Hereditary angioedema is a rare genetic disease transmitted with a autosomal dominant trait result of a quantitative or functional defect of Cl inhibitor. We report three cases of heriditary angioedema from the same famly respectively the 35-year-old sister, the younger bn)ther of 32, and the younger sister of 20 The older sister died due to her airway being obstructel by acute laryngeal edema, and her you igirbrother and sister experienced recurrent episodes oswelling on the hand and forearm. The ore we examined the two patients serum complement levils to confirm diagnosis. In both, the r;ults showed decreased levels of Cl inhibitor and C4 which are the evidence of hereditary a giedema. The younger sister has been administered danazol (600mg/day) to prevent angioedem or 8 weeks, and we have not yet found a recurrenc of he symptoms. However, well cont ol the dosage of danazol because amenorchea has developec.
Adult ; Angioedema ; Angioedemas, Hereditary* ; Complement System Proteins ; Danazol ; Diagnosis ; Forearm ; Hand ; Humans ; Laryngeal Edema ; Siblings

We have analysed 13 patients with malignant obstructive jaundice due to metastasis who were treated with local radiation therapy to the area of porta hepatis at the Radiation Therapy Department of Paik hospital attached to the Inje University between 1984 and 1988. A good response was observed in 6 out of 7 evaluable paitens receiving a total radiation dose ranging from 2600 to 5480 cgy in 2.6 to 6 weeks. A complete response was noted in 5 patients, a partial response in 1 patient, and no response in 1 patient. The overall median survival for 13 patients was 3 months. But two patients lived more than a year without recurrence of jaundice. Moderate dose, localized field radiation therapy appears to the beneficial in relieving obstructive jaundice and gives a good symptomatic relief.
Humans ; Jaundice ; Jaundice, Obstructive* ; Neoplasm Metastasis ; Recurrence

Hepatocellular carcinoma (HCC) has become an important indication for liver transplantation in Korea. Even though the Milan criteria have been accepted as the gold standard in deceased donor liver transplantation, the acceptable indication for living donor liver transplantation is controversial. This review covers several key issues in liver transplantation for advanced HCC: (1) recent developments and published data on expanded criteria, (2) the role of down-staging, (3) an ethical issue in expanding the criteria in living donor liver transplantation, and (4) post-operative management, including the immunosuppressive regimen and post-transplant adjuvant chemotherapy to improve survival after transplantation for advanced HCC. Biological factors, such as AFP, PIVKA-II, and a PET scan, in addition to tumor size and number, may be helpful in selecting eligible patients for liver transplantation among patients with advanced HCC. Low-level immunosuppression with low exposure of calcineurin inhibitor may reduce HCC recurrence after transplantation.
Biological Factors ; Biomarkers ; Calcineurin ; Carcinoma, Hepatocellular ; Chemotherapy, Adjuvant ; Humans ; Immunosuppression ; Korea ; Liver ; Liver Transplantation ; Living Donors ; Positron-Emission Tomography ; Protein Precursors ; Prothrombin ; Recurrence ; Tissue Donors ; Transplants

BACKGROUND: Methods to detect and quanitify Mycobacterium leprae(M. leprae)are needed for studies involving the epidemiology, pathogenesis, and chemotherapy of leprosy. Serological assays and skin tests lack the sensitivity and specificity to serve as diagnostic tool for M. leprae infection. The polymerase chain reaction(PCR) based on the selective amplification of an 530-bp frangment of the gene encoding the proline-rich antigen of M. leprae was performed with sections of fixed or frozen biopsy samples from leprosy patients. OBJECTIVE: This study was done to investigate the applicability of PCR for the detection of low numbers of M. leprae in tissues and peripheral blood. METHODS: The PCR was used to amplify a 530-base-pair M. leprae DNA with the thermoxtable Taq DNA polymerase. RESULTS: The In frozen skin tissues and peripheral blood of leprosy patients. relatively high detection rates of PCR products was achieved by using direct gel analysis as well as Southern blot hybridization. CONCLUSION: These results suggest that PCR amplification for the detection of M. leprae may be useful for the epidemiologic study of large papulations as well as coinical astudies on the individual patients.
Biopsy ; Blotting, Southern ; DNA ; Drug Therapy ; Epidemiologic Studies ; Epidemiology ; Humans ; Leprosy ; Mycobacterium leprae* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Skin ; Skin Tests ; Taq Polymerase

Despite the therapeutic equivalence between twice-daily and once-daily tacrolimus, patient safety after conversion is still a concern. We reviewed 218 liver transplantation (LT) patients who converted twice-daily to once-daily tacrolimus between May 2011 and January 2014. Thirty (13.8%) patients had adverse events after conversion, with a liver function test (LFT) abnormality being the most common adverse event (n = 17). Despite the decrease in serum tacrolimus of > 30% after conversion, none of the patients who were converted to a dosage ratio (once-daily tacrolimus dosage: twice-daily tacrolimus dosage) > 1 had an LFT abnormality. Most patients with an LFT abnormality improved after increasing the once-daily tacrolimus dosage (n = 2), returned to a previous medication, and/or added another immunosuppressant (n = 15). One patient had acute cellular rejection, which improved after steroid pulse treatment, and another patient had graft failure. In patients with a dosage ratio ≤ 1, the conversion time within 5 years after LT was the only significant risk factor for an LFT abnormality after conversion (odds ratio: 11.850, 95% confidence interval: 1.321–106.325, P = 0.027). In conclusion, the dosage ratio and time after LT should be carefully considered during conversion from twice-daily to once-daily tacrolimus.
Humans ; Liver Function Tests ; Liver Transplantation* ; Liver* ; Patient Safety ; Risk Factors* ; Tacrolimus* ; Transplants

Authors recorded standard electroretinogram in two groups of diabetic patients. Group A, consisted of 60 eyes with no visible diabetic retinopathy and Group B, 30 eyes with mild nonproliferative diabetic retinopathy. The electroretinogram was recorded according to the standard electroretinogram procedure recommanded by the ISCEV. In rod and cone response, the amplitude of b wave were 329.0+/-46.9 microvoltin Group A and 308.8+/-37.8 microvoltin Group B. The implicit time of b wave were 40.5+/-3. 0microvoltin Group A and 45.8+/-5.4microvolti n Group B. The summed amplitude of oscillatory potentials were 125.7+/-38.7microvolt in Group A and 112.0+/-17.7microvoltin Group B. Above results indicate that for the disgnostic criteria for diabetic retinopathy, the amplitude and implict time of b wave, and the summed amplitude of oscillatory potentials in maximal combined response were useful. On receiver operating characteristic(ROC) curves in maximal combined response, cut off value for the amplitude and implicit time of b wave were 315 microvoltand 42ms espectively. Cut off value for the summed amplitude of oscillatory potentia-als was 118 microvolt. In results, on ROC curve, the implicit time of b wave in maximal combined response was most accurate, and the summed amplitude of oscillary potentials was the next, followed by the amplitude of b wave in the maximal combined response.
Diabetic Retinopathy* ; Early Diagnosis* ; Humans ; ROC Curve

BACKGROUND: The incidence of herpes zoster is higher among patients with impaired cell mediated immunity. Herpes zoster skin lesions frequently become more severe and run a more protracted course in such patients. OBJECTIVE: This study aimed to firstly elucidate whether there are changes in cell mediated immunity, even in immunocompetent, patients with herpes zoster, and secondly to investigate relationships between these change and the clinical appearance of herpes zoster. METHODS: T lymphocyte subsets in peripheral blood and delayed hypersensitivity reactions using the Multitest(R) CMI kit were measured in 33 healthy patients with herpes zoster and 28 controls. RESULTS: As compared with controls, there was a slight decrease in percentages of CD4 lymphocytes, a significant decr eas in percentages of CD8 lyrnphocytes, and a slight increase in CD4/ CD8 ratios in the acute phasr of herpes zoster. The percentages of CD3 lymphocytes were also significantly decreased. Based on the severity of the skin lesion, there was a significant increase in duration of acute herpetic pain. However, there were no signigicant differences in percentages of T lymphocyte subsets based on the severity of skin lesion and duration of acute horpetic pain. In delayed hypersensitivity reations with the Multitest(R)" CMI kit, the intensity and frequencies of positive reactions were significintly decreased in the patients group. CONCLUSIONS: There are significant changes in peripheral blood T lymphocyte subsets and delayed hypersensitivity reactions even in other wise healthy patients.
Herpes Zoster* ; Humans ; Hypersensitivity, Delayed ; Immunity, Cellular ; Incidence ; Lymphocytes ; Skin ; T-Lymphocyte Subsets*

Between December 1983 and December 1989, twenty-five breast carcinoma patients were treated with surgical resection and postoperative radiotherapy at Inje University Seoul Paik Hospital. Twenty-three of 25 were evaluable and there were 7 patients with stageII, 14 patients with stageIII, and 2 patients with stageIV. Twenty-one patients were treated with modified radical mastectomy and the remained 2 patients with simple mastectomy. The follow-up period ranged from 2 to 8 years. The local control rate was 83c13 for the entire group. The local control rates for each stage were 100%(6/6) for stage II, 73%(l1/15) for stageIII, and 100%(2/2) for stageIV. The number of metastatic axillary nodes was a good predictor of locoregional cotrol. It was 100% for the patients with 0-3 metastatic nodes and 72% for more than 4 nodes, respectively. The 5-year overall survival rate for the entire group was 59%, and the disease-free survival rate was 32%. The 5-year survival rates for each stageII,III and IV was 83%, 59% and 50%, respectively. The distant metastasis occurred in 10 out of 23 patients and the most common site was bone. The results indicate that postoperative radiotherapy continues to play an important role in the primary mangement of the high-risk breast cancer patients.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Simple ; Neoplasm Metastasis ; Radiotherapy* ; Seoul ; Survival Rate

Cutaneous metastasis from internal malignacy is recognized but infrequently occuring manifestation. The prostatic carcinoma rarely acts as a primary source for cutaneous metastasis. We report a case of cutaneous metstasis from prostatic carcinoma. A 82-year-old male presents multiple painless erythematous nodules on suprapubic area, having an episode of surgical removal of prostate carcinoma two years ago. Histologic finding shows atypical anaplastic cell infiltration at the dermis and subcutaneous tissue, forming dermal tumor island, and have features similar to primary prostatic carcinoma. Immunohistochemical staining for prostate specific antigen shows positive reaction within cells, can assist in localization of the metatatic adenocarcinoma to a prostate origin.
Adenocarcinoma ; Aged, 80 and over ; Dermis ; Humans ; Male ; Neoplasm Metastasis* ; Prostate ; Prostate-Specific Antigen ; Subcutaneous Tissue

Cutaneous metastasis from internal malignacy is recognized but infrequently occuring manifestation. The prostatic carcinoma rarely acts as a primary source for cutaneous metastasis. We report a case of cutaneous metstasis from prostatic carcinoma. A 82-year-old male presents multiple painless erythematous nodules on suprapubic area, having an episode of surgical removal of prostate carcinoma two years ago. Histologic finding shows atypical anaplastic cell infiltration at the dermis and subcutaneous tissue, forming dermal tumor island, and have features similar to primary prostatic carcinoma. Immunohistochemical staining for prostate specific antigen shows positive reaction within cells, can assist in localization of the metatatic adenocarcinoma to a prostate origin.
Adenocarcinoma ; Aged, 80 and over ; Dermis ; Humans ; Male ; Neoplasm Metastasis* ; Prostate ; Prostate-Specific Antigen ; Subcutaneous Tissue