The presence of anti-dsDNA is included in diagnostic criteria for systemic lupus erythematosus (SLE) according to the American College of Rheumatology (ACR). It has been the most useful factor in the diagnosis, prognosis, and therapeutic monitoring of patients with SLE. A number of methods are available but radioimmunoassay (RIA) has been regarded as standard method. A shift from RIAs to nonisotopic assay has been observed with other tests. Still, RIA assays are standard methods for anti-nDNA antibodies. A comparative study of the Crithidia luciliae immunofluorescence (CLIF) assay and an RIA was made. METHOD: Sera from 144 patients were tested by an indirect immunofluorescent antibody technique employing Crithidia luciliae and IT-1 cell lines as a substrate and radioimmunoassay was based on the Farr technique. RESULTS: 1. Thirty-nine of 122 sera with positive antinuclear antibody (ANA) tests had the possibility of positive anti-nDNA antibodies. 2. The RIA was positive in 54 sera, and 37 of these showed a discrepancy between the RIA and the ANA pattern (false positive rate 25.7%). 3. The CLIF was positive in 15 sera, and 5 of these showed a discrepancy between CLIF and the ANA pattern (false positive rate 3.5%). 4. Only CLIF was positive in 2 sera of which one showed a discrepancy between CLIF and the ANA pattern. 5. Only RIA was positive in 41 sera, and 33 of these showed a discrepancy between RIA amp; the ANA pattern. CONCLUSION: The immunofluorescence assay using Crithidia luciliae is a valid method to detect anti-dsDNA antibodies and has a much lower false positive rate compared with RIA. The simple and inexpensive CLIF test could either replace the RIA in clinical laboratories or be used in conjunction with the ANA pattern as a confirmatory test for antibodies to nDNA.
Antibodies* ; Antibodies, Antinuclear ; Cell Line* ; Crithidia* ; Diagnosis ; Fluorescent Antibody Technique ; Humans ; Lupus Erythematosus, Systemic ; Prognosis ; Radioimmunoassay ; Rheumatology

BACKGROUND: It has been known that blood group antibodies are not produced in the neonatal period and that if the antibodies exist, they are probably maternal in origin which had crossed the placenta. There have been several studies conducted abroad on when these antibodies are formed but none has been done in Korea. This study was carried out to determine the ABO blood type and blood group antibodies in children from neonates up to 5 year old. We hoped to determine when and in what pattern blood group antibodies were produced. METHODS: We selected 337 children from neonates up to 5 year old who were admitted to Hanyang university Hospital in Seoul or Kuri from 1994 to 1996. Cell typing was done immediately by the slide method. The anti-A and anti-B used for cell typing were supplied by Immucor (Norcrosis, Ga) . Sera were stored at -70 degrees C until they were tested for ABO blood group antibodies by the standard saline test tube method. When uncertain results were obtained, a drop of the mixture was placed on a slide and observed under a microscope. RESULTS: ABO blood group antibodies were detected in 9 of 50 (18%) infants less than 1 week old and in 10 of 51 (20%) infants between 1 week and 3 months of age. The pattern of ABO blood group antibody production was similar to that of the fetal period up to 3 months after birth, after which antibody production increased rapidly to reach approximately 80% at 6 months of age, There was no difference in ABO antibody production between boys and girls. The antibody formation pattern of group A and group B infants less than 6 months of age showed anti-A to be 35% and anti-B to be 20%. In group O infants of the same age, anti-A was positive In 42% and antral-B In 33%. However, after 6 months of age, there was no difference in antibody production among groups A, B, or O. CONCLUSIONS: Antibodies directed toward ABO antigens were detected in 19 out of 101 (19%) infants less than 3 months old. We therefore believe it is necessary to Perform serologic typing as well as cell typing in these Infants. Furthermore, the emergency transfusion of type A or B blood to a type O infant under the impression that anti-A and anti-B do not exist should be forbidden.
Antibodies* ; Antibody Formation ; Child* ; Child, Preschool ; Emergencies ; Female ; Hope ; Humans ; Infant ; Infant, Newborn ; Korea ; Parturition ; Placenta ; Seoul

BACKGROUND: Topical photodynamic therapy (PDT) has been increasingly used to treat malignant skin tumors including the Bowen disease. However, patients could be displeased with the long incubation time required for conventional PDT. OBJECTIVE: We evaluated the efficacy and safety of PDT with a short incubation time of ablative CO2 fractional laser pretreatment for treating Bowen disease. METHODS: Ten patients were included. Just before applying the topical photosensitizer, all lesions were treated with ablative CO2 fractional laser, following the application of methyl aminolevulinate and irradiation with red light (Aktilite CL 128). Histological confirmation, rebiopsy, and clinical assessments were performed. Adverse events were also recorded. RESULTS: Five of the ten (50%) lesions showed a complete response (CR) within three PDT sessions. After four treatment sessions, all lesions except one penile shaft lesion (90%) achieved clinical and histological CR or clinical CR only. The average number of treatments to CR was 3.70+/-1.70. The treatments showed favorable cosmetic outcomes and no serious adverse events. CONCLUSION: The results suggest that pretreatment with an ablative fractional CO2 laser before PDT has similar treatment efficacy and requires a shorter photosensitizer incubation time compared with the conventional PDT method.
Bowen's Disease ; Carbon ; Carbon Dioxide ; Cosmetics ; Humans ; Lasers, Gas ; Light ; Photochemotherapy ; Skin ; Treatment Outcome ; Triazenes

BACKGROUND: Topical photodynamic therapy (PDT) has been increasingly used to treat malignant skin tumors including the Bowen disease. However, patients could be displeased with the long incubation time required for conventional PDT. OBJECTIVE: We evaluated the efficacy and safety of PDT with a short incubation time of ablative CO2 fractional laser pretreatment for treating Bowen disease. METHODS: Ten patients were included. Just before applying the topical photosensitizer, all lesions were treated with ablative CO2 fractional laser, following the application of methyl aminolevulinate and irradiation with red light (Aktilite CL 128). Histological confirmation, rebiopsy, and clinical assessments were performed. Adverse events were also recorded. RESULTS: Five of the ten (50%) lesions showed a complete response (CR) within three PDT sessions. After four treatment sessions, all lesions except one penile shaft lesion (90%) achieved clinical and histological CR or clinical CR only. The average number of treatments to CR was 3.70+/-1.70. The treatments showed favorable cosmetic outcomes and no serious adverse events. CONCLUSION: The results suggest that pretreatment with an ablative fractional CO2 laser before PDT has similar treatment efficacy and requires a shorter photosensitizer incubation time compared with the conventional PDT method.
Bowen's Disease ; Carbon ; Carbon Dioxide ; Cosmetics ; Humans ; Lasers, Gas ; Light ; Photochemotherapy ; Skin ; Treatment Outcome ; Triazenes

A 21-month-old girl with cri-du-chat syndrome in conjunction with developmental delay underwent brain magnetic resonance imaging (MRI). The MRI showed hypoplasia of the brain stem, a normal cerebellum, thinning of the corpus callosum, and a lack of myelination in both anterior limbs of the internal capsule. She also had neonatal bilateral subependymal cysts. We believe that the symmetrical lack of myelination in both anterior limbs of the internal capsule could be a diagnostic clue of cri-du-chat syndrome.
Brain ; Brain Stem ; Cerebellum ; Corpus Callosum ; Cri-du-Chat Syndrome* ; Extremities* ; Female ; Humans ; Infant ; Internal Capsule* ; Magnetic Resonance Imaging ; Myelin Sheath*

PURPOSE: The presence of normal fingernail is important for the hand function and cosmetic appearance. We studied the results of the microsurgical reconstruction of the defected fingernail using composite toenail transfer. MATERIALS AND METHODS: From March of 2004 to May of 2009, eleven fingernails were reconstructed using microsurgical composite toenail transfer in 10 patients with a mean age of 27 years (range, 13 to 47 years). There were three thumbs, five index fingers, and three long fingers. Whole fingernail was destructed in three cases and remaining eight cases had partial nail defect. Toenail was grafted from great toe in eight cases and from second toe in three cases. Five cases were harvested as an osteoonychocutaneous flap, two as a endoosteoonychocutaneous flap and four as an onychocutaneous flap. RESULTS: All cases survived without any tissue necrosis. One arterial obstruction had occurred one day after surgery, which was resolved by repeated decompression and reanastomosis of the artery. All fingernails regenerated successfully. According to the rating system including assessment of shape, size and thickness of nail, nail pinch, pain, and patient's satisfaction, ten cases were rated as excellent and one as good. All patient's were satisfied with their hand function and appearance. CONCLUSION: Microsurgical composite toenail transfer can be an acceptable surgical reconstruction for the fingernail defect after trauma, providing satisfactory hand functions and cosmetic appearance.
Arteries ; Cosmetics ; Decompression ; Fingers ; Hand ; Humans ; Nails ; Necrosis ; Thumb ; Toes ; Transplants

Background: Few studies have reported on the trends in influenza vaccination rates among cancer survivors in Korea. We investigated these trends over a recent 11-year period (2005–2015). Methods: Data were obtained from the Korea National Health and Nutrition Examination Survey (KNHANES) III– VI (2005–2015). After excluding individuals younger than 40 years of age, the participants included 2,210 cancer survivors (861 men and 1,349 women). We categorized these study participants into four groups according to age and sex. Results: The influenza vaccination rate decreased significantly among male cancer survivors, with rates of 74.8, 64.7, 56.2, and 55.2% (β coefficient=-0.257, P for trend <0.001) in KNHANES III, VI, V, and VI, respectively. While influenza vaccination rates decreased significantly among older male cancer survivors (≥65 years) (β coefficient=-0.359, P for trend=0.017), they increased among older female cancer survivors (β coefficient=0.375, P for trend=0.011) from 2005 to 2015. Conclusion Influenza vaccination rates in older cancer survivors significantly decreased in men but increased in women in successive KNHANES phases. Efforts are needed to improve immunization education and awareness, especially in older male cancer survivors.

BACKGROUND/AIMS: Type 2 diabetes with microvascular complications is often accompanied by macrovascular complications. However, the relationship between the two complications is unclear. In this study, we determined the relationship between diabetic retinopathy and morphological changes of the carotid artery. METHODS: We analyzed the presence of plaque and mean carotid intima-media thickness (CIMT) in patients with type 2 diabetes (n = 133) using high-resolution ultrasound. The presence and severity of retinopathy were graded according to fundus photographs. RESULTS: The mean CIMT of the diabetic retinopathy (DR) group (0.111 +/- 0.048 cm) was significantly greater than that of the nondiabetic retinopathy (No DR) group (0.074 +/- 0.039 cm, p = 0.007). An abnormal mean CIMT (> 0.08 cm) was more frequently observed in the DR group (76%) than that in the No DR group (23.1%; odds ratio, 10.609; 95% confidence interval, 3.072-36.639; adjusted by age, body mass index, hypertension, and diabetes duration). Although the mean CIMT in patients with plaque was significantly greater than that of patients without plaque, no significant difference was observed between the DR (36%, 17 patients) and NoDR (18.5%, 20 patients) groups in the presence of plaque. CONCLUSIONS: Diabetic retinopathy was associated with an increased CIMT but not with atherosclerotic plaques. However, the increases in IMT were associated with the presence of plaques, which predispose patients to cardiovascular disease. These results imply that the microvascular complications of diabetes have indirect relationships with the cardiovascular complications of diabetes.
Atherosclerosis ; Body Mass Index ; Cardiovascular Diseases ; Carotid Arteries ; Carotid Intima-Media Thickness ; Diabetes Mellitus ; Diabetic Retinopathy ; Humans ; Hypertension ; Odds Ratio ; Plaque, Atherosclerotic

A primary benign schwannoma of the liver is extremely rare. Only nine cases have been reported in the medical literature worldwide and no case has been reported in Korea previously. A 36-yr-old woman was admitted to our hospital with vague epigastric pain. The ultrasound and computed tomography scan revealed a multiseptated cystic mass in the right lobe of the liver. The mass was resected; it was found to be a 5x4x2 cm mass filled with reddish yellow fluid. The histological examination confirmed the diagnosis of a benign schwannoma, proven by positive immunoreaction with the neurogenic marker S-100 protein and a negative response to CD34, CD117 and smooth muscle actin. This is the first report of a benign schwannoma of the liver parenchyma in a Korean patient.
Adult ; Antigens, CD34/analysis ; Female ; Humans ; Liver Neoplasms/diagnosis/*pathology ; Neurilemmoma/diagnosis/*pathology ; Proto-Oncogene Proteins c-kit/analysis

McCune-Albright syndrome is characterized by polyostotic fibrous dysplasia, Caf -au-lait pigmentation and precocious puberty or other endocrinopathy. It can be caused by substitution of His, Cys or Gly for Arg 201st amino acid of the Gs protein subunit. The case of a 32-year-old woman, with atypical McCune-Albright syndrome, is reported. She had no skin lesion or precocity puberty. The polyostotic fibrous dysplasia was examined by a simple radiological image and whole body scan. She developed hyperthyroidism, with a multinodular toxic goiter. No thyroid related autoantibodies were detected. The cause of hyperthyroidism was thought to be a non- autoimmune thyroid hyperfunction. The level of growth hormone was not suppressed by oral glucose load. After a bromocriptine suppression test, the level of growth hormone decreased. There was no mass in the pituitary gland on a sellar MRI. A case of atypical McCune-Albright syndrome, including hyperthyroidism and hypersecretion of growth hormone, is reported.
Adolescent ; Adult ; Autoantibodies ; Bromocriptine ; Female ; Fibrous Dysplasia, Polyostotic* ; Glucose ; Goiter ; Growth Hormone* ; Humans ; Hyperthyroidism* ; Magnetic Resonance Imaging ; Pigmentation ; Pituitary Gland ; Protein Subunits ; Puberty ; Puberty, Precocious ; Skin ; Thyroid Gland ; Whole Body Imaging