PURPOSE: High interleukin-1 beta(IL-1beta) expression in the skin biopsy specimens of patients with Henoch-Schonlein Purpura(HSP) has been observed. We examined IL-1beta gene polymorphism in patients with HSP. The purpose of this study is to examine the relationship between IL-1beta gene polymorphism and renal involvement in HSP. METHODS: Patients from mideast Korea with HSP were studied. All patients had at least 6 months of follow up. Patients and ethnically matched controls were genotyped for IL-1beta gene polymorphism by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). RESULTS: Thirty-four patients(all younger than 15 years old) who had been diagnosed with HSP and 27 controls were examined. No allele or genotype differences between the HSP and control groups were observed. No significant association between the carriage of IL-1beta(-511) T allele and renal involvement(P=0.525, OR:1.417, CI:0.545-3.686) was found. CONCLUSION: In unselected patients with HSP, carriage of IL-1beta(-511) T allele does not appear to influence renal involvement.
Alleles ; Biopsy ; Follow-Up Studies ; Genotype ; Humans ; Interleukin-1 ; Interleukin-1beta* ; Interleukins* ; Korea ; Purpura, Schoenlein-Henoch* ; Skin

OBJECTIVE: Rheumatoid arthritis (RA) is a systemic disease that can affect the cervical spine, especially the atlantoaxial region. The present study evaluated the risk factors for atlantoaxial subluxation (AAS) development and progression in patients who have undergone surgical treatment. METHODS: We retrospectively analyzed the data of 62 patients with RA and surgically treated AAS between 2002 and 2015. Additionally, we identified 62 patients as controls using propensity score matching of sex and age among 12667 RA patients from a rheumatology registry between 2007 and 2015. We extracted patient data, including sex, age at diagnosis, age at surgery, disease duration, radiographic hand joint changes, and history of methotrexate use, and laboratory data, including presence of rheumatoid factor and the C-reactive protein (CRP) level. RESULTS: The mean patient age at diagnosis was 38.0 years. The mean time interval between RA diagnosis and AAS surgery was 13.6±7.0 years. The risk factors for surgically treated AAS development were the serum CRP level (p=0.005) and radiographic hand joint erosion (p=0.009). The risk factors for AAS progression were a short time interval between RA diagnosis and radiographic hand joint erosion (p<0.001) and young age at RA diagnosis (p=0.04). CONCLUSION: The CRP level at RA diagnosis and a short time interval between RA diagnosis and radiographic hand joint erosion might be risk factors for surgically treated AAS development in RA patients. Additionally, a short time interval between RA diagnosis and radiographic hand joint erosion and young age at RA diagnosis might be risk factors for AAS progression.
Arthritis, Rheumatoid* ; C-Reactive Protein ; Diagnosis* ; Hand ; Humans ; Joints ; Methotrexate ; Propensity Score ; Retrospective Studies ; Rheumatoid Factor ; Rheumatology ; Risk Factors* ; Spine

Trisomy 9p syndrome was first described by Rethore et al in 1970 and about 150 cases have been reported. The characteristic features of the partial trisomy 9p syndrome is clearly recognizable faces, which include microcephaly, facial deformities, skeletal and dermatoglyphic anomalies with variable degrees of mental retardation. The 3-ketothiolase deficiency was first described in 1971 and about 30 cases have been reported. The 3-ketothiolase deficeiency is an inborn error of isoleucine and ketone body catabolism that shows autosomal recessive traits, caused by a deficiency of mitochondrial acetoacetyl-coenzyme A thiolase(T2). We report a case of partial trisomy 9p syndrome with 3-ketothiolase deficeiency in a 4-years-old female. The karyotype of the patient was confirmed as 46,XY, add(9)(p23) mat. In the urine organic acid test, 3-ketothiolase deficiency was reported.
Acetyl-CoA C-Acyltransferase* ; Congenital Abnormalities ; Dermatoglyphics ; Female ; Humans ; Intellectual Disability ; Isoleucine ; Karyotype ; Metabolism ; Microcephaly ; Trisomy*

BACKGROUND AND OBJECTIVES: Recurrent squamous carcinoma of head and neck carcinoma is not encountered infrequently. Surgical salvage is the most reasonable treatment for recurrence. The aim of the present review is to provide more information on the results and prognosis of surgical salvage after surgery alone or surgery with combined radiotherapy. MATERIALS AND METHODS: The operative salvage of recurrent head and neck carcinoma after surgery alone or surgery with combined radiotherapy was retrospectively studied in 18 patients treated between 1994 and 1999. Of the 18 patients in this retrospective review, there were 6 with local recurrence, 8 with regional recurrence, and 4 with stomal recurrence. RESULTS: The operative mortality was 16.6% and 72% of patients had one or more surgical complications. The 2-year crude survival rate in this series was 30% and the mean period of survival was 11.4 months. The 2-year survival rate were 33.3% for local recurrence and 50% for regional recurrence, and 0% for stomal recurrence. CONCLUSION: We concluded that surgical salvage had unsatisfactory results for patients with recurrent head and neck carcinoma after surgery alone or surgery with combined radiotherapy. Because of this low salvage rate, we should regard salvage surgery as palliative rather than therapeutic.
Carcinoma, Squamous Cell ; Head and Neck Neoplasms* ; Head* ; Humans ; Mortality ; Neck ; Neoplasm Metastasis ; Prognosis ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Salvage Therapy ; Survival Rate

OBJECTIVES : We investigated the relationship between periventricular and deep white matter hyperintensity and cognitive function in Alzheimer's disease (AD) and mild cognitive impairment (MCI). METHODS : T2-weighted MRI scans were performed in 41 subjects with AD 38 subjects with mild cognitive impairment and 38 control subjects. Periventricular and deep white matter hyperintensities were rated on a Fazekas 0-3 scale by a medical specialist of the department of radiology blind to clinical diagnosis. Cognitive function was assessed by using Cognitive Assessment and Reference Diagnoses System. RESULTS : No significant differences between demographic characteristics and vascular risk factors were revealed comparing AD, MCI and controls. The frequencies of AD were significantly higher than those of MCI and normal control in Grade 2 and 3 of periventricular hyperintensity and Grade 3 of deep white matter hyperintensity. The scores of amnesia, executive function and attention were significantly lower in Grade 2 and 3 of periventricular hyperintensity than in Grade 0 and 1. The scores of attention were significantly lower in Grade 3 of deep white matter hyperintensity than in Grade 0, 1 and 2. CONCLUSION : Periventricualr hyperintensities are associated with cognitive decline in amnesia, executive function and attention, while deep white matter hyperintensities are associated with cognitive decline in attention.
Alzheimer Disease ; Amnesia ; Executive Function ; Humans ; Magnetic Resonance Imaging ; Mild Cognitive Impairment ; Risk Factors ; Specialization

OBJECTIVES : We investigated the relationship between periventricular and deep white matter hyperintensity and cognitive function in Alzheimer's disease (AD) and mild cognitive impairment (MCI). METHODS : T2-weighted MRI scans were performed in 41 subjects with AD 38 subjects with mild cognitive impairment and 38 control subjects. Periventricular and deep white matter hyperintensities were rated on a Fazekas 0-3 scale by a medical specialist of the department of radiology blind to clinical diagnosis. Cognitive function was assessed by using Cognitive Assessment and Reference Diagnoses System. RESULTS : No significant differences between demographic characteristics and vascular risk factors were revealed comparing AD, MCI and controls. The frequencies of AD were significantly higher than those of MCI and normal control in Grade 2 and 3 of periventricular hyperintensity and Grade 3 of deep white matter hyperintensity. The scores of amnesia, executive function and attention were significantly lower in Grade 2 and 3 of periventricular hyperintensity than in Grade 0 and 1. The scores of attention were significantly lower in Grade 3 of deep white matter hyperintensity than in Grade 0, 1 and 2. CONCLUSION : Periventricualr hyperintensities are associated with cognitive decline in amnesia, executive function and attention, while deep white matter hyperintensities are associated with cognitive decline in attention.
Alzheimer Disease ; Amnesia ; Executive Function ; Humans ; Magnetic Resonance Imaging ; Mild Cognitive Impairment ; Risk Factors ; Specialization

The midtarsal joint which consists of the talonavicular and calcaneocuboid joints lies transversely across the medial and lateral arches of the foot. Complete dislocation of this joint unassociated with fracture is extremely rare. A 36 year-old male who was injured by motor vehicle accident came to help for his left midfoot pain and deformity. We misdiagnosed as subtalar dislocation. Closed reduction was performed. We reviewed initial and post-reduction X-rays, and then we diagnosed as Chopart's dislocation. CT scan was taken; it showed fracture of the anterior process of the calcaneous.
Adult ; Congenital Abnormalities ; Dislocations* ; Foot ; Humans ; Joints ; Male ; Motor Vehicles ; Tomography, X-Ray Computed

OBJECTIVES: This study was carried out to estimate the prevalence of isocyanate-induced occupational asthma in toluene diisocyanate (TDI) exposed workers. METHODS: We examined 170 workers who had been directly exposed to TDI through a medical questionnaire, physical examination, and pulmonary function test. Based on screening examination, workers with suspected occupational asthma were selected for further evaluation such as methacholine and TDI challenge tests. RESULTS: Eleven (6.9%) among 170 workers complained of symptoms of occupational asthma, and 7 among these 11 symptomatic workers showed positive responses to the methacholine challenge test (4.1%). One spray painter was confirmed as having the TDI induced occupational asthma following a positive response to TDI challenge test. CONCLUSIONS: The prevalence of TDI-induced asthma was at 0.58% was lower than that for former studies (2-20%). Improved workplace environment, lower level of TDI exposure compared to the past, and the healthy workers effect may have contributed to this low rate of asthma prevalence in workers with TDI exposure.
Asthma ; Asthma, Occupational* ; Mass Screening ; Methacholine Chloride ; Physical Examination ; Prevalence* ; Questionnaires ; Respiratory Function Tests ; Toluene 2,4-Diisocyanate

PURPOSE: Syncope is a common clinical problem. However, diagnosis of the cause of syncope is not simple due to a wide variety of forms of syncope. The aim of this study was to assess current diagnostic methods and the associated medical costs which accompany the evaluation of patients suffering syncope who admitted to an emergency department (ED). METHODS: This study is a prospective, observational, single center study. Patients included in the study visited the ED of a single, tertiary hospital between January and December 2009, and were diagnosed with syncope. We investigated the diagnostic yields (DY) for the tests that were employed and evaluated factors related to medical costs. RESULTS: A total of 124 patients were enrolled in this study. Blood tests, chest radiography, postural blood pressure (BP) measurement and computerized tomography of the brain were performed in over 60% of cases, but DY for each of these tests was less than 3%, except for postural BP measurement (7.4%). The test which demonstrated a relatively high DY was the head-up tilt test (68.1%). The ratio of the cost of each test among the total medical costs required by all patients (constituent ratio) was highest for brain imaging tests (12.2%). The total cost of syncope evaluation per patient was 1,454,000+/-2,865,000 won. Factors including hospital admission and diagnosis of cardiac syncope resulted in significantly higher total medical costs for those patients. CONCLUSION: Among the tests performed in the ED for syncope evaluation, blood tests, chest x-ray and brain imaging tests were commonly used but resulted in relatively low diagnostic yield. Independent factors which increased medical costs were hospital admission and diagnosis of cardiac syncope.
Blood Pressure ; Brain ; Emergencies ; Hematologic Tests ; Humans ; Neuroimaging ; Prospective Studies ; Stress, Psychological ; Syncope ; Tertiary Care Centers ; Thorax

A pandemic influenza A (H1N1) virus strain was isolated from a pig farm in Korea in December 2009. The strain was propagated in and isolated from both the Madin-Darby canine kidney cell line and embryonated eggs. The partial and complete sequences of the strain were identical to those of A/California/04/2009, with >99% sequence similarity in the HA, NA, M, NS, NP, PA, PB1, and PB2 genes. The isolated strain was inactivated and used to prepare a swine influenza vaccine. This trial vaccine, containing the new isolate that has high sequence similarity with the pandemic influenza A (H1N1) virus, resulted in seroconversion in Guinea pigs and piglets. This strain could therefore be a potential vaccine candidate for swine influenza control in commercial farms.
Agriculture ; Animals ; Cell Line ; Eggs ; Guinea Pigs ; Influenza Vaccines ; Influenza, Human* ; Kidney ; Korea* ; Orthomyxoviridae* ; Ovum ; Pandemics* ; Seroconversion ; Swine