Nutritional rickets, which is caused by deficiency of calcium or vitamin D, is a rare disease in developed countries. However some cases have been reported recently, that developed as a result of a restricted and nutritionally imbalanced diet due to atopic dermatitis and related food allergy. We treated two infant cases of nutritional rickets. The infants had suffered from atopic dermatitis, and were fed "Sun-sik" (a powdery mixture of several grains and fruits) without receiving cow's milk or any milk products in their diet. After an adequate supply of calcium and nutritional management, they were markedly improved.
Calcium ; Edible Grain ; Dermatitis, Atopic* ; Developed Countries ; Diet* ; Food Hypersensitivity ; Humans ; Infant ; Milk ; Rare Diseases ; Rickets* ; Vitamin D

Generally, esophageal cancer metaetasizes to lymph node, lung, liver but metastasis to another digestive organ is very rare. A 51 year old man who had experienced dysphagia for 1 month was diagnosed as an esophageal cancer. After combined radiation therapy and chematherapy(5-FU, cisplatinum), he still had dysphagia. After implanta tion of self-expandable metallic esophageal stent, he could swallow solid food. Recently, he experienced pharyngeal pain for 1 month. Endoscopy showed multiple nodules in right pyriform sinus. Biopsy specimen revealed squamous cell carcinoma. Because the distance between esophageal cancer and pharyngeal nodule is more than 10 cm and computed tomography of the neck shows normal esophageal wall no cervical lymphadenopathy, we concluded that this case was an esophageal cancer with metastasis to the pharynx. Hence, we reported a case of esophageal cancer with pharyngeal metastasis with a review of literatures.
Biopsy ; Carcinoma, Squamous Cell ; Deglutition Disorders ; Endoscopy ; Esophageal Neoplasms* ; Humans ; Liver ; Lung ; Lymph Nodes ; Lymphatic Diseases ; Middle Aged ; Neck ; Neoplasm Metastasis* ; Pharynx* ; Pyriform Sinus ; Stents

Generally, esophageal cancer metaetasizes to lymph node, lung, liver but metastasis to another digestive organ is very rare. A 51 year old man who had experienced dysphagia for 1 month was diagnosed as an esophageal cancer. After combined radiation therapy and chematherapy(5-FU, cisplatinum), he still had dysphagia. After implanta tion of self-expandable metallic esophageal stent, he could swallow solid food. Recently, he experienced pharyngeal pain for 1 month. Endoscopy showed multiple nodules in right pyriform sinus. Biopsy specimen revealed squamous cell carcinoma. Because the distance between esophageal cancer and pharyngeal nodule is more than 10 cm and computed tomography of the neck shows normal esophageal wall no cervical lymphadenopathy, we concluded that this case was an esophageal cancer with metastasis to the pharynx. Hence, we reported a case of esophageal cancer with pharyngeal metastasis with a review of literatures.
Biopsy ; Carcinoma, Squamous Cell ; Deglutition Disorders ; Endoscopy ; Esophageal Neoplasms* ; Humans ; Liver ; Lung ; Lymph Nodes ; Lymphatic Diseases ; Middle Aged ; Neck ; Neoplasm Metastasis* ; Pharynx* ; Pyriform Sinus ; Stents

OBJECTIVE: The authors developed a stereotactic device for irradiation of small animals with Leksell Gamma Knife(R) Model C. Development and verification procedures were described in this article. METHODS: The device was designed to satisfy three requirements. The mechanical accuracy in positioning was to be managed within 0.5 mm. The strength of the device and structure were to be compromised to provide enough strength to hold a small animal during irradiation and to interfere the gamma ray beam as little as possible. The device was to be used in combination with the Leksell G-frame(R) and KOPF(R) rat adaptor. The irradiation point was determined by separate imaging sequences such as plain X-ray images. RESULTS: The absolute dose rate with the device in a Leksell Gamma Knife was 3.7% less than the value calculated from Leksell Gamma Plan(R). The dose distributions measured with GAFCHROMIC(R) MD-55 film corresponded to those of Leksell Gamma Plan(R) within acceptable range. The device was used in a series of rat experiments with a 4 mm helmet of Leksell Gamma Knife. CONCLUSION: A stereotactic device for irradiation of small animals with Leksell Gamma Knife Model C has been developed so that it fulfilled above requirements. Absorbed dose and dose distribution at the center of a Gamma Knife helmet are in acceptable ranges. The device provides enough accuracy for stereotactic irradiation with acceptable practicality.
Animals ; Gamma Rays ; Head Protective Devices ; Rats

Asthma is a chronic obstructive airway disease that involves inflammation of the respiratory tract. Biological contaminants in indoor air can induce innate and adaptive immune responses and inflammation, resulting in asthma pathology. Epidemiologic surveys indicate that the prevalence of asthma is higher in developed countries than in developing countries. The prevalence of asthma in Korea has increased during the last several decades. This increase may be related to changes in housing styles, which result in increased levels of indoor biological contaminants, such as house dust mite-derived allergens and bacterial products such as endotoxin. Different types of inflammation are observed in those suffering from mild-to-moderate asthma compared to those experiencing severe asthma, involving markedly different patterns of inflammatory cells and mediators. As described in this review, these inflammatory profiles are largely determined by the involvement of different T helper cell subsets, which orchestrate the recruitment and activation of inflammatory cells. It is becoming clear that T helper cells other than Th2 cells are involved in the pathogenesis of asthma; specifically, both Th1 and Th17 cells are crucial for the development of neutrophilic inflammation in the airways, which is related to corticosteroid resistance. Development of therapeutics that suppress these immune and inflammatory cells may provide useful asthma treatments in the future.
Allergens ; Asthma ; Developed Countries ; Developing Countries ; Dust ; Housing ; Inflammation ; Korea ; Neutrophils ; Prevalence ; Pulmonary Disease, Chronic Obstructive ; Respiratory System ; Stress, Psychological ; T-Lymphocytes, Helper-Inducer ; Th17 Cells ; Th2 Cells

No abstract available.
T-Lymphocytes*

INTRODUCTION: It has been reported that the survival of low-grade glioma patients depends upon the time of malignant transformation. The authors presents the clinical analysis of histologically proven trasformed gliomas. MATERIALS AND METHODS: A total 92 patients who were consecutively treated and histologically confirmed hemispheric low-grade gliomas between 1980 and 1998 were analyzed and followed. All cases meet the criteria of WHO glioma classification of grade II. RESULTS: The mean follow-up period was 73 months. Twenty two among 92 cases(24%) were histologically proven to be transformed into malignant ones. The mean time to transformation was 56 months. The 5-year and 10-year survival rates of the transformed group were 66% and 30% respectively and significantly different from the survival rates of the non-transformed group(p=0.0018). Among clinical factors at presentation, the initial tumor volume had a tendency to be larger in the transformed group than that of the non-transformed group and became significant when it was divided into more than 30cm3 or not(p=0.02). Among therapeutic factors, the extent of removal had no influence on the rate of malignant transformation. But postoperative radiation therapy were more frequently given to the pre-transformed group than the non-transformed group and the frequency was significantly different(p=0.02). CONCLUSIONS: The authors had found that the initial tumor volume and radiation therapy could be clinical prognostic factors for the malignant transformation of low-grade gliomas.
Classification ; Follow-Up Studies ; Glioma* ; Humans ; Survival Rate ; Tumor Burden

BACKGROUND: Dipeptidyl peptidase-4 (DPP-4) inhibitors are widely used in the treatment of patients with type 2 diabetes and have proven protective effects on diabetic kidney disease (DKD). Whether DPP-4 inhibitors have renoprotective effects on insulin-deficient type 1 diabetes has not been comprehensively examined. The aim of this study was to determine whether gemigliptin, a new DPP-4 inhibitor, has renoprotective effects in streptozotocin (STZ)-induced type 1 diabetic mice. METHODS: Diabetes was induced by intraperitoneal administration of a single dose of STZ. Mice with diabetes were treated without or with gemigliptin (300 mg/kg) for 8 weeks. Morphological changes of the glomerular basement membrane (GBM) were observed by electron microscopy and periodic-acid Schiff staining. In addition, we measured blood glucose and urinary albumin excretion and evaluated fibrotic markers using immunohistochemical staining, quantitative reverse transcription polymerase chain reaction analysis, and Western blot analysis. RESULTS: Gemigliptin did not reduce the blood glucose levels of STZ-treated mice. In gemigliptin-treated mice with STZ, a significant reduction in urinary albumin excretion and GBM thickness was observed. Immunohistological examination revealed that gemigliptin attenuated renal fibrosis induced by STZ and decreased extracellular matrix protein levels, including those of type I collagen and fibronectin, and Smad3 phosphorylation. In cultured rat renal cells, gemigliptin inhibited transforming growth factor β-stimulated type I collagen and fibronectin mRNA and protein levels via down-regulation of Smad3 phosphorylation. CONCLUSION: Our data demonstrate that gemigliptin has renoprotective effects on DKD, regardless of its glucose-lowering effect, suggesting that it could be used to prevent DKD, including in patients with type 1 diabetes.
Animals ; Blood Glucose ; Blotting, Western ; Collagen Type I ; Diabetes Mellitus, Type 1 ; Diabetic Nephropathies ; Down-Regulation ; Extracellular Matrix ; Fibronectins ; Fibrosis ; Glomerular Basement Membrane ; Humans ; Mice* ; Microscopy, Electron ; Phosphorylation ; Polymerase Chain Reaction ; Rats ; Reverse Transcription ; RNA, Messenger ; Streptozocin ; Transforming Growth Factors

Pleural effusion is a rare complication in non-tuberculous mycobacterial infection. We report a case of Mycobacterium intracellulare pleuritis with idiopathic pulmonary fibrosis in a 69-year-old man presenting with dyspnea. Pleural effusion revealed lymphocyte dominant exudate. M. intracellulare was identified using a polymerase chain reaction-restriction fragment length polymorphism method and liquid cultures of pleural effusion and pleural biopsy. After combination therapy for M. intracellulare pulmonary disease, the patient was clinically well at a 1-month follow-up.
Biopsy ; Dyspnea ; Exudates and Transudates ; Follow-Up Studies ; Humans ; Idiopathic Pulmonary Fibrosis ; Lung Diseases ; Lymphocytes ; Mycobacterium ; Mycobacterium avium Complex ; Mycobacterium Infections, Nontuberculous ; Pleural Effusion ; Pleurisy

BACKGROUND: As the importance of the quality of life is emphasiged in our society, efforts to improve the quality of life in the field of medicine have intensified. Terminal cancer patients, facing death, need not only biomedical therapy, but also systematic and continuous treatments such as mental or psycho-social intervention. The purpose of this study was to investigate the family caregiver's depression level and the associated factors. METHODS: The survey was conducted with 52 family caregivers of the terminal cancer patients who had been hospitalized at Chungnam National University Hospital from October 2003 to June 2004. The questionnaire consisted of the general characteristics of the subjects, BDI (Beck's Depression Inventory) evaluating the depression level and family APGAR score evaluating the family function. RESULTS: The mean age of the subjects was 50.4 years. The relationship with patients as 'spouse' accounted for 30 individuals (57.7%). The mean (+/-SD) BDI score was 24.0 (+/-10.9) points and 57.7 percent of the subjects were suggested to have depression tendency (> or =21 point). There was no relationship between the caregiver's depression level and their gender, religion, household income and family APGAR score. However, the depression level was significant related to the total caregiving duration (P=0.001), visiting frequency of visitors (P=0.004) and caregiving hours per day (P= 0.005). CONCLUSION: More than half of the family caregivers were suggested to have depression tendency. The depression level as influenced by the burden of caregiving and the visiting frequency of visitors. There is a need to activate social resources to share the burden of caregiving and to develop continuous and comprehensive care for terminal cancer patients and their families.
Apgar Score ; Caregivers* ; Chungcheongnam-do ; Depression* ; Family Characteristics ; Humans ; Quality of Life ; Surveys and Questionnaires