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*

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

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

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

Allergen-specific immunotherapy (SIT) reduces allergen specific IgE (sIgE) levels and achieves clinical and immunological tolerance by modulating innate and adaptive immunological responses. Increased temperature and CO2 concentrations caused by climate changes contribute to an increase of pollen count and allergenicity that influences clinical SIT outcomes. In this study, we investigated the changes of IgE binding components to tree and weed pollens in pollinosis patients who showed a paradoxical increase of serum sIgE level during pollen-SIT. We enrolled nine patients who showed an increasing pattern of serum sIgE level to alder, birch, ragweed and mugwort pollens by enzyme-linked immunosorbant assay. IgE immunoblot analysis confirmed the intensification or new generation of major IgE binding components that could be induced by climate change. The findings suggest that the regular monitoring of sIgE levels and symptom changes is required to improve the clinical outcomes of SIT in patients undergoing SIT for tree and weed pollens.
Adult ; Climate Change ; *Desensitization, Immunologic ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulin E/*blood ; Male ; Middle Aged ; Pollen/immunology ; Rhinitis, Allergic, Seasonal/*therapy ; Skin Tests ; Young Adult

PURPOSE: Pollinosis is one of the major allergic diseases caused by airborne pollens. Alder and birch pollens are the major sensitizing tree pollens in this country. The immunoglobulin E (IgE) reactivity to each pollen allergen is known to be variable according to the region. We determined the major IgE binding components of these tree pollens in sera of adult patients with allergic rhinitis. METHODS: Allergic rhinitis patients, of whom specific IgE level to birch and/or alder pollens (>10 kU/L by ImmunoCAP) were included. The protein bands of two pollen extracts were determined by sodium dodecyl sulphate-polyacrylamide gel electrophoresis, and their IgE-binding components were identified by IgE immunoblot analysis. The binding specificity and cross-reactivity between two pollens were evaluated by IgE enzyme linked immunosorbent assay (ELISA) inhibition test. RESULTS: Six IgE binding components were found in birch pollens in which two (14 kDa and 17 kDa) were major components. Two IgE binding components were found in alder pollens in which the 17 kDa was a major component. The IgE binding component to the major allergen component of 17 kDa was observed in 90.3% of the study subjects sensitive to alder pollens and 72.7% of them sensitive to birch pollens. The ELISA inhibition tests showed significant inhibitions with additions of birch/alder pollen extracts. CONCLUSION: We identified two major IgE binding components (17 kDa and 14 kDa) from birch pollens and one component (17 kDa) from alder pollens. Significant cross reactivity was noted between these two pollens.
Adult ; Allergens ; Alnus ; Betula ; Cross Reactions ; Electrophoresis ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoblotting ; Immunoglobulin E ; Immunoglobulins ; Pollen ; Rhinitis ; Rhinitis, Allergic, Perennial ; Rhinitis, Allergic, Seasonal ; Sodium

BACKGROUND: Although pulmonary artery catheters are useful to monitor hydration, these devices may be associated with severe morbidity and are not routinely used in kidney transplantation. A central venous pressure (CVP) catheter is preferred rather than a pulmonary artery catheter. Noninvasive continuous blood pressure monitors may substitute for intraarterial catheters, thereby preserving the radial artery in kidney transplantation patients should it be needed later to create an arteriovenous fistula. If there is a relationship between central venous and radial arterial blood for acid-base (pH, BE, HCO3(-)), we can use the blood sample from a CVP catheter instead of arterial blood from aradial artery catheter for testing acid-base and it can help patients. METHODS: A central venous catheter and radial artery catheter was inserted in 67 patients while undergoing kidney transplantation. To assess arteriovenous differences in acid-base status at operation start, before reperfusion of the transplanted kidney, after reperfusion, we measured the pH, BE and HCO3(-) simultaneously from the arterial and central venous circulation. RESULTS: Aacid-base using arterial and central venous samples at operation start, before reperfusion and after reperfusionb was evaluated. We found the relationship as follows: pH between arterial (pHa) and central venous blood (pHcv) in each: linear regression equation; pHcv = 0.668 + (0.906 X pHa), pHcv = 0.225 + (0.965 X pHa), pHcv = 0.646 + (0.908 X pHa), determination coefficient; 0.908, 0.926, 0.888, P values < 0.001 in each period. Base excess (BE) between BEa and BEcv in each period: linear regression equation; BEcv = 0.483 + (0.952 X BEa), BEcv = 0.032 + (0.939 X BEa), BEcv = 0.008 + (0.954 X BEa), determination coefficient; 0.844, 0.954, 0.962 P values < 0.001 in each period. HCO3(-) concentration between HCO3(-)a and HCO3(-)cv in each period: linear regression equation; HCO3(-)cv = 2.434 + (0.937 X HCO3(-)a), HCO3(-)cv = 2.093 + (0.942 X HCO3(-)a), HCO3(-)cv = 1.755 + (0.954 X HCO3 a), determination coefficient; 0.950, 0.925, 0.932 P values < 0.001 in each period. CONCLUSIONS: The acid base status of arterial blood is similar to that of central venous blood. Central venous blood gas values (pH, BE, HCO3(-)) may be an acceptable alternative to arterial blood gas values in kidney transplantation patients.
Arteries ; Arteriovenous Fistula ; Blood Pressure Monitors ; Catheters ; Central Venous Catheters ; Central Venous Pressure ; Humans ; Hydrogen-Ion Concentration ; Kidney ; Kidney Transplantation ; Linear Models ; Pulmonary Artery ; Radial Artery ; Reperfusion

No abstract available.
Cell Proliferation* ; Female ; Humans ; Trophoblasts*

Cutis laxa is a rare disorder of the elastic tissue characterized by loosely hanging and folded skin giving a premature senile appearance, often with internal organ involvement. Recently, we experienced a case of cutis laxa in a neonate. The patient who presented with dyspnea and loose skin at birth was delivered by Cesarean section in our hospital. He was the third baby of his mother and his siblings had no problem including skin. Physical examination on admission revealed a dyspneic neonate with skin showing loose folds, wrinkles and sagging over the face, neck, trunk and thighs. He had no family history of skin disease suggestive of cutis laxa. Histopathologic study of the skin specimen showed widespread breakdown and decreased number of elastic fibers with granular degeneration, shortening, and fragmentation. He had been dependent on ventilatory support throughout his hospital course and finally succumbed to intractable pulmonary emphysema at the age of 220 days.
Cesarean Section ; Cutis Laxa* ; Dyspnea ; Elastic Tissue ; Female ; Humans ; Infant, Newborn ; Mothers ; Neck ; Parturition ; Physical Examination ; Pregnancy ; Pulmonary Emphysema* ; Siblings ; Skin ; Skin Diseases ; Thigh