ABSTRACT
PURPOSE: Meningitis is among the most common infections affecting the central nervous system. It can be difficult to determine the exact pathogen responsible for the infection and patients are often treated with empiric antibiotics. This study was conducted to identify the most common clinical characteristics of enteroviral meningitis in children and evaluate the diagnostic efficacy of reverse transcriptase-polymerase chain reaction (RT-PCR) for early detection of an enterovirus. METHODS: We analyzed the medical records of children admitted to Korea University Medical Center and diagnosed with meningitis on the basis of cerebrospinal fluid (CSF) analysis and RT-PCR from CSF and other samples from January 2010 to August 2013. RESULTS: A total of 333 patients were enrolled and classified into four groups based on diagnosis: enteroviral meningitis (n=110), bacterial meningitis (n=23), other viral meningitis (n=36), and unknown etiology (n=164). Patients with bacterial meningitis were younger than those in the other groups (P<0.001). Pleocytosis in CSF was similar across all groups. Of patients in the enteroviral meningitis group, 92.7% were diagnosed based on RT-PCR findings. Mean length of hospital stay for patients with enteroviral meningitis was 6.08 days, which was significantly shorter than that for patients with meningitis of bacterial etiology (19.73 days, P<0.001). CONCLUSION: Diagnosis of enteroviral meningitis before viral culture results are available is possible using RT-PCR. Accurate diagnosis reduces the length of hospital stay and helps to avoid unnecessary empiric antibiotic treatment.
Subject(s)
Child , Humans , Academic Medical Centers , Anti-Bacterial Agents , Central Nervous System , Cerebrospinal Fluid , Diagnosis , Early Diagnosis , Enterovirus , Korea , Length of Stay , Leukocytosis , Medical Records , Meningitis , Meningitis, Bacterial , Meningitis, Viral , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
Endodermal sinus tumor is a type of germ cell tumor that is relatively common in children. An important problem concerns secondary neoplasms after treatment. We report a case of osteosarcoma that developed five years after treatment of intrapelvic endodermal sinus tumor. The patient was a seven-year-old girl who presented with right thigh and knee joint pain. The patient had been diagnosed with endodermal sinus tumor five years previously and treated with a regimen consisting of high dose cisplatin, etoposide, bleomycin and surgery but without radiotherapy. We detected a mass shadow on the right distal femur that proved to be osteoblastic osteosarcoma by incisional biopsy. The patient received surgical treatment after chemotherapy that included high dose methotrexate. The follow-up bone scan revealed no abnormal uptakes. There has been no evidence of recurrence eighteen months of follow-up after chemotherapy.
Subject(s)
Child , Female , Humans , Biopsy , Bleomycin , Cisplatin , Drug Therapy , Endodermal Sinus Tumor , Etoposide , Femur , Follow-Up Studies , Knee Joint , Methotrexate , Neoplasms, Germ Cell and Embryonal , Neoplasms, Second Primary , Osteoblasts , Osteosarcoma , Radiotherapy , Recurrence , ThighABSTRACT
Endodermal sinus tumor is a type of germ cell tumor that is relatively common in children. An important problem concerns secondary neoplasms after treatment. We report a case of osteosarcoma that developed five years after treatment of intrapelvic endodermal sinus tumor. The patient was a seven-year-old girl who presented with right thigh and knee joint pain. The patient had been diagnosed with endodermal sinus tumor five years previously and treated with a regimen consisting of high dose cisplatin, etoposide, bleomycin and surgery but without radiotherapy. We detected a mass shadow on the right distal femur that proved to be osteoblastic osteosarcoma by incisional biopsy. The patient received surgical treatment after chemotherapy that included high dose methotrexate. The follow-up bone scan revealed no abnormal uptakes. There has been no evidence of recurrence eighteen months of follow-up after chemotherapy.
Subject(s)
Child , Female , Humans , Biopsy , Bleomycin , Cisplatin , Drug Therapy , Endodermal Sinus Tumor , Etoposide , Femur , Follow-Up Studies , Knee Joint , Methotrexate , Neoplasms, Germ Cell and Embryonal , Neoplasms, Second Primary , Osteoblasts , Osteosarcoma , Radiotherapy , Recurrence , ThighABSTRACT
PURPOSE: As the mobile internet spread, patients can access to health information via mobile applications. But this information must be a reliable for treatment. This study evaluated the quality of information of mobile applications that with atopic dermatitis. METHODS: On April 2014, the 98 mobile applications that had been searched on three application markets using the keywords, 'atopic dermatitis' etc. were enrolled. Thirty-one applications with information about atopic dermatitis written in Korean were surveyed. The informational quality of each application was examined using DISCERN tool and we also examined authorship, price, number of downloads. And we analyzed relations between these factors and informational quality. RESULTS: The mean score (+/-standard deviation) of overall rating of the publications of the 31 applications were 1.55 (+/-0.888) points. The overall quality of the publication was 'low' in 80.6% of applications, 'moderate' in 16.1%, 'high' in 3.2% of the applications we evaluated. There were no significant differences between the score of price of applications in all questions. However the mean score of group of downloads 1,000 and more were 2.25 (+/-1.035), significantly higher than group of downloads less than 1,000, 1.30 (+/-0.703) (P=0.043). CONCLUSION: The quality of mobile applications providing health information on atopic dermatitis needs significant improvement. Some guidelines and certifications of the mobile application are needed to provide health information about atopic dermatitis, association with experts.
Subject(s)
Humans , Authorship , Certification , Consumer Health Information , Dermatitis, Atopic , Internet , Korea , Mobile Applications , PublicationsABSTRACT
PURPOSE: Gonadotropin-releasing hormone agonist (GnRHa) is known for improving final adult height in patients with central precocious puberty (CPP). This study aimed to investigate the age of menarche and near adult height in girls with CPP who had been treated with GnRHa. METHODS: In this retrospective study, we reviewed the medical records of 71 Korean girls with CPP who had started menarche or reached over 13 years of bone age after long-term GnRHa treatment. We estimated near adult height using the Bayley-Pinneau method and identified the age of menarche in girls with CPP. RESULTS: Mean chronological and bone age at menarche were 11.9+/-0.7 and 12.8+/-0.4 years, respectively. The period between menarche and the end of treatment was 14.0+/-5.6 months. Posttreatment near adult height was 163.8+/-4.7 cm, which was significantly greater than pretreatment predicted adult height (158.7+/-4.1 cm). CONCLUSION: GnRHa treatment in girls with CPP could improve final adult height and made the age of menarche close to that of the general population.