PURPOSE: we studied the clinical outcome of a step-by-step treatment approach for congenital nasolacrimal duct obstruction (CNDO). METHODS: we analyzed 186 patients (222 eyes) who had been treated for CNDO between January 1996 and December 2000. According to age, conservative treatment, nasolacrimal duct probing and silicone intubation were applied systematically until a successful outcome was achieved. Patients were grouped according to their age at the time of first visit.: Group 1 (0~6 months), Group 2 (7~12 months), Gruop 3 (13~24 months), Group 4 (25~72 months). Treatment efficacy was determined according to age and success rate was compared. RESULTS: Conservative treatment was applied only in children less than 1 year of age and was successful in 75.9% of Group 1 and 47.3% of Group 2. The difference between these two success rates was significant (p=0.0001). The overall success rate for first probing in all groups was 65.2% with a range 75.8% in Group 1, 62.1% in Group 2, 65.0% in Group 3, and 40.0% in Group 4. After second probing, the overall cure rates for the entire cohort were 82.6% with a range 87.9% in Group 1, 89.7% in Group 2, 80.0% in Group 3, and 50.0% in Group 4. There was no real difference in first probing cure rate relative to age (p=0.208). But after second probing, overall cure rate was significantly decreased when the age of the patients was over 12 months (p=0.027). Silicone intubation was performed in 4 of Group 1, 3 of Group 2, 4 of Group 3, and 5 of Group 4 and was successful in all cases. CONCLUSIONS: Systematic treatment approach to CNDO including conservative treatment, nasolacrimal duct probing, and silicone intubation, was highly successful. In this study, the cure rate for this combined approach was 100% in 186 patients (222 eyes).
Child ; Cohort Studies ; Humans ; Intubation ; Nasolacrimal Duct* ; Silicones ; Treatment Outcome

Anaphylaxis is a life - threatening syndrome elicited in a hypersensitive individual on subsequent exposure to a sensitizing antigen with, reactions ranging widely in severity from mild pruritus and criteria to shock and death. Anaphylaxis occurs in the United States at rates estimated to be as high as one in every 3000 inpatients and may account for more than 500 deaths annually. Preparations of kelp Laminaria digitata are used as tents in gynecologic procedures to dilate the cervix, and the kelp consists principally of a glucagon carbohydrate called laminarin. Laminarin is thought to function as the active ingredient in dilatation by changing osmotic pressure or uterine prostaglandin metabolism. The tent is inserted into the cervix several hours before the procedure. As the cervix desiccates and dilates, the tent develops an hourglass shape. Recently, we experienced one patient with anaphylaxis to laminaria diagnosed by skin test and showing good response to treatment.
Anaphylaxis* ; Cervix Uteri ; Dilatation ; Female ; Glucagon ; Humans ; Inpatients ; Kelp ; Laminaria* ; Metabolism ; Osmotic Pressure ; Pruritus ; Shock ; Skin Tests ; United States

BACKGROUND: Caveolin, a family of integral membrane proteins are a principal component of caveolae membranes. In this study, we investigated the effect of p38 kinase on differentiation and on inflammatory responses in sodium nitroprusside (SNP)- treated chondrocytes. METHODS: Rabbit articular chondrocytes were prepared from cartilage slices of 2-week-old New Zealand white rabbits by enzymatic digestion. SNP was used as a nitric oxide (NO) donor. In this experiments measuring SNP dose response, primary chondrocytes were treated with various concentrations of SNP for 24 h. The time course of the SNP response was determined by incubating cells with 1 mM SNP for the indicated time period (0~24 h). The cyclooxygenase-2 (COX-2) and type II collagen expression levels were determined by immunoblot analysis, and prostaglandin E2 (PGE2) assay was used to measure the COX-2 activity. The tyrosine phosphorylation of caveolin-1 was determined by immunoblot analysis and immunostaining. RESULTS: SNP treatment stimulated tyrosine phosphorylation of caveolin-1 and activation of p38 kinase. SNP additionally caused dedifferentiation and inflammatory response. We showed previously that SNP treatment stimulated activation of p38 kinase and ERK-1/-2. Inhibition of p38 kinase with SB203580 reduced caveolin-1 tyrosine phosphorylation and COX-2 expression but enhanced dedifferentiation, whereas inhibition of ERK with PD98059 did not affect caveolin-1 tyrosine phosphorylation levels, suggesting that ERK at least is not related to dedifferentiation and COX-2 expression through caveolin-1 tyrosine phosphorylation. CONCLUSION: Our results indicate that SNP in articular chondrocytes stimulates dedifferentiation and inflammatory response via p38 kinase signaling in association with caveolin-1 phosphorylation.
Cartilage ; Caveolae ; Caveolin 1 ; Chondrocytes* ; Collagen Type II ; Cyclooxygenase 2* ; Digestion ; Dinoprostone ; Humans ; Membrane Proteins ; Membranes ; Nitric Oxide ; Nitroprusside ; Phosphorylation ; Phosphotransferases* ; Rabbits ; Tissue Donors ; Tyrosine

BACKGROUND: The aim of this study was to evaluate the longitudinal changes of trabecular bone score (TBS) during and after bisphosphonate (BP) treatment in postmenopausal Korean women with osteoporosis. METHODS: We analyzed 191 patients who took BP and underwent bone mineral density (BMD) test for the period from January 2010 to December 2015. The mean follow up period during treatment and after treatment was 22.8 months and 18 months, respectively. The TBS and BMD values were evaluated by the percent changes relative to the baseline. RESULTS: In 191 patients, who treated with BPs, L-spine BMD increased 3.65±0.5% and TBS increased 0.26±0.4% from baseline during first 1 year. At 2 to 4 years, the changes of BMD and TBS from baseline gradually increased up to 9.3±3.25% and 2.69±0.98% and both results showed statistically significant correlation. In 86 patients who stopped BPs, L-spine BMD decreased -0.54±1.07% and TBS increased 0.33±1.96% from baseline during 3 years follow up period. CONCLUSIONS: Lumbar spine TBS increase over time with BPs treatment although the changes were less than that of BMD. Also, it preserve for years after stopping treatment, as the changes of lumbar spine BMD. The results of BMD and TBS showed significant correlation during treatment but not during drug withdrawal.
Bone Density ; Female ; Follow-Up Studies ; Humans ; Osteoporosis* ; Spine ; Withholding Treatment

PURPOSE: To evaulate the effects of chlorhexidine and H2O2 on matrix metalloproteinase-1 (MMP-1), tissue inhibitor of metalloproteinase(TIMP-1, TIMP-2), Type 1 collagen, fibronectin and UNCL expressions in human periodontal ligament fibroblasts (hPDLF). MATERIALS AND METHODS: 1.2x10(-1)%, 1.2x10(-2)% and 1.2x10(-3)% CHX and 3x10(-3)%, 3x10(-4)% and 3x10(-5)% H2O2 and mixture of CHX and H2O2 were applied to hPDLF for 1 min and 30 min. The mRNA expressions of MMP-1, TIMP-1 and 2, Type 1 collagen, fibronectin and UNCL in hPDLF were analysed by RT-PCR. RESULTS: The result were as follows: 1. The expression of UNCL mRNA was higher than that of other mRNAs. 2. 1.2x10(-3) % CHX increased mRNA expressions of hPDLF as application time increased. 3. H2O2 lower than 3x10(-3) % increased expression of UNCL mRNA, and did not decrease mRNA expression of hPDLF. 4. hPDLF treatment with 1.2x10(-1) % CHX (with or without H2O2) resulted in no gene expression. 5. hPDLF treatment with 1.2x10(-2) % CHX (with or without H2O2) for 30 minutes resulted in no gene expression. CONCLUSION: Because low concentration of CHX and H2O2 increased UNCL mRNA expression of hPDLF, low concentraction of CHX and H2O2 may have an antioxidative effect.
Chlorhexidine ; Collagen Type I ; Fibroblasts ; Fibronectins ; Humans ; Matrix Metalloproteinase 1 ; Periodontal Ligament ; RNA, Messenger ; Tissue Inhibitor of Metalloproteinase-1

BACKGROUND: The aim of this study was to investigate the health problems which women feel important and what they want to know from their doctors in the family practice clinics. METHODS: The subjects were all female patients who visited the family practice clinics at the four hospitals in which some members of the Study Group for Women's Health in Korean Academy of Family Medicine worked from December 10 to 15, 2001. We surveyed by self-administered questionnaire on important health topic, health care services they woud like to receive, what they expected from their doctors, what topics they have difficulty in discussing with, the doctors preference of physician's gender. We analyzed the results by age groups; 19~44, 45~64, and 65 years old and over. RESULTS: A total of 437 women answered the questionnaires, whose mean age was 49.4 year. Health topics that women felt important were osteoporosis, stress, cervical cancer, arthritis, and stroke, which varied with the age groups and recent health perception. The provision of health care services which they desired were in the order of treatment, prevention and health promotion, and diagnosis, which varied with the age groups and recent health perception. What they expected from their doctors were in the order of giving accurate diagnosis, explaining the treatment plan, and answering their questions. They had difficulty undergoing physical exam undressed, gynecological exam, and discussing on their sexual problems. CONCLUSION: Women who visited the family practice clinics felt differently on important health problems according to the age groups. Overall, they wanted to receive health services on the treatment, prevention and health promotion of osteoporosis, stress, cervical cancer, and arthritis.
Aged ; Arthritis ; Attitude to Health ; Delivery of Health Care ; Diagnosis ; Family Practice ; Female ; Gynecological Examination ; Health Promotion ; Health Services ; Humans ; Osteoporosis ; Patient Education as Topic ; Stroke ; Uterine Cervical Neoplasms ; Women's Health ; Surveys and Questionnaires

PURPOSE: This study is aimed at identifying the effects of telephone counseling as nursing support on distress, anxiety, depression, and adverse events in cancer patients undergoing their first chemotherapy. METHODS: This was a randomized controlled trial (pretest-posttest design). A total of 70 patients who showed 4 or higher distress scores were selected from the screening process. Four patients dropped out; therefore, 66 patients participated in this research. Thirty-two and 34 patients were randomly assigned to the experimental and the control group, respectively. After a preliminary survey, telephone counseling support was given to the experimental group at three time points. The post survey was done before the second cycle of chemotherapy. RESULTS: Regarding distress, both groups showed a statistically significant decrease in the scores: 3.4 for the experimental group and 1.8 for the control group (p=.002). Furthermore, the experimental group demonstrated a statistically significant decrease relative to the control group. Anxiety and depression showed no statistically significant difference between the two groups. CONCLUSION: This study concludes that nursing support through phone counseling is effective in decreasing distress in patients undergoing chemotherapy for the first time.
Anxiety* ; Counseling* ; Depression* ; Drug Therapy* ; Humans ; Mass Screening ; Nursing ; Telephone*

BACKGROUND: Recent studies have documented increased release of endothelin(ET) during acute attack of asthma. The purpose of this study is to observe the link between plasma level and urinary excretion of each and changes during acute exacerbation. METHOD: Plasma and 24 hour urine were collected from sixteen asthmatics during acute exacerbation, twice ; first day of symptomatic exacerbation and two weeks after treatment. Controls were ten healthy normal subjects. All patients were treated with corticosteroid and beta-2 adrenergic agonist on admission. ET was determined by radioimmmunoassay and had 100% cross reactivity with ET-1, 67% with ET-2, 84% with ET-3, and 8% with Big-ET. RESULTS: Plasma ETs were significantly elevated during acute attack of asthma compared with those in remission and controls. However, there was no significant changes in urine ET concentrations or total ET amounts in 24 hour urine during exacerbation upto two weeks. Those levels of urine ET in asthmatics were still higher than controls. ET concentrations in plasma or urine were not correlated with pulmonary functional parameters and hypoxemia. CONCLUSION: The findings suggests that increased plasma ETs are related with exaggerated release during acute asthma. Urinary ET excretion is increased in asthma. However, urine ET changes during exacerbation should be observed in a larger and longer scale.
Adrenergic Agonists ; Anoxia ; Asthma* ; Endothelin-2 ; Endothelins* ; Humans ; Plasma*

BACKGROUND: Chemokines and their receptors are important players in tumorigenesis by facilitating tumor proliferation and metastasis. Little is known about the possible function of chemokine receptors in relation to the development and progression of malignant cutaneous tumors. OBJECTIVE: The aim of this study was to determine the chemokine receptor CCR3 expression pattern and the protein expression level in selected malignant cutaneous tumors. METHODS: Four types of cell lines (G361, A431, SK-MEL-2, SK-MEL-24) were analyzed, using Western blotting, for the expression of CCR3 protein. Immunohistochemical staining for CCR3 was done on 36 skin cancer tissue samples that included 16 squamous cell carcinomas (SCCs), 16 basal cell carcinomas (BCCs), 16 malignant melanomas (MMs) and 6 normal tissue samples. RESULTS: Western blot analysis showed that CCR3 protein was more expressed in the MM cell lines (G361, SK-MEL-2,SK-MEL-24) than that in the SCC cell line (A431), and the immunohistochemical analysis showed that CCR3 protein was overexpressed in MM and SCC, it was mildly expressed in BCC and it was hardly expressed in normal tissue. CONCLUSION: This study demonstrated via immunochemistry that CCR3 was more expressed in MM, followed by SCC and BCC. The existence of CCR3 protein may enhance the tumorigenic potential of malignant cutaneous tumors.
Blotting, Western ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cell Line ; Cell Transformation, Neoplastic ; Chemokines ; Immunochemistry ; Melanoma ; Neoplasm Metastasis ; Receptors, CCR ; Receptors, Chemokine ; Skin Neoplasms

PURPOSE: To predict the energy expenditure using the stress factor representing the ratio of the metabolic variation between pre-operation and post-operation in a pancreaticoduodenectomy (PD). METHODS: This was a prospective study conducted on 17 patients (11 males and 6 females) who underwent PD at Chonbuk National University Hospital between March 2010 and October 2011. The rest energy expenditure was measured by indirect calorimetry 1 day before and 3 days after surgery. The height, weight, and fat free mass were also measured 1 day before surgery. RESULTS: The mean measured rest energy expenditure 1 day before PD (mREEpre) and 3 days after PD (mREEpost) were significantly different (16.8±2.6 vs. 18.8±3.5 kcal/kg/d, P=0.0076). The stress factor, representing the ratio of the metabolic changes between pre- and post-PD, was 1.12±0.17. The recommended energy requirement for PD patients is estimated to be 23∼24 kcal/ideal body weight/d [determined from the measured preoperative rest energy expenditure (16.8±2.6 kcal/kg/d)×activity factor (1.2∼1.3)×stress factor (1.12)]. CONCLUSION: PD patients maintained a hypermetabolic status and the applicable stress factor was 1.12.
Calorimetry, Indirect* ; Energy Metabolism* ; Humans ; Jeollabuk-do ; Male ; Pancreaticoduodenectomy* ; Prospective Studies