BACKGROUND: Ceramides are the main lipid component of the stratum corneum and are a structurally heterogeneous and complex group of sphingolipids of which sphingoid bases are the basic structural constituents. Altered levels of sphingoid bases have been reported in skin conditions that involve dryness and barrier disruption, including atopic dermatitis. OBJECTIVE: The purpose of this study was to investigate the altered levels of sphingoid bases in psoriatic epidermis and their relationship with the clinical severity of the psoriasis. METHODS: Samples from the lesional and non-lesional epidermis were obtained from eight psoriasis patients. Levels of sphingosine and sphinganine were analyzed by high-performance liquid chromatography. The expression of ceramide synthase and ceramidase proteins, which are related to sphingosine and sphinganine metabolism, were measured using Western blot analysis. RESULTS: Levels of sphingosine and sphinganine in the lesional epidermis were significantly higher than those in the non-lesional epidermis. Although there was no altered ceramide synthase and ceramidase, there was a highly significant positive correlation between the % change of ceramidase, the degradative enzyme of ceramide into sphingosine, and the Psoriasis Area Severity Index (PASI) score. CONCLUSION: The levels of sphingosine and sphinganine were significantly increased in psoriatic epidermis and the % change of ceramidase was positively correlated with the clinical severity of psoriasis.
Blotting, Western ; Ceramidases ; Ceramides ; Chromatography, Liquid ; Epidermis ; Humans ; Oxidoreductases ; Proteins ; Psoriasis ; Skin ; Sphingolipids ; Sphingosine

BACKGROUND: Ceramides are the main lipid component of the stratum corneum and are a structurally heterogeneous and complex group of sphingolipids of which sphingoid bases are the basic structural constituents. Altered levels of sphingoid bases have been reported in skin conditions that involve dryness and barrier disruption, including atopic dermatitis. OBJECTIVE: The purpose of this study was to investigate the altered levels of sphingoid bases in psoriatic epidermis and their relationship with the clinical severity of the psoriasis. METHODS: Samples from the lesional and non-lesional epidermis were obtained from eight psoriasis patients. Levels of sphingosine and sphinganine were analyzed by high-performance liquid chromatography. The expression of ceramide synthase and ceramidase proteins, which are related to sphingosine and sphinganine metabolism, were measured using Western blot analysis. RESULTS: Levels of sphingosine and sphinganine in the lesional epidermis were significantly higher than those in the non-lesional epidermis. Although there was no altered ceramide synthase and ceramidase, there was a highly significant positive correlation between the % change of ceramidase, the degradative enzyme of ceramide into sphingosine, and the Psoriasis Area Severity Index (PASI) score. CONCLUSION: The levels of sphingosine and sphinganine were significantly increased in psoriatic epidermis and the % change of ceramidase was positively correlated with the clinical severity of psoriasis.
Blotting, Western ; Ceramidases ; Ceramides ; Chromatography, Liquid ; Epidermis ; Humans ; Oxidoreductases ; Proteins ; Psoriasis ; Skin ; Sphingolipids ; Sphingosine

BACKGROUND: Intracranial germ cell tumors are higher in the East Asia such as Korea and Japan than any other Western countries. By analyzing common clinical features of intracranial germ cell tumors in children, we will prevent from misdiagnosing and delaying in the establishment of diagnosis. Furthermore, we can choose appropriate therapeutic plans to improve patient's prognosis.METHODS: We retrospectively reviewed the medical records of 68 patients to investigate and analyze clinical characteristics of intracranial germ cell tumors in children.RESULTS: The average age of 68 patients was 14.8 years old, and the male to female ratio in all patients was 3:1. The most common symptom presented by 30 patients was headache regarded as a nonspecific symptom in brain tumors. Sixty four patients were diagnosed by histologic method called biopsy and most of them were come out into germinoma. Thirty five patients were included in low-risk group and 30 patients were in high-risk group. Intracranial germ cell tumors in this study were most commonly located in the pineal gland.CONCLUSION: There are a variety of types in intracranial germ cell tumors, and they have been accurately diagnosed by radiologic, histologic methods and elevated tumor markers. We concluded that it is necessary for early diagnosis to evaluate exhaustively in patients suspected of brain tumors.
Biopsy ; Brain Neoplasms ; Child ; Early Diagnosis ; Far East ; Female ; Germ Cells ; Germinoma ; Headache ; Humans ; Japan ; Korea ; Male ; Medical Records ; Neoplasms, Germ Cell and Embryonal ; Retrospective Studies ; Biomarkers, Tumor

OBJECTIVES: This cross-sectional study was performed to examine if the serum gamma-glutamyltransferase (GGT) level that is within its normal range is associated with the risk of type 2 diabetes and if the association between the waist hip ratio (WHR) and type 2 diabetes is different depending on the serum GGT levels. METHODS: The study subjects were 23,436 persons aged 40 years or older and who participated in regular health check-ups at 11 hospitals (males: 5,821, females: 17,615). The gender-specific quintiles of the serum GGT and WHR were used to examine the associations with type 2 diabetes. RESULTS: The serum GGT levels within their normal range were positively associated with type 2 diabetes only in women. The adjusted odds ratios (ORs) were 1.0, 1.0, 1.4, 2.1, and 2.5 according to the quintiles of the serum GGT (p(trend)<0.01). The WHR was more strongly associated with the prevalence of diabetes among the women with a high-normal serum GGT level as compared with those with a low-normal serum GGT level (p for interaction=0.02). For example, the adjusted ORs for women with a low normal serum GGT level were 1.0, 1.2, 1.5, 2.2, and 2.4 according to the quintiles of the WHR, while those figures were 1.0, 2.4, 3.6, 5.0, and 8.3 among the women with a high normal serum GGT level. However, in men, the serum GGT was very weakly associated with type 2 diabetes and the association between the WHR and type 2 diabetes was not different depending on the serum GGT level. CONCLUSIONS: Serum GGT within its normal range was positively associated with type 2 diabetes, and central obesity was more strongly associated with the prevalence of type 2 diabetes when the serum GGT level was high-normal. However, these associations were observed only in women, which is different from the previous findings. The stronger relation between central obesity and type 2 diabetes among women with a high-normal serum GGT level can be useful for selecting a group that is at high risk for type 2 diabetes irregardless of whatever the underlying mechanism is.
Blood Glucose ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/blood/enzymology/*epidemiology ; Epidemiologic Studies ; Female ; Humans ; Male ; Middle Aged ; Obesity, Abdominal/*epidemiology ; Odds Ratio ; Prevalence ; Republic of Korea/epidemiology ; *Waist-Hip Ratio ; gamma-Glutamyltransferase/*blood

BACKGROUND: The role of Helicobacter pylori (H. pylori) in the pathogenesis of coronary artery disease (CAD) is still controversial, and the relation between current H. pylori infection and CAD has not been fully examined. This study evaluated the relation between H. pylori infection as confirmed by gastroduodenoscopic biopsy and CAD. METHODS: We determined the presence of H. pylori infections, via gastroduodenoscopy, in 88 patients of the normal coronary angiographic group and also in 175 patients of the CAD group, and the latter patients had more than 50% coronary stenosis angiographically demonstrated. We excluded those patients with a history of previous H. pylori eradication and/or malignancy. A small piece of tissue from the antrum, which was obtained by gastroduodenoscopic biopsy, was stained by Warthin-starry silver stain. We defined a negative staining result that there was no stained tissue in the sample and the stained tissue was also positive for H. pylori infection. RESULTS: There was no significant difference, except for gender, age, smoking and high density lipoprotein cholesterol (HDL-c), of the demographic and laboratory characteristics between the groups. Twenty seven (30.7%) patients of the normal control group and 71 (40.6%) patients of the CAD group were positive of H. pylori infection, yet there was no statistical difference. We angiographically followed up the 80 patients of the CAD group who were treated by percutaneous coronary intervention (PCI) at 6 to 9 months after their primary intervention. Twenty two (37.9%) of the 58 patients of the H. pylori negative group and 10 (45.5%) of the 22 patients of the H. pylori positive group were treated with reintervention, but reintervention was also not significantly different between the group with H. pylori infection and the group without the infection. CONCLUSIONS: These data indicated that H. pylori infection had a modest influence on CAD and progressive atheroma, but the showed a tendency to increase. Further studies are needed to evaluate the relationship between H. pylori infection and CAD.
Aged ; Angioplasty, Transluminal, Percutaneous Coronary ; Biopsy ; Case-Control Studies ; Coronary Angiography ; Coronary Artery Disease/*microbiology/radiography/therapy ; Duodenoscopy ; Female ; Gastroscopy ; Helicobacter Infections/complications/*microbiology/pathology ; Helicobacter pylori/*isolation & purification ; Humans ; Male ; Middle Aged ; Pyloric Antrum/pathology ; Time Factors

A 59-year-old woman was scheduled for mitral valvuloplasty and Maze operation. As operation was planed to use the robotically controlled camera (Aesop 3000, Computermotion(r), USA) for the minimally invasive robot-assisted thoracotomy, a superior vena cava (SVC) cannula (Femoral arterial cannula [21 Fr], Medtronic(r), USA) was inserted in the right internal jugular vein. After insertion of the SVC cannula, a pulmonary artery (PA) catheter (Swan-Ganz CCOmbo V [7.5 Fr], Edwards(r), USA) was inserted through an advanced venous access device (AVA 3Xi [8.5 Fr], Edwards(r), USA) in the right subclavian vein. The tip of the PA catheter could not be advanced into SVC and blood was not regurgitated. In the chest AP X-ray, it was found that the advanced venous access device was kinked by the SVC cannula. So the advanced venous access device was withdrawn about 5 cm and the PA catheter was advanced easily to the destination.
Catheters* ; Female ; Humans ; Jugular Veins ; Middle Aged ; Pulmonary Artery* ; Subclavian Vein ; Thoracic Surgery* ; Thoracotomy ; Thorax ; Vena Cava, Superior*

PURPOSE: It is very important to compare the particle size and total output from inhalation devices for standardization of bronchial provocation test. METHODS: Total output (mass output, salt output) from 4 nebulizer/compressor combination (LC plus/Pari-boy, Long life/Pari-boy, Pulmoaid/Pulmoaid, DeVilbiss/DeVilbiss) which were charged with 2 mL of 0.9% normal saline was measured. Aerosol particle size was measured directly using laser diffraction by Marvern Master Sizer and by evaluating Mass median aerodynamic diameter (MMAD). RESULTS: The LC plus nebulizer had the highest output rate and delivered the largest particles. The Maximal output rates of the 3 nebulizer/compressor combination was half that LC plus /Pari-boy combination. CONCLUSION: The results suggest that it might be different in mass output and particle size by inhalation devices. These differences can influence to the results of bronchial provocation test such as FEV1. We emphasizes that it is necessary to standardize the total output and particle size from each inhalation devices to perform and interpretate the results of bronchial provocation test.
Bronchial Provocation Tests* ; Inhalation* ; Nebulizers and Vaporizers* ; Particle Size*

OBJECTIVE: To discover the etiology of birth defects and low birth weight, it is necessary to establish epidemiological birth defects monitoring system in Korea. Our aim was to develop new practical model in Incheon to establish birth defects monitoring system to evaluate the incidence rate and patterns of birth defects in Korea. METHODS: Public health center and private hospitals and clinics participated in this monitoring system. Web based reporting system have been built. Trained nurses actively collected the records obtained from delivery units in the participating hospitals during 2 years (first year: December 1st, 1998-November. 31, 1999; second year: January 1 st, 2000-December 31 th, 2000). RESULTS: Through this monitoring system at 1 st year and 2 nd year, we observed 25 birth defect cases from 2482 births, 28 birth defect cases from 3490 births including live births and stillbirths. The incidence of birth defect per thousand person was 10.1, 8.0 respectively. At 1st year, the highest proportion of birth defects was 28.0% in musculoskeletal system. The proportion of birth defects in gastrointestinal system, cardiovascular system and cleft lip & cleft palate were 20.0%, 12.0%. 12.0%. At 2 nd year, the highest proportion of birth defects was 21.4% in gastrointestinal system The proportion of birth defects in cardiovascular system and musculoskeletal system were 17.9% and 14.3%. CONCLUION: In conclusion, we could build population-based monitoring system for birth defects successfully in Yonsu gu, Incheon. To establish population-based monitoring system for birth defects in Korea, it is necessary to organize the reporters of public health center and private hospitals and clinics, to build an available reporting system, and to extend participating centers for birth defects monitoring systems.
Cardiovascular System ; Cleft Lip ; Cleft Palate ; Congenital Abnormalities* ; Environmental Exposure ; Hospitals, Private ; Humans ; Incheon* ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Live Birth ; Musculoskeletal System ; Parturition* ; Public Health ; Stillbirth

OBJECTIVE: To define whether lactase-deficient subjects are intolerable to even a pack of milk(200ml) and whether milk intolerance in the patients with IBD is only due to lactose malabsorption, we performed this study. METHODS: We evaluated 32 healthy adults and 12 patients with active stage of inflammatory bowel disease(IBD) who had not received antibiotics therapy within the previous 3 weeks. Thirty-two healthy adults underwent H2-breath test with 200, 400, 600 and 800ml of milk at 1st, 2nd, 3rd and 4th day of study, respectively. We measured their end-expiratory hydrogen concentrations and asked them to record the gastrointestinal symptoms. Twelve patients with IBD were tested only with 200ml of milk. Lactose malabsorption was defined as the increase of 20ppm over basal H2 concentration and lactose intolerance as having two or more of the following symptoms; abdominal pain, diarrhea, borborygmus and flatus. RESULTS: The prevalence of lactase deficiency was 72%(23 of 32 subjects) at 800ml of milk(lactose 40g). Among the lactase-deficient subjects, lactose intolerance at 200ml of milk(lactose 10g) was noticed only in 13%(3 of 23 subjects). In the patients with active stage of IBD, the frequency of milk intolerance at 200ml of milk was 50%(6 of 12 subjects), which was higher than in the healthy adults(9%). But the prevalence of lactose malabsorber in the patients with IBD at 200ml of milk(17%) was not higher than in the healthy adults(16%). CONCLUSION: Most of lactase-deficient subjects(87%) can ingest one pack of milk without lactose intolerance. The increased prevalence of lactose intolerance in the patients with IBD at 200ml of milk is not originated from lactose malabsorption, but probably from incomplete colonic compensation salvage.
Abdominal Pain ; Adult ; Anti-Bacterial Agents ; Colon ; Compensation and Redress ; Diarrhea ; Drinking* ; Flatulence ; Humans ; Hydrogen ; Inflammatory Bowel Diseases* ; Lactase* ; Lactose Intolerance* ; Lactose* ; Milk* ; Prevalence

It would be possible to manage the intestinal anastomotic failure with intraluminal stenting, but its reports are very rare. We experienced a effective and dramatic improvement of esophago-jejunal anastomotic leak in a esophageal and gastric double cancer patient with intraluminal stenting. The intraluminal stenting was tried at the 28th postoperative day and the anastomotic leak and inflammatory signs were disappeared about 3 weeks later. Postoperative 11th months now, the stent was moved about 1 cm downward but not changed further, and he enjoys regular diet without any problems. And we think the stenting would be helful with some limitations in the intestinal anastomotic leak patient.
Anastomotic Leak ; Diet ; Esophageal Neoplasms ; Fistula ; Humans ; Stents*