gender ratio was reversed in the highest age group (>75 yrs) (44.6% : 55.4%). During the period in question, the gender ratio and age distribution remained reasonably constant throughout. The proportion of younger AMI patients (<45 yrs) did not increase. CONCLUSION: Admissions due to AMI increased substantially during the 1990s. Almost half the cases were from the 6074 yrs age group, and two third were male. There were little changes in the compositions of age and gender of the AMI cases during this period.
Age Distribution ; Busan ; Coronary Disease ; Daegu ; Female ; Hospitals, University* ; Humans ; Korea ; Male ; Medical Records ; Mortality ; Myocardial Infarction* ; Prevalence

In the diagnosis of acute spinal trauma, meticulous physical examination and history taking is the most important tool and auxilliary support support can be given by plain X-ray, CT or myelography, etc. But these cannot show the state of cord injury directly. On the contrary, MRI shows the cord directly as well as the soft and bony tissues. We analysed retrospectively 39 patients who suffered from acute spinal trauma at the level of cervical and thoracic spine and had their spine MRI taken. We verified the meaningful correlation between the signal change in the spinal cord on MRI and the degree of neurologic deficit and prognosis, using Frankel classification and trauma motor index at the time of admission and the final follow-up.
Classification ; Diagnosis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Myelography ; Neurologic Manifestations ; Physical Examination ; Prognosis ; Retrospective Studies ; Spinal Cord ; Spine

Henoch-Shonlein(H-S) purpura, or anaphylactoid purpura is a hypersensitivity vasculitis characterized by palpable purpura usually on buttock and low extremities; arthralgia mostly polyarhtralgia in the absence of frank arthritis; gastraintestinal involvement with colicky abdominal pain, nausea, vomiting, diarrhea, constipation and bleeding; and renal involvement, manifested chiefly by hematuria and proteinuria. Gastrointestinal involvement is seen in 70 percent of pediatric patients and one third of adult patients. Any portion of the gastrointestinal tract distal to the esophagus maybe involved, but most frequently affected sites are jejunum and ileum. We report one case of H-S purpura with duodenal involvement observed in 16, male patient.
Abdominal Pain ; Adult ; Arthralgia ; Arthritis ; Buttocks ; Constipation ; Diarrhea ; Esophagus ; Extremities ; Gastrointestinal Tract ; Hematuria ; Hemorrhage ; Humans ; Ileum ; Jejunum ; Male ; Nausea ; Proteinuria ; Purpura* ; Purpura, Schoenlein-Henoch ; Vasculitis, Leukocytoclastic, Cutaneous ; Vomiting