We report a case of acute transient encephalopathy with mental alteration, myoclonic jerks, and periodic triphasic wave electroencephalographic patterns caused by a therapeutic dose of baclofen. The clinical and electroencephalo-graphic abnormalities improved to a normal range shortly after baclofen was discontinued. We discuss the pathogenesis and review the literature about baclofen-induced encephalopathies.
Baclofen ; Myoclonus ; Reference Values

PURPOSE: Efonidipine, which inhibits both T- and L-type calcium channels, has been shown to be effective in reducing proteinuria and preserve renal function. This study was conducted to compare the effects of efonidipine versus amlodipine on the management of hypertension and proteinuria in patients with chronic kidney disease (CKD) receiving ACE inhibitors or ARB. METHODS: This study included 41 CKD patients who were at stages 2-4 and had a urine spot protein/ creatinine ratio of >0.5. Patients were administered amlodipine (5 mg/day) and efonidipine (40 mg/ day) for 3 months in a cross-over design. Blood pressure and spot urine protein/creatinine ratio were compared before and after the cross-over treatment. RESULTS: There were 24 male patients and 17 female patients. The mean age of the patients was 55.9+/-12.9 years. When the patients' medication was changed to eponidifine, we obtained the following results. First, there were no significant changes in blood pressure and serum creatinine. Second, the urine spot protein/creatinine ratio was significantly decreased (before the cross-over, 2.9+/-2.6; after the cross-over, 2.3+/-1.9 g/g; p=0.02). Finally, the reduction rate of proteinuria was significantly higher in patients with CKD at stages 2-3 than in those with CKD at stage 4 after the cross-over (stage 2, - 26.1%; stage 3, -17%; stage 4, +12.8%; p=0.03). CONCLUSION: It is concluded that efonidipine may significantly decrease proteinuria compared with amlodipine in CKD patients receiving ACE inhibitors or ARB. Further double-blind clinical trials with a larger sample size are needed to confirm our results.
Amlodipine ; Angiotensin-Converting Enzyme Inhibitors ; Blood Pressure ; Calcium Channels, L-Type ; Creatinine ; Cross-Over Studies ; Dihydropyridines ; Female ; Humans ; Hypertension ; Male ; Nitrophenols ; Organophosphorus Compounds ; Proteinuria ; Renal Insufficiency, Chronic ; Sample Size

PURPOSE: Prevalence of food allergy and perceptions on food allergen labeling in school foodservice among elementary, middle, and high school students were investigated in Korea. METHODS: A total of 1,000 elementary, middle, and high schools were selected in 16 cities and provinces of Korea and students attending the schools were surveyed using a questionnaire modified from the Korean International Study of Asthma and Allergies in Childhood questionnaire in July 2012. Responses from 27,679 students were used for data analysis. RESULTS: The ratio of the students who had experienced food allergy was 12.6%; 7.6% of the responding students had food allergy reactions last 12 months and 6.8% of the students had been diagnosed for food allergy by doctors. Eggs, milk, peach, and crabs were the most frequent allergenic foods for the elementary school 1st graders, 5th graders, middle, and high school students, respectively, who had experienced food allergy last 12 months. The students with food allergy read menus more frequently and were more interest in food allergen labeling in school foodservice than their counterparts. Both of the student groups with and without food allergy perceived food allergen labeling important for the students with food allergy and their parents. CONCLUSION: The prevalence of food allergy and major allergenic foods varied by school years. The Korean students had positive perception on allergic food labeling in school foodservice. An effective food allergen labeling system for school foodservice should be developed and implemented that reflects prevalence, symptoms, and food allergens among Korean students.
Allergens ; Asthma ; Eggs ; Food Hypersensitivity ; Food Labeling ; Humans ; Hypersensitivity ; Korea ; Milk ; Ovum ; Prevalence ; Prunus persica ; Surveys and Questionnaires

BACKGROUND: Genomic instability, which is manifested by the replication error (RER) phenotype, has been proposed for the promotion of genetic alterations necessary for carcinogenesis. Merlo et al. reported frequent microsatellite instability in primary small cell lung cancers. However, Kim et al. found that instability occurred in only 1% of the loci tested and did not resemble the replication error-positive phenotype. The significance of microsatellite instability in the tumorigenesis of small cell lung cancer ( as well as the relationship between microsatellite instability and its clinical prognosis was investigated in our study. METHODS: Fifteen primary small cell lung cancers were chosen for this study. The DNAs extracted from paraffin-embedded tissue blocks with both primary tumor and corresponding control tissue were investigated. This phrase is unclear. Does this mean the blocks contained both primary tumor and control tissue samples? Forty microsatellite markers on chromosome 1p, 2p, 3p, 5q, 6p, 6q, 9p, 9q, 13q, and 17p were used in the microsatellite analysis. RESULTS: 1) Thirteen (86.7%) of 15 tumors exhibited LOH in at least one of the tested microsatellite markers. 2) Three of 13 tumors exhibiting LOH lost a larger area in chromosome 9p. 3) LOH was shown in 72.7% on chromosome 2p, 40% on 3p, 50% on 5q, 46.7% on 9p, 69.2% on 13q, and 66.7% on 17p(Table 1). 4) Nine (60%) of 15 tumors exhibited shifted bands in at least one of the tested microsatellite markers. 5) Nine cases exhibiting shifted bands showed altered loci ranging 2.5~52.5% (mean 9.4% +/-16.19)(Table 2). 6) Shifted bands occurred in 5.7% (34 of 600) of the loci tested Table 2. 7) Nine cases with shifted bands exhibited LOH ranging between 0~83.3%(,) and the median survival duration of those cases was 35 weeks. Six cases without shifted bands exhibited LOH ranging between 0~83.3%(,) and the median survival duration of those cases was 73 weeks. There was no significant difference between median survival durations of the two groups(p=0.4712). CONCLUSION: Microsatellite instability as well as the inactivation of several tumor suppressor genes may play important roles in the development and progression process of tumors. However, the relationship between microsatellite instability and its clinical prognosis in primary small cell lung cancer could not be established.
Carcinogenesis ; DNA ; Genes, Tumor Suppressor ; Genomic Instability ; Loss of Heterozygosity ; Lung Neoplasms* ; Lung* ; Microsatellite Instability* ; Microsatellite Repeats* ; Phenotype ; Prognosis ; Small Cell Lung Carcinoma

Objectives: . Balloon dilation of the Eustachian tube (BDET) is widely recognized as a minimally invasive treatment for obstructive Eustachian tube dysfunction (ETD). We employed a Delphi consensus methodology to develop recommendations for the clinical management of BDET in cases of obstructive ETD. Methods: . A Delphi panel consisting of 26 expert physicians specializing in otology participated in two rounds of anonymous, iterative questionnaires. Consensus was defined as agreement from ≥70% of the panelists on a recommendation, while disagreement was defined as <70% agreement. The responses from the Delphi study were analyzed using both the content validity ratio and Kendall’s coefficient of concordance. Results: . The panel finally evaluated 26 topics, reaching agreement on 9 and failing to reach consensus on 17 after two rounds. While consensus was not achieved regarding the postoperative follow-up period, a duration of 12 months was most commonly adopted. The Valsalva maneuver and questionnaire responses were identified as the most agreed-upon postoperative assessment tools following BDET. Conclusion . Consensus was reached on several recommendations for managing BEDT in obstructive ETD. This agreement will guide future research aimed at defining standard postoperative management for BEDT.

Objectives: . Balloon dilation of the Eustachian tube (BDET) is widely recognized as a minimally invasive treatment for obstructive Eustachian tube dysfunction (ETD). We employed a Delphi consensus methodology to develop recommendations for the clinical management of BDET in cases of obstructive ETD. Methods: . A Delphi panel consisting of 26 expert physicians specializing in otology participated in two rounds of anonymous, iterative questionnaires. Consensus was defined as agreement from ≥70% of the panelists on a recommendation, while disagreement was defined as <70% agreement. The responses from the Delphi study were analyzed using both the content validity ratio and Kendall’s coefficient of concordance. Results: . The panel finally evaluated 26 topics, reaching agreement on 9 and failing to reach consensus on 17 after two rounds. While consensus was not achieved regarding the postoperative follow-up period, a duration of 12 months was most commonly adopted. The Valsalva maneuver and questionnaire responses were identified as the most agreed-upon postoperative assessment tools following BDET. Conclusion . Consensus was reached on several recommendations for managing BEDT in obstructive ETD. This agreement will guide future research aimed at defining standard postoperative management for BEDT.

Objectives: . Balloon dilation of the Eustachian tube (BDET) is widely recognized as a minimally invasive treatment for obstructive Eustachian tube dysfunction (ETD). We employed a Delphi consensus methodology to develop recommendations for the clinical management of BDET in cases of obstructive ETD. Methods: . A Delphi panel consisting of 26 expert physicians specializing in otology participated in two rounds of anonymous, iterative questionnaires. Consensus was defined as agreement from ≥70% of the panelists on a recommendation, while disagreement was defined as <70% agreement. The responses from the Delphi study were analyzed using both the content validity ratio and Kendall’s coefficient of concordance. Results: . The panel finally evaluated 26 topics, reaching agreement on 9 and failing to reach consensus on 17 after two rounds. While consensus was not achieved regarding the postoperative follow-up period, a duration of 12 months was most commonly adopted. The Valsalva maneuver and questionnaire responses were identified as the most agreed-upon postoperative assessment tools following BDET. Conclusion . Consensus was reached on several recommendations for managing BEDT in obstructive ETD. This agreement will guide future research aimed at defining standard postoperative management for BEDT.