A 42-year-old man presented with severe pancytopenia and uncontrolled epistaxis. The diagnosis of SLE was made and the pancytopenia was found to be due to myelofibrosis. The pulse therapy with methylprednisolone and maintenance therapy with prednisolone reversed both pancytopenia and myelofibrosis. Although myelofibrosis has been described in SLE, this coexistence must be very rare since there has been only 19 cases showing this combination. We report a case of SLE with myelofibrosis which was reversed by the treatment with glucocorticoid.
Adult ; Diagnosis ; Epistaxis ; Humans ; Lupus Erythematosus, Systemic* ; Methylprednisolone ; Pancytopenia ; Prednisolone ; Primary Myelofibrosis*

The inhibitory effect of rice(Oryza sartiva L., illpumbyeo) against mutagenicity induced by tryptophan pyrolysates were investigated using Salmonella typhimurium reversion assay. Both methanol extracts of obtained from brown and white rice were found to possess strong activites of inhibiting the mutagenicities of 3-amino-1,4-dimethyl-5H-pyriod[4,3-b]indol(Trp-P-1) and 3-amino-1-methyl-5H-pyrido[4,3-b]indol(Trp-P-2) on Salmonella typhimurium reversion assay. As the concentration of methanol extract increased, inhibitory effect on mutagenicity increased but reached at steady state as inhibition rate of 90% when the concentration was above 10mg/plate. There was no significant difference(p>0.05) in inhibitory effect of methanol extracts between brown and white rice against tryptophan pyrolysates.
Methanol ; Salmonella typhimurium ; Tryptophan*

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

Bronchial asthma and chronic obstructive pulmonary disease (COPD) are 2 representative diseases of chronic obstructive inflammatory airway diseases, and both show a wide range of heterogeneity in their clinical features. Although one end of typical asthma and the other end of COPD are clearly different, both diseases share lots of similarities in biological aspects and clinical manifestations. Currently, 2 different guidelines exist for asthma and COPD management, respectively, and in many clinical situations it is not easy to manage patients especially who have both features and show refractoriness to available medications. Since the features of the diseases are remarkably diverse in terms of clinical courses, prognosis and responses to therapeutic drugs, there have been vigorous efforts to classify appropriate subtypes in order to improve management of the diseases. However, dichotomous thinking about asthma and COPD precludes precise classification of the diseases in the real world. In this article, thus, chronic obstructive airway disease (COAD) ranging from asthma particularly in adults to COPD is proposed as 1 target subject to analyze precise classification based on exact phenotyping and endotyping of the diseases. In the current article, the reasonable precision medicine approach is also suggested based on treatable traits of COAD to achieve the best treatment for COAD patients.
Adult ; Asthma ; Classification ; Humans ; Population Characteristics ; Precision Medicine* ; Prognosis ; Pulmonary Disease, Chronic Obstructive* ; Thinking

BACKGROUND: Although the basic cellular and molecular requirements for the induction and synthesis of whole human IgE antibody have extensively been investigated, the mechanisms involved in the regulation of allergen-specific IgE synthesis are not yet fully understood. OBJECTIVES: The aims of this study were to elucidate the differences in the total and specific IgE regulation by hydrocortisone(HC) with interleukin 4 (IL-4) between atopics and non-atopics and to determine the relationship between in vitro IgE synthesis and serum IgE levels. METHODS: Peripheral blood mononuclear cells(PBMCs) from sixteen atopic asthma patients sensitive to Dermatophagoides farinae(D.f) and seven non-atopics were cultured with IL-4 and/or HC. Total and D.f-specific IgE in culture supernatant were measured using ELISA and FAST methods respectively. RESULTS: PBMCs from 8 of 16 atopics produced D.f-specific IgE in vitro either spontaneously or by IL-4 and/or HC. HC had more profound effects than IL-4 in these patients. They also showed higher total IgE synthesis by HC, and higher specific serum IgE levels than the others. IL-4 and/or HC did not induce any D.f-specific IgE synthesis by PBMCs from non-atopics. CONCLUSION: These data suggest that atopic patients have allergen-specific B cells that have already been switched to IgE production, probably due to in vivo priming effect of IL-4.
Asthma ; B-Lymphocytes ; Dermatophagoides farinae ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hydrocortisone* ; Immunoglobulin E* ; Interleukin-4* ; Interleukins* ; Pyroglyphidae

No abstract available.
Cough*

Paraquat (1, 1'-dimethy-14, 4' dipyridium chloride: Gramoxon(r)) was first discovered in England in 1955. It has been widely distributed for use in Korea since 1970 as a pesticide and also often the cause of accidental intoxications. The authors would like to report the following case of paraquat intoxicatio in a 13 year old female child admitted via emergency room with complaints of epigastric pain, vomiting and hematuria of four days duration. On admission the data of laboratory evaluation were as follows: BUN/Cr 126/11.6 mg/dl; sGOT/sGPT 641/641 IU/L; total bilirubin/direct bilirubin 3.9/2.4 mg/dl; alkaline phosphatase 396.1 U/L; fecal occult blood test-positive; pH 7.428, pCO2 26.2 mmHg, pO2 131.4 mmHg, base excess -5.0 mmol/L on arterial blood gas analysis (ABGA). Gastroendoscopy revealed esophageal ulcers, and as symptoms of renal failure could not be relieved by hemodialysis, kidney biopsy was performed on the otherwise previously healthy child to establish the cause of renal failure. The result of biopsy revealed tubular necrosis with eosinophilic infiltrations. A more detailed retrograde probe of the child's past medical history evoked that the patient had ingested paraquat in a suicidal attempt. Supportive therapy and hemodialysis were continued thereafter, but the symptoms of renal failure could not be reversed, and the patient eventually died due to acute respiratory distress syndrome.
Adolescent ; Alkaline Phosphatase ; Bilirubin ; Biopsy ; Blood Gas Analysis ; Child ; Emergency Service, Hospital ; England ; Eosinophils ; Female ; Hematuria ; Humans ; Hydrogen-Ion Concentration ; Kidney ; Korea ; Necrosis* ; Occult Blood ; Paraquat* ; Renal Dialysis ; Renal Insufficiency ; Respiratory Distress Syndrome, Adult ; Ulcer ; Vomiting

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

PURPOSE: The purpose of this study was to examine the effect of laughter therapy on arthralgia, ankylosis, depression and sleep of elderly housebound women suffering from osteoarthritis. METHODS: The study used a nonequivalent control group pretest-posttest design. The participants were 48 elderly women: 23 in the experimental group and 25 in the control group. The experimental group received laughter therapy twice a week for 4 weeks. The results were analyzed by using chi2-test, ANCOVA, and t-test with the SPSS/WIN 21.0 program. RESULTS: The results showed that laughter therapy had a significant statistical effective in reducing arthralgia, ankylosis, and depression and improving the quality of sleep as evidenced by the differences between the two groups. CONCLUSION: The results of this study indicated that laughter therapy is an effective nursing intervention reducing arthralgia, ankylosis, and depression and improving the quality of sleep in these women. Therefore, it is necessary to develop laughter therapy as an independent nursing intervention for elderly women with osteoarthritis who are housebound.
Aged* ; Ankylosis* ; Arthralgia* ; Depression* ; Female ; Humans ; Laughter Therapy* ; Laughter* ; Nursing ; Osteoarthritis*

Severe refractory asthma is a group of asthmatic patients showing heterogeneous phenotypes with frequent exacerbations and progressive airway remodeling despite high levels of therapy. Studies of severe asthma is difficult not only because of diverse pathogenesis, difficulty in translating pre-clinical human and animal models to clinical trials, and absence of biomarkers that predict therapeutic efficacy but because of lack of consensus on precise definition and diagnostic criteria of severe asthma. Furthermore, the burden of severe asthma is considerably high, therefore, there has been an urgent need for researching strategies to overcome severe asthma. In conclusion, precise characterization, exact definition, and appropriate classification of severe asthma would be critical to improve management of this challenging disease and these efforts could help to develop novel therapeutic strategies.
Airway Remodeling ; Asthma ; Biomarkers ; Consensus ; Humans ; Models, Animal ; Phenotype ; Population Characteristics ; Translating