The relationship between stroke and quality of life in Korean adults: based on the 2010 Korean community health survey

[Purpose] The purpose of this study was to investigate the status of stroke in the Republic of Korea and its relationship with QOL based on standardized data. [Subjects and Methods] This study utilized raw data from the 2010 KCHS. In total, 229,229 individuals participated in the 2010 survey. The final analysis identified 4,604 individuals who had been diagnosed by a doctor with stroke. To identify the correlation between the aftereffect-related characteristics of stroke patients and QOL, a multiple linear regression analysis was performed. [Results] Participants experiencing aftereffects had a statistically significantly lower QOL than participants who had not experienced aftereffects. Regarding the types of aftereffects, participants experiencing palsy in the arms and legs, facial palsy, communication disabilities, swallowing or eating disabilities, and visual disabilities had a statistically significantly lower QOL than participants without aftereffects. The QOL of participants with one, two, three, four, or five aftereffects was statistically significantly less than that of participants without aftereffects [Conclusion] Stroke directly influences QOL and the number of types of aftereffects experienced by patients. Therefore, it is highly important that physical therapists seek to end the occurrence of one or more types of aftereffects in stroke patients.Key words: Stroke, Quality of life, Korean community healthy survey     

Evaluation of microvascular bone graft reconstruction of the head and neck with 3-D Tc-DPD SPECT scans

Objective: We conducted a prospective investigation to evaluate the diagnostic accuracy of computer-aided 3-dimensional (3-D) technetium 99m dicarboxypropane methylene diphosphonate (^99mTc-DPD) single photon emission computed tomography (SPECT) reconstruction in the evaluation of microvascular bone flaps used for maxillofacial reconstruction. Study Design: Twenty patients who received 20 autogenous microvascular bone flaps for reconstruction of the mandible and maxilla were evaluated. Forty bone scans with subsequent computer-aided reconstruction were performed. Each graft could be assessed within 48 to 72 hours after surgery. The second bone scan was performed between 12 and 14 days after surgery. Results: Complications were observed in 5 grafts. SPECT investigation performed at the 2 time points after reconstruction showed a significantly higher tracer uptake in grafts with an uncomplicated further course than in those that developed complications. Conclusions: Computer-aided 3D ^99mTc-DPD SPECT reconstruction serves as a useful prognostic tool and helps in the very early recognition of complications. This technique adds significantly to the value of planar bone scintigraphy and conventional SPECT images. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;90:679-85)     

Effect of non‐steroidal anti‐inflammatory drugs on non‐melanoma skin cancer incidence in the SKICAP‐AK trial

Recent studies link the prostaglandin metabolic pathway to skin carcinogenesis expanding possibilities that cyclooxygenase (COX) inhibitors may be utilized in non‐melanoma skin cancer (NMSC) chemoprevention. Using data from a study of the efficacy of retinol supplementation on incidence of NMSC, we sought to determine the role of non‐steroidal anti‐inflammatory drugs (NSAIDs) in NMSC development. Cox proportional hazards models describe the relationship between NSAID use and time to first squamous cell carcinoma (SCC) or basal cell carcinoma (BCC) among participants categorized by use pattern: continuous users (use for length of study duration), new users (use for less than study duration), and non‐users. For SCC and BCC, there was a statistically significant protective effect for participants who reported use for less than the study duration (HR = 0.49, 95%CI 0.28–0.87 and HR = 0.43, 95%CI 0.25–0.73, respectively). Categorical examination of NSAIDs (aspirin (ASA) vs. non‐ASA NSAIDs) showed significant effects for BCC among those using non‐ASA NSAIDs for less than the study duration (HR = 0.33, 95%CI 0.13–0.80). For SCC and BCC, NSAID use of shorter duration and potentially more recent, was more protective than longer duration of use. These results are counter to the idea that longer duration of NSAID use is more protective. Additional investigations are needed into the role NSAIDs play in the chemoprevention of NMSC. Copyright © 2009 John Wiley & Sons, Ltd.     

Transforming growth factor-β in breast milk: A potential regulator of atopic disease at an early age

Background: According to data from animal and in vitro studies, transforming growth factor-β (TGF-β) has a crucial effect on 2 essential parts of the mucosal immune system: IgA production and oral tolerance induction. Objective: We sought to ascertain whether TGF-β in breast milk is associated with specific IgA production and atopic disease in human subjects. Methods: Forty-seven infants with several atopic family members were followed during their first year of life. The concentrations of TGF-β1 and TGF-β2 in maternal colostrum, mature milk, and the infants’ sera were determined. The enzyme-linked immunospot assay was used to assess the infants’ specific IgA production in response to β-lactoglobulin, casein, gliadin, and ovalbumin. Results: At 12 months, atopic dermatitis was confirmed in 29 of 47 infants; in 11, atopic disease had begun during exclusive breast-feeding (preweaning onset), whereas in 18 the disease manifested itself after weaning (postweaning onset). The concentrations of both TGF-β1 and TGF-β2 were higher in maternal colostrum, but not in mature milk and infants’ serum, in infants with postweaning-onset atopic disease compared with those with preweaning-onset disease (P = .0008 and P = .015, respectively). The concentration of TGF-β2 was, and that of TGF-β1 tended to be, higher in the colostrum of mothers whose infants had specific IgA-secreting cells at 3 months in response to at least one of the dietary antigens tested compared with those who did not have such cells (P = .048 and P = .076, respectively). Conclusion: TGF-β in colostrum may prevent the development of atopic disease during exclusive breast-feeding and promote specific IgA production in human subjects. (J Allergy Clin Immunol 1999;1251-7.)     

Identification and cloning of a complementary DNA encoding a vicilin-like proprotein, Jug r 2, from English walnut kernel (Juglans regia), a major food allergen

Background: Walnuts and other tree nuts are important food-allergen sources that have the potential to be associated with life-threatening, IgE-mediated systemic reactions in some individuals. Objective: The purpose of this study was to characterize a complementary (c)DNA clone encoding one of the walnut food allergens. Methods: A cDNA expression library prepared from walnut somatic embryo was screened for IgE reactivity with patient serum. A reactive clone of 2060 bp, which encoded a protein of 593 amino acids in length, was subcloned by excision into the pGEX expression vector. IgE-binding inhibition experiments were performed.Results: A recombinant fusion protein was induced and shown to bind serum IgE from 9 of 15 patients tested, thus identifying a major allergen. This clone, named Jug r 2, exhibited significant homology with genes encoding the vicilin group of seed proteins. An IgE-binding inhibition experiment suggested that the encoded protein undergoes posttranslational modification into at least one major polypeptide (47 kd) and possibly several others, which is similar to the vicilin-like proteins characterized in cocoa bean (Theobroma cacao) and cottonseed (Gossypium hirsutum ). N-terminal sequencing of the 47-kd band, Jug r 2, identified it as a mature protein obtained from the precursor. A second IgE-binding inhibition experiment showed that there is minimal or no cross-reactivity between Jug r 2 and pea vicilin, peanut proteins, or cacao proteins. Conclusion: Jug r 2 is the third vicilin food allergen identified in addition to vicilins from soy and peanut. The availability of recombinant food allergens should help advance studies on the immunopathogenesis and possible treatment of IgE-mediated food hypersensitivity. (J Allergy Clin Immunol 1999;1311-20.)     

Allergy to the heat-labile proteins α-lactalbumin and β-lactoglobulin in mare’s milk

BACKGROUND: Allergy to mare’s milk is rare. Recently, however, mare’s milk has been recommended for treatment of various ailments by practitioners of “alternative medicine,” and it is available in health food stores. OBJECTIVE: We report a case of allergic reaction to mare’s milk in a 51-year-old woman who was able to tolerate cow’s milk. METHODS: The protein composition of mare’s milk was determined by methods based on measurement of nitrogen content. The patient underwent prick and intracutaneous tests with commercially available bovine milk proteins and several mare’s milk preparations, including mare’s milk granulate and boiled mare’s milk. RAST and immunoblotting were also performed. RESULTS: Results of skin testing and RAST with cow’s milk were negative but demonstrated an IgE-mediated allergy to mare’s milk. Immunoblotting revealed two allergen bands with molecular weights of 16 and 18 kd, most likely representing the whey proteins α-lactalbumin and β-lactoglobulin. The bands disappeared after the mare’s milk was boiled, indicating that the proteins are heat-labile. CONCLUSION: The results of this study demonstrate the existence of an IgE-mediated mare’s milk allergy caused by low molecular weight heat-labile proteins, most likely α-lactalbumin and β-lactoglobulin, which do not cross-react with the corresponding whey proteins in cow’s milk. (J ALLERGY CLIN IMMUNOL 1996;97:1304-7.)