PURPOSE: An understanding of the immunological process is required if primary prevention of atopic diseases is to be developed in early childhood. But, it is too hard to distinguish atopy from nonatopy under the age of two clinically, because the expression of phenotype and cytokines is vague in early childhood. We evaluated DNA methylation changes at Th2 interleukin-4 gene in peripheral blood from atopic children. METHODS: We selected 15 allergic children (mild: eight, moderate to severe: seven) and seven normal controls by using family allergy scores and clinical histories. We measured Total IgE and Der f II specific IgE levels and cultured peripheral blood mononuclear cells with Der f II stimulation and extracted DNA from Der f II specific T cells. We examined the change of CpG methylation in DNA from atopic and nonatopic children. RESULTS: In T cells from normal children, IL-4 DNA were predominantly methylated; otherwise, CpG demethylation occurred in Der f II specific T cells from allergic children. CONCLUSION: IL-4 DNA methylation changes occurred in T genes from allergic children and DNA methylation assay in early childhood.
Child* ; Cytokines ; DNA Methylation* ; DNA* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Interleukin-4* ; Methylation ; Phenotype ; Primary Prevention ; T-Lymphocytes

PURPOSE: A number of studies on the treatment of atopic dermatitis have focused on the therapeutic effects of interferon-gamma (IFN-gamma) in patients with severe atopic dermatitis, although therapeutic protocols such as duration and dosage of recombinant IFN-gamma were different among studies. The beneficial effects of IFN-gamma have probably been attributed mainly to its immune modulating effect on the expression of several immunologic mediators although the mechanism of action of IFN-gamma therapy in atopic dermatitis is not clear. OBJECTIVE: The purpose of the present study was to evaluate the therapeutic effect of recombinant IFN-gamma on moderate to severe atopic dermatitis with changes in immunologic markers such as IgE level and eosionophil cationic protein (ECP). METHODS: Thirty children with moderate to severe atopic dermatitis were selected for the treatment with recombinant IFN-gamma, and 10 children with atopic dermatitis were recruited for the controls without IFN-gamma treatment. They were followed up every 4 weeks for 3 months after IFN-gamma treatment. We evaluated the SCORAD index and immunologic markers including serum IgE and ECP and total eosinophil and neutrophil counts. RESULTS: Significant clinical improvement in reduced SCORAD index was observed 12 weeks after treatment with regimen of recombinant IFN-gamma. This clinical outcome was correlated more with changes in eosinophil counts and ECP levels than with those in serum IgE levels. CONCLUSIONS: The efficacy of recombinant human IFN-gamma therapy for children with moderate to severe atopic dermatitis was maintained without serious side effects for 6 months after final injection of recombinant IFN-gamma. Recombinant IFN-gamma therapy corrected cellular immune deficits, but not humoral immune defects in patients with atopic dermatitis.
Biomarkers ; Child ; Dermatitis, Atopic ; Eosinophils ; Humans ; Immunoglobulin E ; Interferon-gamma ; Neutrophils

A retrospective review of fifty patients with carcinoma of hypopharynx treated with RT+/-surgery was studied for eleven-year period from 1974 to 1984. Of the 50 patients, 46 were pyriform sinus in origin, 4 were posterior pharyngeal wall. Eighty-eight percent of patients were locoregionally advance (stage III, IV) and 78% of patients presented cervical lymphadenopathy. 5-year disease-free survival rate of the pyriform sinus ca. was 25.4% in RT alone group, 80% in combined modality group and 30.6% in overall. Local control rate with RT alone in early stage (II) was excellent (100%), however combined modality appears to be better for local control (80%) in advanced stage (III, IV) as compared with that of RT alone group (32%). On basis of this study, RT alone is effective in terms of local control and functional preservation in treatment of early stage of pyriform sinus ca. while surgery can be reserved for salvage purpose when RT fails and combined modality is recommended in patients with locally advanced stage for better local control and survival.
Disease-Free Survival ; Humans ; Hypopharynx ; Lymphatic Diseases ; Pyriform Sinus ; Radiotherapy ; Retrospective Studies

From January 1970 through December 1984, 15 patients with sinonasal Non-Hodgkin's lymphoma combined to the head and neck were treated by external irradiation. 13 patients were stage IE and 2 were stage IIE by Ann Arbor Classification. However, when using TNM system, 7 were locally advanced T3, T4 lesions. All patients had follow up from 3.7 to 16 years with the median follow-up of 8.5 years. The overall actuarial 5-year survival rates were 25%, 28% for IE and 0% for IIE. Total tumor dose varied from 40 to 68 Gy. 100% complete response with a total tumor dose of more than 55 Gy and 73% complete response with less than 55 Gy. When the disease was staged using the TNM (AJC) system, the five-year disease free survival for T1 and T2 patients was 50% as compared with 14% for T3 and T4. Failure rate by stage was 33% (2/6) for T1 and T2, 86% (6/7) for T3 and T4, and 100% (2/2) for IIE. The results suggest that 1. Higher CR could be obtained with a total tumor dose of more than 55 Gy. 2. Use of TNM staging system is as important as Ann arbor in management of sinonasal NHL. 3. The addition of combination chemotherapy should be considered for T3, T4 and IIE the sinonasal Non-Hodgkin's lymphoma although the disease is limited to head and neck.
Classification ; Disease-Free Survival ; Drug Therapy, Combination ; Follow-Up Studies ; Head ; Humans ; Lymphoma, Non-Hodgkin* ; Neck ; Neoplasm Staging ; Radiotherapy ; Survival Rate

PURPOSE: To evaluate accuracy and reliability of program to measure facial soft tissue thickness using 3D computed tomographic images by comparing with direct measurement. MATERIALS AND METHODS: One cadaver was scanned with a Helical CT with 3 mm slice thickness and 3 mm/sec table speed. The acquired data was reconstructed with 1.5 mm reconstruction interval and the images were transferred to a personal computer. The facial soft tissue thickness were measured using a program developed newly in 3D image. For direct measurement, the cadaver was cut with a bone cutter and then a ruler was placed above the cut side, The procedure was followed by taking pictures of the facial soft tissues with a high-resolution digital camera. Then the measurements were done in the photographic images and repeated for ten times. A repeated measure analysis of variance was adopted to compare and analyze the measurements resulting from the two different methods. Comparison according to the areas was analyzed by Mann-Whitney test. RESULTS: There were no statistically significant differences between the direct measurements and those using the 3D images (p>0.05). There were statistical differences in the measurements on 17 points but all the points except 2 points showed a mean difference of 0.5 mm or less. CONCLUSION: The developed software program to measure the facial soft tissue thickness using 3D images was so accurate that it allows to measure facial soft tissues thickness more easily in forensic science and anthropology.
Anthropology ; Cadaver ; Forensic Sciences ; Imaging, Three-Dimensional ; Microcomputers ; Tomography, Spiral Computed ; Tomography, X-Ray Computed

OBJECTIVE: Restless legs syndrome (RLS) is known to be associated with chronic renal failure (CRF) patients on hemodialysis, however the prevalence of RLS in CRF patients on hemodialysis is variable due to different diagnostic criteria or dialysis technique. A few reports have indicated the association between RLS symptom and lower life quality in CRF patients on hemodialysis. This study aims to investigate the prevalence of RLS and its association with the quality of life in CRF patients of a single dialysis unit in Korea. METHODS: A total of 83 Korean CRF patients on hemodialysis in the Korea University Hospital were examined. International Restless Legs Syndrome Study Group (IRLSSG) criteria and International Restless Legs Scale (IRLS) were used to determine the diagnosis and severity of RLS. Questionnaires including Athens Insomnia Scale (AIS), Epworth sleepiness scale (ESS), and Medical Outcome Study Form-36 (SF-36) were administered to all the patients for the assessment of sleep and quality of life. Hamilton Depression Rating Scale (HDRS) and Clinical Global Impression (CGI) were also measured for depression and status of mental illness by psychiatrist. RESULTS: Of the 83 patients, 31 (37.3%) patients were found to have RLS and 43 (51.8%) patients met at least one of the RLS diagnostic criteria. The AIS (t=2.40, p=0.019), ESS (t=2.41, p=0.018), HDRS (t=3.85, p<0.001) and CGI (t=3.52, p=0.001) were higher in the subjects with RLS compared to other subjects. The SF-36 scores were significantly lower in the patients with RLS except physical functioning and bodily pain. Total (p=0.005), physical component (p=0.019), and mental component scores (p=0.019) of SF-36 were significantly lower in patients with more severe RLS symptoms. CONCLUSION: There was significant relationship between RLS and poor quality of sleep and life. More severe RLS symptom was proven to be an important factor to make a quality of life worsen.
Depression ; Diagnosis ; Dialysis ; Humans ; Kidney Failure, Chronic ; Korea ; Outcome Assessment (Health Care) ; Prevalence ; Psychiatry ; Quality of Life* ; Surveys and Questionnaires ; Renal Dialysis* ; Restless Legs Syndrome* ; Sleep Initiation and Maintenance Disorders

BACKGROUND: Bone mineral density (BMD) is under strong genetic control. A recently reported case of severe estrogen resistance caused by a germ-line mutation at the estrogen receptor gene locus suggests the possibility that other variants of the estrogen receptor (ER) gene could be responsible for the heritable components of bone density. METHODS: Two restriction fragment length polymorphisms (RFLPs) at the ER gene locus, represented as PvuII and XbaI, and their relationship to bone mineral density (BMD) and bone turnover markers were examined in 95 healthy premenopausal women. Their mean age was 29 +-6.9 years (mean+-SD). RESULTS: The distribution of the PvuII and XbaI RFLPs was as follows: PP 20 (21.1%), Pp 40 (42.1%), pp 35 (36.8%), and XX 5 (5.3%), Xx 33 (34.7%), xx 57 (60.0%) (capital letters signify the absence of, and lower case letters signify the presence of the restriction site of each RFLP). There was no significant relation between ER genotypes and BMD measured at several sites such as lumbar spine (L2-4), distal forearm, and femoral neck. Also no significant genotypic differences were found in the several biochemical markers and sex hormone status. CONCLUSION: These data indicate that these polymorphisms are not predietive of bone turnover nor BMD in a sample of healthy Korean premenopausal women.
Biomarkers ; Bone Density* ; Estrogens* ; Female ; Femur Neck ; Forearm ; Genotype* ; Germ-Line Mutation ; Humans ; Osteoporosis ; Polymorphism, Restriction Fragment Length ; Spine

OBJECTIVE: Restless legs syndrome (RLS) is known to be associated with chronic renal failure (CRF) patients on hemodialysis, however the prevalence of RLS in CRF patients on hemodialysis is variable due to different diagnostic criteria or dialysis technique. A few reports have indicated the association between RLS symptom and lower life quality in CRF patients on hemodialysis. This study aims to investigate the prevalence of RLS and its association with the quality of life in CRF patients of a single dialysis unit in Korea. METHODS: A total of 83 Korean CRF patients on hemodialysis in the Korea University Hospital were examined. International Restless Legs Syndrome Study Group (IRLSSG) criteria and International Restless Legs Scale (IRLS) were used to determine the diagnosis and severity of RLS. Questionnaires including Athens Insomnia Scale (AIS), Epworth sleepiness scale (ESS), and Medical Outcome Study Form-36 (SF-36) were administered to all the patients for the assessment of sleep and quality of life. Hamilton Depression Rating Scale (HDRS) and Clinical Global Impression (CGI) were also measured for depression and status of mental illness by psychiatrist. RESULTS: Of the 83 patients, 31 (37.3%) patients were found to have RLS and 43 (51.8%) patients met at least one of the RLS diagnostic criteria. The AIS (t=2.40, p=0.019), ESS (t=2.41, p=0.018), HDRS (t=3.85, p<0.001) and CGI (t=3.52, p=0.001) were higher in the subjects with RLS compared to other subjects. The SF-36 scores were significantly lower in the patients with RLS except physical functioning and bodily pain. Total (p=0.005), physical component (p=0.019), and mental component scores (p=0.019) of SF-36 were significantly lower in patients with more severe RLS symptoms. CONCLUSION: There was significant relationship between RLS and poor quality of sleep and life. More severe RLS symptom was proven to be an important factor to make a quality of life worsen.
Depression ; Diagnosis ; Dialysis ; Humans ; Kidney Failure, Chronic ; Korea ; Outcome Assessment (Health Care) ; Prevalence ; Psychiatry ; Quality of Life* ; Surveys and Questionnaires ; Renal Dialysis* ; Restless Legs Syndrome* ; Sleep Initiation and Maintenance Disorders

BACKGROUND: Measles is a highly infectious disease throughout the world and has not yet been eradicated with aggressive vaccination in Korea since 1960's. Recently, measles outbreaks have occurred periodically every 2 to 4 years. Unlike measles in children, few clinical studies on the measles of adult in our domestic area were carried out. In this study, we analyzed epidemiologic and clinical features of adult measles patients. METHODS: From January to June in 2001, 23 adult measles patients were admitted in Sun general hospital in Daejeon. Epidemiologic findings, clinical course, and laboratory findings were reviewed retrospectively. RESULTS: Measles was predominant in male patients (M : F=2.3 : 1). Many of the patients were late teenagers and early twenties. Major symptoms were fever (100%), cough (100%), rash (100%), diarrhea (69.6%), vomiting (60.9%), headache (60.9%), rhinorrhea (30.4%), and sore throat (30.4%). Koplik spot was observed in 11 (47.8%) patients. Rash appeared 1-6 days after the onset of fever. Fever lasted for 5-9 days and cough lasted for 10-14 days. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were elevated in 12 (52.2%) and 9 (39.1%) patients, respectively. Only 14 (60.9%) patients were seropositive for measles specific IgG antibody, but all the patients were seropositive for measles specific IgM antibody. No fatal complication was observed. CONCLUSION: Gastrointestinal symptom and hepatic dysfunction were the clinical characteristics of adult measles outbreak in Daejeon, 2001. Different from previous studies, all patients were seropositive for measles specific IgM antibody.
Adolescent ; Adult* ; Alanine Transaminase ; Aspartate Aminotransferases ; Child ; Communicable Diseases ; Cough ; Diarrhea ; Disease Outbreaks ; Exanthema ; Fever ; Headache ; Hospitals, General ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Korea ; Male ; Measles* ; Pharyngitis ; Retrospective Studies ; Solar System ; Vaccination ; Vomiting

BACKGROUND: Measles is a highly infectious disease throughout the world and has not yet been eradicated with aggressive vaccination in Korea since 1960's. Recently, measles outbreaks have occurred periodically every 2 to 4 years. Unlike measles in children, few clinical studies on the measles of adult in our domestic area were carried out. In this study, we analyzed epidemiologic and clinical features of adult measles patients. METHODS: From January to June in 2001, 23 adult measles patients were admitted in Sun general hospital in Daejeon. Epidemiologic findings, clinical course, and laboratory findings were reviewed retrospectively. RESULTS: Measles was predominant in male patients (M : F=2.3 : 1). Many of the patients were late teenagers and early twenties. Major symptoms were fever (100%), cough (100%), rash (100%), diarrhea (69.6%), vomiting (60.9%), headache (60.9%), rhinorrhea (30.4%), and sore throat (30.4%). Koplik spot was observed in 11 (47.8%) patients. Rash appeared 1-6 days after the onset of fever. Fever lasted for 5-9 days and cough lasted for 10-14 days. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were elevated in 12 (52.2%) and 9 (39.1%) patients, respectively. Only 14 (60.9%) patients were seropositive for measles specific IgG antibody, but all the patients were seropositive for measles specific IgM antibody. No fatal complication was observed. CONCLUSION: Gastrointestinal symptom and hepatic dysfunction were the clinical characteristics of adult measles outbreak in Daejeon, 2001. Different from previous studies, all patients were seropositive for measles specific IgM antibody.
Adolescent ; Adult* ; Alanine Transaminase ; Aspartate Aminotransferases ; Child ; Communicable Diseases ; Cough ; Diarrhea ; Disease Outbreaks ; Exanthema ; Fever ; Headache ; Hospitals, General ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Korea ; Male ; Measles* ; Pharyngitis ; Retrospective Studies ; Solar System ; Vaccination ; Vomiting