The relationship between respiratory infections and exacerbations of wheezing in patients with wheezy bronchitis or asthma has been described. Most respiratory infections were viral or Mycoplasma pneumoniae. This study was performed to evaluate the effect of Mycoplasma pneumoniae infection on bronchial reactivity and atopic background. 106 patients with Mycoplasma pneumoniae pneumonia who were admitted to the department of pediatrics, Fatima Hospital, Taegu during the period of two years from January 1989 to December 1990 were involved in this study. The results were as follows 1) Out of 106 cases, 69 were male,37 were female and 34.9% of the cases were between 5~6 years of age. 35 cases(33.0%) had wheezing and the incidence of wheezing were higher in male than in female. 2) The incidence of wheezing was high in the patients with serum IgE level higher than 200IU/ml, patients with past and family history of allergy and the patients fed with formula feeding in infancy. 3) Eosinophils and the associated maxillary sinusitis had no effect on the incidence of wheezing. 4) The recurrence of wheezing was higher in Mycoplasma pneumoniae pneumonia with wheezing(26.8%) than in patients without wheezing(3.8%).
Asthma ; Bronchitis ; Child* ; Daegu ; Eosinophils ; Female ; Humans ; Hypersensitivity ; Immunoglobulin E ; Incidence ; Male ; Maxillary Sinus ; Maxillary Sinusitis ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pediatrics ; Pneumonia* ; Pneumonia, Mycoplasma* ; Recurrence ; Respiratory Sounds* ; Respiratory Tract Infections

BACKGROUND AND OBJECTIVES: Recurrent vestibulopathy is defined a disease characterized by more than a single episode of vertigo of duration characteristic of endolymphatic hydrops but without auditory or clinical neurological symptoms or signs. To investigate the clinical characteristics and the efficacy of combination therapy, we analyzed the clinical records of the patients diagnosed as recurrent vestibulopathy. MATERIALS AND METHOD: Clinical records of sixty four patients diagnosed as recurrent vestibulopathy were retrospectively reviewed. The data on age, sex distribution, natural history, family history of recurrent vestibulopathy, concurrent headache, caloric response was analyzed. The efficacy of combination therapy for vertigo control in the patients with a minimum 24-month follow-up was also evaluated. RESULTS: Mean onset age of recurrent vestibulopathy was 43 years and there was a female preponderance. Concurrent headache and elevated SP/AP ratio in electrocochleogram was frequently observed in these patients. After the combination medical therapy, patients with severe recurrent vestibulopathy showed significant decrease in the number of vertigo spells with 37.5% of complete control of vertigo. CONCLUSION: As a distinctive clinical disorder with unknown cause, recurrent vestibulopathy should be always considered to the patients complaining recurrent episodic vertigo. Combination therapy individualized to the symptoms and signs of the patients with recurrent vestibulopathy might be effective in reducing the frequency of vertigo attacks. Further case-control studies with large population should be necessary.
Age of Onset ; Case-Control Studies ; Endolymphatic Hydrops ; Female ; Follow-Up Studies ; Headache ; Humans ; Natural History ; Retrospective Studies ; Sex Distribution ; Vertigo ; Vestibular Neuronitis*

No abstract available.
Ring Chromosomes*

PURPOSE: The platelet synthesis is extremely variable after intravenous immunoglogulin injection (IVIG) in acute idiopathic thrombocytopenic purpura (ITP). To investigate the size variation of platelet according to the time sequence of ITP, the relationship between platelet number and mean platelet volume (MPV) was analyzed. METHODS: Twenty acute ITP patients who showed abrupt increase of platelets within 48 hours after IVIG were selected. We checked the platelet number and MPV, thereafter analyzed the relationship. RESULTS: At the early phase of ITP before IVIG, MPV was normal or slightly decreased. However, as the number of platelet increased after IVIG, MPV increased together until platelet count reached 100, 000/mm3. The MPV decreased afterward, therefore the platelet mass was preserved. CONCLUSION: At the early phase of ITP before the increase of platelet, MPV decreased in spite of low number of platelet. After IVIG, there was an abrupt increase of MPV with platelet number. There might be some contributing factors for these, particularly IL-6, IL-11 and thrombopoietin. Now, we need more experimental data to explain these findings.
Blood Platelets* ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Interleukin-11 ; Interleukin-6 ; Mean Platelet Volume* ; Platelet Count* ; Purpura, Thrombocytopenic, Idiopathic* ; Thrombopoietin

We expressed anti-HBsAg human antibody fragment (B7 Fd) using pRSET-A vector and BL21(DE3)pLysS strain of E. coli. B7 Fd is composed only of variable domain (VH) and CH1 constant domain of IgG heavy chain molecule. This Fd molecule was solubilized using guanidine salt and then expressed in the form of inclusion body and successfully refolded into functional antibody molecule by rapid dilution in refolding buffer. B7 Fd reacted with d epitope of hepatitis B virus surface antigen (HBsAg). Its affinity was determined by competition enzyme-linked immunosorbent assay (competition ELISA). The K value of B7 Fd was 3.3 * 10.
Antigens, Surface ; Enzyme-Linked Immunosorbent Assay ; Guanidine ; Hepatitis B virus ; Humans* ; Immunoglobulin G ; Inclusion Bodies

Spontaneous anterior cerebral artery (ACA) dissection, although extremely rare, is often associated with severe morbidity and mortality. It could lead to cerebral hemorrhage, ischemic stroke, or, rarely, combination of hemorrhage and ischemia due to hemodynamic changes. Prompt and accurate diagnosis is essential for determining the appropriate management. However, the optimal treatment for ACA dissection remains controversial. Herein, we report on two rare cases of subarachnoid hemorrhage (SAH) caused by ACA dissection; a case presenting with simultaneous SAH and infarction without aneurysmal formation and another case presenting with SAH with fusiform aneurysmal formation. A review of the related literature is provided, and optimal treatments for each type of dissection are suggested.
Aneurysm* ; Anterior Cerebral Artery* ; Cerebral Hemorrhage ; Diagnosis ; Hemodynamics ; Hemorrhage* ; Infarction ; Ischemia* ; Mortality ; Stroke ; Subarachnoid Hemorrhage*

PURPOSE: To evaluate the results of postoperative radiotherapy in patients with extra-hepatic bile duct cancer (EHBDC) and identify the prognostic factors for local control and survival. MATERIALS AND METHODS: Between January 2001 and December 2010, we retrospectively reviewed the cases of 70 patients with EHBDC who had undergone curative resection and received postoperative radiotherapy. The median radiation dose was 50.4 Gy (range, 41.4 to 54 Gy). The resection margin status was R0 in 30 patients (42.9%), R1 in 25 patients (35.7%), and R2 in 15 patients (21.4%). RESULTS: The 5-year rates of overall survival (OS), event-free survival (EFS), and locoregional control (LRC) for all patients were 42.9%, 38.3%, and 61.2%, respectively. The major pattern of failure was distant relapses (33 patients, 47.1%). A multivariate analysis showed that the postradiotherapy CA19-9 level, radiation dose (> or =50 Gy), R2 resection margins, perineural invasion, and T stage were the significant prognostic factors for OS, EFS, and LRC. OS was not significantly different between the patients receiving R0 and R1 resections, but was significantly lower among those receiving R2 resection (54.6%, 56.1%, and 7.1% for R0, R1, and R2 resections, respectively). CONCLUSION: In patients with EHBDC who had undergone curative resection, a postoperative radiotherapy dose less than 50 Gy was suboptimal for OS and LRC. Higher radiation doses may be needed to obtain better LRC. Further investigation of novel therapy or palliative treatment should be considered for patients receiving R2 resection.
Bile Duct Neoplasms* ; Bile Ducts* ; Bile* ; Disease-Free Survival ; Humans ; Multivariate Analysis ; Palliative Care ; Radiotherapy Dosage ; Radiotherapy* ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies

Actinomycosis is a chronic suppurative and granulomatous disease caused by Actinomyces species and characterized by sulfur granule formation. Depending on the site of primary infection, it is generally classified as cervicofacial, thoracic and abdominal type. Abdominal actinomycosis is often difficult to diagnose before operation because of low frequency and no characteristic clinical features of the disease. As it progresses chronically, it can be misdiagnosed such as cancer, inflammatory bowel disease or other abscess. The diagnosis is usually based on histologic demonstration of sulfur granules in pus or surgically resected specimen. In vast majority of cases, treatment has consisted of long-term antibiotic therapy coupled with surgical resection. We experienced a case of colonic actinomycosis initially diagnosed as Dieulafoy's ulcer and confirmed by colonoscopic biopsy. Treatment with intravenous penicillin for 4 weeks was successful independently, and we report this case with a brief review of literatures.
Abscess ; Actinomyces ; Actinomycosis* ; Biopsy ; Colon ; Colonoscopy ; Diagnosis ; Inflammatory Bowel Diseases ; Penicillins ; Sulfur ; Suppuration ; Ulcer*

BACKGROUND: The North Korean defectors are suffering from multiple psychologic and physical health problems. However, because of their emotional maladaptation, noncooperation and suspiciousness and distrust toward others, it is difficult for South Korean doctors to build effective therapeutic relationships with them. Therefore, we made efforts to clarify the characteristics of North Korean defectors in symptom expressions and illness behaviors which would help South Korean doctors to gain rapport. METHODS: We performed qualitative study with focus group interview. Three focus groups were composed of 14 North Korean defectors and group interviews were performed twice for each group. The contents of each interview were analyzed and conclusions were drawn by extracting and arranging significant findings. RESULTS: The North Korean defectors showed psychologic symptoms such as anxiety, depression and various somatic symptoms. Among them, 'Laeng-Dol ('cold mass) and 'Jeog' mean subjective mass-feeling, such as globus sensation. And 'Tag-Gi-Byeong ('chicken heart disease')' means recurrent chest pain. These expressions reflect their anxious, depressive, and somatizing tendency. Among illness concept, 'Laeng-Byeong' ('cold related disease') means that they consider the cold weather to be the cause of various somatic symptoms. Characteristic illness behaviors include continuous complaining of recurrent symptoms, distrusting medical staffs and institutions, self-diagnosis, self- prescription, and reliance upon folk remedies. These illness behaviors were precipitated by the current breakdown of health-care system and economic crisis of the North Korea. CONCLUSION: South Korean doctors should be able to understand these characteristics of the North Korean defectors in order to build effective therapeutic relationship with them.
Anxiety ; Chest Pain ; Democratic People's Republic of Korea ; Depression ; Focus Groups ; Heart ; Humans ; Illness Behavior* ; Interviews as Topic ; Medical Staff ; Medicine, Traditional ; Prescriptions ; Sensation ; Weather

BACKGROUND: The North Korean defectors are suffering from multiple psychologic and physical health problems. However, because of their emotional maladaptation, noncooperation and suspiciousness and distrust toward others, it is difficult for South Korean doctors to build effective therapeutic relationships with them. Therefore, we made efforts to clarify the characteristics of North Korean defectors in symptom expressions and illness behaviors which would help South Korean doctors to gain rapport. METHODS: We performed qualitative study with focus group interview. Three focus groups were composed of 14 North Korean defectors and group interviews were performed twice for each group. The contents of each interview were analyzed and conclusions were drawn by extracting and arranging significant findings. RESULTS: The North Korean defectors showed psychologic symptoms such as anxiety, depression and various somatic symptoms. Among them, 'Laeng-Dol ('cold mass) and 'Jeog' mean subjective mass-feeling, such as globus sensation. And 'Tag-Gi-Byeong ('chicken heart disease')' means recurrent chest pain. These expressions reflect their anxious, depressive, and somatizing tendency. Among illness concept, 'Laeng-Byeong' ('cold related disease') means that they consider the cold weather to be the cause of various somatic symptoms. Characteristic illness behaviors include continuous complaining of recurrent symptoms, distrusting medical staffs and institutions, self-diagnosis, self- prescription, and reliance upon folk remedies. These illness behaviors were precipitated by the current breakdown of health-care system and economic crisis of the North Korea. CONCLUSION: South Korean doctors should be able to understand these characteristics of the North Korean defectors in order to build effective therapeutic relationship with them.
Anxiety ; Chest Pain ; Democratic People's Republic of Korea ; Depression ; Focus Groups ; Heart ; Humans ; Illness Behavior* ; Interviews as Topic ; Medical Staff ; Medicine, Traditional ; Prescriptions ; Sensation ; Weather