, Yon Ju Ryu, Hye Won Kang, Doo Hyun Baek, Soo Hyun Kim, Min Young Choi, Hye Sung Park, Jin Hwa Lee, Eun-Mi Chun, Jung Hyun Chang, Young Joo Cho, Yoon Hee Jun, Sung Shine Shim, Miae Lee Obesity, the most common health problem facing children, is known to have been ascribed to multifactors. Our research is aimed at finding out if there exists any relation of children's obesity with their family and also with their daily habits.
The study included 145 obese children and 44 non-obese children, who visited our pediatric clinic from January 2006 to December 2008. The children were divided into three groups according to body mass index(BMI)(group I:non-obese control children, group II:children with BMI between 85 and 94 percentile, group III:children with BMI above 95 percentile). Research was performed in three groups by measuring of body weight, height and questionnaires.
There was no significant difference in sex and age. The parental BMI of the obese children were higher than those of non-obese children. Obesity of children was more highly related to maternal BMI than partenal BMI. Birth weight and birth order in the obese children showed no remarkable difference from those of non-obese children. The sleeping hours of the obese children were much longer than those of non-obese children. Television viewing hours of the obese children showed no remarkable difference from those of non-obese children. Family members with group III children had many complications which developed from obesity.
The development of obesity in children is attributed to the hereditary factors of their parents and daily habits such as sleeping hours. Therefore, family-based weight control is important to treat childhood obesity.
, Hae Young Choi, Ki Bum Myung, You Won Choi Urticaria is multifactorial disease. Type 1 hypersensitivity reaction plays an important role in developing or aggravating the disease, so determining of the causative allergens and avoiding them from patient's environment are helpful in treating the disease. The purpose of this study is to estimate the positive rate of each allergens in urticaria patients and to assess the differences by sex, age, year, residence type and the duration of the disease.
We retrospectively reviewed the medical records of 304 patients with urticaria who underwent skin prick test and 707 patients with urticaria who underwent serum allergen test at the department of dermatology in Mok-Dong Hospital, Ewha Womans University for 10 years from March 1998 to April 2008.
In skin prick test, the positive rates of major allergen were D.farinae 52.0%, D.pteronyssinus 47.7%, cockroach mix 27.3%, weeds 15.8%, shellfish 15.1% in that order. D.farinae, D.pteronyssinus and cockroach mix had the highest positive rates in acute and chronic urticaria, but the rates in acute urticaria were much lower than those in chronic urticaria. In serum allergen test, the positive rates of major allergen were D.farinae 31.8%, D.pteronyssinus 24.5%, housedust 24.0%, acarus siro 11.0%, cat fur 9.3%. D.farinae and D.pteronyssinus showed the highest positive rates in 20s and cockroach mix in 40s.
Some allergens had statistically significant differences of positive rates by each parameter. Therefore identifying and analysing allergen trends would play an important role in deprivation therapy in urticaria patients.
, Ki Sook Hong Cardiac troponin T(cTnT) levels are elevated in patients with chronic renal fail-ure(CRF) with dialysis which represent myocardial damage. But the cut-off levels were different in laboratories and clinical physicians. We conducted a study to find out the cut-off levels of acute myocardial infarction(AMI), ischemic heart disease(IHD), and cardiovascular disease (CVD) in CRF patients with dialysis and prognostic aspect according to cTnT levels.
Cardiac troponin T(cTnT) of total 98 patients(men 43, women 55, mean age 60.4±13.0 years) was reviewed the diagnosis and progress for 3 years by the medical records. Serum cTnT by Elecsys 2010(Roche diagnostics, Germany), the 4th generation assay was performed.
Mean cTnT level of total 98 patients was 0.26ng/mL and the patients with CVD were 59(60.2%) and their cTnT level was 0.41 ng/mL. The mean levels of cTnT in AMI, IHD, and CVD were 1.10, 0.52, and 0.41 ng/mL, respectively. cTnT, CK, CK-MB, and glucose were increased according to severity of cardiovascular disease. The cut-off levels of cTnT in AMI, IHD, and CVD was 0.10, 0.07 and 0.06 ng/mL. The sensitivity and specificity of AMI, IHD, and CVD in each cut-off level were 88.2/71.6%, 76.2/71.4%, and 81.4/71.8%, respectively. The survival rate above cTnT 0.1 ng/mL during 3 years was significantly decreased(p<0.001) than less than 0.1 ng/mL.
The degree of cTnT elevation in CRF patients with dialysis represents severity of cardiovascular disease and poor survival rate.
, Ki-Nam Shim, Hyoung Won Cho, Ju Young Choi, Shin A Lee, Min Jin Lee, Da Yeon Oh, Sun Hee Roh, Chung Hyun Tae, Seong-Eun Kim, Hye-Kyung Jung, Tae Hun Kim, Sung-Ae Jung, Sun Young Yi, Kwon Yoo, Il Hwan Moon Ingestion of corrosive substances can produce severe injury to the gastrointestinal tract and can even result in death in the acute phase. The extent and degree of damage depends on the type and amount of substances. There are occasional reports of severe contiguous injury to the esophagus and stomach caused by strong alkali ingestion in the acute phase. Usually the deaths occur within a couple of days due to multi-organ failure after ingestion of relatively much amount of agent for a suicidal attempt. But death due to late progression is very rare.
We have reported a case of 60-year-old female patient who was diagnosed as corrosive esophagitis after accidental ingestion of strong alkali. Initial endoscopic findings were compatible with IIa-IIa-0(according to Zargar's classification) in the esophagus, stomach and duodenum, respectively. After several weeks of supportive care, her subjective symptoms were much improved during she had been wating for the operation of colon interposition due to esophageal stricture. Metabolic acidosis and thrombocytopenia developed abruptly probably due to upper gastrointestinal tract necrosis and she died when 60 days had passed after the occurrence of initial esophageal injury.
Citations
, Chang Yoon Ha, Hyun Jeong Jang, Eun Young Yun, Ji Hyun Ju, Yeon Jeong Ahn, Hyun Ju Min, Tae Hyo Kim, Hyun Jin Kim, Woon Tae Jung, Ok Jae Lee, Sun Young Yi A 55-year-old man was admitted to our hospital with symptom of fever, chilling, abdominal discomfort and weight loss for 2months. Abdominal computed tomography(CT) revealed a 5×3.75 cm sized low attenuated lesion in the left lateral segment of liver. Esophagogastrodedodenoscopy showed a fistula with dirty exudates at the fundus and a yellowish stone and food debris at the choledochoduodenostomy site. Endoscopic retrograde cholangiopancreatography (ERCP) was performed and stone and food materials in common bile duct was removed with snare and basket. We experienced a case of liver abscess due to sump syndrome and spontaneous drainage to the stomach.
, Min-Young Choi, Soo-Hyun Kim, Eun Mi Song, Doo Hyun Baek, Ji Hye Kim, Yon Ju Ryu, Eun-Mi Chun, Jin Hwa Lee, Jung Hyun Chang, Sung Shine Shim Cryptococcal infections occur frequently in patients with cell-mediated immune deficiency, such as acquired immune deficiency syndrome, organ transplants, hematologic malignancy patients and immunocompromised patients who receiving cancer chemotherapy or corticosteroid therapy. In these conditions, cryptococcosis can cause serious infections requiring systemic antifungal therapy such as meningoencephalitis and sepsis. However, pulmonary cryptococcosis in immunocompetent hosts may have self-limited course and improve without treatment. We experienced various pulmonary manifestations of pulmonary cryptococcosis in five immunocompetent patients. We diagnosed three cases of isolated pulmonary cryptococcosis and two cases of disseminated cryptococcosis involving lungs. All cases were treated with intravenous injection of amphotericin B during hostpital care, and maintained with oral fluconazole after discharge. During the follow-up, clinical symptoms and radiologic features were markedly improved.
Citations
, Ha Suk Bae, Tae Sik Yoon Post stroke dysphagia is a common disorder presented in 30-65% of stroke patients. It can result in severe complication such as aspiration pneumonia. Thus nutritional support with nasogastric(NG) feeding tube is needed in these patients. But this method is not recommended more than 4 weeks. In the patients with severe dysphagia, the percutaneous endoscopic gastrostomy(PEG) is recommended in respective with the complication and prognosis.
We experienced a case of 46 year-old-male with esophagogastric ulcer because of remnant NG feeding tube on stomach. He had not a special past history until admission. He was bedridden and quadriplegic state due to spontaneous intracranial hemorrhage on both fronto-parietal lobe and subdural hemorrhage. NG feeding tube(polyvinyl chloride, 16 French) was inserted because of severe dysphagia and the clinicians attempted the PEG tube insertion but removed the PEG tube due to the sepsis with wound infection and reinserted NG feeding tube. After transfer into our hospital, a sudden blood clot from NG feeding tube was drained. We performed gastrofibroscopic examination and found NG feeding tube remnant (23cm) on stomach. It was removed and multiple esophagogastric linear ulcer with hemorrhage due to exposed vessel was observed. He obtained nutrition by total parenteral nutrition for 4 weeks after that. On follow up gastrofibroscopic examination, esophagogastric ulcers were being healing. So we tried PEG tube insertion again but failed because of granulation tissue on previous PEG tube insertion site and inserted NG feeding tube. After 3 months, he was inserted PEG tube and being supported sufficient nutrition.
Many complications are associated with the prolonged NG feeding tube insertion. So recent studies showed alternative method in case of prolonged dysphagia. We report a case with esophagogastric ulcer associated with remnant NG feeding tube on stomach.
, Eun Mi Song, Doo Hyun Beak, Hyun Jung Oh, Hyun Kyung Kim, Min Young Choi, Kyung Joo Kwon, Hye Won Kang, Seo Woo Kim, Unjin Shim, Yeon Ah Sung, Young Sun Hong Propylthiouracil(PTU) is a commonly used antithyroid drug in the management of hyperthyroidism. However, it is associated with a variety of side effects. Antineutrophil cytoplasmic antibody( ANCA)-positive vasculitis is an extremely rare side effect of PTU. We report a case of a patient with diffuse pulmonary hemorrhage while being treated with PTU. A 28-year-old woman was admitted due to fever and abdominal pain. She was diagnosed as Graves' disease 4 years before the admission, and was taking PTU intermittently. Thyroid storm was suspected and we treated her with PTU, hydrocortisone, lugol solution and propranolol. However, coughing was aggravated, with chest X-ray and computed tomography revealing diffuse alveolar hemorrhage. Perinuclear-ANCA was positive. After discontinuation of PTU, all symptoms resolved. In conclusion, ANCA-positive diffuse alveolar hemorrhage is a rare but a potential side-effect of PTU. Therefore, early awareness of this complication is important.
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