BACKGROUND: Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by a severe reduction in the number of circulating platelets. Corticosteroid therapy, which has been used in ITP for many years, has produced a complete or partial response rate of 65% to 75%, although sustained remissions have been reported in only 18% to 32% of the patients. The purpose of the present study is to define response to each treatment and ultimate outcome of adults with ITP. METHOD: A clinical study was done on 35 cases of ITP who had admitted to the department of Internal Medicine, Yeungnam University Hospital from June 1983 to July 1996. The response of each treatment modalities was based on criteria of Defino and Cooperative Latin American Group on Hemostasis and Thrombosis. RESULTS: The mean age of patients was 41.9 years old and female to male ratio was 1:0.6 (female:22 cases, male:13 cases). The complete response rate to intravenous gamma-globulin as early therapy was obtained in 72% of the patients and the duration to platelet count above 50,000/ microliter was 3 days after intravenous gamma-globulin therapy. Duration of response was 15 days. The CCR (continuing complete response) to corticosteroid was obtained in 16% of the patients, and no CCR to reinduction with corticosteroid was observed. The CR to splenectomy was obtained in 85% of the patients. The overall results of all therapeutic modalities were CCR 43%, TCR (temporary complete response) 20%, PR (partial response) 31%, and NR (no response) 6%. CONCLUSION: This analysis of ITP in adults suggests that splenectomy remains as the most effective treatment and intravenous gamma-globulin is effective for rapid elevation of platelet count.
Adult* ; Female ; gamma-Globulins ; Hemostasis ; Humans ; Internal Medicine ; Male ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic* ; Secondary Prevention ; Splenectomy ; Thrombosis

The skin over the nose is less mobile for primary closure of defects. In addition to skin graft and secondary intention healing, there are various local flap techniques and their modifications for the reconstruction of nasal defects. Imprecise engineering of wound repair methods and contracture can lead to twisting of the nose and distortion of surrounding anatomic structures such as the nasal ala and paranasal sulcus. The skin defects on the nasal dorsum were reconstructed with a modified bilateral rombic flap. In our case, there were no significant complications and the final result was satisfactory in both functional and cosmetic aspects. Through our experience, we can confirm that the modified bilateral rhombic flap can reconstruct defects on the center area of the nasal dorsum effectively and in a single stage.
Contracture ; Intention ; Nose ; Skin ; Transplants ; Wounds and Injuries

BACKGROUND: Atopic dermatitis (AD) is associated with severe pruritus, but there are only a few effective treatment modalities. Previous studies have demonstrated that infrared light inhibited the development of atopic dermatitis. OBJECTIVE: This study is to evaluate the efficacy and safety of StoneTouch(R) infrared device in reducing pruritus associated with atopic dermatitis. METHODS: A total of 92 patients with atopic dermatitis with mild to moderate AD were enrolled in the randomized single-blind, placebo-controlled study. Randomly assigned StoneTouch(R) or sham device was irradiated three times daily for 14 days trial. Efficacy was evaluated by visual analogue scales and investigator's assessments. RESULTS: Pruritus scores using VAS evaluated by patients revealed greater improvement in the StoneTouch(R) infrared treatment group. Assessment of treated skin lesion by physicians showed significant improvement of skin findings in treated group. Transient erythema and mild irritation on the treated site were reported in a few patients. These symptoms were diminished within 1~2 days of treatment. CONCLUSION: StoneTouch(R) infrared device is safe and effective in reducing pruritus in patients with atopic dermatitis.
Dermatitis, Atopic ; Erythema ; Humans ; Light ; Pruritus ; Salicylamides ; Skin ; Weights and Measures

BACKGROUND: Atopic dermatitis (AD) is associated with severe pruritus, but there are only a few effective treatment modalities. Previous studies have demonstrated that infrared light inhibited the development of atopic dermatitis. OBJECTIVE: This study is to evaluate the efficacy and safety of StoneTouch(R) infrared device in reducing pruritus associated with atopic dermatitis. METHODS: A total of 92 patients with atopic dermatitis with mild to moderate AD were enrolled in the randomized single-blind, placebo-controlled study. Randomly assigned StoneTouch(R) or sham device was irradiated three times daily for 14 days trial. Efficacy was evaluated by visual analogue scales and investigator's assessments. RESULTS: Pruritus scores using VAS evaluated by patients revealed greater improvement in the StoneTouch(R) infrared treatment group. Assessment of treated skin lesion by physicians showed significant improvement of skin findings in treated group. Transient erythema and mild irritation on the treated site were reported in a few patients. These symptoms were diminished within 1~2 days of treatment. CONCLUSION: StoneTouch(R) infrared device is safe and effective in reducing pruritus in patients with atopic dermatitis.
Dermatitis, Atopic ; Erythema ; Humans ; Light ; Pruritus ; Salicylamides ; Skin ; Weights and Measures

BACKGROUND: Atopic dermatitis is a chronic inflammatory skin disease. It is caused by immunological abnormalities, abnormalities of the skin barrier, environmental factors and genetic factors. Atopic dermatitis destroys the skin barrier and passes through the skin, triggering an immune response. To treat atopic dermatitis, we anticipate use of hypoallergenic cures to hydrate skin that has been dried by destruction of the skin barrier. OBJECTIVE: We did a preclinical trial to identify inhibitory effects of the StoneTouch(R) infrared scanner on atopic dermatitis. We conducted skin safety tests, comparing the use of infrared energy to drug treatment. We then confirmed the effects of the StoneTouch(R) infrared scanner through animal tests using Nc/Nga mice as a model of atopic dermatitis in order to identify any inhibition of the immune response in atopic dermatitis. METHODS: We irradiated Nc/Nga mice using a StoneTouch(R) infrared scanner under a variety of conditions. During skin safety tests of the StoneTouch(R) infrared scanner on hairless mice, we assessed immune response and burn risk in irradiated mouse skin. We identified any inhibitory effects on atopic dermatitis using Dermoscope assessments, measurements of transepidermal water loss (TEWL) and IgE levels, measurements of pro-inflammatory cytokines, H&E staining and immunofluorescence staining (IF) of substance P and CGRP as neurotransmitters on the backs and ears of Nc/Nga mice irradiated by the StoneTouch(R) infrared scanner. RESULTS: We did not observe any skin abnormalities after using the StoneTouch(R) infrared scanner on Nc/Nga mice. We confirmed the inhibitory effect of the StoneTouch(R) infrared scanner irradiation on atopic dermatitis. We found that irradiated epidermis was thinner than that of the epidermis in Nc/Nga mice in which atopic dermatitis was induced. We observed no significant between groups differences in expression level of substance P. The expression of CGRP in mice with atopic dermatitis was decreased, but, the increased irradiation led to greater expression of CGRP in irradiated skin. CONCLUSION: The StoneTouch(R) infrared scanner does not as a function of irradiation dosage. It inhibits the development of atopic dermatitis.
Animals ; Burns ; Cytokines ; Dermatitis, Atopic ; Ear ; Epidermis ; Fluorescent Antibody Technique ; Immunoglobulin E ; Mice ; Mice, Hairless ; Neurotransmitter Agents ; Skin ; Skin Abnormalities ; Skin Diseases ; Substance P

Sphingosine 1-phosphate (S1P) is a bioactive lipid molecule that mediates cell proliferation, differentiation, migration, and angiogenesis in vivo. However, the roles of S1P on pathogenesis of arthritis have been not completely understood. This study was designed to determine the effects of S1P modulation on collageninduced arthritis (CIA) model. DBA/1J mice were injected with collagen into the tail for induction of CIA model. S1P was administered into the peritoneal cavity every other days from day 1 to day 42 after collagen injection. To determine the degree of damage in CIA, we examined macroscopic findings of CIA. The inflammation and bone destruction of CIA mice were evaluated by histo-patholigy and radiography (CT and microradiography). The expressions of TNF-alpha, IL-6, and RANKL which have important roles in pathogenesis of rheumatoid arthritis and bone destruction were observed by immuno-histochemical staining. After injection with collagen in the DBA/1J mice, CIA was induced by swelling in the knee and ankle joint. Administration of S1P suppressed damages and incidence of arthritis elicited by collagen. In histologic and radiographic studies, S1P strongly suppressed the infiltration of inflammatory cells, the swelling of synovial membrane, erosion, and the destruction of bone on CIA mice. Injection of S1P resulted in down-regulation of the expression of the pro-inflammatory and bone destruction mediators such as TNF-alpha, IL-6, and RANKL on CIA mice. Furthermore, S1P suppressed the differentiation of bone marrow cells into osteoclasts by RANKL. In conclusion, this study suggest that S1P has protective effects on inflammation and bone destruction during pathogenesis of CIA, which indicates S1P can be a new possible therapeutic strategy for rheumatoid arthritis
Animals ; Ankle Joint ; Arthritis ; Arthritis, Rheumatoid* ; Bone Marrow Cells ; Cell Proliferation ; Collagen ; Down-Regulation ; Incidence ; Inflammation* ; Interleukin-6 ; Knee ; Mice* ; Osteoclasts ; Peritoneal Cavity ; Radiography ; Sphingosine ; Synovial Membrane ; Tail ; Tumor Necrosis Factor-alpha

Background/Aims: To compare the effects of abatacept and conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) on the progression and development of rheumatoid arthritis-associated interstitial lung disease (RA-ILD). Methods: This multi-center retrospective study included RA patients receiving abatacept or csDMARDs who underwent at least two pulmonary function tests and/or chest high-resolution computed tomography (HRCT). We compared the following outcomes between the groups: progression of RA-ILD, development of new ILD in RA patients without ILD at baseline, 28-joint Disease Activity Score with the erythrocyte sedimentation rate (DAS28-ESR), and safety. Longitudinal changes were compared between the groups by using a generalized estimating equation. Results: The study included 123 patients who were treated with abatacept (n = 59) or csDMARDs (n = 64). Nineteen (32.2%) and 38 (59.4%) patients treated with abatacept and csDMARDs, respectively, presented with RA-ILD at baseline. Newly developed ILD occurred in one patient receiving triple csDMARDs for 32 months. Among patients with RA-ILD at baseline, ILD progressed in 21.1% of cases treated with abatacept and 34.2% of cases treated with csDMARDs during a median 21-month follow-up. Longitudinal changes in forced vital capacity and diffusing capacity for carbon monoxide were comparable between the two groups. However, the abatacept group showed a more significant decrease in DAS28-ESR and glucocorticoid doses than csDMARDs group during the follow-up. The safety of both regimens was comparable. Conclusions Abatacept and csDMARDs showed comparable effects on the development and stabilization of RA-ILD. Nevertheless, compared to csDMARDs, abatacept demonstrated a significant improvement in disease activity and led to reduced glucocorticoid use.

Background/Aims: To compare the effects of abatacept and conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) on the progression and development of rheumatoid arthritis-associated interstitial lung disease (RA-ILD). Methods: This multi-center retrospective study included RA patients receiving abatacept or csDMARDs who underwent at least two pulmonary function tests and/or chest high-resolution computed tomography (HRCT). We compared the following outcomes between the groups: progression of RA-ILD, development of new ILD in RA patients without ILD at baseline, 28-joint Disease Activity Score with the erythrocyte sedimentation rate (DAS28-ESR), and safety. Longitudinal changes were compared between the groups by using a generalized estimating equation. Results: The study included 123 patients who were treated with abatacept (n = 59) or csDMARDs (n = 64). Nineteen (32.2%) and 38 (59.4%) patients treated with abatacept and csDMARDs, respectively, presented with RA-ILD at baseline. Newly developed ILD occurred in one patient receiving triple csDMARDs for 32 months. Among patients with RA-ILD at baseline, ILD progressed in 21.1% of cases treated with abatacept and 34.2% of cases treated with csDMARDs during a median 21-month follow-up. Longitudinal changes in forced vital capacity and diffusing capacity for carbon monoxide were comparable between the two groups. However, the abatacept group showed a more significant decrease in DAS28-ESR and glucocorticoid doses than csDMARDs group during the follow-up. The safety of both regimens was comparable. Conclusions Abatacept and csDMARDs showed comparable effects on the development and stabilization of RA-ILD. Nevertheless, compared to csDMARDs, abatacept demonstrated a significant improvement in disease activity and led to reduced glucocorticoid use.

Background/Aims: To compare the effects of abatacept and conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) on the progression and development of rheumatoid arthritis-associated interstitial lung disease (RA-ILD). Methods: This multi-center retrospective study included RA patients receiving abatacept or csDMARDs who underwent at least two pulmonary function tests and/or chest high-resolution computed tomography (HRCT). We compared the following outcomes between the groups: progression of RA-ILD, development of new ILD in RA patients without ILD at baseline, 28-joint Disease Activity Score with the erythrocyte sedimentation rate (DAS28-ESR), and safety. Longitudinal changes were compared between the groups by using a generalized estimating equation. Results: The study included 123 patients who were treated with abatacept (n = 59) or csDMARDs (n = 64). Nineteen (32.2%) and 38 (59.4%) patients treated with abatacept and csDMARDs, respectively, presented with RA-ILD at baseline. Newly developed ILD occurred in one patient receiving triple csDMARDs for 32 months. Among patients with RA-ILD at baseline, ILD progressed in 21.1% of cases treated with abatacept and 34.2% of cases treated with csDMARDs during a median 21-month follow-up. Longitudinal changes in forced vital capacity and diffusing capacity for carbon monoxide were comparable between the two groups. However, the abatacept group showed a more significant decrease in DAS28-ESR and glucocorticoid doses than csDMARDs group during the follow-up. The safety of both regimens was comparable. Conclusions Abatacept and csDMARDs showed comparable effects on the development and stabilization of RA-ILD. Nevertheless, compared to csDMARDs, abatacept demonstrated a significant improvement in disease activity and led to reduced glucocorticoid use.

Background/Aims: To compare the effects of abatacept and conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) on the progression and development of rheumatoid arthritis-associated interstitial lung disease (RA-ILD). Methods: This multi-center retrospective study included RA patients receiving abatacept or csDMARDs who underwent at least two pulmonary function tests and/or chest high-resolution computed tomography (HRCT). We compared the following outcomes between the groups: progression of RA-ILD, development of new ILD in RA patients without ILD at baseline, 28-joint Disease Activity Score with the erythrocyte sedimentation rate (DAS28-ESR), and safety. Longitudinal changes were compared between the groups by using a generalized estimating equation. Results: The study included 123 patients who were treated with abatacept (n = 59) or csDMARDs (n = 64). Nineteen (32.2%) and 38 (59.4%) patients treated with abatacept and csDMARDs, respectively, presented with RA-ILD at baseline. Newly developed ILD occurred in one patient receiving triple csDMARDs for 32 months. Among patients with RA-ILD at baseline, ILD progressed in 21.1% of cases treated with abatacept and 34.2% of cases treated with csDMARDs during a median 21-month follow-up. Longitudinal changes in forced vital capacity and diffusing capacity for carbon monoxide were comparable between the two groups. However, the abatacept group showed a more significant decrease in DAS28-ESR and glucocorticoid doses than csDMARDs group during the follow-up. The safety of both regimens was comparable. Conclusions Abatacept and csDMARDs showed comparable effects on the development and stabilization of RA-ILD. Nevertheless, compared to csDMARDs, abatacept demonstrated a significant improvement in disease activity and led to reduced glucocorticoid use.