Ruptured intracranial aneurysms in infants are rare and infantile fusiform anterior cerebral artery (ACA) aneurysms are much rarer. In this report, we described the case of a 7-month-old infant with a ruptured fusiform ACA aneurysm who presented with seizure and underwent endovascular treatment. The patient was initially in a coma and the neurologic condition did not improve after treatment. The clinical characteristics of the case and literature review were discussed.

Purpose: Exposure to particulate matter (PM) is a well-known risk factor in the triggering and exacerbation of allergic airway disease. Indoor environments, where people spend most of their time, are of utmost importance. To assess the effects of air purifiers [equipped with high-efficiency particulate air (HEPA) filters] on allergic rhinitis (AR) in adult patients, we performed a multicenter, randomized, double-blind, and placebo-controlled study. Materials and Methods: Patients with house dust mite (HDM)-induced AR were randomly assigned to either active or mockup (placebo) air-purification groups. Two air purifiers (placed in living room and bedroom) were operated for 6 weeks in each home environment. The primary study endpoint was to achieve improvement in AR symptoms and medication scores. Secondary endpoints were to achieve improvement in the quality of life (QoL) and visual analog scale (VAS) scores, as well as in the indoor (bedroom and living room) concentrations of PM2.5 and PM10. Results: After 6 weeks of air purifier use, medication scores improved significantly in the active (vs. placebo) group, although subjective measures (symptoms, VAS, and QoL scores) did not differ. Bedroom PM2.5 concentrations initially exceeded living room or outdoor levels, but declined (by up to 51.8%) following active purifier operation. Concentrations of PM2.5 in living room and PM10 in bedroom and living room were also significantly reduced through active purification. Conclusion The use of air purifiers with HEPA filters significantly reduced medication requirements for patients with HDM-induced AR and significantly lowered indoor PM2.5 concentrations, regardless of room placement. Active intervention to reduce household air pollutants may help improve allergic airway disease (clinicaltrials.gov NCT03313453).

BACKGROUND/AIMS: This study compared the efficacy, compliance, and safety of bowel preparation between sodium picosulfate with magnesium citrate (SPMC) and oral sulfate solution (OSS). METHODS: A prospective randomized multicenter study was performed. Split preparation methods were performed in both groups; the SPMC group, 2 sachets on the day before, and 1 sachet on the day of the procedure, the OSS group, half of the OSS with 1 L of water on both the day before and the day of the procedure. The adenoma detection rate (ADR), adequacy of bowel preparation using the Boston Bowel Preparation Scale (BBPS) score, patient satisfaction on a visual analog scale (VAS), and safety were compared between the 2 groups. RESULTS: This study analyzed 229 patients (121 in the SPMC group and 108 in the OSS group). ADR showed no differences between 2 groups (51.7% vs. 41.7%, P>0.05). The mean total BBPS score (7.95 vs. 8.11, P>0.05) and adequate bowel preparation rate (94.9% vs. 96.3%, P>0.05) were similar between the 2 groups. The mean VAS score for taste (7.62 vs. 6.87, P=0.006) was significantly higher in the SPMC group than in the OSS group. There were no significant differences in any other safety variables between the 2 groups except nausea symptom (36.1% vs. 20.3%, P=0.008). CONCLUSIONS: Bowel preparation for colonoscopy using low volume OSS and SPMC yielded similar ADRs and levels of efficacy. SPMC had higher levels of satisfaction for taste and feeling than did OSS.
Adenoma ; Citric Acid ; Colonoscopy ; Compliance ; Humans ; Magnesium ; Nausea ; Patient Satisfaction ; Prospective Studies ; Sodium ; Visual Analog Scale ; Water

BACKGROUND: Electronic Donor Health Questionnaire (e-DHQ) could prevent omissions in filling in the questionnaire. Compared with the paper Donor Health Questionnaire (p-DHQ), it can expect honest answers from donors to the questions relating to high risk behaviors. The aim of this study is to evaluate the effect of e-DHQ on the answers from donors by analyzing variations of the reasons for deferral after the introduction of e-DHQ to the Korean Red Cross (KRC). METHODS: The reasons for deferral determined by p-DHQ in 2008~2011 and by e-DHQ in 2011~2014, which have been accumulated in the database of the Blood Information Management System in KRC, were analyzed and compared. RESULTS: The results showed that the deferral rates for the general health status and medication taken were 0.47% (P=0.0100) and 0.16% (P=0.0103) higher in e-DHQ than in p-DHQ. In particular, for questions including hunger, lack of sleep, fatigue, endoscopy, dental treatment, surgery, tattoo, and acupuncture, the proportion of answers was higher in e-DHQ than in p-DHQ. CONCLUSION: The deferral rates for general health status and medication taken increased after the implementation of e-DHQ. The rate of deferral by some details of general health status, medical treatment for recent one month, and history for recent one year also increased because e-DHQ induced donors to give straightforward answers. e-DHQ is expected to contribute to the strengthening of health protection of blood donors and recipients. However the questions relating to high risk behaviors should be reformed so that honest answers can be induced from donors.
Acupuncture ; Blood Donors ; Endoscopy ; Fatigue ; Humans ; Hunger ; Information Management ; Red Cross ; Risk-Taking ; Tissue Donors*

BACKGROUND: Since 2001, the Korean Red Cross has performed malaria antibody test for blood donors in malaria-risk areas to prevent transfusion-transmitted malaria. However, due to insufficient sensitivity and specificity the malaria antibody assay is not considered an efficient screening method. Therefore, we have considered discontinuing malaria antibody testing for blood donors. METHODS: We analyzed the results of malaria antibody test from 2001 to 2014 utilizing data from the Blood Information Management System of the Korean Red Cross. RESULTS: Among 16,650,812 donations tested from 2001 to 2014, 50,143 donations (0.30%) showed positive results. However, there was no truly infected case at the time of donation. The positive rate among blood donations was between 34 and 39 per 10,000 in 2001, but between 9 and 10 per 10,000 in 2014. There was no interregional disparity in the positive rate of blood donations. CONCLUSION: Korea is in a malaria elimination phase and malaria antibody testing in limited areas is not effective, therefore we propose discontinuing the malaria antibody test.
Blood Donors* ; Humans ; Information Management ; Korea ; Malaria* ; Mass Screening* ; Red Cross ; Sensitivity and Specificity

Recently, the emergency of Middle East Respiratory Syndrome in Korea raised public concern regarding emerging infectious disease (EID) and affected the strategy for blood safety. Although some cases of EID such as West Nile virus in the United States and hepatitis E virus in Japan emerged in a restricted area, the emergence can rapidly affect the situation in other countries in a globalized society with advancements in transportation and international exchange. Because the risk of transfusion-mediated infection may occur by the agent of EID which can be transmitted through blood, the strategy for safety must be considered for agents that were not tested in the stage of blood donor screening. We reviewed the characteristics of transfusion-transmissible EIDs raising concerns worldwide and the strategies which had been adopted.
Blood Donors ; Blood Safety ; Communicable Diseases, Emerging* ; Emergencies ; Hepatitis E virus ; Humans ; Japan ; Korea ; Mass Screening ; Middle East ; Transportation ; United States ; West Nile virus

BACKGROUND: Establishment of a national reference panel for syphilis antibodies is necessary to evaluate the performance of in-vitro diagnostic tests for syphilis and to verify test quality. This study aimed to establish a national reference panel for syphilis antibodies, to assess the suitability of a panel for non-treponemal and treponemal testing, and to assess the reactivity of the various tests currently in use. METHODS: Treponemal pallidum particle agglutination (TPPA)-positive and -negative fresh frozen plasma samples were obtained. After the fresh frozen plasma was converted to serum by defibrination, the samples were pooled. Two candidate reference standards containing no syphilis antibodies and 10 candidate reference standards containing syphilis antibodies were prepared on the basis of reactivity in the TPPA assay. Candidate reference standards were tested by three laboratories using five non-treponemal tests and four treponemal tests. RESULTS: All three laboratories reported positive non-treponemal test results for the mixed-titer performance panel (MP)/6-MP/12. MP/1, MP/2, and MP/3 were negative for non-treponemal tests. MP/4 and MP/5 were reported either as positive or negative according to the laboratories. All laboratories reported positive TPPA results for MP/3-MP/12 and negative results for MP/1 and MP/2. No significant difference was detected among the treponemal testing results in three laboratories. CONCLUSIONS: We established 12 candidate national reference standards containing various concentrations of syphilis antibodies. A collaborative study using nine tests demonstrated that 12 candidate national reference standards presented consistent results, except a few assays with low sensitivity, and thus could be used as a national reference panel for syphilis antibody testing.
Agglutination ; Antibodies* ; Diagnostic Tests, Routine ; Korea* ; Plasma ; Syphilis*

BACKGROUND: CD4(+)CD25(high+)regulatory T cells (Tregs) are considered to be of vital importance for maintaining immunologic self-tolerance and preventing autoimmune diseases. These cells have been found to be deficient in skin lesions and in the peripheral blood of patients with psoriasis. OBJECTIVE: To investigate the role of Tregs in the pathogenesis of psoriasis and to evaluate the changes in Tregs in relation to the severity and the clinical course of psoriasis. METHODS: Immunohistochemistry (CD3, 4, 8, 79 and FOXP3) was performed in 22 psoriatic patients compared to 5 normal controls. Flow cytometry (CD3, 4, 8, 25 and FOXP3) was performed in 18 psoriatic patients and 8 normal volunteers and reverse transcriptase polymerase chain reaction (foxp3 mRNA) was performed in 8 psoriasis patients. RESULTS: An increase in the FOXP3(+) cell fraction was detected in the lesional psoriatic skin irrespective of the severity of psoriasis as compared with the normal skin. However, a decrease in FOXP3(+) cells was observed in the samples obtained from psoriasis of 'acute course'. FOXP3(+) Treg populations in the blood of the 'acute course' psoriasis was not different compared to that of 'chronic course' psoriasis and normal controls. CONCLUSION: The deficiency of FOXP3(+) Tregs in the lesional psoriatic skin might be responsible for the exacerbation of psoriasis.
Autoimmune Diseases ; Flow Cytometry ; Humans ; Immunohistochemistry ; Psoriasis ; Reverse Transcriptase Polymerase Chain Reaction ; Skin ; T-Lymphocytes ; T-Lymphocytes, Regulatory

PROPOSE: Premature ejaculation (PE) is the most prevalent male ejaculation disorder. The premature ejaculation diagnostic tool (PEDT) was developed to systematically apply the DSM-IV-TR criteria in diagnostic PE. This study was designed to assess the validity of the Korean version of the PEDT as a diagnostic tool for PE. MATERIALS AND METHODS: The Korean version development of the PDET involved two stages: (1) Development of the initial language version through two independent forward translations and one backward translation. Discrepancies between the original English form and the first draft Korean translation were reviewed by the panel. Discrepancies between the original English form and the Korean translation were reviewed by the panel. (2) For psychometric validation and scoring system development, data was collected from men with and without PE based on clinician diagnosis, using DSM-IV-TR criteria. A total of 98 patients with a DSM-IV-TR defined PE and 100 men without PE were enrolled into the study and requested to complete the PEDT, which was translated into Korean. The PE patients were also requested to measure intravaginal ejaculatory latency time (IELT). The 50 men of no-PE group and all PE group were requested to come for a second visit to assess the PEDT's retest reliability. The results were analyzed statistically by SPSS version 12. RESULT: The mean age of the no-PE group and PE group were 43.4+/-9.2 and 51.6+/-9.0, respectively. The geometric mean IELT of the PE group was 115.37+/-78.14s. The number of men reporting IELTs of <1, 1-<2 and >2min were 28 (28.6%), 29 (29.6%) and 41 (41.8%), respectively. The Cronbach's alpha score of the Korean version of PEDT was calculated as 0.93, showing adequate internal consistency. The test-retest correlation coefficients of each item were higher than 0.72 and the correlation coefficients of the total score was 0.88. (P<0.001) Sensitivity and specificity analyses suggested a score of < or =8 indicated no-PE, 9 and 10 probable PE, and > or =11 PE. CONCLUSIONS: The Korean version of PEDT was highly effective in detecting the presence of PE. The result of our study supports its validity as a diagnostic instrument in the clinical setting.
Ejaculation ; Humans ; Male ; Premature Ejaculation ; Psychometrics ; Sensitivity and Specificity ; Translations

PURPOSE: The presence of a perfusion-diffusion mismatch is a useful indicator for predicting the progression of acute cerebral infarction. However, not all the area of the perfusion-diffusion mismatch progresses to infarction and a large proportion survives with hypoperfusion. The purpose of this study was to assess 1) whether tissue viability can be predicted using quantitative perfusion values and 2) whether there is correlation between the perfusion value and the time that elapsed after the onset of symptoms. MATERIALS AND METHODS: Twenty-two patients with acute infarction in the middle cerebral artery territory within 12 hours after symptom onset were included in this study. We excluded those patients in whom thrombolysis was attempted or the lesion volume was less than 5 mL. Patients without perfusion-diffusion mismatch on the mean transit time (MTT) map were also excluded. We categorized the ischemic lesions into 3 areas: 1) the initial infarction, 2) the area that progressed to infarction, and 3) the hypoperfused but surviving area, based on the initial and follow up diffusion-weighted images and initial mean transit time (MTT) map. We obtained the relative cerebral blood volume (rCBV), the cerebral blood flow (rCBF) and the MTT in each area by comparing to the contralateral normal area. Statistical analysis was performed using one-way ANOVA to test whether there was a difference in perfusion values between each area. The threshold value was calculated between areas 2 and 3 using the receiver operating characteristics curve. We analyzed the correlation between the perfusion values of each area and the time that elapsed after the inset of symptoms. RESULTS: The perfusion values among each region were significantly different on the rCBV, rCBF and MTT maps. Between regions 2 and 3, the rCBV and rCBF maps showed a significant difference (Bonferroni post hoc analysis), but in case of rCBV, the mean perfusion values in each region approached to the normal level and it was difficult to differentiate between the two regions on the rCBV map. The rCBF in the regions 1, 2 and 3 was 0.40, 0.64, and 0.84, respectively. The difference of the threshold values of the rCBF between regions 2 and 3 was 0.75. There was no significant correlation between the time that elapsed after symptom onset and the perfusion values of each region on the rCBV, rCBF and MTT map. CONCLUSION: The perfusion values between the area of the initial infarction, the area that progressed to infarction and the hypoperfused but surviving area showed significant differences. The rCBF was the most useful parameter in differentiating between areas that progressed to infarction and the surviving areas. Quantitative measurement of the perfusion values may have a role in selecting the candidates for thrombolysis after they have suffered hyperacute stroke.
Blood Volume ; Cerebral Infarction ; Follow-Up Studies ; Humans ; Infarction* ; Middle Cerebral Artery ; Perfusion ; ROC Curve ; Stroke ; Tissue Survival*