BACKGROUND: Beta-adrenergic receptor Kinase 1(betaARK1) is a serine/threonine kinase attached, which inhibits the coupling of beta-adrenergic receptor with G-protein. Myocardial betaARK1 level is usually elevated in heart failure and hypertrophy, but it is not known whether the circulating betaARK1 level is related with the degree of cardiac hypertrophy. This study was performed to evaluate the association of the betaARK1 level in circulating mononuclear leukocytes(MNL) in untreated hypertension with left ventricular mass in hypertensive patients. Method: Nineteen non-treated hypertensive patients were included for this study. High blood pressure was confirmed when systolic BP is over 150 mmHg or diastoli BP is over 95 mmHg. Echocardiography was performed to evaluate the degree of hypertrophy by measuring the left ventricular mass index(LVMI) and relative wall thickness(RWT), and test the LV function by measuring the ejection fraction(EF) according to ASE guideline. At the same time, blood was collected from each patient and MNL were isolated by gradient centrifuge with Ficoll-400. Total RNA was purified from MNL and semi-quantitative RT-PCR was performed. After reverse transcription, PCR was done with primers for human betaARK1 and GAPDH as external control. betaARK1 levels were expressed by ratio to GAPDH level and estimated the relations with clinical and Echocardiographic parameters. Result: We studied confirmed 19 hypertensive patients(10 men and 9 women, mean age of 50.6 years). Echocardiographically measured indices(mean+/-SD) were as follows; LVMI(137.3+/-30.6g/m2), PWT(0.53+/-0.09) and EF(54.6+/-8.5%). Ratio of betaARK1 levels to GAPDH was from 0.10 to 0.96 (0.62+/-0.25). betaARK1 levels were correlated with LVMI(correlation coefficient: r=.502, p=.029) and RWT(r=.627, p=.004). But Systolic BP(r=0.009, p=.93), diastolic BP(r=.07, p=.85) or EF(r=.045, p=.84) were not related to level of betaARK1. CONCLUSIONS: The betaARK1 level of circulating MNL was correlated well with the degree of the cardiac hypertrophy estimated by LVMI and RWT. This data suggests that activation of sympatho-adrenal system would exert a major role in developing cardiac hypertrophy and we can expect the decreased responsiveness to catecholamine in the heart of hypertensive patients. betaARK1 in circulating MNL might be used as a predictor or marker for LV hypertrophy in hypertensive patients.
beta-Adrenergic Receptor Kinases ; Cardiomegaly ; Echocardiography ; Female ; GTP-Binding Proteins ; Heart ; Heart Failure ; Humans ; Hypertension ; Hypertrophy ; Leukocytes, Mononuclear* ; Male ; Phosphotransferases ; Polymerase Chain Reaction ; Reverse Transcription ; RNA

BACKGROUND: To assess the myocardial perfusion state after myocardial infarction, Tl-201 SPECT (Thallium-201 Single Photon Emission Computed Tomography) with a repeated "booster" injection before the acquisition of delayed redistribution image is more sensitive and more effective than conventional 4 hour redistribution image. However, this protocol has several disadvantages such as patient inconvenience, additional Tl-201 dose and compromised quantitative analysis. In this study, we compared 4 hour nitrate-augmented redistribution protocol with standard 24 hour delayed redistribution protocol with reinjection to evaluate the usefulness of sublingual nitrate to augment myocardial perfusion and the effectiveness of myocardial assessment for each protocol. METHODS: In 20 myocardial infarction patients, stress-redistribution Tl-201 SPECT was performed. Immediately after resting redistribution image was taken, each patient was administered 0.6 mg of nitroglycerin sublingually without additional Tl-201 and nitrate-augmented SPECT was taken after 30 minutes. Each patient then returned the next day and was injected with a booster dose of Tl-201 30 minutes before the delayed redistribution SPECT acquisition. For the analysis of SPECT study, the myocardium was divided into 22 segments, and the perfusion to each segment was scored on a four-point scale by consensus. An overall cardiac perfusion score was derived by summing the perfusion score for each segment. RESULTS: Reduced stress perfusion was identified in 258 segment among total 440 segments: 61 (23.6%) had improved perfusion after rest redistribution; 145 (56.2%) had improved perfusion after nitrate-augmented redistribution; 140 (54.2%) had improved perfusion after 24 hour delayed redistribution after Tl-201 reinjection. The cardiac perfusion score after stress was 38.2+/-13.1. The score increased to 41.5+/-13.1 after rest redistribution. The perfusion score were improved to 46.3+/-10.4 (p< or =0.05 vs. rest redistribution) after nitrate augmentation. The cardiac perfusion score, 46.2+/-10.8, did not improve further after delayed redistribution. CONCLUSION: Tl-201 SPECT with sublingual nitrate-augmented redistribution is as same or better than 24-hour delayed redistribution with reinjection to detect viable myocardium. Therefore, Tl-201 SPECT with sublingual nitrate-augmented redistribution has economic and time sparing advantage over traditional 24 hour delayed redistribution with reinjection.
Consensus ; Humans ; Myocardial Infarction ; Myocardium* ; Nitroglycerin ; Perfusion* ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: Vitiligo is a relatively common acquired depigmentating disorder that affects at least 1 % of the population. The mode of transmission has not been clearly,stablished, but either polygenic or autosomal dominant with incomplete penetrance and variable expresion has been proposed. OBJECTIVE: Our purpose was to evaluate the causative factor, variable clinical features and current teratment of generalized vitiligo patients. METHOD: This clinical in vestigation was made with 225 outpatiens of generalized type vitiligo who had visited the Department of Dermatology, Keirnyung Universitv Hospital from January 1987 till December 1991. Results & CONCLUSION: 1. There were 125 female, (55.5%) and 100 males(44.4%). 2. The mean age of onset was 21.4 years(male . 24.3, female: 19.1). 3. The mean age at the first visit was 27.5 years (male : 28.8, female : 26.5). 4. The mean duration of the disease was 10.7 years(male : 9.9, female : 10.9). 5. The mean interval between onset and visiting was 6.1 years (male : 4.5, female : 7.4). 6. The most common sites of involvernent at the first visit was tie face 11.7% (male : 11.4%, female : 11.8%). 7. The most common precipitating factor was trauma(8.8%). 8. The most common previous treatment was sunlight irradiaion after application of topical oxoralene(33.2%). 9. The most common degree of depigmented lesion was 5-10%(64.4%). 10. The most common occupations of the patients were students mals, and housewife females.
Age of Onset ; Dermatology ; Female ; Humans ; Occupations ; Penetrance ; Precipitating Factors ; Sunlight ; Vitiligo*

No abstract available.
Humans

PURPOSE: Serum total and specific IgE levels have been widely used to diagnose allergic disease. However, it has recently been suggested that serum total IgE does not properly reflect specific IgE. Therefore, we evaluated the clinical significance of serum total IgE in pediatric allergic disease. METHODS: This study included 633 patients who visited Kyungpook National University Children's Hospital between March 2013 and April 2015. We used immunoCAP, an inhalant multiple allergen simultaneous test (MAST), and food MAST to measure specific IgE. We used a skin prick test in some patients and measured serum total IgE, eosinophil count, and serum eosinophil cationic protein in all patients. RESULTS: There was a positive correlation between serum total IgE and antigen level in the inhalant immunoCAP test. Specifically, the sum of immunoCAP levels was highly correlated with serum total IgE (r=0.631, P<0.001). Moreover, there was a positive correlation between serum total IgE and the sum of food immunoCAP levels (r=0.323, P<0.001). Among the food immunoCAP antigens, milk was highly correlated with serum total IgE (r=0.558, P<0.001). There was a positive correlation between serum total IgE and the sum of class levels of inhalant/food MAST tests (r=0.709, P<0.001 and r=0.686, P<0.001, respectively). There was also a positive correlation between serum total IgE and the number of positive skin prick tests (r=0.445, P<0.001). CONCLUSION: Serum total IgE may reflect the sum of serum specific IgE levels in pediatric allergic disease.
Eosinophil Cationic Protein ; Eosinophils ; Gyeongsangbuk-do ; Humans ; Immunoglobulin E* ; Milk ; Skin

Mycoplasma pneumoniae pneumonia is one of the most prevalent community-acquired pneumonias in pediatric patients. It commonly presents with mild respiratory symptoms and is well controlled by macrolide antibiotics. Rarely, it can progress to acute respiratory distress syndrome (ARDS) despite appropriate antibiotic therapy, and systemic corticosteroids and quinolone antibiotics are required. We recently treated 2 patients who presented with M. pneumoniae pneumonia with ARDS. Case 1: A 17-year-old girl was admitted with pneumonia that showed no response to antibiotics and progressed to ARDS, which required initiation of mechanical ventilation therapy. The patient was negative for M. pneumoniae IgM; but positive for, M. pneumoniae. After treatment with methylprednisolone and levofloxacin, rapid improvement was observed in both clinical manifestations and chest radiographic findings. Two days after discontinuing a 5-day methylprednisolone treatment regimen, she developed fever, and investigations revealed an elevated C-reactive protein level; this necessitated additional methylprednisolone treatment. Subsequently, she showed complete recovery with no sequelae. Case 2: A 14-year-old girl was admitted with M. pneumoniae pneumonia with ARDS that required mechanical ventilation therapy. She showed a IgM titers against M. pneumoniae of 1:320. After treatment with antibiotics and methylprednisolone, she recovered and was discharged at 48 admission days; however, mild dyspnea persisted. The chest computed tomography showed multiple bronchiectasis areas. After 15 days, because of aggravated dyspnea, she was readmitted and adminis-tered methylprednisolone pulse therapy. Despite 3 courses of methylprednisolone pulse therapy, she still showed mild dyspnea.
Adolescent ; Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Bronchiectasis ; C-Reactive Protein ; Child ; Dyspnea ; Female ; Fever ; Humans ; Immunoglobulin M ; Levofloxacin ; Methylprednisolone ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma* ; Radiography, Thoracic ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult* ; Thorax

Currently used methods for collecting nasal-specific immunoglobulin E (IgE) require administration of a large amount of saline into the nostrils, which is difficult in children. We designed two methods that are easy to use in children. We measured nasal-specific IgE and evaluated clinical characteristics of nasal-specific IgE in pediatric rhinitis. This study included 82 patients who visited Kyungpook National University Children's Hospital from December 2014 to July 2016 with rhinitis symptoms. Thirty patients used the spray method, and 52 patients used the swab method. We examined nasal-specific IgE to Dermatophagoides farinae, Dermatophagoides pteronyssinus, Alternaria, birch, and weed mix. Thirty patients had nasal-specific IgE concentrations of ≥ 0.35 kIU/L. There was a positive correlation between nasal-specific IgE and serum-specific IgE to D. farinae and D. pteronyssinus (r = 0.548, P < 0.001; r = 0.656, P < 0.001). If we regard positivity of skin prick test as standard, cutoff point of nasal-specific IgE to D. farinae was 0.11 kIU/L and to D. pteronyssinus was 0.12 kIU/L. Based on these cutoff points, five patients would be considered to have local allergic rhinitis. The methods showed relatively high positivity for nasal-specific IgE, which reflected the serum-specific IgE as well. These methods can be considered to diagnose local allergic rhinitis in children.
Alternaria ; Betula ; Child ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Gyeongsangbuk-do ; Humans ; Immunoglobulin E* ; Immunoglobulins* ; Methods ; Rhinitis ; Rhinitis, Allergic ; Skin

PURPOSE: Children and adolescent have high prevalences of allergic rhinitis (AR) and nonallergic rhinitis (NAR) as well as adult. The purpose of this study was to assess the symptomatic differences between AR and NAR in children. METHODS: This study included 138 patients with 2 or more of rhinitis symptoms, including rhinorrhea, nasal obstruction, nasal itching, and sneezing for over 1 hour on most days who visited Kyungpook National University Children's Hospital between March 2013 and June 2014. The levels of total IgE, specific IgE, eosinophil cationic protein, peripheral blood eosinophil count, and the skin prick test were carried out. All the patients or parents were asked to fill out a rhinitis symptom questionnaire and contents were rechecked by physician during the consultation. The symptoms of rhinorrhea, sneezing, nasal itching, nasal obstruction and eye itching were checked. Family history and comorbidity were also evaluated. RESULTS: Ninety-one patients were diagnosed with AR, 47 patients with NAR. Their age ranged from 1 to 16 years. AR patients had more sneezing, nasal pruritus and eye symptoms than NAR patients (P=0.003, P=0.036, and P=0.003, respectively). CONCLUSION: This study shows that the several symptomatic differences may help to diagnose the AR. It will be helpful in establishing diagnostic and treatment plans for rhinitis patients before allergic tests.
Adolescent ; Adult ; Child* ; Comorbidity ; Eosinophil Cationic Protein ; Eosinophils ; Gyeongsangbuk-do ; Humans ; Immunoglobulin E ; Nasal Obstruction ; Parents ; Prevalence ; Pruritus ; Rhinitis* ; Rhinitis, Vasomotor ; Skin ; Sneezing

PURPOSE: Previous studies have reported that clinical efficacy of steroid therapy for acute bronchiolitis is controversial. However, since it is still frequently used in clinical practice, we sought to re-evaluate its effectiveness. METHODS: This study included 277 children with acute bronchiolitis who were admitted to Kyungpook National University Children's Hospital from March 2013 to July 2016. Erythrocyte sedimentation rates, C-reactive protein (CRP) levels, and viral polymerase chain reaction testing results were obtained, and respiratory rate (RR) was measured periodically. Forty-eight patients were treated with an intravenous (IV) steroid (17.3%, IV group) and 19 patients were treated with a per oral (PO) steroid medication (6.9%, PO group). The remaining 210 patients were steroid-free patients (74.2%, nonsteroid group). RESULTS: RR and CRP levels were higher in the IV group, along with a longer hospitalization period and duration of wheezing. The rate of change from the fastest initial RR to the mean RR on the first treatment day was greatest in the IV group; this finding was statistically significant after controlling for initial RR (16.06% in the IV group, 3.94% in the PO group, 4.90% in the nonsteroid group; P < 0.01). CONCLUSION: There was a trend of IV steroid treatment toward more severe bronchiolitis. A significant reduction in RR on the first day of steroid treatment was observed in IV steroid-treated patients. IV steroid therapy may play a positive role in initial RR stabilization for severe bronchiolitis.
Blood Sedimentation ; Bronchiolitis* ; C-Reactive Protein ; Child ; Gyeongsangbuk-do ; Hospitalization ; Humans ; Polymerase Chain Reaction ; Respiratory Rate ; Respiratory Sounds ; Retrospective Studies* ; Treatment Outcome

Tailgut cysts are known to originate from the remnants of the embryonic hindgut. They occur exclusively in the retrorectal and presacral spaces. There have been limited reports of tailgut cysts occurring in the left perirenal space. The present case features a huge tailgut cyst extending from the right perirenal to the perivesical space. We believe that this case report will help to further elucidate the characteristics of perirenal and perivesical tailgut cysts.