PURPOSE: To determine whether there is a discrepancy between the medical professions perception of what patients should know and that of the patients themselves, we studied patients need to be informed about different aspects of epilepsy and compared findings with medical personnels perceptions of the issue. METHODS: Our study population consisted of 39 patients with epilepsy from the inpatient epilepsy unit, and 51patients from the outpatients clinic of the S. University Hospital between July and November 1997. However, the patients who declined to participate or who were not able to understand the directions and content of the questionnaire were excluded. The medical personnel participated in this study were 56 residents or nurses who were working in either Neurology or Neuro surgery Units. The questionnaire consisted of 6 categories with a total of 79 questions. The responses were indicated on a 5point Likert scale with 5 indicating the highest need . The data were analyzed with descriptive statistics, students t-tests, and chi-square. RESULTS: Of the 90 patients and 56 medical personnel studied, the need for lifestyle information such as smoking, drinking, sleep, driving, employment, and marriage was significantly higher from medical personnel than that of the patients(p=0.00). Regarding medical knowledge about epilepsy, the patients group had higher scores in the need for information on the structure of the brain (p=0.00), whereas medical personnel had higher scores on the symptoms of epilepsy. There was no correlation between the length of epilepsy and the need for information on every item on the questionnaire. The patients had higher rank regarding diet, although it was not significantly different from the medical personnel. Regarding antiepileptic drugs and what to do when there is an attack, medical personnel scored higher. The items on which the patients group scored higher than 4.5 were the possibility of inheritance, the factors that might reduce the number of attacks, the period of usage of AED, and the food they have to avoid or the food they have to take to reduce seizure attacks. CONCLUSIONS: Our study indicates that the patients group requires higher educational need in the structure of the brain, diet, and surgical treatment, but less in lifestyles and what to do when there is an attack. The educational program for the patients with epilepsy should emphasize medical knowledge with regard to brain anatomy, what to eat and what to avoid, and details of surgical treatment.
Anticonvulsants ; Brain ; Diet ; Drinking ; Employment ; Epilepsy* ; Humans ; Inpatients ; Life Style ; Marriage ; Neurology ; Outpatients ; Surveys and Questionnaires ; Seizures ; Smoke ; Smoking ; Wills

4-1BB, a member of the tumor necrosis factor receptor (TNFR) superfamily, is a major costimulatory receptor that is rapidly expressed on the surface of CD4+ and CD8+ T cells after antigen- or mitogen-induced activation. The interaction of 4-1BB with 4-1BBL regulates immunity and promotes the survival and expansion of activated T cells. In this study, the expression of 4-1BB and 4-1BBL was examined during regeneration of the murine thymus following acute cyclophosphamide-induced involution. Four-color flow cytometry showed that 4-1BB and 4-1BBL were present in the normal thymus and were preferentially expressed in the regenerating thymus, mainly in CD4+CD8+ double-positive (DP) thymocytes. Furthermore, the CD4loCD8lo, CD4+CD8lo and CD4loCD8+ thymocyte subsets, representing stages of thymocyte differentiation intermediate between DP and single-positive (SP) thymocytes, also expressed 4-1BB and 4-1BBL during thymus regeneration but to a lesser degree. Interestingly, the 4-1BB and 4-1BBL positive cells among the CD4+CD8+ DP thymocytes present during thymus regeneration were TCR(hi) and CD69+ unlike the corresponding controls. Moreover, the 4-1BB and 4-1BBL positive cells among the intermediate subsets present during thymus regeneration also exhibited TCRhi/int and CD69+/int phenotypes, indicating that 4-1BB and 4-1BBL are predominantly expressed by the positively selected population of the CD4+CD8+ DP and the intermediate thymocytes during thymus regeneration. RT-PCR and Western blot analyses confirmed the presence and elevated levels of 4-1BB and 4-1BBL mRNA and protein in thymocytes during thymus regeneration. We also found that the interaction of 4-1BB with 4-1BBL promoted thymocyte adhesion to thymic epithelial cells. Our results suggest that 4-1BB and 4-1BBL participate in T lymphopoiesis associated with positive selection during recovery from acute thymic involution.
4-1BB Ligand/genetics/*metabolism ; Animals ; Antigens, CD137/genetics/*metabolism ; CD4-Positive T-Lymphocytes/cytology/metabolism ; CD8-Positive T-Lymphocytes/cytology/metabolism ; Cell Adhesion ; Cell Differentiation ; Cell Line ; Cells, Cultured ; Cyclophosphamide/pharmacology ; Epithelial Cells/cytology ; Gene Expression Regulation ; Immunosuppressive Agents/pharmacology ; Male ; Mice ; Mice, Inbred C57BL ; RNA, Messenger/genetics ; *Regeneration ; T-Lymphocytes/*cytology/metabolism ; Thymus Gland/*cytology/drug effects/*physiology

Catechol-O-methyltransferase (COMT) inhibitors are used to increase the bioavailability of therapeutic L-dopa. We examined the effi cacy of entacapone in Parkinson’s disease patients who had daily “off” duration of ≤2 hours, and carried different COMT polymorphisms. A total of 168 PD patients were recruited from 19 centers. Subjects were administered with 100–200 mg of entacapone in combination with each dose of L-dopa for 2 months. The clinical effi cacy was evaluated based on the activities of daily living (ADL), score on the Unifi ed Parkinson’s Disease Rating Scale (UPDRS), Hoehn and Yahr (H&Y) stage, and Clinical Global Impression (CGI). COMT polymorphisms were genotyped. 3-O-methyldopa (3-OMD) levels were measured before and after the administration of entacapone. Entacapone administration produced signifi cant improvements in the total daily “on” duration, ADL, UPDRS score, and H&Y stage. Nineteen patients (11.3%) had the low-activity COMT genotype, 68 patients (40.5%) had the intermediate-activity COMT genotype, and 81patients (48.2%) had the high-activity COMT genotype. The effi cacy, and adverse effects of entacapone therapy did not differ between the three groups. There was a signifi cant reduction in 3-OMD, but this did not differ among the three genotypes. Entacapone provided an increased “on” duration and improved motor function in all COMT genotypes.

PURPOSE: Inhalant allergen sensitization is one of the major factors involved in the pathogenesis of allergic respiratory diseases. However, the sensitization is determined by interactions between genetic and environmental factors. Thus, testing panels of inhalant allergens may differ among geographical areas. Here we aimed to determine 10 common inhalant allergens in Korean adult patients with suspected respiratory allergies and to examine the variation between different geographical locations. METHODS: A total of 28,954 patient records were retrieved for retrospective analysis, from 12 referral allergy clinics located in 9 different areas. Inclusion criteria were Korean adults (≥18 years old) who underwent the inhalant allergen skin prick test for suspected history of respiratory allergy. The primary outcome was inhalant allergen skin prick response. Demographic and clinical information were also collected. Positive skin prick responses to allergens were defined as allergen-to-histamine wheal ratio ≥1. Based on skin test results, the most prevalent aeroallergens were determined. RESULTS: The overall prevalence of allergic sensitization was 45.3%. Dermatophagoides farinae and Dermatophagoides pteronyssinus were the most commonly sensitized allergens. Other common inhalant allergens were cat epithelium (8.1%), birch (7.7%), mugwort (6.9%), alder (6.7%), hazel (6.7%), beech (6.7%), oak (6.6%), and Tyrophagus putres (6.2%), in decreasing order frequency. These 10 inhalant allergens explained 90% of inhalant allergen sensitization in the study participants. However, distinct patterns of the 10 inhalant sensitization were observed in patients living in Chungnam and Jeju. American cockroach, Gernam cockroach, and Trichophyton metagrophytes were unique in Chungnam. Orchard, Japanese cedar, and Velvet were unique in Jeju. CONCLUSIONS: The present analysis suggests a panel of 10 most common inhalant allergens in Korean adult patients with suspected respiratory allergies, which explained 90% of inhalant allergen sensitization. This panel can be utilized as a practical and convenient tool for primary practice and epidemiological surveys of respiratory allergic diseases.
Adult* ; Allergens ; Alnus ; Animals ; Artemisia ; Betula ; Cats ; Chungcheongnam-do ; Cockroaches ; Cryptomeria ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Epithelium ; Fagus ; Humans ; Hypersensitivity ; Periplaneta ; Prevalence ; Referral and Consultation ; Retrospective Studies* ; Skin ; Skin Tests ; Trichophyton