No abstract available.
Candidiasis* ; Paget Disease, Extramammary* ; Vulva

No abstract available.
Syringoma*

BACKGROUND: Asthmatic patients frequently suffer cold-weather-associated respiratory symptoms. The sensitivity, specificity, accuracy and diagnostic value of isocapnic hyperventilation of cold air(IHCA) using a multistep method was investigated in patients suspected to have asthma. METHOD: One hundred and 29 adult patients who had an IHCA performed between july 1999 and December 2000, had an methacholine bronchoprovocation test because of a clinical suspicion of asthma. RESULTS: According to strict criteria, 50 were defined as asthmatics and 79 as symptomatic nonashmatics. There were no differences in age, sex and smoking state between the asthmatic and symptomatic nonasthmatic groups. There was a significant decrease in the percentage reduction in the forced expiratory volume in 1 second(FEV1) after the IHCA between the asthmatics(-10.0±6.8%) and the symptomatic nonasthmatics(-2.3±2.5%). The factors associated with a reactivity to IHCA were FEV1/FVC, FEF25-75/FVC and FEV1(% of predicted). The accuracy was highest using a 7% fall in FEV1; the sensitivity was 76% and the specificity 96%. CONCLUSION: IHCA is a specific, although not a sensitive, test for diagnosing asthma in adult patients. Furthermore, the diagnostic cut-off value of the different methods of IHCA need to be determined.
Adult* ; Asthma* ; Forced Expiratory Volume ; Humans ; Hyperventilation* ; Methacholine Chloride ; Sensitivity and Specificity ; Smoke ; Smoking

When illuminated by blue light, the human crystalline lens exhibits green autofluorescence. Autofluorescence of the human lens were analyzed quantitatively in vivo as a function of age in 75 healthy individuals{150 eyes) without cataract, ranging in age from 17 to 63 years. Lenses were scanned through the dilated pupil along the optical axis, generating a fluorescence profile consisting of anterior and posterior peaks of lens, using an automated scanning fluorophotometer(Fluorotron master) coupled with a lens system designed for high resolution of the anterior segment structures. Anterior peak autofluorescence increased linearly by 90 ng fluorescein/ml per decade and posterior peak autofluorescence by 70 ng fluorescein/ml per decade. No significant difference between right and left eyes was demonstrated for anterior or posterior peak autofluorescence. We suggest that the quantitative analysis of the autofluorescence of the human lens might be useful to investigate the changes of the aging lens proteins and the pathogenesis of cataract.
Aging* ; Axis, Cervical Vertebra ; Cataract ; Crystallins* ; Fluorescence ; Fluorophotometry ; Humans ; Lens, Crystalline* ; Pupil

PURPOSE: Neointimal hyperplasia (NH) is considered to be one of the main causes of vascular access occlusion in patients receiving hemodialysis. Endothelial injury and TGF-β-mediated proliferation of vascular smooth muscle cells (VSMCs) induce NH. Endothelial microparticles (EMPs) are also increased by endothelial injury. We aimed to investigate the effects of EMPs and TGF-β expression on VSMC proliferation and their contributions to NH formation in an ex vivo model. METHODS: EMPs were collected from the culture media of human umbilical vein endothelial cells treated with indoxyl sulfate (IS, 250 µg/mL) after ultracentrifugation at 100,000 × g. Porcine internal jugular veins were isolated and treated with EMPs (2 × 10⁶ /mL) or left untreated for 12 days and subsequently compared with TGF-β (10 ng/mL)-treated venous tissue. Intima-media thickness and NH area were assessed using a digital program. Masson's trichrome staining and immunohistochemistry (IHC) analysis for α-smooth muscle actin, phosphorylated Akt, ERK1/2, p38 mitogen-activated protein kinase (MAPK), and Smad3 were performed on each vein sample. RESULTS: NH and VSMC proliferation developed to a significantly greater degree in EMP-treated veins compared to controls, with similar patterns seen in TGF-β-stimulated samples. IHC analysis demonstrated that EMPs markedly increased phosphorylation of Akt, ERK1/2, p38 MAPK, and Smad3 in areas of venous NH formation. CONCLUSION: Our results showed that IS-induced EMPs provoked massive VSMC proliferation and NH formation via activation of the TGF-β signaling pathways. Further investigation is needed to elucidate the precise mechanism of EMP activity on vascular access stenosis in vivo.

BACKGROUND/AIMS: Chronic inflammatory status is a possible risk factor for vascular access dysfunction in hemodialysis (HD) patients, but susceptibility differences appear among individuals. Interleukin (IL)-6 is a well-known inflammatory cytokine with various polymorphisms. We examined whether IL-6 polymorphisms are associated with vascular access dysfunction in HD patients. METHODS: A total of 80 HD patients (including 42 diabetic patients) were enrolled. Polymorphisms in the IL-6 gene promoter (-634 C/G and -174 G/C) were studied using restriction length polymorphism polymerase chain reaction analysis. Vascular access patency was compared between the patient groups with respect to IL-6 polymorphisms. An additional 89 healthy individuals were enrolled in the control group. Plasma IL-6 levels were de termined by enzyme-linked immunosorbent assay. RESULTS: The GG genotype and G allele at position -634 in the IL-6 promoter were more frequently observed in HD patients than in controls. Furthermore, the distribution of the -634 polymorphism differed according to vascular access patency in non-diabetic HD patients. However, the G allele was not a significant risk factor for early access failure. No significant association appeared between the IL-6 -634 C/G polymorphism and plasma IL-6 levels. The C allele of the IL-6 -174 G/C polymorphism was not detected in our study population. CONCLUSIONS: The IL-6 -634 G allele appears with greater frequently in patients with end-stage renal disease and may be associated with vascular access dysfunction in non-diabetic HD patients.
Adult ; Aged ; Arteriovenous Shunt, Surgical/*adverse effects ; Asian Continental Ancestry Group/*genetics ; Case-Control Studies ; Chi-Square Distribution ; Enzyme-Linked Immunosorbent Assay ; Female ; Gene Frequency ; Genotype ; Graft Occlusion, Vascular/blood/ethnology/*genetics/physiopathology ; Humans ; Interleukin-6/blood/*genetics ; Kidney Failure, Chronic/blood/ethnology/genetics/immunology/*therapy ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Phenotype ; Polymerase Chain Reaction ; *Polymorphism, Genetic ; Promoter Regions, Genetic ; *Renal Dialysis ; Republic of Korea ; Time Factors ; Treatment Outcome ; Vascular Patency/*genetics

OBJECTIVE: To analyze the relationship of clinical factors and gait parameters of patients with failed back surgery syndrome. METHOD: We investigated 25 male patients with back and /or lower limb pain who underwent lumbar spine operation. The following data were evaluated: clinical symptoms, physical examination, duration from operation to the gait analysis, number and level of operation, Visual Analogue Scales (VAS), modified Dallas pain questionnaire, psychological evaluations (Beck Depression Inventory, BDI) and gait parameters through 3 dimensional gait analysis. RESULTS: Walking velocity was inversely correlated with scores of modified Dallas pain questionnaire and BDI. Stride length was inversely correlated with scores of return to work, neurogenic claudication, VAS, modified Dallas pain questionnaire and BDI. Range of pelvic obliquity was inversely correlated with scores of modified Dallas pain questionnaire and BDI. There was no significant differences between findings of physical exam and gait parameters. CONCLUSION: Results of the gait analysis of patients with failed back surgery syndrome showed significant relationship with clinical factors reflecting psychosocial background of patients.
Depression ; Failed Back Surgery Syndrome* ; Gait* ; Humans ; Lower Extremity ; Male ; Physical Examination ; Surveys and Questionnaires ; Return to Work ; Spine ; Walking ; Weights and Measures

OBJECTIVE: To study gait patterns of patients with chronic lumbosacral radiculopathy, and to investigate whether gait parameters can reflect functional deficit in relation to the level of lumbosacral radiculopathy. METHOD: Conventional physical examinations and three- dimensional gait analysis were performed on 24 patients with chronic lumbosacral radiculopathy (twelves with L5 and twelves with S1 radiculopathy) who were diagnosed by electrophysiologic study and magnetic resonance imaging study, and 12 healthy control subjects. Temporospatial, kine matic and kinetic parameters of patients were compared with those of the control group. RESULTS: In patients with lumbosacral radiculopathy, walking velocity, stride length, ratio of single support time to double support time and range of pelvic obliquity were less than control group. Increased double support time, decreased maximal hip extension angle, decreased ankle plantar flexion angle during preswing phase and decreased maximal ankle plantar flexion moment were noted in S1 radiculopathy patients compared with control group. Decreased pelvic rotational range and decreased ankle dorsiflexion moment were specific in L5 radiculopathy patients compared with control group. CONCLUSION: Using three-dimensional gait analysis, we could identify specific gait parameters to reflect functional deficit related to the level of lumbosacral radiculopathy.
Ankle ; Gait* ; Hip ; Humans ; Low Back Pain* ; Magnetic Resonance Imaging ; Physical Examination ; Radiculopathy* ; Walking

Semantic dementia is a rare, distinct form of frontotemporal lobar degeneration, characterized by a deficit in semantic memory with relative preservation of attention and executive functions. We report a case of semantic dementia that pre-sented with a 3-year history of progressive word-finding difficulty and prosopagnosia. Brain MRI showed prominent atrophic changes in the left temporal region and neuropsychological tests demonstrated semantic memory deficits.
Brain ; Executive Function ; Frontotemporal Dementia* ; Frontotemporal Lobar Degeneration ; Magnetic Resonance Imaging ; Memory ; Memory Disorders ; Neuropsychological Tests ; Prosopagnosia ; Semantics*

There are many therapeutic methods for treating vitiligo, including narrow-band UVB, topical corticosteroids, calcineurin inhibitors, excimer laser, and surgical methods, such as autologous epidermal grafting and dermabrasion. However, although various treatments have been tried, there is still no reliable treatment. Recently, there were several reports about the use of fractional laser combined with narrow-band (NB) UVB to treat vitiligo. A 33-year-old male patient presented with hypopigmented patch on lower right abdominal area. After being diagnosed with vitiligo, the patient underwent NB-UVB treatment and application of a topical agent for two years but failed to show response. To evaluate the efficacy of non-ablative fractional laser, a 1550-nm erbium:glass (Er:Glass) fractional laser was applied to whole area of the lesion. The area showed erythema and brown microscopic epidermal necrotic debris. Five days after the laser procedure, NB-UVB treatment with application of a topical agent was initiated once or twice a week, followed by pigmentation of the treated area . The fractional laser was reapplied three months later, and the patient is currently under observation and is still being treated with NB-UVB. We observed successful treatment of refractory vitiligo with the combination of non-ablative 1550-nm Er:Glass fractional laser, NB-UVB, and a topical agent. We consider non-ablative Er:Glass fractional laser as a favorable choice of treatment for refractory vitiligo.
Adrenal Cortex Hormones ; Adult ; Calcineurin Inhibitors ; Dermabrasion ; Erythema ; Humans ; Lasers, Excimer ; Male ; Pigmentation ; Transplants ; Vitiligo*