BACKGROUND: IgE antibodies have been considered to play an important role in the pathogenesis of atapic asthma. However, there have been only few studies on the role of IgE in airway secretion in the pathogenesis of bronchial asthma. This might be partly due to difficulty in sampling of airway seceretion from asthmatic patients. Recently, sputum induction method by inhalation of nebulized hypertonic saline was developed, and proved to be valid and useful method for obtaining airway secretion from asthmatic patients for studying airway inflammation. OBJECTIVE AND METHOD: To evaluate the usefulness of sputum induction method for studying IgE antibodies in airway secretion from atopic asthmatic patients, total IgE levels in induced sputum from 54 atopic asthmatics were measured by enzyme-linked immunosorbent assay(ELISA) and tried to find an association with sputum eosinophilia. RESULT: Total IgE levels in induced sputum were significantly higher in atopic asthmatic patients(1.27+82.066 IU/ml) than in controls(0.203+0.291 IUgmP)(p<0.05). In atopic asthmatic patients, total IgE levels in induced sputum were not significantly different between patients with and without sputum eosinophilia(>5% of 200 counted leukocytes). There was a significant correlation of total IgE levels between induced sputum and serum in atopic asthmatic patients(r=0.60, p<0.05). Total IgE levels in induced sputum(1.278+ 2.066) were significantly higher than saliva sample(0.504 + 1.111 IU/ml) from atopic asthmatic patients(p<0.05). CONCLUSION: These results suggest that total IgE levels are increased in the induced sputum of atopic asthmat,ic patients and sputum induction method is a useful tool for studying IgE antibodies in airway secretion from asthmatic patients.
Antibodies ; Asthma ; Eosinophilia ; Humans ; Immunoglobulin E* ; Inflammation ; Inhalation ; Saliva ; Sputum*

HM41322 is a novel oral sodium-glucose cotransporter (SGLT) 1/2 dual inhibitor. In this study, the in vitro and in vivo pharmacokinetic and pharmacologic profiles of HM41322 were compared to those of dapagliflozin. HM41322 showed a 10-fold selectivity for SGLT2 over SGLT1. HM41322 showed an inhibitory effect on SGLT2 similar to dapagliflozin, but showed a more potent inhibitory effect on SGLT1 than dapagliflozin. The maximum plasma HM41322 level after single oral doses at 0.1, 1, and 3 mg/kg were 142, 439, and 1830 ng/ml, respectively, and the T(1/2) was 3.1 h. HM41322 was rapidly absorbed and reached the circulation within 15 min. HM41322 maximized urinary glucose excretion by inhibiting both SGLT1 and SGLT2 in the kidney. HM41322 3 mg/kg caused the maximum urinary glucose excretion in normoglycemic mice (19.32±1.16 mg/g) at 24 h. In normal and diabetic mice, HM41322 significantly reduced glucose excursion. Four-week administration of HM41322 in db/db mice reduced HbA1c in a dose dependent manner. Taken together, HM41322 showed a favorable preclinical profile of postprandial glucose control through dual inhibitory activities against SGLT1 and SGLT2.
Animals ; Diabetes Mellitus ; Glucose ; In Vitro Techniques* ; Kidney ; Mice ; Plasma

BACKGROUND: To determine the natural progression of conservatively treated rotator cuff tears, we evaluated changes in radiologic and clinical parameters in patients whose recalcitrant tears were neglected after conservative treatment. METHODS: A total of 73 patients with recalcitrant rotator cuff tears in spite of conservative treatment were included in this study. We measured changes in tear size and in the extent of fatty infiltration of the rotator cuff by comparing the initial and final follow-up magnetic resonance imagings (MRIs). To determine factors influencing the change in tear size, we collected the medical history of patients taken at the time of initial admission. RESULTS: The average follow-up period was 20.1 months, and the average increase in tear size across this period was 6.2 mm. In terms of steroid injection, we found that the increases in tear size of the steroid injection group (p=0.049) and of the sub-group that had received more than three steroid injections (p=0.010) were significantly greater than that of the non-steroid injection group. CONCLUSIONS: We found that the increase in cuff tear size was on average 6.2 mm across the follow-up period, indicating that neglecting cuff tears may cause them to progress into more severe tears. We also observed that a history of steroid injection might be a possible risk factor for a worse prognosis of cuff tears. Therefore, we suggest that patients with rotator cuff tears and a history of steroid injection are recommended aggressive modes of treatment such as surgery.
Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Prognosis ; Retrospective Studies* ; Risk Factors ; Rotator Cuff* ; Tears*

PURPOSE: Worldwide data shows that there is an increasing resistance among urinary tract pathogens to the first-line antimicrobial agents used in domestic areas. The objective of this study was to obtain data on the susceptibility patterns of the pathogens responsible for acute uncomplicated cystitis to currently used antimicrobial agents. MATERIALS AND METHODS: This study was carried out with the participation of fifteen hospitals in South Korea. A total of 239 isolates were obtained from female outpatients with acute uncomplicated cystitis. The antimicrobial susceptibilities to ampicillin, ampicillin/sulbactam, ciprofloxacin, gentamicin, trimethoprim/sulfamethoxazole(TMP/SMX) and tobramycin were determined by Vitek(R) antimicrobial susceptibility test systems. RESULTS: The most prevalent causative organism was Escherichia coli(79.9%), followed by coagulase negative Staphylococcus(4.2%), and a combination of other species of Enterobacteriaceae(8.2%). The mean rates of susceptibility were 35.5, 45.0, 85.7, 81.5, 62.1 and 85.3% to ampicillin, ampicillin/sulbactam, ciprofloxacin, gentamicin, TMP/ SMX and tobramycin, respectively. No significant differences were detected in the resistance rates between the results from 4 regional groups. CONCLUSIONS: The high prevalence of resistance to ampicillin, ampicillin/sulbactam, and TMP/SMX suggest these drugs would not provide adequate initial therapy, and therapies other than TMP/SMX may need to be considered. The relatively high prevalence of resistance to ciprofloxacin, compared with other countries, also requires on going surveillance to identify further changes among urinary tract isolates.
Ampicillin ; Anti-Infective Agents ; Ciprofloxacin ; Coagulase ; Cystitis* ; Disease Susceptibility ; Escherichia ; Female ; Gentamicins ; Humans ; Korea ; Outpatients ; Prevalence ; Tobramycin ; Urinary Tract

OBJECTIVE: Hepatic dysfunction frequently occurs in patients with hematologic malignancies and aplastic anemia who receive intensive chemotherapy or bone marrow transplantation (BMT). The role of laparoscopic liver biopsy in patients with hematologic disorders is very important to determine the etiological factors and to make treatment decisions. The aim of the present study was to evaluate the possible causes of liver disease in patients with abnormal liver function tests. METHODS: Laparoscopy guided liver biopsy was performed in 38 subjects who were receiving intensive cytotoxic therapy with BMT or without BMT. Two to three pieces of liver tissues were obtained in each patients using Vim-Silverman needle with electrocoagulation on biopsy site. Platelet transfusions were given if platelet count was less than 50,000/mm3. 39 biopsies were obtained in 38 patients. RESULTS: At the time of liver biopsy, platelet count was 170,000+/-138000/mm3 (range: 42,000 - 798,000/mm3). No procedure-related complications were observed. Biopsy findings after BMT (n=16) revealed graft versus host disease (GVHD) (n=9), drug induced hepatitis (n=6), veno-occlusive disease (n=2), viral hepatitis (n=1), and nonspecific reactive hepatitis (n=1). 3 patients of GVHD associated with other liver diseases such as drug-induced hepatitis, veno-occlusive disease and chronic active hepatitis B. The authors compared histologic diagnosis with laparoscopic findings. Laparoscopic findings of the liver surface were classified by Shimada's code number system. 5 patients who were biopsed before BMT showed cholestasis and fatty changes and it was possible to be treated with allogenic BMT. Histologic diagnosis in patients without BMT (n=18) showed viral hepatitis (n=6), drug induced hepatitis (n=5), non-specific reactive hepatitis (n=1), and others (n=6). In 12 cases (31%) laparoscopic liver biopsy led to a change in medical management. CONCLUSION: Laparascopic liver biopsy has been proven to be an effective means of assessing the cause of liver dysfunction in patients with hematologic disorders. The diagnosis obtained at laparoscopic liver biopsy could be changed the therapeutic plan in 12 of 39 (31%) patients.
Anemia, Aplastic ; Biopsy* ; Bone Marrow Transplantation ; Cholestasis ; Diagnosis ; Drug Therapy ; Drug-Induced Liver Injury ; Electrocoagulation ; Graft vs Host Disease ; Hematologic Neoplasms ; Hepatitis ; Hepatitis, Chronic ; Humans ; Laparoscopy ; Liver Diseases ; Liver Function Tests ; Liver* ; Needles ; Platelet Count ; Platelet Transfusion

PURPOSE: We wanted to investigate the efficacy and safety of the immunotherapeutic Uro-Vaxom for treating uncomplicated recurrent cystitis in female patients only. MATERIALS AND METHODS: Adult female patients were enrolled in this multicenter, open-label study if they had acute cystitis at the enrollment visit and positive results on urine culture (> or =10(3)CFU/ml). The patients were treated for 3 months with one capsule daily of Uro-Vaxom after antibiotic therapy, and they were observed for another 3 months. The primary efficacy criteria were the cystitis recurrence rates over 6 months, the distribution of cystitis and the proportion of patients with cystitis. RESULTS: A total of 50 patients were evaluated. During the 6-month trial, the number of cystitis recurrences was significantly reduced in comparison with the 6-month pretrial period (on the average 0.64 as compared to 3.0 recurrences, respectively p<0.001). The incidences of frequency, urgency and dysuria remained low until the end of the trial. Uro-Vaxom was well tolerated: side-effects were mentioned by 8% of the 50 patients, and there was no case leading to treatment withdrawal. CONCLUSIONS: Uro-Vaxom significantly reduced the incidence of cystitis during the 6 months of this study, including the 3 months of treatment. These results demonstrate that Uro-Vaxom is a valuable agent for prophylaxis of recurrent cystitis.
Adult ; Cystitis* ; Dysuria ; Escherichia coli ; Female ; Humans ; Incidence ; Recurrence

BACKGROUND: To determine the natural progression of conservatively treated rotator cuff tears, we evaluated changes in radiologic and clinical parameters in patients whose recalcitrant tears were neglected after conservative treatment. METHODS: A total of 73 patients with recalcitrant rotator cuff tears in spite of conservative treatment were included in this study. We measured changes in tear size and in the extent of fatty infiltration of the rotator cuff by comparing the initial and final follow-up magnetic resonance imagings (MRIs). To determine factors influencing the change in tear size, we collected the medical history of patients taken at the time of initial admission. RESULTS: The average follow-up period was 20.1 months, and the average increase in tear size across this period was 6.2 mm. In terms of steroid injection, we found that the increases in tear size of the steroid injection group (p=0.049) and of the sub-group that had received more than three steroid injections (p=0.010) were significantly greater than that of the non-steroid injection group. CONCLUSIONS: We found that the increase in cuff tear size was on average 6.2 mm across the follow-up period, indicating that neglecting cuff tears may cause them to progress into more severe tears. We also observed that a history of steroid injection might be a possible risk factor for a worse prognosis of cuff tears. Therefore, we suggest that patients with rotator cuff tears and a history of steroid injection are recommended aggressive modes of treatment such as surgery.
Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Retrospective Studies ; Risk Factors ; Rotator Cuff ; Tears