BACKGROUND: Recent advances in stroke therapies require patients to be treated very early after the onset of symptoms. To reduce the delay in time upon stroke and arriving at the hospital, we assessed the time delay, stroke recognition, and awareness before and after a public education program designed to increase recognition and awareness. METHODS: Prospective standardized and structured interviews were performed in 155 patients with ischemic stroke who were admitted to the Severance hospital before and after the public education program. The educational program included local newspaper articles, distribution of pamphlets, and lectures to 119 emergency care teams. Time delay, variable factors, stroke recognition, and stroke awareness of patients were then assessed (75 pre-education and 80 post-education groups). RESULTS: 52% of the pre-education group and 52.5% of the post-education group arrived at the hospital within 24 hours. Those who arrived within 3 hours were only 21.3% and 15% respectively. A direct visit to the hospital and a cardioembolic infarction appeared to be associated with a shorter time delay. About half of the patients recognized their symptoms as a stroke before a diagnosis was made by a doctor. Most of them had known that a stroke should be treated urgently. However, the stroke recognition and awareness was not associated with an early arrival, which suggests that their knowledge was not solid. The efforts to inform the public using local newspaper articles and pamphlets geared towards the local residents for the limited time period was not effective in shortening arrival times. CONCLUSIONS: Many of the stroke patients did not arrive within the therapeutic time window. Our findings suggest that extensive and multi-directional campaigns should be performed to reduce the time delay. Our findings also suggest that educational aims should include the need for the rapid treatment of stroke and a therapeutic time window as well as stroke recognition.
Cerebral Infarction ; Cerebrovascular Disorders ; Diagnosis ; Education ; Emergency Medical Services ; Humans ; Infarction ; Lectures ; Periodicals ; Pamphlets ; Prospective Studies ; Stroke*

BACKGROUND: Interleukin 31 (IL-31) is a T helper type 2 effector cytokine that plays an important role in the pathogenesis of atopic and allergic diseases. IL-31 may be involved in promoting allergic inflammation and in inducing airway epithelial responses such as allergic asthma. METHODS: Single-base extension analysis was used to detect the genotypes of IL-31 single nucleotide polymorphisms (SNPs), and we compared the genotype and allele frequencies of the IL-31 SNPs between patients with asthma and healthy controls. RESULTS: There were no significant differences in the genotype and allele frequencies of the IL-31 SNPs between patients with asthma and healthy controls. Furthermore we compared the genotype and allele frequencies of IL-31 SNPs between patients with atopic asthma, those with non-atopic asthma and healthy controls. This showed that the SNPs were not associated with the susceptibility to atopic asthma. There were no significant differences in the haplotype frequencies of IL-31 SNPs between patients with asthma and healthy controls. In patients with asthma, the IL-31 SNPs were significantly correlated with total serum levels of IgE (p=0.035). CONCLUSIONS: Our results indicate that, the IL-31 SNPs may be associated with IgE production in patients with asthma.
Asthma ; Gene Frequency ; Genotype ; Haplotypes ; Humans ; Immunoglobulin E ; Inflammation ; Interleukins ; Polymorphism, Single Nucleotide

No abstract available.
Sweet Syndrome*

PURPOSE: E2F-1 is a transcriptor that converts G1 to S in the cell cycle, and Topoisomerase II-alpha is a key enzyme in the metabolism of DNA, and an indicator of cell replication. The purpose of this study was to evaluate the clinical validity of E2F-1 and Topoisomerase II-alpha as prognostic factors in colorectal cancer. METHODS: The expressions of E2F-1 and Topoisomerase II-alpha were studied immunohistochemically using tumor specimen sections fixed with formalin and paraffin-embedded for 84 cases of colorectal cancer. The correlation between E2F-1 and Topoisomerase II-alpha expressions, and their relationship with the clinicopathological factors, such as tumor differentiation, tumor invasion, lymph node metastasis and tumor stage were investigated. RESULTS: Of the 84 specimens, 43 (51.2%) were immunohistochemically negative for E2F-1, and 41 (48.8%) were positive. The expression of E2F-1 correlated with poor tumor differentiation, increased lymph node metastasis and high tumor stage. The expression of Topoisomerase II-alpha also correlated with poor tumor differentiation, increased lymph node metastasis and high tumor stage. The E2F-1 and Topoisomerase II-alpha expressions indices were significantly correlated. CONCLUSION: These results suggest that the expressions of E2F-1 and DNA Topoisomerase II-alpha may play a role as a prognostic factor for colorectal cancer, but further studies will be required for its comfirmation.
Cell Cycle ; Colorectal Neoplasms* ; DNA ; DNA Topoisomerases, Type I* ; Formaldehyde ; Lymph Nodes ; Metabolism ; Neoplasm Metastasis

Granulomatosis with polyangiitis (GPA) is a disease characterized by a granulomatous necrotizing vasculitis of the small vessels, along with the presence of antineutrophil cytoplasmic antibody (ANCA), serologically. GPA is a multisystem disease, in which the diagnosis is frequently based on respiratory and renal manifestations, with rare breast invasion. To date, several cases of breast invasion by GPA have been published, and most cases have been positive for ANCA. However, ANCA-negative forms of breast invasion by GPA are extremely rare and have not been reported in Korea thus far. Therefore, we report a case of ANCA-negative GPA in a 70-year-old woman, who was initially presented with a localized palpable mass in the left breast.
Aged ; Antibodies ; Antibodies, Antineutrophil Cytoplasmic ; Breast* ; Cytoplasm* ; Diagnosis ; Female ; Humans ; Korea ; Vasculitis

PURPOSE: The p27Kip1 gene has been recognized as a negative regulator of the cell cycle and a potential tumor suppressor gene. Reduced expression of the p27Kip1 protein has been reported in several human tumors and has been associated with a poor prognosis in breast, lung, colon, prostate, bladder, esophageal and gastric cancers. In the present study, we assessed p27 expression in patients with colorectal cancer in relation to their clinicohistological parameters. METHODS: We investigated p27 expression in 80 patients with colorectal cancers using immunohistochemical staining and the results were analyzed regarding the survival and clinicopathological parameters. RESULTS: Among 80 cases of clolorectal carcinomas, p27Kip1 expression was detected in the nuclei of tumor cells in 48 cases (60%). With the exception of differentiation (p<0.01), no significant correlation was found between p27Kip1 and TMN stage, lymph node metastasis, depth of tumor invasion or overall survival. CONCLUSION: The results suggest that reduced expression of p27Kip1 protein plays a role in the differentiation of colorectal carcinoma and may be a potential prognostic factor. But, more studies are reqired in order to determine whether p27Kip1 protein expression is a clinically valuable prognostic factor.
Breast ; Cell Cycle ; Colon ; Colorectal Neoplasms* ; Cyclin-Dependent Kinase Inhibitor p27* ; Genes, Tumor Suppressor ; Humans ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Prostate ; Stomach Neoplasms ; Urinary Bladder

We present a case of a 65-year-old man with psoriasis who developed autoimmune hepatitis (AIH) without receiving immunosuppressive therapy with either anti-tumor necrosis factor-α or methotrexate. The AIH had completely resolved at 2 months after prednisolone and azathioprine therapy. This case confirms the need to consider AIH in psoriasis patients who experience new elevations in liver enzymes. To our knowledge, this is first description of the development of AIH in an immunosuppressant-naïve patient with psoriasis.
Aged ; Azathioprine ; Hepatitis, Autoimmune* ; Humans ; Liver ; Methotrexate ; Necrosis ; Prednisolone ; Psoriasis*

BACKGROUND/AIMS: Despite improvements in surgical techniques and postoperative patient care, bile leakage can occur after hepatobiliary surgery and may lead to serious complications. The aim of this retrospective study was to evaluate the efficacy of endoscopic treatment of bile leakage after hepatobiliary surgery. METHODS: The medical records of 20 patients who underwent endoscopic retrograde cholangiopancreatography because of bile leakage after hepatobiliary surgery from August 2009 to September 2014 were reviewed retrospectively. Endoscopic treatment included insertion of an endoscopic retrograde biliary drainage stent after endoscopic sphincterotomy. RESULTS: Most cases of bile leakage presented as percutaneous bile drainage through a Jackson-Pratt bag (75%), followed by abdominal pain (20%). The sites of bile leaks were the cystic duct stump in 10 patients, intrahepatic ducts in five, liver beds in three, common hepatic duct in one, and common bile duct in one. Of the three cases of bile leakage combined with bile duct stricture, one patient had severe bile duct obstruction, and the others had mild strictures. Five cases of bile leakage also exhibited common bile duct stones. Concerning endoscopic modalities, endoscopic therapy for bile leakage was successful in 19 patients (95%). One patient experienced endoscopic failure because of an operation-induced bile duct deformity. One patient developed guidewire-induced microperforation during cannulation, which recovered with conservative treatment. One patient developed recurrent bile leakage, which required additional biliary stenting with sphincterotomy. CONCLUSIONS: The endoscopic approach should be considered a first-line modality for the diagnosis and treatment of bile leakage after hepatobiliary surgery.
Abdominal Pain ; Bile Ducts ; Bile* ; Catheterization ; Cholangiopancreatography, Endoscopic Retrograde ; Cholestasis ; Common Bile Duct ; Congenital Abnormalities ; Constriction, Pathologic ; Cystic Duct ; Diagnosis ; Drainage ; Hepatic Duct, Common ; Humans ; Liver ; Medical Records ; Patient Care ; Retrospective Studies ; Sphincterotomy, Endoscopic ; Stents