House dust mite is the most important causative allergens of childhood asthma and its positive rate of allergy skin test reaches up to 80% in atopic asthmatic children in Korea. Although the mite sensitization is more significant in older children(>4 years), it is also important in some younger(<4 years) asthmatic children. To identify the major allergens in Korean atopic asthmatic children and find the variations of IgE binding pattern to Dermatophagoides pteronyssinus(Dp) in younger and older age groups, we conducted IgE immunoblot. Sera were collected in 25 children with Dp-sensitive atopic asthma : GroupI(younger children aged 1-3), Goup molder children aged 442). Using our own-made crude Dp extract, we conducted IgE-immunoblot (biotin-avidine-phos-phatase system). In the group I, the 15KD protein was significantly bound by 69.2%(9/13) of sera and 98KD, 59KD, 311KD, 25KD components were bound by 8-16% of sera, respectively. In the group II, the 15KD and 25KD proteins were significant1y bound Immunob1ot by 100% and 67% of sera, and 18KD, 94KD by 33%, 98KD by 25%, 45KD by 8% of sera, respectively. In conclusion, the 15KD protein is the most prevalent IgE-binding antigen in all age groups, on the other hands, IgE-sensitization to 25KD component is confirmed mainly in the cases of older age group in this study.
Allergens ; Asthma ; Child* ; Dermatophagoides pteronyssinus* ; Hand ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Korea ; Mites ; Pyroglyphidae* ; Skin Tests

Objectives: Despite greater access to training positions and the presence of more women in emergency medicine, it has remained a men-dominated field. This study aims to identify the key issues causing the gender gap in Korea and establish measures to overcome them. Methods: Using the annual statistical reports of the National Emergency Medical Center and data published on the Korean Society of Emergency Medicine website, cases that listed the current status and positions of members in its organization and its committees were analyzed. Secondary analysis was conducted using data from the 2015 Korean Society of Emergency Survey that included physicians’ demographics, academic ranking, years of experience, clinical work hours, training and board certification, core faculty status, position, and salaries. Results: As of September 2019, women account for only 12.7% of the total number of emergency physicians (EP) in Korea; of 119 chair/ vice‐chair academic positions, women represented only 9.2%. Women EP were more often assistant professors and fellowship-trained, with fewer in core faculty. However, they worked the same numbers of clinical hours as their men counterparts. The median annual salary of women EP was less than that of men EP after adjusting for academic hospital rank, clinical hours, and core faculty status. Conclusions A gender gap still exists among Korean EP, and women earn less than men regardless of their rank, clinical hours, or training. Future studies should evaluate more data and develop system-wide practices to eliminate gender disparities.

In an epidemiological study of metal workers exposed to metalworking fluids(MWF), the prevalence time of evoultion, seasonal occurrence and clinical type of contact dermatitis were investigated. Composinal analyses of MWF with HPLC, dermatological examination and two consecutive questionnaire surveys were conducted. Study population was divided into two groups ; workers contact to cutting oil and workers contact to rust preventive oil. In the analysis of MWF, aliphatic hydrocarbons, having 12-20 carbons, was most common composition(49.04%) of cutting oil otherwise, major contents (90.99%) of the rust preventives oil were aliphatic hydrocarbons composed of 6-9 carbons. The frequency (point prevalence) of contact dermatitis(CD) was 7(12.7 per 100 subjects) in the dermatological examination of 55 workers. As the result of second survey for contact dermatitis, cumulative prevalence of oil working full-time and recent 1 year prevalence in two groups were 28.0, 16.7 and 15.1, 12.5 per 100 subjects. There were no difference in the prevalence of CD by oil, age, oil contact duration. Summer is the most common evolution season in workers exposed to cuttiogs, but not in workers exposed to rust preventive oil. Major clinical type of CD was erythematous papules in both groups. It presents the importance of preventive measures that 51.1% suffer from contact dermatitis had medical care at their own expense, and 47.1% of them felt serious about their contact dermatitis. From the fact that 68.6% think cotton gloves protective apparatus, we emphasize the need for health education.
Carbon ; Chromatography, High Pressure Liquid ; Dermatitis, Contact* ; Epidemiologic Studies ; Health Education ; Humans ; Hydrocarbons ; Male* ; Prevalence ; Surveys and Questionnaires ; Seasons

PURPOSE: The purpose of this study was to identify the clinical and pathological factors that differentiate pleomorphic invasive lobular carcinoma (PILC) from classic invasive lobular carcinoma (CILC). METHODS: We retrospectively reviewed the medical records of 65 patients (4.0% of all invasive breast cancer patients) who underwent surgical excision for invasive lobular carcinoma (ILC) between January 2000 and November 2013. All 65 patients were diagnosed with ILC with negative immunohistochemical staining for E-cadherin in the tumor cells. All hematoxylin and eosin slides of the previously diagnosed ILC were reviewed and confirmed by two expert pathologists and we compared the clinicopathologic features between CILC and PILC. RESULTS: CILC was found in 46 cases and PILC, in 19 cases. Of the mammographic findings, a mass or asymmetric density was the most common feature (42.3% of all ILC patients). The most common ultrasonographic feature was a mass (94.9% of all ILC patients). Tumor multiplicity was noted in 10 patients (15.4%) among all ILC patients; eight patients (17.4%) had CILC and two patients (10.5%) had PILC. PILC patients had more grade III tumors (66.7% vs. 8.7%, p=0.002) and a higher Ki-67 labeling index (55.6% vs. 18.6%, p=0.004) than those with CILC. There were no statistical differences in the type of combined in situ component, extensive intraductal component, tumor size, lymphovascular invasion, stage, hormone receptor status, human epidermal growth factor receptor 2 status, distribution of intrinsic subtype, or imaging findings. Moreover, there was no significant difference in survival between CILC and PILC. CONCLUSION: PILC showed more pathological aggressiveness than CILC in terms of tumor grade and Ki-67 index.
Breast ; Breast Neoplasms ; Cadherins ; Carcinoma, Lobular* ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Medical Records ; Receptor, Epidermal Growth Factor ; Retrospective Studies

Hereditary neuropathy with liability to pressure palsy (HNPP) is a rare neurological genetic disease caused by deletion of the peripheral myelin protein 22 gene and presents in childhood or young adulthood. We report four cases of HNPP with typical and rare presentations, reflecting the broad clinical spectrum of this disease. Two patients presented with mononeuropathies that are frequently observed in HNPP; the remaining two presented with bilateral neuropathy or mononeuropathy anatomically present in the deep layer. This reflects the broad clinical presentation of HNPP, and clinicians should differentiate these conditions in young patients with monoparesis or bilateral paresis. Although HNPP is currently untreatable, early diagnosis in the emergency department can lead to early detection, eventually resulting in less provocation and recurrence which may cause early motor nerve degeneration.

Fecal incontinence (FI) undoubtedly reduces quality of life and adversely affects the social life of the affected individual. FI has a higher prevalence with age and has an equivalent prevalence to urinary incontinence in patients with genitourinary disease, but is often not confirmed in these cases. A thorough investigation is needed to diagnose FI, with the common etiology of this condition in mind, and several questionnaires can be used to identify symptoms. The physical examination contains digital rectal examination carries out to identify the patient’s condition. Ultrasound, colonoscopy, and rectum pressure test can be performed. Patients educated in diet-related issues, bowel movements, and defecation mechanism. Nonoperative options such as diet control and Kegel exercise should be performed at first. Surgical treatment of FI is considered when conservative management and oral medications produce no improvement. Surgical options include less invasive procedures like bulking agent injections, and more involved approaches from sacral nerve stimulation to invasive direct sphincter repair and artificial bowel sphincter insertion. Good outcomes in FI cases have also recently been reported for barrier devices.

Fecal incontinence (FI) undoubtedly reduces quality of life and adversely affects the social life of the affected individual. FI has a higher prevalence with age and has an equivalent prevalence to urinary incontinence in patients with genitourinary disease, but is often not confirmed in these cases. A thorough investigation is needed to diagnose FI, with the common etiology of this condition in mind, and several questionnaires can be used to identify symptoms. The physical examination contains digital rectal examination carries out to identify the patient’s condition. Ultrasound, colonoscopy, and rectum pressure test can be performed. Patients educated in diet-related issues, bowel movements, and defecation mechanism. Nonoperative options such as diet control and Kegel exercise should be performed at first. Surgical treatment of FI is considered when conservative management and oral medications produce no improvement. Surgical options include less invasive procedures like bulking agent injections, and more involved approaches from sacral nerve stimulation to invasive direct sphincter repair and artificial bowel sphincter insertion. Good outcomes in FI cases have also recently been reported for barrier devices.

Behcet's disease (BD) is a chronic systemic inflammatory disorder characterized by four major manifestations: recurrent uveitis, oral and genital ulcers and skin lesions. To identify some pathogenic variants associated with severe Behcet's uveitis, we used targeted and massively parallel sequencing methods to explore the genetic diversity of target regions. A solution-based target enrichment kit was designed to capture whole-exonic regions of 132 candidate genes. Using a multiplexing strategy, 32 samples from patients with a severe type of Behcet's uveitis were sequenced with a Genome Analyzer IIx. We compared the frequency of each variant with that of 59 normal Korean controls, and selected five rare and eight common single-nucleotide variants as the candidates for a replication study. The selected variants were genotyped in 61 cases and 320 controls and, as a result, two rare and seven common variants showed significant associations with severe Behcet's uveitis (P<0.05). Some of these, including rs199955684 in KIR3DL3, rs1801133 in MTHFR, rs1051790 in MICA and rs1051456 in KIR2DL4, were predicted to be damaging by either the PolyPhen-2 or SIFT prediction program. Variants on FCGR3A (rs396991) and ICAM1 (rs5498) have been previously reported as susceptibility loci of this disease, and those on IFNAR1, MTFHR and MICA also replicated the previous reports at the gene level. The KIR3DL3 and KIR2DL4 genes are novel susceptibility genes that have not been reported in association with BD. In conclusion, this study showed that target enrichment and next-generation sequencing technologies can provide valuable information on the genetic predisposition for Behcet's uveitis.
Adult ; Aged ; Behcet Syndrome/*genetics ; Case-Control Studies ; Female ; Histocompatibility Antigens Class I/genetics ; Humans ; Intercellular Adhesion Molecule-1/genetics ; Interferon-alpha/genetics ; Male ; Middle Aged ; *Polymorphism, Single Nucleotide ; Receptors, IgG/genetics ; Receptors, KIR/genetics ; Receptors, KIR2DL4/genetics

Acupuncture is globally practiced extensively, especially in Northeast Asian countries. We present a case of bladder injury with vesicocutaneous fistula (VCF) subsequent to acupuncture treatment on the lower abdomen. We believe that no similar case has been reported in previous literature. A 54-year-old woman was admitted to our emergency department, complaining of lower abdominal pain with erythema, after undergoing acupuncture. Physical examination revealed swelling with erythema and slight pus-like discharges in the lower abdomen, with accompanying tenderness over the area of the swelling. An abdominal computed tomography showed evidence of bladder injury with VCF and abscess. Considering the underlying disease and the risk of surgical treatment, the patient was successfully treated with percutaneous abscess drainage and an indwelling urinary catheter. Considering the outcome of this case, we recommend that practitioners need to perform acupuncture treatment with sufficient anatomical knowledge and proper technique, to reduce the possibility of subsequent complications.

PURPOSE: Transforming growth factor-beta1 (TGF-beta1) plays a dual role in apoptosis and in proapoptotic responses in the support of survival in a variety of cells. The aim of this study was to determine the function of TGF-beta1 in bladder cancer cells. MATERIALS AND METHODS: The role of TGF-beta1 in bladder cancer cells was examined by observing cell viability by using the tetrazolium dye (MTT) assay after treating the bladder cancer cell lines 253J, 5637, T24, J82, HT1197, and HT1376 with TGF-beta1. Among these cell lines, the 253J and T24 cell lines were coincubated with TGF-beta1 and the pan anti-TGF-beta antibody. Fluorescence-activated cell sorter (FACS) analysis was performed to determine the mechanism involved after TGF-beta1 treatment in 253J cells. RESULTS: All six cell lines showed inhibited cellular growth after TGF-beta1 treatment. Although the T24 and J82 cell lines also showed inhibited cellular growth, the growth inhibition was less than that observed in the other 4 cell lines. The addition of pan anti-TGF-beta antibodies to the culture media restored the growth properties that had been inhibited by TGF-beta1. FACS analysis was performed in the 253J cells and the 253J cells with TGF-beta1. There were no significant differences in the cell cycle between the two treatments. However, there were more apoptotic cells in the TGF-beta1-treated 253J cells. CONCLUSIONS: TGF-beta1 did not stimulate cellular proliferation but was a growth inhibitory factor in bladder cancer cells. However, the pattern of its effects depended on the cell line. TGF-beta1 achieved growth inhibition by enhancing the level of apoptosis.
Antineoplastic Agents/administration & dosage/*pharmacology ; Apoptosis/drug effects ; Cell Line, Tumor/drug effects/pathology ; Cell Proliferation/drug effects ; Cell Separation/methods ; Dose-Response Relationship, Drug ; Drug Screening Assays, Antitumor/methods ; Flow Cytometry/methods ; Humans ; Transforming Growth Factor beta1/administration & dosage/*pharmacology ; Urinary Bladder Neoplasms/*pathology