BACKGROUND: Eotaxin, a CC chemokine specific for eosinophils, is implicated in the pathogenesis of asthma recruiting eosinophils into the airways. Theophylline has been used for the treatment of asthma and rece was proposed to have an anti-inflammatory action. The aim of this study is to examine whether theophylline may inhibit the eosinophilic airway inflammation by reducing the expression of eotaxin. METHODS: The expression of eotaxin mRNA was assessed by Northern analysis in A549 cells 4 h after stimulation with TNF-α or IL-1β And then, theophylline was added to A549 cells stimulated with 0.1 ng/ml IL-1β. RESULTS: Eotaxin mRNA expression rates induced by 0.1, 1, 10 ng/mL TNF-α as compared with β-action were 7%, 22%, 28%, respectively. Eotaxin mRNA expression rates induced by 0.01, 0.1, 1, 10 ng/ml IL-1β as compared with β-action, were 10%, 42%, 63%, 72%, respectively. Eotaxin mRNA expression rates after addition of 0, 0.001, 0.01, 0.1 µM dexamethasone induced by 10 ng/mL TNF-α, as compared with β-action were 27%, 18%, 8%, respectively. Eotaxin mRNA expression rates after the addition of 0.001, 0.01, 0.1 mM dexamethasone induced by 0.1 ng/mL IL-1β, as compared with β -action, were 43%, 47%, 12%, 8%, respectively. Eotaxin mRNA expression rates after the addition of 0, 0.001, 0.01, 0.1, 1, 10 mM theophylline induced by 0.1 ng/mL IL-1β, as compared with β-action, were 48%, 40%, 33%, 22%, 16%, 14%, respectively. CONCLUSION: These results suggest that theophylline may reduce eosinophil infiltration of the airway at least in part by reducing the expression of eotaxin under the conditions of these experiments.
Asthma ; Dexamethasone ; Eosinophils ; Epithelial Cells* ; Inflammation ; RNA, Messenger* ; Theophylline*

Removal of blunt esophageal foreign bodies using Foley catheter under a fluoroscopic guidance is a well-recognized procedure. However, since this procedure is rather cumbersome and uncomfortable to the patient, the authors tried to find an easier and more convenient modified technique. For 10 patients with esophageal foreign body, we tried the method to the patients who is lying in the right lateral decubitus position and 3 assistants hold head. arms, trunk and legs of the patients without tilting the table and without using immobilizer. Foley catheter is inserted through nostril, nasal cavity and pharynx to esophagus. In order to identify the Foley catheter in esophagus, 0.025 inch short wire was inserted in the Foley catheter. The balloon of a Foley catheter was inflated by 10cc of air, and the syringe was kept attached to the Foley catheter during the procedure. After passage of the foreign body through the upper esophageal sphincter, the balloon was deflated immediately and the foreign body was removed through the mouth. We successfully removed in removing all the blunt esophageal foreign body with ease. This modified method is also fast, safe and efficient.
Arm ; Catheters* ; Deception ; Esophageal Sphincter, Upper ; Esophagus ; Foreign Bodies* ; Head ; Humans ; Leg ; Methods* ; Mouth ; Nasal Cavity ; Pharynx ; Syringes

We present a case which seems identical to REM(Reticular Erythematous Mucinosis) syndrome in 26 year-old male. The lesion was initiated about 2 years ago and waxed and waned. The clinical findings were localized, grouped, erythematous papules and vesicles on the anterior middle chest with intermittent mild itching. Histopathology showed normal epidermis, extensive mucin deposition, telangiectasia and mild perivascular round cell infiltrations on the upper dermis. The mucin was stainable with alcian blue at pH 2. 5, but was not stained by either PAS or mucicarmine. Skin lesions were not responded to the oral steroid, but improved slowly after topical application of 5% para-aminobenzoic acid in ethanol for 9 months. The lesion does not recur until present time.
4-Aminobenzoic Acid ; Adult ; Alcian Blue ; Dermis ; Epidermis ; Ethanol ; Humans ; Hydrogen-Ion Concentration ; Male ; Mucins ; Pruritus ; Skin ; Telangiectasis ; Thorax

No abstract available.

Since the first laparoscopic bariatric surgery in Korea introduced in January 2003, the number of metabolic and bariatric surgery has been steadily increasing. According to the report from National Health Insurance big data analysis, the prevalence of morbid and super obesity has greatly increased and metabolic and bariatric surgery also increased in the last 10 years. As the incidence of morbid obesity is more frequent in people of poor socioeconomic status, the need for a reimbursement by the government seemed to be necessary. Finally, the national health insurance system decided to financially cover metabolic and bariatric surgery from January 2019. In order to improve the safety and qualify of metabolic and bariatric surgery, the Korean Society for Bariatric and Metabolic Surgery (KSMBS) introduced surgeon's and institution's accreditation system. The authors intend to introduce comprehensive overview of accreditation system of bariatric surgery and discuss the contents of national health insurance for metabolic and bariatric surgery.
Accreditation ; Bariatric Surgery ; Incidence ; Korea ; National Health Programs ; Obesity ; Obesity, Morbid ; Prevalence ; Social Class ; Statistics as Topic

A 64-year-old male was admitted due to weight loss of 5kg during a month. Chest X-ray showed two large, lobulated masses on both lower lobe. Chest CT showed ill-defined, multilobulated mass on left lower lobe and r-regular, relatively homogenous mass with air-bronchogram on right lower lobe. Left lower lobectomy and right lower lobectomy was performed sequentially with three months intervaL Microscopic findings showed squamous cell carcinoma of both mass. It was thought that this patient had synchronous double primary lung cancer.
Carcinoma, Squamous Cell ; Humans ; Lung Neoplasms ; Lung* ; Male ; Middle Aged ; Thorax ; Tomography, X-Ray Computed ; Weight Loss

Familial male-limited precocious puberty (FMPP) is a rare form of gonadotropin-independent precocious puberty that is caused by an activating mutation of the LHCGR gene. Herein, we report a case of FMPP with a mutation of the LHCGR gene in a Korean boy with familial history of precocious puberty through 3 generations. A 16-month-old boy presented with signs of precocious puberty, including pubic hair, acne, and increased growth velocity. The patient's grandfather and father had a history of precocious puberty and profound short stature. On physical examination, the patient had prepubertal testes with pubic hair development appropriate for Tanner stage II. The stretched penile length was 7 cm (>2 standard deviation score), and observed bone age was that of a 4-year-old boy. Laboratory findings showed high serum testosterone (5.74 ng/mL [appropriate for Tanner IV–V]; normal range, <0.05 ng/mL) with suppressed luteinizing hormone (<0.07 mIU/mL) and normal serum level of follicular stimulating hormone (0.56 mIU/mL; normal range, 0.38–1.11 mIU/mL). Genetic testing revealed a pathogenic variant of LHCGR (c.1730 C>T (p.Thr577Ileu)), confirming FMPP. Bicalutamide and anastrozole were administered, and pubertal progression was sufficiently suppressed without any specific side effects. To our knowledge, this is the first case of genetically confirmed FMPP in Korea.

OBJECTIVES: Since Mountain proposed the new staging system of non-small cell lung cancer in 1986, the indications for operation of NSCLC have been extended. However, operative mortality is from 3 to 6%. Therefore it is important to reduce unnecessary operation and to evaluate unresectability of tumor correctly, preoperatively The purpose of this study is to find out the causes of unresectability in patients who were initially thought to be resectable preoperatively. METHODS: By retrospective analysis, 64 patients out of 291 NSCLC patients who were undergone operation for curative resection in Seoul National University Hospital from Jan. of 1987 to Dec. of 1991, ware found to be unresectable at operating roost were selected for this study. Out of 64 patients,42 were evaluable. The analysis was focused on the change of pre- & post-operative staging and the causes of unresectability of tumors. RESULTS: Among B2 patients with unresectable tumor who could be evaluated, preoperative CT finding showed resectable tumors in 55% (23 patients) and suspicious for unresectable tumors in 45% (19 patients). The causes of unresectability were technically unresectable T3 lesions in 7% (3 patients), T4 lesions in 62% (26 patients), N2 lesions in 17% (7 patients) and N3 lesions in 14% (6 patients). CONCLUSION: The major causes of unresectability of NSCLC were pulmonary artery invasions. It is suggested that careful evaluation of mediastinal structure, especially great vessels by additional imaging technique other than CT (like MRI) is indicated in selected NSCLC cases.
Carcinoma, Non-Small-Cell Lung* ; Humans ; Mortality ; Pulmonary Artery ; Retrospective Studies ; Seoul

Von Recklinghausen's disease is an autosomal dominant hereditary disease associated with characteristic cafeau-lait spots of skin and multiple neurofibromatosis. It is complicated by malignancies, which in most cases is neurofibrosarcoma. The development of lung cancer in von Recklinghausen's disease is rare. A 61-year-old male was admitted for cough and sputum for 20 days. He had multiple cafe-au-lait spots and subcutaneous neurofibromas in whole body area and Lisch nodules in both iris and he had been diagnosed von Recklinghausen s disease 35 years ago. Chest radiography showed emphysematous buliae in both upper lung field and mass in right upper lung field. Chest CT scan revealed subcarinal lymph node enlargement. Bronchoscopic biopsy was done in mass in superior segment of right lower lobe and the results showed squamous cell carcinoma. The presence of von Recklinghausen's disease and lung cancer are noteworthy.
Biopsy ; Cafe-au-Lait Spots ; Carcinoma, Squamous Cell ; Cough ; Genetic Diseases, Inborn ; Humans ; Iris ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Male ; Middle Aged ; Neurofibroma ; Neurofibromatoses ; Neurofibromatosis 1* ; Neurofibrosarcoma ; Radiography ; Skin ; Sputum ; Thorax ; Tomography, X-Ray Computed

Objective: To analyze the rheological and biochemical properties of saliva in healthy adults. Methods: The subjects were seven healthy young adults (20-39 years). The whole saliva was collected by the spitting method between 9:00 am and 12:00 am. Unstimulated saliva was collected first, which was followed by the collection of stimulated saliva using citric acid was collected. The viscosity was measured using a capillary viscometer to examine the rheological properties. The MUC5B concentration was analyzed using an enzyme-linked immunosorbent assay (ELISA) for the biochemical properties. Results: Ten and five minutes were required on average for unstimulated saliva and stimulated saliva, respectively, to collect the minimum amount needed for analysis (8 ml). The flow rate increased from 1.037±0.323 ml/min to 1.823± 0.660 ml/min after stimulation (P=0.018). Citric acid stimulation also increased the MUC5B concentration in the saliva from 3.706±3.575 μg/ml to 6.928±2.03 μg/ml (P=0.028). The viscosity of saliva, however, did not show a significant difference between with (1.1±0.164 cSt) or without (1.019±0.08 cSt) stimulation (P=0.128). A positive correlation was observed between the flow rate and MUC5B concentration (Spearman’s rho=0.547, P=0.043). On the other hand, there was no significant correlation between the MUC5B concentration and viscosity both in the unstimulated and stimulated saliva (P=0.939 and 0.819, respectively). Conclusion No significant correlation was observed between the MUC5B concentration and viscosity. Considering the time required to collect samples, an analysis of the stimulated saliva appears feasible in various research settings.The feasibility of these analysis methods should be examined in a patient population.