Objective: This study was conducted to investigate the prevalence, status, severity, frequency, and impact on life of drooling in children with cerebral palsy. Methods: A total of 74 children with cerebral palsy, aged 2-6 years (53.68±17.33 months), who exhibited drooling symptoms were assessed using the Drooling Severity and Frequency Scale (DSFS) and the Drooling Impact Scale (DIS) to determine the status, severity, frequency, and impact of drooling in drooling group and control group. The study also examined differences in drooling-related factors based on gender, age, and prematurity status. Results: The overall prevalence of drooling was 60.8%, 35.6% in those with spastic quadriplegia, and 77.8% in children at Gross Motor Function Classification System (GMFCS) level III-V. Significant differences were found in drooling severity based on gender, prematurity, and age. Higher scores were observed for drooling severity and frequency, frequency of wiping the mouth, and the impact of drooling on the child’s life compare to control group.Although a few had undergone drooling-related treatments, many parents expressed a desire to receive treatment. It was reported that treatment for drooling was primarily provided by occupational therapists through referrals to rehabilitation medicine, with dysphagia rehabilitation and oral motor therapy being the main interventions. Conclusion By utilizing standardized assessment tools, the severity of drooling according to the specific conditions of children with disabilities was assessed. It is believed that the necessary steps to be taken include identifying the cause of drooling and setting appropriate treatment goals, followed by the provision for a suitable intervention.

Objective: This study was conducted to investigate the prevalence, status, severity, frequency, and impact on life of drooling in children with cerebral palsy. Methods: A total of 74 children with cerebral palsy, aged 2-6 years (53.68±17.33 months), who exhibited drooling symptoms were assessed using the Drooling Severity and Frequency Scale (DSFS) and the Drooling Impact Scale (DIS) to determine the status, severity, frequency, and impact of drooling in drooling group and control group. The study also examined differences in drooling-related factors based on gender, age, and prematurity status. Results: The overall prevalence of drooling was 60.8%, 35.6% in those with spastic quadriplegia, and 77.8% in children at Gross Motor Function Classification System (GMFCS) level III-V. Significant differences were found in drooling severity based on gender, prematurity, and age. Higher scores were observed for drooling severity and frequency, frequency of wiping the mouth, and the impact of drooling on the child’s life compare to control group.Although a few had undergone drooling-related treatments, many parents expressed a desire to receive treatment. It was reported that treatment for drooling was primarily provided by occupational therapists through referrals to rehabilitation medicine, with dysphagia rehabilitation and oral motor therapy being the main interventions. Conclusion By utilizing standardized assessment tools, the severity of drooling according to the specific conditions of children with disabilities was assessed. It is believed that the necessary steps to be taken include identifying the cause of drooling and setting appropriate treatment goals, followed by the provision for a suitable intervention.

Objective: This study was conducted to investigate the prevalence, status, severity, frequency, and impact on life of drooling in children with cerebral palsy. Methods: A total of 74 children with cerebral palsy, aged 2-6 years (53.68±17.33 months), who exhibited drooling symptoms were assessed using the Drooling Severity and Frequency Scale (DSFS) and the Drooling Impact Scale (DIS) to determine the status, severity, frequency, and impact of drooling in drooling group and control group. The study also examined differences in drooling-related factors based on gender, age, and prematurity status. Results: The overall prevalence of drooling was 60.8%, 35.6% in those with spastic quadriplegia, and 77.8% in children at Gross Motor Function Classification System (GMFCS) level III-V. Significant differences were found in drooling severity based on gender, prematurity, and age. Higher scores were observed for drooling severity and frequency, frequency of wiping the mouth, and the impact of drooling on the child’s life compare to control group.Although a few had undergone drooling-related treatments, many parents expressed a desire to receive treatment. It was reported that treatment for drooling was primarily provided by occupational therapists through referrals to rehabilitation medicine, with dysphagia rehabilitation and oral motor therapy being the main interventions. Conclusion By utilizing standardized assessment tools, the severity of drooling according to the specific conditions of children with disabilities was assessed. It is believed that the necessary steps to be taken include identifying the cause of drooling and setting appropriate treatment goals, followed by the provision for a suitable intervention.

Purpose: Recently, we developed allele-discriminating priming system (ADPS) technology. This method increases the sensitivity of conventional quantitative polymerase chain reaction up to 100 folds, with limit of detection, 0.01%, with reinforced specificity. This prospective study aimed to develop and validate the accuracy of ADPS epidermal growth factor receptor (EGFR) Mutation Test Kit using clinical specimens. Materials and Methods: In total 189 formalin-fixed paraffin-embedded tumor tissues resected from patients with non–small cell lung cancer were used to perform a comparative evaluation of the ADPS EGFR Mutation Test Kit versus the cobas EGFR Mutation Test v2, which is the current gold standard. When the two methods had inconsistent results, next-generation sequencing–based CancerSCAN was utilized as a referee. Results: The overall agreement of the two methods was 97.4% (93.9%-99.1%); the positive percent agreement, 95.0% (88.7%-98.4%); and the negative percent agreement, 100.0% (95.9%-100.0%). EGFR mutations were detected at a frequency of 50.3% using the ADPS EGFR Mutation Test Kit and 52.9% using the cobas EGFR Mutation Test v2. There were 10 discrepant mutation calls between the two methods. CancerSCAN reproduced eight ADPS results. In two cases, mutant allele fraction was ultra-low at 0.02% and 0.06%, which are significantly below the limit of detection of the cobas assay and CancerSCAN. Based on the EGFR genotyping by ADPS, the treatment options could be switched in five patients. Conclusion The highly sensitive and specific ADPS EGFR Mutation Test Kit would be useful in detecting the patients who have lung cancer with EGFR mutation, and can benefit from the EGFR targeted therapy.

Background: Acinetobacter baumannii infections cause high morbidity and mortality in intensive care unit (ICU) patients. However, there are limited data on the changes of longterm epidemiology of imipenem resistance in A. baumannii bacteremia among pediatric ICU (PICU) patients. Methods: A retrospective review was performed on patients with A. baumannii bacteremia in PICU of a tertiary teaching hospital from 2000 to 2016. Antimicrobial susceptibility tests, multilocus sequence typing (MLST), and polymerase chain reaction for antimicrobial resistance genes were performed for available isolates. Results: A. baumannii bacteremia occurred in 27 patients; imipenem-sensitive A. baumannii (ISAB, n = 10, 37%) and imipenem-resistant A. baumannii (IRAB, n = 17, 63%). There was a clear shift in the antibiogram of A. baumannii during the study period. From 2000 to 2003, all isolates were ISAB (n = 6). From 2005 to 2008, both IRAB (n = 5) and ISAB (n = 4) were isolated. However, from 2009, all isolates were IRAB (n = 12). Ten isolates were available for additional test and confirmed as IRAB. MLST analysis showed that among 10 isolates, sequence type 138 was predominant (n = 7). All 10 isolates were positive for OXA-23-like and OXA-51-like carbapenemase. Of 27 bacteremia patients, 11 were male (41%), the median age at bacteremia onset was 5.2 years (range, 0–18.6 years). In 33% (9/27) of patients, A. baumannii was isolated from tracheal aspirate prior to development of bacteremia (median, 8 days; range, 5–124 days). The overall case-fatality rate was 63% (17/27) within 28 days. There was no statistical difference in the case fatality rate between ISAB and IRAB groups (50% vs. 71%; P = 0.422). Conclusion IRAB bacteremia causes serious threat in patients in PICU. Proactive infection control measures and antimicrobial stewardship are crucial for managing IRAB infection in PICU.

Warty dyskeratoma (WD) is an uncommon skin tumor that histologically presents as focal acantholysis and dyskeratosis and is a common finding among acantholytic diseases such as Darier’s disease. WD most commonly occurs on the head or neck of adults as an isolated papule or nodule. To our knowledge, only 6 cases of WD in the genital area have been previously reported in the literature, and no case have occurred on the scrotum to date.We report the first case of multiple WD that occurred on the scrotum successfully treated with 0.025% tretinoin cream. A 55-year-old male presented with asymptomatic, multiple, 0.1∼0.2-cm-sized, skin-colored papules on the scrotum for the previous 6 months. A skin punch biopsy and human papillomavirus (HPV) polymerase chain reaction test were performed for a clinical suspicion of genital warts or bowenoid papulosis. The histopathologic examination showed cup-shaped epidermal invaginations with central keratotic plug. Prominent villi, acantholytic clefting and corps ronds were also shown. The patient tested negative for HPV and was diagnosed with WD with typical pathologic findings. The patient was treated with 0.025% tretinoin cream for 2 weeks, and the lesions decreased in both size and number.

Background/Aims: The gut microbiota regulates intestinal immune homeostasis through host-microbiota interactions. Multiple factors affect the gut microbiota, including age, sex, diet, and use of drugs. In addition, information on gut microbiota differs depending on the samples.The aim of this study is to investigate whether changes in cecal microbiota depend on aging. Methods: Gut microbiota in cecal contents of 6-, 31-, and 74-week-old and 2-year-old male Fischer-344 rats (corresponding to 5-, 30-, 60-, and 80-year-old humans in terms of age) were analyzed using 16S ribosomal RNA metagenome sequencing and phylogenetic investigation of communities by reconstruction of unobserved states (PICRUSt) based on the Kyoto Encyclopedia of Genes and Genomes orthology.Moreover, short-chain fatty acid (SCFA) level in cecum and inflammation related factors were measured using real-time quantitative polymerase chain reaction and enzyme linked immunosorbent assay. Results: Alpha and beta diversity did not change significantly with age. At the family level, Lachnospiraceae and Ruminococcaceae, which produce SCFAs, showed significant change in 31-week-old rats: Lachnospiraceae significantly increased at 31 weeks of age, compared to other age groups, while Ruminococcaceae decreased. Butyrate levels in cecum were significantly increased in 31-week-old rats, and the expression of inflammation related genes was increased followed aging. Especially, EU622775_s and EU622773_s, which were highly abundance species in 31-week-old rats, showed significant relationship with butyrate concentration. Enzymes required for producing butyrate—acetyl-CoA transferase, butyryl-CoA dehydrogenase, and butyrate kinase—were not predicted by PICRUSt. Conclusions Major bacterial taxa in the cecal lumen, such as Lachnospiraceae, well-known SCFAs-producing family, changed in 31-week-old rats.Moreover, unknown species EU622775_s and EU622773_s showed strong association with cecal butyrate level at 31 weeks of age.

This study aimed to determine the impact of dysglycemia on myocardial injury and cardiac dysfunction in acute myocardial infarctions (AMIs). From 2005 to 2016, a total of 1,593 patients with AMIs who underwent percutaneous coronary intervention were enrolled. The patients were classified into five groups according to the admission glucose level: ≤80, 81 to 140, 141 to 200, 201 to 260, and ≥261 mg/dL. The clinical and echocardiographic parameters and 30-day mortality were analyzed. The peak troponin I and white blood cell levels had a positive linear relationship to the admission glucose level. The left ventricular ejection fraction had an inverted U-shape trend, and the E/E' ratio was U-shaped based on euglycemia. The 30-day mortality also increased as the admission glucose increased, and the cut-off value for predicting the mortality was 202.5 mg/dL. Dysglycemia, especially hyperglycemia, appears to be associated with myocardial injury and could be another adjunctive parameter for predicting mortality in patients with AMIs.

This study aimed to determine the impact of dysglycemia on myocardial injury and cardiac dysfunction in acute myocardial infarctions (AMIs). From 2005 to 2016, a total of 1,593 patients with AMIs who underwent percutaneous coronary intervention were enrolled. The patients were classified into five groups according to the admission glucose level: ≤80, 81 to 140, 141 to 200, 201 to 260, and ≥261 mg/dL. The clinical and echocardiographic parameters and 30-day mortality were analyzed. The peak troponin I and white blood cell levels had a positive linear relationship to the admission glucose level. The left ventricular ejection fraction had an inverted U-shape trend, and the E/E' ratio was U-shaped based on euglycemia. The 30-day mortality also increased as the admission glucose increased, and the cut-off value for predicting the mortality was 202.5 mg/dL. Dysglycemia, especially hyperglycemia, appears to be associated with myocardial injury and could be another adjunctive parameter for predicting mortality in patients with AMIs.

Background/Aims: Effect of proton pump inhibitor (PPI) use on the risk of hipfracture is controversial. This study aimed to clarify the association between PPIuse and hip fracture risk using a large cohort. Methods: This study recruited participants from the nationwide cohort (n =1,025,340). After exclusion of participants who had hip fractures or were aged less than 40 years during the baseline period (2002 to 2004), 371,806 participants were followed to 2013. Participants prescribed PPIs for more than 90 days during baseline period were defined as users. Fracture cases were defined when participants were hospitalized with claims of a hip fracture. Results During 4,159,343 person-years of follow-up, fractures developed more oftenin PPI users than in nonusers (relative risk [RR], 1.787; 95% confidence interval [CI], 1.260 to 2.534; p = 0.002). The results persisted after adjusting for age, sex, andmany drugs relevant to osteoporosis or influential in bone health. Furthermore,fracture risk associated with PPI use increased with duration of use ( p trend < 0.001). The fully adjusted RRs of hip fracture development were 1.350 (95% CI, 1.203 to 1.515) for 1- to 90-day users, 1.487 (95% CI, 0.957 to 2.311) for 91- to 180-day users, and 1.771 (95% CI, 0.931 to 3.368) for > 180-day users. The positive association between PPI use and fracture was also confirmed in a subgroup with health screening data where further adjustment for body mass index, smoking status, alcohol consumption, and physical activity was available (adjusted RR, 2.025; 95% CI, 1.151 to 3.564, p = 0.014). Conclusions: PPI use is associated with hip fracture development.