BACKGROUND: Atopic dermatitis has been thought be a T cell mediated disease and autoimmune response may be responsible for chronicity of typical skin manifestation. Mycophenolate mofetil(MMF), a new immunosuppressive agent can be tried in the treatment of atopic dermatits. OBJECTIVE: We examined the efficacy and safety of MMF in the treatment of atopic dermatitis in Korean patients. METHODS: 7 patients with moderate to severe atopic dermatits were recruited in the treatment of oral MMF 2 g daily for 6 weeks and followed up for another 6 weeks. Severity of atopic dermatitis was measured using SCORAD index. Laboratory examination was performed to check the side effect of MMF during the study. RESULTS: Six of 7 patients finished the treatment courses. After 6 weeks of therapy with MMF, patients' symptoms were improved and mean SCORAD index was significantly reduced from 67.2+/-15.5 to 28.7+/-13.5(p<0.01). Significant side effects such as neutropenia, infection, renal toxicity and hepatotoxicity were not observed. During the follow-up period, patients could be managed by topical steroid and oral antihistamine and flare-up was not observed. CONCLUSION: According to our study, MMF is an effective, safe and well-tolerated immunosuppressive agent in the treatment of moderate to severe atopic dermatitis. MMF is a promising alternative in the treatment of severe atopic dermatitis.
Autoimmunity ; Dermatitis, Atopic* ; Follow-Up Studies ; Humans ; Neutropenia ; Skin Manifestations

When the endotracheal tube is removed, blood pressure elevates and heart rate increases. In order to evaluate the hemodynamic changes after removal of a new developed device-laryngeal mask airway, we measured the change of the systolic & diastolic blood pressure and heart rate of 120 patients undergoing general anesthesia. The results were elevation of blood pressure and heart rate after extubation or removal on both groups immediately. But the degree of changes were 18.7+/-1.6% in the endotracheal tube groups and 12.3+/-1.4% in the laryngeal mask airway groups in systolic blood pressure respectively. Therefore the degree of changes of the laryngeal mask airway groups was significantly small (p<0.05). The comparison of the change of diastolic blood pressure was not significant. The degree of the change in heart rate was 19.6+/-2.8% in the endotracheal tube groups and 9.2+/-2.2% in the laryngeal mask airway groups. Therefore the degree of the ehange in blood pressure and heart rate of the laryngeal mask airway groups was significantly small (p<0.05).
Anesthesia, General ; Blood Pressure* ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Laryngeal Masks* ; Masks

Hypoglycemic hemiplegia is an under-recognized manifestation of hypoglycemia and mimics cerebrovascular dis-ease, especially in elderly patients. We report a 70-year-old diabetic woman with hypoglycemic hemiplegia, whose dif-fusion- and perfusion- weighted images showed large cortical high signal intensities and hypoperfusion of the right hemisphere during the period of hypoglycemia. We suggest that the regional cerebral blood redistribution and selective vulnerability in hypoglycemia are responsible for the laterality of neurological deficits observed during hypoglycemic episodes.
Aged ; Female ; Hemiplegia* ; Humans ; Hypoglycemia ; Magnetic Resonance Imaging*

The generally accepted taste pathway in an animal projects ipsilaterally from the solitary nucleus. However, the path-way of gustatory fibers in the human brainstem has not been sufficiently clarified. A 57-year-old hypertensive man was admitted with sudden dizziness and hemiageusia. A neurological examination revealed also a diminution of taste on the left half of his tongue. A MRI showed a high signal intensity in the right lower pontine area. This case suggests that the unilateral lesion of the pons may lead to contralateral taste disturbances.
Ageusia ; Animals ; Brain Stem ; Cerebral Infarction ; Dizziness ; Facial Nerve ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Examination ; Pons ; Solitary Nucleus ; Tongue

Prader-Willi syndrome (PWS) is a rare genetic disorder reported rarely in dentistry. Dental practitioners should know the features of PWS because affected patients have a variety of dental symptoms. The current report describes a case of PWS. An 18-year-old male patient presented with traumatic injuries. Initial emergency treatments were performed under sedation, and further treatments were conducted under general anesthesia. After adequate healing, periodic follow-up and dietary management according to the patient's age and nutritional phase were recommended. Dental management of PWS patients consists of active preventive measures in addition to dietary consultation according to age and nutritional phase.
Adolescent* ; Anesthesia, General* ; Conscious Sedation ; Dentistry ; Emergency Treatment ; Follow-Up Studies ; Humans ; Hyperphagia ; Male ; Practice Management, Dental ; Prader-Willi Syndrome*

Orbital complications after endoscopic sinus surgery (ESS), such as optic nerve or medial rectus injuries, are well known, but isolated complete oculomotor nerve palsy has never been reported. In this case, a 31-year-old male was transferred to our hospital after ESS. Physical examination showed complete left oculomotor nerve palsy, with a bony defect on the sellar floor, which had not fully recovered after more than 1 year. We hypothesized that blunt trauma could be the main cause of the oculomotor palsy. Surgeons performing ESS must keep in mind the possibility of oculomotor palsy due to blunt trauma, especially when operating around the sphenoid and posterior ethmoid sinus.
Adult ; Ethmoid Sinus ; Ethmoid Sinusitis ; Fistula* ; Humans ; Male ; Oculomotor Nerve Diseases ; Optic Nerve ; Orbit ; Paralysis ; Physical Examination

PURPOSE: This study aimed to evaluate periodontal and pulpal healing in replanted rat teeth, preserved under different storage conditions, with or without root conditioning using doxycycline. METHODS: A total of 40 maxillary first molars extracted from 20 Sprague-Dawley rats were stored for different durations under different conditions (5 minutes in dry storage and 60 minutes in Hank's balanced salt solution [HBSS]) and subsequently replanted. The rats were divided into 2 groups based on the use of root surface treatment: the doxycycline group (root surface treated with doxycycline) and the control group (no doxycycline treatment). Eight weeks after replantation, the animals were sacrificed, and the teeth were evaluated using micro-computed tomography (micro-CT) and histomorphometric analysis. RESULTS: In the micro-CT analysis, the doxycycline group showed the same rate of occurrence of periapical radiolucency as was observed in the control group, but a lower degree of root resorption in teeth replanted after 60 minutes of storage in HBSS (P<0.05). In the histomorphometric analysis, the doxycycline group exhibited no improvement in either pulpal or periodontal healing of the replanted tooth after 5 minutes of dry storage, but showed a lower grade of surface root resorption (1.37±0.77) and inflammatory resorption in the teeth stored for 60 minutes in HBSS (1.33±0.71). CONCLUSIONS: In conclusion, doxycycline improved the periodontal healing of replanted teeth stored for 60 minutes in HBSS, whereas doxycycline did not improve periodontal healing of replanted tooth after 5 minutes of dry storage. Within the limits of this study, doxycycline showed more favorable periodontal healing despite delayed replantation.
Animals ; Doxycycline ; Molar ; Rats ; Rats, Sprague-Dawley ; Regeneration ; Replantation ; Root Resorption ; Tooth ; Tooth Injuries

The aim of this study is to investigate the awareness and perception of pediatric dentists regarding dental health insurance (DHI) system in Korea. Online surveys were sent to the members of the Korean Academy of Pediatric Dentistry (KAPD), and the responses were collected. The survey, consisting of 41 questions, was subdivided into ‘general background of the respondents’, ‘the awareness on national health insurance (NHI) and DHI’, ‘the awareness on DHI pertaining to pediatric dentistry’, ‘issues that need improvement on DHI pertaining to pediatric dentistry’, ‘DHI claims’, and ‘the roles of KAPD in DHI’. In total, 302 responded, with a response rate of 28.9%. Excluding 2 questionnaires with insufficient answers, a total of 300 survey results were analyzed. According to the analysis, pediatric dentists thought that the coverage of DHI was not as sufficient compared to that of NHI, but were expecting its scope to broaden in the future. The satisfaction rate was higher in pit and fissure sealant and composite resin filling than in caries-detecting quantitative light-induced fluorescence. Pediatric dentists considered permanent tooth composite resin filling (65.7%) needed an increase in insurance copayment, while topical fluoride application (74.7%) to require insurance coverage. DHI claims were generally handled by dental hygienists and/or nursing assistants. Approximately half of the respondents answered that they have had experiences on appealing for insurance denials. Lastly, pediatric dentists generally had a positive attitude towards providing information for the DHI. This study is expected to be used as a sound dataset for the DHI policy development concerning pediatric dentistry.

BACKGROUND/AIMS: Inadequate bowel preparation can result in prolonged procedure time and increased missed lesion and complication rates. This prospective study aimed to evaluate bowel preparation quality and identify the predictive factors for inadequate bowel preparation in actual clinical practice. METHODS: We included 399 patients who underwent colonoscopy between June 2015 and July 2016. Using the Aronchick bowel preparation scale, we defined a score ≤2 as adequate preparation and a score >2 as inadequate preparation. RESULTS: Mean patient age was 58.38±12.97 years; 60.6% were male. Indications for colonoscopy included screening (69.7%) and surveillance after polyp removal (21.3%). A split-dose regimen was prescribed to 55.4% of patients. The inadequate bowel preparation rate was 28.1%. Overall, the median time between the last bowel preparation agent dose and start of colonoscopy was 5.0 hours (range, 1.5–16.0 hours); that of the adequate group was 5.0 hours (range, 1.5–16.0 hours); and that of the inadequate group was 5 hours (range, 2–23 hours). The mean bowel preparation scale score of the ascending colon (1.94±0.25) was significantly higher than that of other colon segments. On multivariate analysis, elderly age, history of cerebrovascular disease, history of gastrectomy or appendectomy, and total preparation solution uptake < 2 L were the independent predictors of inadequate bowel preparation. CONCLUSIONS: The inadequate bowel preparation rate was 28.1%. Risk factors included elderly age and history of cerebrovascular disease or abdominal surgery. Patients with these risk factors require special care and education.
Aged ; Appendectomy ; Cerebrovascular Disorders ; Colon ; Colon, Ascending ; Colonoscopy* ; Education ; Gastrectomy ; Humans ; Male ; Mass Screening ; Multivariate Analysis ; Polyethylene Glycols ; Polyps ; Prospective Studies* ; Risk Factors

PURPOSE: Thymidylate synthase (TS) gene encodes a tightly regulated enzyme that catalyzes the conversion of deoxyuridylate to thymidylate, and contains a tandem repeat polymorphism, of which a triple repeat is associated with increased expression of TS. TS is a key enzyme in the folate metabolism and compete with methylenetetrahydrofolate reductase (MTHFR) for limiting supplies of folate required for the remethylation of homocysteine. We studied to clarify the association between MTHFR C677T and TS polymorphism and prognosis in epilepsy. METHODS: 119 patients with antiepileptic drug more than one year were included. We investigated the MTHFR C677T and TS polymorphism using PCR, and analyzed the association between plasma homocysteine, folate levels, clinical profiles (especially seizure frequencies) and polymorphism. RESULTS: In seizure frequencies during one year, TT type in MTHFR and 3R3R type in TS polymorphism had higher frequencies than any other types without statistical significance. In plasma homocysteine levels, TT type had significantly higher homocsyteine levels than any other types, but 3R3R type had higher homocsyteine levels than any other types without statistical significance. Combined analysis of MTHFR C677T and TS polymorphism revealed that plasma homocysteine levels (18.22+/-8.32 micromol/l; p=0.039) and seizure frequencies (6.38+/-7.35/year; p=0.04) in patients with TT/3R3R were significantly higher than any other groups. A significant correlation between plasma homocysteine levels and seizure frequencies also was shown in multivariate linear regression analysis (B=0.160, Std error=0.069, adjusted R2=0.039, p=0.021). CONCLUSION: Epileptic patients with hyperhomocysteinemia, especially when combined with mutant allele for MTHFR and TS genes, have higher seizure frequencies. Therefore, our results suggest that the genotyping for the MTHFR and TS polymorphism may become a useful indicator in determining prognosis of epilepsy.
Alleles ; Epilepsy* ; Equipment and Supplies ; Folic Acid ; Homocysteine ; Humans ; Hyperhomocysteinemia ; Linear Models ; Metabolism ; Methylenetetrahydrofolate Reductase (NADPH2) ; Plasma ; Polymerase Chain Reaction ; Prognosis ; Seizures ; Tandem Repeat Sequences ; Thymidylate Synthase