Allopurinol is widely used for chronic tophaceous gout as a uric acid lowering agent. Hypersensitivity to allopurinol occurrs in about 10% of patients, which limits the usage of allopurinol. The successful oral and intravenous desensitization of allopurinol has been reported worldwide since 1976. We recently experienced a 51-year-old male patient with gouty arthritis and hyperuricemia, who had previously experienced skin rash after allopurinol treatment. When allopurinol was retried, erythematous and foliative skin rash developed on entire body. Because allopurinol was essential in controlling hyperuricemia, the oral desensitization of allopurinol was tried. We report successful rapid oral allopurinol desensitization in the patient with chronic tophaceous gout, who exhibited exfoliative dermatitis as allopurinol hypersensitivity.
Allopurinol* ; Arthritis, Gouty ; Dermatitis, Exfoliative* ; Exanthema ; Gout ; Humans ; Hypersensitivity ; Hyperuricemia ; Male ; Middle Aged ; Uric Acid

No abstract available.
Body Weight* ; Diet* ; Exercise Therapy* ; Humans

BACKGROUND: The purpose of this study is to investigate impact of increased tobacco price in 2015 on the adult smoking rate in South Korea. METHODS: This study used 6th Korea National Health and Nutrition Examination Survey from 2013 to 2015. Total 14,860 adults were included in the analysis. The chi-square test, univariate- and multivariate survey logistic regressions, and subgroup analysis were conducted. RESULTS: Results show that adult smoking rate before price increase were 19.08% and after price increase were 16.69%. Adjusted by variables associated with smoking behavior and others, multivariate survey logistic regressions revealed that smoking rate decreased after introduction of increased tobacco price policy (odds ratio [OR], 0.745; 95% confidence interval [CI], 0.575 to 0.967) and the impact was different by various social status (male: OR, 0.688; 95% CI, 0.523 to 0.905; age over 60: OR, 0.487; 95% CI, 0.315 to 0.754; rural area: OR, 0.531; 95% CI, 0.309 to 0.912; household income Q1: OR, 0.593; 95% CI, 0.352 to 0.999; household income Q4, OR, 0.616; 95% CI, 0.386 to 0.983). CONCLUSION: The study revealed decreased smoking rate after increased tobacco price policy and different trend depending on various social characteristics. We recommend that government agencies and policy makers should pursue tobacco price control policy continuously and population specific manner and concurrently non-price policy should be implemented as well.
Administrative Personnel ; Adult* ; Family Characteristics ; Government Agencies ; Humans ; Korea* ; Logistic Models ; Nutrition Surveys ; Smoke* ; Smoking* ; Sociological Factors ; Tobacco*

BACKGROUND: The purpose of this study is to investigate impact of increased tobacco price in 2015 on the adult smoking rate in South Korea. METHODS: This study used 6th Korea National Health and Nutrition Examination Survey from 2013 to 2015. Total 14,860 adults were included in the analysis. The chi-square test, univariate- and multivariate survey logistic regressions, and subgroup analysis were conducted. RESULTS: Results show that adult smoking rate before price increase were 19.08% and after price increase were 16.69%. Adjusted by variables associated with smoking behavior and others, multivariate survey logistic regressions revealed that smoking rate decreased after introduction of increased tobacco price policy (odds ratio [OR], 0.745; 95% confidence interval [CI], 0.575 to 0.967) and the impact was different by various social status (male: OR, 0.688; 95% CI, 0.523 to 0.905; age over 60: OR, 0.487; 95% CI, 0.315 to 0.754; rural area: OR, 0.531; 95% CI, 0.309 to 0.912; household income Q1: OR, 0.593; 95% CI, 0.352 to 0.999; household income Q4, OR, 0.616; 95% CI, 0.386 to 0.983). CONCLUSION: The study revealed decreased smoking rate after increased tobacco price policy and different trend depending on various social characteristics. We recommend that government agencies and policy makers should pursue tobacco price control policy continuously and population specific manner and concurrently non-price policy should be implemented as well.
Administrative Personnel ; Adult* ; Family Characteristics ; Government Agencies ; Humans ; Korea* ; Logistic Models ; Nutrition Surveys ; Smoke* ; Smoking* ; Sociological Factors ; Tobacco*

Human monoclonal antibodies have considerable potential in the prophylaxis and treatment of viral disease. By cloning human Ig gene segments from the B cells of volunteer into pComb3 phagemid vector, antibody library was created of filamentous phage particles displaying Fab fragments on their surface after being rescued with M13KO7 helper phages. The size of library was 7x10' pfu. Phage antibodies (phabs) were panned against biotinylated preS1 using streptavidine coated Dynabead. The soluble Fab antibodies were prepared from phagemid colonies and assayed directly for the ability to bind preS1 by ELISA. And then 3DW and SGW specific to preS1 which have both heavy and light chain to form Fab fragment, were selected. The soluble Fab antibody from 3DW was expressed highly at the concentration of 0.1 - 1.0 mM of IPTG, and 5 hours postinduction. The soluble antibodies from 3DW and SGW showed their relative affinities of 2x10' M ', and Sx10 M ', respectively, and the specificities to preS1 on ELISA. Our results suggest that antibody phage display library is very useful method to generate the human monoclonal antibody and that the human Fab monoclonal antibodies specific to preS1 selected in this study open the way to treat hepatitis B as a component of passive irnmunotherapeutics.
Antibodies ; Antibodies, Monoclonal ; B-Lymphocytes ; Bacteriophages* ; Clone Cells ; Cloning, Organism ; Enzyme-Linked Immunosorbent Assay ; Genes, Immunoglobulin ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans* ; Immunoglobulin Fab Fragments ; Isopropyl Thiogalactoside ; Streptavidin ; Virus Diseases ; Volunteers

Direct intraarterial measurement of blood pressure is an important diagnostic procedure in critical patients and premature baby care. Direct measurement was more accepted and confident method in physician than the indirect methods. But the presence of a significant amplification of systolic pressure in peripheral artery may lead to important error. So we have investigated the degree of the systolic pressure amplification from the ascending aorta to the femoral artery in children. Pressure waves recorded in the ascending aorta, aortic arch, diaphragmatic level of the descending aorta, common iliac artery, and femoral artery in 37 patients with congenital heart disease, aged 9 months to 21 years old (mean 7.16 yrs old) during diagnostic cardiac catheterization. The results were as follows 1) Amplification of the systolic pressure increased progressively from the ascending aorta to the femoral artery (16.7%) 2) Diastolic pressure decreased progressively from the ascending aorta to the femoral artery (6.5%) 3) Mean pressure decreased progressively from the ascending aorta to the femoral artery (1.5%) 4) Pulse pressure increased progressively from the ascending aorta to the femoral artery (42.8%) 5) There was significant drop (7%) of the systolic pressure of the ascending aorta compared with that of left ventricle. The results showed that the peripheral amplifications were limited to the systolic and pulse pressure, but the diastolic and mean pressure in peripheral arteries were lower than that of central artery.
Aorta ; Aorta, Thoracic ; Arterial Pressure* ; Arteries ; Blood Pressure* ; Cardiac Catheterization ; Cardiac Catheters ; Child* ; Femoral Artery ; Heart Defects, Congenital* ; Heart Ventricles ; Humans ; Iliac Artery ; Young Adult

No abstract available.
Heart Defects, Congenital* ; Plasma*

BACKGROUND: Several antibiotics can be used to treat ventilator-associated pneumonia caused by carbapenem-resistant A. baumannii (CRAB-VAP) including high-dose sulbactam. However, the effectiveness of high-dose sulbactam therapy is not well known. We report our experience with high-dose sulbactam for treatment of CRAB-VAP. METHODS: Medical records of patients with CRAB-VAP who were given high-dose sulbactam between May 2013 and June 2015 were reviewed. RESULTS: Fifty-eight patients with CRAB-VAP were treated with high-dose sulbactam. The mean age was 72.0 ± 15.2 years, and the acute physiology and chronic health evaluation II (APACHE II) score was 15.1 ± 5.10 at the time of CRAB-VAP diagnosis. Early clinical improvement was observed in 65.5% of patients, and 30-day mortality was 29.3%. Early clinical failure (odds ratio [OR]: 8.720, confidence interval [CI]: 1.346-56.484; p = 0.023) and APACHE II score ≥ 14 at CRAB-VAP diagnosis (OR: 10.934, CI: 1.047-114.148; p = 0.046) were associated with 30-day mortality. CONCLUSIONS: High-dose sulbactam therapy may be effective for the treatment of CRAB-VAP. However, early clinical failure was observed in 35% of patients and was associated with poor outcome.
Acinetobacter baumannii* ; Acinetobacter* ; Anti-Bacterial Agents ; APACHE ; Diagnosis ; Humans ; Medical Records ; Mortality ; Pneumonia, Ventilator-Associated* ; Sulbactam*

Heterotopic pregnancy is the coexistency of intrauterine and extrauterine pregnancy. The incidence of heterotopic pregnancy is about 1 to 30,000 pregnancy in a natural cycle. However, the frequency of heterotopic pregnancy has steadily increased because of rising incidence of pelvic inflammatory disease, pelvic surgery and the development of ovulation induction and assisted reproduction. Because heterotopic pregnancy is difficult to diagnose and it has high morbidity and mortality rate, one should always take this into consideration and should conduct careful and thorough gynecologic evaluation. We have experienced a case of heterotopic pregnancy in a 29-year old woman who presented with acute abdominal pain in a natural cycle and report this case with a brief review of literature.
Abdominal Pain ; Adult ; Female ; Humans ; Incidence ; Mortality ; Ovulation Induction ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Heterotopic* ; Reproduction

OBJECTIVE: The purpose of this study was to evaluate outcome of intracytoplasmic sperm injection (ICSI) using epididymal and testicular sperm in patients with azoospermia. METHODS: From March, 1993 to May, 1999, a retrospective clinical analysis was done of a total of 140 cycles in 112 patients who underwent ICSI. Subjects were divided into three group: ejaculated-ICSI group included 42 cycles in 34 patients with ejaculated sperm who underwent ICSI due to severe oligospermia and past history of failed or poor fertilization in the previous in vitro fertilization and embryo tranfer (IVF-ET) cycles, microsurgical epididymal sperm aspiration and intracytoplasmic sperm injection (MESA-ICSI) group included 50 cycles in 42 patients with congenital absence of the vas deferens (CAVD) or unreconstructable obstructive azoospermia and testicular sperm extraction and intracytoplasmic sperm injection (TESE-ICSI) group included 48 cycles in 36 patients with no spermatozoa which can be retrieved from epididymis or non-obstructive azoospermia. RESULTS: Normal two-pronuclear fertilization rates were similar in three groups: 64.4% for ejaculated-ICSI group, 59.4% for MESA-ICSI group and 60.4% for TESE-ICSI group. The pregnancy rates were 26.2%, 26.0% and 25.0% respectively. There were no significant differences in the fertilization, cleavage, and clinical pregnancy rates among ICSI cycles using ejaculated, epididymal and testicular sperm. CONCLUSION: Epididymal and testicular sperm obtained in azoospermic patients can fertilize oocyte successfully and may lead to be similar fertilization rates and clinical pregnancy rates to ejaculated sperm.
Azoospermia ; Embryonic Structures ; Epididymis ; Fertilization ; Fertilization in Vitro ; Humans ; Male ; Oligospermia ; Oocytes ; Pregnancy Rate ; Retrospective Studies ; Sperm Injections, Intracytoplasmic* ; Sperm Retrieval ; Spermatozoa* ; Vas Deferens