BACKGROUND AND OBJECTIVES: Though the surgical intervention of subclavian artery stenosis has been effective, its high morbidity and mortality have limited its clinical application. In 1980 percutaneous balloon angioplasty of stenotic artery was introduced as a substitute for surgical intervention and subsequent reports have supported its efficacy noting that it is more effective when combined with stent. The purpose of this study was to assess the feasibility, safety, and efficacy of percutaneous intervention as an alternative or primary therapy for symptomatic subclavian artery stenosis. METHODS: Between September 1993 and October 1998, 17 lesions in 16 patients of symptomatic subclavian artery stenosis were enrolled as candidates for nonsurgical intervention. We performed percutaneous balloon angioplasty with stenting to the subclavian artery stenosis and evaluated the early results. RESULTS: 1)The patients had a mean age of 55+/-14 years and 13 of 16 patients were male. 2)Subclavian artery stenting was successful in 94% (16/17) of the lesion without significant complications. The cause of failure was suboptimal result after deployment of stent. 3)The types of stents deployed were Strecker stents in 4, Palmaz stents in 8, Wall stents in 3 and Jo stents in 2 cases. 4)The peak and mean pressure gradient reduced from 58.5+/-17.0 to 8.5+/-7.4 and 31.4+/-13.0 to 4.7+/-5.5 mmHg respectively (p<0.01) and the degree of luminal stenosis decreased from 92.5+/-8.5% to 10.0+/-14.3%. (p<0.01) CONCLUSION: Subclavian artery stenosis can be managed safely and effectively through percutaneous balloon angioplasty with stenting, with an excellent technical success rate and less morbidity and mortality particularly in patients coexisting other vascular and systemic diseases. However, the long-term patency and clinical effects should be warranted.
Angioplasty, Balloon ; Arteries ; Constriction, Pathologic ; Humans ; Male ; Mortality ; Phenobarbital ; Stents* ; Subclavian Artery* ; Subclavian Steal Syndrome

PURPOSE: Recently, an increase in the number of patients sensitized to rice allergen with or without clinical symptoms has been reported. This study was designed to determine the major allergens in rice and their clinical significance. METHODS: Twenty-four children (15 boys and 9 girls; mean age, 16.3 months) with allergic disease, who were sensitized to rice antigen (by UniCAP) in the Pediatric Allergy Respiratory Center at Soonchunhyang University Hospital, were enrolled in this study. The allergenicity of various types of rice (raw, cooked, and heat-treated, simulated gastric fluid [SGF], and simulated intestinal fluid [SIF]) was investigated using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoglobulin E (IgE) immunoblots. The patients' medical records, including laboratory data and allergy symptoms after ingestion of rice were reviewed. RESULTS: Patients were sensitized to an average of 13.5 food antigens and their mean total IgE was 6,888.7 kU/L. In SDS-PAGE, more than 16 protein bands were observed in the raw rice, whereas only 14-16 kDa and 31-35 kDa protein bands were observed in cooked rice. The common SDS-PAGE protein bands observed in SGF-, SIF-, and heat-treated rice were 9, 14, and 31 kDa. In a heated-rice IgE immunoblot, protein bands of 9, 14, and 31-33 kDa were found in 27.8%, 38.9%, and 38.9% of all sera, respectively, and in 50%, 50%, and 75%, of ser a from the 4 symptomatic patients, respectively. CONCLUSION: The 9-, 14-, and 31-kDa protein bands appeared to be the major allergens responsible for rice allergy symptoms.
Allergens ; Child ; Eating ; Electrophoresis ; Electrophoresis, Polyacrylamide Gel ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulins ; Medical Records ; Respiratory Center ; Sodium

Objective: Atopic dermatitis (AD) is a chronic inflammatory disease of the skin that is diagnosed by clinical characteristics including itchiness, eczema, dry skin, etc. High levels of indoor air pollutants may exacerbate atopic diseases, along with various allergic respiratory diseases, especially for those who spend most of their lives indoors. This study was conducted to evaluate the main components responsible for the aggravation of AD symptoms. Methods: A total of 31 patients with AD aged 6 months and 6 years old were enrolled. The measurement of air quality included particulate matter with a diameter of 2.5 μm or less (PM2.5), temperature, relative humidity, and CO2 in their homes. The symptom severity of AD was assessed by the daily record of symptom scores and the degree of skin hydration. Results: The skin hydration level at the most severe area selected by the patient’s caregiver was decreased by median 1.7% (interquartile range [IQR], 0.4%–3.0%) or median 15% (IQR, 5.3%–24%) with a unit increase of indoor PM2.5 (P=0.0133) or room temperature (P=0.0034). CO2 also showed a potentially negative association with the change of skin hydration level but it was not statistically significant. Conclusion Our study showed that indoor PM2.5 and temperature could impact the aggravation of skin hydration in children. Therefore, further studies including a large number of cases and interventions are necessary.

This study aimed to develop a short version of the International Classification of Functioning, Disability, and Health (ICF) core set and verify functioning levels of patients for stroke rehabilitation in Korea. Using the Delphi technique, a 3-round consensus process was conducted. Thirty multidisciplinary rehabilitation experts from different hospitals completed the consensus study. The questionnaire for this study adopted the comprehensive ICF core set for stroke developed by the Geyh group. A 7-point Likert-type scale was used by participants to weigh the impact of each category on activities of daily living or rehabilitation after a stroke. The consensus of ratings was assessed with Spearman's rho and inter-quartile range indices. A core set to assess functioning levels of patients with stroke was developed from those categories. A short version of ICF core set to assess and verify functioning levels of patients with stroke was developed for 12 categories, including 3 categories (consciousness, muscle power, and attention) from body functions, 1 (structure of brain) from body structures, 5 (eating, walking, moving around, changing basic body position, and carrying out daily routine) from activities and participation, and 3 (individual attitudes of immediate family members, immediate family, and personal care providers/personal assistants) from environmental factors. This preliminary study developed a Delphi consensus process, gathering statistical evidence and expert commands based on the short version of ICF core set for rehabilitation of stroke patients in Korea.

Objective: Atopic dermatitis (AD) is a chronic inflammatory disease of the skin that is diagnosed by clinical characteristics including itchiness, eczema, dry skin, etc. High levels of indoor air pollutants may exacerbate atopic diseases, along with various allergic respiratory diseases, especially for those who spend most of their lives indoors. This study was conducted to evaluate the main components responsible for the aggravation of AD symptoms. Methods: A total of 31 patients with AD aged 6 months and 6 years old were enrolled. The measurement of air quality included particulate matter with a diameter of 2.5 μm or less (PM2.5), temperature, relative humidity, and CO2 in their homes. The symptom severity of AD was assessed by the daily record of symptom scores and the degree of skin hydration. Results: The skin hydration level at the most severe area selected by the patient’s caregiver was decreased by median 1.7% (interquartile range [IQR], 0.4%–3.0%) or median 15% (IQR, 5.3%–24%) with a unit increase of indoor PM2.5 (P=0.0133) or room temperature (P=0.0034). CO2 also showed a potentially negative association with the change of skin hydration level but it was not statistically significant. Conclusion Our study showed that indoor PM2.5 and temperature could impact the aggravation of skin hydration in children. Therefore, further studies including a large number of cases and interventions are necessary.

Background: To investigate the clinicopathologic pattern of prostate cancer (PCa) in elderly patients compared with their younger counterparts with a prostate-specific antigen (PSA) level below the low-risk threshold (< 10 ng/mL), which is often a deciding factor for biopsy. Methods: A nationwide database of PCa at the time of biopsy from 2010 to 2020 was constructed from 39 hospitals. Patients were categorized into age groups of < 64 years, 65–69 years, 70–74 years, and ≥ 75 years considering guidelines that recommend PSA testing only for those aged 55–69 years during the study period, the average age of Korean PCa registrants of 70.3 years (2010–2020), and the average life expectancy of Korean males of 80.3 years (2020). Results: The mean ± standard deviation age was 70.3 ± 8.2 years, which was normally distributed (kurtosis = 0.095). Among 14,548 subjects, 54.1%, 39.5%, and 6.4% of them had high-risk disease, intermediate-risk disease, and low-risk disease, respectively. Based on three risk parameters, a marked increase in high-risk cancer was observed in the oldest age group (linear combination, P < 0.001). The same pattern was observed among patients with low-risk disease (PSA < 10 ng/mL), who were divided into PSA tiers as follows: 4–5 ng/mL (P < 0.001), 5–6 ng/mL (P < 0.001), 6–7 ng/mL (P < 0.001), 7–8 ng/mL (P < 0.001), 8–9 ng/mL (P = 0.009), and 9–10 ng/mL (P < 0.001). In all PSA tiers between 4 and 10 ng/mL, multivariate analysis demonstrated a significantly higher prevalence of high-risk cancer in the oldest age group than in the youngest age group. In the lowest tier (4–5 ng/mL), 35.2% of those aged over 75 years had high-risk PCa. Conclusion The older the patient, the more aggressive the PCa. Moreover, there was an increase in high-risk PCa in older males compared with younger males even with a PSA level below the low-risk threshold of 10 ng/mL, suggesting the need to strengthen cancer screening policies in the older population.

Background: To investigate the clinicopathologic pattern of prostate cancer (PCa) in elderly patients compared with their younger counterparts with a prostate-specific antigen (PSA) level below the low-risk threshold (< 10 ng/mL), which is often a deciding factor for biopsy. Methods: A nationwide database of PCa at the time of biopsy from 2010 to 2020 was constructed from 39 hospitals. Patients were categorized into age groups of < 64 years, 65–69 years, 70–74 years, and ≥ 75 years considering guidelines that recommend PSA testing only for those aged 55–69 years during the study period, the average age of Korean PCa registrants of 70.3 years (2010–2020), and the average life expectancy of Korean males of 80.3 years (2020). Results: The mean ± standard deviation age was 70.3 ± 8.2 years, which was normally distributed (kurtosis = 0.095). Among 14,548 subjects, 54.1%, 39.5%, and 6.4% of them had high-risk disease, intermediate-risk disease, and low-risk disease, respectively. Based on three risk parameters, a marked increase in high-risk cancer was observed in the oldest age group (linear combination, P < 0.001). The same pattern was observed among patients with low-risk disease (PSA < 10 ng/mL), who were divided into PSA tiers as follows: 4–5 ng/mL (P < 0.001), 5–6 ng/mL (P < 0.001), 6–7 ng/mL (P < 0.001), 7–8 ng/mL (P < 0.001), 8–9 ng/mL (P = 0.009), and 9–10 ng/mL (P < 0.001). In all PSA tiers between 4 and 10 ng/mL, multivariate analysis demonstrated a significantly higher prevalence of high-risk cancer in the oldest age group than in the youngest age group. In the lowest tier (4–5 ng/mL), 35.2% of those aged over 75 years had high-risk PCa. Conclusion The older the patient, the more aggressive the PCa. Moreover, there was an increase in high-risk PCa in older males compared with younger males even with a PSA level below the low-risk threshold of 10 ng/mL, suggesting the need to strengthen cancer screening policies in the older population.

Background: To investigate the clinicopathologic pattern of prostate cancer (PCa) in elderly patients compared with their younger counterparts with a prostate-specific antigen (PSA) level below the low-risk threshold (< 10 ng/mL), which is often a deciding factor for biopsy. Methods: A nationwide database of PCa at the time of biopsy from 2010 to 2020 was constructed from 39 hospitals. Patients were categorized into age groups of < 64 years, 65–69 years, 70–74 years, and ≥ 75 years considering guidelines that recommend PSA testing only for those aged 55–69 years during the study period, the average age of Korean PCa registrants of 70.3 years (2010–2020), and the average life expectancy of Korean males of 80.3 years (2020). Results: The mean ± standard deviation age was 70.3 ± 8.2 years, which was normally distributed (kurtosis = 0.095). Among 14,548 subjects, 54.1%, 39.5%, and 6.4% of them had high-risk disease, intermediate-risk disease, and low-risk disease, respectively. Based on three risk parameters, a marked increase in high-risk cancer was observed in the oldest age group (linear combination, P < 0.001). The same pattern was observed among patients with low-risk disease (PSA < 10 ng/mL), who were divided into PSA tiers as follows: 4–5 ng/mL (P < 0.001), 5–6 ng/mL (P < 0.001), 6–7 ng/mL (P < 0.001), 7–8 ng/mL (P < 0.001), 8–9 ng/mL (P = 0.009), and 9–10 ng/mL (P < 0.001). In all PSA tiers between 4 and 10 ng/mL, multivariate analysis demonstrated a significantly higher prevalence of high-risk cancer in the oldest age group than in the youngest age group. In the lowest tier (4–5 ng/mL), 35.2% of those aged over 75 years had high-risk PCa. Conclusion The older the patient, the more aggressive the PCa. Moreover, there was an increase in high-risk PCa in older males compared with younger males even with a PSA level below the low-risk threshold of 10 ng/mL, suggesting the need to strengthen cancer screening policies in the older population.

Background: To investigate the clinicopathologic pattern of prostate cancer (PCa) in elderly patients compared with their younger counterparts with a prostate-specific antigen (PSA) level below the low-risk threshold (< 10 ng/mL), which is often a deciding factor for biopsy. Methods: A nationwide database of PCa at the time of biopsy from 2010 to 2020 was constructed from 39 hospitals. Patients were categorized into age groups of < 64 years, 65–69 years, 70–74 years, and ≥ 75 years considering guidelines that recommend PSA testing only for those aged 55–69 years during the study period, the average age of Korean PCa registrants of 70.3 years (2010–2020), and the average life expectancy of Korean males of 80.3 years (2020). Results: The mean ± standard deviation age was 70.3 ± 8.2 years, which was normally distributed (kurtosis = 0.095). Among 14,548 subjects, 54.1%, 39.5%, and 6.4% of them had high-risk disease, intermediate-risk disease, and low-risk disease, respectively. Based on three risk parameters, a marked increase in high-risk cancer was observed in the oldest age group (linear combination, P < 0.001). The same pattern was observed among patients with low-risk disease (PSA < 10 ng/mL), who were divided into PSA tiers as follows: 4–5 ng/mL (P < 0.001), 5–6 ng/mL (P < 0.001), 6–7 ng/mL (P < 0.001), 7–8 ng/mL (P < 0.001), 8–9 ng/mL (P = 0.009), and 9–10 ng/mL (P < 0.001). In all PSA tiers between 4 and 10 ng/mL, multivariate analysis demonstrated a significantly higher prevalence of high-risk cancer in the oldest age group than in the youngest age group. In the lowest tier (4–5 ng/mL), 35.2% of those aged over 75 years had high-risk PCa. Conclusion The older the patient, the more aggressive the PCa. Moreover, there was an increase in high-risk PCa in older males compared with younger males even with a PSA level below the low-risk threshold of 10 ng/mL, suggesting the need to strengthen cancer screening policies in the older population.

PURPOSE: We aim to compare the effectiveness and safety of fluticasone propionate (Flt) plus tulobuterol (Hk) versus high-dose Flt alone in controlling asthma in children. METHODS: Fifty three children aged 4 to 8 years, who were diagnosed with mild persistent asthma and underwent maintenance therapy with a low dose of inhaled corticosteroid (Flt) of 50-100 microgram/day were randomized to receive Flt plus Hk (Hokunalin(R) patch 1 mg, Abbott Japan, Tokyo, Japan), or Flt alone at twice the dosage. Patients underwent new treatment for 4 weeks. Asthma symptom scores, mean changes in morning and evening peak expiratory flow (PEF), the frequency of night awakenings, the use of reliever medication, caregiver's overall satisfaction and safety were evaluated and compared in each group. And they were followed-up again 4 week after treatment course for the evaluation of treatment-emergent adverse event (TEAE). RESULTS: No significant difference was found between the groups in terms of mean changes in the morning and evening PEF, the frequency of night awakening, the use of rescue medication and caregiver's overall satisfaction (P=0.83, P=0.83, P=0.17, P=0.32 and P=0.63). Furthermore, no statistically significant difference was observed between 2 groups in the incidence of any TEAE (P=1.00). CONCLUSION: This study demonstrated that a combination of Flt and Hk was as effective as a high-dose Flt therapy in the management of mild persistent asthma in children. The results of this study suggest that tulobuterol add-on therapy can be considered as a reasonable substitute to an increase in the dosage of steroid in the patients with steroid-phobia and it might be used to reduce the risk of high dose steroid therapy.
Aged ; Androstadienes ; Asthma ; Child ; Diethylpropion ; Humans ; Incidence ; Japan ; Terbutaline ; Tokyo ; Fluticasone