Asthma is a chronic disease associated with airway constriction due to inflammation caused by eosinophils, mast cells, and T lymphocytes, leading to serious chronic illness in children. The eotaxin gene family has been shown to play an important role in the pathogenesis of asthma. We hypothesized that the distinctive variations among the four seasons in Korea may affect the expression of eotaxin polymorphisms, especially in children. We examined the possible effects of birth season (spring, March-May; summer, June-August; fall, September-November; and winter, December-February) on the phenotype of asthma in children. All SNP data sets of the eotaxin-2 and eotaxin-3 genes were collected from 78 asthma patients and 101 controls. Here, we investigated the effects of birth season on the expression of eotaxin-2 and eotaxin-3 in Korean children. Using the HAPLOTYPE procedure with the HTR method in SAS/Genetics, we showed that children born in spring and summer show significant haplotypes in both the eotaxin-2 and eotaxin-3 genes. Thus, the expression of polymorphisms in eotaxin-2 and eotaxin-3 may vary by season.
Asthma ; Chemokine CCL24 ; Child ; Chronic Disease ; Constriction ; Eosinophils ; Haplotypes ; Humans ; Inflammation ; Korea ; Mast Cells ; Parturition ; Phenotype ; Seasons ; T-Lymphocytes

Idiopathic pulmonary hemosiderosis (IPH), a rare disease of unknown etiology, is characterized by iron deficiency anemia and chronic recurrent pulmonary symptoms such as cough, hemoptysis, and dyspnea. Recurrent intra-alveolar hemorrhage resulting in hemosiderin accumulation and progressive fibrosis often leads to death. We experienced a case of IPH in a two-year-old male who was presented with cough, dyspnea, hemoptysis and anemia. The diagnosis was confirmed by hemosiderin-laden macrophages in a gastric aspirate. He was initially treated with oral iron and prednisolone for one year. But pulmonary symptoms such as cough and hemoptysis recurred five times while he was on oral prednisolone and the side effects of moon face and truncal obesity developed. So inhaled steroid (budesonide) was administered for 18 months, with improvement of pulmonary symptoms. This suggests that early treatment with inhaled steroids may work in IPH without the serious side effects of systemic steroid. The effect of inhaled steroid should be evaluated as the initial treatment of IPH.
Anemia ; Anemia, Iron-Deficiency ; Child ; Cough ; Diagnosis ; Dyspnea ; Fibrosis ; Hemoptysis ; Hemorrhage ; Hemosiderin ; Hemosiderosis* ; Humans ; Inhalation* ; Iron ; Macrophages ; Male ; Obesity ; Prednisolone ; Rare Diseases ; Steroids

Idiopathic pulmonary hemosiderosis (IPH), a rare disease of unknown etiology, is characterized by iron deficiency anemia and chronic recurrent pulmonary symptoms such as cough, hemoptysis, and dyspnea. Recurrent intra-alveolar hemorrhage resulting in hemosiderin accumulation and progressive fibrosis often leads to death. We experienced a case of IPH in a two-year-old male who was presented with cough, dyspnea, hemoptysis and anemia. The diagnosis was confirmed by hemosiderin-laden macrophages in a gastric aspirate. He was initially treated with oral iron and prednisolone for one year. But pulmonary symptoms such as cough and hemoptysis recurred five times while he was on oral prednisolone and the side effects of moon face and truncal obesity developed. So inhaled steroid (budesonide) was administered for 18 months, with improvement of pulmonary symptoms. This suggests that early treatment with inhaled steroids may work in IPH without the serious side effects of systemic steroid. The effect of inhaled steroid should be evaluated as the initial treatment of IPH.
Anemia ; Anemia, Iron-Deficiency ; Child ; Cough ; Diagnosis ; Dyspnea ; Fibrosis ; Hemoptysis ; Hemorrhage ; Hemosiderin ; Hemosiderosis* ; Humans ; Inhalation* ; Iron ; Macrophages ; Male ; Obesity ; Prednisolone ; Rare Diseases ; Steroids

This study was conducted to assess the relationship between estimated glomerular filtration rate (eGFR) and bone mineral density (BMD) in Korean postmenopausal women with mild renal dysfunction. A total of 328 postmenopausal women who underwent BMD measurement during health check-up was investigated. BMD was measured in lumbar spine (L1-L4), femoral neck, total proximal femur and femoral trochanteric areas by dual energy radiography absorptiometry and renal function was estimated by eGFR using Cockcroft-Gault equation. Of the 328 subjects, 317 (96.6%) had an eGFR > or =60 mL/min/1.73 m2. By using simple linear regression analysis, age, height, weight and eGFR were significantly associated with BMD for the 4 aforementioned anatomic sites, while serum levels of creatinine and blood urea nitrogen did not influence BMD. When multiple regression analyses were applied, age and body weight still had significant associations with BMD at 4 different anatomic sites (P < 0.001). A significant association of eGFR with BMD remained in the lumbar spine, femoral neck and proximal total femur (P < 0.05) but not in the trochanteric area (P = 0.300). Our study suggests that a decline of renal function is associated with lower BMD in the lumbar spine, femoral neck and total proximal femur areas in Korean menopausal women with mild renal dysfunction.
Absorptiometry, Photon ; Aged ; Blood Urea Nitrogen ; *Bone Density ; Creatinine/blood ; Female ; Femur Neck/physiology ; *Glomerular Filtration Rate ; Humans ; Kidney Diseases/*physiopathology ; Kidney Function Tests ; Lumbar Vertebrae/physiology ; Middle Aged ; Osteoporosis, Postmenopausal/*physiopathology ; Republic of Korea

Dermatofibrosarcoma protuberance is a relatively rare malignant soft tissue tumor which is locally invasive and looks like a protruded hardened plaque composed of multiple nodules. It seldom occurs on the scalp and the occurrence rate is less than 5%. Nowadays there is a tendency to choose Mohs surgery as a primary treatment instead of a wide excision, because Mohs surgery can reduce cases of recurrence. We report a case of multiple dermatofibrosarcoma protuberans on the scalp of a 32-year-old man. We planned a delayed operation using tissue expanders. We inserted two skin expanders and successfully expanded scalp tissue more than 150% after 7 months. Mohs surgery was performed with a 4 cm distance from borderline of lesions and then the large scalp skin defect was covered by the expanded skin which had been prepared by tissue expanders. It has been 9 months since the operation was performed and there have been no signs of recurrence.
Adult ; Dermatofibrosarcoma* ; Humans ; Mohs Surgery* ; Recurrence ; Scalp* ; Skin ; Tissue Expansion Devices ; Tissue Expansion*

BACKGROUND: Xanthelasma palpebrarum is the most common type of xanthoma. Due to its delicate location near the eye, treatment of xanthelasma palpebrarum is rather difficult. The treatment includes surgical excision, local treatment with chemicals, and various laser therapies. OBJECTIVE: This study was designed to review the various therapeutic modalities and to evaluate the efficacy and safety of bichloroacetic acid (BCA) for the treatment of xanthelasma palpebrarum. METHODS: Nine patients, with a total of 19 xanthelasma lesions, were treated with BCA. The efficacy and safety were assessed over a follow-up period of 6 to 24 months (average, 16 months). RESULTS: All lesions were grossly removed completely with a single treatment and the treatment was well-tolerated by patients. Erythema and oozing were observed in six patients but improved after two weeks' dressing. Xanthelasma palpebrarum recurred in three patients, but the mean size of the recurred lesions was smaller in comparison to the primary lesion. CONCLUSION: BCA is an effective and safe therapeutic modality for xanthelasma palpebrarum. Advantages include simplicity, cost-effectiveness, speed, safety and efficacy.
Bandages ; Dichloroacetic Acid* ; Erythema ; Follow-Up Studies ; Humans ; Laser Therapy ; Xanthomatosis

Leukocytoclastic vasculitis is a small vessel inflammatory disease, mediated mostly by deposition of immune complexes. Medications cause 10~24% of cases of leukocytoclastic vasculitic skin lesions, but warfarin has rarely been implicated. We report a case of warfarin-induced leukocytoclastic vasculitis in a 72-year-old woman which developed 45 days after warfarin medication. Palpable purpura, hemorrhagic vesicles, and ulcers developed on both lower legs. A skin biopsy showed characteristic features of leukocytoclastic vasculitis. Warfarin was replaced by clopidogrel, and the skin lesions gradually disappeared after 3 weeks.
Aged ; Antigen-Antibody Complex ; Biopsy ; Female ; Glycosaminoglycans ; Humans ; Leg ; Purpura ; Skin ; Ticlopidine ; Ulcer ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous ; Warfarin

Decubitus ulcer is a pressure-induced ischemia-reperfusion injury overlying a bony prominence. Various dressing methods have been developed to treat it, but clinical management is still a challenging practice. A patient presented with stage IV decubitus ulcer on the left lateral side of the buttock, which was caused by compulsively lying down on the left side due to schizophrenia. The ulcer was resistant to occlusive dressing method for five weeks. However, the patient successfully recovered in three weeks by our applying a negative pressure dressing with the portable vacuum-assisted closure (VAC) system. Our experience shows negative pressure dressing can be effectively used to treat intractable decubitus ulcer in outpatient settings.
Bandages ; Buttocks ; Deception ; Humans ; Negative-Pressure Wound Therapy ; Occlusive Dressings ; Outpatients ; Pressure Ulcer ; Reperfusion Injury ; Schizophrenia ; Ulcer

Heterotopia refers to the finding of normal tissue in foreign sites, entirely separate from the main organ. Heterotopic gastric mucosa has been observed throughout the alimentary tract, everywhere from the oral cavity to the rectum. However, occurrences in the umbilicus are an extremely rare and peculiar phenomena. We report the case of heterotopic gastric mucosa in the umbilicus.
Gastric Mucosa ; Mouth ; Rectum ; Umbilicus

PURPOSE: This study evaluated the clinical characteristics of brain tumors in children according to their location, the parental delay and the doctor's delay between the onset of symptoms and the diagnosis of a pediatric brain tumor. In addition, this study compared the relationship between the pre-diagnostic symptomatic interval and the tumor location. METHODS: A retrospective study was undertaken of 45 children with primary brain tumors admitted to Inha Hospital from July, 1986 to June, 2004. A diagnosis of the tumor location was made using brain MRI. RESULTS: The male to female ratio was 1:0.67. The median age at diagnosis was 6.0 years in supratentorial tumors, 7.0 years in infratentorial tumors. Twenty four cases(53.3 percent) were located in the supratentorial area, 21 cases(46.6 percent) were located in the infratentorial area. The distribution of supratentorial tumors were 14(58.3 percent) in the cerebral hemisphere and temporal lobe, seven (29.1 percent) in the suprasellar area, and three(12.5 percent) in the pineal gland and posterial lateral ventricle. The distributions of the infratentorial tumors were 12(57.1 percent) in the cerebellar vermis and fourth ventricle, four(19.1 percent) in the brain stem, and five(23.8 percent) in the cerebellar hemisphere. The most common initial symptom was seizure(37.5 percent) in the supratentorial tumor and headache(38.0 percent) in infratentorial tumors. The median pre-diagnostic symptomatic interval (PSI) was 21 days(range 0-240 days). The median PSI with a parental delay in supratentorial tumor was six days(range 1-240 days), and 30 days(range 1-40 days) in the infratentorial tumor. We immediately diagnosed most cases after visiting the hospital. There was no significant relationship between the tumor location and the pre-diagnostic symptomatic interval. CONCLUSION: The most common symptom of supratentorial tumors and infratentorial tumors was seizure and headache, respectively. Although, the median pre-diagnostic symptomatic interval was shorter than in previous studies, a detailed medical history and a correctly interpreted neurological examination should lead to an earlier diagnosis of pediatric brain tumors.
Brain Neoplasms* ; Brain Stem ; Brain* ; Cerebrum ; Child ; Diagnosis ; Female ; Fourth Ventricle ; Headache ; Humans ; Infratentorial Neoplasms ; Lateral Ventricles ; Magnetic Resonance Imaging ; Male ; Neurologic Examination ; Parents ; Pineal Gland ; Retrospective Studies ; Seizures ; Supratentorial Neoplasms ; Temporal Lobe