A Method for Generate a Mouse Model of Stroke: Evaluation of Parameters for Blood Flow, Behavior, and Survival

Stroke is one of the common causes of death and disability. Despite extensive efforts in stroke research, therapeutic options for improving the functional recovery remain limited in clinical practice. Experimental stroke models using genetically modified mice could aid in unraveling the complex pathophysiology triggered by ischemic brain injury. Here, we optimized the procedure for generating mouse stroke model using an intraluminal suture in the middle cerebral artery and verified the blockage of blood flow using indocyanine green coupled with near infra-red radiation. The first week after the ischemic injury was critical for survivability. The survival rate of 11% in mice without any treatment but increased to 60% on administering prophylactic antibiotics. During this period, mice showed severe functional impairment but recovered spontaneously starting from the second week onward. Among the various behavioral tests, the pole tests and neurological severity score tests remained reliable up to 4 weeks after ischemia, whereas the rotarod and corner tests became less sensitive for assessing the severity of ischemic injury with time. Further, loss of body weight was also observed for up 4 weeks after ischemia induction. In conclusion, we have developed an improved approach which allows us to investigate the role of the cell death-related genes in the disease progression using genetically modified mice and to evaluate the modes of action of candidate drugs.

Erratum: A Method for Generating Mouse Model of Stroke: Evaluation of Parameters for Blood Flow, Behavior, and Survival

We correct a typo in the title.

Nationwide Survey on the Prevalence of Allergic Diseases according to Region and Age / 소아알레르기및호흡기학회지

PURPOSE: It is widely known that allergic diseases progress through a sequential course known as the allergic march. However, there have been no recent reports in Korea regarding the progress of allergic diseases based on the medical claim data of the National Health Insurance Corporation. METHODS: Medical claim data of 2005 and 2008 from the National Health Insurance Corporation were used. Data was classified according to the administrative districts of metropolitan cities and provinces, and divided according to age in increments of 5 years. RESULTS: According to the nationwide survey on the prevalence of allergic diseases according to region, the prevalence of allergic diseases increased in 2008 compared to 2005. Especially, the prevalence of allergic rhinitis significantly rises in all regions. When comparing the prevalence of allergic diseases according to age, there was no significant difference in the prevalence of atopic dermatitis and asthma between 2005 and 2008. In contrast, allergic rhinitis demonstrated a rise of more than 5% in all age groups. CONCLUSION: According to the nationwide survey on the prevalence of allergic diseases using the medical claim data from the National Health Insurance Corporation, the prevalence of allergic rhinitis had significantly increased in 2008 compared to 2005. More survey studies should be conducted in the future using the medical claim data of the National Health Insurance Corporation.

Evaluation of Information of Websites on Precocious Puberty

PURPOSE: To evaluate the quality and scientific accuracy of internet information regarding precocious puberty. METHODS: We identified websites by entering "precocious puberty" or "early puberty" into 5 search engines from May to July 2011. The top 50 websites from each search engine were included, excluding websites that were duplicate, inaccessible, or had poor information (containing fewer than two subjects of definition, causes, diagnosis, or treatment); 60 sites were identified. We classified the websites according to website author, evaluated the quality with the DISCERN instrument, giving a scientific accuracy with information score (IS) ranging from 0 to 30 points. RESULTS: Analysis of the quality with the DISCERN instrument showed that the majority of websites received low overall ratings regardless of the authors. Assessing the scientific accuracy, the mean IS of oriental websites (10.82) was significantly low compared to that of academic authors (22.61), physician authors (21.50), commercial authors (22.88), and other authors (27.00). CONCLUSION: With the exception of oriental websites, scientifically accurate information was provided on the websites regarding precocious puberty. Most of the analyzed websites showed low reliability. It is important to provide reliable information as well as scientifically accurate information

Association between Major Single Nucleotide Polymorphism and Haplotype of the ADRB2 Gene and Korean Children with Asthma / 소아알레르기및호흡기학회지

PURPOSE: Development of asthma involves the interaction between genetic factors and environmental stimuli. This study aims to investigate whether major single nucleotide polymorphism (SNP)s and their haplotypes of the ADRB2 (beta2-adrenoceptor) gene are associated with children with asthma in Korea. METHODS: Children with asthma aging 5 to 15 years old were recruited as the patient group, and children without respiratory diseases or asthma of the same age were recruited as the control group. Blood samples of 5 mL were collected and DNA was extracted by standard methods. Genotyping was done for 6 SNPs known to have a frequency of more than 4%, including 1309A>G, 1342C>G, 1515G>A, 1786C>A, 2316G>C, 2502G>A. RESULTS: Overall, 438 subjects (214 patients and 224 controls) were included in this study. Minor allele homozygote frequency of 6 SNP were 22%, 1.8%, 11%, 12.3%, 21.2% and 13.0%, respectively. Differences between both groups of individual SNP frequencies were not statistically significant, although the difference of the frequency of the second SNP (1342C>G) has borderline significance (P=0.06). Overall distributions of haplotypes were not significantly different between both groups. However, analysis of specific SNPs among haplotypes revealed that haplotypes including the 2nd SNP were significantly associated with asthma (odds ratio, 1.7; 95% confidence interval, 1.1 to 2.6). Combinations of haplotypes excluding the 2nd SNP did not show significant difference between both groups. CONCLUSION: This study suggests that the ADRB2 gene polymorphism is associated with susceptibility to childhood asthma and that analysis of haplotypes rather than SNPs is more reliable in this association.

The Social and Environmental Risk Factors of Allergic Rhinitis in Children / 소아알레르기및호흡기학회지

PURPOSE: We investigated the risk factors related to the development and aggravation of allergic rhinitis, which is associated with residential environment and lifestyle habits of children residing in Incheon. METHODS: A total of 182 children diagnosed with moderate to severe allergic rhinitis and 67 healthy children were enrolled. A detailed questionnaire of the environmental characteristics and the dietary habits were completed by the parents. Further, skin prick tests with 14 common allergens were performed. RESULTS: The mean age of the children with allergic rhinitis and healthy control was 8.2+/-2.8 and 9.4+/-2.0 years, respectively. The presence of indoor mold was associated with an increased risk of development of allergic rhinitis. (adjusted odds ratio [aOR], 4.26; 95% confidence interval [CI], 1.96-9.27) Among the food groups, there was no significant difference of the daily intake of milk and yogurt between the patients and the controls. However, daily intake of vegetables, except Kimchi, and daily intake of fruits or fruit juice were associated with a decreased risk of allergic rhinitis. (aOR, 0.43; 95% CI, 0.20-0.92 / aOR, 0.43; 95% CI, 0.13-0.90, respectively) CONCLUSION: The results indicate that an indoor dampness is one of the risk factors of development and aggravation of allergic rhinitis. Control of indoor humidity and daily intake of fruits and vegetables can prevent the development and control symptoms of allergic rhinitis.

A Case of Turner Syndrome Associated with Idiopathic Central Diabetes Insipidus / 대한소아내분비학회지

We report a case of Turner syndrome associated with idiopathic central diabetes insipidus in a 12-year-old girl, who presented with polyuria and polydipsia after a year. The patient was very short and and centrally obese, and was initially diagnosed with Turner syndrome, hyperlipidema, and diabetes mellitus. A water deprivation test revealed central diabetes insipidus, and sellar magnetic resonance imaging (MRI) showed a thickening of the pituitary stalk, with normal high signal intensity in the posterior pituitary gland. Replacement therapy with desmopressin was initiated, and follow-up sellar MRI findings after two years showed spontaneous regression of the thickened pituitary stalk. There are only few reports of concomitant Turner syndrome with central diabetes insipidus worldwide. Further observation is needed in order to disclose the cause of central diabetes insipidus in patients having Turner syndrome.

A Case of Turner Syndrome Associated with Idiopathic Central Diabetes Insipidus / 대한소아내분비학회지

We report a case of Turner syndrome associated with idiopathic central diabetes insipidus in a 12-year-old girl, who presented with polyuria and polydipsia after a year. The patient was very short and and centrally obese, and was initially diagnosed with Turner syndrome, hyperlipidema, and diabetes mellitus. A water deprivation test revealed central diabetes insipidus, and sellar magnetic resonance imaging (MRI) showed a thickening of the pituitary stalk, with normal high signal intensity in the posterior pituitary gland. Replacement therapy with desmopressin was initiated, and follow-up sellar MRI findings after two years showed spontaneous regression of the thickened pituitary stalk. There are only few reports of concomitant Turner syndrome with central diabetes insipidus worldwide. Further observation is needed in order to disclose the cause of central diabetes insipidus in patients having Turner syndrome.

Beta-Lactam Antibiotic Sensitization and Its Relationship to Allergic Diseases in Tertiary Hospital Nurses

PURPOSE: Skin allergies through type 1 and 4 hypersensitivity reactions are the most frequent manifestations of drug allergies. We had previously experienced a case of a nurse with cefotiam-induced contact urticaria syndrome. To aid in preventing the progression of drug-induced allergic disease in nurses, we conducted a survey of tertiary hospital nurses who were likely to have been exposed professionally to antibiotics. METHODS: All 539 staff nurses at a tertiary hospital were asked to respond to a questionnaire regarding antibiotic exposure. Of the 457 nurses (84.8%) who responded, 427 (79.2%) received a physical examination of the hands and 318 (59.0%) received skin prick tests with the beta-lactam antibiotics cefotiam, cefoperazone, ceftizoxime, flomoxef, piperacillin and penicillin G. RESULTS: A positive response to at least one of the antibiotics occurred in 8 (2.6%) of the 311 subjects included in the analysis and stages 1 and 2 contact urticaria syndrome were observed in 38 (8.9%) and 3 (0.7%) of 427 nurses, respectively. The frequencies of a positive antibiotic skin test (6.9 versus 1.3%, chi-square=7.15, P=0.018), stage 1 contact urticaria syndrome (14.4 versus 7.4%, chi-square=4.33, P=0.038) and drug allergy (15.3 versus 3.6%, chi-square=18.28, P=0.000) were higher in subjects with a positive skin allergy history than in those without. Allergic rhinitis (P=0.02, OR=3.86, CI=1.23-12.06), night cough (P=0.04, OR=3.12, CI=1.03-9.41) and food allergy (P=0.00, OR=9.90, CI=3.38-29.98) were significant risk factors for drug allergy. CONCLUSIONS: Antibiotic sensitization and drug allergy occurred more frequently in nurses with a positive skin allergy history. Atopy may be an important risk factor for drug allergy.

Beta-Lactam Antibiotic Sensitization and Its Relationship to Allergic Diseases in Tertiary Hospital Nurses

PURPOSE: Skin allergies through type 1 and 4 hypersensitivity reactions are the most frequent manifestations of drug allergies. We had previously experienced a case of a nurse with cefotiam-induced contact urticaria syndrome. To aid in preventing the progression of drug-induced allergic disease in nurses, we conducted a survey of tertiary hospital nurses who were likely to have been exposed professionally to antibiotics. METHODS: All 539 staff nurses at a tertiary hospital were asked to respond to a questionnaire regarding antibiotic exposure. Of the 457 nurses (84.8%) who responded, 427 (79.2%) received a physical examination of the hands and 318 (59.0%) received skin prick tests with the beta-lactam antibiotics cefotiam, cefoperazone, ceftizoxime, flomoxef, piperacillin and penicillin G. RESULTS: A positive response to at least one of the antibiotics occurred in 8 (2.6%) of the 311 subjects included in the analysis and stages 1 and 2 contact urticaria syndrome were observed in 38 (8.9%) and 3 (0.7%) of 427 nurses, respectively. The frequencies of a positive antibiotic skin test (6.9 versus 1.3%, chi-square=7.15, P=0.018), stage 1 contact urticaria syndrome (14.4 versus 7.4%, chi-square=4.33, P=0.038) and drug allergy (15.3 versus 3.6%, chi-square=18.28, P=0.000) were higher in subjects with a positive skin allergy history than in those without. Allergic rhinitis (P=0.02, OR=3.86, CI=1.23-12.06), night cough (P=0.04, OR=3.12, CI=1.03-9.41) and food allergy (P=0.00, OR=9.90, CI=3.38-29.98) were significant risk factors for drug allergy. CONCLUSIONS: Antibiotic sensitization and drug allergy occurred more frequently in nurses with a positive skin allergy history. Atopy may be an important risk factor for drug allergy.

A Case of Primary Hyperparathyroidism in Child Presented with Acute Abdominal Pain / 대한소아내분비학회지

Primary Hyperparathyroidism is the metabolism abnormality of calcium, phosphate, and bone due to the high synthesis of parathyroid hormone, a rare endocrine disease in children. It scarcely occurs in children so that till now it was reported only 4 cases in Korea, especially with abdominal symptoms. We report this case of primary hyperparathyroidism with brief review of literatures.

Subclinical rickets in breastfed infants / 소아과

PURPOSE: The prevalence of rickets in the world is on the rise not only in developing but also in developed countries. In Korea, breastfeeding has increased. There have been few studies on the possible association of rickets with breastfeeding. The purpose of this study was to identify the development and the clinical presentation of subclinical rickets in breastfed infants. METHODS: We investigated patients who were breastfed and had hypovitaminosis D in the blood from May 2006 to April 2007, and who were diagnosed with vitamin D deficient rickets from May 2003 to April 2006. We evaluated the results of blood tests, x-rays and other relevant information in the medical record. A questionnaire that included questions on the diet of patients, the mothers activity during pregnancy and place of residence was administered. RESULTS: Twelve patients (66%: male, 34%: female) were enrolled in this study. There were eight in the asymptomatic and four in the symptomatic group. The median age for each group was 8 months (range 4-11 month) and 5.5 months (5-8 month). All patients in the symptomatic group were breastfed until diagnosed. In the asymptomatic group, they were breastfed for four to six months, and then weaned with only thin rice soup and vegetables. Nine patients had a vitamin D concentration below 20 ng/mL and three patients had levels between 20 and 29 ng/mL. Alkaline phosphatase (ALP) and parathyroid hormone (PTH) were elevated in both groups. There were statistically significant 25-OHD3 levels in the blood in both groups (P=0.008). Ten of the patients (83%) also had iron deficient anemia. CONCLUSION: Vitamin D deficiency and subclinical rickets has been identified in Korea. However, the prevalence of this disease has not been determined. The main limitation of this study was the small number of patients and the absence of a control group.

A Case of Menkes disease with Infantile Spasm / 대한소아신경학회지

Menkes disease, so called kinky-hair syndrome, is a rare, genetic and progressive neurodegenerative disorder. It is caused by a mutation in the ATP7A gene, which codes for the copper transporting ATPase in the cell organelles. The dysfunction of many copper-dependent enzymes results in low concentration of copper in some tissues and accumulation of copper in others. We report a boy presented with kinky hairs, developmental delay, hypotonia and connective tissue abnormalities at the age of 4 months. Despite the treatment with various antiepileptic drugs, atonic seizures still persisted. At the age of 7 months, his atonic seizures was changed into extensor spasms with modified hypsarrhythmia for some years. The seizure were controlled by topiramate and vigabatrin. At the age of 22 months, serum copper and ceruloplasmin rechecked as 17 ug/dL(80-150 ug/dL) and 7.3 mg/dL(20-46 mg/ dL) respectively. The gene study showed ATP7A mutation and the patient was diagnosed as Menkes disease so that copper-histidine was daily injected. We experienced a case of a 4-month-old boy with Menkes disease and infantile spasm, confirmed by ATP7A mutation.

A Case of Erythromelalgia in Adolescent with Diabetes Mellitus / 대한소아내분비학회지

Erythromelalgia is a rare clinical condition of unknown etiology characterized by severe burning pain in the distal limbs. It can be accompanied by pronounced erythema and increased skin temperature precipitated by heat or activity and can be improved by cooling the affected part. It can be divided into two categories, primary, which begins spontaneously at any age, and secondary, which is infrequently associated with diabetes mellitus. However, the significance of this association is little known. We report a rare case of intractable erythromelalgia in an adolescent with diabetes mellitus.