Low-level laser or light therapy (LLLT) was used to accelerate wound healing without the use of thermal effects in the early days. Although the exact mechanism of LLLT is still unclear, it has been recognized as a photobiomodulation process. Today, LLLT is being credited as a non-invasive treatment modality, and in particular, being widely applied in the field of dermatology. In this review, we summarize the basic principles and clinical applications of LLLT to provide an up-to-date guidance on its practical and safe uses. Further studies are needed to elucidate the mechanism of action of LLLT in various indications, and to determine the wavelength and dose for optimal clinical use.
Dermatology* ; Low-Level Light Therapy ; Phototherapy ; Wound Healing

No abstract available.
Humans ; Skin

Chryseobacterium meningosepticum is rarely encountered as a pathogen causing peritonitis in peritoneal dialysis (PD) patients. We report a case of peritonitis due to Chryseobacterium meningosepticum, which was treated successfully with intraperitoneal (IP) vancomycin and ciprofloxacin, and without PD catheter removal. Peritonitis was developed in a 53-year-old PD patient on the third hospital day. Although empirical IP treatment with cefazolin and tobramycin was initiated and maintained for 3 days, the fever and signs of peritonitis persisted. Antibiotics were changed to cefoperazone/sulbactam, amikacin, and vancomycin due to clinical deterioration. After 3 days of vancomycin use, leukocyte count in PD fluid was less than 100/mm3 and the patient became asymptomatic. On seventh day after the onset of peritonitis, Chryseobacterium meningosepticum was isolated from initial dialysate sample, and this strain was susceptible to ciprofloxacin, piperacillin, and piperacillin/tazobactam. Accordingly, we changed the antibiotics to ciprofloxacin and vancomycin, which were given for the total of 14 days. Even though Chryseobacterium meningosepticum is an uncommon causative organism of peritonitis in PD patients, this report suggests that vancomycin and ciprofloxacin are effective as empiric therapy, and early suspicion and appropriate antimicrobial therapy are crucial to the successful treatment of peritonitis due to Chryseobacterium meningosepticum without catheter removal.
Amikacin ; Anti-Bacterial Agents ; Catheters ; Cefazolin ; Chryseobacterium ; Ciprofloxacin ; Fever ; Humans ; Leukocyte Count ; Middle Aged ; Peritoneal Dialysis ; Peritonitis ; Piperacillin ; Sprains and Strains ; Tobramycin ; Vancomycin

BACKGROUND: Therapeutic education is important for successful management of atopic dermatitis (AD). OBJECTIVE: To provide effective therapeutic education, clear common misunderstandings, and answer questions regarding AD among patients and caregivers. METHODS: A questionnaire survey was conducted for patients and caregivers who visited the Department of Dermatology at Seoul National University Hospital, Seoul, Korea, regarding the course, etiology, and management of AD. RESULTS: Among the 327 subjects who participated in the study, only 35.2% were aware of the natural course of AD, which usually improves with age. Many subjects (53.2%) misinterpret AD relapse as resistance to topical steroids. We found that 87.8% of subjects were under the impression that improvement in a patient's immunity can improve the symptoms of AD. Dietary restriction was considered an essential management strategy, and 59.0% of subjects agreed to delay the initiation of weaning foods. Most subjects did not have accurate information about cleansing methods, and 30.9% of subjects reported that they used only water without any cleanser. We noted that 47.5% of subjects obtained information regarding AD from medical doctors who they considered the most reliable sources (82.5%). Subjects preferred printed materials (41.3%) over seminars or video-clips to obtain educational information. CONCLUSION: Therapeutic education regarding the course, etiology, and management of AD using printed materials put together by physicians would be a valuable tool for the effective management of AD. Institutional support such as educational programs covered by the National Health Insurance Service is required.
Caregivers ; Dermatitis, Atopic* ; Dermatology ; Education* ; Humans ; Korea ; National Health Programs ; Recurrence ; Seoul ; Steroids ; Water ; Weaning

BACKGROUND: Therapeutic education is important for successful management of atopic dermatitis (AD). OBJECTIVE: To provide effective therapeutic education, clear common misunderstandings, and answer questions regarding AD among patients and caregivers. METHODS: A questionnaire survey was conducted for patients and caregivers who visited the Department of Dermatology at Seoul National University Hospital, Seoul, Korea, regarding the course, etiology, and management of AD. RESULTS: Among the 327 subjects who participated in the study, only 35.2% were aware of the natural course of AD, which usually improves with age. Many subjects (53.2%) misinterpret AD relapse as resistance to topical steroids. We found that 87.8% of subjects were under the impression that improvement in a patient's immunity can improve the symptoms of AD. Dietary restriction was considered an essential management strategy, and 59.0% of subjects agreed to delay the initiation of weaning foods. Most subjects did not have accurate information about cleansing methods, and 30.9% of subjects reported that they used only water without any cleanser. We noted that 47.5% of subjects obtained information regarding AD from medical doctors who they considered the most reliable sources (82.5%). Subjects preferred printed materials (41.3%) over seminars or video-clips to obtain educational information. CONCLUSION: Therapeutic education regarding the course, etiology, and management of AD using printed materials put together by physicians would be a valuable tool for the effective management of AD. Institutional support such as educational programs covered by the National Health Insurance Service is required.
Caregivers ; Dermatitis, Atopic* ; Dermatology ; Education* ; Humans ; Korea ; National Health Programs ; Recurrence ; Seoul ; Steroids ; Water ; Weaning

Transfusion-related acute lung injury (TRALI) is a noncardiogenic pulmonary edema that occurs during or within 6 hours after transfusion. Risk factors for TRALI, which is relatively common in critically ill patients, include recent surgery, hematologic malignancy, and sepsis. Here, we report a case of TRALI induced by anti-human leukocyte antigen (anti-HLA) class II antibodies (HLA-DR) occurring after transfusion of platelet concentrates in a patient with acute leukemia. Although most patients with TRALI show improvement within 48-96 hours, our patient's condition rapidly worsened, and he did not respond to supportive treatment. TRALI is a relatively common and serious adverse transfusion reaction that requires prompt diagnosis and management.
Acute Lung Injury ; Antibodies ; Blood Group Incompatibility ; Blood Platelets ; Critical Illness ; Hematologic Neoplasms ; Humans ; Leukemia ; Leukocytes ; Pulmonary Edema ; Risk Factors ; Sepsis

To study tubal adhesion, tubal patency and histologic difference under light, electronic microcopy in a site of anastomosis, authors performed three anastomosis surgery in rabbit fallopian tube;1-layer and 2-layer anastomosis in splint-not-used group(group 1) and in splint-used group(group 2) and laser anastomosis in splint-used group(group 3). 10 rabbits were used in each group, therefore the total number of experimental rabbits in 3 groups were 30. The results were as follows; 1. The degree of gross adhesion in group II was significantly high as compared with other groups but there was no difference between left and right tube in the degree of adh- esion in each group(Table 1). 2. The incidence of tubal patency in group I was significantly high(89%) as compared with group I(44%). Especially, the incidence of tubal patency in group III was significantly high(100%) but there was no difference between left and right tube in incidence of tubal patency in each group. 3. Inflammatory cell infiltration appeared in each group on optical microscopic examin- ation. Especially, fibrosis and inflammatory cell infiltration appeared more in group II but there was no statistically significant difference. And there was no significant difference between left and right tube in each group. 4. Transmission electron microscopic examination of group I, as compared with normal control group, showed increase of microvilli and secretory granules and decrease in size of epithelial cell. Epithelial cell was morphologically transformed but maintained the original structure comparatively. TEM examination of group II, as compared with normal control group, showed decrease of microvilli and secretory granules and flattening of epithelial cell. It showed that epithelial cell vanished in it's original structure. TEM examination of group III, as compared with normal control group, showed decrease of microvilli and increase of secretory granules and morphological transformation of epithelial cell. Group III showed the resemblence to normal control group. From the above results, in reversal tuboplasty and tubal factor infertility, it is consi- dered that simple splint-used anastomosis or splint-used anastomosis with Nd-YAG laser will improve the successful rate of tubal anastomosis.
Epithelial Cells ; Fallopian Tubes* ; Female ; Fibrosis ; Incidence ; Infertility ; Lasers, Solid-State* ; Microvilli ; Rabbits ; Secretory Vesicles ; Splints*

Langerhans cell histiocytosis is a rare disorder with abnormal proliferation of histiocytes. Besides the infiltration of a variety of organs, patients with Langerhans cell histiocytosis can develop sclerosing cholangitis, with bile duct involvement, progressive fibrosis, and cirrhosis. We report a case of Langerhans cell histiocytosis with sclerosing cholangitis. Endoscopic retrograde cholangiopancreatography revealed multiple strictures and dilatations of left intrahepatic and extrahepatic bile duct. Endoscopic biopsy of common bile duct showed diffuse infiltration of histiocytes and eosinophiles in lamina propria. Immunohistochemical stain showed positive reactions for S-100 and CD1a and a negative reaction for cytokeratin in infiltrating histiocytes.
Bile Ducts ; Bile Ducts, Extrahepatic ; Biopsy ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis, Sclerosing* ; Common Bile Duct ; Constriction, Pathologic ; Dilatation ; Eosinophils ; Fibrosis ; Histiocytes ; Histiocytosis, Langerhans-Cell* ; Humans ; Keratins ; Mucous Membrane

BACKGROUND: The survival benefit of combination chemotherapy comparing supportive care to patients with advanced non-small cell lung cancer, especially stage IV non-small cell lung cancer patients with metastatic disease, is controversial. The main goal of this study was to evaluate the difference in survival between patients treated with chemotherapy and those who were not and to identify prognostic factors in the patients with stage IV non-small cell lung cancer. METHODS: From January 1989 to December 1994, total 67 patients including 20 patients treated with combination chemotherapy and 47 patients treated with only supportive care in stage IV non-small cell lung cancer patients with metastatic disease were enrolled in this study. Combination chemotherapy consisted of etoposide 120mg/m2 iv for 3 days and cis-platin iv day 1 every 4 weeks. The treatment groups were retrospectively analyzed by age, sex, histologic cell type, weight loss, serum LDH level, ECOG performance status and major organ metastasis. RESULTS: The significant prognostic factors influencing survival on this study were ECOG performance status and histologic subtype. Overall response rate by combination chemo-therapy was 30%(complete response 0%, partial response 30%). Median survival of overall patients was 13.6 weeks and median survival of chemotherapy group, 20 weeks, was significantly longer than that of supportive care group, 11.7 week(p<0.01). Median survival of responder in patients receiving chemotherapy, 45.5 weeks, was significantly longer than that of non-responder, 17.3 weeks(p<0.05). 1 year-survival rate of chemotherapy group and supportive care group was 15% and 8%, respectively. Nausea or vomiting, alopecia and anemia were seen in nearly most cases after this combination chemotherapy. Toxicities above grade 3 included neutropenia, anemia, thrombocytopenia, infection, fever, nausea, vomiting and alopecia. But this combination chemotherapy was relatively well tolerated except one treatment-related death from sepsis associated with severe granulocytopenia. CONCLUSION: These results suggest that systemic chemotherapy might be helpful to the stage IV non-small cell lung cancer patients with good performance status and large scale randomized prospective trials should be performed.
Agranulocytosis ; Alopecia ; Anemia ; Carcinoma, Non-Small-Cell Lung* ; Drug Therapy ; Drug Therapy, Combination* ; Etoposide ; Fever ; Humans ; Nausea ; Neoplasm Metastasis ; Neutropenia ; Retrospective Studies ; Sepsis ; Thrombocytopenia ; Vomiting ; Weight Loss

Renal anemia is a common complication of chronic kidney disease and known to be caused by erythropoietin or iron deficiency. However, erythrocytosis in patients on dialysis has rarely been reported and usually associated with renal cell carcinoma, polycythemia vera or acquired cystic kidney disease. Here we report a case of erythrocytosis in an ESRD patient with resolution after kidney transplantation. A 38-year-old man on peritoneal dialysis for 5 years was admitted for kidney transplantation. On admission, blood Hgb and Hct was 19.7 g/dL and 61.4%, respectively. Serum erythropoietin level was 347 mIU/mL. Multiple variable sized cystic lesions were identified on both kidneys without evidence of internal malignancy in abdomen and pelvis CT scan. After kidney transplantation, Hgb was 12.5 g/dL and serum erythropoietin level was 13.1 mIU/mL. Some of renal cysts on CT scan disappeared or decreased in size. This finding suggests that erythrocytosis in this patient can be associated with acquired cystic kidney disease.
Abdomen ; Adult ; Anemia ; Carcinoma, Renal Cell ; Dialysis ; Erythropoietin ; Humans ; Iron ; Kidney ; Kidney Diseases, Cystic ; Kidney Failure, Chronic ; Kidney Transplantation ; Pelvis ; Peritoneal Dialysis ; Polycythemia ; Polycythemia Vera ; Renal Insufficiency, Chronic