Betaine derivatives are considered major ingredients of shampoos and are commonly used as antistatic and viscosity-increasing agents. Several studies have also suggested that betaine derivatives can be used as antimicrobial agents. However, the antifungal activity and mechanism of action of betaine derivatives have not yet been fully understood. In this study, we investigated the antifungal activity of six betaine derivatives against Malassezia restricta, which is the most frequently isolated fungus from the human skin and is implicated in the development of dandruff. We found that, among the six betaine derivatives, lauryl betaine showed the most potent antifungal activity. The mechanism of action of lauryl betaine was studied mainly using another phylogenetically close model fungal organism, Cryptococcus neoformans, because of a lack of available genetic manipulation and functional genomics tools for M. restricta. Our genome-wide reverse genetic screening method using the C. neoformans gene deletion mutant library showed that the mutants with mutations in genes for cell membrane synthesis and integrity, particularly ergosterol synthesis, are highly sensitive to lauryl betaine. Furthermore, transcriptome changes in both C. neoformans and M. restricta cells grown in the presence of lauryl betaine were analyzed and the results indicated that the compound mainly affected cell membrane synthesis, particularly ergosterol synthesis. Overall, our data demonstrated that lauryl betaine influences ergosterol synthesis in C. neoformans and that the compound exerts a similar mechanism of action on M. restricta.
Anti-Infective Agents ; Betaine ; Cell Membrane ; Cryptococcus ; Cryptococcus neoformans ; Dandruff ; Ergosterol ; Fungi ; Gene Deletion ; Genetic Testing ; Genomics ; Humans ; Malassezia ; Methods ; Skin ; Transcriptome

BACKGROUND: The aspartate transaminase (AST)/alanine transferase (ALT) ratio increases with alcohol consumption. This study investigated AST/ALT ratio according to alcohol drinking and predictive power of AST/ALT ratio for heavy drinking in Korean men. METHODS: In 2015, 830 men with no history of disease or medication affecting liver function values were selected. Using 14 g of alcohol as the standard glass, odd ratios (ORs) of AST/ALT ratio over 1 among the drinking group were compared with the non-drinking group by multiple logistic analyses. Screening of heavy drinkers was conducted according to both NIAAA and Korean guidelines. Using AST/ALT ratio >1, sensitivity, specificity, positive predictive values, negative predictive values, positive likelihood ratios, negative likelihood ratios and odds ratios were investigated. RESULTS: After correcting for age, body mass index, exercising, and smoking history, ORs (95% confidence interval) of AST/ALT >1 were 1.607 (1.048-2.464) in <8 glasses group, 2.172 (1.160-4.065) in the 14 glasses group, and 3.670 (2.218-6.053) in the >14 glasses group. When AST/ALT >1 in the drinking group, sensitivity, specificity, positive predictive values, negative predictive values, likelihood ratios (LR)+, LR- and OR according to NIAAA guidelines, were 57.2%, 52.7%, 23.2%, 76.8%, 1.21 (1.04-1.41), 0.81 (0.67-0.98), and 1.49 (1.05-2.01), respectively. By Korean guidelines, these values were 55.2%, 55.3%, 33.7%, 66.3%, 1.24 (1.03-1.36), 0.84 (0.72-0.98), and 1.40 (1.04-1.89), respectively. CONCLUSIONS: Healthy male adults showed a positive correlation between risk of AST/ALT >1 and drinking amount compared to the non-drinking group. Use of the AST/ALT >1 in combination with other blood markers to predict excessive drinking is advisable.
Adult* ; Alanine Transaminase* ; Alanine* ; Alcohol Drinking* ; Aspartate Aminotransferases* ; Aspartic Acid* ; Body Mass Index ; Drinking ; Eyeglasses ; Glass ; Humans ; Liver ; Male* ; Mass Screening ; National Institute on Alcohol Abuse and Alcoholism (U.S.) ; Odds Ratio ; Sensitivity and Specificity ; Smoke ; Smoking ; Transferases

OBJECTIVE: To provide reference ranges of the fetal gall bladder in the Korean population. MATERIALS AND METHODS: Fetal gall bladder development was evaluated in well-dated, non-anomalous fetuses in the Korean population between February and April 2003 and the visualization rate and reference values were determined from the obtained data. RESULTS: The visualization rate of the fetal gall bladder increased as gestation advanced to a plateau above 90%, which was maintained between 16 and 34 weeks. The measured parameters from the fetal gall bladder had a significant positive relationship with gestational age (p = 0.000 for all cases), and the correlation of length and area with the gestational age (r = 0.741 and r = 0.690, respectively) was better than the correlation of width, height, and volume with gestational age. The repeatability coefficients and coefficients of variation between the two operators were 5.56 mm and 12.9% for the length and 344.11 mm(2) and 33.52% for the area. The median length of the fetal gall bladder in the Korean population was not significantly different from the mean length of gall bladders in the Caucasian and African-American populations (p = 0.915). CONCLUSION: We have provided reference values for the fetal gall bladder throughout the gestation period in the Korean population.
Female ; Gallbladder/*embryology/ultrasonography ; Gestational Age ; Humans ; Korea ; Pregnancy ; Reference Values ; Statistics, Nonparametric ; Ultrasonography, Doppler, Color ; *Ultrasonography, Prenatal

BACKGROUND AND OBJECTIVES: Direct stenting (DS) has been shown to be safe and feasible, with demonstrable reductions in cost, procedural time and radiation exposure, and may also result in less vessel injury. The aim of this study was to compare the immediate and six month clinical and angiographic outcomes of direct stent (DS) with stent implantation implantation following balloon predilatation (conventional stenting, CS). SUBJECTS AND METHODS: Between July 2001 and June 2004, 266 patients (293 lesions) with angina pectoris were included in this study. Patients having lesion characteristics with excessive calcification, left main lesion, chronic total occlusion, severe proximal tortuosity and a bifurcated lesion were excluded. Follow up angiography was performed about six months after the initial procedure. RESULTS: Direct (73 lesions) and conventional stenting (220 lesions) were performed respectively. In the DS group, the minimal luminal diameter was larger (0.36+/-0.18 vs. 0.31+/-0.19 mm, p=0.036) and diameter stenosis lower than in the CS group (89.1+/-5.1 vs. 90.6+/-3.9%, p=0.026). However, no difference was found in the reference vessel diameter between the two groups. From the immediate angiographic results, the CS group showed a longer stent length than the DS group (18.84+/-5.61 vs. 16.16+/-3.67 mm, p=0.000), but the DS group had a higher balloon inflation pressure than the CS group (12.25+/-1.71 vs. 11.35+/-1.72 atm, p=0.000). However, no difference was found in the post-stent minimal luminal diameter, acute gain and angiographic success rates. Follow up angiography was performed in 68.6% (201/293) of lesions. The angiographic restenosis rate was similar between the two groups (DS, 19.6 vs. CS, 19.3%, p=0.966), as were the other angiographic findings. The rates of in-hospital and 6 month follow up major adverse cardiovascular events (MACE) were similar between the two groups. CONCLUSION: Direct stenting showed similar rates of angiographic restenosis as well as inhospital and 6 months MACE (death, myocardial infarction, target lesion revascularization, cerebrovascular accident) compared with conventional stenting.
Angina Pectoris* ; Angiography ; Constriction, Pathologic ; Coronary Restenosis ; Follow-Up Studies ; Humans ; Inflation, Economic ; Myocardial Infarction ; Phenobarbital ; Stents*

PURPOSE: Acute appendicitis still remains one of the most common causes of childhood abdominal surgery. Despite of the development of modern diagnostic tools, it presents more serious problems than in adults due to the higher perforation rate. METHODS: In our hospital, 5-year term clinical reviews have been performed, over the last 2 decades to see if there were any changing tendencies of this disease entity. We reviewed 186 cases of child acute appendicitis between January 1997 and December 2001. RESULTS: The results were as follows: 1) The male to female ratio was 1.35: 1. 2) The peak incidence occurred in the 11 to 15 years old age group. 3) The overall perforation rate was 24.7%, which was decreased compared with 34.7% of our previous study (P<0.05, Odd ratio=0.60). 4) The negative exploration rate was 8.06%. 5) The overall complication rate were 2.85% and 32.6% in non-perforated and perforated cases, respectively. CONCLUSION: In conclusion, the incidence of acute appendicitis were shown to be almost the same as for the previous decade, but the perforation rate had dropped, maybe due to the early intervention, and advances in the diagnostic tools.
Adult ; Appendicitis* ; Child* ; Early Intervention (Education) ; Female ; Humans ; Incidence ; Male

BACKGROUND AND OBJECTIVES: Anterior attic bony plate (cog) is a coronally oriented bony septum which is suspended from the anterior petrosal tegmen, and the anterior epitympanic recess is partitioned from epitympanum by this bony plate. It is an important pathway for anterior drainage which can cause inflammation in obstructed conditions; therefore, it needs appropriate procedure to eradicate the lesions without recurrence. We aimed to classify types of the anterior attic bony plates on the temporal bone CT and to find correlation between the types of the anterior attic bony plates and the development of chronic otitis media and cholesteatoma. MATERIALS AND METHODS: We reviewed 264 cases of the temporal bone CT of the normal and the chronic otitis media patients, of which 64 cases were excluded as lesions could not be identified due to severe destruction and obscurity of the figure. RESULTS: In normal ears, the incidence of the anterior attic bony plate was 67% in the plate type, 28% in the pyramid type, and 5% in the anterior type. In the diseased ear, the incidences were 40%, 44%, 16%, in the plate type, pyramid type, and anterior type, respectively and in the cholesteatoma ear, 30%, 43%, 27%, respectively. The difference of incidence was statistically significant. CONCLUSION: We assumed that the development of the chronic otitis media is related to the type of the anterior attic bony plate in some degree. Especially, the anterior type was more prominent in cholesteatoma than in noncholesteatoma with a statistical significance. Further studies are needed to figure out the correlation between the type of the anterior attic bony plate and it's clinical importance.
Cholesteatoma ; Classification* ; Drainage ; Ear ; Humans ; Incidence ; Inflammation ; Otitis Media ; Recurrence ; Temporal Bone* ; Ventilation

PURPOSE: The object of this study is to evaluate the efficacy and toxicity of induction chemotherapy followed by concomitant chemoradiotherapy in locoregional esophageal cancer. MATERIALS AND METHODS: Between December 1992 and December 1999, 43 patients with locoregional esophageal cancer were enrolled in this phase II trial. Patients were treated with 2-cycles of induction chemotherapy followed by concomitant chemoradiotherapy. F-P chemotherapy consists of 1,000 mg/m2/Day of 5-FU as continuous infusion on day 1~5 and 80 mg/m2 of cisplatin as an intravenous bolus on day 1 and was repeated every 3~4 weeks. All patients received 60 Gy of external beam radiation concomitantly with F-P chemotherapy; intraluminal brachytherapy was added in 12 patients. A total of 4 cycles of chemotherapy were delivered. No further treatment was planned in patients who achieved complete remission after completion of the treatment. RESULTS: Among the 43 patients entered, 35 patients completed the protocol. Of the 35 evaluable patients, 12 patients (34%) achieved complete response and 13 patients (37%) achieved partial response. In 26 of 33 patients, dysphagia was improved. At a median follow-up of 22 months, the 2-year and 5-year survival rates were 39% and 19%, respectively. The median survival duration of the complete responder group was 69 months (4~100 months) and the 2-year survival rate of the complete responder group was 82%. Toxicities were tolerable, comprised of mucositis and cytopenia. CONCLUSION: Induction chemotherapy followed by concurrent chemoradiotherapy in locoregional esophageal cancer is well tolerated and effective.
Brachytherapy ; Chemoradiotherapy* ; Cisplatin ; Deglutition Disorders ; Drug Therapy ; Esophageal Neoplasms* ; Fluorouracil ; Follow-Up Studies ; Humans ; Induction Chemotherapy* ; Mucositis ; Survival Rate

A 57-year-old woman developed an inflammatory carcinoma in her left breast next to the spot of a silicone injection that had been used for augmentation some 20 years previously. She underwent a modified radical mastectomy with an axillary lymph node dissection. There have been relatively few cases reported in the literature that have noted breast cancer associated with silicone injections. During physical examinations, such breasts are frequently firm, tender, painful, and inflamed. Far more important, in silicone-injected breasts, carcinomas become more difficult to detect by physical examination, mam mography, and other known methods. Although no causal relationship between silicone and breast carci nomas is implied, a heightened awareness of the possible coexistence of silicone mastopathy and a breast carcinoma is necessary.
Breast Neoplasms* ; Breast* ; Female ; Humans ; Lymph Node Excision ; Mastectomy, Modified Radical ; Middle Aged ; Noma ; Physical Examination ; Silicones*

A 57-year-old woman developed an inflammatory carcinoma in her left breast next to the spot of a silicone injection that had been used for augmentation some 20 years previously. She underwent a modified radical mastectomy with an axillary lymph node dissection. There have been relatively few cases reported in the literature that have noted breast cancer associated with silicone injections. During physical examinations, such breasts are frequently firm, tender, painful, and inflamed. Far more important, in silicone-injected breasts, carcinomas become more difficult to detect by physical examination, mam mography, and other known methods. Although no causal relationship between silicone and breast carci nomas is implied, a heightened awareness of the possible coexistence of silicone mastopathy and a breast carcinoma is necessary.
Breast Neoplasms* ; Breast* ; Female ; Humans ; Lymph Node Excision ; Mastectomy, Modified Radical ; Middle Aged ; Noma ; Physical Examination ; Silicones*

The current patient management system has several limitations. To develop the critical pathway (CP) as a cost-effective method via continuous patient management, we investigated the medical records of 77 patients who underwent FP chemotherapy in Seoul National University Hospital from Feb, 1 to 28, 1999. And the pilot study was done to 12 patients admitted to undergo the FP chemotherapy. 1. The vertical contents in the CP consisted of 7 items; assessment, activity, diet, IV therapy, medication, education and evaluation. The duration of the horizontal axis was 6 days from admission to discharge. 2. The medical performance according to the vertical axis in the preliminary CP, consisted of 72 , and modified to 74 items in the final form of CP. 3. The nursing record consisted of a vertical axis of 4 items; assessment, IV therapy, medication and education. The duration of the horizontal axis was 6 days from admission to discharge of hospital days.
Axis, Cervical Vertebra ; Critical Pathways* ; Diet ; Drug Therapy* ; Education ; Humans ; Medical Records ; Nursing Records* ; Nursing* ; Pilot Projects ; Seoul