PURPOSE: To evaluate the results of anterolateral thigh perforator free flap for reconstruction of foot and ankle in old diabetic patients. MATERIALS AND METHODS: Fifteen diabetic foot ulcer patients over the age of 55 were operated with anterolateral thigh perforator free flap. Hematological, hemodynamic, diabetic, bacteriologic and radiologic tests were checked with examination of blood vessel state in both the donor site and the recipient site. After surgery, serial check-up was performed at 6 week, 6 month, and 1 year postoperatively on the survival of transplantation tissue, condition of foot, and condition of walking. RESULTS: There are one case of transplantation failure and four cases of partial tissue-necrosis. Delayed wound-healing was observed both recipient and donor tissue sites. At the final follow up, three cases of small ulcer were found at junction of flap and recipient tissue in plantar area. Fourteen out of fifteen patients could walk without any brace or walking aids. CONCLUSION: Reconstruction of foot and ankle region in old diabetic patients with the anterolateral thigh perforator free flap is a useful method which can prevent the amputation of foot and ankle
Aged ; Amputation ; Animals ; Ankle ; Blood Vessels ; Braces ; Diabetic Foot ; Follow-Up Studies ; Foot ; Free Tissue Flaps ; Glycosaminoglycans ; Hemodynamics ; Humans ; Thigh ; Tissue Donors ; Transplants ; Ulcer ; Walking

BACKGROUND: Little knowledge is available on the characteristic differences between patients with atopic dermatitis (AD) with and without atopic march after childhood. OBJECTIVE: To observe and compare the phenotypes of patients with AD in regards to atopic march tendency at a single point. METHODS: We enrolled patients with AD aged between 10 and 30 years. The patients were divided into the atopic march and non-atopic march groups on the basis of an investigator-designed survey questionnaire, and their serum-specific immunoglobulin E (IgE) levels or results of the skin prick test were compared. RESULTS: In a total of 182 patients enrolled in the study, 93 patients with atopic march and 89 patients with non-atopic march were observed. When their serum-specific IgE levels or results of the skin prick test were compared between the two groups, there was no significant difference, except for a in the atopic march group. Analysis of AD severity, family history of allergic diseases, and total IgE levels between the two groups showed no statistically significant differences. CONCLUSION: Our findings suggest that although no apparent phenotype characteristics could differentiate the presence of atopic march, the history of the patient's allergic diseases should be revalidated, and clinicians should watch out for future developments of atopic march when a patient shows a high-class sensitization rate to dust mite.
Dermatitis, Atopic* ; Dust ; Humans ; Immunoglobulin E ; Immunoglobulins ; Mites ; Phenotype ; Skin

No abstract available.
Netherton Syndrome*

No abstract available.
Azathioprine* ; Dermatitis, Atopic* ; Humans

No abstract available.
Abdomen* ; Lichen Sclerosus et Atrophicus* ; Vitiligo*

No abstract available.
Adipose Tissue/*transplantation ; Cryopreservation/*methods ; Face/*surgery ; Female ; Humans ; Injections ; Middle Aged

No abstract available.
Hemangiosarcoma

PURPOSE: In extrinsic atopic dermatitis (AD), house dust mites (HDM) play a role in eliciting or aggravating allergic lesions. The nature of skin inflammation in AD has raised a growing interest in allergen-specific immunotherapy (SIT). Thus, we assessed clinical improvement and laboratory parameters for evaluation of the benefit of long-term SIT. MATERIALS AND METHODS: A total of 217 AD patients who were treated with SIT for at least 3 years were retrospectively assessed, by using their investigator global assessment, pruritus scores, loss of sleep (LOS), total serum IgE, and eosinophil counts collected. Patients were additionally classified into subgroups according to age, initial AD severity and mono- or multi-sensitization to include different individual factors in the evaluation of SIT efficacy. Lastly, we compared laboratory data of good responders to SIT with that of poor responders to SIT. RESULTS: Improvement after SIT therapy was observed in 192 out of 217 patients (88.4%). Among these patients, 138 (63.5%) achieved excellent, near-complete or complete clinical remission. Significant reduction of pruritus, LOS, and the mean value of total serum IgE were observed (p<0.01). Better outcome was found in patients younger than 12 years of age (p=0.024). Patients with moderate to severe AD showed better treatment outcomes (p=0.036). Patients sensitized only to HDM had the better response to treatment, but SIT was also effective in multi-sensitized groups (p=1.051). No significant differences in baseline laboratory results were observed between good and poor responders (p>0.05). CONCLUSION: We emphasize the usefulness of long-term HDM SIT as a disease-modifying therapy for AD.
Adolescent ; Adult ; Allergens/*immunology ; Animals ; Child ; Dermatitis, Atopic/*therapy ; Desensitization, Immunologic/*methods ; Dose-Response Relationship, Drug ; Female ; Humans ; Male ; Middle Aged ; Pyroglyphidae/*immunology ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome ; Young Adult

PURPOSE: Atopic dermatitis (AD) is a chronic eczematous dermatitis that has a high prevalence and diverse clinical features. Although several hypotheses about its multifactorial pathogenesis have been suggested, the cause is not yet fully understood. A better understanding of the clinical features may helpful inelucidating the pathogenesis of AD. METHODS: This retrospective study analyzed the questionnaires, medical charts, and laboratory examination results of 5,000 patients diagnosed with AD at a single tertiary hospital in Korea. RESULTS: The demographics, allergic comorbidities, family history, severity, and treatment experiences of the patients were analyzed. Most of the patients were adults, 76.3% of whom were classified as havingan extrinsic type of AD. The mean eczema area and severity index (EASI) score was found to be 13.68, and adult patients were found to have higher severity than the other age groups. The anatomical involvements were different among the age groups, with more involvements of the head and neck in adults. The patients reported seasonal changes and stress as the factors that aggravated their symptoms the most. Topical steroids and oral cyclosporine were the most used medications at our clinic, whereas 10.1% of the patients underwent allergen-specific immunotherapy. CONCLUSION: This analysis of 5,000 patients would lead to a better understanding of various subtypes and diverse clinical features of AD in Koreans. Distinct characteristics were observed among different age groups; thus, treatment strategies may need to be differentiated accordingly.
Adult ; Comorbidity ; Cyclosporine ; Demography ; Dermatitis, Atopic* ; Eczema ; Head ; Humans ; Immunotherapy ; Korea ; Neck ; Prevalence ; Retrospective Studies ; Seasons ; Steroids ; Tertiary Care Centers

We have previously isolated a novel protein "B/K" that contains two C2-like domains. Here, we report the isolatioin and mRNA distribution of a human B/K isoform, and protein kinase A (PKA)-dependent phosphorylation of the B/K protein. The 1.5 kb human B/K cDNA clone exhibits 89% and 97% identities with rat B/K in the sequences of nucleotide and amino acid, respectively. Human B/K isoform encodes a 474 amino acid protein and shows structural features similar to the rat counterpart including two C2 domains, three consensus sequences for PKA, absence of a transmembrane region, and conservation of the N-terminal cysteine cluster. On Northern and dot blot analyses, a 3.0 kb B/K transcript was abundantly present in human brain, kidney, and prostate. Among the brain regions, strong signals were observed in the frontal and temporal lobes, the hippocampus, the hypothalamus, the amygdala, the substantia nigra, and the pituitary. Recombinant B/K proteins containing three consensus sites for PKA was very efficiently phosphorylated in vitro by PKA catalytic subunit. B/K protein which was overexpressed in LLC-PK1 cells was also strongly phosphorylated in vivo by vasopressin analog DDAVP, and PKA-specific inhibitor H89 as well as type 2 vasopressin receptor antagonist specifically suppressed DDAVP-induced B/K phosphorylation. These results suggest that B/K proteins play a role as potential substrates for PKA in the area where they are expressed.
Sequence Homology, Amino Acid ; Sequence Analysis, DNA ; Rats ; Protein Isoforms/genetics ; Phosphorylation ; Phosphoproteins/genetics/*metabolism ; Molecular Sequence Data ; Mice ; Male ; Humans ; Gene Expression Profiling ; Female ; DNA, Complementary/chemistry/genetics ; Cyclic AMP-Dependent Protein Kinases/*physiology ; Cloning, Molecular ; Cell Line ; Base Sequence ; Animals ; Amino Acid Sequence ; Adult