The blue rubber bleb nevus syndrome(CRBNS) is a rare disorder characterized by distinctive vascular malformations of the skin and gastrointestinal tract. The syndrome is associated commonly with iron deficiency anemia due to gastrointestinal bleeding. Most cases are sporadic, although a few have been reported with autosomal dominant inheritance. We report a case with clinical characteristics of the blue rubber bleb nevus syndrome. The patient had typical skin manifestations of the BRBNS and chronic iron deficiency anemia. However, we could not find any gastrointestinal vascular malformations radiologically.
Anemia, Iron-Deficiency ; Blister* ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Nevus* ; Rubber* ; Skin ; Skin Manifestations ; Vascular Malformations ; Wills

BACKGROUND: Vitiligo is an acquired depigmentary disorder characterized by loss of melanocytes from the epidermis. Autografting using the suction blistered epidermis technique is one of the surgical modalities of vitiligo treatment, and has been successfully used by several authots. OBJECTIVE: The purpose of this study was to evaluate the effect of the autografting using the suction blistered epidermis technique for the treatment of vitiligo. METHODS: 142 sites from 39 patients with vitiligo were treated with autografting using the suction blistered epidermis technique. The recipient sites were prepared by freezing with liquid nitrogen of the sites 48 hours prior to grafting. RESULTS: Better results were seen in cases with the following Factors: a) cases where the disease had been present for more than 3 years b) the post-operative period had been Longer than a year c) the Lesional sites of the vitiligo were on the trunk and neck rather than the neck and extremities d) the vitiligo had affected the grabous rather than the hairy areas on the face. However, there were no differences between the clinical types(such as generalized, localized, and segmental) in the success rate of treatment. Preopera'tive PUVA or post operative PUVA also did not affect the statistical results. CONCLUSION: On autografting using the suction blistered epidermis, it is better to select the patients who have had the disease for more than 3 years, and graft the epidermis which has increased melanocytes by preoperative PUVA for good treatment results and even pigmentation.
Autografts* ; Blister* ; Epidermis* ; Extremities ; Freezing ; Humans ; Melanocytes ; Neck ; Nitrogen ; Pigmentation ; Suction* ; Transplantation, Autologous* ; Transplants ; Vitiligo*

PURPOSE: Therapeutic hypothermia (TH) has been a standard treatment for ventricular fibrillation (VF) cardiac arrest survivors to improve neurological outcomes. However, there is a lack of evidence that TH has a neuroprotective effect to asphyxial cardiac arrest, which is one of the most prevalent causes of sudden death besides VF cardiac arrest. We studied whether TH improves the neurological outcomes after resuscitation from asphyxial cardiac arrest. METHODS: We included asphyxial cardiac arrest survivors from January 2002 to December 2010. Clinical and neurological outcome data of 24 consecutive patients undergoing TH were compared with 18 patients who did not undergo TH (11 historical controls and seven refusal of TH by patient's next-of-kin). Neurological outcome was assessed at discharge according to the Cerebral Performance Category scale. The incidence of complications after asphyxial cardiac arrest was compared between the two groups. RESULTS: Baseline characteristics except arterial pH after recovery of spontaneous circulation were not different between the TH group and the non-hypothermic group. Good neurological outcome was similar between the TH group and the non-hypothermic group (8.3% vs 0.0%, p=0.498). The TH group included 18 hypokalemic patients, while non-hypothermic group included eight hypokalemic patients (p=0.044). The rate of other complication did not differ significantly between the two groups. CONCLUSION: Therapeutic hypothermia was not associated with good neurological outcome in asphyxial cardiac arrest survivors and was not associated significantly with the incidence of complications after asphyxial cardiac arrest. However, the findings are not conclusive because of a lack of patients, lack of randomization, and uncertainty of appropriateness of therapeutic hypothermia method to asphyxial cardiac arrest.
Asphyxia ; Coma ; Death, Sudden ; Disulfiram ; Heart Arrest ; Humans ; Hydrogen-Ion Concentration ; Hypothermia ; Hypothermia, Induced ; Incidence ; Neuroprotective Agents ; Random Allocation ; Resuscitation ; Survivors ; Uncertainty ; Ventricular Fibrillation

PURPOSE: Compared to urban areas, access to emergency medical services in rural areas is relatively restricted both in quality and quantity. However, based on the aged population model, the need for such services is greater in rural areas, due to accidents and underlying disease. We set out to investigate whether education for emergency medical services would be helpful for utilization of poor resources for emergency medical services in rural areas and how efficient it might be. METHODS: Goheung (n=796) and Haenam (n=819), which appeared to be similar in terms of area, population composition, and quality and quantity of emergency medical services, were selected. While one area received Life Helper for the Village, one of the educational programs for emergency medical services, the other did not. A questionnaire containing items on recognition of emergency medical services and roles of the primary responder was administered. RESULTS: Significant differences were observed in the recognition of emergency medical services and safety awareness in Goheung, to which education for emergency medical services was provided. However, we did not find a relationship between injury or accident development and education for the rural emergency medical service system in two areas. CONCLUSION: Thus, provision of education is needed for development of common residents into primary responders in alienated rural and fishing villages, offering them ongoing and repeating education in order to increase their recognition of emergency medical services and safety awareness, and expand such education to areas that are in a similar situation.
Aged ; Emergencies ; Emergency Medical Services ; Emigrants and Immigrants ; Humans ; Surveys and Questionnaires

BACKGROUND: It is mandatory to measure the minimal phototoxic dose(MPD) in order to determine adequate irradiation of UV-A in photochemotherapy. However, the measurement of MPD is not easy in some cases due to inadequte size and site of lesions, time and manpower. OBJECTIVE: The purspose of this study was to standardize the minimal phototoxic dose for a vitiliginous lesion. METHODS: The minimal phototoxic dose of UV-A was measured in 82 vitiligo patients. Then we analyzed the MPD according to the sex, age, site of the vitiliginous lesions, duration of disease, and administration route of the photosensitizer. RESULTS: 1. There were no significant differences between exposed and unexposed areas in MPD in both cases of topical and systemic administration of the photosensitiser. 2. There was no significant correlation between disease duration and MPD in both cases of topical and systemic administration of the photosensitiser. 3. In the group of topical application of 8-methoxypsoralen cream, MPD for males and females were 0.53+0.38J/cm2 and 0.48+0.32J/cm2 respectively without significant difference in sex. 4. In the group of systemic administration of 8-methoxypsoralen, there was a significant difference between males and females in MPD. The MPD in males and females were 1.38+0.72J/cm2 and 2.51 + 1.40J/cm2, respectively. 5. In the group of topical application of 8-methoxypsoralen cream, the MPD in 2nd decade patients was the highest(0.80+0.55J/cm2). The MPD had a tendency to decrease gradually as age receded from the 2nd decade. 6. In the group of systemic administration of 8-methoxypsoralen, there was a tendency for the MPD to be increased according to age without statistical significance. 7. MPD in the group systemically administrated with 8-methoxypsoaralen was four-fold to that of the topical application group. CONCLUSION: It may be valuable to keep in mind that there was a statistical differrence in MPD between sexes in systemic administration of the photosensitizer, and that MPD was different according to patients age in the topical application group.
Female ; Humans ; Male ; Methoxsalen ; Photochemotherapy ; Skin* ; Vitiligo

PURPOSE: To detect differentially expressed genes in the patients with uterine cervical cancer during the radiation therapy. MATERIALS AND METHODS: In patients with biopsy proven uterine cervical cancer, we took a tumor tissue just before radiation therapy and at 40 minutes after external irradiation of 1.8 Gy. Total RNAs isolated from non-irradiated and irradiated tumor tissue samples were analyzed using the differential-display reverse transcription-polymerase chain reaction (DDRT-PCR). Complementary DNA (cDNA) fragments corresponding to differentially expressed messenger RNAs(mRNAs) were eluted, and cloned. The differential expression of the corresponding mRNAs was confirmed by reverse northern blot. Differentially expressed cDNA bands were sequenced. Nucleotide sequence data were analyzed in the Gene Bank and EMBL databases via the BLAST network server to identify homologies to known genes or cDNA fragments. Expression pattern of down-regulated clone was examined using RT-PCR in 5 patients undergoing radiotherapy. RESULTS: We identified 18 differentially expressed bands by DDRT-PCR, which were eluted and cloned. There were 10 up-regulated clones and 1 down-regulated clone in reverse northern blot. One cDNA fragment had homology to chemokine receptor CXCR4, four were identified as Human ESTs in the EMBL database in EST clones. Down-regulated CxCa-11 was also down regulated in all patients. CONCLUSION: Using the DDRT-PCR, we have identified 10 up-regulated and 1 down-regulated clone(s) in the patients with uterine cervix cancer during the radiation therapy. The clinical relevance and the functions of these genes will be further investigated.
Base Sequence ; Biopsy ; Blotting, Northern ; Cervix Uteri* ; Clone Cells ; DNA, Complementary ; Expressed Sequence Tags ; Female ; Humans ; Radiotherapy* ; RNA ; RNA, Messenger ; Uterine Cervical Neoplasms

The presence of facial wrinkles can have a significant effect on a person's self image relating to physical appearance and social acceptance. Many treatment modalities for wrinkle reduction, such as surgical method, injection of Botulinum toxin, chemical peeling, and laser peeling have been developed. The resurfacing carbon dioxide laser has recently proved to be a useful and safe tool in the treatment of facial wrinkles. We have attempted to treat pecular perioral wrinkles using a combination of laser and chemical peeling techniques. This combination treatment has resulted in a good cosmetic appearance. We report and encourage use of this method for wrinkle reduction.
Botulinum Toxins ; Lasers, Gas ; Social Distance

Transglutaminase is an calcium dependent enzyme involved in various biological events such as cell growth and proliferation, apoptosis, fertilization, embryogenesis, and carcinogenesis. Biochemically it can be detected in many organs but no systemic in situ localization has been carried out so far. In the present study we report the immuno-histochemical localization of TG1, 2, 3 in rat kidney tissue using newly purificated polyclonal anti-goat traglutaminase 1 and anti-rabbit polyclonal transglutaminase 2 or 3 antibody. The results are as follows 1. The presence of transglutaminase 1, 2 and 3 was demonstrated in the both renal cortex and renal medulla of the rat. Although the in situ localization patterns were very similar, strength of the immunoreactivity was different; transglutaminase 1, 2, 3 in order. 2. More strong immunoreactivity for transglutaminase 1, 2, 3 were detected in the renal tubule than the renal glomerulus. 3. The strong immunoreactivity was demonstrated in the capsule, brush border of proximal convoluted tubule and collecting duct and thin limb of Henle's loop. The functional implications of these findings are presently unknown. However, based on its wide distribution in the renal tubule, certain essential role of these enzymes in maintaining the electrolytes balance may be suggested.
Animals ; Apoptosis ; Calcium ; Carcinogenesis ; Electrolytes ; Embryonic Development ; Extremities ; Female ; Fertilization ; Immunohistochemistry ; Kidney* ; Microvilli ; Pregnancy ; Rats*

The Korea National Health and Nutrition Examination Survey (KNHANES) is a national program designed to assess the health and nutritional status of the noninstitutionalized population of South Korea. The KNHANES was initiated in 1998 and has been conducted annually since 2007. Starting in the latter half of 2008, ophthalmologic examinations were included in the survey in order to investigate the prevalence and risk factors of common eye diseases such as visual impairment, refractive errors, strabismus, blepharoptosis, cataract, pterygium, diabetic retinopathy, age-related macular degeneration, glaucoma, dry eye disease, and color vision deficiency. The measurements included in the ophthalmic questionnaire and examination methods were modified in the KNHANES IV, V, and VI. In this article, we provide detailed information about the methodology of the ophthalmic examinations in KNHANES in order to aid in further investigations related to major eye diseases in South Korea.
*Epidemiologic Methods ; Eye Diseases/*epidemiology ; Humans ; Nutrition Surveys/*statistics & numerical data ; Ophthalmology/*methods ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; *Surveys and Questionnaires

BACKGROUND: The manifestation of Membranoproliperative glomerulonephritis (MPGN) is variable from asymptomatic hematuria, nephrotic syndrome to advanced chronic kidney disease. The etiology, pathogenesis, and treatment of MPGN are unclear. The incidence of idiopathic MPGN is also rare in Korea, and the clinical course was rarely studied. So we investigated clinical course of idiopathic MPGN type 1. METHODS: From March 1990 to November 2004, renal biopsy was done in about 1500 patients in Dong-A universty hospital. Among them, 16 patients were diagnosed as idiopathic MPGN. Fourteen patients were observed over 6 months. We analyzed clinical data of these patients retrospectively. RESULTS: Male to female ratio of total 16 patients is 2.2:1. Mean age of patients was 37.6 years (14-76 years) at the time of diagnosis. Thirteen cases (81%) had nephrotic range proteinuria, 8 cases (50%) had hypertention, 12 cases (75%) had edema, and 4 cases (25%) had decreased renal fuction (serum creatinine>1.2 mg/dL) at the time of diagnosis. Average observation time was 55.7+/-37.4 (6-122)months. Six cases ended up with progressive renal failure. Three cases achieved complete remission. Renal survival time for 50% of cases was 92 months. In our study, edema and decreased renal fucntion at the time of diagnosis were related with later development of progressive renal failure (p<0.05). Of the total 14 cases, 4 cases ware treated conservatively, 6 cases were treated with anti-platelet agents, and 4 cases were treated with anti-platelet agents and prednisone. In conservative treatment group, 1 case ended up with progressive renal failure and 1 case achieved complete remission. In anti-platelet agents treatment goup, 4 cases ended up progressive renal failure. In combined anti-platelet agents and prednisone treatment group, 1 case ended up progressive renal failure and 2 cases achieved complete remission. However, the effect of each treatment is inconclusive because the number of the patients are too small. CONCLUSIONS: We suspect that deceased renal function and edema at the time of diagnosis may be risk factor predicting progressive renal failure in patients with idiopathic MPGN type 1.
Biopsy ; Diagnosis ; Edema ; Female ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative* ; Hematuria ; Humans ; Incidence ; Korea ; Male ; Nephrotic Syndrome ; Prednisone ; Proteinuria ; Renal Insufficiency ; Renal Insufficiency, Chronic ; Retrospective Studies ; Risk Factors