No abstract available.
Scleroderma, Localized

Churg-Strauss syndrome (CSS) or allergic granulomatosis angiitis is a rare primary vasculitic disease. CSS can be diagnosed by the presence of any four or more of the six criteria, which include asthma, eosinophilia greater than 10%, paranasal sinusitis, pulmonary infiltration, histological proof of vasculitis and mono- or poly-neuropathy. We report here on a 45-year-old male who developed erythematous macules, papules and hemorrhagic vesicles on both right extremities along with a tingling sensation and sacral pain. He has been suffering from recurrent allergic rhinitis and bronchial asthma for 6 months. The laboratory findings showed severe eosinophilia (22.3%), hyper-IgE and positivity for p-ANCA. On the histological examination of the hemorrhagic vesicle on the right lower leg, leukocytoclsatic vasulitis and many neutrophils and eosinophils around the cutaneous vessels were observed in the dermis.
Antibodies, Antineutrophil Cytoplasmic ; Asthma ; Churg-Strauss Syndrome ; Dermis ; Eosinophilia ; Eosinophils ; Extremities ; Humans ; Leg ; Male ; Middle Aged ; Neutrophils ; Rhinitis ; Rhinitis, Allergic, Perennial ; Sensation ; Sinusitis ; Stress, Psychological ; Vasculitis

PURPOSE: This study was done to identify the risk factors influencing suicidal ideation in Korean elders. METHODS: Data from the Korean national health & nutrition examination survey 2007 collected by the Korean Center for Disease Control were analyzed using chi2 test and t-test. RESULTS: Differences in suicidal ideation according to individual factors were as follows: gender, education status, recognition of stress, experience of depression, and smoking. Differences in suicidal ideation according to health related factors were as follows: subjective health status, EQ-5D (EuroQoL-5 Dimensions), and restriction of activity. Differences in suicidal ideation according to family related factors were as follows: spouse, and status of dietary life. CONCLUSION: The findings suggest that board intervention programs should be provided to prevent problems of suicidal ideation. It is also recommended that programs be developed that can help control the variables identified in this study along with follow up study to verify the model.
Centers for Disease Control and Prevention (U.S.) ; Depression ; Education ; Humans ; Risk Factors ; Smoke ; Smoking ; Spouses ; Suicidal Ideation ; Suicide ; Thinking

BACKGROUND: Cardiac tamponade is associated with the expiratory increase and the expira-tory decrease in left ventricular filling flow. With Doppler echocardiography, we analyzed the respiratory variations of mitral and tricuspid inflows, and pulmonary and hepatic venous flows in patients with cardiac tamponade. METHODS: Respiratory hemodynamic changes in mitral and tricuspid inflows and pulmonary and hepatic venous flows were evaluated using Doppler echocardiography in 13 patients (6 men and 7 women; mean age 51+/-13 years) with large pericardial effusion and clinical cardiac tamponade, and compared the results with those of 11 control subjects (3 men and 8 women, mean age 53+/-13 years). Doppler examination was repeated after pericardiocentesis in 6 patients. RESULTS: Peak velocity of early diastolic mitral inflow (E velocity) decreased during inspiration compared with expiratory increase; the mean percentage change was 40%. Peak velocity of late diastolic mitral inflow (A velocity) decreased 13% during inspiration. E/A ratio decreased 31% during inspiration. Deceleration time (DT) and isovolumic relaxation time (IVRT) increased by 26% and 44%, respectively, during inspiration. But respiratory variations of tricuspid inflow were opposite to those of mitral inflow. Tricuspid E velocity increased during inspiration and decre-ased during expiration. The mean percentage change was 123%, which was larger than thte 40% of mitral inflow. The most characteristic findings of pulmonary venous flow during respiration were the expiratory increases of peak diastolic velocity (DV) and diastolic time-velocity integral (D-TVI). The mean percentage changes of peak systolic velocity (SV), DV and D-TVI during respiration were 27%, 45% and 53% respectively. In contrast, the SV and DV of hepatic venous flow increased during inspiration and decreased during expiration. The respiratory variations of peak systolic reverse flow velocity (SR) and peak diastolic reverse flow velocity (DR) were opposite to those of SV and DV. DR notably increased during expiration, and the mean percentage change was 61%. The ratio of RFI (Inspiratory reverse flow integral) to FFI (forward flow integral) of the tamponade group was 270%. The mean percentage changes of each parameters decreased after pericardiocentesis. CONCLUSION: Patients with cardiac tamponade showed inspiratory increases of diastolic tri-cuspid filling flow and hepatic forward flow. Expiratory increases included diastolic mitral filling flow, pulmonary venous systolic and diastolic flow, and hepatic venous reverse flow. Such res-piratory variations decreased after pericardiocentesis.
Cardiac Tamponade* ; Deceleration ; Echocardiography* ; Echocardiography, Doppler ; Female ; Hemodynamics ; Humans ; Male ; Pericardial Effusion ; Pericardiocentesis ; Relaxation ; Respiration

Ribes fasciculatum var. chinense MAX. (R. fasciculatum) has traditionally been used in Korea to treat inflammatory diseases. However, the exact mechanism that accounts for the anti-inflammatory effect of R. fasciculatum is not completely understood. We aimed to ascertain the pharmacological effects of R. fasciculatum on both compound 48/80- or histamine-induced scratching behaviors and 2, 4-dinitrochlorobenzene (DNCB)-induced atopic dermatitis (AD) in mice. Additionally, to find a possible explanation for the anti-inflammatory effects of R. fasciculatum, we evaluated the effects of R. fasciculatum on the production of inflammatory mediators in LPS-stimulated macrophage cells. Treatment of R. fasciculatum significantly reduced compound 48/80- or histamine-induced the pruritus in mice. R. fasciculatum attenuated the AD symptoms such as eczematous, erythema and dryness and serum IgE levels in AD model. Additionally, R. fasciculatum inhibited the production of tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6). The maximal rates of TNF-alpha and IL-6 inhibition by R. fasciculatum (1 mg/ml) were approximately 32.12% and 46.24%, respectively. We also showed that R. fasciculatum inhibited the activation of nuclear factor-kappa B in LPS-stimulated macrophages. Collectively, the findings of this study provide us with novel insights into the pharmacological actions of R. fasciculatum as a potential molecule for use in the treatment of allergic inflammatory diseases.
Animals ; Dermatitis, Atopic ; Erythema ; Immunoglobulin E ; Inflammation* ; Interleukin-6 ; Korea ; Macrophages ; Mice ; Pruritus ; Ribes* ; Tumor Necrosis Factor-alpha

Emerging evidences have reported that periodontitis can be a risk factor for the pathogenesis of various systemic diseases. Porphyromonas gingivalis (Pg), one of the crucial pathogens in chronic periodontitis, has been spotlighted as a potential cause for the promotion and acceleration of periodontitis-associated systemic disorders. To investigate the association between Pg and intestinal disease or homeostasis, we treated Pg-derived lipopolysaccharide (LPS) in murine colitis model or intestinal organoid, respectively. Pg-derived LPS (Pg LPS) was administrated into chemically induced murine colitis model and disease symptoms were monitored compared with the infusion of LPS derived from E. coli (Ec LPS). Organoids isolated and cultured from mouse small intestine were treated with Pg or Ec LPS and further analyzed for the generation and composition of organoids. In vivo observations demonstrated that both Pg and Ec LPS exerted slight protective effects against murine colitis. Pg LPS did not affect the generation and growth of intestinal epithelial organoids. Among subtypes of epithelial cells, markers for stem cells, goblet cells or Paneth cells were changed in response to Pg LPS. Taken together, these results indicate that Pg LPS leads to partial improvement in colitis and that its treatment does not significantly affect the self-organization of intestinal organoids but may regulate the epithelial composition.
Acceleration ; Animals ; Chronic Periodontitis ; Colitis ; Epithelial Cells ; Goblet Cells ; Homeostasis ; Intestinal Diseases ; Intestinal Mucosa ; Intestine, Small ; Mice ; Organoids ; Paneth Cells ; Periodontitis ; Porphyromonas gingivalis ; Porphyromonas ; Risk Factors ; Stem Cells

PURPOSE: Oral cavity or other head and neck inflammation may invade the orbit because paranasal sinuses are close to the orbital wall. The authors report a case of orbital abscess and central retinal artery occlusion followed by orbital invasion of the abscess after tooth extraction. METHODS: A 61-year old woman complained of persistent dental abscess and sudden visual loss for 2 weeks following tooth extraction. We performed a brain MRI (Magnetic Resonance Imaging) and an orbit CT (Computed Tomography) that revealed orbital cellulitis and orbital abscess. On fundus exam, cherry-red spot and retinal edema were noticed. RESULTS: Although ocular symptoms were improved with intravenous antibiotic therapy and surgical intervention, there was no recovery of visual acuity. CONCLUSIONS: Visual loss can be associated with delayed treatment in the case of orbital abscess. Therefore early diagnosis and proper treatment of orbital invasion following dental abscess is crucial for the recovery of vision.
Abscess* ; Brain ; Early Diagnosis ; Female ; Head ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Middle Aged ; Mouth ; Neck ; Orbit ; Orbital Cellulitis ; Papilledema ; Paranasal Sinuses ; Retinal Artery Occlusion* ; Retinal Artery* ; Tooth Extraction ; Visual Acuity

Facial asymmetry can be classified into the rolling-dominant type (R-type), translation-dominant type (T-type), yawing-dominant type (Y-type), and atypical type (A-type) based on the distorted skeletal components that cause canting, translation, and yawing of the maxilla and/or mandible. Each facial asymmetry type represents dentoalveolar compensations in three dimensions that correspond to the main skeletal discrepancies. To obtain sufficient surgical correction, it is necessary to analyze the main skeletal discrepancies contributing to the facial asymmetry and then the skeletal-dental relationships in the maxilla and mandible separately. Particularly in cases of facial asymmetry accompanied by mandibular yawing, it is not simple to establish pre-surgical goals of tooth movement since chin deviation and posterior gonial prominence can be either aggravated or compromised according to the direction of mandibular yawing. Thus, strategic dentoalveolar decompensations targeting the real basal skeletal discrepancies should be performed during presurgical orthodontic treatment to allow for sufficient skeletal correction with stability. In this report, we document targeted decompensation of two asymmetry patients focusing on more complicated yaw-dependent types than others: Y-type and A-type. This may suggest a clinical guideline on the targeted decompensation in patient with different types of facial asymmetries.
Chin ; Facial Asymmetry* ; Humans ; Mandible ; Maxilla ; Orthognathic Surgery ; Tooth Movement

PURPOSE: The aim of this study was to evaluate the radiological and clinical outcomes of scarf osteotomy for hallux valgus (HV) deformity in elderly patient with osteoporosis. MATERIALS AND METHODS: A total of 58 elderly patients (mean age, 72.6 years) underwent scarf osteotomy for HV deformity between 2008 and 2015. The mean follow-up period was 24.4 months. Of the 58 patients, 42 were diagnosed with osteoporosis and 16 were diagnosed as normal. The radiological and clinical outcomes were assessed preoperatively, postoperatively, and at final follow-up, including HV angle, intermetatarsal (IM) angle, American Orthopaedic Foot and Ankle Society (AOFAS) score, patient satisfaction, visual analogue scale (VAS), and complication. RESULTS: There was no significant difference in HV angle and IM angle between the osteoporosis group and normal bone mineral densitometry group at all time points, preoperative, postoperative, and final follow-up. Moreover, there was no statistically significant difference between the two groups with respect to the AOFAS score and VAS evaluations. In the osteoporosis group, the mean HV angle improved from 36.7° preoperatively to 11.3° at the time of final follow-up, and the mean IM angle improved from 13.2° to 5.7°. The mean AOFAS score improved from 52.6 preoperatively to 89.1 at the time of final follow-up. With respect to satisfaction, 83.4% of patients were very satisfied or satisfied. There were no serious complications, and all cases showed complete union at the osteotomy site. CONCLUSION: We believed that scarf osteotomy is a safe, effective procedure for the correction of elderly patients with osteoporosis.
Aged* ; Ankle ; Congenital Abnormalities ; Densitometry ; Follow-Up Studies ; Foot ; Hallux Valgus* ; Hallux* ; Humans ; Miners ; Osteoporosis* ; Osteotomy* ; Patient Satisfaction

BACKGROUND: Obligatory continuing medical education was applied by medical law for lifelong education to Physicians in Korea. A new method of continuing medical education was needed because of wide -spread and easy access to internet which resulted in improved public knowledge medicine, and appearance of a new internet site for doctor's continuing medical education. METHODS: A questionnaire was sent twice by mail and fax to randomly selected 256 office based family physicians in Seoul and Kyonggi Province in May 2001 and 124 available responses were received. RESULTS: The response rate to the questionnaire was 60.77, Median studying time Per week for the past one year of the responders was 3 hours and there was no significant correlation studying time per week with duration in practice, age, sex, or internet accessibility at clinic. The group with more than or equal to 6 years in duration of practice was significantly more than the group with less than or equal to 6 years in number of subscribing medical journals (P=0.001), number of participating academic conferences (P=0.027) , number of participating lectures for office based physicians (P=0.001) and points of formal continuing medical education (P=0.002). The practice pattern change after attendance was 51.3% in 5years or less in duration of Practice, 42.7% in 6years or more. Main causes of being reluctant to attend continuing medical education activities were'no practical content' and' long distance'. CONCLUSION: For the improvement of quality of care by continuing medical education, practical program applicable to the clinical practices should be developed and continuing medical education activities be carried out in various areas.
Congresses as Topic ; Education ; Education, Medical, Continuing* ; Gyeonggi-do ; Humans ; Internet ; Jurisprudence ; Korea ; Lectures ; Physicians, Family* ; Postal Service ; Seoul ; Surveys and Questionnaires