N,N-dimethylformamide (DMF), a widely used solvent in the chemical industry, is known to induce toxic hepatitis. However, there have been no reported cases of DMF-associated autoimmune hepatitis. A 31-year-old healthy man working at a glove factory since July 2015 had intermittently put his bare hands into a diluted DMF solution for his first 15 days at work. After 2 months, he felt nausea, fatigue, and hand cramping, and a jaundice followed. His laboratory findings showed positive autoantibodies and elevated immunoglobulin G (IgG), and his liver biopsy pathology was typical of autoimmune hepatitis (AIH). Prednisolone and azathioprine therapy began, and he recovered rapidly without adverse events. Though his liver chemistry was normalized, the IgG level remained persistently upper normal range. His 2nd liver biopsy performed in April 2019 showed mild portal activity, and he was well under a low dose immunosuppressive therapy up to April 2020. This case warns of the hazard of occupational exposure to DMF, and clinicians should be aware of DMF-related AIH for timely initiation of immunosuppressive therapy.

PURPOSE: Data are lacking on the association between the allergic rhinitis (AR) phenotype and sensitization to specific allergens or bronchial hyperresponsiveness (BHR) in children. We here investigated risk factors and comorbidities, including sensitization to specific allergens and BHR, for the AR phenotype by AR and its Impact on Asthma (ARIA) classification in a general population-based birth cohort study. METHODS: We enrolled 606 children aged 7 years from the Panel Study of Korean Children. The AR phenotype was assigned in accordance with the ARIA classification in children. Skin prick tests and Provocholine provocation test were performed. Risk factors and comorbidities for AR phenotypes were then analyzed. RESULTS: The prevalence of mild and moderate to severe AR in our study cohort was 37.2% and 8.8%, respectively. Recent use of analgesics or antipyretics and current cat ownership were associated with the risk of mild persistent AR. Sensitizations to Dermatophagoides Pteronyssinus (Der p), Japanese hop and cat were associated with moderate to severe persistent AR. Children with moderate to severe AR had a higher risk of current asthma and BHR compared to mild AR cases (adjusted odds ratio [aOR], 5.26; 95% confidence interval [CI], 1.77–15.62). Moderate to severe AR with allergic sensitization was associated with the highest risk of BHR (aOR, 11.77; 95% CI, 3.40–40.74). CONCLUSIONS: Moderate to severe-persistent AR is more closely related to respiratory comorbidities and sensitizations than mild AR. Stratifying the AR phenotype by ARIA classification may assist in disease management.
Allergens ; Analgesics ; Animals ; Antipyretics ; Asian Continental Ancestry Group ; Asthma ; Bronchial Hyperreactivity ; Cats ; Child ; Classification ; Cohort Studies ; Comorbidity ; Dermatophagoides pteronyssinus ; Disease Management ; Humans ; Methacholine Chloride ; Odds Ratio ; Ownership ; Parturition ; Phenotype ; Prevalence ; Rhinitis, Allergic ; Risk Factors ; Skin

PURPOSE: It is controversial whether indoor pet exposure is either a risk or protective factor developing sensitization to pet allergens or asthma. Therefore, we investigated whether indoor pet ownership entails a risk for the development of asthma and sensitization in childhood. METHODS: The Panel Study of Korean Children (PSKC) is a general-population-based birth cohort study that recruited 2,078 mother-baby dyads in Korea between April and July of 2008. Among 1,577 children who were followed up in 2015, 559 underwent skin prick tests, spirometry and bronchial provocation tests using Provocholine. Having a cat or a dog and the prevalence of asthma were evaluated by using self-reported questionnaires and physicians’ medical records. RESULTS: During infancy, the rate of dog ownership was 4.5% (71 of 1,574) and that of cat ownership was 0.5% (8 of 1,574). Of the subjects, 7.9% (n=109) currently had at least 1 dog and 2.5% (n=34) had at least 1 cat. Pet ownership during infancy was associated with sensitization to cats or dogs (adjusted odds ratio [aOR], 4.24; 95% confidence interval [CI], 1.29–13.98), wheezing within 12 months (aOR, 5.56; 95% CI, 1.65–18.75) and current asthma (wheezing episode in the last 12 months+diagnosed asthma by physicians) (aOR, 6.36; 95% CI, 1.54–26.28). In contrast, pet ownership during the last 12 months was not associated with sensitization to cats or dogs or current asthma. CONCLUSION: Indoor pet exposure during infancy can be critical for developing sensitization to cats or dogs and asthma in childhood. Avoidance of pet exposure in early life may reduce sensitization to cats or dogs and development of asthma.
Allergens ; Animals ; Asthma ; Bronchial Provocation Tests ; Cats ; Child ; Cohort Studies ; Dogs ; Humans ; Infant ; Korea ; Medical Records ; Methacholine Chloride ; Odds Ratio ; Ownership ; Parturition ; Pets ; Prevalence ; Protective Factors ; Respiratory Sounds ; Risk Factors ; Skin ; Spirometry

BACKGROUND: A US Food and Drug Administration (FDA)-approved drug methacholine chloride (Provocholine®) was recently introduced to Korea where it is now widely used in clinical practice. We aimed to evaluate the prevalence, risk factors and cutoff value of bronchial hyperresponsiveness (BHR) to Provocholine in 7-year-old children. METHODS: Six hundred and thirty-three children from the Panel Study on Korean Children who visited 16 regional hospitals were evaluated. Skin prick tests, spirometry and bronchial provocation tests for Provocholine as well as a detailed history and physical examinations were performed. The bronchial provocation test was reliably performed on 559 of these children. RESULTS: The prevalence of ever-diagnosed asthma via medical records was 7.7%, and that of current asthma (wheezy episode in the last 12 months + diagnosed asthma by physicians) was 3.2%. The prevalence of BHR to Provocholine was 17.2% and 25.8%, respectively, for a PC20 < 8 and < 16 mg/mL. The risk factors for BHR (PC20 < 16 mg/mL) were atopic dermatitis diagnosis and current dog ownership, whereas those for current asthma were allergy rhinitis diagnosis, a history of bronchiolitis before the age of 3, recent use of analgesics/antipyretics and maternal history of asthma. The BHR prevalence trend showed an increase along with the increased immunoglobulin E (IgE) quartile. The cutoff value of PC20 for the diagnosis of current asthma in children at age 7 was 5.8 mg/mL (sensitivity: 47.1%, specificity: 87.4%). CONCLUSIONS: BHR to Provocholine (PC20 < 8 mg/mL) was observed in 17.2% of 7-year-olds children from the general population and the cutoff value of PC20 for the diagnosis of current asthma was 5.8 mg/mL in this age group. The risk factors for BHR and current asthma showed discrepancies suggesting different underlying mechanisms. Bronchial provocation testing with Provocholine will be a useful clinical tool in the future.
Animals ; Asthma ; Bronchial Hyperreactivity ; Bronchial Provocation Tests ; Bronchiolitis ; Child* ; Dermatitis, Atopic ; Diagnosis ; Dogs ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulins ; Korea ; Medical Records ; Methacholine Chloride* ; Ownership ; Physical Examination ; Prevalence* ; Rhinitis ; Risk Factors* ; ROC Curve ; Sensitivity and Specificity ; Skin ; Spirometry ; United States Food and Drug Administration

Although advances in multi-detector computed tomography (CT) technique make it possible to evaluate peripheral subsegmental pulmonary arteries, several studies have reported that small peripheral embolisms may still be missed. Recently, some reports demonstrated that dual-energy CT improved the capability to detect peripheral pulmonary embolism. We report a case of lymphoma presenting as disseminated microvascular pulmonary tumor embolism, detected by perfusion images using dual energy CT.
Embolism ; Lymphoma ; Neoplastic Cells, Circulating ; Perfusion ; Pulmonary Artery ; Pulmonary Embolism ; Tomography, X-Ray Computed

BACKGROUND: Androgenetic alopecia (AGA) is a common hair loss disease with genetic predisposition among men and women, and it may commence at any age after puberty. It may significantly affect a variety of psychological and social aspects of one's life and the individual's overall quality of life (QoL). OBJECTIVE: This study aimed to investigate the QoL of AGA patients and discover the factors that can influence the QoL of AGA patients, including previous experience in non-medical hair care, reasons for hospital visits, age, duration, and the severity of AGA. METHODS: A total of 998 male patients with AGA were interviewed, using the Hair Specific Skindex-29 to evaluate the QoL of AGA patients. RESULTS: The results of the Hair Specific Skindex-29 on patients with AGA were as follows: symptom scale: 26.3+/-19.5, function scale: 24.0+/-20.1, emotion scale: 32.1+/-21.8, and global score: 27.3+/-19.1. According to this assessment, QoL was more damaged if the patient had severe alopecia, a longer duration of AGA, younger age, had received previous non-medical hair care, and visited the hospital for AGA treatment. CONCLUSION: This study showed that AGA could harmfully affect the patients' QoL. These findings indicate that dermatologists should address these QoL issues when treating patients with alopecia.
Alopecia ; Female ; Genetic Predisposition to Disease ; Hair ; Humans ; Male ; Prospective Studies ; Puberty ; Quality of Life

BACKGROUND: Topical 5% minoxidil solution stimulates new hair growth and it helps stop the loss of hair on individuals with androgenetic alopecia (AGA). OBJECTIVE: We wanted to assess the efficacy and safety of topical 5% minoxidil solution for treating Korean men with AGA. METHODS: This was a 24-week, open label, clinical trial that was conducted at 14 university dermatologic centers nationwide throughout South Korea as a multicenter study of the Korean Hair Research Society. The eligible subjects for this study were 18- to 65 year-old men with androgenetic alopecia, as defined by the Norwood scale as type III vertex, IV and IVA. A total of 175 men (20~62 years old) with AGA applied topical 5% minoxidil solution twice daily. Efficacy was evaluated by 1) the total hair count per 1 cm2 and 2) the mean hair diameter and 3) the patient assessment and 4) the investigator assessment of the change in scalp coverage and the benefit of treatment. RESULTS: At week 24 as compared with baseline, there was a statistically significant increase in the total hair counts and the mean hair diameter (p<.0001). Topical 5% minoxidil solution helped improve the investigator and patient assessments. The topical 5% minoxidil solution was well tolerated over a 24-week period. CONCLUSION: We believe that topical 5% minoxidil solution is a safe and effective drug for Korean men with AGA.
Alopecia ; Hair ; Humans ; Male ; Minoxidil ; Republic of Korea ; Research Personnel ; Scalp

PURPOSE: The HSV1-tk reporter gene system is the most widely used system because of its advantage that direct monitoring is possible without the introduction of a separate reporter gene in case of HSV1-tk suicide gene therapy. In this study, we investigate the usefulness of the reporter probe (substrate), 9-(4-[18F]fluoro-3-hydroxymethylbutyl)guanine ([18F]FHBG) for non-invasive reporter gene imaging using PET in HSV1-tk expressing hepatoma model. MATERIALS AND METHODS: Radiolabeled FHBG was prepared in 8 steps from a commercially available triester. The labeling reaction was carried out by NCA nucleophilic substitution with K[18F]/K2.2.2. in acetonitrile using N2-monomethoxytrityl-9-[4-(tosyl)-3-monomethoxytritylmethylbutyl]guanine as a precursor, followed by deprotection with 1 N HCl. Preliminary biological properties of the probe were evaluated with MCA cells and MCA-tk cells transduced with HSV1-tk reporter gene. In vitro uptake and release-out studies of [18F]FHBG were performed, and was analyzed correlation between [18F]FHBG uptake ratio according to increasing numeric count of MCA-tk cells and degree of gene expression. MicroPET scan image was obtained with MCA and MCA-tk tumor bearing Balb/c-nude mouse model. RESULTS: [18F]FHBG was purified by reverse phase semi-HPLC system and collected at around 16-18 min. Radiochemical yield was about 20-25% (corrected for decay), radiochemical purity was >95% and specific activity was around >55.5 GBq/micro mol. Specific accumulation of [18F]FHBG was observed in HSV1-tk gene transduced MCA-tk cells but not in MCA cells, and consecutive 1 hour release-out results showed more than 86% of uptaked [18F]FHBG was retained inside of cells. The uptake of [18F]FHBG was showed a highly significant linear correlation (R2=0.995) with increasing percentage of MCA-tk numeric cell count. In microPET scan images, remarkable difference of accumulation was observed for the two type of tumors. CONCLUSION: [18F]FHBG appears to be a useful as non-invasive PET imaging substrate in HSV1-tk expressing hepatoma model.
Animals ; Carcinoma, Hepatocellular* ; Cell Count ; Gene Expression ; Genes, Reporter ; Genetic Therapy ; Guanine* ; Mice ; Suicide ; Thymidine Kinase

The present study was undertaken to investigate the effect of bradykinin on secretion of catecholamines (CA) evoked by stimulation of cholinergic receptors and membrane depolarization from the isolated perfused model of the rat adrenal glands, and to elucidate its mechanism of action. Bradykinin (3 X 10 (-8) M) alone produced a weak secretory response of the CA. however, the perfusion with bradykinin (3 X 10 (-8) M) into an adrenal vein of the rat adrenal gland for 90 min enhanced markedly the secretory responses of CA evoked by ACh (5.32 X 10 (-3) M), excess K+ (5.6 X 10 (-2) M, a membrane depolarizer), DMPP (10 (-4) M, a selective neuronal nicotinic agonist) and McN-A-343 (10 (-4) M, a selective M1-muscarinic agonist). Moreover, bradykinin (3 X 10 (-8) M) in to an adrenal vein for 90 min also augmented the CA release evoked by BAY-K-8644, an activator of the dihydropyridine L-type Ca2+ channels. However, in the presence of (N-Methyl-D-Phe7) -bradykinin trifluoroacetate salt (3 X 10 (-8) M), an antagonist of BK2-bradykinin receptor, bradykinin no longer enhanced the CA secretion evoked by Ach and high potassium whereas the pretreatment with Lys- (des-Arg9, Leu8) -bradykinin trifluoroacetate salt (3 X 10 (-8) M), an antagonist of BK1-bradykinin receptor did fail to affect them. Furthermore, the perfusion with bradykinin (3 X 10 (-6) M) into an adrenal vein of the rabbit adrenal gland for 90 min enhanced markedly the secretory responses of CA evoked by excess K+ (5.6 X 10 (-2) M). Collectively, these experimental results suggest that bradykinin enhances the CA secretion from the rat adrenal medulla evoked by cholinergic stimulation (both nicotininc and muscarinic receptors) and membrane depolarization through the activation of B2-bradykinin receptors, not through B1-bradykinin receptors. This facilitatory effect of bradykinin seems to be associated to the increased Ca2+ influx through the activation of the dihydropyridine L-type Ca2+ channels.
(4-(m-Chlorophenylcarbamoyloxy)-2-butynyl)trimethylammonium Chloride ; 3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethyl-5-nitro-4-(2-(trifluoromethyl)phenyl)-, Methyl ester ; Adrenal Glands ; Adrenal Medulla* ; Animals ; Bradykinin* ; Catecholamines ; Dimethylphenylpiperazinium Iodide ; Membranes ; Neurons ; Perfusion ; Potassium ; Rats* ; Receptors, Bradykinin ; Receptors, Cholinergic ; Trifluoroacetic Acid ; Veins

BACKGROUND: The prognostic outlook for multiple myeloma has markedly improved in recent decades, which is probably related to the introduction of chemotherapy and the development of supportive care for various complications. In the present work we analysed retrospectively the therapeutic outcomes of newly diagnosed patients with multiple myeloma treated at Korea Cancer Center Hospital (KCCH). And we studied to identify prognostic factors influencing the therapeutic outcome of the disease. METHODS: Between January 1987 and December 1998, eighty three patients were diagnosed as multiple myeloma by the criteria of Southwestern Oncology Group at KCCH. Of these patients, clinical analysis was performed retrospectively for sixty-one patients who were treated with combination chemotherapy. RESULTS: The median age at diagnosis was 55 years of age, which was lower than that of western countries and 48% of patients were in their 4th decade. Male to female ratio was 1: 1.1. The main chief complaint at diagnosis was bone pain. Ninety-one percent of the patients were clinical stage III. Serum immuno-electrophoresis revealed M-protein as IgG in 41%. The ratio of micro to lambda light chain was 1.5:1. The response rate to initial chemotherapy was 75% (95% C. I.=63.4~86.6%) and median progression free interval was 20.9 months. The median overall survival of total 61 patients was 28.5 months. The patients' age at diagnosis and the response to initial chemotherapy were statistically significant prognostic factors influencing the overall survival of patients. CONCLUSION: This study showed that we could get relatively high response rate with conventional chemotherapy for the patients with multiple myeloma, but, that most patients eventually progressed and the cure was nearly impossible. To obtain cure or to have much longer survival time, we need more delicate strategies including more intensive chemotherapy with stem cell transplantation for the treatment of multiple myeloma patients.
Diagnosis ; Drug Therapy ; Drug Therapy, Combination ; Female ; Humans ; Immunoglobulin G ; Korea ; Male ; Multiple Myeloma* ; Retrospective Studies* ; Stem Cell Transplantation ; Treatment Outcome*