Patient education is important for successful management of atopic dermatitis; however, due to limited time and resources, patient education remains insufficient. This study aimed to investigate the current state of education provided by Korean dermatologists, pediatric allergists, and allergists to patients with atopic dermatitis. A questionnaire survey consisting of items regarding educational programs for patients with atopic dermatitis was conducted via e-mail. In total, 153 participants responded to the questionnaires, and 26.8% indicated that they have had separate educational programs. The workforce involved in the educational program included nurses, residents or fellows, dieticians, pharmacists, and clinical psychologists. Most education protocols addressed the characteristics and natural course of atopic dermatitis and environmental management. Overall, 96.7% of the participants replied that an additional charge is needed for education; moreover, additional assistance from an academic society or association, in the form of medical staff, organized data, and advertisement, is required to develop and provide a well-structured educational program. A standardized education protocol will effectively provide appropriate education for patients with atopic dermatitis. Arrangement of education fees, covered by the National Health Insurance Service, will lead to the establishment of a structured educational program and participation of an additional medical workforce.
Dermatitis, Atopic ; Education ; Electronic Mail ; Fees and Charges ; Humans ; Korea ; Medical Staff ; National Health Programs ; Nutritionists ; Patient Education as Topic ; Pharmacists ; Psychology

PURPOSE: Female lung cancers have different clinical features and therapeutic results as compared to those of male lung cancers. The aim of this study was to analyze the differences of Korean men and women with lung cancer. MATERIALS AND METHODS: We re-analyzed the results of a national survey of lung cancer conducted by the Korean Association for the Study of Lung Cancer in 2005. RESULTS: Of the 8,788 patients, 2,124 (24.2%) were female. The mean age at the diagnosis was 62.5 years for the females and 64.8 years for the males and the difference was significant (p<0.001). An age <50 years was more frequent for the women than for the men (16.2% vs. 7.9%, respectively; p=0.001). The stages between genders were different for the patients with non-small cell carcinoma (NSCLC) (p<0.001), but not for the patients with small cell carcinoma. The overall survival time was longer for woman than that for the man (p<0.001). However, the male patients had longer survival for the smokers with adenocarcinoma and the smokers with squamous cell carcinoma. The never smoker female patients had a better survival time than did the smoking female patients, but the male patient' survival was not influenced by the smoking status. The stage-specific survival rates were better for the women at all stages of NSCLC (p<0.001). The women who received chemotherapy had a longer survival time did the men who received chemotherapy (p<0.001). CONCLUSION: Women with lung cancer were relatively overrepresented among the younger patients and they smoked less intensively, raising the question of gender- specific differences in the carcinogenesis of lung cancer. Over-representation of adenocarcinoma was observed in the women regardless of their smoking status. Women with lung cancer had a better prognosis than men; however, the smoking females showed the worst prognosis. Gender and the smoking status are clearly important factors in the therapeutic approach to lung cancer.
Adenocarcinoma ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Female ; Humans ; Korea ; Lung ; Lung Neoplasms ; Male ; Prognosis ; Republic of Korea ; Smoke ; Smoking ; Survival Rate

Hot tub lung has been described as a pulmonary illness associated with exposure to nontuberculous mycobacteria, mainly hot bathtub water contaminated with Mycobacterium avium complex (MAC) and hence the name. Although not entirely clear, its etiology has been thought to involve either an infection or a hypersensitivity pneumonitis secondary to MAC. Herein, we describe 2 female patients (60 and 53 years old) admitted to our hospital with hot tub lung, and both of whom worked in a public bath. Both women were initially admitted following several months of exertional dyspnea and cough. The patients had been working as body-scrubbers in a public bath for several years. Their chest CT scans showed bilateral diffuse ground-glass opacities with multifocal air-trappings and poorly defined centrilobular nodules in both lungs. Pathological findings from lung specimens revealed small non-necrotizing granuloma in the lung parenchyme with relatively normal-looking adjacent alveoli. Discontinuation of working in the public bath led to an improvement in symptoms and radiographic abnormalities, without antimycobacterial therapy.
Alveolitis, Extrinsic Allergic ; Baths ; Cough ; Dyspnea ; Female ; Granuloma ; Humans ; Lung ; Mycobacterium avium Complex ; Nontuberculous Mycobacteria ; Thorax

A female infant (4 months-old) with Goldenhar syndrome was scheduled for cheiloplasty to treat a transverse facial cleft and congenital macrostomia. There was no past history of difficulty during feeding or airway obstruction. Following induction of anesthesia using an inhalational anesthetic technique, conventional oro-tracheal intubation was possible. However, following extubation of the endotracheal tube she developed an upper airway obstruction. Her lungs could not be ventilated using a facial mask and oxygen saturation was decreased. A #1 laryngeal mask airway (LMA) was inserted immediately, which allowed us to ventilate her lungs and restore the oxygen saturation. Here we describe the use of a LMA for emergency airway management in an infant.
Airway Management ; Airway Obstruction ; Anesthesia ; Emergencies ; Female ; Goldenhar Syndrome ; Humans ; Infant ; Intubation ; Laryngeal Masks ; Lung ; Macrostomia ; Masks ; Oxygen

Phenylketonuria (PKU), an autosomal recessive disorder, occurs in one of 53,000 births in Korea. The disorder is associated with deficient activity of phenylalanine hydroxylase. In PKU, phenylalanine cannot be used in a normal fashion because of the deficient enzyme. Untreated, affected individuals develop marked mental disabilities, behavioral difficulties, seizures, rashes, pigment dilution, and unusual body odor. PKU treatment consists of a phenylalanine-restricted diet supplemented with a phenylalanine-free mixture of amino acids. During the restricted diet, PKU patients have an increased risk of developing vitamin B12 deficiency because of a limited intake of animal products. We report a successful anesthetic management in a patient with phenylketonuria for dental procedures.
Amino Acids ; Anesthesia, General* ; Animals ; Diet ; Exanthema ; Humans ; Korea ; Nitrous Oxide ; Odors ; Outpatients* ; Parturition ; Phenylalanine ; Phenylalanine Hydroxylase ; Phenylketonurias* ; Seizures ; Vitamin B 12 ; Vitamin B 12 Deficiency

Glanzmann's thrombasthenia is a rare autosomal recessive disorder characterized by bleeding tendency due to decreased coagulation function of platelets. Perioperative adequate blood transfusion including preoperative platelet transfusion seems to be the most important component affecting anesthetic management. Also, minimally invasive techniques should be used at the time of induction of anesthesia and the use of recombinant activated coagulation factor VII may be considered. We successfully conducted an anesthetic management for dental procedure in a four-year-old child with Glanzmann's thrombasthenia using preoperative platelet transfusion. Thus we present this anesthetic experience and share informations on anesthetic management of patients with Glanzmann's thrombasthenia.
Anesthesia ; Blood Transfusion ; Child ; Factor VII ; Hemorrhage ; Humans ; Platelet Transfusion ; Thrombasthenia*

BACKGROUND: The amplitude (AMP) of Photoplethysmogram (PPG) is used as a marker of vasodilatation. The pulse transit time (PTT), which shows a good correlation with blood pressure (BP), is not strong enough to detect the changes in BP. This study examined the sensitivity of the combined effect of the finger and toe AMP, and the PTT of PPG as a marker of the changes in BP during general anesthesia. METHODS: Forty patients receiving maxillofacial surgery under general anesthesia were enrolled in this study. During surgery, the intra-arterial BP, ECG, finger and toe PPG signals were measured. Using the R-wave from the ECG, the AMP and PTT was derived from PPG data. The correlation between BP and PPG parameters (AMP and PTT) were compared. New parameters that show high correlation with the BP were found. Regression equations for calculating the BP using the PPG parameters were formulated. RESULTS: The new parameter, log (fingerAMP/toeAMP), showed the highest correlation in each patient (mean correlation coefficient in the systolic BP: -0.846, diastolic BP: -0.858). However, when the data from all 40 patients were combined, the correlation coefficient of the toe PTT was highest (systolic BP: -0.726, diastolic BP: -0.646). The regression equation showed the highest correlation between the actual BP and calculated BP when the toe PTT and log (fingerAMP/toeAMP) were included. CONCLUSIONS: The AMP of the toe and finger PPG can be used to estimate the invasive continuous blood pressure.
Anesthesia, General ; Blood Pressure* ; Electrocardiography ; Fingers* ; Humans ; Pulse Wave Analysis* ; Surgery, Oral ; Toes* ; Vasodilation

This study demonstrated that xenogenic human marrow mesenchymal stem cells (hMSCs) could elicit the regeneration of the sensory nerve after axotomy in the adult rats'infraorbital nerves without immunosuppression. For this, we evaluated the behavioral testing for functional recovery of the nerve and histological findings at weeks 3 and 5 compared to controls. Xenogenic hMSCs did not evoke any significant inflammatory or immunologic reaction after systemic and local administrations. HMSCs-treated rats exhibited significant improvement on sensory recovery tested with von Frey monofilaments. At 5 postoperative weeks, in the hMSCs treated nerve, expression of myelin basic protein (MBP), neurofilament (NF) at the site of axotomy was higher than control. And mRNA expression of neurotropin receptor Trk precursor (TrkPre), nerve growth factor receptor (NGFR) and neuropeptide (NPY) in trigeminal ganglion were also higher. The number of myelinated nerve at distal stump and cells in trigeminal ganglion were higher in hMSC treated rats. So it was supposed that transplanted MSCs contributed to reducing post-traumatic degeneration and production of neurotrophic factors. Immunofluorescence labeling showed small portion of hMSCs(<10%) expressed a phenotypic marker of Schwann cell (S-100). Xenogenic or allogenic mesenchymal stem cells might have immune privileged characteristics and useful tool for cell based nerve repair.
Adult ; Animals ; Axotomy ; Bone Marrow* ; Fluorescent Antibody Technique ; Humans* ; Immunosuppression ; Mesenchymal Stromal Cells* ; Myelin Basic Protein ; Myelin Sheath ; Nerve Growth Factor ; Nerve Growth Factors ; Nerve Regeneration ; Neuropeptides ; Rats* ; Regeneration* ; RNA, Messenger ; Trigeminal Ganglion

BACKGROUND: Glucocorticoids have anti-inflammatory effects and have been used to treat many types of nerve injury- associated chronic pain conditions. A randomized double-blind study was performed to determine if methylprednisolone could prevent the development of neuropathic pain after a peripheral nerve injury in rats. METHODS: Two groups of rats, one group (n = 50) injected intraperitoneally with methylprednisolone (100 mg/kg/day, for 7 days starting from 3 days prior to the nerve injury) and the other (n = 58) treated with saline with same manner, were compared in terms of the incidence and intensity of allodynia after a superior caudal trunk transection at the level between the 3rd and 4th sacral spinal nerves. The tail-flick responses to normally innocuous mechanical and thermal stimuli applied to the tail were observed as the behavioral signs of neuropathic pain. RESULTS: The proportions of rats exhibiting tail-flick responses to the mechanical (but not thermal) stimuli 7, 14 and 21 days after the nerve injury were significantly smaller in the methylprednisolone-treated group (2, 3 and 4 of 50 rats, respectively) than in the saline-treated, control group (11, 14 and 15 of 58 rats, respectively) (P = 0.009). However, the pain intensity was similar in mechanical allodynia developed rats of the two groups (P > 0.05), which was estimated based on the frequency and latency of the tail-flick responses after applying mechanical and thermal stimuli, respectively. CONCLUSIONS: These results suggest that a pre-emptive treatment with high methylprednisolone doses may be used to prevent the development of mechanical allodynia following peripheral nerve injuries.
Animals ; Axotomy ; Chronic Pain ; Double-Blind Method ; Glucocorticoids ; Hyperalgesia* ; Incidence ; Methylprednisolone* ; Neuralgia ; Peripheral Nerve Injuries* ; Peripheral Nerves* ; Rats* ; Spinal Nerves

PURPOSE: We examined the relationship between BIS, sedation score and plasma midazolam concentration to verify the usefulness of BIS to assess the patient's consciousness during sedation. PATIENTS AND METHODS: Twenty-five young, healthy adult volunteers participated in this clinical study. Midazolam was administered intravenously up to 0.08 mg/kg to induce unconsciousness and we monitored the patient's physiological and conscious status until complete recovery from sedation. BIS and sedation score were measured before sedation, 10, 20, 30 minutes after midazolam administration. Plasma midazolam concentration was measured 10 minutes after midazolam administration. BIS was measured using A-2000 BISTM monitor (Aspect Medical Systems, USA) and the degree of sedation was evaluated with the sedation score. RESULTS: The BIS score correlated with the sedation score (r = 0.676, P < 0.05). With the decreased plasma midazolam concentration, the correlation was better with sedation score(r = -0.656).Although BIS values did not correlate with calculated plasma concentration of midazolam (r = 0.467) at 10 minutes after midazolam administration, values after sedation were well distinguished from those before sedation. CONCLUSIONS: BIS is known for an effective predictor of patient's hypnotic state, and it is correlated with the sedation score. But, it doesn't always coincide with the clinical parameters of depth of sedation. So more attention is needed using BIS only during sedation, and it is advisable that the patient's consciousness is monitored with variable sedation score systems every several minutes.
Adult ; Consciousness ; Humans ; Midazolam* ; Plasma* ; Unconsciousness ; Volunteers