BACKGROUND: Although the precise pathogenesis of the Behçet's disease is not yet undertween the severity of Behçet's disease and the serum cytokine level. development of cytokine research has made it possible to find out if there is an association between the severity of Behçet's syndrome and the serum cytokine level. OBJECTIVE: Our purpose was to elucidate whether the immunopathological mechanism is associated with the serum tumor necrosis factor (TNF) and interleukin-1β (I1,1β) which are predominantly produced by monocytes/macrophages, and mterleukm-6 (IL-6). METHOD: Sixty seven patients of Behçet's disease and ten healthy adults as a control group were studied. Serum TNF and IL-6 levels were detected by enzyme immunoassay and serum IL-lβ levels by radioimmunoassay. RESULTS: There were no statistically significant differences in the serum levels of TNF, IL-1β, TL-6 compared with the control group. CONCLUSION: These data suggest that the immunopathological reactions of the Behçet's disease are not associated with a monocyte/macrophage dependent mechanism, possibly due to other immunocompetent cells.
Adult ; Humans ; Immunoenzyme Techniques ; Interleukin-6* ; Methods ; Necrosis* ; Radioimmunoassay ; Tumor Necrosis Factor-alpha

No abstract available.
Umbilical Cord*

PURPOSE: Keloid is a clinical term characterized by elevation and extension of scar tissue beyond wound margin. Currently, there is no known treatment that shows consistent effect in all patients. Postoperative radiation therapy is known to prevent recurrence of keloid. METHODS: We reviewed data of patients who had undergone operation or operation followed by radiation therapy at our institute for the last 12 years. Follow up was possible in 39 patients(21 patients treated only by operation and 18 treated by operation and radiation therapy) We then investigated recurrence in both groups by VAS score. By mail, patients were asked to score their current condition on the bar in 4 aspects(itching, pain, mass lesion(by patients and other persons)). Two criteria were used for defining successful treatment. One is the case which total VAS score was 0, and the other is sum of VAS score of mass lesion was 0 to 5. RESULTS: In the former, recurrence rate is 90.5% in operations-only group but 66.7% in operations plus radiation therapy group(p 0.05). In the latter, recurrence rate is 66.7% in operation-only group but 22.2% in operations plus radiation therapy group(p 0.05). CONCLUSION: These results shows postoperative radiation therapy is effective method in keloid treatment.
Cicatrix ; Follow-Up Studies ; Humans ; Keloid* ; Postal Service ; Recurrence ; Retrospective Studies* ; Wounds and Injuries

Purpose: To evaluate the clinical characteristics of Korean patients diagnosed with retinitis pigmentosa. Methods: We retrospectively reviewed the medical records of patients diagnosed with retinitis pigmentosa from January 2014 to December 2019. We evaluated age, gender, the chief complaints, posterior subcapsular cataract status, abnormalities on optical coherence tomography, visual field test results, and electrooculograms. Results: A total of 492 eyes of 246 patients were included. The mean patient age was 48.0 ± 16.0 years and the chief complaints were decreased vision and night blindness. The mean logarithm of the minimal angle of resolution (logMAR) best‐corrected visual acuity (BCVA) was 0.31 ± 0.50. The BCVA was 0.5 or better in 368 eyes (74.8%). A total of 328 (71.0%) of 462 eyes that underwent visual field testing exhibited visual field defects within 10º. The mean Arden ratio was 1.28 ± 0.28 for the 242 eyes that underwent electro‐oculography. Optical coherence tomography revealed vitreomacular traction/an epiretinal membrane, cystoid macular edema, and retinal thinning in 135 (27.4%), 48 (9.8%), and 112 (22.8%) eyes, respectively. The ellipsoid zone was intact in 222 eyes (45.1%), disrupted in 220 (44.7%), and absent in 50 (10.2%). Conclusions Most patients with retinitis pigmentosa exhibited visual acuity of 0.5 or better, but also had central visual field defects. Various abnormalities were noted on optical coherence tomography of most patients.

OBJECTIVE: The purpose of this study was to evaluate the usefulness of approximate entropy on fetal heart rate variability of electronic fetal monitoring taken during antepartum and intrapartum periods as a new diagnostic method of fetal distress. METHODS: Among 76 pregnant women who underwent computerized electronic fetal monitoring and cord blood gas analysis, we divided them into 3 groups, i.e.; 36 into normal fetus group, 26 into presumed distress group and 14 into acidemic distress group. We performed a frequency analysis on time series of heart rate variability in three groups. In order to perform non-linear analysis on the raw data of the fetal heart rate, after resampling and low pass filtering, we investigated approximate entropy. RESULTS: The results of the approximate entropy showed that the value in normal fetus group was significantly high than the value in distress group. But in the distress group, ApEn value was not difference between acidemic and non-acidemic subgroup. ApEn of HRV was confirmed in nonlinear parameter without low pass filtering and resampling. CONCLUSION: The results show that the fetal heart rate variability has nonlinear characteristics and could distinguish normal fetal heart rate pattern and distress pattern numerically and objectively. And these ApEn value are useful for prediction and diagnosis of fetal distress in ante and prenatal periods.
Ants ; Diagnosis ; Entropy* ; Female ; Fetal Blood ; Fetal Distress* ; Fetal Heart* ; Fetal Monitoring ; Fetus ; Heart Rate ; Heart Rate, Fetal* ; Humans ; Pregnancy ; Pregnant Women

Cutaneous polyarteritis nodosa (CPAN) is an uncommon form of vasculitis involving small and medium sized arteries of unknown etiology. The disease can be differentiated from polyarteritis nodosa by its limitation to the skin and lack of progression to visceral involvement. The characteristic manifestations are subcutaneous nodule, livedo reticularis, and ulceration, mostly localized on the lower extremity. Arthralgia, myalgia, peripheral neuropathy, and constitutional symptoms such as fever and malaise may also be present. We describe a 34-yr-old woman presented with severe ischemic change of the fingertip and subcutaneous nodules without systemic manifestations as an unusual initial manifestation of CPAN. Therapy with corticosteroid and alprostadil induce a moderate improvement of skin lesions. However, necrosis of the finger got worse and the finger was amputated.
Vasodilator Agents/therapeutic use ; Skin Diseases, Vascular/*complications/drug therapy/pathology ; Polyarteritis Nodosa/*complications/drug therapy/pathology ; Humans ; Gangrene/*etiology/surgery ; Fingers ; Female ; Amputation ; Alprostadil/therapeutic use ; Adult ; Adrenal Cortex Hormones/therapeutic use

BACKGROUND: The alkaline single cell gel electrophoresis comet assay was applied to study the genotoxic properties of enflurane on the human peripheral blood lymphocytes (PBL) of cancer patients before and during anesthesia as compared to an non-cancer control group. Method: The cancer group consisted of 24 patients (aged 15-77 years), while the control group consisted of 14 trauma individuals (aged 20-81 years). After anesthesia induction (thiopental 4 mg/kg and vecuronium 0.1 mg/kg), it was maintained by enflurane inhalation; 1-2 minimal alveolar concentration in oxygen - nitrous oxide mixture. Venous blood samples were obtained before the induction of anesthesia, and after 60 and 120 min of anesthesia. The comet assay detects DNA damage, such as strand breaks and alkaline labile sites induced directly by genotoxic agents, and DNA degradation due to cell death. Fifty cells from each sample were examined and Olive tail moments (OTM) were calculated using Komet 4TM software. RESULTS: OTM values were no different between controls and patients before anesthesia. However, the OTMs of blood sampled from cancer patients at 60 (7.97 +/- 1.83) and 120 min (7.86 +/- 2.05), and from trauma patients at 120 min (8.04 +/- 1.32) of anesthesia were significantly increased. CONCLUSIONS: In immunocompromised cancer patients, we suggest the existence of a higher risk of an association DNA damage and enflurane exposure.
Anesthesia ; Cell Death ; Comet Assay ; DNA ; DNA Damage ; Electrophoresis* ; Enflurane* ; Humans* ; Inhalation ; Lymphocytes* ; Nitrous Oxide ; Olea ; Oxygen ; Vecuronium Bromide

BACKGROUND: Since the treatment guidelines for atopic dermatitis (AD) were issued by the Korean Atopic Dermatitis Association (KADA) work group in 2006, there have been further advances in the systemic treatment of AD. OBJECTIVE: We aimed to establish updated evidence- and experience-based systemic treatment guidelines for Korean AD. METHODS: We compiled a database of references from relevant systematic reviews and guidelines regarding the systemic management of AD, including antihistamines, antimicrobials, systemic immunomodulators, allergen-specific immunotherapy, phototherapy, adjunctive treatment, and complementary and alternative medicines. Evidence for each statement was graded and classified based on the strength of the recommendation. Thirty-nine council members of KADA participated in the three rounds of votes and expert consensus recommendations were established. RESULTS: The use of antihistamines is recommended to relieve pruritus and to prevent exacerbation due to scratching in AD patients. Infection should be controlled as needed and long-term medication should be avoided. For moderate to severe AD patients, concomitant active treatments with systemic immunomodulators are indicated. Cyclosporine is the first choice among systemic immunomodulators and others should be considered as second-line alternatives. Allergen-specific immunotherapy could be effective in AD patients with aeroallergen hypersensitivity. Phototherapy can be useful for moderate to severe AD patients and narrow-band ultraviolet B is the most effective option. Complementary and alternative medicines cannot be recommended for treating AD. CONCLUSION: We expect these recommendations to be a reference guide for physicians and AD patients in choosing the appropriate treatment to improve quality of life and decrease unnecessary social medical costs.
Consensus* ; Cyclosporine ; Dermatitis ; Dermatitis, Atopic* ; Histamine Antagonists ; Humans ; Hypersensitivity ; Immunologic Factors ; Immunotherapy ; Korea* ; Phototherapy ; Pruritus ; Quality of Life

BACKGROUND: Since the treatment guidelines for atopic dermatitis (AD) were released by the Korean Atopic Dermatitis Association (KADA) work group in 2006, there have been several advances in AD management. OBJECTIVE: We aimed to establish updated evidence- and experience-based treatment guidelines for Korean AD. METHODS: We collected a database of references from relevant systematic AD reviews and guidelines regarding general AD management such as bathing and skin care, avoidance of exacerbating factors, education and psychosocial support, and the use of moisturizers and topical anti-inflammatory and antipruritic drugs. Evidence for each statement was graded and the strength of the recommendation for each statement classified. Thirty-nine KADA council members participated in three rounds of voting to establish an expert consensus of recommendations. RESULTS: Basic AD treatment includes proper bathing and skin care, avoidance of exacerbating factors, proper education and psychosocial support, and use of moisturizers. The regular use of moisturizer has a steroid-sparing effect and reduces relapse episodes. The short- and long-term use of topical corticosteroids and calcineurin inhibitors improves AD symptoms and should be encouraged to use in an active and proactive treatment. Wet-wrap therapy can be used for rapid recovery of acute exacerbation. Topical antipruritic drugs cannot be recommended for the treatment of AD. CONCLUSION: This report provides up-to-date evidence- and experience-based treatment guidelines for AD regarding general management and topical treatment. In addition, the average agreement scores obtained by a panel of experts based on the Korean healthcare system and patient adherence are presented.
Adrenal Cortex Hormones ; Antipruritics ; Baths ; Calcineurin ; Consensus* ; Delivery of Health Care ; Dermatitis, Atopic* ; Education ; Korea* ; Patient Compliance ; Politics ; Recurrence ; Skin Care

BACKGROUND: Since the treatment guidelines for atopic dermatitis (AD) were issued by the Korean Atopic Dermatitis Association (KADA) work group in 2006, there have been further advances in the systemic treatment of AD. OBJECTIVE: We aimed to establish updated evidence- and experience-based systemic treatment guidelines for Korean AD. METHODS: We compiled a database of references from relevant systematic reviews and guidelines regarding the systemic management of AD, including antihistamines, antimicrobials, systemic immunomodulators, allergen-specific immunotherapy, phototherapy, adjunctive treatment, and complementary and alternative medicines. Evidence for each statement was graded and classified based on the strength of the recommendation. Thirty-nine council members of KADA participated in the three rounds of votes and expert consensus recommendations were established. RESULTS: The use of antihistamines is recommended to relieve pruritus and to prevent exacerbation due to scratching in AD patients. Infection should be controlled as needed and long-term medication should be avoided. For moderate to severe AD patients, concomitant active treatments with systemic immunomodulators are indicated. Cyclosporine is the first choice among systemic immunomodulators and others should be considered as second-line alternatives. Allergen-specific immunotherapy could be effective in AD patients with aeroallergen hypersensitivity. Phototherapy can be useful for moderate to severe AD patients and narrow-band ultraviolet B is the most effective option. Complementary and alternative medicines cannot be recommended for treating AD. CONCLUSION: We expect these recommendations to be a reference guide for physicians and AD patients in choosing the appropriate treatment to improve quality of life and decrease unnecessary social medical costs.
Consensus* ; Cyclosporine ; Dermatitis ; Dermatitis, Atopic* ; Histamine Antagonists ; Humans ; Hypersensitivity ; Immunologic Factors ; Immunotherapy ; Korea* ; Phototherapy ; Pruritus ; Quality of Life