We investigated the adenoviral etiology and seasonal epidemic trends in intussusception and each adenoviral subgroup. Also we confirmed whether we can use the adenovirus data of Acute Infectious Agents Laboratory Surveillance Report (AIALSR) as an epidemic predictor of intussusception. Patients with intussusception (n = 126), < 5 years old, were enrolled and matched by age and sex with controls suffering acute gastroenteritis without intussusception (n = 106), all recruited at 8 centers. All fecal specimens were assayed for adenovirus, including subgroups A, B, C, E, and F, with reverse transcriptase-polymerase chain reaction (RT-PCR). Adenovirus was detected in 53 cases and 13 controls (P < 0.001). Nonenteric adenoviruses (NEAds) were detected in 51 cases and four controls (P < 0.001). We used Spearman's correlation analysis to analyze the incidence of intussusception and adenoviral epidemic trends, and compared them with fecal and respiratory adenoviral epidemic trends in the AIALSR. The trend of intussusception correlated with total NEAds (r = 0.635; P = 0.011), as did the fecal AIALSR adenovirus trends (r = 0.572; P = 0.026). Among the NEAd subgroups, subgroup C was dominant (P < 0.001), but subgroups B (P = 0.007) and E (P = 0.013) were also significant to intussusception. However, only subgroup C showed a significant epidemic correlation (r = 0.776; P = 0.001) with intussusception. Not respiratory but fecal AIALSR adenovirus trends correlated with the incidence of NEAds and intussusception. We suggest the possibility of using fecal AIALSR adenovirus data as an approximate epidemic predictor of intussusception.
Adenoviridae* ; Child ; Gastroenteritis ; Humans ; Incidence ; Intussusception* ; Korea* ; Seasons

STUDY DESIGN: A noninterventional, multicenter, cross-sectional study. PURPOSE: We investigated the prevalence of neuropathic pain (NP) and patient-reported outcomes (PROs) of the quality of life (QoL) and functional disability in Korean adults with chronic low back pain (CLBP). OVERVIEW OF LITERATURE: Among patients with CLBP, 20%–55% had NP. METHODS: Patients older than 20 years with CLBP lasting for longer than three months, with a visual analog scale (VAS) pain score higher than four, and with pain medications being used for at least four weeks before enrollment were recruited from 27 general hospitals between December 2014 and May 2015. Medical chart reviews were performed to collect demographic/clinical features and diagnosis of NP (douleur neuropathique 4, DN4). The QoL (EuroQoL 5-dimension, EQ-5D; EQ-VAS) and functional disability (Quebec Back Pain Disability Scale, QBPDS) were determined through patient surveys. Multiple linear regression analyses were performed to compare PROs between the NP (DN4≥4) and non-NP (DN4 < 4) groups. RESULTS: A total of 1,200 patients (females: 65.7%; mean age: 63.4±13.0 years) were enrolled. The mean scores of EQ-5D, EQ-VAS, and QBPDS were 0.5±0.3, 55.7±19.4, and 40.4±21.1, respectively. Among all patients, 492 (41.0%; 95% confidence interval, 38.2%–43.8%) suffered from NP. The prevalence of NP was higher in male patients (46.8%; p < 0.01), in patients who had pain based on radiological and neurological findings (59.0%; p < 0.01), and in patients who had severe pain (49.0%; p < 0.01). There were significant mean differences in EQ-5D (NP group vs. non-NP group: 0.4±0.3 vs. 0.5±0.3; p < 0.01) and QBPDS (NP group vs. non-NP group: 45.8±21.2 vs. 36.3±20.2; p < 0.01) scores. In the multiple linear regression, patients with NP showed lower EQ-5D (β=−0.1; p < 0.01) and higher QBPDS (β=7.0; p < 0.01) scores than those without NP. CONCLUSIONS: NP was highly prevalent in Korean patients with CLBP. Patients with CLBP having NP had a lower QoL and more severe dysfunction than those without NP. To enhance the QoL and functional status of patients with CLBP, this study highlights the importance of appropriately diagnosing and treating NP.
Adult* ; Back Pain ; Cross-Sectional Studies ; Diagnosis ; Hospitals, General ; Humans ; Linear Models ; Low Back Pain* ; Male ; Neuralgia* ; Prevalence* ; Quality of Life ; Visual Analog Scale

Bladder urothelial carcinoma typically occurs in individuals in their sixties or seventies: it rarely occurs in persons <20 years old. Moreover, in young patients, bladder urothelial carcinoma lesions are reported to be solitary and nonmuscle invasive, with low malignant potential. However, 13% of lesions in this age group are reported to be noninvasive high-grade papillary urothelial carcinoma but these are extremely rare in children <15 years. There is no specific consensus regarding treatment of bladder urothelial carcinoma in children and adolescent. In particular, method has been suggested for follow-up of high-grade bladder urothelial carcinoma. Therefore we report our experience of one case the, discuss surveillance methods, and provide a brief review of the literature.
Adolescent ; Child* ; Consensus ; Follow-Up Studies ; Humans ; Methods ; Pediatrics ; Urinary Bladder*

IgA nephropathy is the most common type of glomerulonephritis worldwide. Although primary IgA nephropathy receives the most attention, many other diseases are also associated with IgA nephropathy. Among these, chronic liver diseases such as alcoholic liver disease or hepatitis B or C have been reported as secondary causes of glomerular IgA deposits. Recently, as the prevalence of hepatitis A virus (HAV) infection is increasing in Korea, HAV-associated renal diseases occur frequently. Acute kidney injury (AKI) is one of the most common complications of HAV infection, mainly due to acute tubular necrosis or interstitial nephritis. However, unlike hepatitis B and C, glomerular involvement is extremely rare in acute HAV infection. Here, we report a case of biopsy-proven IgA nephropathy with serologically documented HAV infection. The patient presented moderate degree of proteinuria without evidence of AKI. Renal biopsy revealed mesangial IgA deposits but tubular or interstitial inflammation was not observed. This report suggests that HAV infection may be a secondary cause of IgA nephropathy. However, further studies are required to elucidate a causal link between hepatitis A and mesangial IgA deposits.
Acute Kidney Injury ; Aluminum Hydroxide ; Biopsy ; Carbonates ; Glomerulonephritis ; Glomerulonephritis, IGA ; Hepatitis ; Hepatitis A ; Hepatitis A virus ; Hepatitis B ; Humans ; Immunoglobulin A ; Inflammation ; Korea ; Liver Diseases ; Liver Diseases, Alcoholic ; Necrosis ; Nephritis, Interstitial ; Prevalence ; Proteinuria

Although a moderate degree of proteinuria is common in patients with IgA nephropathy (IgAN), nephrotic syndrome combined with IgAN is rare. It has been reported that approximately 5% of all patients with IgAN are complicated by minimal change disease and these patients respond well to corticosteroid therapy. However, spontaneous remission is uncommon in heavy proteinuric patients with IgAN. Recently, we experienced two cases of spontaneous remission of nephrotic syndrome combined with IgAN without use of corticosteroid. In these patients, heavy proteinuria disappeared in 1 month after the onset and no recurrence occurred during follow-up. With such limited number of cases, factors associated with spontaneous remission in these patients could not be explored. Further study with a larger number of patients is required and careful attention should be paid to these complicated cases.
Follow-Up Studies ; Glomerulonephritis, IGA ; Humans ; Immunoglobulin A ; Nephrosis, Lipoid ; Nephrotic Syndrome ; Proteinuria ; Recurrence ; Remission, Spontaneous

In systemic lupus erythematosus patients, prevalence of renal involvement is high, even in the absence of overt clinical manifestation. Lupus nephritis can usually be categorized according to the widely used WHO classification. however, clinically significant renal disease unrelated to lupus nephritis have rarely been described in patients with SLE. Especially, there has been few reported cases of IgA nephropathy with SLE since first reported in 1995, but their relationship is not apparent yet. We experienced a 72-year-old female who was admitted to our hospital due to generalized edema, arthralgia, proteinuria, microscopic hematuria. Her diagnosis of IgA nephropathy was estabilished on biopsy. At the same time, she was diagnosed as SLE. in that the serology for ANA was positive at 1:640, lupus anticoagulant and anti-cardiolipin antibody were positive, hemolytic anemia, arthritis and oral ulcer. and eventually she was diagnosed end-stage renal disease 2 months later. In conclusion, atypical glomerular lesion in SLE should raise the possibility of a non-lupus glomerulopathy, including IgA nephropathy.
Aged ; Anemia, Hemolytic ; Arthralgia ; Arthritis ; Biopsy ; Classification ; Diagnosis ; Edema ; Female ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Kidney Failure, Chronic ; Lupus Coagulation Inhibitor ; Lupus Erythematosus, Systemic* ; Lupus Nephritis ; Oral Ulcer ; Prevalence ; Proteinuria

Susceptibilities of 5 different mice strains, including C3H/HeN, BALB/c, C57BL6, FvB and ICR, to Echinostoma hortense infection, was evaluated. The worm expulsion rate, worm size and egg production were observed from 1 to 8 weeks after infection with 30 metacercariae. C3H/HeN and ICR mice showed the highest worm maturation rates. The worm recovery rate and the number of eggs per gram (EPG) of feces was also higher in C3H/HeN and ICR mice than in BALB/c, C57BL6, and FvB mice. It is suggested that E. hortense is highly infectious to ICR and C3H/HeN mice, but not to the other strains of mice. Based on the results obtained, we believe that the susceptibility of different mouse strains to E. hortense infection is dependent on the genetic and immunologic background of mice.
Animals ; Echinostoma/*growth & development ; Echinostomiasis/genetics/*parasitology ; Feces/parasitology ; Female ; Genetic Predisposition to Disease ; Intestines/parasitology ; Mice/*parasitology ; Mice, Inbred BALB C ; Mice, Inbred C3H ; Mice, Inbred C57BL ; Mice, Inbred ICR ; Parasite Egg Count

OBJECTIVE: To assess the umbilical nucleated red blood cell counts and perinatal outcomes according to umbilical artery Doppler end diastolic velocity in severe preeclampsia. MATERIALS AND METHODS: A prospective case-control study comparing 42 severe preeclampsia patients who had present umbilical artery end diastolic velocity with 7 severe preeclampsia patients who absent end diastolic velocity for umbilical nucleated red blood cell counts and perinatal outcomes. RESULTS: Those with absent end diastolic velocity did not have significantly greater nucleated red blood cell counts, but they had increased hemoglobin, hematocrit. These newborn had significantly lower birth weight, increased Cesarean section rate for fetal distress and been more frequently admitted to the neonatal intensive care unit. These newborn also had significantly increased intracranial hemorrhage,assisted ventilation and longer hospital days. CONCLUSION: No correlation with nucleated red blood cell counts and chronic fetal hypoxia were presented. However further study with more expanded cases for the role of nucleated red blood cell counts as a marker of fetal hypoxia will be needed.
Birth Weight ; Case-Control Studies ; Cesarean Section ; Erythrocyte Count* ; Erythrocytes* ; Female ; Fetal Distress ; Fetal Hypoxia ; Hematocrit ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Pre-Eclampsia* ; Pregnancy ; Prospective Studies ; Umbilical Arteries ; Ventilation

OBJECTIVE: Our purpose is to determine the optimal cutoff value for the TDx-FLM assay for predicting fetal lung maturity and its clinical efficiency. METHODS: We reviewed records of 81 pregnant women (117 fetuses), who had TDx-FLM assay performed from 1996 through 2000 at Ajou University Hospital. All were delivered between 28 and 37 weeks' gestation. Women treated with steroids after fetal lung maturity test were excluded in this study. In neonatal respiratory outcomes, result of fetal lung maturity was defined as neonates who were not affected by respiratory distress syndrome (RDS). All neonates were divided into mature and immature group according to their respiratory outcomes and clinical characteristics of both groups were evaluated. The predictive values for maturity and immaturity were calculated as previously defined. RESULTS: Among 117 newborns, RDS developed in 8 cases (immature group), and 109 cases were unaffected (mature group). In mature and immature group, mean gestational age was 35.0 weeks and 33.1 weeks (p=0.038), mean fetal birth weight 2313.4 gm and 2036.3 gm respectively (p=0.279). Preterm deliveries were due to preterm labor (32.1% vs 25.0%, p=0.676), premature rupture of membranes (11.9% vs 12.5% p=0.962), preeclamsia (17.4% vs 37.5%, p=0.384), intrauterine growth restriction (11.0% vs 0%, p=0.211), discordant twin (16.5% vs 0%, p=0.212) and other maternal complications (35.8% vs 37.5%, p=0.922) And also, frequencies of twin were 0% vs 64.2% (p<0.001), gestational diabetes 3.7% vs 12.5% (p=0.233), steroid usage 67.0% vs 12.5% (p=0.002), and median TDx-FLM level 59.2 mg/g (range 13.8 - 120.4 mg/g) vs 13.1 mg/g (range 1.20-27.9 mg/g) (p=0.004). The best cutoff point to calculate predictive value for a mature result was >or=24.7 mg/g which gave a sensitivity 93.6%, specificity 87.5%, positive predictive value (PPV) 99.0%, negative predictive value (NPV) 50.0% and efficiency 93.1. CONCLUSION: The best cutoff value of TDx-FLM levels for assessment of fetal lung maturation was 24.7 mg/g in our study group.
Birth Weight ; Diabetes, Gestational ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Lung* ; Membranes ; Obstetric Labor, Premature ; Pregnancy ; Pregnant Women ; Rupture ; Sensitivity and Specificity ; Steroids

OBJECTIVE: Our purpose is to determine the optimal cutoff value for the TDx-FLM assay for predicting fetal lung maturity and its clinical efficiency. METHODS: We reviewed records of 81 pregnant women (117 fetuses), who had TDx-FLM assay performed from 1996 through 2000 at Ajou University Hospital. All were delivered between 28 and 37 weeks' gestation. Women treated with steroids after fetal lung maturity test were excluded in this study. In neonatal respiratory outcomes, result of fetal lung maturity was defined as neonates who were not affected by respiratory distress syndrome (RDS). All neonates were divided into mature and immature group according to their respiratory outcomes and clinical characteristics of both groups were evaluated. The predictive values for maturity and immaturity were calculated as previously defined. RESULTS: Among 117 newborns, RDS developed in 8 cases (immature group), and 109 cases were unaffected (mature group). In mature and immature group, mean gestational age was 35.0 weeks and 33.1 weeks (p=0.038), mean fetal birth weight 2313.4 gm and 2036.3 gm respectively (p=0.279). Preterm deliveries were due to preterm labor (32.1% vs 25.0%, p=0.676), premature rupture of membranes (11.9% vs 12.5% p=0.962), preeclamsia (17.4% vs 37.5%, p=0.384), intrauterine growth restriction (11.0% vs 0%, p=0.211), discordant twin (16.5% vs 0%, p=0.212) and other maternal complications (35.8% vs 37.5%, p=0.922) And also, frequencies of twin were 0% vs 64.2% (p<0.001), gestational diabetes 3.7% vs 12.5% (p=0.233), steroid usage 67.0% vs 12.5% (p=0.002), and median TDx-FLM level 59.2 mg/g (range 13.8 - 120.4 mg/g) vs 13.1 mg/g (range 1.20-27.9 mg/g) (p=0.004). The best cutoff point to calculate predictive value for a mature result was >or=24.7 mg/g which gave a sensitivity 93.6%, specificity 87.5%, positive predictive value (PPV) 99.0%, negative predictive value (NPV) 50.0% and efficiency 93.1. CONCLUSION: The best cutoff value of TDx-FLM levels for assessment of fetal lung maturation was 24.7 mg/g in our study group.
Birth Weight ; Diabetes, Gestational ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Lung* ; Membranes ; Obstetric Labor, Premature ; Pregnancy ; Pregnant Women ; Rupture ; Sensitivity and Specificity ; Steroids