BACKGROUND: Topical tacrolimus is an effective anti-inflammatory therapy for acute and chronic states of atopic dermatitis (AD) in both adults and children. Topical tacrolimus has particular use at sensitive areas such as the face, anogenitals, and skin folds of neck and extremities. However, many AD patients also experience aggravated symptoms on trunk. OBJECTIVE: The aim of this study was to investigate the efficacy and safety of topical tacrolimus for AD patients with truncal lesions. METHODS: AD patients with truncal lesions who were aged ≥2 years were recruited from 20 centres in Korea. They received treatment with topical tacrolimus ointment twice daily during 4 weeks. The primary end point was change of the local eczema area and severity index (EASI) of the trunk from baseline to day 28. The secondary end points were changes in the patient global assessment (PGA) score and itch visual analogue scale (VAS) score of the trunk between baseline and day 28. RESULTS: Two hundred and ninety-one patients were recruited, and 176 patients completed the full 4-week treatment course. By the end of the treatment, the mean local EASI of the trunk (2.2±4.71) was significantly decreased from that at baseline (4.71±4.03, p < 0.001). PGA (1.71±1.15) and itch VAS score of the trunk (2.61±2.19) on day 28 were also profoundly decreased compared with the baseline (2.96±1.07 and 5.15±2.47, respectively). No serious adverse events were observed during the study period. CONCLUSION: Topical tacrolimus is an effective and safe therapy for truncal lesions in AD patients.
Administration, Topical ; Adult ; Child ; Dermatitis, Atopic* ; Eczema ; Extremities ; Humans ; Korea ; Neck ; Skin ; Tacrolimus*

Leucine-rich repeat kinase 2 (LRRK2) mutations are the most common genetic cause of Parkinson's disease (PD). LRRK2 contains a functional kinase domain and G2019S, the most prevalent LRRK2 pathogenic mutation, increases its kinase activity. LRRK2 regulates mitochondria morphology and autophagy in neurons. LPS treatment increases LRRK2 protein level and mitochondrial fission in microglia, and down-regulation of LRRK2 expression or inhibition of its kinase activity attenuates microglia activation. Here, we evaluated the direct role of LRRK2 G2019S in mitochondrial dynamics in microglia. Initial observation of microglia in G2019S transgenic mice revealed a decrease in mitochondrial area and shortage of microglial processes compared with their littermates. Next, we elucidated the molecular mechanisms of these phenotypes. Treatment of BV2 cells and primary microglia with LPS enhanced mitochondrial fission and increased Drp1, a mitochondrial fission marker, as previously reported. Importantly, both phenotypes were rescued by treatment with GSK2578215A, a LRRK2 kinase inhibitor. Finally, the protein levels of CD68, an active microglia marker, Drp1 and TNF-α were significantly higher in brain lysates of G2019S transgenic mice compared with the levels in their littermates. Taken together, our data suggest that LRRK2 could promote microglial mitochondrial alteration via Drp1 in a kinase-dependent manner, resulting in stimulation of pro-inflammatory responses. This mechanism in microglia might be a potential target to develop PD therapy since neuroinflammation by active microglia is a major symptom of PD.
Animals ; Autophagy ; Brain ; Down-Regulation ; Mice ; Mice, Transgenic ; Microglia* ; Mitochondria ; Mitochondrial Dynamics* ; Neurons ; Parkinson Disease ; Phenotype ; Phosphotransferases*

PURPOSE: In spite of many reports about Helicobacter pylori infection in children with functional gastrointestinal disorders, there are few reports about the influence of H. pylori infection to functional dyspepsia and gastric motility. Therefore, we studied the influence of H. pylori infection on gastric myoelectrical activity in children with functional dyspepsia. METHODS: Between August 2006 and December 2008 upper gastrointestinal endoscopies with biopsies, the rapid urease test and/or 13C urea breath test, and electrogastrography (EGG) were performed on 63 patients with histologic chronic gastritis; patients with chronic disorders were excluded. Comparisons about gastric myoelectrical activities were made between H. pylori-positive children (n=25) and H. pylori- negative children (n=38). RESULTS: The percentage of pre- and post-prandial normogastria was relatively lower in H. pylori-positive children than H. pylori-negative children (80% vs. 65%, and 80% vs. 68%, respectively). Compared to H. pylori-negative children, H. pylori-positive children had lower postprandial predominant power (8.18+/-22.36 dB and 32.20+/-24.18 dB, respectively; p<0.01) and a lower power ratio (deltaP; delta1.28+/-6.18 vs. +.62+/-5.93, respectively; p<0.01). CONCLUSION: It was suggested that the gastric myoelectrical activity in children with chronic gastritis can be influenced by H. pylori infection. Thus, this study indicates that H. pylori infection may be predictable in children with functional dyspepsia through analyzing the EGG parameters, and treatment may be considered in H. pylori-positive children with impaired gastric activity, especially in the lower prevalence area.
Adolescent ; Biopsy ; Breath Tests ; Child ; Dyspepsia ; Endoscopy, Gastrointestinal ; Gastritis ; Gastrointestinal Diseases ; Helicobacter ; Helicobacter pylori ; Humans ; Ovum ; Prevalence ; Urea ; Urease

OBJECTIVES: The purpose of this study was to examine daytime sleepiness-related factors, including sleeping patterns and daytime activities, in shift and non-shift workers. METHODS: One hundred and twenty two shift workers, and two hundred and fifty four non-shift workers, were selected and identified in terms of their general characteristics, such as age, tenure, educational level, marital status and religion. Screening questionnaires were composed of the Epworth Sleepiness Scale (ESS) for evaluation of daytime sleepiness, the Multidimensional Fatigue Scale (MFS) for fatigue, and the Korean version of the National Institute for Occupational Safety and Health (NIOSH) for sleeping patterns. RESULTS: The shift worker group reported significantly higher rates of sleep disturbance and higher fatigue scores compared with the non-shift workers (all p<0.01). The prevalence of daytime sleepiness was higher in the shift workers (19.7%) than the non-shift workers (10.6%) (p<0.05). The significant daytime sleepiness-related factors were found to be shift work, tenure and difficulties in falling back to sleep once woken (p<0.05). Shift work was proved to be an important factor in workers aged less than 40 years (p<0.05). However, this association was not evident in workers aged 40 years and over. CONCLUSIONS: The shift workers showed a significantly higher prevalence of daytime sleepiness compared with the non-shift workers. The present study suggests a need for the implementation of sleeping and fatigue management programs for shift workers in order to improve working efficiency and control safety accidents during shift work.
Adult* ; Fatigue* ; Humans ; Male* ; Marital Status ; Mass Screening ; National Institute for Occupational Safety and Health (U.S.) ; Prevalence ; Questionnaires

PURPOSE: The purpose of this study is to evaluate the psychometric properties of the Korean version of the King's Health Questionnaire(KHQ) in patients with stress urinary incontinence. MATERIALS AND METHODS: Multicenter prospective study was undertaken in 106 patients with stress urinary incontince. Psychometric properties including discriminant validity, convergent validity were evaluated and the Cronbach's alpha coefficients were calculated. Test-retest analysis was performed and the sensitivity to clinical change before and after treatment was also evaluated. RESULTS: The psychometric properties and clinical validity of the KHQ Korean version were confirmed in 106 study population. The KHQ's good reliability was evidenced by Cronbach's alpha coefficients of>0.60, indicating to change in patients' perception of bladder condition in all domains. CONCLUSION: Our analyses confirm excellent psychometric properties for the Korean version of KHQ, which appears to provide a valid and reliable instrument for clinical usages in Korea.
Female ; Humans ; Korea ; Prospective Studies ; Psychometrics* ; Surveys and Questionnaires* ; Translations ; Urinary Bladder ; Urinary Incontinence* ; Urination

Passive smoking is a major cause of respiratory morbidity, and is associated with increased bronchial responsiveness in children. To evaluate the effect of smoking by a parent on asthma symptoms, atopy, and airway hyperresponsiveness (AHR), we conducted a cross-sectional survey of 503 schoolchildren that involved questionnaires, spirometry, allergy testing, and a bronchial challenge test. If the PC20 methacholine was less than 16 mg/mL, the subject was considered to have AHR. The prevalence of a parent who smoked was 68.7%. The prevalence of AHR was 45.0%. The sensitization rate to common inhalant allergens was 32.6%. Nasal symptoms such as rhinorrhea, sneezing, nasal itching, and nasal obstruction were present in 42.7%. Asthma symptoms such as cough and wheezing were present in 55.4%. The asthma symptoms were significantly more prevalent in children who had a parent who smoked than in those whose parents did not. The nasal symptoms, atopy, and AHR did not differ according to whether a parent smoked. In a multiple logistic regression model, the asthma symptoms and atopy were independently associated with AHR, when adjusted for confounding variables. Passive smoking contributed to asthma symptoms in schoolchildren and was not an independent risk factor of airway hyperresponsiveness in an epidemiological survey.
Adult ; Asthma/*epidemiology/physiopathology ; Bronchial Hyperreactivity/*epidemiology/physiopathology ; Child ; Data Collection ; Female ; Human ; Hypersensitivity/*epidemiology/physiopathology ; Male ; Parents ; Prevalence ; Risk Factors ; Support, Non-U.S. Gov't ; Tobacco Smoke Pollution/*adverse effects/*statistics & numerical data

BACKGROUND: It has been reported that the association between blood pressure and cognitive impairment could be modified by factors such as gender, education, and Apo E genotypes. This study was aimed to investigate whether `age' could also be a modifier of the association. METHODS: The study group consisted of 489 participants aged 65 years or over who lived in Namwon, Korea. The presence of hypertension was ascertained by the measurement of their resting blood pressure. A cognitive impairment was considered to be present when a Korean Mini-Mental State Examination score was less than 19 (30th percentile). RESULTS: A higher systolic blood pressure was significantly associated with cognitive impairment, after an adjustment for age, gender, education, and occupation. However, the significance was lost in subjects aged 71 or over. CONCLUSIONS: High systolic blood pressure is a factor strongly associated with cognitive impairment in an aged population. However, in the subjects with far advanced age, the association is not significant. Further studies are required to elucidate whether blood pressure lowering strategies should be differentiated according to age in order to reduce cognitive impairment.
Adult* ; Aged* ; Apolipoproteins E ; Blood Pressure* ; Education ; Genotype ; Humans ; Hypertension ; Jeollabuk-do ; Korea ; Occupations

PURPOSE: The purpose of our study was to evaluate the outcome of intensified induction therapy using the Vanderbilt regimen in patients with a poor prognosis non-Hodgkin's lymphoma (NHL). MATERIALS AND METHODS: We retrospectively analyzed the results of two pilot studies, which enrolled the patients aged 60 years or less, with a previously untreated NHL of intermediate grade on the Working formulation, having 2 or 3 adverse prognostic factors on the age- adjusted International Prognostic Index. Patients received an intensified induction, with the regimen described by the Vanderbilt group. RESULTS: Thirty-five patients were analyzed. After induction, 29 patients (83%) achieved more than partial response (PR): 22 (63%) complete response (CR) and 7 (20%) PR. Three of the PRs were subsequently converted to CR following consolidation therapy. The overall CR rate, following the completion of treatment, was 71%. The 3-year overall survival (OS) rate of all patients was 53%. In the univariate analysis, age (50 years) was the only factor affecting the OS. The 3-year disease-free survival (DFS) rate of patients with CR was 68%. In the univariate analysis, age and bone marrow involvement were the factors affecting the DFS. Two patients died from the treatment-related toxicity of the induction therapy: one due to sepsis and the other due to congestive heart failure. CONCLUSION: Although the CR rate was relatively high, the OS or DFS of patients with a poor prognosis NHL, who had received the intensified induction using the Vanderbilt regimen, were no different from those that had received the conventional chemotherapy, as reported by the International Prognostic Index Project. However, the OS or DFS in the young patient groups were encouraging. To test the hypothesized benefits of our approach in the young patient groups, a larger cohort of patients aged 50 years or less should be studied.
Bone Marrow ; Cohort Studies ; Disease-Free Survival ; Drug Therapy ; Heart Failure ; Humans ; Lymphoma, Non-Hodgkin* ; Pilot Projects ; Prognosis ; Retrospective Studies ; Sepsis

Extraskeletal Ewing's sarcomas (EES) are rare. Recently, Ewing's sarcoma of the bone, primitive neuroectodermal tumor (PNET), Askin tumor and EES have been included into the family of Ewing's tumors, due to the overlapping features relating to their clinico-pathological and cytogenetic appearance. We experienced a case of an EES arising from the duodenum in a 14-year-old girl who presented with hematemesis and epigastric discomfort. A duodenal biopsy specimen revealed the infiltration of small round cells and rich vasculatures, with immunohistochemical finding of MIC-2 (CD99) (+), vimentin (+), CD56 (NCAM) (+), LCA (-), T-cell (-), B-cell (-), CD43 (-) and CD68 (-). She was treated with several cycles of multiagent chemotherapy, and achieved an initial partial response, but rapid progression of tumor followed, so she was treated with surgical excision. This is the first case report of an EES arising from the duodenum in the literature.
Adolescent ; B-Lymphocytes ; Biopsy ; Cytogenetics ; Drug Therapy ; Duodenum* ; Female ; Hematemesis ; Humans ; Neuroectodermal Tumors, Primitive ; Sarcoma ; Sarcoma, Ewing* ; T-Lymphocytes ; Vimentin

BACKGROUND: In Korea, the proportion and absolute number of old people are increasing very rapidly. And the concern about the quality-of-life of elderly is to increase more and more among health care workers. The quality-of-life of elderly is affected by chronic medical conditions in some part. The purpose of this study is to evaluate the association between eight chronic medical conditions and health-related quality of life among the community-based elderly. METHODS: Target areas were 22 dongs in Dong-gu,Kwangju and 2 dongs in Buk-gu. Six hundreds subjects were randomly sampled from target ares. Interview survey was performed for chronic medical conditions by check list and health-related quality of life by COOP chart. Actual subjects were 568 elderlies. RESULTS: The results are followed ; 1) Compared with other domains of health-related quality of life, overall health was the most associated with chronic medical conditions, and social activity the least associated. 2) Stroke were significantly associated with every domain. And also back problems/joint problems were except the domain of social activity. Compared with other disease, stroke was the most associated with health-related quality of life except the domain of pain. 3) Migraine/chronic headache, gastroduodenal problems, and heart conditions were significantly associated with overall health, bodily pain, and one or two domains. 4) Hypertension and diabetes mellitus were signi ficantly associated with only one domain; overall health 5) Asthma and chronic bronchitis was not associated with any domains. CONCLUSION: Generally, health-related quality of life was highly associated with mobility limiting diseases such as back problems/joint problems stroke. And also moderately associated with pain relation disease such ans migraine/chronic headache, gastroduodenal problems, and heart condition.
Aged ; Asthma ; Bronchitis, Chronic ; Chronic Disease* ; Delivery of Health Care ; Diabetes Mellitus ; Headache ; Heart ; Humans ; Hypertension ; Korea ; Quality of Life* ; Stroke