PURPOSE: This study aims to determine the efficacy and safety of house dust mite (HDM)-sublingual immunotherapy (SLIT) in elderly patients with AR. METHODS: A total of 45 patients aged ≥ 60 years with HDM-induced AR who had ≥ 3 A/H ratio on skin prick test and/or ≥ 0.35 IU/L to both Dermatophagoides farinae and Dermatophagoides pteronyssinus by ImmunoCAP were enrolled in 4 university hospitals. To evaluate additional effects of HDM-SLIT, they were randomized to the SLIT-treated group (n = 30) or control group (n = 15). Rhinoconjunctivitis total symptom score (RTSS), rhinoscopy score, Korean rhinoconjunctivitis quality of life questionnaire, rhinitis control assessment test, asthma control test scores, and adverse reactions, were assessed at the first visit (V1) and after 1 year of treatment (V5); for immunological evaluation, serum levels of HDM-specific immunoglobulin A/IgE/IgG1/IgG4 antibodies and basophil response to HDMs were compared between V1 and V5 in both groups. RESULTS: There were no significant differences in demographics, RTSS, skin reactivity to HDMs, or serum total/specific IgE levels to HDMs (P < 0.05, respectively) between the 2 groups. Nasal symptom score and RTSS decreased significantly at year 1 in the 2 groups (P < 0.05). There were no significant differences in percent decrease in nasal symptom score and RTSS at year 1 between the 2 groups (P < 0.05); however, rhinoscopic nasal symptom score decreased significantly in the SLIT-treated group (P < 0.05). Immunological studies showed that serum specific IgA levels (not specific IgE/IgG) and CD203c expression on basophils decreased significantly at V5 in the SLIT-treated group (P = 0.011 and P = 0.001, respectively), not in the control group. The control group required more medications compared to the treatment group, but there were no differences in adverse reactions. CONCLUSIONS: It is suggested that HDM-SLIT for 1 year could induce symptom improvement and may induce immunomodulation in elderly rhinitis patients.
Aged* ; Antibodies ; Asthma ; Basophils ; Demography ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dust* ; Hospitals, University ; Humans ; Immunoglobulin A ; Immunoglobulin E ; Immunoglobulins ; Immunomodulation ; Immunotherapy ; Pyroglyphidae* ; Quality of Life ; Rhinitis* ; Rhinitis, Allergic ; Skin ; Sublingual Immunotherapy*

BACKGROUND: There have been many efforts to rectify lifestyles that contribute to obesity using a variety of methodologies in heterogeneous settings, but effective and sustainable interventions that are suitable for children are still needed. We developed a smartphone application called "HAPPY ME" for guiding health behavior decisions, which employs gamification and self-monitoring strategies. The aim of this paper is to outline the rationale and methods for the development and feasibility test of "HAPPY ME". METHODS: The study consisted of two phases: 1) description of theory-based conceptual framework and rationales for smartphone application development and 2) outline of a pre- and post-test design in 4th-6th grade of healthy elementary school students for 4 weeks. The students will be delivered missions or messages on a daily basis, which is to stretch the knowledge and skills for action. They will simultaneously be engaged in self-monitoring their eating and physical activities to clear daily quests. To measure acceptability and feasibility we will monitor usability, compliance, and satisfaction for a 4-week study period and evaluate the intervention effects on self-efficacy, readiness, and intention to engage in healthy behavior. CONCLUSIONS: The results of the feasibility study will show whether the smartphone application "HAPPY ME" for children is acceptable, as well as if it is usable and feasible for self-directed health management. The results will provide preliminary evidence of the effectiveness of smartphone application-supported child behavioral modification for child obesity prevention and management.
Child Behavior ; Child* ; Compliance ; Eating ; Feasibility Studies ; Health Behavior ; Humans ; Intention ; Life Style ; Missions and Missionaries ; Motor Activity ; Obesity ; Pediatric Obesity* ; Smartphone

The dietary intake of whole grains is known to reduce the incidence of chronic diseases such as obesity, diabetes, cardiovascular disease, and cancer. To investigate whether there are anti-adipogenic activities in various Korean cereals, we assessed water extracts of nine cereals. The results showed that treatment of 3T3-L1 adipocytes with Sorghum bicolor L. Moench, Setaria italica Beauvois, or Panicum miliaceum L. extract significantly inhibited adipocyte differentiation, as determined by measuring oil red-O staining, triglyceride accumulation, and glycerol 3-phosphate dehydrogenase activity. Among the nine cereals, P. miliaceum L. showed the highest anti-adipogenic activity. The effects of P. miliaceum L. on mRNA expression of peroxisome proliferator-activated receptor-gamma, sterol regulatory element-binding protein 1, and the CCAAT/enhancer binding protein-alpha were evaluated, revealing that the extract significantly decreased the expression of these genes in a dose-dependent manner. Moreover, P. miliaceum L. extract changed the ratio of monounsaturated fatty acids to saturated fatty acids in adipocytes, which is related to biological activity and cell characteristics. These results suggest that some cereals efficiently suppress adipogenesis in 3T3-L1 adipocytes. In particular, the effect of P. miliaceum L. on adipocyte differentiation is associated with the downregulation of adipogenic genes and fatty acid accumulation in adipocytes.
3T3-L1 Cells ; Adipocytes ; Adipogenesis ; Cardiovascular Diseases ; Edible Grain ; Chronic Disease ; Down-Regulation ; Fatty Acids ; Fatty Acids, Monounsaturated ; Glycerol ; Glycerophosphates ; Incidence ; Obesity ; Oxidoreductases ; Panicum ; Peroxisomes ; RNA, Messenger ; Setaria Plant ; Sorghum ; Sterol Regulatory Element Binding Protein 1 ; Transcription Factors ; Water

Cardiac myxoma is the most common benign cardiac tumor and it presents various clinical symptoms and signs. Although two-thirds of patients have abnormal electrocardiographic findings, atrial flutter or conduction abnormalities are known to be rare. We report on a case of a large left atrial myxoma which was diagnosed by trans-thoracic, trans-esophageal echocardiography, chest computerized tomography, and histological examination. The myxoma was presented as atrial flutter in a 41-year old man who was complaining palpitation and dyspnea on exertion. After surgical excision of the mass, atrial flutter converted to normal sinus rhythm. We report this case with review of literatures on left atrial myxoma associated with arrhythmia.
Arrhythmias, Cardiac ; Atrial Flutter ; Dyspnea ; Echocardiography ; Electrocardiography ; Heart Neoplasms ; Humans ; Myxoma ; Thorax

A 38-year-old Korean man was diagnosed with hereditary sensory and autonomic neuropathy (HSAN) type 2 because of his chronic sensory neuropathy and progressive acro-mutilation. Genetic analysis revealed that he was a compound heterozygous for two novel mutations in the HSN2 gene including a nonsense mutation (Gln73X) and a 1-bp insertion mutation (Asp379fsX1). To our knowledge, this is the first report of a genetically confirmed case of HSAN type 2 in the Asian population and supports the genetic homogeneity of this rare disease.
Adult ; Asian Continental Ancestry Group ; Codon, Nonsense ; Hereditary Sensory and Autonomic Neuropathies ; Humans ; Mutagenesis, Insertional ; Rare Diseases

Respiratory bronchiolitis associated interstitial lung disease is a rare condition among current or ex-smokers, which has features consistent with interstitial lung disease. The presentations are non-specific, but symptoms generally include a cough and dyspnea on exertion, and its pathology is characterized by the accumulation of pigmented macrophages within the respiratory bronchioles and adjacent air spaces, and is associated with mild thickening of the peribronchiolar interstitium. Recently, the case of a 54-year-old woman passive smoker, diagnosed as having respiratory bronchiolitis associated interstitial lung disease, was experienced at our institution.
Bronchioles ; Bronchiolitis* ; Cough ; Dyspnea ; Female ; Humans ; Lung Diseases, Interstitial* ; Macrophages ; Middle Aged ; Pathology ; Tobacco Smoke Pollution*

BACKGROUND: Thyrotoxic periodic paralysis is an uncommon illness characterized by intermittent flaccid paralysis of skeletal muscle, usually accompanied by hypokalemia, in patient with hyperthyroidism. However. the pathophysiology of thyrotoxic periodic paralysis remains largely unexplained and controversial. This report describes the clnical and biochemical findings in 19 patients with thyrotoxic periodic paralysis who were examined at the Yeungnam University Medical Center (YUMC) during the past decade. METHODS: The medical records of 997 YUMC patients, seen between 1986 and 1996, with dignosis of hyperthyroidism were reviewed. Nineteen patients out of 997 hyperthyrodism patients were diagnosed, and examined by history, physical examination, serum electrolyte value, and thyroid function test during paralysis. On the basis of these results, compasons were made on age. sex, precipitating factors, timing, affected limbs, prognosis, serum potassium and serum phosphate and thyroid hormone levels. RESULTS: the prevalence of periodic paralysis in hyperthyroidism was 1.9 percent and the male to female prevalence ratio was 30:1 and in all patients, the development of perodic paralysis was correlated with hyperfuntional state of the throid gland. Eleven cases of periodic paralysis were associated with hypokalemia and their throid hormon levels were significantly more increased than those of the patients without hypokalemia. interestingly, our study shows the recurrence of paralysis after treatment. CONCLUSION: Although the precise pathophysiology of the disease is as yet undefined and controversial, it occurs primarily in Asians with an overwhelming male preponderance and prevalence of 2 percent in hyperthyrodism. The interactive roles of thyroid hormon. Na-K pump. and genetically inherited defect in the celluar membrance potential of the skeletal muscle can be speculated. Further investigation will be neede to firmly establish the mechanism of thyrotoxic periodic paraysis.
Academic Medical Centers ; Asian Continental Ancestry Group ; Extremities ; Female ; Humans ; Hyperthyroidism ; Hypokalemia ; Hypophosphatemia ; Male ; Medical Records ; Muscle, Skeletal ; Paralysis* ; Physical Examination ; Potassium ; Precipitating Factors ; Prevalence ; Prognosis ; Recurrence ; Thyroid Function Tests ; Thyroid Gland

BACKGROUND: As lack of myocardial perfusion was demonstrated on myocardial contrast echocardiography(MCE) despite angiographic documentation of reflow, patency of infarct related artery (IRA) after acute myocardial infarction(AMI) does not guarantee myocardial tissue perfusion. Myocardial enhancement on MCE is associated with myocardial perfusion and microvascular integrity. We are to assess myocardial perfusion immediately after thrombolysis and to correlate myocardial enhancement with functional recovery of postischemic dysfunctional myocardium. METHODS: MCE was performed by intracoronary injection of hand-agitated Ioxaglate in 17 consecutive AMI patients immediately after thrombolysis. Myocardial enhancement of 37 infarct segment was quantified as corrected peak videointensity(PI) by videodensitometry and the PI ratio of infarct to normal segments was used to assess myocardial reperfusion. Viable myocardium was defined as the presence of functional recovery on follow-up echocardiography. RESULTS: 1) MCE was performed in 37 segments of 17 AMI patient and functional recovery was noted in 28 segments of 12 patients on follow-up echocardiography. 2) Six infarct segments with no reflow on MCE showed severe fixed perfusion defect in thallium scan and no functional recovery in follow-up echocardiography. 3) The peak cardiac enzyme level was significantly higher in patients without functional recovery(p<0.005), but mean PI ratio(p<0.005) and patency of IRA(p<0.05) were significantly higher in patient with functional recovery. Age, sex, time to thrombolysis and stenosis of IRA were not associated with functional recovery. 4) Apical segment(p<0.01), TIMI grade 2 patency(p<0.01) and LAD territory(p<0.05) were significantly associated with nonviable myocardium, and PI ratio(p<0.001) was significantly correlated to viable myocardium. The PI ratio was the most significant predictor of myocardial functional recovery on multiple logistic regression analysis. CONCLUSION: Myocardial contrast echocardiography immediately after thrombolysis can be used for assessment of myocardial reperfusion, decision of revascularization and prediction of functional recovery.
Arteries ; Constriction, Pathologic ; Echocardiography* ; Follow-Up Studies ; Humans ; Ioxaglic Acid ; Logistic Models ; Myocardial Reperfusion* ; Myocardium* ; Perfusion ; Thallium

BACKGROUND: As lack of myocardial perfusion was demonstrated on myocardial contrast echocardiography(MCE) despite angiographic documentation of reflow, patency of infarct related artery (IRA) after acute myocardial infarction(AMI) does not guarantee myocardial tissue perfusion. Myocardial enhancement on MCE is associated with myocardial perfusion and microvascular integrity. We are to assess myocardial perfusion immediately after thrombolysis and to correlate myocardial enhancement with functional recovery of postischemic dysfunctional myocardium. METHODS: MCE was performed by intracoronary injection of hand-agitated Ioxaglate in 17 consecutive AMI patients immediately after thrombolysis. Myocardial enhancement of 37 infarct segment was quantified as corrected peak videointensity(PI) by videodensitometry and the PI ratio of infarct to normal segments was used to assess myocardial reperfusion. Viable myocardium was defined as the presence of functional recovery on follow-up echocardiography. RESULTS: 1) MCE was performed in 37 segments of 17 AMI patient and functional recovery was noted in 28 segments of 12 patients on follow-up echocardiography. 2) Six infarct segments with no reflow on MCE showed severe fixed perfusion defect in thallium scan and no functional recovery in follow-up echocardiography. 3) The peak cardiac enzyme level was significantly higher in patients without functional recovery(p<0.005), but mean PI ratio(p<0.005) and patency of IRA(p<0.05) were significantly higher in patient with functional recovery. Age, sex, time to thrombolysis and stenosis of IRA were not associated with functional recovery. 4) Apical segment(p<0.01), TIMI grade 2 patency(p<0.01) and LAD territory(p<0.05) were significantly associated with nonviable myocardium, and PI ratio(p<0.001) was significantly correlated to viable myocardium. The PI ratio was the most significant predictor of myocardial functional recovery on multiple logistic regression analysis. CONCLUSION: Myocardial contrast echocardiography immediately after thrombolysis can be used for assessment of myocardial reperfusion, decision of revascularization and prediction of functional recovery.
Arteries ; Constriction, Pathologic ; Echocardiography* ; Follow-Up Studies ; Humans ; Ioxaglic Acid ; Logistic Models ; Myocardial Reperfusion* ; Myocardium* ; Perfusion ; Thallium

BACKGROUND: Conventional visual assessment of coronary arteriogram is fraught with large interobserver variance and disagreement with pathologic findings. Thus quantitative coronary angiography had been recently developed to meet the requirement of more reproducible measurement of severity of coronary artery disease. This study was designed to evaluate the interobserver variability of quantitative coronary angiography and its usefulness in clinical application. METHODS: Three independent observers analysed coronary angiogram of 31 consecutive patients by visual assessment and quantitative measurement using computer based algorithm. RESULTS: 1) There was considerable disagreement between 3 observers in the identification of significant coronary stenosis. Complete agreement was achieved in only 29/61 (47%) coronary lesion and agreement of more than 2 observers in 41/61(67%) lesion. 2) In visual assessment, the largest interobserver variance was found in acute marginal artery and distal circumflex artery, whereas the least variance was observed in proximal right coronary artery. 3) The average interobserver variance was 13.1% in visual assessment, 14.9% in geometric analysis, and 10.5% in video densitometric analysis. There was no significant difference between these values. 4) Visual assessment was noted to overestimate the severity of stenotic lesion, by 5.6% compared to geometric analysis and by 11.8% compared to video-densitometric analysis. CONCLUSION: These findings suggest that identifying significant lesion is major source of interobserve variability in both visual and quantitative analysis of coronary arteriogram. In addition, suboptimal image quality was responsible for the inability of quantitative analysis to reduce the variance. These factors seem to be major limitation of quantitative coronary arterirogam.
Arteries ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Humans ; Observer Variation*