PURPOSE: The effective management of atopic dermatitis (AD) adjusted to individual clinical courses and demands can be challenging to both patients and physicians. Understanding of actual situations, experienced and perceived by patients with AD and their caregivers, is essential to improve clinical outcomes and satisfaction in real practice. METHODS: This multicenter survey was conducted in patients with AD or their caregivers from 9 centers with questionnaires on diagnosis and management of AD. RESULTS: A total of 324 patients and caregivers participated in the study. Most of the AD cases were initially diagnosed by physicians (80.6%), followed by self-diagnosis. Patients and caregivers thought that allergic substances, such as house dust mites, food, and pollutants, are responsible for AD development; moisturization, environmental control, and improvement of the body constitution are important for AD management. Allergy tests were performed in 194 patients (59.9%), but allergen avoidance strategy was instructed in only 81 subjects (41.8%). Major topical medications were steroids (81.8%) and topical immunomodulators (34.3%), while systemic medications were steroids (42.6%), antihistamines (36.4%), and cyclosporins (2.8%). One hundred eighty-one subjects (55.9%) had received complementary alternative medicine, including Oriental medicine. Many subjects desired to receive individualized management, use of specialized institutions for AD as well as evidence-based, effective, sustainable treatment. CONCLUSION: Our findings suggest that there may still be an unmet need for patients with AD in real practice. Personalized, evidencebased, and multidisciplinary approaches, including patient education, should be implemented for good outcomes.
Body Constitution ; Caregivers ; Complementary Therapies ; Cyclosporine ; Cyclosporins ; Dermatitis, Atopic* ; Diagnosis ; Histamine Antagonists ; Humans ; Hypersensitivity ; Immunologic Factors ; Korea* ; Medicine, East Asian Traditional ; Patient Education as Topic ; Pyroglyphidae ; Steroids

PURPOSE: We aimed to evaluate the histologic and radiologic findings of vascular lesions after stereotactic radiosurgery (SRS) categorized as radiation-induced cavernous hemangioma (RICH). MATERIALS AND METHODS: Among 89 patients who underwent neurosurgery for cavernous hemangioma, eight RICHs from 7 patients and 10 de novo CHs from 10 patients were selected for histopathological and radiological comparison. RESULTS: Histologically, RICHs showed hematoma-like gross appearance. Microscopically, RICH exhibited a hematoma-like area accompanied by proliferation of thin-walled vasculature with fibrin deposits and infiltrating foamy macrophages. In contrast, CHs demonstrated localized malformed vasculature containing fresh and old clotted blood on gross examination. Typically, CHs consisted of thick, ectatic hyalinized vessels lined by endothelium under a light microscope. Magnetic resonance imaging of RICHs revealed some overlapping but distinct features with CHs, including enhancing cystic and solid components with absence or incomplete popcorn-like appearance and partial hemosiderin rims. CONCLUSION: Together with histologic and radiologic findings, RICH may result from blood-filled space after tissue destruction by SRS, accompanied with radiation-induced reactive changes rather than vascular malformation. Thus, the term "RICH" would be inappropriate, because it is more likely to be an inactive organizing hematoma rather than proliferation of malformed vasculature.
Adult ; Aged ; Brain/*pathology ; Brain Neoplasms/*pathology ; Female ; Hemangioma, Cavernous/complications/*pathology/surgery ; Hematoma/surgery ; Humans ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiosurgery/adverse effects ; Treatment Outcome

Neurofascin, one of the members of L1CAM, has been known to have some important roles during the development of nerve fibers. In order to investigate the role of neurofascin associated with the development of nerve fibers in the rat sciatic nerve, the initial development of NF155 in the paranode was studied with immuno-fluorescence and immuno-electron microscopy. The result of the present study showed NF155 was not detected in the fetal sciatic nerve and began to reveal at the postnatal day 0 (P0) and dramatically increased by time lapse until postnatal day 7 (P7). NF155 was prominently localized in the axolemma of paranode and not detected in the central region of node of Ranvier. According to the present study, NF155 is likely to have some relationships with the formation of paranode and myelin sheath.
Animals ; Immunohistochemistry ; Microscopy, Immunoelectron ; Myelin Sheath ; Nerve Fibers ; Neural Cell Adhesion Molecule L1 ; Rats ; Sciatic Nerve

BACKGROUND: This study was conducted to evaluate the significance of serum eosinophil cationic protein (ECP) and high-sensitivity C-reactive protein (hs-CRP) levels in children with allergic diseases and non-allergic inflammatory diseases, and to assess the relationships between serum ECP levels and inflammatory parameters. METHODS: In this study, we included 146 children with allergic diseases, 76 children with non-allergic inflammatory diseases, and 25 control subjects. Serum concentrations of ECP, hs-CRP, total IgE, and allergen-specific IgE were measured. RESULTS: Serum ECP levels (77.5+/-88.2 microg/L) of patients with allergic diseases were significantly higher than those of the patients with non-allergic inflammatory diseases (42.2+/-58.8 microg/L) and control subjects (12.7+/-4.2 microg/L) (P<0.001, respectively). The serum ECP levels in patients with non-allergic inflammatory diseases were also significantly higher than those in the controls (42.2+/-58.8 vs. 12.7+/-4.2 microg/L; P<0.001). The hs-CRP levels were significantly higher in patients with allergic diseases than in the controls (0.4+/-0.9 vs. 0.1+/-0.2 mg/dL; P<0.05). No significant relationship was observed between serum ECP and hs-CRP levels in the allergic patients (r=0.09, P>0.05). CONCLUSIONS: Measurement of serum ECP and hs-CRP concentrations can be helpful in the clinical evaluation and monitoring of patients with allergic diseases. No significant correlation was observed between serum ECP and hs-CRP levels in allergic patients, thereby suggesting that elevated levels of ECP do not necessarily reflect the degree of systemic inflammation in allergic diseases.
C-Reactive Protein ; Child ; Eosinophil Cationic Protein ; Eosinophils ; Humans ; Immunoglobulin E ; Inflammation

We report a case of chronic myelogenous leukemia displaying a variant Philadelphia translocation t(11;22)(q25;q11.2). Breakpoint 11q25 has not previously been reported. Reverse transcriptase polymerase chain reaction and fluorescence in-situ hybridization demonstrated the BCR/ABL rearrangement.
Fluorescence ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Reverse Transcriptase Polymerase Chain Reaction

We report a case of a female karyotype that was normal except for double minutes (dmin) in acute myeloid leukemia. Using fluorescence in situ hybridization, the amplification of C-MYC was detected in both interphase and metaphase cells. The patient of the present case had received only limited therapy with cytosine arabinoside, but lived for more than one year. It supports the recent notion that dmin may not necessarily be associated with a poor outcome.
Cytarabine ; Female ; Fluorescence ; Humans ; In Situ Hybridization ; Interphase ; Karyotype* ; Leukemia, Myeloid, Acute* ; Metaphase ; Oncogenes*

Cold agglutinins are serum autoantibodies activated at reduced body temperatures to produce red blood cell agglutination and hemolysis. They are commonly found in the sera of healthy people but rarely become clinically important, because most of them exist at very low titers, and exert their greatest effect at low temperatures. By contrast, during open heart surgery, systemic hypothermia and cold cardioplegia are commonly used, and cold agglutinins can be a appreciable threat. This report describes a patient with documented cold agglutinins who successfully underwent atrial septal defect closure and patent ductus arteriosus ligation by normothermic cardiopulmonary bypass in an effort to avoid the adverse effects of hypothermia.
Agglutination ; Agglutinins ; Anemia, Hemolytic, Autoimmune* ; Autoantibodies ; Body Temperature ; Cardiopulmonary Bypass ; Ductus Arteriosus, Patent ; Erythrocytes ; Heart Arrest, Induced ; Heart Septal Defects, Atrial ; Heart* ; Hemolysis ; Humans ; Hypothermia ; Ligation ; Thoracic Surgery*

Dermatomyositis is a disease of non-pyogenic inflammation of skin and muscles in which tissues and cells are damaged by pathogenic autoantibodies and immune complexes. Diffuse subcutaneous and interstitial muscular calcinosis is well recognised and common in childhood dermatomyositis. However, soft tissue calcification in a patient with adult onset dermatomyositis has been rarely reported. We have experienced a patient with adult onset dermatomyositis who had diffuse subcutaneous tissue calcification on hands, arms, chest, abdomen and buttocks.
Abdomen ; Adult* ; Antigen-Antibody Complex ; Arm ; Autoantibodies ; Buttocks ; Calcinosis ; Dermatomyositis* ; Hand ; Humans ; Inflammation ; Muscles ; Skin ; Subcutaneous Tissue ; Thorax

Angioedema is a non-pitting edema that occurs in the skin and mucus membranes. It is known that major etiologies include hereditary deficiency of C1 esterase inhibitor, temperature extreme, trauma, food sensitivity, and medications such as penicillin, aspirin, NSAIDS and ACE inhibitors. ACE inhibitors are blocking the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor, and increasing local levels of bradykinin, a potent vasodilator. This increased bradykinin has been theorized to cause angioedema and cough in patients on ACE inhibitors. However, there has been very few causes of angioedema induced by angiotensin II receptor blocker. This is the first report of a patient presenting angioedema induced by losartan -angiotensin II receptor blocker- in this century.
Angioedema* ; Angiotensin I ; Angiotensin II ; Angiotensin-Converting Enzyme Inhibitors ; Anti-Inflammatory Agents, Non-Steroidal ; Aspirin ; Bradykinin ; Cough ; Edema ; Hereditary Angioedema Types I and II ; Humans ; Losartan* ; Membranes ; Mucus ; Penicillins ; Receptors, Angiotensin ; Skin

Cobalt is known as a hard metal used in cement and various household products. Occupational exposure occurs during the production of cobalt powder, the processing of hard metals, the polishing of diamonds, and the processing of cobalt alloys. There have been cases of cobalt induced interstitial pneumonitis, occupational asthma, and allergic dermatitis. We report a 21-year-old patient with rhinitis and asthma induced by cobalt in a factory manufacturing diamond-cutter made from hard metal. The patient complained of rhinorrhea, sneezing, and dyspnea 5 months after working in the diamond-cutting industry. Skin prick test and patch test with cobalt(CoCl2) showed negative responses. Bronchoprovocation with CoCl2 showed a early asthamtic response. In conclusion, we report a case of cobalt-induced occupational rhinitis and asthma who worked in a factory manufacturing diamond-cutter. Further studies will be needed to investigate the pathogenesis of bronchoconstriction induced by cobalt.
Alloys ; Asthma ; Asthma, Occupational* ; Bronchoconstriction ; Cobalt ; Dermatitis ; Diamond ; Dyspnea ; Household Products ; Humans ; Lung Diseases, Interstitial ; Metals ; Occupational Exposure ; Patch Tests ; Rhinitis ; Skin ; Sneezing ; Young Adult