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

Collective actions by physicians have occurred frequently worldwide, including in Korea.The literature primarily focuses on justifying industrial actions or assessing their impact on clinical outcomes. However, few studies have examined physicians’ actions in response to government health policies. A comprehensive review of this literature could provide valuable insights into how physicians can effectively address and resolve conflicts with governments.This study aimed to investigate the existing literature on physicians’ collective actions against government health policies and identify research gaps. A scoping review was conducted based on the methodology proposed by Arksey and O’Malley. We searched for terms related to physicians (e.g., doctors, trainees) and strikes (e.g., protests, walkouts) in PubMed, Embase, Scopus, Web of Science, KMbase, and RISS on March 25, 2024. A total of 5,248 articles published between 1974 and 2023 were screened, and 26 articles were selected for analysis. The authors of these studies were predominantly from the fields of social sciences, history, jurisprudence, and public health administration. Physician collective actions were documented in 16 countries across various levels of development. Physicians engaged in collective action for five main reasons: 1) Opposition to socialized medicine policies, 2) Opposition to healthcare privatization policies, 3) Dissatisfaction with poor or stagnant public healthcare systems and infrastructure, 4) Resistance to unreasonable medical reforms, and 5) Protests against inequitable health workforce policies. Government responses to physician strikes followed four main strategies: 1) Unilateral policy enforcement, 2) Instigation of conflicts, 3) Suppression of physicians through unwarranted use of governmental power, and 4) Use of mediators to negotiate resolutions. These strategies were employed regardless of whether the government was authoritarian or democratic. Physicians’ strategies against government policies were categorized as 1) Strengthening physician organizations, 2) Improving public relations, 3) Disrupting government policy implementation, and 4) Reducing the available medical workforce. In conclusion, this study highlights the need for more theory-based research and greater integration of social sciences into physicians’ education. We recommend that Korean physicians reflect on the strategies used by both governments and physicians in other countries and prepare for potential conflicts.

Collective actions by physicians have occurred frequently worldwide, including in Korea.The literature primarily focuses on justifying industrial actions or assessing their impact on clinical outcomes. However, few studies have examined physicians’ actions in response to government health policies. A comprehensive review of this literature could provide valuable insights into how physicians can effectively address and resolve conflicts with governments.This study aimed to investigate the existing literature on physicians’ collective actions against government health policies and identify research gaps. A scoping review was conducted based on the methodology proposed by Arksey and O’Malley. We searched for terms related to physicians (e.g., doctors, trainees) and strikes (e.g., protests, walkouts) in PubMed, Embase, Scopus, Web of Science, KMbase, and RISS on March 25, 2024. A total of 5,248 articles published between 1974 and 2023 were screened, and 26 articles were selected for analysis. The authors of these studies were predominantly from the fields of social sciences, history, jurisprudence, and public health administration. Physician collective actions were documented in 16 countries across various levels of development. Physicians engaged in collective action for five main reasons: 1) Opposition to socialized medicine policies, 2) Opposition to healthcare privatization policies, 3) Dissatisfaction with poor or stagnant public healthcare systems and infrastructure, 4) Resistance to unreasonable medical reforms, and 5) Protests against inequitable health workforce policies. Government responses to physician strikes followed four main strategies: 1) Unilateral policy enforcement, 2) Instigation of conflicts, 3) Suppression of physicians through unwarranted use of governmental power, and 4) Use of mediators to negotiate resolutions. These strategies were employed regardless of whether the government was authoritarian or democratic. Physicians’ strategies against government policies were categorized as 1) Strengthening physician organizations, 2) Improving public relations, 3) Disrupting government policy implementation, and 4) Reducing the available medical workforce. In conclusion, this study highlights the need for more theory-based research and greater integration of social sciences into physicians’ education. We recommend that Korean physicians reflect on the strategies used by both governments and physicians in other countries and prepare for potential conflicts.

Collective actions by physicians have occurred frequently worldwide, including in Korea.The literature primarily focuses on justifying industrial actions or assessing their impact on clinical outcomes. However, few studies have examined physicians’ actions in response to government health policies. A comprehensive review of this literature could provide valuable insights into how physicians can effectively address and resolve conflicts with governments.This study aimed to investigate the existing literature on physicians’ collective actions against government health policies and identify research gaps. A scoping review was conducted based on the methodology proposed by Arksey and O’Malley. We searched for terms related to physicians (e.g., doctors, trainees) and strikes (e.g., protests, walkouts) in PubMed, Embase, Scopus, Web of Science, KMbase, and RISS on March 25, 2024. A total of 5,248 articles published between 1974 and 2023 were screened, and 26 articles were selected for analysis. The authors of these studies were predominantly from the fields of social sciences, history, jurisprudence, and public health administration. Physician collective actions were documented in 16 countries across various levels of development. Physicians engaged in collective action for five main reasons: 1) Opposition to socialized medicine policies, 2) Opposition to healthcare privatization policies, 3) Dissatisfaction with poor or stagnant public healthcare systems and infrastructure, 4) Resistance to unreasonable medical reforms, and 5) Protests against inequitable health workforce policies. Government responses to physician strikes followed four main strategies: 1) Unilateral policy enforcement, 2) Instigation of conflicts, 3) Suppression of physicians through unwarranted use of governmental power, and 4) Use of mediators to negotiate resolutions. These strategies were employed regardless of whether the government was authoritarian or democratic. Physicians’ strategies against government policies were categorized as 1) Strengthening physician organizations, 2) Improving public relations, 3) Disrupting government policy implementation, and 4) Reducing the available medical workforce. In conclusion, this study highlights the need for more theory-based research and greater integration of social sciences into physicians’ education. We recommend that Korean physicians reflect on the strategies used by both governments and physicians in other countries and prepare for potential conflicts.

Collective actions by physicians have occurred frequently worldwide, including in Korea.The literature primarily focuses on justifying industrial actions or assessing their impact on clinical outcomes. However, few studies have examined physicians’ actions in response to government health policies. A comprehensive review of this literature could provide valuable insights into how physicians can effectively address and resolve conflicts with governments.This study aimed to investigate the existing literature on physicians’ collective actions against government health policies and identify research gaps. A scoping review was conducted based on the methodology proposed by Arksey and O’Malley. We searched for terms related to physicians (e.g., doctors, trainees) and strikes (e.g., protests, walkouts) in PubMed, Embase, Scopus, Web of Science, KMbase, and RISS on March 25, 2024. A total of 5,248 articles published between 1974 and 2023 were screened, and 26 articles were selected for analysis. The authors of these studies were predominantly from the fields of social sciences, history, jurisprudence, and public health administration. Physician collective actions were documented in 16 countries across various levels of development. Physicians engaged in collective action for five main reasons: 1) Opposition to socialized medicine policies, 2) Opposition to healthcare privatization policies, 3) Dissatisfaction with poor or stagnant public healthcare systems and infrastructure, 4) Resistance to unreasonable medical reforms, and 5) Protests against inequitable health workforce policies. Government responses to physician strikes followed four main strategies: 1) Unilateral policy enforcement, 2) Instigation of conflicts, 3) Suppression of physicians through unwarranted use of governmental power, and 4) Use of mediators to negotiate resolutions. These strategies were employed regardless of whether the government was authoritarian or democratic. Physicians’ strategies against government policies were categorized as 1) Strengthening physician organizations, 2) Improving public relations, 3) Disrupting government policy implementation, and 4) Reducing the available medical workforce. In conclusion, this study highlights the need for more theory-based research and greater integration of social sciences into physicians’ education. We recommend that Korean physicians reflect on the strategies used by both governments and physicians in other countries and prepare for potential conflicts.

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

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

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*