We experienced two cases of occupational asthma induced by Elk dander in Elk-feeders and confirmed these cases by the bronchial provocation test with Elk dander. Both of them showed dual asthmatic response. They also showed positive reaction to the skin prick test with EIK dander. Now one of them has no asthmatic symptoms at all after complete avoidnce of EIK dander.
Asthma, Occupational* ; Bronchial Provocation Tests ; Dander ; Skin

Digital therapeutics is an evidence-based intervention using high-quality software, with the sole purpose of treatment. As many healthcare systems are encountering high demands of quality outcomes, the need for digital therapeutics is gradually increasing in the clinical field. We conducted review of the implications of digital therapeutics in the treatment of neurological deficits for stroke patients. The implications of digital therapeutics have been discussed in four domains: cognition, speech and aphasia, motor, and vision. It was evident that different forms of digital therapeutics such as online platforms, virtual reality trainings, and iPad applications have been investigated in many trials to test its feasibility in clinical use. Although digital therapeutics may deliver high-quality solutions to healthcare services, the medicalization of digital therapeutics is accompanied with many limitations. Clinically validated digital therapeutics should be developed to prove its efficacy in stroke rehabilitation.
Aphasia ; Aphasia, Broca ; Cognition ; Delivery of Health Care ; Hemianopsia ; Hemiplegia ; Humans ; Medicalization ; Neurologic Manifestations ; Rehabilitation ; Stroke

No abstract available.
Perfusion* ; Peripheral Arterial Disease*

No abstract available.
Thyroid Diseases* ; Thyroid Gland*

No abstract available.
Thyroid Diseases* ; Thyroid Gland*

OBJECTIVE: There is need for more objective diagnostic parameters to identify cervical dysplastic or neoplastic cells. So, we examined the p16(INK4A) expression in the cervical tissues to evaluate the value of p16(INK4A) as a diagnostic parameter. METHODS: We examined the p16(INK4A) expression by immunohistochemical staining in normal cervical tissues (n=3), preneoplastic lesions (n=6), carcinoma in situ (CIS, n=5), and invasive carcinomas (n=5) of the cervix, which were selected randomly by H and E staining from the archives of formalin-fixed and paraffin-embedded tissues and we also examined the status of human papillomavirus (HPV) infection in the same tissues. RESULTS: The positive rates of p16(INK4A) expression was significantly higher in all abnormal cervical tissues including subclinical papillomavirus infection (SPI), dysplasia, CIS, and invasive carcinoma than in normal cervical epithelium (p=0.001). Despite the strong expression of p16(INK4A) in the area of CIS, no expression of p16(INK4A) was observed in the area of normal epithelium in the vicinity of CIS. 11 cases among 19 cases of examined tissue samples were tested for HPV infection. Seven of them showed positivity for HPV DNA. CONCLUSION: We herein demonstrated that p16(INK4A) would be a sensitive and specific marker for the abnormal cervical cells in tissue sections. This approach will help to reduce interobserver variations in the histopathologic interpretation of cervical biopsy specimens.
Biopsy ; Carcinoma in Situ ; Cervix Uteri ; Cyclin-Dependent Kinase Inhibitor p16* ; Diagnosis* ; DNA ; Epithelium ; Female ; Humans ; Observer Variation ; Papillomavirus Infections

Hypercalcemia due to hyperparathyroidism is a proposed mechanism of pancreatitis. The occurrence of acute pancreatitis caused by hypercalcemia represents a diagnostic clue for hyperparathyroidism. The incidence of acute pancreatitis caused by hyperparathyroidism appears to be decreasing, and it reflects the earlier diagnosis of hyperparathyroidism due to wide spread application of screening method. In a 71-year-old female patient who was admitted to hospital because of acute pancreatitis, hypercalcemia led to the discovery of the parathyroid adenoma. The patient recovered by parathyroidectomy with medical management of hypercalcemia.
Aged ; Diagnosis ; Female ; Humans ; Hypercalcemia ; Hyperparathyroidism* ; Incidence ; Mass Screening ; Pancreatitis* ; Parathyroid Neoplasms ; Parathyroidectomy

Nutcracker esophagus is thought to be a common cause of noncardiac chest pain although has not been clearly established, and the effective treatment is lacking. The usual forms of therapy for noncardiac chest pain by nutcracker esophagus have been directed traditionally toward reducing esophageal hypermotility and muscle tone such as nitrate and calcium channel blocker. However, the results of this treatment in the long term care of patient with esophageal symptoms have been generally disappointing and often unsatisfactory. Recently, psychosomatic aspect of esophageal motility disorder including antidepressant treatment has been accepted in the treatment of noncardiac chest pain. We report a 48 year old female with nutcracker esophagus associated chest pain by ambulatory 24 hour esophageal manometry who failed diagnosis by conventional manometry. The symptoms of chest pain, quality of life, and depression of the patient were improved after antidepressant medication.
Calcium Channels ; Chest Pain* ; Depression ; Diagnosis ; Esophageal Motility Disorders* ; Female ; Humans ; Long-Term Care ; Manometry ; Middle Aged ; Quality of Life ; Thorax*

BACKGROUND/AIMS: The aim of this study was to assess the diagnostic use of endoscopic ultrasonograpy (EUS) in detecting the cause of common bile duct (CBD) dilatation in patients in whom abdominal ultrasonography or abdominal CT scan could not identify the cause of dilatation. METHODS: Thirty-seven patients (23 men, 14 women, mean age 62.2 years) with uncertain causes of CBD dilatation on abdominal sonogram and CT scan between October 1999 and November 2003 were enrolled. All patients were evaluated by EUS and endoscopic retrograde cholangiopancreatography (ERCP). Final diagnosis were determined by ERCP, surgical exploration and clinical follow-up. RESULTS: The following diagnosis were made by EUS: choledocholithiasis in 11 patients, CBD dilatation only in 12, benign stricture of distal CBD in 8, periampullary tumor in 6. The definitive diagnosis of choledocholithiasis (n=11), benign stricture of distal CBD (n=10), ampullary tumor (n= 5) were determined by ERCP with or without sphincterotomy and surgical exploration. EUS provided the accurate explanation for CBD dilatation in 32 of the 37 patients (86%). CONCLUSIONS: When the diagnosis of biliary obstruction remains obscure on abdominal sonography or CT scan, EUS may be useful.
Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Common Bile Duct* ; Constriction, Pathologic ; Diagnosis ; Dilatation* ; Endosonography* ; Female ; Follow-Up Studies ; Humans ; Male ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND: Hyperhomocysteinemia plays an important role in atherosclerosis resulting from endothelial dysfunction and injury followed by platelet activation and thrombus formation. We evaluated the prevalence and determinants of hyperhomocysteinemia in patients with chronic renal failure(CRF) and relationship between hyperhomocysteinemia and cardiovascular diseases. METHODS: We evaluated the prevalence of hyperhomocysteinemia in CRF patients and hemodialysis patients. Fasting plasma homocysteine, vitamin B12, vitamin B6, creatinine, fibrinogen, lipoprotein(a), glucose, total cholesterol, HDL cholesterol, and TG levels were assessed in 69 patients. RESULTS: Hyperhomocysteinemia was detected 5% in controls, 86% in CRF groups, and 85% in hemodialysis group. Serum folate value in hemodialysis group was significantly higher than normal controls (10.7+/-4.8 vs. 15.3+/- 5.4nmoL/L; p<0.05). Plasma homocysteine concentration negatively correlated with serum folate level in hemodialysis patients(r=-0.42, p<0.05). Cardiovascular diseases were deteceted 14% in CRF patients and 25% in hemodialysis patients. Matched odds ratios(with 95% confidence intervals) were respectively 118.75, 107.7 for homocysteine in CRF and hemodialysis patients compaired with control group. CONCLUSION: Plasma homocysteine level correlated negatively with serum folate level in hemodialysis patients. In univariate analysis, determinant of plasma homocysteine concentration in hemodialysis patients is plasma folate concentration. We considered that hyperhomocysteinemia is also an independent risk factor of cardiovascular diseases.
Atherosclerosis ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Creatinine ; Fasting ; Fibrinogen ; Folic Acid ; Glucose ; Homocysteine ; Humans ; Hyperhomocysteinemia* ; Kidney Failure, Chronic* ; Lipoprotein(a) ; Plasma ; Platelet Activation ; Prevalence* ; Renal Dialysis ; Risk Factors ; Thrombosis ; Vitamin B 12 ; Vitamin B 6