Clinical predictors of polyps recurring in patients with chronic rhinosinusitis and nasal polyps: a systematic review and meta-analysis.

BACKGROUND: Identification of perioperative risk factors for recurrent nasal polyps (RNPs) is important for selection of further treatment and determination of appropriate follow-up period. However, the relative prognostic significance of these risk factors has not been investigated. METHODOLOGY: We compared the nasal symptoms, endoscopic polyp and Lund-Mackey computed tomography scores, and the laboratory and pathological findings of RNP and non-RNP patients. The risk of bias was assessed using the Newcastle-Ottawa scale. RESULTS: Patients with poor nasal symptom scores and olfactory dysfunctions and high Lund-Mackey computed tomography scores were at higher risk of postoperative RNPs, as were those with allergic conditions and elevated tissue and serum eosinophil levels. The tissue neutrophil counts/percentages were significantly lower in the RNP than the other group. The tissue eosinophil level was of higher diagnostic utility than the serum eosinophil level. The RNP diagnostic odds ratio afforded by the tissue eosinophil count or percentage was 54.1247. The area under the receiver operating characteristic curve was 0.936. The sensitivity and specificity were 0.8809 and 0.8834, respectively. CONCLUSION: The tissue eosinophil level reliably predicts RNP after endoscopic sinus surgery.

Histone deacetylase inhibition has cardiac and vascular protective effects in rats with pressure overload cardiac hypertrophy.

Histone deacetylase (HDAC) inhibitors have shown beneficial effects in animal models of cardiovascular diseases. We hypothesized that HDAC inhibitor, sodium valproate (VPA), has cardiac and vascular protective effects in rats with pressure overload cardiac hypertrophy induced by transverse aortic constriction (TAC). Sections of the heart were visualized after hematoxylin and eosin staining, picrosirius red staining and immunohistochemistry. The expression of genes related to cardiac hypertrophy, fibrosis, and oxidative stress was determined by quantitative real-time polymerase chain reaction. The aortic ring tension analysis was conducted using both the ascending aorta and descending thoracic aorta. TAC increased the expression of hypertrophic, fibrotic, and oxidative stress genes, which was attenuated by VPA. In the ascending aorta with intact endothelium, there was a significant decrease in the relaxation response, which was recovered by VPA treatment. These results indicate that VPA has cardiac and vascular protective effects in rats with pressure overload cardiac hypertrophy.

Bacterial strain changes during chronic otitis media surgery.

OBJECTIVE: Cultures obtained from pre-operative middle-ear swabs from patients with chronic otitis media have traditionally been used to guide antibiotic selection. This study investigated changes in the bacterial strains of the middle ear during chronic otitis media surgery. METHODS: Pre-operative bacterial cultures of otorrhoea, and peri-operative cultures of the granulation tissue in either the middle ear or mastoid cavity, were obtained. Post-operative cultures were selectively obtained when otorrhoea developed after surgery. RESULTS: Bacterial growth was observed in 45.5 per cent of pre-operative cultures, 13.5 per cent of peri-operative cultures and 4.5 per cent of post-operative cultures. Methicillin-resistant Staphylococcus aureus was identified as the most common bacteria in all pre-operative (32.4 per cent), peri-operative (52.4 per cent) and post-operative (71.4 per cent) tests, and the percentage of Methicillin-resistant S aureus increased from the pre- to the post-operative period. CONCLUSION: The bacterial culture results for post-operative otorrhoea showed low agreement with those for pre-operative or peri-operative culture, and strain re-identification was required.

Sixteen novel mutations in PNPLA1 in patients with autosomal recessive congenital ichthyosis reveal the importance of an extended patatin domain in PNPLA1 that is essential for proper human skin barrier function.

BACKGROUND: Autosomal recessive congenital ichthyosis (ARCI) is a genetically heterogeneous group of rare Mendelian skin disorders characterized by cornification and differentiation defects of keratinocytes. Mutations in nine genes including PNPLA1 are known to cause nonsyndromic forms of ARCI. To date, only 10 distinct pathogenic mutations in PNPLA1 have been reported. OBJECTIVES: To identify new causative PNPLA1 mutations. METHODS: We screened genetically unresolved cases, including our ARCI collection, comprising more than 700 families. Screening for mutations was performed either by direct Sanger sequencing or in combination with a multigene panel, followed by sequence and mutation analysis. RESULTS: Here we report on 16 novel mutations present in patients from 17 families. While all previously reported mutations and most of our novel mutations are located within the core patatin domain, we report five novel PNPLA1 mutations that are downstream of this domain. Thus, as recently described for PNPLA2, we hypothesize that a region larger than the core domain is required for full enzymatic activity of PNPLA1 in human skin barrier formation. CONCLUSIONS: We estimate the frequency of PNPLA1 mutations among patients with ARCI to be around 3%. Most of our patients were born as collodion babies and showed a relatively mild ichthyosis phenotype. In four unrelated patients we observed a cyclic scaling course, which seems to be a potential phenotypic variation in a small percentage of patients with PNPLA1 mutations. The variability of the clinical manifestations and the lack of typical clinical features are specific for patients with PNPLA1 mutations, and emphasize the importance of DNA sequencing for differential diagnosis of ARCIs.

Bunch-by-bunch position measurement and analysis at PLS-II.

A bunch-by-bunch measurement system has been developed at Pohang Light Source II. The system consists of a four-channel button pick-up, 20 GHz sampling oscilloscope and an 800 MHz low-pass digital filter. Upon measuring a bunch-by-bunch spatio-temporal beam motion matrix over many turns, singular-value decomposition analysis is used to reveal the dominant coupled-bunch modes. The system can diagnose injection oscillations due to kicker errors and the effect of resistive-wall impedance that gives rise to instability during operation.

Localized insulin amyloidosis with use of concentrated insulin: a potential complication.

BACKGROUND: Insulin-derived amyloidosis is a rare form of amyloidosis composed of insulin fibrils. The pH and concentration of insulin are known to influence the conformational state of the insulin hormone, with an increasing concentration favouring a more complex conformation. Concentrated insulin delivers a large amount of insulin to a localized area, raising the possibility of inducing conformational changes, forming insulin fibrils and leading to localized insulin amyloidosis. CASE REPORT: A middle-aged woman with long history of Type 2 diabetes mellitus, treated with concentrated human insulin (U-500 insulin) presented with nodular lesions at the site of her daily insulin injections. A punch biopsy of the nodules showed skin with dermal amyloidosis staining favourably with Congo Red stain. The amyloid tumours were resected and areas positive for Congo Red stain were sent for liquid chromatography tandem mass spectrometry, which showed a peptide profile consistent with amyloid insulin. CONCLUSION: Concentrated insulin was first introduced in 1952, however, it is only over the last two decades that it has been used increasingly, in congruence with the increasing incidence of obesity and diabetes mellitus seen in the USA. Only a few cases of insulin amyloidosis at the site of injection have been described in literature. With the increase in the use of insulin, this complication seems to be occurring more frequently. This is the first case report of a person with diabetes mellitus who developed localized insulin amyloidosis with the use of concentrated insulin, and points towards a potential complication of developing insulin amyloidosis with the use of concentrated insulin.

Adherence with renal dosing recommendations in outpatients undergoing haemodialysis.

WHAT IS KNOWN AND OBJECTIVE: Adjustment of drug dosage in patients with end-stage renal disease prevents serious adverse effects, which occur due to the accumulation of drugs or other toxic metabolites. Nevertheless, dosing errors occur most commonly among patients with end-stage renal disease. The aim of this study was to assess the quality of care for end-stage renal disease outpatients using their renal dosing adjustment status. METHODS: A cross-sectional study was performed using the data collected from 43 South Korean medical institutions via questionnaires. A total of 2428 patients on haemodialysis, who were at least 18 years of age, were included. Among these patients, the study population was confined to patients who were taking medications and required renal dosing adjustments from three therapeutic classes: antihypertensives, antihyperglycaemics and lipid-modifying agents. The study population (n = 828) was prescribed a total of 1097 drug orders for the target drugs. Determination of appropriate dosage adjustment was based on GFR (glomerular filtration rate) using the Modification of Diet in Renal Disease revised 4-variable equation. The primary outcome was non-adherence to drug dosing requirements for end-stage renal disease patients with consideration to their renal function. RESULTS AND DISCUSSION: Among the study population (n = 828), 469 haemodialysis patients were identified as having drug orders that were adherent to renal dosing recommendations. There were significant differences between the patient groups who received recommendation-adherent and non-adherent drug orders in the characteristics of the medical institutions they visited, causes of chronic renal failure and prevalence of concurrent diabetes mellitus. The primary factor of non-adherence to renal dosing adjustment recommendations was characteristics of medical institutions. Compared to tertiary hospitals, secondary hospitals and primary care clinics were 1·16 and 1·22 times, respectively, more non-adherent in accordance with the multivariate analysis (OR: 1.16, 95% CI: 1.02-1.20, OR: 1.22, 95% CI: 1·00-1·36, respectively). WHAT IS NEW AND CONCLUSIONS: Dosing error is one of the most common problems among patients with renal failure. To decrease the dosing errors, an improvement needs to be made in medical institutions. This can be accomplished by implementing the clinical decision support systems that educate physicians on appropriate renal dosing and help them prescribe appropriate drug dosages.

Analysis of the coplanarity of functional pairs of semicircular canals using three-dimensional images reconstructed from temporal bone magnetic resonance imaging.

OBJECTIVES: This study was conducted to investigate the angles and orientation of semicircular canals, and the coplanarity of functional canal pairs. METHODS: Fluid signals in semicircular canals were reconstructed with three-dimensional reconstruction software using 20 temporal bone magnetic resonance images of normal subjects. The angles between each pair of semicircular canals were measured. RESULTS: The mean angles between the anterior and horizontal semicircular canal plane, the horizontal and posterior semicircular canal plane, and the anterior and posterior semicircular canal plane were 83.7°, 82.5° and 88.4°, respectively. Pairs of contralateral synergistic canal planes were formed 15.1° between the right and left horizontal semicircular canal planes, 21.2° between the right anterior and left posterior semicircular canal, and 21.7° between the left anterior and right posterior semicircular canal. CONCLUSION: Each semicircular canal makes an almost right angle with other canals, but synergistically acting functional canal pairs of both ears do not lie in exactly the same plane.

Korean mistletoe lectin regulates self-renewal of placenta-derived mesenchymal stem cells via autophagic mechanisms.

OBJECTIVES: The balance between survival and death is a key point for regulation of physiology of stem cells. Recently, applications of natural products to enhance efficiencies in culturing and differentiation of stem cells are increasing. Korean mistletoe lectin (Viscum album L. var. coloratum agglutinin, VCA) has been known to be toxic to some cancer cells, but it is still unclear whether VCA has a cytotoxic or indeed a proliferative effect on mesenchymal stem cells (MSCs). Here, we have compared effects of VCA in naïve placenta-derived stem cells (PDSCs), immortalized PDSCs and cancer cells (HepG2), and analysed their mechanisms. MATERIALS AND METHODS: MTT assay was performed to analyse effects of VCA on naïve PDSCs, immortalized PDSCs and HepG2. FACS, ROS, caspase-3 assay, western blotting and immunofluorescence were performed to detect signalling events involved in self-renewal of the above cell types. RESULTS: VCA had cancer cell-specific toxicity to HepG2 cells even with low concentrations of VCA (1-5 pg/ml), toxicity was observed to immortalized PDSCs and HepG2s, while proliferation of naïve PDSCs was significantly increased (P < 0.05). ROS production by VCA treatment in naïve PDSCs was significantly lower compared to controls (P < 0.05). Furthermore, autophagy was activated in naïve PDSCs treated with VCA through increase in type II LC3 and decrease in phosphorylated mTOR. CONCLUSIONS: VCA can promote MSC proliferation through an activated autophagic mechanism.

Synthesis and enhanced electrochemical performance of Li2CoPO4F cathodes under high current cycling.

Lithium cobalt fluorophosphate, Li(2)CoPO(4)F, is successfully synthesized by a solid state reaction under Ar flow at 700 °C. X-ray diffraction and scanning electron microscopic studies are utilized to analyze the structural and morphological features of the synthesized materials, respectively. The presence of fluorine is also supported by energy-dispersive X-ray spectroscopy. The electrochemical properties are evaluated by means of Li/Li(2)CoPO(4)F half-cell configurations in both potentiostatic and galvanostatic modes. The Li/Li(2)CoPO(4)F cell delivers an initial discharge capacity of 132 mA h g(-1) at a current density of 0.1 mA cm(-2) between 2.0 and 5.1 V at room temperature. Due to the higher operating potential of the Co(2+/3+) couple in the fluorophosphate matrix, this cell shows a capacity retention of only 53% after 20 cycles, still the material delivered 108 mA h g(-1) at a high current rate of 1 C. Cyclic voltammetric studies corroborate the insertion and extraction of Li(+) ions by a single phase reaction mechanism during cycling.

Production of rare isotope beams at the Texas A&M University Cyclotron Institute.

The Cyclotron Institute at Texas A&M is currently configuring a scheme for the production of radioactive-ion beams that incorporates a light-ion guide and a heavy-ion guide coupled with an electron-cyclotron-resonance ion source constructed for charge-breeding. This scheme is part of an upgrade to the facility and is intended to produce radioactive beams suitable for injection into the K500 superconducting cyclotron. The current status of the project and details on the ion sources used in the project is presented.

Genetic variation of the HIV-1 integrase region in newly diagnosed anti-retroviral drug-naïve patients with HIV/AIDS in Korea.

The survival time of HIV/AIDS patients in Korea has increased since HAART (highly active anti-retroviral therapy) was introduced. However, the occurrence of drug-resistant strains requires new anti-retroviral drugs, one of which, an integrase inhibitor (INI), was approved by the US Food and Drug Administration (FDA) in 2007. INIs have been used for therapy in many countries and are about to be employed in Korea. Therefore, it is important to identify basic mutant variants prior to the introduction of INIs in order to estimate their efficacy. To monitor potential drug-resistant INI mutations in Korean HIV/AIDS patients, the polymorphism of the int gene was investigated together with the pol gene using a genotypic assay for 75 randomly selected Korean HIV-1 patients newly diagnosed in 2007. The drug-resistant mutation sequences were analysed using the Stanford HIV DB and the International AIDS Society resistance testing-USA panel (IAS-USA). Seventy strains of Korean subtype B were compared with foreign subtype-B strains, and there were no significantly different variants of the int gene region in the study population. Major mutation sites in the integrase (E92Q, F121Y, G140A/S, Y143C/R, Q148H/R/K and N155H) were not detected, and only a few minor mutation sites (L74M, V151I, E157Q, V165I, I203M, S230N and D232N) were identified in 21 strains (28%). Resistance due to mutations in the pol gene was observed in a single strain (1.3%) resistant to protease inhibitors (PIs) and in four strains (5.3%) resistant to reverse transcriptase inhibitors (RTIs). In summary, this demonstrates that INIs will be susceptible to drug naïve HIV/AIDS patients in Korea.

Removal of heavy metals in an abandoned mine drainage via ozone oxidation: a pilot-scale operation.

The objective of this study was to evaluate the ozone oxidation of dissolved heavy metals in an abandoned mine drainage (AMD) by conducting a pilot-scale operation at two different ozone doses of 7.5 and 24.0 g O(3)/h into an ozone reactor. A portion of the abandoned mine drainage near the Jungam Mine in Samchuck, Korea was pumped into this pilot-scale plant and used as an influent for the ozone oxidation. Some possible precipitates of metal oxides and hydroxides that resulted from the pilot-scale ozone oxidation of the dissolved Fe and Mn ions in the AMD (with a hydraulic retention time of 106 seconds in the ozone reactor) were effectively removed via sand filtration. A six-hour ozone oxidation with an ozone dose of 24.0 g O(3)/h and subsequent sand filtration, before backwashing the sand filter bed, can meet Korean drinking water quality standards (less than 0.3 mg/L) for Fe and Mn in the sand filter effluent under the operating conditions that were used in this study. The SO(4)(-2) concentrations and alkalinities of the influents were not affected by the ozone oxidation. The pH values of the influents were neutral or slightly alkaline, and after the six-hour oxidation, increased very slightly. These experiment results show that the ozone oxidation of dissolved heavy metals and the subsequent sand filtration of metal precipitates are desirable alternatives to removing heavy metals in an abandoned mine drainage.

Culture and in vitro hepatogenic differentiation of placenta-derived stem cells, using placental extract as an alternative to serum.

OBJECTIVES: Translational research using adult stem cells derived from various tissues has been highlighted in cell-based therapy. However, there are many limitations to using conventional culture systems of adult stem cells for clinically applicability, including limited combinations of cytokines and use of nutrients derived from animals. Here, we have investigated the effects of placental extract (PE) for culture of placenta-derived stem cells (PDSCs) as well as their potential for hepatogenic differentiation. MATERIALS AND METHODS: Placental extract, extracted using water-soluble methods, was used as a supplement for culture of PDSCs. Cell viability was determined using the MTT assay, and cytokine assay was performed using Luminex assay kit. Gene expression, indocyanine green (ICG) up-take, PAS (Periodic Acid-Schiff) staining and urea production were also analysed. RESULTS: The placental extract contained several types of cytokine and chemokine essential for maintenance and differentiation of stem cells. Expression of stemness markers in PDSCs cultured with PE is no different from that of PDSCs cultured with foetal bovine serum (FBS). After hepatogenic differentiation, expression patterns for hepatocyte-specific markers in PDSCs cultured with PE were consistent and potential for hepatogenic differentiation of PDSCs cultured with PE was similar to that of PDSCs cultured with FBS, as shown by PAS staining and urea production assays. CONCLUSIONS: Our findings revealed that placental extract could be used as a new component for culture of adult stem cells, as well as for development of human-based medium, in translational research for regenerative medicine.

Preparation of titanium dioxide nanoparticles from electrocoagulated sludge using sacrificial titanium electrodes.

A comprehensive investigation of electrocoagulation using sacrificial titanium (Ti) electrodes in wastewater was carried out. The effects of specific process variables, such as initial pH, mixing, current density, initial organic loading, and ionic/electrolyte strength were first optimized to produce recyclable Ti-based sludge. The sludge was incinerated at 600 degrees C to produce functional TiO(2) photocatalyst. X-ray diffraction analysis revealed that TiO(2) produced at optimum electrocoagulation conditions was mostly anatase structure. The specific surface area of the synthesized TiO(2) photocatalyst was higher than that of the commercially available and widely used Degussa P-25 TiO(2). Furthermore, energy dispersive X-ray and X-ray photoelectron spectroscopy analyses showed that in additional to titanium and oxygen, this photocatalyst is also composed of carbon and phosphorus. These elements were mainly doped as a substitute site for the oxygen atom. Transmission electron microscopy images exhibited sharply edged nanorods, round nanoparticles, and nanotubes with nonuniform shapes showing some structural defects. Photodecomposition of gaseous acetaldehyde by this photocatalyst was also conducted under UV and visible light irradiation to study the photocatalytic properties of the doped TiO(2) photocatalyst. While no photocatalytic activity was observed under visible light irradiation, this doped TiO(2) photocatalyst exhibited high photocatalytic activity under UV light.

Decrease of initial CD4+ T-cell counts at the time of diagnosis of HIV infection in Korea; 1988-2006.

The aim of the study was to evaluate the trends of initial CD4+ T-cell counts (CD4+) at HIV diagnoses and to identify the factors influencing the annual changes of CD4+ cell counts in Korea during 1988-2006. As a retrospective study, 2613 individuals (>/=15 years at diagnosis, their CD4+ counts were measured within six months) were selected from all 4580 HIV-infected Koreans diagnosed between 1985 and 2006. The mean CD4+ cell counts in all the selected individuals was 312 cells/mm(3), and this value decreased significantly by 20.3 cells/mm(3)/year over the 19 year study period. Men had lower CD4+ cell count than women by 22.7 cells/mm(3), and age at HIV diagnosis had an inverse relationship with CD4+ cell counts of 23.5 cells/mm(3) lower per 10 years advancing age. Cases diagnosed in hospitals showed CD4+ cell count levels 33.9 cells/mm(3) lower than public institutions by 33.9 cells/mm(3). Gender and age seemed to affect trends of CD4+ count; however the institution where cases were diagnosed had the strongest effect on decreasing CD4+ cell counts. The results suggest that HIV diagnoses in recent years are being made in later stages of HIV infection and that it is imperative to develop more efficient programmes for early HIV diagnosis to prevent transmission.

Thrombolytic evacuation of post-craniotomy epidural haematomas using closed suction drains: a pilot study.

BACKGROUND: As an effective treatment for post-craniotomy epidural haematomas (EDHs), a novel method of urokinase instillation using a closed suction drain is presented and the procedure feasibility and outcomes assessed. METHOD: A closed system, comprising a closed suction drain with a three-spring 200 mL evacuator, fluid bag with urokinase, and syringe, was constructed to instill urokinase and evacuate a postoperative EDH. Nine patients with a symptomatic, localised EDH under a bone flap after a craniotomy underwent successive urokinase instillation following the proposed protocol. Measurement of the EDH volume and clinical evaluation were performed. FINDINGS: An improvement of computerised tomography findings and clinical state after urokinase instillation was observed in all patients. Six urokinase instillations lasting 12 h in 6 patients with an EDH (18.2 +/- 2.4 mL) and 12 urokinase instillations lasting 24 h in the other 3 patients with an EDH (33.0 +/- 7.9 mL) succeeded in achieving a minimal residual EDH (6.1 +/- 2.8 mL). The EDH volume decreased at a rate of 13.0 +/- 2.3 mL/12 h. The GCS scores increased immediately after thrombolytic evacuation of the EDHs in 6 out of the 9 patients. For the other three patients who did not show a change of GCS score, the severe headaches were improved. All the patients were successfully treated using the proposed technique with no procedural complications such as haemorrhage or infection in the operative wound. CONCLUSIONS: This pilot study demonstrated that thrombolytic evacuation of a post-craniotomy EDH using a closed suction drain is feasible without complications and may be associated with better outcomes.

Preparation of titanium dioxide (TiO2) from sludge produced by titanium tetrachloride (TiCl4) flocculation of wastewater.

Sludge disposal is one of the most costly and environmentally problematic challenges of modern wastewater treatment worldwide. In this study, a new process was developed, which has a significant potential for lower cost of waste disposal, protection of the environment and public health, and yield of economically useful byproducts. Titanium oxide (TiO2), which is the most widely used metal oxide, was produced from the wastewater sludge generated by the flocculation of secondary wastewater with titanium tetrachloride (TiCl4). Detailed analyses were conducted to compare TiCl4, ferric chloride (FeCl3), and aluminum sulfate (Al2(SO4)3) flocculation. Removal of organic matter and different molecular sizes by Ti-salt flocculation was similar to that of the most widely used Fe- and Al-salt flocculation. The mean size of Ti-, Fe-, and Al-salt flocs was 47.5, 42.5, and 16.9 microm, respectively. The decantability of the settled flocs by TiCl4 coagulant was similar to that by FeC13 coagulant and much higher than that of Al2(SO4)3. The photocatalyst from wastewater (PFW) produced by TiCl4 flocculation was characterized by X-ray diffraction, BET surface area, scanning electron microscopy/energy dispersive X-ray, transmission electron microscopy, photocatalytic activity, and X-ray photoelectron spectroscopy. The resulting PFW was found to be superior to commercial TiO2 (P-25) in terms photocatalytic activity and surface area. The PFW as also found to be mainly doped with C and P atoms. The atomic percentage of the PFW was TiO(1.42)C(0.44)P(0.14).

Generation of protein lineages with new sequence spaces by functional salvage screen.

A variety of different methods to generate diverse proteins, including random mutagenesis and recombination, are currently available and most of them accumulate the mutations on the target gene of a protein, whose sequence space remains unchanged. On the other hand, a pool of diverse genes, which is generated by random insertions, deletions and exchange of the homologous domains with different lengths in the target gene, would present the protein lineages resulting in new fitness landscapes. Here we report a method to generate a pool of protein variants with different sequence spaces by employing green fluorescent protein (GFP) as a model protein. This process, designated functional salvage screen (FSS), comprises the following procedures: a defective GFP template expressing no fluorescence is first constructed by genetically disrupting a predetermined region(s) of the protein and a library of GFP variants is generated from the defective template by incorporating the randomly fragmented genomic DNA from Escherichia coli into the defined region(s) of the target gene, followed by screening of the functionally salvaged, fluorescence-emitting GFPs. Two approaches, sequence-directed and PCR-coupled methods, were attempted to generate the library of GFP variants with new sequences derived from the genomic segments of E.coli. The functionally salvaged GFPs were selected and analyzed in terms of the sequence space and functional properties. The results demonstrate that the functional salvage process not only can be a simple and effective method to create protein lineages with new sequence spaces, but also can be useful in elucidating the involvement of a specific region(s) or domain(s) in the structure and function of protein.

Multicenter study of the frequency of contact allergy to gold.

Gold sodium thiosulfate (GSTS) is reputed to be the most reliable gold antigen, but control studies are still required. Although Koreans have more varied sources of contact with gold, such as herbal medicines with gold coatings and indwelling gold acupuncture needles, no epidemiological studies have been performed. This study examined the frequency and sources of contact allergy to gold in South Korea by a multicenter study. Patch testing with 0.5% GSTS in pet. was conducted in 255 eczema patients and 58 control subjects. Results were observed at 21 days (D) to ensure there were no undetected late reactions in 54 observed patients and 47 controls. 8 (3.1%) of the 255 patients reacted positively to GSTS, including 1 with a late reaction. 1 of the 58 controls showed a positive reaction to GSTS on D4 with a negative reaction on D14. Clinical relevance was lacking in the patients with positive reactions. Unexpectedly, the above particular sources of gold contact gave rise to few allergic reactions in our patients.