No abstract available.
Asthma*

Recurrent zoster myelitis is quite rare. We present a previously healthy 27-year-old woman who developed recurrent attacks of myelopathy shortly after the characteristic skin rashes of herpes zoster. Magnetic resonance imaging studies demonstrated each lesion in the spinal cord at the same segments as the skin lesions. She had two attacks at opposite sites at the same spinal cord level and complete recovery after being treated with intravenous acyclovir. We suspect that direct invasion of varicella zoster virus was the cause of recurrent myelopathy in our patient.
Adult ; Case Report ; Female ; Herpes Zoster/complications* ; Human ; Magnetic Resonance Imaging ; Myelitis/virology* ; Myelitis/diagnosis ; Recurrence

BACKGROUND: Inducible heat shock protein 70s (iHSP70) are expressed by stressful stimuli that result in protein denaturation, and are thought to assist in the maintenance of cellular integrity and viability. In addition, iHSP70 is known to be a sensitive marker of neuronal injury. To my best knowledge, no previous studies have been documented on iHSP70 induction by nociceptive impulse transmission through peripheral nerves not by direct neural damage. The purpose of this study was to examine the hypothesis that iHSP70 can be expressed in the nervous system, which is related to the dental nociceptive pathway, by tooth pulp inflammation. METHODS: The pulp of rat mandibular molars was exposed. Animals were sacrificed at 1, 4, and 7 days after pulpal exposure, and the pulps were evaluated histologically. Also, iHSP70 levels were examined in the Gasserian ganglion (GG) and the trigeminal sensory nucleus (TSN). RESULTS: At 4 days after pulpal exposure, iHSP70 was significantly more expressed in the ipsilateral GG than in the contralateral GG. In the histological study, inflammation was found in the entire pulp tissue at 4 days. There were no significant differences in iHSP70 levels between the ipsilateral TSN and the contralateral TSN. Also, there were no significant differences in iHSP70 expression of GG and TSN between both sides at 1 and 7 days after pulpal exposure. CONCLUSIONS: These results suggest that iHSP70 can be expressed in the GG at 4 days after pulpal exposure by nociceptive impulses due to pulpal inflammation.
Animals ; Heat-Shock Proteins* ; Hot Temperature* ; HSP70 Heat-Shock Proteins* ; Inflammation ; Molar ; Nervous System ; Neurons ; Peripheral Nerves ; Protein Denaturation ; Rats* ; Tooth ; Trigeminal Ganglion

PURPOSE: Diagnosis of a hemodynamically significant patent ductus arteriosus (PDA) that should be treated is difficult to determine by clinical and echocardiographic examination. The purpose of this study is to clarify the usefulness of diastolic flow velocity (DFV) of the left pulmonary artery (LPA) determined by echocardiography in the assessment of significant PDA in preterm infants. METHODS: Clinical and echocardiographic findings, including DFV in LPA, of PDA were evaluated at 24 hours, 48-72 hours of age and after indomethacin treatment in thirty-nine infants ranging from 25 to 34 gestational weeks of age. DFVs of the study group (N=13) with significant PDA were compared with those of healthy control group (N=26) without significant PDA. RESULTS: DFVs in healthy preterm infants were high in the first few days and were significantly decreased after spontaneous ductal closure. DFVs in preterm infants with significant PDA who underwent indomethacin treatment were significantly higher than that of healthy control infants. After indomethacin treatment, DFVs in this study group remained high with continuing significant PDA and markedly decreased with disappearance of significant PDA. Until ductus arteriosus closed, DFVs showed a significant correlation with the magnitudes of ductal shunt. A cutoff value for DFV of 30 cm/sec showed a sensitivity of 77% and a specificity of 92% as a predictor of significnat PDA in preterm infants. CONCLUSION: Measurement of DFV in LPA by echocardiography is a useful method for assessing the significnat PDA which may require treatment in preterm infants.
Diagnosis* ; Ductus Arteriosus ; Ductus Arteriosus, Patent* ; Echocardiography ; Humans ; Indomethacin ; Infant ; Infant, Newborn ; Infant, Premature* ; Pulmonary Artery* ; Sensitivity and Specificity

PURPOSE: Allergic inflammation in the airway of asthmatics was characterized by recruitment and activation of inflammatory cells. The recognition of the underlying inflamatory nature of asthma led to suggestions that early intervention of the airway inflammation by inhaled corticosteroid could provide the key to improve a clinical outcome of asthma treatment in children. The assessment of airway inflammation may be indirectly achieved by measuring inflammatory markers in serum. We have tried to measure ECP, soluble (s) ICAM-1, sVCAM-1, IL-6 and sIL-6 receptor(R) levels in serum of children with acute asthma, to define efficacy of monitoring inflammation with soluble markers and then compare them in two treatment modalities of inhaled salbutamol or combined with budesonide. METHODS: Thirty-five children with acute asthma were randomly classified into two study groups : group I consisted of 17 subjects with inhaled budesonide plus beta-agonist and the 18 subjects of group II with beta-agonis alone. Of two groups, eosinophil, ECP, sICAM-1, sVCAM-1, IL-6 and sIL-6R were quantitatively measured at acute and stable phases in asthma, and the results compared relevantly. RESULTS: 1) The initially elevated levels of the inflammatory markers such as ECP, sICAM-1, sVCAM-1 and sIL-6R except for IL-6 were significantly decreased in stable phase. However, there was no significant difference between two groups in ECP and inflammatory markers in acute asthmatics. 2) The observed reduction in symptom score and %PEFR followed by budesonide nebulization regularily until the improvement of clinical symptom was significant, whereas beta-agonist salbutamol inhalation has less effect on the variables. Interestingly, ECP levels depicted inverse correlation with %PEFR in acute phase of asthma, and ECP and infalmmatory markers were relevant to the clinical symptom in long-term follow-up. 3) There was a trend for some correlation between sICAM-1 and CRP, sVCAM-1 and CRP, but not ECP and IL-6 in two study groups, respectively. CONCLUSION: Treatment with an inhaled steroid plus beta-agonist had significantly caused improvement of clinical symptoms, and the decrements of peak flow variability, eosinophil, ECP, sICAM-1, sVCAM-1 and sIL-6R as potential markers of the airway inflammation, when compared with a group treated with beta-agonist alone. The measurements of ECP and other inflammatory markers may be enormously useful for the evaluation of the successful anti-inflamatory therapy for asthma in children.
Albuterol ; Asthma* ; Budesonide* ; Child* ; Early Intervention (Education) ; Eosinophil Cationic Protein ; Eosinophils ; Follow-Up Studies ; Humans ; Inflammation ; Inhalation ; Intercellular Adhesion Molecule-1* ; Interleukin-6* ; Vascular Cell Adhesion Molecule-1*

With the wide and extensive use of immunosuppressive agents and broad-spectrum antibiotics, opportunistic fungla infections have been increased. Fusarium spp. are known to be significant emerging pathogens of opporthunistic local infection. But very rarely it may cause fatalc systemic infection. A 4-year-old boy with acute lymphocytic leukemia develped asymptomatic disseminated purpura with high fever unresponsive to the antibiotics during chemotherapy. The skin lesions gradually increased in size and number, and prgreassed to forming central necrosis. Many septated hyphae and variable sized spore-like fungal elements are found in the epidrmis, dermis and subcuit on histologic sections. The pathogenic fungus was idenified as Fusarium oxysporum by culture and scanning electronic microscopic findings.
Anti-Bacterial Agents ; Child, Preschool ; Dermis ; Drug Therapy ; Fever ; Fungi ; Fusarium* ; Humans ; Hyphae ; Immunocompromised Host* ; Immunosuppressive Agents ; Male ; Necrosis ; Opportunistic Infections ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Purpura ; Skin

PURPOSE: A feasible palliative care model for advance cancer patients is needed in Korea with its rapidly aging population and corresponding increase in cancer prevalence. This study describes the process involved in the development of a community-based palliative care (CBPC) model implemented originally in a Busan pilot project. MATERIALS AND METHODS: The model development included steps I and II of the pilot project, identification of the service types, a survey exploring the community demand for palliative care, construction of an operational infrastructure, and the establishment of a service delivery system. Public health centers (including Busan regional cancer centers, palliative care centers, and social welfare centers) served as the regional hubs in the development of a palliative care model. RESULTS: The palliative care project included the provision of palliative care, establishment of a support system for the operations, improvement of personnel capacity, development of an educational and promotional program, and the establishment of an assessment system to improve quality. The operational infrastructure included a service management team, provision teams, and a support team. The Busan Metropolitan City CBPC model was based on the principles of palliative care as well as the characteristics of public health centers that implemented the community health projects. CONCLUSION: The potential use of the Busan CBPC model in Korea should be explored further through service evaluations.
Aging ; Busan* ; Chronic Disease ; Humans ; Korea* ; Palliative Care* ; Pilot Projects ; Prevalence ; Public Health* ; Social Welfare

PURPOSE: Bronchial hyperresponsiveness (BHR) is one of the key components of childhood asthma phenotype. Patients with mild asthma may have coexisting severe BHR, although the reasons for this are uncertain. The factors of any relationship between BHR has been identified as a central issue in our understanding of asthma. METHODS: To investigate the factors that determine the presence of BHR in mild childhood asthmatics, 62 children (49 boys and 13 girls) with mild asthma were studied. Patients were characterized by skin prick tests, spirometry and bronchial challenge with methacholine. BHR to methacholine was expressed as the provocative methacholine concentration causing a 20 percent fall in FEV1 (PC20), PC20 value of 8 mg/mL was used as a cut-off for defining a BHR to methacholine. RESULTS: This cohort of 62 children with mild asthma was classified into two groups according to the results of methacholine challenge test (MCT). A positive MCT group was obtained for 33 subjects (53.2 percent). The proportion of children sensitized to house-dust mites (HDM) was significantly higher in the MCT-positive group than the negative one. Results showed a, a positive rate of skin prick test: 47% vs. 23% (P< 0.05) and HDM-specific IgE: 68% vs. 43% (P< 0.05). CONCLUSION: Asthmatics with positive MCT were clearly accompanied by increased sensitization to house-dust mites and reduced small airway calibers. Therefore, sensitization to common aeroallergens and changed small airway calibers might be crucial factors in the successful management of asthma.
Asthma* ; Child* ; Cohort Studies ; Humans ; Immunoglobulin E ; Methacholine Chloride ; Mites ; Phenotype ; Skin ; Spirometry

PURPOSE: The social and economic impact of asthma is remarkable worldwide. To date, there have been many unanswered questions about factors related to asthma progression and persistence. This study focused on possible risk factors for persistent asthma that had developed between infancy and late childhood. METHODS: Sixty-seven children with persistent mild-to-moderate asthma were enrolled in this study. They were classified into 2 groups according to the Global Initiative for Asthma (GINA) guideline 2006: early-onset (<3 years, n=28) and late-onset (>3 years, n=39) asthmatics. All patients were interviewed on the personal and familial history of atopy, breast feeding, parental smoking and the recent use of inhaled corticosteroids. We performed spirometry, and skin prick tests and measured body mass index, serum allergen-specific IgE, serum eosinophil counts and serum ECP in asthmatics. All asthmatics underwent the bronchial challenge by methacholine inhalation and outdoor free running. RESULTS: Risk factors such as eczema and frequent wheezing were more common in early-onset asthmatics than in late-onset asthmatics (P<0.05). However, there was no difference between the 2 groups in the overall incidence of airway hyperresponsiveness (AHR) determined by the PC20 and postexercise decrease of FEV1 (P>0.05). Inhaled corticosteroids were more frequently used in early-onset asthmatics than in late-onset asthmatics (P<0.0001). A reciprocal relationship between FEV1/FVC and the duration of asthma was also detected in persistent asthmatics (n=57, r=-0.398, P=0.002). CONCLUSION: The results of this study suggest that atopic dermatitis and frequent wheezing may be important risk factors for the persistence of asthma and lung function decline from early to late childhood.
Adrenal Cortex Hormones ; Asthma ; Body Mass Index ; Breast Feeding ; Bronchial Provocation Tests ; Child ; Dermatitis, Atopic ; Eczema ; Eosinophils ; Humans ; Immunoglobulin E ; Incidence ; Inflammation ; Inhalation ; Lung ; Methacholine Chloride ; Parents ; Respiratory Sounds ; Risk Factors ; Running ; Skin ; Smoke ; Smoking ; Spirometry

Cutaneous plasmacytosis is characterized by multiple red-brown plaques, mainly on the trunk, that histologically show marked hyperplasia of mature plasma cells with no apparent underlying disease that could cause secondary infiltration by plasma cells. Although well recognized in Japan, this disorder is rare in Korea. We report a case of cutaneous plasmacytosis in a 24-year-old man.
Humans ; Hyperplasia ; Japan ; Korea ; Plasma Cells ; Young Adult