PURPOSE: Atopic dermatitis is a chronic, inflammatory skin disease characterized by intense pruritus and an immunologic profile consistent with allergic disease. It is associated with increased eosinophil and IgE level and decreased INF-gamma production. We describe the result of a treatment with INF-gammaand assess the clinical, immunologic, and laboratory data of 12 patients with atopic dermatitis. METHODS: Twelve patients were treated for 12 weeks with 2x106 units/m2 INF-gamma by subcutaneous injection. General hematologic tests were done, and total eosinophil counts, eosinophil fractions, neutrophil fractions, and IgE levels were measured before the treatment, 2 weeks after the treatment, 12 weeks after the treatment serially. We also followed up the patients for 12 weeks after discontinuing INF-gammatherapy. RESULTS: All patients showed clinically significant improvement after 12 weeks of the systemic INF-gammatherapy. There was no clinical aggravation during the therapy period and the follow-up 4 weeks without the therapy. But the recurrence rate in the 12 weeks after discontinuing the therapy was about 40%. Eosinophil counts and eosinophil fractions were significantly decreased after the therapy. And, eosinophil counts and eosinophil fractions were increased in clinically aggravated patients during the 12 weeks of off-therapy. CONCLUSION: We conclude that INF-gammais an effective therapy in atopic dermatitis without significant side effects. The eosinophil counts and eosinophil fractions were decreased during the INF-gamma therapy, and increased in clinically aggravated patients after the off-therapy. There was no aggravation during the therapy. But 5 patients were clinically aggravated during the 12 weeks of off-therapy. Further studies for a long-term maintenance therapy and its side effect might be needed in chronic atopic dermatitis.
Dermatitis, Atopic* ; Eosinophils ; Follow-Up Studies ; Hematologic Tests ; Humans ; Immunoglobulin E ; Injections, Subcutaneous ; Interferon-gamma* ; Neutrophils ; Pruritus ; Recurrence ; Skin Diseases

BACKGROUND: Carcinoembryonic antigen (CEA) is a glycoprotein on cellular surface, which is highly condensed in embryonic tissue and tumor of various kinds. Previous study found out that CEA may grow with various cancer or other diseases other than cancer as well. Besides, it is widely known that smoking also influences the rise in CEA. Among the same smokers, some of them show high CEA figures in serum when others remain in normal range. There are those whose pulmonary function is not influenced by smoking when that of others are susceptible to it. Therefore, this study was undertaken with an aim to study the relationship between serum CEA and pulmonary function by investigating how the change in pulmonary function caused by smoking influences serum CEA. METHODS: From Nov, 1997 to Feb, 2001, this study carried out tests on adult male smokers ages 35 to 64 who visited a hospital located in Kang Nung city. The subjects were divided into two groups: one group of 29 subjects with high CEA with over 6.0 ng/ml with normal colon study; the other group, which is the CEA normal group, consisted of 58 subjects selected through age adjusted random sampling. Data on personal information, smoking and clinical history was collected from a questionnaire. CEA was tested using radioimmunoassay of Abott. Pulmonary function was examined using Analyzer assembly Vmax 20C from Sensormedics Company. These examinations was limited to those who have been screened not to have cancer by chest X-ray, abdominal ultrasonography, and duodenofibroscopy. RESULTS: Smoking per day for the group with high serum CEA was 1.3 pack ( 0.4 pack), which was found to be significantly higher compared to that of normal group (P<0.01). Pack-years with high serum CEA group was 32.6 13.5 which was also comparatively higher than that of the normal group with 22.4 10.9 (P<0.01). Pulmonary function test indicated that FEV1 for the group with high serum CEA was 3.0 0.5 L, which marked lower than that of the normal group with 3.4 0.5 L (P<0.05). After compensating for age and pack years, FEV1 decreased in proportion to the rise in CEA. CONCLUSION: This study has established a link between serum CEA and daily smoking, pack years, and pulmonary function and found that FEV1 was inversely proportionate to the rise in CEA regardless of corrected pack years and daily smoking. Consequently, serum CEA alone is thought to be related to the pulmonary function. Therefore, it is advised that smokers with high serum CEA need to take heed of the influence on pulmonary function.
Adult ; Carcinoembryonic Antigen* ; Colon ; Glycoproteins ; Humans ; Male* ; Radioimmunoassay ; Reference Values ; Respiratory Function Tests ; Smoke ; Smoking ; Thorax ; Ultrasonography ; Surveys and Questionnaires

We experienced a case of isolated fetal pleural effusion diagnosed by antenatal ultrasonogram in the 33th week of gestational age. Chest PA at birth showed massive pleural effusion in both lungs. The serous pleural fluid changed to a milky nature after feeding so we diagnosed it as congenital chylothorax. The infant was managed by chest tube drainage, NPO & TPN with good response and was discharged on the 28th hospital day. We report the case with a brief review of its related literature.
Chest Tubes ; Chylothorax* ; Drainage ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Lung ; Parturition ; Pleural Effusion ; Thorax ; Ultrasonography

PURPOSE: Perforator flap-using ischial sore reconstruction is performed in a prone position. But after the surgery, recurrence frequently occurs in a sitting position. In this sense, we introduce modified flap insetting method which closely resembles patient's sitting position to lessen the flap tension surgically. MATERIALS AND METHODS: Authors tried to check a skin tension difference between prone position and sitting position in normal people group and to find out the importance of performing flap insetting in hip flexion position. Healthy volunteers were collected (n=20) and designed the same length of 4 divided sections around the ischium. Lengths of each section were measured when hip joint was flexed to 90 degree and when both hip and knee joints were flexed to 90 degree and the statistical evaluation was performed. Twenty cases with ischial sore underwent reconstructive surgery using perforator flap under hip flexion position and followed-up for any recurrences. RESULTS: There was a meaningful difference between the joint flexed skin length and that of the neutral position. Flap showed sufficient thickness over 12 months. CONCLUSION: It seems that recurrence could be reduced when the reconstructed flap could sufficiently cover in a sitting position regarding its significant length difference in normal people group.
Healthy Volunteers ; Hip Joint ; Hip* ; Ischium ; Joints ; Knee Joint ; Methods ; Perforator Flap* ; Pressure Ulcer ; Prone Position ; Recurrence ; Skin

Purpose: Dominant optic atrophy is one of the most common hereditary optic neuropathies, causing progressive bilateral vision loss that begins early in life. Optic atrophy 1 (OPA1) gene mutation brings about mitochondrial dysfunction, which results in clinical manifestations of dominant optic atrophy. Here, we report a case of dominant optic atrophy caused by the c.1334G>A mutation of the OPA1 gene, the first known case in Korea to our knowledge.Case summary: A 12-year-old female patient with no specific medical history or systemic symptoms visited our clinic complaining of a progressive decrease in vision in either eye. Slit-lamp microscopy, intraocular pressure, ocular motility, and pupil reflex were normal. However, her best-corrected visual acuity in both eyes was 20/100, and her color vision was reduced to 8/12 in Ishihara’s test. Fundus examination showed temporal pallor of the optic nerve head in both eyes, and a corresponding cecocentral scotoma was observed on Goldmann visual field examination. Optical coherence tomography revealed significant thinning of the peripapillary retinal fiber layer and macular ganglion cell layer in both eyes. Genetic examination confirmed the c.1334G>A mutation of the OPA1 gene. Conclusions We report a case of dominant optic nerve atrophy caused by c.1334G>A mutation of the OPA1 gene and its clinical manifestations.

PURPOSE: Until now, the rejection was diagnosed through a biopsy, but this method of diagnosis reflected the advanced tissue damage of the transplanted organ and contained the innate problem of being invasive. Activation of T lymphocytes, which occurs before the overt tissue damage has a pivotal role in rejection. In relation, our research attempted to evaluate the viability of analyzing the surface antigens of the peripheral blood activated T lymphocytes in mice after skin transplantation as a noninvasive and early diagnostic tool for diagnosis of rejection. METHODS: After the mouse's skin was transplanted, the expression patterns of activated T lymphocyte markers, CD44 and CD45RB were analyzed along with T lymphocyte markers, CD3, CD4, and CD8 using flow cytometry. The skins from the tails of allogeneic Balb/c (H2(d)) mice and syngeneic C57BL/6J mice were transplanted to C57BL/6J (H2(b)) mice as test and control groups, respectively. Peripheral blood, which was sampled from the tail every other day from day 3 to day 15 was stained with anti-CD44 (or CD45RB), anti-CD4 (or CD8) and anti-CD3 monoclonal antibodies simultaneously, and analyzed by 3-color FACS. Repeated ANOVA test and Mann-Whitey test were used to analyze the differences between the expression patterns of peripheral blood T lymphocyte surface antigen in the control and test groups (SPSS 8.0). RESULTS: Rejection occurred only in the test group from day 8 to day 13 (median: day 10). Although the proportions of CD3(+)lymphocytes (CD3(+)%), CD4(+)lymphocytes (CD4(+) %), and CD8 lymphocytes (CD8(+)%) showed no difference between the control and test groups, the total number of peripheral blood lymphocytes and the number of CD3(+)lymphocytes (CD3(+)) and CD8(+)lymphocytes (CD8(+)) decreased more sharply in the control group after day 7. The proportion and the number of CD44 CD3(+)lymphocytes, CD44 CD4(+)lymphocytes, and CD44(+) CD4(+) CD3(+)lymphocytes began to increase after day 7, to peak on day 11, and then to decrease, showing a significant difference from those of the control group. The proportion and number of CD44(+) CD3(+)lymphocytes, in particular, showed the most significant difference among these significant markers. The proportion and number of CD44(+) CD8(+) lymphocytes and CD44(+) CD8(+) CD3(+)lymphocytes showed similar trends to those of CD44(+) CD3(+) or CD44(+) CD4(+), but the differences between the subset proportions in control and test groups were statistically insignificant. No significant difference was observed in any subsets of the CD45RB antigen. CONCLUSION: CD44(+)CD3(+) lymphocytes representing activated T lymphocytes increased significantly compared to the control group during the rejection period of skin transplantation. The analysis of the expression patterns of surface antigen CD44 on peripheral blood T lymphocytes using flow cytometry is sensitive, safe, easily repeatable, and controllable, and, therefore, can be considered a promising tool for the diagnosis of rejection. However, the clear change in CD44 occurred between day 9 and day 13, when rejection was observed grossly. Therefore, it is regarded more useful as a screening test or follow-up indicator rather than as an early diagnostic tool.
Animals ; Antibodies, Monoclonal ; Antigens, Surface ; Biopsy ; Diagnosis ; Flow Cytometry ; Follow-Up Studies ; Graft Rejection ; Lymphocytes ; Mass Screening ; Mice* ; Skin Transplantation* ; Skin* ; T-Lymphocytes* ; Tail

PURPOSE: We explored whether a gender difference was evident in terms of the associations of snoring with hemoglobin A1c (HbA1c) and homeostatic model assessment-insulin resistance (HOMA-IR) levels in a healthy population without type 2 diabetes mellitus (DM). MATERIALS AND METHODS: We analyzed 2706 males and 4080 females who participated in the baseline survey of the Namwon Study. In terms of self-reported snoring frequency, participants were classified as non-snorers or occasional (1–3 days/week), frequent (4–6 days/week), or constant (7 days/week) snorers. Participants with DM, defined as a fasting blood glucose level ≥126 mg/dL and/or use of insulin or hypoglycemic medication, were excluded from the analysis. RESULTS: In females, the fully adjusted mean (95% confidence interval) HbA1c levels in non-snorers and in occasional, frequent, and constant snorers were 5.53% (5.47–5.59%), 5.53% (5.47–5.59%), 5.57% (5.49–5.64%), and 5.57% (5.51–5.64%), respectively, reflecting a dose-response relationship (p trend=0.004). Compared with female non-snorers, the risk of an elevated HbA1c level (top quintile, ≥5.9%) in constant snorers remained significant (odds ratio 1.30, 95% confidence interval 1.02–1.66) after full adjustment. In addition, in females, a significant linear trend in HbA1c level odds ratio by increased snoring frequency was apparent (p trend=0.019 in model 3). In contrast, no significant association between snoring frequency and HbA1c level was identified in males. No significant association between snoring frequency and HOMA-IR was detected in either gender. CONCLUSION: We discovered a gender-specific association between snoring and HbA1c level in a healthy, community-dwelling population free of DM.
Blood Glucose ; Diabetes Mellitus, Type 2* ; Fasting ; Female ; Hemoglobin A ; Humans ; Insulin ; Insulin Resistance ; Jeollabuk-do ; Male ; Odds Ratio ; Snoring* ; Surveys and Questionnaires

Brugada syndrome, an autosomal dominantly inherited form of ventricular fibrillation, is characterized by ST-segment elevation in leads V1-3 and right bundle-branch block on surface electrocardiogram. It is caused by mutations in the cardiac sodium channel gene, SCN5A, and to the best of our knowledge, there has been no report of this mutation in Korea. Three members of a family were heterozygous for a G to T substitution at the nucleotide position 5851 in exon 28 of the SCN5A gene. This nucleotide alteration makes a missense mutation, leading to a valine to leucine substitution (V1951L), in the carboxy terminal region of the sodium channel a subunit. We report here a missense mutation in a Korean family with Brugada-type electrocardiogram.
Brugada Syndrome ; Bundle-Branch Block ; Electrocardiography ; Exons ; Humans ; Korea ; Leucine ; Mutation, Missense* ; Sodium Channels ; Valine ; Ventricular Fibrillation

BACKGROUND: This research is to find out the object of Medical Phone Counsel rational and satisfactory by investigating in local clinic the actual state of Medical Phone Counsel, which is a form of medical care between doctor and patient, and by grasping the difference of expectation and recognition between doctor and patient on Medical Phone Counsel which is one of the service items of Attending Physician Registration System which is to be put into effect in near future. METHODS: This research conducted a se7-administered questionnaire targeting all practitioners to the number of forty four who gave primary care in Kangnung city from August to September in 1999, and each twenty patients Per Practitioner. This research compared and analyzed the difference of recognition between doctor and patient on the following contents of Medical Phone Counsel ; General Characteristic, Frequency, Contents, Time, Satisfiability, For or Against the Medical Phone Counsel to be executed under Attending Physician Registration System and Expectations. RESULTS: The questionnaire for doctor had a 70.5% of response rate, and the one for patient 17.2%. The 40.7% of the practitioners took a Phone Counsel actively, the 55.6% took part in Phone Counsel passively and the rest 3.7% did not participate in it. The 74.2% of them took this counsel for less than three minutes. Regarding recognition on Phone Counsel, the 48.1% of them answered that they executed it as it is their duty and the 48.4% responded that they took it reluctantly in spite of their busy business. The 3.2% answered that it is not their duty. Among those in favor of Phone Counsel under Attending Physician (or Prime Doctor) Registration System, the 28.6% agreed as it is their own duty and the 71.4% was for it subject to economic compensation. While, the 62.9% of the patients answered that they had never experienced the Phone Counsel, and the 34.4% responded that they had experienced it one or two times in a yea. Among those who had experienced Phone Counsel, the 46.4% was satisfied with it. As far as the difference of expectation and recognition between doctor and patient on Medical Phone Counsel is concerned, only 45.2% of the practitioners were in favor of Medical Phone Counsel under the Attending Physician Registration System. While, the 70.1% among the patients was in favor of its execution. These two values showed a significant difference between doctor and patient (P<0.05), And the 83.9% of the practitioners insisted that the charge should be paid against Phone Counsel and only 56.2% of the patients insisted the same. There was also a significant difference between two values. (P<0.05) CONCLUSION: The practitioners were taking part in Medical Phone Counsel at any form. To the contrary, most of the patients were not. As far as the systematization of Phone Counsel is concerned, most of the practitioners had mental reluctance if there is no economic compensation. On the other hand, most of the patients had high expectation regardless of economic matters. If Medical Phone Counsel becomes systematized, it is expected that there will be a great trouble between its supply and demand.
Commerce ; Compensation and Redress ; Hand ; Hand Strength ; Humans ; Primary Health Care* ; Surveys and Questionnaires

Benzidine Industry in Korea has started after Japan has banned its production in early 1970's. and it has been in operation in Korea for over 20 years. However, it is not known yet whether any bladder cancer has developed from benzidine exposure. This study was done to screen benzidine-exposed workers for bladder cancer, and to examine the feasibility of employing screening test at the workplace. All the workplaces that manufacture or use benzidine for more than 20 years in Korea have been covered in this study, and they include 2 benzidine manufacturing factories, 5 benzidine using factories, as well as 2 benzidine free factories as an outside control. In total, 516 workers were screened with urine stick test and urine cytology test for the evidence of hematuria and abnormal urothelial cells. Each worker was also asked about risk factors and symptoms of bladder cancer including past medical history, smoking, medication and occupational history. Benzidine in the air was measured by personal and area sampling. Out of 516 screened workers, 84(16.3%)workers showed positive hematuria in urine stick test, and 7(1.4%)workers showed degenerative cells in urine cytology tests. Those workers with abnormal urine test results who have been exposed to benzidine for more than 10 years were further screened, and, in total. 23 workers were examined with intra-venous pyelography and cystoscopy. None of those screened had any evidence of bladder cancer. When workers with only past hematuria history were included in the positive hematuria group, 96(18.5%) had positive hematuria. On the multiple logistic regression analysis, positive hematuria was significantly associated with benzidine exposure history of other occupations with elevated bladder cancer risk, pyuria and glycosuria. The association got stronger as direct benzidine exposure was accounted through individual task analysis, and as exposure duration was accounted with tenure analysis. For those with benzidine exposure with more than 10 years of tenure, the odds of having positive hematuria was elevated 2.14(95%C.I is 1.08 to 4.25) times more than for those without exposure. Even though bladder cancer was not detected for several limitations including short observation period, majority of studied workers with short latency, healthy worker effect, and low sensitivity of single screening test in a cross-sectional study, the study results suggest that hematuria screening is a feasible and very useful test for bladder cancer screening among benzidine exposed workers.
Cross-Sectional Studies ; Cystoscopy ; Glycosuria ; Healthy Worker Effect ; Hematuria* ; Humans ; Japan ; Korea ; Logistic Models ; Mass Screening ; Occupations ; Pyuria ; Risk Factors ; Smoke ; Smoking ; Urinary Bladder Neoplasms ; Urography