Toxic epidermal necrolysis (TEN) is a rare, acute, serious, and potentially fatal skin disease, in which cell death causes the epidermis to separate from the dermis. It is thought to be a hypersensitivity complex that affects the skin and mucous membranes, and is caused by certain medications, infections, genetic factors, underlying immunologic disease, or more rarely, cancers. We report two cases of TEN associated with deflazacort (DFZ), a derivative of prednisolone, used in the first episode of nephrotic syndrome (NS). The skin eruption appeared on the 4(th) and 5(th) weeks after DFZ administration, while NS was in remission. The widespread lesions were managed by intensive supportive treatment, discontinuation of DFZ, and oral administration of cyclosporine. Both patients showed a rapid improvement in symptoms of TEN without any complications or relapse of NS.
Administration, Oral ; Cell Death ; Cyclosporine* ; Dermis ; Epidermis ; Humans ; Hypersensitivity ; Immune System Diseases ; Mucous Membrane ; Nephrotic Syndrome* ; Prednisolone ; Recurrence ; Skin ; Skin Diseases ; Stevens-Johnson Syndrome*

PURPOSE: The purpose of this study was to compare the validity of Onen's alternative grading system (AGS) with that of the APDRP and SFU grading systems in patients with isolated and complicated congenital hydronephrosis. METHODS: We retrospectively reviewed the medical records of 153 patients (204 renal units) diagnosed with congenital hydronephrosis between January 2002 and December 2011. We classified patients into 2 groups; isolated or complicated hydronephrosis. All renal units were graded according to anterior-posterior diameter of renal pelvis (APDRP), Society for Fetus Urology (SFU) and Onen's grading systems. We analyzed the prognosis of hydronephrosis, according to each grading system, at 2 years of age. RESULTS: There were 152 renal units with isolated hydronephrosis and 52 renal units with complicated hydronephrosis. The isolated hydronephrosis group had a lower grade according to Onen's AGS, and showed more frequent spontaneous remission by 2 years of age. There was more frequent obstruction (P=0.000) and surgical treatment (P=0.000) of units with high-grade hydronephrosis according to Onen's AGS. In the complicated hydronephrosis group the frequencies of spontaneous remission (P=0.015) and renal dysfunction (P=0.013) were significantly higher than those in high-grade hydronephrosis, as indicated by Onen's AGS. There were no significant differences in clinical outcomes among the highest grade groups, according to the 3 systems, in either isolated or complicated hydronephrosis. CONCLUSION: Onen's AGS reflects the prognosis of hydronephrosis as well as other grading systems in those with isolated hydronephrosis. It was better predictor of renal dysfunction in those with complicated hydronephrosis. However, Onen's AGS was not superior to the other grading systems in terms of predicting prognosis, especially in high-grade hydronephrosis.
Fetus ; Humans ; Hydronephrosis* ; Kidney Pelvis ; Medical Records ; Prognosis ; Remission, Spontaneous ; Retrospective Studies ; Ultrasonography ; Urology

Background: The Korean Blood Safety Commission established the Regional Networks for Blood Transfusion Management (RNBTM) Project which has operated in 14 regions across the country since 2017 to help blood transfusion management in small and medium-sized medical institutions. Since implementation of the RNBTM, participant’s satisfaction has not been evaluated, therefore in order to evaluate participant’s satisfaction and assist in future planning a survey was conducted. Methods: Fourteen facilitators participated in an anonymous on-line survey (5 questions). Laboratory Medicine (LM) doctors from small and medium-sized medical institutions from 14 regions also participated in a separate anonymous on-line survey (15 questions). Results: 14/14 (100%) facilitators responded to the survey. In addition to the RNBTM they were also in favor of establishing a Network of University Hospitals. 135 LM doctors responded to the survey. Of the RNBTM participants, 94.1% (111/118) replied that RNBTM was helpful in providing and exchanging blood transfusion information. Respondents indicated that they wished to remain part of RNBTM into the future because they felt that RNBTM not only helped improve quality of blood transfusions but also other aspects in the laboratory. In 70.4% (95/135) of participating medical institutions, LM doctors have been the Chairperson of the Hospital Transfusion Committee. Conclusion Extremely positive survey results were received from LM doctors. These survey results from LM doctors and facilitators will be helpful in developing and planning future projects related to RNBTM.

Objectives: Community Water Fluoridation (CWF) was suspended in Ansan city in 2018. The purpose of this study was to inspect the status of caries in the permanent teeth of adolescents and suggest the index as the baseline for cohort study in the CWF suspended area. Methods: Oral examinations and questionnaire surveys were conducted on adolescents aged 12 years. Of 1,479 individuals, 890 (60.2%) consented to the examinations. Frequency and logistic regression analyses were used to investigate the status of permanent dental caries by demographic, sociological, and health behavioral characteristics. The study was conducted with approval from IRB Kyung Hee University. Results: The findings reveal gaps in the prevalence of caries among the study sample according to demographic, sociological and health behavioral factors. Rates of untreated caries were higher among adolescents who stayed in the area for a lesser duration, had foreign parents, or had cariogenic drinks more often (p<0.05). Conclusions A gap in untreated caries was observed based on demographic, sociological, and health behavioral factors. The findings of the study suggest the need to monitor oral health following cessation of CWF, along with developing alternative programs in the near future.

Objectives: Community Water Fluoridation (CWF) was suspended in Ansan city in 2018. The purpose of this study was to inspect the status of caries in the permanent teeth of adolescents and suggest the index as the baseline for cohort study in the CWF suspended area. Methods: Oral examinations and questionnaire surveys were conducted on adolescents aged 12 years. Of 1,479 individuals, 890 (60.2%) consented to the examinations. Frequency and logistic regression analyses were used to investigate the status of permanent dental caries by demographic, sociological, and health behavioral characteristics. The study was conducted with approval from IRB Kyung Hee University. Results: The findings reveal gaps in the prevalence of caries among the study sample according to demographic, sociological and health behavioral factors. Rates of untreated caries were higher among adolescents who stayed in the area for a lesser duration, had foreign parents, or had cariogenic drinks more often (p<0.05). Conclusions A gap in untreated caries was observed based on demographic, sociological, and health behavioral factors. The findings of the study suggest the need to monitor oral health following cessation of CWF, along with developing alternative programs in the near future.

Reversible thermal injury to the esophagus as the result of drinking hot liquids has been reported to generate alternating white and red linear mucosal bands, somewhat reminiscent of a candy cane. This phenomenon is associated with chest pain, dysphagia, odynophagia, and epigastric pain. Here, we report a case of thermal injury to the esophageal and oral cavity due to the drinking of hot tea, including odynophagia and dysphagia. A 69-year-old man was referred due to a difficulty in swallowing which had begun a week prior to referral. The patient, at the time of admission, was unable to swallow even liquids. He had recently suffered from hiccups, and had consumed five cups of hot adlay tea one week prior to admission, as a folk remedy for the hiccups. Upon physical examination, the patient's oral cavity evidenced mucosal erosion, hyperemia, and mucosa covered by a whitish pseudomembrane. Nonspecific findings were detected on the laboratory and radiological exams. Upper endoscopy revealed diffuse hyperemia, and erosions with thick and whitish pseudomembraneous mucosa on the entire esophagus. The stomach and duodenum appeared normal. We diagnosed the patient with thermal esophageal injury inflicted by the hot tea. He was treated with pantoprazole, 40 mg/day, for 14 days, and evidenced significant clinical and endoscopic improvement.
Tea/*adverse effects ; Mouth Mucosa/injuries ; Male ; Humans ; Heat/adverse effects ; Esophagus/*injuries ; Deglutition Disorders/*etiology ; Chest Pain ; Burns/drug therapy/*etiology/physiopathology ; Anti-Ulcer Agents/therapeutic use ; Aged ; 2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use

There is little evidence on the effects of environmental tobacco smoke (ETS) on prevalence of periodontal disease. The aims of this study were to explore the trends of prevalence of periodontal disease and types of exposure to smoke, including ETS according to the survey year, identify factors affecting periodontal disease, and compare the effect size of periodontal disease between active smokers and secondhand smokers. Data on 11,643 individuals were obtained from the fourth and fifth Korean National Health and Nutritional Examination Surveys. Information on exposure to ETS at home and work was self-reported. Severity of periodontal disease was evaluated using the community periodontal index. A multivariate logistic regression analysis was performed to model periodontal disease using types of smoking and the survey year. Overall, the prevalence of periodontal disease was 26.0% (n=3,029) and about 9% of the study population were secondhand smokers. The prevalence of periodontal disease among smokers was significantly increased according to smoking types by year. Active smokers showed a statistically significant adjusted odds ratio (aOR) for having periodontal disease except in the year 2007, whereas secondhand smokers had significant associations only in 2010 (aOR, 1.68; 95% confidence interval, 1.05 to 2.70) compared to non-smokers. For secondhand smokers, the statistical relationship of predicting periodontal disease was weaker than that of active smokers. However, ETS should separately be considered as an important risk factor for periodontal disease. This study suggested the need for further investigation of the impact of ETS on prevalence of periodontal disease using in-depth research designs and objective measurements for assessing periodontal disease and ETS.
Health Surveys ; Korea* ; Logistic Models ; Nutrition Surveys ; Odds Ratio ; Periodontal Diseases* ; Periodontal Index ; Prevalence ; Research Design ; Risk Factors ; Smoke* ; Smoking* ; Tobacco ; Tobacco Smoke Pollution

BACKGROUND: We studied the time course of gene expression of dynorphin, enkephalin, c-fos, and the changes of allodynia, and the effect of chemical sympathectomy on the gene expression and allodynia in neuropathic rat. METHODS: In two groups of rat (Sprague-Dawley), the left L5 and L6 spinal nerves were tight ligated. In gene expression group (N=25), behavioral tests for mechanical allodynia and cold allodynia were perfomed for the next two weeks. After the test of allodynia, the expression of dynorphin, enkephalin, c-fos were assessed by Northern blot hybridization. In chemical sympathectomy group (N=16), after chemical sympathectomy (guanethidine 70 mg/kg intraperitoneally, from postoperative 7 days to 9 days), the changes of allodynia and the gene expression of enkephalin, c-fos were tested. RESULTS: Mechanical allodynia and cold allodynia was developed on the postoperative 3, 5, 7, 14 days. Preprodynorphin mRNA expression was reached peak level at the postoperative 8 hrs, sustained increase by the postoperative 3 days, but preproenkephalin mRNA expression increased slightly after operation. c-Fos mRNA expression was increased immediately at the postoperative 30 min, 1 hr, returned to normal level thereafter, and increased again on the postoperative 3, 5, 7 days that neuropathic pain was developed. Mechanical allodynia and cold allodynia were decreased by chemical sympathectomy. The increased c-fos mRNA expression and pain at postoperative 7 days was reduced by chemical sympathectomy. CONCLUSION: These results suggest that the transient gene expression of dynorphin and c-fos after tight ligation of L5 and L6 spinal nerves induces the development neuropathic pain, and late c-fos expression is related to neuropathic pain.
Animals ; Blotting, Northern ; Dynorphins* ; Enkephalins* ; Gene Expression* ; Hyperalgesia ; Ligation ; Neuralgia ; Rats* ; RNA, Messenger ; Spinal Nerves ; Sympathectomy, Chemical

PURPOSE: The purpose of this study was to investigate the value of hypoechoic lesions on transrectal ultrasound (TRUS) as a prognostic factor for patients with localized prostate cancer. MATERIALS AND METHODS: The patients consisted of 71 patients with pT2N0M0 disease following radical prostatectomy between 2002 and 2008. The group with hypoechoic lesions was labeled group 1, whereas the group without hypoechoic lesions was labeled group 2. The presence of hypoechoic lesions on preoperative TRUS was analyzed as a prognostic factor along with several parameters, including preoperative factors and pathologic factors. The biochemical progression-free survival (BPFS) rate was compared between the two groups according to the presence of hypoechoic lesions on TRUS. RESULTS: A total of 35 patients had hypoechoic lesions on TRUS, whereas 36 had no hypoechoic lesions. Preoperative baseline characteristics were not significantly different between the two groups. In the univariate analysis, BPFS showed significant differences according to the presence of hypoechoic lesions on TRUS and the preoperative prostate-specific antigen level. The BPFS rates over the first 24 months were 97.0% in group 1 and 97.1% in group 2; however, the difference in the BPFS rate over 48 months significantly widened to 75.3% compared with 91.7%, respectively. Despite this finding, no significant independent prognostic factor for BPFS was found on multivariate analysis in this patient cohort. CONCLUSIONS: The presence of hypoechoic lesions on TRUS may suggest worse prognostic characteristics in pT2 prostate cancer. Further studies involving larger subject populations are needed to corroborate the significance of the presence of hypoechoic lesions as a prognostic factor.
Disease-Free Survival ; Humans ; Multivariate Analysis ; Prognosis ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms

OBJECTIVE: Premenstrual syndrome (PMS) is a disease with specific psychologic and physical symptoms on luteal phase. Its incidence is variable in 20~80%, but its cause is not definitely proved. Because progesterone and estrogen affect the balance of the body mineral, the alteration of progestorone and estrogen in the patients with PMS may effect the imbalance of tissue mineral, that can induce the specific symptoms of PMS. This study examines the relationship between symptoms of PMS and mineral count by tissue mineral test. METHODS: Women who volunteered for the tissue mineral test completed MMDQ questionnaire and checked blood test for Ca, Mg, Na, K, Cu, Zn. The tissue mineral test used the hair not treated within 3 weeks and not washed within 3 hours. The hair was send to TEI for the analysis. We used SPSS (14.0) for statistical analysis. RESULTS: The MMDQ score of the normal Mg group is significantly higher than the high Mg group (22.5+/-17.8 vs. 13.9+/-11.1), and the behavioral disorder score of the normal Na group is significantly lower than the low Na group (2.2+/-1.7 vs. 3.4+/-2.2). The MMDQ score of the normal Cu group is significantly lower than abnormal group (15.7+/-11.9 vs. 24.9+/-16.9). CONCLUSIONS: Total score of MMDQ showed difference according to magnesium and copper concentrations in tissue, and scores of behavioral disorder was affected by sodium concentration of tissue. Additional study about cause and effect relationship is required.
Copper ; Estrogens ; Female ; Hair ; Hematologic Tests ; Humans ; Incidence ; Luteal Phase ; Magnesium ; Premenstrual Syndrome ; Progesterone ; Surveys and Questionnaire ; Sodium