We experienced a cose of occupational asthma induced by the tobacco leaf in 49-year old man. He has worked at the Korean Tobacco and Ginseng company for 23 years but suffered from the intermittent mild wheezing and dyspnea since 6 years ago. He has not involved in the process making the tobacco directly, but just managed it at the storage barn. He showed a whole negative reaction to 55 inhalant allergens(Bencard, UK) and the allergen extracted from the yellow Korean tobacco leaf, but showed the dual asthmatic respose to the allergen bronchial provocation test with it. His basal PC is 6.35 mg/ml with methacholine inhalation challenge. Now he changed the workplace far away from the barn at the same company and is treated with bronchodilator and anti-asthmatic inhaler.
Asthma, Occupational* ; Bronchial Provocation Tests ; Dyspnea ; Humans ; Inhalation ; Methacholine Chloride ; Middle Aged ; Nebulizers and Vaporizers ; Panax ; Respiratory Sounds ; Tobacco*

No abstract available.

Allopurinol is widely used for chronic tophaceous gout as a uric acid lowering agent. Hypersensitivity to allopurinol occurrs in about 10% of patients, which limits the usage of allopurinol. The successful oral and intravenous desensitization of allopurinol has been reported worldwide since 1976. We recently experienced a 51-year-old male patient with gouty arthritis and hyperuricemia, who had previously experienced skin rash after allopurinol treatment. When allopurinol was retried, erythematous and foliative skin rash developed on entire body. Because allopurinol was essential in controlling hyperuricemia, the oral desensitization of allopurinol was tried. We report successful rapid oral allopurinol desensitization in the patient with chronic tophaceous gout, who exhibited exfoliative dermatitis as allopurinol hypersensitivity.
Allopurinol* ; Arthritis, Gouty ; Dermatitis, Exfoliative* ; Exanthema ; Gout ; Humans ; Hypersensitivity ; Hyperuricemia ; Male ; Middle Aged ; Uric Acid

OBJECTIVES: With the increase in cancer prevalence, the health behavior of cancer survivors has become an important issue. This study was conducted to examine the psychosocial correlates of behavior changes after cancer diagnosis. METHODS: 95 patients completed questionnaires assessing depression, anxiety, insomnia, posttraumatic stress symptoms, social constraints, personal beliefs about cancer cause and health-related behavior changes after cancer diagnosis. RESULTS: In the multiple logistic regression analysis, insomnia was the only significant predictor of positive change in physical behavior : normal sleep group(Odds ratio=9.462, 95% CI 1.738-51.509) and subthreshold insomnia group(Odds ratio=10.529, 95% CI 1.701-65.161) showed a larger increase compared to the insomnia group. In psychosocial behavior, low age, religion and causal belief in hormonal factors were independent factors that predicted increase in positive change. CONCLUSIONS: This study showed a difference between predictors of physical and psychosocial health behavior change after breast cancer diagnosis. Multi-faceted approaches are required to promote positive change in health behavior in cancer patients.
Anxiety ; Breast ; Breast Neoplasms ; Depression ; Health Behavior ; Humans ; Logistic Models ; Prevalence ; Questionnaires ; Sleep Initiation and Maintenance Disorders ; Survivors

PURPOSE: Oxaliplatin is a third-generation platinum compound, and it has no nephrotoxicity and has reduced bone marrow toxicity. Cancer cells that are resistant to cisplatin are sensitive to oxaliplatin. Oxaliplatin is used widely for the treatment of colon cancers. Recently, oxaliplatin was reported to inhibit the expression of survivin, which protects cell apoptosis. However, there are no reports on the expressions of survivin variants and the changes in intracellular localization of survivin in cancer cells. We studied the expression of survivin caused by oxaliplatin in HCT116 colon cancer cells, and we observed the localization of survivin in the mitotic phase. METHODS: We treated the HCT116 colon cancer cells with 2.0 micrometer of oxaliplatin, and we studied the expressions of survivin protein, and survivin mRNA variants, as well as the changes in intracellular localization, by using the Western blot method, RT-PCR, immunocytochemistry, and flowcytometry. RESULTS: Oxaliplatin inhibits the expression of the survivin protein and survivin mRNA in HCT116 colon cancer cells. The expression of the survivin-2B variants, which have no antiapoptotic activity but control cell mitosis by localization on a microtubule, is reduced continuously 2 days after treatment with oxaliplatin. In immunocytochemistry, expression of survivin in the cytoplasm is reduced and especially is not expressed in microtubules and contractile rings. CONCLUSION: One of the mechanisms of oxaliplatin is to inhibit the expression of and to change the localization of survivin. Based on these results, we suggest that changes in the expression of survivin variants and in their localization are two effects of oxaliplatin.
Apoptosis ; Blotting, Western ; Bone Marrow ; Cisplatin ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Cytoplasm ; Immunohistochemistry ; Microtubules ; Mitosis ; Organoplatinum Compounds ; Platinum ; RNA, Messenger

No abstract available.
Leiomyosarcoma*

Double outlet right ventricle, a complex of congenital cardiac anomalies in which both great arteries arise wholly or in large part from the morphologic right ventricle presents diverse clinical manifestations according to the morphological characteristics. Eighty cases with DORV were diagnosed and operated at Yonsei Cardiovascular Center from 1988 to 1992. The analysis of the morphological characteristics of this anomaly and comparative study of operative methods and mortality according to the morphological classification led to the following results: 1) The location of VSD varied to be subaortic in 40 cases, subpulmonic in 15, doubly committed in 6 and noncommitted in 19 cases. The great arteries were interrelated in D-malposition in 43 cases and L-malposition in 18 and 26 cases among above mentioned 61 cases revealed the side-by-side relationship. Ten of the cases showed normal position and the rest 9, A-malposition. 2) Pulmonary stenosis was found in 60 cases, and when associated with subpulmonic VSD, occurring less frequently. PDA and ASD secundum were associated in successional order and only 3 cases were verified to carry aortic arch anomalies such as coarctation and interruption, all with subpulmonic VSD. 3) Intraventricular tunnel repair was possible in every case associated with subaortic VSD and the postoperative prognosis was excellent. In comparison, most of the cases associated with other types of VSD in which only palliative surgery or various types of intraventricular repair were performed, the general outcome was poor. But total cavopulmonary connection, one of the physiological corrective methods, showing a better postoperative prognosis is being carefully considered for its broad adoptation in future. In conclusion, double outlet right ventricle, a pathophysiological complex of various anomalies, should be thoroughly evaluated for the morphological characteristics to decide the most appropriate types of operation and for consequent improvement of prognosis.
Aorta, Thoracic ; Arteries ; Classification ; Double Outlet Right Ventricle* ; Heart Ventricles ; Mortality ; Palliative Care ; Prognosis ; Pulmonary Valve Stenosis

The word "Delayed" in the legend of Figure 2 should have been written as "Controls."

Automatic implantable cardioverter defibrillator(AICD) is a device that senses ventricular tarchycardia and ventricular fibrillation and responses with counter-shocks to the heart. We experienced a case of AICD implantation to prevent sudden cardiac death. A-22-year-old male was operated under O2, N2o, fentanyl, low dose enflurane anesthesia. The diagnosis was familial long QT syndrome. Lead was introduced to the right ventricular apex through left subclavian vein and generator was placed between pectoralis muscles. Then defibrillation threshold testing was performed. Ventricular fibrillation was induced with Twave shock of 3 joule and defibrillation with 5 joule terminated ventricular fibrillation successfully. After ventricular fibrillation, his blood pressure decreased to 30mmHg. When ventricular fibrillation was converted to normal rhythm, it retured to normal range. After operation, patient was transferred to the ICU and stayed there for 3 days.
Anesthesia ; Arrhythmias, Cardiac ; Blood Pressure ; Death, Sudden, Cardiac ; Defibrillators* ; Diagnosis ; Enflurane ; Fentanyl ; Heart ; Humans ; Long QT Syndrome ; Male ; Pectoralis Muscles ; Reference Values ; Shock ; Subclavian Vein ; Ventricular Fibrillation

We successfully closed the isolated patent ductusarteriosus(PDA) in 2 female patients using the Rashkind Double-Disc Occlusion system. nonsurgical closure of PDA usin plug was introduced by Porstmann in 1968 through transfemoral artery catheter and using umbrella by Rashkind in 1977 througth venous site. There has been continued improvement and simplification of the equipment as well as in the implantation technique. Nowaday, a multicenter study was conducted to test the safety and effectiveness of this interventioal method in States. Successful closure rate was high but some problems were reported such as embolization, abnormal deployment and residual shunt. Residual shunt was visualized by aortography in our both cases immediately after intervention but continuous murmur could not be heard in both cases. Oxygen step-up disappeared immediately after occluder implantation in both cases. Complete occlusion was expected with thrombus in near future.
Aortography ; Arteries ; Catheters ; Ductus Arteriosus, Patent* ; Female ; Humans ; Oxygen ; Thrombosis