BACKGROUND AND OBJECTIVE: The outcome of asthma treatment has traditionally been assessed by measuring the conventional clinical parameters such as symptoms, expiratory flow rates and needs for medications. But none of them tells us whether the patients are actually able to function properly in their lives. Only assessment of the quality of life (QOL) can reflect the parts of patients lives affected by the disease. However, there is no measure to assess the quality of life of patients with any chronic diseases in Korea yet. We developed the QOL Questionnaire for Korean Asthmatics and evaluated its measurement properties. METHOD: The questionnaire was composed of 18 items in four domains : i.e. activity limitation (6 items), symptoms (5 items), emotional function (3 items) and environmental stimuli (4 items). At our out-patient clinic, 32 adults with moderate to severe persistent bronchial asthma were enrolled. The study design consisted of 4 week unblinded single cohort with visits at 0 and 4 weeks, and the patients were asked to answer the questionnaire by self administration method at the two separate visits. Forced expiratory volume for 1 second (FEV1) and peak expiratory flow rate (PEFR) were recorded at each visit. According to the patients and physicians global assessment, the patients were divided into two groups, i.e. stable and changed (improved). The responsiveness, reproducibility and validity of the questionnaire were evaluated. RESULTS: The total QOL scores at the second visit in the changed group were significantly higher than those at the first visit. The score differences between the two visits in the changed group were higher than in the stable group. In the stable group, the responses to the questionnaire were reproducible. The QOL scores showed good longitudinal correlation with the expiratory flow rates, whereas FEV1 did not correlate with the QOL in cross-sectional analysis. CONCLUSION: The questionnaire proved to be reproducible, responsive and valid in the subjects. It could be recommended for the outcome evaluation of Korean asthmatics.
Adult ; Asthma ; Chronic Disease ; Cohort Studies ; Cross-Sectional Studies ; Forced Expiratory Volume ; Humans ; Korea ; Outpatients ; Peak Expiratory Flow Rate ; Quality of Life* ; Self Administration ; Surveys and Questionnaires

BACKGROUND: Oral allergy syndrome(OAS) is composed of it,ching sense and edema in oral cavity, lips, throat, pharynx, and larynx following eating some fresh fruits or vegetables. It has been known that most of patients with OAS are allergic to pollens. Common epitopes were found among pollens, fruits and vegetables. Although OAS is a common farm of food allergy in adults, this is the first epidemiologic study of OAS in Korea. MATERIAL AND METHOD: One hundred and fifty one patients who showed positive skin reaction to pollens were telephone-interviewed. Investigation of the prevalence and clinical manifestations of OAS was possible in 81 patients. RESULT: The prevalence of OAS among these patients was 34.6% (28/81). OAS was found in 24(48%) out of 50 patients sensitized to tree pollens, whereas 4(13%) of 31 grass or weed pollen-sensitized paients had OAS. Most common causative food was apple and all of 17 apple- OAS patients were sensitized to tree pollens. Peach was the second common food and 14 of 15 peach-OAS patients were sensitized to tree pollens. Besides oral symptoms, rhinitis, asthma, diarrhea, nausea, vomiting or generalized urticaria were accompanied in half of the OAS patients (14/28). Some patients showed OAS to some unique Korean foods such as dropwort, taro and Aster. CONCLUSION: OAS was very common in pollen-sensitized patients. Larger epidemiologic studies are needed to find unique Korean foods and their antigensm causing OAS.
Adult ; Asthma ; Colocasia ; Diarrhea ; Eating ; Edema ; Epidemiologic Studies ; Epitopes ; Filipendula ; Food Hypersensitivity ; Fruit ; Humans ; Hypersensitivity* ; Korea ; Larynx ; Lip ; Mouth ; Nausea ; Pharynx ; Poaceae ; Pollen* ; Prevalence ; Prunus persica ; Rhinitis ; Skin ; Urticaria ; Vegetables ; Vomiting

The hippocampus is a central area of the memory-related neural system. Combined immunohistochemistry against choline acetyl transferase and retrograde transneuronal labelling of the pseudorabies virus were used to identify cholinergic neurons in the central nervous system projecting to the hippocampal formation of the rat. Five to ten microL of Bartha strain of pseudorabies virus were injected into the dentate gyrus, CA1 and CA3 of the hippocampus of 20 Sprague Dawley rats using stereotaxic instrument. Forty eight to 96 hr after the injection, the brains were removed and the tissue sections were processed for double immunofluorescence procedure using polyclonal antibodies against pseudorabies virus or choline acetyl transferase. The double labelled neurons were distributed at several different nuclei and the labelling patterns of three different areas of the hippocampus were similar. These data suggests that the cholinergic innervation to the hippocampus were distributed in a transsynaptic manner throughout the whole brain area.
Animal ; Antibodies ; Choline O-Acetyltransferase/*analysis/immunology ; Cholinergic Fibers/*enzymology ; Herpesvirus 1, Suid/immunology ; Hippocampus/*cytology ; Immunohistochemistry ; Microinjections ; Neural Pathways ; Rats ; Rats, Sprague-Dawley

PURPOSE: To evaluate the repeatability of macular thickness and total macular volume measurements made using spectral domain optical coherence tomography (OCT) in normal subjects and subjects with macular disease. METHODS: Among a total of 108 subjects, there were 50 normal subjucts, 20 patients with diabetic macular edema, 10 patients with retinal vein occlusion, 15 patients with age-related macular degeneration, and 13 subjects with other conditions. Two serial macular measurements were obtained from each subject by a single experienced examiner using spectral domain OCT. The repeatability of the measurements was evaluated by comparing two consecutive foveal and perifoveal thickness measurements and total macular volume measurements. The intraclass correlation coefficient was also calculated to evaluate the repeatability of measurements made in normal and macular disease subjects. Result: Spectral domain OCT measurements of macular thickness and macular volume were found to be consistent. Measurements of normal subjects were the most consistent, followed by measurements of patients with age-related macular degeneration, retinal vein occlusion, and diabetic macular edema. CONCLUSIONS: Although measurements made using spectral domain OCT were repeatable across all subjects, they were more consistent in normal subjects than in patients with macular disease. The differences in repeatability should be considered in the context of diseased pathologic anatomy. Physicians should remain cautious when using these measurements for clinical evaluation.
Humans ; Macular Degeneration ; Macular Edema ; Retinal Vein Occlusion ; Tomography, Optical Coherence

BACKGROUND: Chronic cough is a common clinical problem to which various etiologies are attributable; postnasal drip, asthma, gastroesophageal reflux (GER) and chronic bronchitis, However, in some cases, no particular etiology can be confirmed. OBJECTIVE: This study was aimed to evaluate cough sensitivity and the clinical manifestations of patients with idiopathic chronic cough. MATERIALS AND METHODS: We recruited 70 non-smoking patients who had been coughing for more than 3 weeks without any history, symptoms or signs of rhinitis, sinusitis, typical asthma, GER or recent upper respiratory infection episodes. Nineteen healthy controls were also enrolled. Bronchial provocation tests with methacholine, capsaicin and distilled water (DW) were performed. RESULTS: Thirteen patients were positive to rnethacholine test (PC20 < 25mg/ml) and defined as cough variant asthma. The others are classified into idiopathic chronic cough. By capsaicin and DW challenge tests, idiopathic cough patients could be divided into two groups, i.e., increased cough sensitivity (ICS) and normal cough sensitivity (NCS) groups. DW- induced cough counts were negatively correlated with C7 (lowest capsaicin concentration inducing continuous 7 or more coughs) (r=-0.739, p<0.001). No difference was found in clinical features such as age, sex, atopy, or peripheral eosinophil counts between these two groups but cough counts per cough burst were significantly higher in the ICS group. CONCLUSION: The heterogeneity in cough sensitivity of idiopathic chronic cough patients may refiect different pathophysiologic mechanisms. It is unclear whether patients with NCS merely have habitual or psychogenic cough or not. These suggest that different therapentic strategies should be established on idiopathic chronic cough patients according to cough sensitivity.
Asthma ; Bronchial Provocation Tests ; Bronchitis, Chronic ; Capsaicin ; Cough* ; Eosinophils ; Gastroesophageal Reflux ; Humans ; Methacholine Chloride ; Population Characteristics ; Rhinitis ; Sinusitis ; Water

Cyclosporin A (CsA)-induced hyperkalemia is caused by alterations in transepithelial K(+) secretion resulting from the inhibition of renal tubular Na(+), K(+) -ATPase activity. Thyroxine enhances renal cortical Na(+), K(+) -ATPase activity. This study investigated the effect of thyroxine on CsA-induced hyperkalemia. Sprague-Dawley rats were treated with either CsA, thyroxine, CsA and thyroxine, or olive-oil vehicle. CsA resulted in an increase in BUN and serum K(+), along with a decrease in creatinine clearance, fractional excretion of potassium, and renal cortical Na(+), K(+) -ATPase activity, as compared with oil vehicle administration. Histochemical study showed reduced Na(+), K(+) -ATPase activity in the proximal tubular epithelial cells of the CsA-treated compared with the oil-treated rats. Histologically, isometric intracytoplasmic vacuolation, disruption of the arrangement and swelling of the mitochondria, and a large number of lysosomes in the tubular epithelium were characteristic of the CsA-treated rats. Co-administration of thyroxine prevented CsA-induced hyperkalemia and reduced creatinine clearance, Na(+), K(+) -ATPase activity, and severity of the histologic changes in the renal tubular cells when compared with the CsA-treated rats. Thyroxine increased the fractional excretion of potassium via the preservation of Na(+), K(+) -ATPase activity in the renal tubular cells. Thus, the beneficial effects of thyroxine may be suited to treatment modalities for CsA-induced hyperkalemia.
Animals ; Cyclosporine/antagonists & inhibitors/*toxicity ; Hyperkalemia/chemically induced/*drug therapy/metabolism/prevention & control ; Immunosuppressive Agents/antagonists & inhibitors/*toxicity ; Kidney Cortex/*drug effects/*enzymology/pathology ; Male ; Microsomes/enzymology ; Potassium/blood/metabolism ; Rats ; Rats, Sprague-Dawley ; Sodium-Potassium-Exchanging ATPase/*metabolism ; Thyroxine/*pharmacology

No abstract available.
Anaphylaxis* ; Aprotinin* ; Thoracic Surgery*

From February 1987 through July 1990, the seventeen cases of inoperabelintracranial arteriovenous malformation (AVM) were treated using 6 MV linear accelerator at the Division of Therapeutic Radiology, Kang Nam St. Mary's Hospital. Of seventeen cases, fourteen were male and three were female. Ages ranged from 10 to 51 years (median age of 26 years). The main symptoms were headache, epilepsy and hemiparesis in decreasing order of frequency. The middle cerebral artery is the most common origin of the feeding vessel (41.2%). Four were treated by conventionally fractionated radiation therapy (CRT), thirteen were treated by stereotactic radiosurgery (RS). Duration of follow-up study, two of four CRT group showed minimal response. Of thirteen cases of RS group, two (15.4%) showed complete response, five (38%) partial response, two (15.4%) minimal response and four (30.7%) no response by the same assessment. There was no statistical significance in terms of follow-up period (p=0.22), size of lesion (p=0.82) and treated dose (p=0.65). Further accumulation of experience s recommended with proper case selection and sufficient follow-up period.
Arteriovenous Malformations ; Epilepsy ; Female ; Follow-Up Studies ; Headache ; Humans ; Intracranial Arteriovenous Malformations* ; Male ; Middle Cerebral Artery ; Paresis ; Particle Accelerators ; Radiation Oncology ; Radiosurgery*

Central nervous system (CNS) toxicity has been reported in approximately 10-30% of patients receiving intravenous infusions of ifosfamide. Encephalopathy is a rare but serious CNS adverse reaction in these patients, and although usually transient and reversible, may cause persistent neurological dysfunction or death. Clinical features range from fatigue and confusion to coma and death. Although methylene blue can be used to treat ifosfamide-induced neurotoxicity, including encephalopathy, its mechanism of action remains poorly defined. We describe here two patients with recurrent epithelial ovarian cancer who experienced fatal encephalopathy following ifosfamide/mesna treatment.
Brain Diseases, Metabolic ; Central Nervous System ; Coma ; Fatigue ; Humans ; Ifosfamide ; Infusions, Intravenous ; Mesna ; Methylene Blue ; Neoplasms, Glandular and Epithelial ; Ovarian Neoplasms

Systemic lupus erythematosus(SLE) is the prototypic immune complex disease which involves various organs. Chronic interstitial cystitis and protein-losing enteropathy are uncommon manifestations of SLE and have good response to steroid. Only one case of SLE associated with chronic interstitial cystitis and protein-losing enteropathy has been reported which was resistant to steroid treatment but dramatically responded to cyclophosphamide. We describe a case of a female patient who developed systemic lupus erythematosus associated with chylothorax, interstitial cystitis and protein-losing enteropathy with literature review. This case was initially resistant to steroid but with the addition of cyclophosphamide, chylothorax, chronic interstitial cystitis and protein-losing enteropathy markedly improved. This is the first case of SLE that developed chylothorax as well as chronic interstitial cystitis and protein-losing enteropathy.
Chylothorax* ; Cyclophosphamide ; Cystitis, Interstitial* ; Female ; Humans ; Immune Complex Diseases ; Lupus Erythematosus, Systemic* ; Protein-Losing Enteropathies*