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

BACKGROUNDS: As the elderly population in-creases the health problem, especially dementia, becomes the clinically important problem. So in the part of primary care medicine it becomes so important that family physician make a focus on the detection, evaluation, and management of demented patient. Until nowadays there is few cohort study about the dementia and few nursing home in Korea. So author performed the MMSE-K in the elderly who are over 65 to get the cognitive function for early diagnosis, management and rehabilitation of psychosocial problem. METHODS: One hundred three persons who included in community society in Seoul and nursing home of Kyunggido were tested. The survey was done twice on september 1997 and September 1998. Author used the MMSE-K to the elderly by same doctors. The analysis was done by SAS 6.12 and t-test, one-way ANOVA and two-way ANOVA with linear trend test. RESULTS: The mean of first MMSE-K score in the community is 26.1 and in the nursing home is 24.4. And the mean of second MMSE-K score in the community is 25.5 and in the nursing home is 22.0. The MMSE-K score is elevated with male and longer duration of education and is decreased with the advanced age in two groups. According to the classification by MMSE-K score the number of people who have normal cognitive function is 45(43.7%), mild impaired cognitive function is 45(43.7%), moderately impaired cognitive function is 13(12.6%) and none has severely impaired cognitive function in both groups. The follow up MMSE-K score shows that the difference of two MMSE-K scores increases as the age increases. CONCLUSION: Until todays there is few study that designed in the form of cohort study about the elderly cognitive function in Korea. So family physicians must perform the prospective cohort study with the consistent concern and effort to get the research data about the dementia for earthy detection, management and rehabilitation for elderly.
Aged* ; Classification ; Cohort Studies ; Dementia ; Early Diagnosis ; Education ; Follow-Up Studies* ; Gyeonggi-do ; Humans ; Korea ; Male ; Nursing Homes ; Physicians, Family ; Primary Health Care ; Rehabilitation ; Seoul

No abstract available.
Endocarditis*

PURPOSE: For medical students to have a meaningful learning experience, the curriculum must integrate what students are learning in class with the skills and knowledge required in the clinicalsetting. To satisfy these needs, an integrated curriculum (IC) has been operating at Chonnam National University Medical School since 1999. The purpose of this study was to evaluate the changes in IC students during two implementation periods, the first in 2001 and the second in 2004. This study focused on the student viewpointin order to create an authentic IC program. METHODS: Questionnaires were used to evaluate the differences in the student perception of IC. The content of the questionnaire dealt with the appropriateness of time management, coherence of the content, teachinglearning method, and IC evaluation. RESULTS: There were positive responses from the second implementation period than from the first, for almost all sub-items. However, the results showed that IC has to be reinforced by instructors teaching a coherentcontent, by using a variety of teaching-learning methods, by having the students participate actively, and by offering holistic and integrated assessments. CONCLUSION: The following three steps are recommended for the improvement of IC: facilitate an IC committee, develop teaching-learning methods, and guide student participation.
Curriculum* ; Humans ; Jeollanam-do ; Learning ; Schools, Medical ; Students, Medical ; Time Management ; Surveys and Questionnaires

PURPOSE: To evaluate the treatment outcome and prognostic factor of postoperative radiotherapy for extremity soft tissue sarcoma (STS). MATERIALS AND METHODS: Forty three patients with extremity STS were treated with conservative surgery and postoperative radiotherapy from January 1981 to December 2010 at Korea University Medical Center. Median total 60 Gy (range, 50 to 74.4 Gy) of radiation was delivered and 7 patients were treated with chemotherapy. RESULTS: The median follow-up period was 70 months (range, 5 to 302 months). Twelve patients (27.9%) sustained relapse of their disease. Local recurrence occurred in 3 patients (7.0%) and distant metastases developed in 10 patients (23.3%). The 5-year overall survival (OS) was 69.2% and disease free survival was 67.9%. The 5-year local relapse-free survival was 90.7% and distant relapse-free survival was 73.3%. On univariate analysis, no significant prognostic factors were associated with development of local recurrence. Histologic grade (p = 0.005) and stage (p = 0.02) influenced the development of distant metastases. Histologic grade was unique significant prognostic factor for the OS on univariate and multivariate analysis. Severe acute treatment-related complications, Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4, developed in 6 patients (14.0%) and severe late complications in 2 patients (4.7%). CONCLUSION: Conservative surgery with postoperative radiotherapy achieved a satisfactory rate of local control with acceptable complication rate in extremity STS. Most failures were distant metastases that correlate with tumor grade and stage. The majority of local recurrences developed within the field. Selective dose escalation of radiotherapy or development of effective systemic treatment might be considered.
Academic Medical Centers ; Disease-Free Survival ; Extremities ; Follow-Up Studies ; Humans ; Korea ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence ; Sarcoma ; Treatment Outcome

Tympanic membrane perforations are frequently encountered diseases and can be treated with several different methods, induding tympanoplasty with tympanic membrane grafting which requires more profound techniques and clinical care. A fat graft myringoplasty is a cost-effective techniquc managing small tympanic membrane perforations and is used when challenged by a myringoplasty failure, or following tympanostomy tube extrusion. It involves wedging a piece of fat from the ear lobule into the perforation with local anesthesia in a one-day-stay procedure. This study demonstrates the efficacy of this method in a persistent small tympanic membrane perforation.
Anesthesia, Local ; Ear ; Middle Ear Ventilation ; Myringoplasty* ; Transplants* ; Tympanic Membrane ; Tympanic Membrane Perforation ; Tympanoplasty

Supernumerary tooth, named mesodens, occur between the maxillary central incisors are generally found in pairs, although it is sometimes found singly. An inverted mesiodens may move toward the nasal cavity and erupt in the floor of the nose. Approximately 90% of all supernumerary tooth usually appear in the area of the maxilla, where they disrupt the position and eruption of normal teeth. A supernumerary tooth may closely resemble the teeth of the group to which it belongs, i.e., molars, premolars or anterior teeth.
Bicuspid ; Incisor ; Maxilla ; Molar ; Nasal Cavity* ; Nose ; Tooth ; Tooth, Supernumerary*

Sudden infant death syndrome (SIDS) in Korea remains a poorly-understood subject for both professionals and the public. Recent reports have emphasized ethnic differences in SIDS rates, suggesting that making adjustments in child-rearing practices may contribute substantially to SIDS reduction. Two of the three major risk factors for SIDS-vulnerability of the infant and exogenous factors-need to be understood in particular depth due to their broad scope and sociocultural grounding. This paper presents substantial issues regarding preterm birth and male gender on infants’ vulnerability to SIDS in Korea. Practices of caring for healthy infants are addressed in the context of sleeping practices, including sleeping position, bedding arrangements, sleeping on the floor, the back-to-sleep position, high indoor temperatures and ondol floor heating, and swaddling. Professional and social awareness about how to reduce SIDS should be raised by promoting a better understanding of risk factors in the context of ethnic and cultural variations in child-rearing practices.

The levels of expressions and catalytic activities of cytochrome P450 (CYP1A1) and glutathione-S-transferase class mu (GSTM1) enzymes in lungs and their metabolic balance may be an important determinant host factor underlying lung cancer. Genetic differences in metabolism, MspI restriction sites, Ile-Val polymorphism of CYP1A1 gene, and the null genotype of GSTM1 have been reported to be associated with susceptibility to lung cancer. The present studies were undertaken to establish frequencies of the polymorphic genotypes of CYP1A1 and GSTM1 in Koreans, and to evaluate linkage disequilibrium of the genotypes associated with higher lung cancer risks among Koreans. GSTM1(-) genotype was found in 52% of control subjects, whereas it was found in 55% of lung cancer patients. The allelic variants in CYP1A1 were distributed differently in lung cancer patients and controls. The heterozygous genotype frequency of the MspI site in lung cancer patients (53%) was higher than in controls (49%). The frequency of Ile/Val genotype of CYP1A1 was low in lung cancer patients, which are mostly squamous cell carcinoma.
Adenocarcinoma/genetics ; Carcinoma, Small Cell/genetics ; Carcinoma, Squamous Cell/genetics ; Cytochrome P-450 CYP1A1/genetics* ; Gene Frequency ; Genotype ; Glutathione Transferase/genetics* ; Human ; Korea ; Linkage Disequilibrium ; Lung Neoplasms/genetics* ; Mutation ; Polymorphism (Genetics)*

The principal objective of this study was to examine the quality characteristics of yanggaeng supplemented with powder derived from Sanghwang mushroom (Phellinus linteus) mycelia. We analyzed the potential of utilizing Phellinus linteus mycelia as a functional food material by estimating total polyphenol and flavonoid contents, electron-donating abilities, as well as antioxidative activities of the water and ethanol extracts of Sanghwang mushroom mycelia. The total phenol and flavonoid contents of ethanol extracts from Phellinus linteus mycelia were 0.69 mg/ml and 0.16 mg/ml, respectively, while the contents from the water extract of Phellinus linteus mycelia were 0.66 mg/ml and 0.22 mg/ml, respectively. The electron-donating abilities of ethanol and water extracts from Phellinus linteus mycelia were 88.64 and 90.29%, respectively. The ABTS radical scavenging activities of ethanol and water extracts from Phellinus linteus mycelia were 89.74 and 71.35%, respectively. In terms of color values, as the level of powder increased, the value of L (lightness) decreased, whereas those of a (redness) and b (yellowness) increased. In regard to the mechanical properties of the samples, we noted significant differences in hardness, springiness, chewiness, and gumminess (P<0.05). The results of the sensory evaluation showed that the score from SHM (Sanghwang mushroom mycelia) with 4% powder was significantly higher than other samples in terms of sweetness, color, taste, texture and overall quality (P<0.05). Taken together, the recommended level of Phellinus linteus mycelia powder in yanggaeng is 4% for optimal sensory characteristics.
Agaricales ; Benzothiazoles ; Ethanol ; Functional Food ; Hardness ; Phenol ; Sulfonic Acids ; Water