BACKGROUND/AIMS: It has been reported that the difference in the hepatitis C virus (HCV) genotype due to genetic heterogeneity of HCV influence the clinical features, prognosis of HCV associated liver disease and response to interferon therapy. Prevalence of different genotypes of HCV may also vary between geographic areas. The aim of this study was to examine the relationship between the response to interferon alpha (IFN-a) therapy and HCV genotypes in patients with chronic HCV infection in Taegu and its environs. METHODS: One hundred seventy six patients known to be HCV antibody and HCV-NA positive were evaluated for HCV genotypes by restriction fragment length polymorphism. Among patients who had elevated ALT levels, 67 patients have been investigated for the role of the HCV genotype on disease outcome and the response of IFN-a therapy. RESULTS: Genotype 1b were found in 59.0% of patients (103/176), genotype 2a in 37.5% (66/176). The mode of transmission of HCV infection was guessed as transfusion in genotype 1b, but as parenteral infection in genotype 2a. According to their response to IFN-a therapy, 73 patients were divided into three groups, complete response, 18 (60%) of 30 patients with genotype 2a and 21 (48.8%) of 43 patients with genotype 1b: partial response, 5 (16.7%) of 30 patients with genotype 2a and 7 (16.2%) of 43 patients with genotype 1b: no response, 7 (23.3%) of 30 patients with genotype 2a and 15 (34.9%) of 43 patients with genotype 1b. Good response to IFN-a therapy was observed among patients group showing normal platelet count in patients with genotype 1b and normal GGT in patients with genotype 2a. CONCLUSIONS: The most frequently identified genotype was genotype 1b in Taegu and its environs, followed by genotype 2a. The HCV genotype was not a reliable predictor of response to IFN-a therapy. When a standardized regimen of IFN-a was administered, pretreatment serum platelet counts and GGT level seem to be useful predictor of IFN-a therapy in HCV infection. Further investigations are required in order to establish a correlation between viral factors and therapeutic responses.
Daegu* ; Genetic Heterogeneity ; Genotype* ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Interferon-alpha ; Interferons ; Liver Diseases ; Platelet Count ; Polymorphism, Restriction Fragment Length ; Prevalence ; Prognosis

Ulcerative colitis is an inflammatory disorder that affects the rectum and extends proximally to affect a variable extent of the colon. The major symptoms of ulcerative colitis include diarrhea, rectal bleeding, the passage of mucus, and abdominal pain. Ulcer-ative colitis also may be complicated by many local and systemic disorders as extrain-testinal manifestations. Pyoderma gangrenosum is the most severe dermatologic com-plication associated with ulcerative colitis. It is a painful , chronic, ulcerating skin disease of unknown cause. Diagnosis is clinical, there being no accepted histological diagnostic criteria. Conventional therapy is empirical, usually with high dose corticosteroids, but var-ious other agents have been tried with occasional success including topical antibiotics, cyclosporine, disodium cromoglycate, and dapsone. This patient was treated with high dose corticosteroid (prednisolone 1 mg/kg/day) and discharged with clinical improvement. So we report this case with a literature review.
Abdominal Pain ; Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Colitis ; Colitis, Ulcerative* ; Colon ; Cromolyn Sodium ; Cyclosporine ; Dapsone ; Diagnosis ; Diarrhea ; Hemorrhage ; Humans ; Mucus ; Pyoderma Gangrenosum* ; Pyoderma* ; Rectum ; Skin Diseases ; Ulcer*

Idiopathic eosinophilic esophagitis is a part of disorders that comprise eosinophilic gastroenteritis, a condition characterized by eosinophilic infiltration of the gastrointestinal tract. Its clinical feature depends on the type of layer and location involved. A 56-year-old man presented with dysphagia and abdominal pain. Endoscopic ultrsonography and esophageal manometry showed definite smooth muscle hypertrophy of the esophagus and vigorous achalasia like motility disturbance. We report a case of eosinophilic eosphagitis that resolved by steroid treatment, with a review of relevant literatures.
Abdominal Pain ; Deglutition Disorders ; Eosinophilic Esophagitis* ; Eosinophils* ; Esophageal Achalasia* ; Esophagus ; Gastroenteritis ; Gastrointestinal Tract ; Humans ; Hypertrophy ; Manometry ; Middle Aged ; Muscle, Smooth

BACKGROUND: Dendritic cell (DC)-based vaccines are currently being evaluated as a novel strategy for tumor vaccination and immunotherapy. However, inducing long-term regression in established tumor-implanted mice is difficult. Here, we show that deoxypohophyllotoxin (DPT) induces maturation and activation of bone marrow-derived DCs via Toll-like receptor (TLR) 4 activation of MAPK and NF-kappaB. METHODS: The phenotypic and functional maturation of DPT-treated DCs was assessed by flow cytometric analysis and cytokine production, respectively. DPT-treated DCs was also used for mixed leukocyte reaction to evaluate T cell-priming capacity and for tumor regression against melanoma. RESULTS: DPT promoted the activation of CD8+ T cells and the Th1 immune response by inducing IL-12 production in DCs. In a B16F10 melanoma-implanted mouse model, we demonstrated that DPT-treated DCs (DPT-DCs) enhance immune priming and regression of an established tumor in vivo. Furthermore, migration of DPT-DCs to the draining lymph nodes was induced via CCR7 upregulation. Mice that received DPT-DCs displayed enhanced antitumor therapeutic efficacy, which was associated with increased IFN-gamma production and induction of cytotoxic T lymphocyte activity. CONCLUSION: These findings strongly suggest that the adjuvant effect of DPT in DC vaccination is associated with the polarization of T effector cells toward a Th1 phenotype and provides a potential therapeutic antitumor immunity.
Animals ; Dendritic Cells ; Immunotherapy ; Interleukin-12 ; Lymph Nodes ; Lymphocyte Culture Test, Mixed ; Lymphocytes ; Mice ; Phenotype ; Podophyllotoxin ; T-Lymphocytes ; Toll-Like Receptors ; Up-Regulation ; Vaccination ; Vaccines

BACKGROUND: Onychomycosis, especially toenail onychomycosis has become one of the common fungal infection and has historically been regarded as a cosmetic rather than medical problem by many patients, even by physicians. Recently, however, there are several reports that this is a refractory disease which may cause a deleterious effect on patients' quality of life (QOL). OBJECTIVE: The purpose of this study was to investigate the impact of toenail onychomycosis on QOL in Korea and to assess the changes of QOL after treatment. METHODS: Total 1004 patients with toenail onychomycosis which was confirmed by clinical findings and KOH preparation were enrolled at 47 dermatologic centers in Korea, and interviewed with standardized QOL questionnaire before and after systemic antifungal treatment. Responses to the questionnaire were scored by f-point scale (0~4) and averaged, and were analyzed for 5 dimensions of emotional impact, social impact, symptom and functional impact, patients' views concerning treatment, and relationship with doctor. RESULTS: 1. Before and after treatment, the most serious impact was emotional dimension showing 1.90 and 1.30 in average score (AS), and social (AS: 1.14 and 0.83) and symptom and functional impact (AS: 1.05 and 0.92) was also affected. 2. In female rather than male, statistically more significant impact on patients' QOL was observed in all dimensions. 3. After treatment, 3 of 5 dimensions were improved significantly - emotional dimension (AS: from 1.90 to 1.30), social dimension (AS: from 1.14 to 0.83), patients' view concerning treatment(AS: from 1.34 to 1.02) 4. The degree of patients' satisfaction at the therapeutic effect was very high - 62.4% (immediately after. treatment) and 65.8% (9 months after initiation of treatment) of patients answered excellent or good. CONCLUSION: This study confirms that toenail onychomycosis has significant Impact on the overall QOL of patients. Also the effect of antifungal therapy on patients' QOL were satisfactory. Therefore, both doctor and patient should pay more attention to the treatment of onychomycosis.
Female ; Humans ; Korea* ; Male ; Nails* ; Onychomycosis* ; Quality of Life* ; Social Change ; Surveys and Questionnaires