No abstract available.
Glycogen Storage Disease Type I*

As the number of Korean adults with diabetes is expected to increase continuously, the health care for these patients is becoming increasingly important. In recent years, the prevention of infectious diseases through vaccination of the adult population has attracted much interest. Patients with diabetes are more vulnerable to various infectious diseases and the prevention of these diseases through adequate vaccination is especially important. With the recent introduction of newly developed vaccines throughout the country, clinicians have more options for vaccinating their patients. In 2012, the Korean Society of Infectious Diseases developed revised guidelines for adult vaccination, which include recommendations for diabetic patients. Generally, vaccines for healthy adults are also recommended for diabetic patients, and these vaccines include those for Streptococcus pneumoniae, influenza, tetanus-diphtheria-pertussis, hepatitis A and B and herpes zoster. In this review, we will focus our discussion on the pneumococcal (PSV-13 and PPSV 23), influenza and zoster vaccines.
Adult ; Appointments and Schedules ; Communicable Diseases ; Delivery of Health Care ; Diabetes Mellitus ; Hepatitis A ; Herpes Zoster ; Humans ; Immunization ; Influenza, Human ; Korea ; Streptococcus pneumoniae ; Vaccination ; Vaccines

Pancreatic cancer is a disease with poor prognosis mainly due to low resection rates and late diagnosis. To increase resectability and improve survival rates, a better understanding of pancreatic cancer pathogenesis and more effective screening techniques are required. New methods, such as genetic and molecular alterations, may suggest novel approaches for pancreatic cancer diagnosis and treatment. We immunohistochemically investigated 44 formalin-fixed, paraffin-embedded specimens of pancreatic ductal adenocarcinoma using monoclonal anti-p16 antibodies and monoclonal anti-p53 antibodies. The expressions of p16 and p53 proteins were compared using the Chi-square test with SPSS. Disease-free survival was analyzed using the Kaplan-Meier method, verified by the Log- Rank test. Loss of p16 expression was noted in 20 (45.5%) cases and aberrant p53 protein expression was detected in 14 (31.8%) cases. Loss of p16 expression was associated with a higher incidence of lymph node metastasis (p=0.040) and a more advanced stage (p=0.015), although there was no significant correlation between p16 expression and survival. Aberrant p53 protein expression correlated with histologic grade (p= 0.038). Disease-free survival rate was significantly lower in the aberrant p53 protein positive group compared to the negative group (p=0.029). From our results, we suggest that p53 is not a prognostic factor; however, p16 and p53 genes do play important roles in the progression of pancreatic ductal adenocarcinoma.
Adult ; Aged ; Female ; Genes, p16 ; Genes, p53 ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Neoplasm Staging ; Pancreatic Neoplasms/*chemistry/genetics/mortality/pathology ; Protein p16/*analysis ; Protein p53/*analysis ; Sex Characteristics

OBJECTIVE: Mirtax is a generic mirtazapine widely used since 2003. We conducted an open-label, uncontrolled 6-week study to evaluate the efficacy and safety of Mirtax for major depressive disorder (MDD). METHODS: Ninety three MDD patients with the diagnosis of MDD and 17-item Hamilton Depression Rating Scale (HDRS) score > or =14 were recruited. The HDRS, Montgomery-Asberg Depression Rating Scale (MADRS), and the Clinical Global Impressions-Severity Scale (CGI-S) were administered at baseline, 1, 2, 4 and 6 weeks. Response (> or =50% decrease in the HDRS or MADRS score), remission (absolute HDRS score < or =7 or MADRS score < or =10) and CGI-I score < or =2 were also calculated. Adverse event (AE) frequency and severity, weight, blood pressure, and pulse rate were checked to assess safety. RESULTS: The starting dosage was 11.5+/-6.4 mg/day, and the maintenance dosage was 23.1+/-9.4 mg/day. During 6 weeks, HDRS, MADRS and CGI-S scores decreased from 25.1+/-5.6 to 11.9+/-8.6 (mean change -13.1+/-8.3, p<0.001), from 30.2+/-6.3 to 13.73+/-10.40 (mean change -16.5+/-9.8, p<0.001), and from 5.0+/-0.8 to 2.5+/-1.3 (mean change -2.5+/-1.3, p<0.001), respectively. The percentages of responders, remitters by HDRS and patients with a CGI-I score < or =2 were 64.6%, 35.4% and 52.7%, respectively. Significant decreases in HDRS, MADRS and CGI-S scores were confirmed at week 1. The total rate of AEs was 32.3%; the most frequently reported AEs were sedation (4.3%) and constipation (4.3%). Weight was increased from 58.8+/-10.6 to 60.3+/-9.3 kg (mean change 0.7+/-1.7 kg, p=0.004). CONCLUSION: This study, as the first clinical trial of generic mirtazapine, demonstrated the efficacy and tolerability of Mirtax for MDD using a single treatment design.
Blood Pressure ; Constipation ; Depression ; Depressive Disorder, Major* ; Diagnosis ; Drugs, Generic ; Heart Rate ; Humans ; Prospective Studies*

PURPOSE: Dysregulated cysteinyl leukotriene (CysLT) synthesis is prominent in exercise-induced bronchoconstriction (EIB). Secreted phospholipase A2 (sPLA2) plays a key regulatory role in the biosynthesis of CysLTs. We previously found that serum leptin levels correlate with (EIB) in children with asthma. The aim of this study was to address the relationship between plasma sPLA2/leptin levels and EIB. METHODS: Sixty-seven prepubertal children between the ages of 6 and 10 years were included in the study. They were asthmatics with EIB (n=25), asthmatics without EIB (n=21), and healthy subjects (n=21). We measured the plasma sPLA2 and leptin levels. We also performed pulmonary function tests at baseline, after bronchodilator inhalation, and after exercise. RESULTS: The sPLA2 and leptin levels were significantly higher in asthmatics with EIB than in those without and control subjects. In addition, sPLA2 levels were significantly correlated with body mass index (Speraman correlation coefficient r=0.343, P=0.023) and leptin levels (partial correlation coefficient r=318, P=0.033). The maximum decrease in % forced expiratory volume in 1 second after exercise was significantly correlated with both PLA2 levels (r=0.301, P=0.041) and leptin levels (r=0.346, P=0.018). CONCLUSION: The sPLA2 and leptin levels were significantly higher in asthmatics with EIB than in asthmatics without EIB and control subjects. In addition, sPLA2 levels were significantly correlated with leptin levels and EIB in asthmatic children.
Asthma ; Body Mass Index ; Bronchoconstriction* ; Child* ; Forced Expiratory Volume ; Humans ; Inhalation ; Leptin* ; Phospholipases A2* ; Plasma* ; Respiratory Function Tests

PURPOSE: Recently, component-resolved diagnosis (CRD) using microarray technology has been introduced to the field of clinical allergy. This study was aimed to investigate the clinical usefulness of microarray-based IgE detection for diagnosing clinical raw fruit allergy in birch pollen-sensitized children. METHODS: Thirty-one children with allergic disease who had been sensitized to pollen were studied. A pollen-sensitized patient was defined as having an allergen-specific history with concomitant positive skin-prick tests (SPTs) to natural allergen extracts or positive allergen-specific IgE. All subjects underwent SPTs for pollen and fruit. In all subjects, specific IgE to pollen and fruit were measured by ImmunoCAP. Specific IgE antibodies to allergen components were determined by a customized allergen microarray (ISAC). RESULTS: Thirteen of the 31 patients (41.9%) had a history of fruit hypersensitivity with positive SPTs. Measuring IgE to allergen components by ISAC, all the 13 patients with fruit hypersensitivity were positive to at least one of Mal d 1, Pru p 1, Pru p 3, Act d 8, and Act d 2 compared to 12 of the 13 patients (92.3%) who had at least 1 positive IgE to fruits (apple, peach, and kiwi) using ImmunoCAP. The sensitivity of ISAC microarray was 100.0% for the diagnosis of fruit hypersensitivity, but its specificity was 27.7% (5/18). The sensitivity of ImmunoCAP was 92.3%, and its specificity was 83.3%. CONCLUSION: The sensitivity of allergen components tested using microarray for the diagnosis of clinical fruit hypersensitivity in children with pollen allergy was high; however, its specificity was low.
Antibodies ; Betula* ; Child* ; Diagnosis* ; Fruit* ; Humans ; Hypersensitivity* ; Immunoglobulin E ; Pollen* ; Prunus persica ; Rhinitis, Allergic, Seasonal

PURPOSE: Epidemiological data indicate that obesity is a risk factor in asthma, however effects related to obesity and adipokines on airway inflammation and bronchial hyper-responsiveness (BHR) have not yet been demonstrated in the human airway. The aim of this study was to investigate the relationship between serum adipokine levels and BHR to mannitol in asthmatic children. METHODS: Serum adipokine levels were measured and pulmonary function tests were perfomed: baseline, postbronchodilator inhalation, methacholine inhalation, and mannitol inhalation. The response to mannitol was expressed as the dose causing a 15% decrease in forced expiratory volume in one second (FEV1) (PD15), and as the response-dose ratio (RDR) (% fall in FEV1/cumulative dose). RESULTS: Sixty-nine prepubertal children between the ages of 6 and 10 years were participated in the study. They comprised asthmatic children (n=40) and healthy (n=29). Twenty-two subjects (55.5%) with asthma had a positive mannitol bronchial provocation test (BPT) result. The body mass index (BMI) was higher in those asthmatics with positive mannitol BPTs than in asthmatics with negative mannitol BPTs and in the control group (19.30 kg/m2 vs. 17.60 kg/m2 vs. 17.93 kg/m2, P=0.035, P=0.046). Serum leptin levels were also significantly higher in asthmatics with positive mannitol BPTs than in asthmatics with negative mannitol BPTs and in the control group (10.58 ng/mL vs. 5.49 ng/mL vs. 6.75 ng/mL, P=0.002, P=0.016). Leptin values were significantly associated with a PD15 (r=-0.498, P=0.022) and RDR to mannitol (r=0.346, P=0.033) in asthmatic children after adjustment for BMI. CONCLUSION: Serum leptin levels were significantly associated with BHR to mannitol in asthmatic children.
Adipokines ; Asthma ; Body Mass Index ; Bronchial Provocation Tests ; Child* ; Forced Expiratory Volume ; Humans ; Inflammation ; Inhalation ; Leptin* ; Mannitol* ; Methacholine Chloride ; Obesity ; Respiratory Function Tests ; Risk Factors

BACKGROUND: Since 1997, the annual case occurrence of vivax malaria in the Republic of Korea have exceeded 1,000 cases since 1997. The military is thought to be an important source of the current outbreak. We collected various informations about malaria cases (soldiers, veterans and civilians) which occurred in 2000, and analyzed the characteristics of the current outbreak. METHODS: Informations about malaria cases of soldiers, veterans and civilians, including name, age, sex, day of onset, region, etc., were collected through the National Institute of Health. RESULTS: Out of total 4,141 cases, 1,288 (31.1%) occurred in the military, 1,273 (30.7%) occurred among the veterans, and 1,580 (38.2%) occurred among civilians. The monthly case occurrence reached its peak in early August. Areas such as Cheolwon, Yeoncheon and Paju showed the highest prevalence. CONCLUSION: It is considered that the current malaria outbreak has escaped from the exponential growth phase, however, more attention should be paid to prevent further spreading of malaria infection.
Humans ; Malaria ; Malaria, Vivax* ; Military Personnel ; Prevalence ; Republic of Korea* ; United Nations ; Veterans

PURPOSE: Laparoscopic cholecystectomy has been performed even in case of acute cholecystitis and GB empyema with increasing experience of laparoscopic surgery. Many previous studies has been recommended early laparoscopic cholecystectomy in acute cholecystitis. METHODS: From February, 1997 to January, 2000, 364 patients were attempted to laparoscopic cholecystectomy and 71 patients of them were attempted to laparoscopic cholecystectomy due to acute cholecytitis. They were divided into 4 groups based on the time of operation form the onset of symptom. These groups were compared in conversion rate and postoperative clinical outcomes, such as operation time, time of bowel movement, starting diet, starting soft diet and discharge. The affecting factors on conversion were analyzed (age, sex, fever, murphy sign, accompanying pancreatitis, SGOT/SGPT, alkaline phosphatase, GB wall thickening, WBC count). RESULTS: Among 71 patients who were attempt to laparoscopic cholecystectomy in acute cholecystitis, 20 patients (28.1%) required converting to open surgery. There were no statistically significant difference in clinical outcomes and conversion rate between four groups (p>0.568). In univariate analyis, high frequency of conversion to open surgery in acute cholecystitis was observed in male (p=0.012). CONCLUSION: Even though conversion rate to open surgery is still high in acute cholecystitis, the time of laparoscopic surgery in acute cholecystits does not affect on the conversion rate and postoperative clinical outcomes. Considering of the hospital stay and its related economic problems, laparoscopic cholecystectomy should be attempted as soon as possible without hesitation. It may be due to advanced laparoscopic techniques and experiences.
Alkaline Phosphatase ; Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute* ; Conversion to Open Surgery ; Diet ; Empyema ; Fever ; Humans ; Laparoscopy ; Length of Stay ; Male ; Pancreatitis

BACKGROUND: Acute lung injury (ALI) is a commonly encountered respiratory disease and its prognosis is poor when the treatment is not provided promptly and properly. However no specific pharmacologic treatment is currently available for ALI, although recently several supportive drugs have been under scrutiny. We studied anti-inflammatory effects of pentoxifylline (PF), a methylated xanthine, and ONO-5046, a synthetic neutrophil elastase inhibitor on lipopolysaccharide (LPS)-induced ALI in vitro. METHODS: To establish an in vitro model of LPS-induced ALI, primary rat alveolar macrophages and peripheral neutrophils in various ratios (1:0, 5:1,1:1,1:5,0:1) were co-cultured with transformed rat alveolar epithelial cells (L2 cell line) or vascular endothelial cells (IP2-E4 cell line) under LPS stimulation. Each experiment was divided into five groups-control, LPS, LPS+PF, LPS+ONO, and LPS+PF+ONO. We compared LPS-induced superoxide anion productions from primary rat alveolar macrophages and peripheral neutrophils in various ratios, and the resultant cytotoxxicity on L2 cells or IP2-E4 cells between groups. In addition we also compared the productions of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, monocyte chemotactic protein(MCP)-1, IL-6, and IL-10 as will as mRNA expressions of TNF-α, inducible nitric oxide synthetase(iNOS), and MCP-1 from LPS-stimulated primary rat alveolar macrophages between groups. RESULTS: (1) PF and ONO-5046 in each or both showed a trend to suppress LPS-induced superoxide anion productions from primary rat alveolar macrophages and peripheral neutrophils regardless of their ratio, except for the LPS+PF+ONO group with the 1:5 ratio, although statistical significance was limited to a few selected experimental conditions. (2) PF and ONO-5046 in each or both showed a trend to prevent IP2-E4 cells from LPS-induced cytotoxicity by primary rat alveolar macrophages and peripheral neutrophils regardless their ratio, although statistical significance was limited to a few selected experimental conditions. The effects of PF and/or ONO-5046 on LPS-induced L2 cell cytotoxicity varied according to expaerimental conditions. (3) PF showed a trend to inhibit LPS-induced productions of TNF-α, MCP-1, and IL-10 from primary rat alveolar macrophages. ONO-5046 alone didnot affect the LPS-induced productions of proinflammatory cytokines from primary rat alveolar macrophages but the combination of PF and ONO-5046 showed a trend to suppress LPS-induced productions of TNF-αand IL-10 PF and ONO-5046 in each or both showed a trend to increase LPS-induced IL-β and IL-6 productions from primary rat alveolar macrophages. (4) PF and ONO-5046 in each or both showed atrend to attenuate LPS-induced mRNA expressions of TNF-α and MCP-1 from primary rat alveolar macrophages but at the same time showed a trend increase iNOS mRNA expression. CONCLUSION: These results suggest that PF and ONO-5046 may play a role in attenuating inflammation in LPS-induced ALI and that further study is needed to use these drugs as a new supportive therapeutic strategy for ALI.
Acute Lung Injury* ; Animals ; Cytokines ; Endothelial Cells ; Epithelial Cells ; Inflammation ; Interleukin-10 ; Interleukin-6 ; Interleukins ; Leukocyte Elastase* ; Macrophages, Alveolar ; Monocytes ; Neutrophils* ; Nitric Oxide ; Pentoxifylline* ; Prognosis ; Rats ; RNA, Messenger ; Superoxides ; Tumor Necrosis Factor-alpha ; Xanthine