No abstract available.

BACKGROUND: Oral isotretinoin has been widely used in severe acne patients and is known as a very effective drug. Recently it is being used in any grades and any types of acne. However we have few reports of clinical study about oral isotretinoin in our country. OBJECTIVE: To investigate clinical efficacy, factors influencing the result and side effects of oral isotretinoin in mild to moderate acne patients in Korea, prospectively. NATERIALS AND METHODS: The patients with mild to moderate acne visiting out-patient dermatology clinics of four university hospitals have taken oral isotretinoin 0.3-1.0mg/kg/day over 16 weeks. The clinical improvement was assessed by the scores using photographs before treatment and at 8 weeks, 12 weeks, 16 weeks, 20 weeks after treatment, and by the satisfaction of patients and physicians at the end of treatment. The side effects were recorded and SGOT, SGPT, cholesterol and triglyceride were checked at regular intervals. RESULTS: The grade of acne was much improved proportional to the duration of treatment. The factors showing better results were dosage and duration of oral isotretinoin, older age, more severe acne and severe acne in the past. About 90% of patients and physicians were satisfied with the result at the end of treatment. The side effects, mainly mucocutaneous symptoms were expectable and tolerable in the most cases. The values of SGOT, SGPT, cholesterol and triglyceride were increased after treatment but within normal reference range. CONCLUSION: Oral isotretinoin is a very effective agent in Korean patients with mild to moderate acne. We expect the better result in patients having high dose and long duration of oral isotretinoin, old ages and more severe acne. If we understand it's side effects enough, we can use it very safely.
Acne Vulgaris* ; Alanine Transaminase ; Aspartate Aminotransferases ; Cholesterol ; Dermatology ; Hospitals, University ; Humans ; Isotretinoin* ; Korea ; Outpatients ; Prospective Studies ; Reference Values ; Triglycerides

BACKGROUND: Pharmacists could dispense medicines without doctors' prescription in Korea before July 2000. The aim of this study was to compare the prescription behaviors of practicing doctors and pharmacists to common cold by the simulated patients. We selected the common cold as a subject of simulation because it was the most frequent health problem to visit doctors and pharmacists and the abuse of antibiotics might be prevalent in management of it. METHODS: Seventy five private clinics and drug stores were selected in Seoul, Korea. The simulated patients were selected and trained standardized symptoms of common cold. The simulated patients recorded the prescription behaviors of doctors and pharmacists. RESULTS: Average number of prescribed medicines were 5.0 and 5.6 in clinic and drug store respectively. 54.7% of the clinics and 61.3% of the drug stores prescribed antibiotics respectively with no significant difference between them. The most frequently prescribed antibiotics were penicillines. About 7% of the doctors and 11% of the pharmacist prescribed glucocorticoid to simulated patients respectively. About 20% of the pharmacists performed some kinds of physical examination to the simulated patients. Both doctors and pharmacist gave little information or advice on use of medicines, possible side effects and past side effects of medicines. CONCLUSION: There were frequent abuse of antibiotics and occasional use of glucocorticoid in private clinics and drug stores. Both doctors and pharmacists did not give enough information on use of medicines to the simulated patients.
Anti-Bacterial Agents ; Common Cold* ; Humans ; Korea ; Patient Simulation ; Penicillins ; Pharmacists* ; Physical Examination ; Prescriptions* ; Seoul

Purpose: Recently the incidence of vancomycin resistant enterococcus (VRE) infection and colonization has increased in the hospitalized patients. The purpose of present study is to examine the clinical significance of VRE infection and colonization in liver transplantation (LT) patients and to investigate the outcome. Methods: Among 194 patients who underwent LT from January 2001 to July 2004, 15 patients had at least one report of culture positive of VRE (VRE(+)). We compared the clinical outcome of 15 VRE(+) patients with those of VRE(-) patients. Results: One year mortality was higher in VRE(+) patients than VRE(-) patients (27% vs 4%; P=0.0001). Causes of death were primary graft non-function, infective endocarditis, MRSA sepsis and CMV pneumonitis. Mean duration of hospital stay was 102+/-63 days in VRE(+) patients, which shows significant difference with 51+/-30 days in VRE(-) patients (P=0.008). Cases who underwent gastroscopy (1.00+/-1.51 vs. 0.12+/-0.47; P=0.04) and percutaneous catheter drainage (1.33+/-1.49 vs. 0.40+/-1.05; P=0.03) were significantly more frequent in VRE(+) patients. The findings of gastroscopy were upper gastrointestinal bleeding (n=4), and bile duct obstruction (n=1). The contents of percutaneous catheter drainage were hematoma (n=3), bile juice (n=3) and ascites (n=1). Conclusion: VRE infected patients experienced more frequently gastrointestinal tract complications including bleeding or biliary complication and they showed higher 1-year mortality rate, although these patients died of causes other than VRE infection.
Ascites ; Bile ; Catheters ; Cause of Death ; Cholestasis ; Colon ; Drainage ; Endocarditis ; Enterococcus* ; Gastrointestinal Tract ; Gastroscopy ; Hematoma ; Hemorrhage ; Humans ; Incidence ; Length of Stay ; Liver Transplantation* ; Liver* ; Methicillin-Resistant Staphylococcus aureus ; Mortality ; Pneumonia ; Sepsis ; Transplants ; Vancomycin*

OBJECTIVE: To examine expression of survivin and Bcl-2 in eutopic endometrium with endometriosis and without endometriosis by immunohistochemical stain. METHODS: Expression of survivin and Bcl-2 was immunohistochemically investigated in eutopic endometrium with endometriosis (n=30, study group I; laparoscopy-proved endometriosis, study group II; adenomyosis) or without endometriosis (n=34, control group). The score of immunohistochemical staining was evaluated semi-quantitative method modified by Sinicrope and Lu. Statistical analyses was carried out using one-way ANOVA with Turkey test. RESULTS: Survivin expression was significantly higher in nucleus of glandular epithelium of eutopic endometrium with endomtriosis compared to that without endometriosis (p<0.05). Increased expression of Bcl-2 was found in glandular epithelium of eutopic endometrium with endometriosis than without endometriosis, but there was no significantly difference. CONCLUSION: Our findings suggest that increased survivin expression may contribute to survival of endometriosis. Moreover, survivin could play an important role in pathogenesis of endometriosis.
Endometriosis* ; Endometrium* ; Epithelium ; Female ; Turkey

PURPOSE: Cyclosporine (CsA) dosing is traditionally based on trough levels (C0) rather than area under the concentration- time curve (AUC), although AUC correlates better with post- transplantation acute rejection and toxicity. It was reported that C2 (2-hour post-dose blood level) is an accurate single- sample marker for AUC0-4 in patients receiving CsA. No trials of C2 monitoring have been carried out in liver transplant recipients who are immunosuppressed with the combination of CsA and Mycophenolate Mofetil (MMF). The purpose of this study was to evaluate the correlation between C0, 1, 2, 3, 4 levels and AUC0-4 and define recommended target C2 in liver transplant recipients who are treated with CsA and MMF. METHODS: Thirty adult living donor liver transplant recipients were followed up 12 weeks after transplantation. CsA and MMF were administered in all recipients. CsA dose was reduced to the half level of target C0 in recipients treated solely with CsA. C0 and C2 were measured during in-patient period post-transplant. RESULTS: The best correlation between CsA concentration at various time points and the AUC0-4 was found at C2 (r2=0.931) (P<0.05). Mean C2 was 543.2+/-260.1 ng/mL (mean+/-SD). We observed complications associated with the immunosuppressants in six patients (20%). But, only one patient experienced acute rejection proven by biopsy and, there is no the graft loss and nephrotoxicity. CONCLUSION: In early post-transplant days, AUC0-4 was strongly correlated with C2. Reduced CsA dosing can be attempted in recipients who are immunosuppressed with the combination of CsA and MMF. The optimal target C2 probably can be suggested as about 543.2+/-260.1 ng/mL (mean+/-SD). During the in-patient period, C0 matched with target C2 can be decided. Target C0 can be individualized because C0 matched with target C2 differs in each recipients and C2 can't be checked routinely during the out-patient period.
Adult ; Area Under Curve ; Biopsy ; Cyclosporine* ; Humans ; Immunosuppressive Agents ; Liver Transplantation ; Liver* ; Living Donors ; Outpatients ; Transplantation* ; Transplants

OBJECTIVES: The objective of this study was to compare the long-term auditory performance and language skill depending on the age of cochlear implantation in the Korean population. We especially tried to separate the effect of maturation/development from that of the age at implantation. METHODS: Eighty-six pre-lingual children with profound hearing loss who underwent a cochlear implantation before the age of six and had been followed for more than 3 yr were included in this study prospectively. Categories of Auditory Performance (CAP) and Korean Picture Vocabulary Test (K-PVT) were serially followed up. In order to separate the age at implantation effect, K-PVT results were readjusted to the child's chronological age in the normal hearing population. RESULTS: When the CAP and K-PVT scores were directly compared without chronological readjustment, we failed to show a significant difference for improvements according to the age at implantation. Early cochlear implantation was associated with better language development, only when the K-PVT scores were readjusted to percentile scores of their chronological age. CONCLUSION: Early cochlear implantation was associated with better language development even within the critical period. This advantage may be recognized only when the effect of the age at implantation is separated from the effect of maturation/development.
Child ; Cochlear Implantation ; Cochlear Implants ; Critical Period (Psychology) ; Hearing ; Hearing Loss ; Humans ; Imidazoles ; Korea ; Language Development ; Language Tests ; Nitro Compounds ; Prospective Studies

PURPOSE: This study aimed to evaluate the value of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels to detect gastric cancer recurrence. MATERIALS AND METHODS: We retrospectively reviewed 154 patients who developed recurrence within 2 years after curative gastric cancer surgery and analyzed the relationship between postoperative CEA and CA19-9 levels and recurrence. We readjusted the cut-off values to improve the detection of recurrence. Subgroup analysis according to clinicopathologic variables was performed to further investigate the relationship between recurrence and CEA and CA19-9 levels. RESULTS: The sensitivity and specificity for elevated CEA levels to detect recurrence were 40.6% and 89.5%, respectively, and those for CA19-9 were 34.2% and 93.6%, respectively. The sensitivity and specificity for elevation of either tumor marker were 54.3% and 84.0%, respectively; those for elevation of both tumor markers were 19.2% and 98.4%, respectively. By readjusting the cut-off values from 5.0 ng/ml to 5.2 ng/ml for CEA and from 37.00 U/ml to 30.0 U/ml for CA19-9, the sensitivity was increased from 34.2% to 40.2% for CA19-9, while there was no increase in sensitivity for CEA. In subgroup analysis, the sensitivity of CEA was higher in patients with elevated preoperative CEA levels than in patients with normal preoperative CEA levels (86.7% versus 33.7%; P<0.001). Furthermore, the sensitivity of CA19-9 was higher in patients with elevated preoperative CA19-9 levels than in patients with normal preoperative CA19-9 levels (82.61% versus 26.83%; P<0.001). CONCLUSIONS: CEA and/or CA19-9 measurement with the readjusted cut-off values allows for more effective detection of gastric cancer recurrence.
Carcinoembryonic Antigen* ; Humans ; Recurrence* ; Retrospective Studies ; Sensitivity and Specificity ; Stomach Neoplasms* ; Biomarkers, Tumor

PURPOSE: The mass cultivation of functional hepatocytes is a key factor of a bioartificial liver. Combining spheroid and microcarrier cultures has been applied for enhancing the cell viability and metabolic activities. Hence, the optimal number of hepatocytes per microcarrier was investigated. METHODS: Firstly, spheroid cultures were carried out with 1 g Cytodex 3 microcarrier plus 2 x 10(9), 4 x 10(8) and 8 x 10(7) viable hepatocytes per flask. The numbers of hepatocytes per microcarrier were approximately 666.7, 133.3 and 26.7, respectively. The control group consisted of a spheroid culture of 4 x 10(8) hepatocytes without any microcarrier. According to the primary experimental results, spheroid cultures with 1 x 10(8) of hepatocytes plus 1 g, 2 g and 3 g of the Cytodex 3 microcarrier were performed. The numbers of hepatocytes per microcarrier were approximately 33.3, 16.7 and 11.1, respectively. The control group consisted of a spheroid culture of 1 x 10(8) hepatocytes. The cell viabilities were assayed using a Cell Counting Kit-8; with the albumin production assayed using ELISA. RESULTS: According to the primary experiment, the group consisting of 26.7 hepatocytes per microcarrier showed the highest viability (P<0.01). However, there was no statistical difference in the albumin production between the groups (P=0.744). The second Experiment showed the groups consisting of 11.1 and 16.7 hepatocytes per microcarrier had higher viabilities than the other hepatocyte and control groups (P<0.01). The albumin production was similar for each group (P=0.187). CONCLUSION: With respect to their application to a bioartificial liver, about 130 hepatocytes per microcarrier was appeared to be good for the mass cultivation of a hepatocytes spheroid culture using the Cytodex 3 microcarrier.
Cell Count ; Cell Survival ; Enzyme-Linked Immunosorbent Assay ; Hepatocytes* ; Liver, Artificial

BACKGROUND: The detection of micrometastatic cells in patients with breast cancer may aid in determining of prognosis and in developing new therapeutic approaches. In this study, we evaluate an assay to identify breast cancer cells in the bone marrow of patients with breast cancer by using reverse-transcriptase polymerase chain reaction (RT-PCR) assay for cytokeratin 19 (CK-19) transcripts. METHODS: A CK-19 specific-nested RT-PCR assay was developed and optimized by using limited dilutions of an MCF-7 breast-cancer cell line mixed with normal bone-marrow specimens. The optimized assay was then used to examine bone-marrow samples obtained from 60 patients with breast cancer. The specificity was assessed by examining 20 negative controls using malignant hematologic disease. RESULTS: In the sensitivity calibration system, CK-19 expressing tumor cells were detected in the mixture of 10 MCF-7 cells in 107 normal bone-marrow cells. All 20 neagtive control samples failed to amplify. Bone marrow samples from 10 of 60 patients (16.7%) with breast cancer scored positive, indicating micrometastasis of the bone marrow. Seven of the 37 samples from patients whose axillary lymph nodes were negative based on conventional histopathological studies were positive when the CK-19 RT-PCR method was used. CONCLUSION: RT-PCR for CK-19 is a sensitive, specific, and rapid method for detecting micrometastatic mammary carcinoma cells in the bone marrow of patients with breast cancer. It could be helpful in diagnosing and monitoring metastastic breast cancer and detecting of micrometastasis. This method should be evaluated using a larger number of patients for long-term follow-up.
Bone Marrow* ; Breast Neoplasms* ; Breast* ; Calibration ; Cell Line ; Hematologic Diseases ; Humans ; Keratin-19 ; Keratins ; Lymph Nodes ; MCF-7 Cells ; Neoplasm Micrometastasis* ; Polymerase Chain Reaction ; Prognosis ; Sensitivity and Specificity