Regardless of the any cause leg ulcers are painful and inconvenient to patients and present clinical and economic problems due to their chronicity. Conventional skin grafts, cultured allogenic epidermis, and cultured autologous epidermis have been used for the treatment of leg ulcers. In a twenty-year-old woman with leg ulcers, autologous pure epidermal sheets were obtained from the lower chest by means of suction blisters and grafted to the leg ulcers. All lesions were healed completely in 20 days after grafting. The donor sites showed slight postinflammatory hyperpigmentations without scars. The autologous epidermal graft using suction blisters appears to be a useful method for the treatment of leg ulcers, with no immunologic rejection, no need for cultivation and anesthesia, no desiccation, and no scars on the donor sites.
Anesthesia ; Blister* ; Cicatrix ; Desiccation ; Epidermis ; Female ; Humans ; Leg Ulcer* ; Leg* ; Methods ; Skin ; Suction* ; Thorax ; Tissue Donors ; Transplants*

No abstract available.
Glaucoma* ; Manometry* ; Mass Screening*

BACKGROUND/AIMS: The female sex hormones are thought to affect gastrointestinal function. However, the relationship between female sex hormone and gastrointestinal function has not been identified. The aim of this study was to evaluate the relationship between constipation and hormonal changes in young women and to find the difference of colon transit time (CTT) across the menstrual cycle. METHODS: Two hundred and five students completed questionnaires. CTT as well as serum estradiol and progesterone levels were measured in 15 regularly menstruating volunteers. RESULTS: One hundred and six experienced changes in bowel habit across menstrual cycle. The mean estradiol concentration in the follicular phase was not significantly different from that in the luteal phase (118.0 +/- 28.8 pg/mL vs. 76.9 +/- 10.5 pg/mL, p > 0.05). The mean progesterone concentration in the luteal phase was significantly higher than that in the follicular phase (3.0 +/- 0.9 ng/mL vs. 1.2 +/- 0.4 ng/mL, p < 0.05). The mean CTT was not significantly delayed in the luteal phase than the time in the follicular phase (45 +/- 20 vs. 35 +/- 22 hours, p > 0.05). However, CTT was delayed at the progesterone peak in 11 of 15 (73.3%) women. CONCLUSIONS: Our study suggested a possible role of female sex hormones as a cause of constipation in young women.
Colon* ; Constipation ; Estradiol ; Female ; Follicular Phase ; Gonadal Steroid Hormones ; Humans ; Luteal Phase ; Menstrual Cycle* ; Progesterone ; Volunteers ; Surveys and Questionnaires

OBJECTIVES: Autism is a complex neurodevelopmental spectrum disorder with a strong genetic component. Previous neurochemical and genetic studies have suggested the possible involvement of the serotonin system in autism. Tryptophan 2,3-dioxygenase(TDO2) is the rate-limiting enzyme in the catabolism of tryptophan, which is the precursor of serotonin synthesis. The aim of this study was to investigate the association between the TDO2 gene and autism spectrum disorders(ASD) in a Korean population. METHODS: The patients were diagnosed with ASD on the basis of the DSM-IV diagnostic classification outlined in the Korean version of the Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule. The present study included the detection of four single nucleotide polymorphisms(SNPs) in the TDO2 gene(rs2292536, rs6856558, rs6830072, rs6830800) and the family-based association analysis of the single nucleotide polymorphisms in Korean ASD trios using a transmission disequilibrium test(TDT) and haplotype analysis. The family trios of 136 probands were included in analysis. 87.5% were male and 86.0% were diagnosed with autism. The mean age of the probands was 78.5+/-35.8 months(range: 26-264 months). RESULTS: Two SNPs showed no polymorphism, and there was no significant difference in transmission in the other two SNPs. We also could not find any significant transmission in the haplotype analysis(p>.05). CONCLUSION: We could not find any significant statistical association between the transmission of SNPs in the TDO2 gene and ASD in a Korean population. This result may not support the possible involvement of the TDO2 gene in the development of ASD, and further exploration might be needed to investigate other plausible SNP sites.
Appointments and Schedules ; Autistic Disorder* ; Child ; Autism Spectrum Disorder* ; Classification ; Diagnostic and Statistical Manual of Mental Disorders ; Haplotypes ; Humans ; Male ; Metabolism ; Polymorphism, Single Nucleotide ; Serotonin ; Tryptophan

Codeine is widely prescribed in clinical settings for the relief of pain and non-productive coughs. Common adverse drug reactions to codeine include constipation, euphoria, nausea, and drowsiness. However, there have been few reports of serious adverse reactions after codeine ingestion in adults. Here, we present a case of severe anaphylaxis after oral ingestion of a therapeutic dose of codeine. A 30-year-old Korean woman complained of the sudden onset of dyspnea, urticaria, chest tightness, and dizziness 10 minutes after taking a 10-mg dose of codeine to treat a chronic cough following a viral infection. She had previously experienced episodes of asthma exacerbation following upper respiratory infections, and had non-atopic rhinitis and a food allergy to seafood. A skin prick test showed a positive response to 1-10 mg/mL of codeine extract, with a mean wheal size of 3.5 mm, while negative results were obtained in 3 healthy adult controls. A basophil histamine release test showed a notable dose-dependent increase in histamine following serial incubations with codeine phosphate, while there were minimal changes in the healthy controls. Following a CYP2D6 genotype analysis, the patient was found to have the CYP2D6*1/*10 allele, indicating she was an intermediate metabolizer. An open label oral challenge test was positive. To the best of our knowledge, this is the first report of a patient presenting with severe anaphylaxis after the ingestion of a therapeutic dose of codeine, which may be mediated by the direct release of histamine by basophils following exposure to codeine.
Adult ; Alleles ; Anaphylaxis* ; Asthma ; Basophil Degranulation Test ; Basophils ; Codeine* ; Constipation ; Cough ; Cytochrome P-450 CYP2D6 ; Dizziness ; Drug-Related Side Effects and Adverse Reactions ; Dyspnea ; Eating ; Euphoria ; Female ; Food Hypersensitivity ; Genotype ; Histamine ; Histamine Release ; Humans ; Nausea ; Respiratory Tract Infections ; Rhinitis ; Seafood ; Skin ; Sleep Stages ; Thorax ; Urticaria

No abstract available.
Asthma* ; Hypersensitivity* ; Phenotype* ; Urticaria*

BACKGROUND: Changes in acid-base balance and serum electrolytes by infusion of lactated Ringer's solution in liver cirrhosis patienst during liver surgery are poorly characterized. In this study, we evaluated the effects of infusing large amount of lactated Ringer's solution on acid-base and serum electrolytes during liver surgery in cirrhosis patients. METHODS: Thirty-two patients were divided into two groups. Group I (n = 21) was made up of patients who had received liver lobectomy without cirrhrosis. Group II (n = 11) was made up of patients who had received liver lobectomy with cirrhosis above a moderate level. Arterial blood gas and serum electrolyte levels were checked 4 times during the study in each patient: just after the operation start, after infusing 3,000 ml and 6,000 ml of lactated Ringer's solution during operation, and 30 minutes after arrival at the postanesthesia care unit. RESULTS: pH and base excess decreased according to the amount of lactated Ringer's solution used in both groups and these results were significant. Serum electrolyte levels were not changed and only Ca2+ levels were significantly different in the two groups. The cause of changing of Ca2+ levels found out by intravenous infusion of Ca2+ solution. CONCLUSIONS: In liver surgery patients with or without liver cirrhosis decreased pH and base excess in serum by increased amount of used lactated Ringers solution during liver surgery but in serum electrolytes and others acid-base parameters, CVP, changes on there were not any statistical significant. When a large amount of LR solution is used in liver surgery, we recommend regular arterial blood gas analyses for acid-base balance and an infusing speed of 20 ml/kg/h.
Acid-Base Equilibrium ; Blood Gas Analysis ; Electrolytes ; Fibrosis* ; Humans ; Hydrogen-Ion Concentration ; Infusions, Intravenous ; Liver Cirrhosis ; Liver*

PURPOSE: The purpose of this study was to develop a resource-based relative value scale (RBRVS) and its conversion factor for advanced nursing practices carried out by critical care nurse practitioners (CCNP) in intensive care units. METHODS: The methodology was developed by calculating CCNP's RBRVS for 32 advanced nursing services based on CCNP's workload and time spent in the context of national health insurance. A cost analysis was performed to estimate the conversion factor of CCNP's RBRVS. The share of CCNP's contribution to fee-for-service in intensive care units was also analyzed. RESULTS: Calculation of the RBRVS of 32 advanced nursing practices showed a range of points from 100.0 to 1,181.4 and an average of 296.1 points. The relevant conversion factor for advanced nursing practices in CCNP were estimated at 37.3-48.4 won. The contribution rate of CCNP's advanced nursing practices in the relative value scale of the national health insurance was estimated at 0.1-31.3%. CONCLUSION: Measuring the economic value of advanced nursing services will be a basis for esta-blishing a reimbursement system for CCNP's practices and thus encourage a social demand for advanced nurse practitioners.
Adult ; Advanced Practice Nursing/*economics ; Costs and Cost Analysis ; Humans ; Intensive Care Units ; National Health Programs ; Nurse Practitioners/*economics ; *Relative Value Scales ; Workload

OBJECTIVES: Methyl-CpG binding protein 2 (MeCP2) is a ubiquitous epigenetic factor that represses gene expression by modifying chromatin. Mutations in the MeCP2 gene cause Rett syndrome, a progressive neurodevelopmental disorder. Recent studies also have shown that MeCP2 plays a role in carcinogenesis. Specifically, functional ablation of MeCP2 suppresses cell growth and leads to the proliferation of cancer cells. However, MeCP2's function in adult tissues remains poorly understood. We utilized a weight matrix-based comparison software to identify transcription factor binding site (TFBS) of MeCP2-regulated genes, which were recognized by cDNA microarray analysis. METHODS: MeCP2 expression was silenced using annealed siRNA in HEK293 cells, and then a cDNA microarray analysis was performed. Functional analysis was carried out, and transcriptional levels in target genes regulated by MeCP2 were investigated. TFBS analysis was done within genes selected by the cDNA microarray analysis, using a weight matrix-based program and the TRANSFAC 6.0 database. RESULTS: Among the differentially expressed genes with a change in expression greater than two-fold, 189 genes were up-regulated and 91 genes were down-regulated. Genes related to apoptosis and cell proliferation (JUN, FOSL2, CYR61, SKIL, ATF3, BMABI, BMPR2, RERE, and FALZ) were highly up-regulated. Genes with anti-apoptotic and anti-proliferative functions (HNRPA0, HIS1, and FOXC1) were down-regulated. Using TFBS analysis within putative promoters of novel candidate target genes of MeCP2, disease-related transcription factors were identified. CONCLUSIONS: The present results provide insights into the new target genes regulated by MeCP2 under epigenetic control. This information will be valuable for further studies aimed at clarifying the pathogenesis of Rett syndrome and neoplastic diseases.
Adult ; Apoptosis ; Binding Sites ; Carcinogenesis ; Carrier Proteins ; Cell Proliferation ; Chromatin ; Epigenomics ; Gene Expression ; HEK293 Cells ; Humans* ; Methyl-CpG-Binding Protein 2 ; Microarray Analysis ; Oligonucleotide Array Sequence Analysis ; Rett Syndrome ; RNA, Small Interfering ; Transcription Factors

OBJECTIVES: Methyl-CpG binding protein 2 (MeCP2) is a ubiquitous epigenetic factor that represses gene expression by modifying chromatin. Mutations in the MeCP2 gene cause Rett syndrome, a progressive neurodevelopmental disorder. Recent studies also have shown that MeCP2 plays a role in carcinogenesis. Specifically, functional ablation of MeCP2 suppresses cell growth and leads to the proliferation of cancer cells. However, MeCP2's function in adult tissues remains poorly understood. We utilized a weight matrix-based comparison software to identify transcription factor binding site (TFBS) of MeCP2-regulated genes, which were recognized by cDNA microarray analysis. METHODS: MeCP2 expression was silenced using annealed siRNA in HEK293 cells, and then a cDNA microarray analysis was performed. Functional analysis was carried out, and transcriptional levels in target genes regulated by MeCP2 were investigated. TFBS analysis was done within genes selected by the cDNA microarray analysis, using a weight matrix-based program and the TRANSFAC 6.0 database. RESULTS: Among the differentially expressed genes with a change in expression greater than two-fold, 189 genes were up-regulated and 91 genes were down-regulated. Genes related to apoptosis and cell proliferation (JUN, FOSL2, CYR61, SKIL, ATF3, BMABI, BMPR2, RERE, and FALZ) were highly up-regulated. Genes with anti-apoptotic and anti-proliferative functions (HNRPA0, HIS1, and FOXC1) were down-regulated. Using TFBS analysis within putative promoters of novel candidate target genes of MeCP2, disease-related transcription factors were identified. CONCLUSIONS: The present results provide insights into the new target genes regulated by MeCP2 under epigenetic control. This information will be valuable for further studies aimed at clarifying the pathogenesis of Rett syndrome and neoplastic diseases.
Adult ; Apoptosis ; Binding Sites ; Carcinogenesis ; Carrier Proteins ; Cell Proliferation ; Chromatin ; Epigenomics ; Gene Expression ; HEK293 Cells ; Humans* ; Methyl-CpG-Binding Protein 2 ; Microarray Analysis ; Oligonucleotide Array Sequence Analysis ; Rett Syndrome ; RNA, Small Interfering ; Transcription Factors