Background/Aims: Although the number of domestic adverse drug reactions (ADRs) reported in Korea is rapidly increasing, the analysis of ADRs in cancer patients remains limited. We sought to investigate the clinical features of ADRs in cancer patients. Methods: ADR data were collected from a spontaneous reporting system at single university hospital, between July 2010 and June 2015. ADR cases assessed to be “unlikely” or “unclassifiable” as per the criteria of the World Health Organization-Uppsala Monitoring Center were excluded. Additional medical information was retrospectively collected from chart reviews, and clinical features of ADRs were analyzed. Results: In total, 1,455 cases were reported. Of these, 822 ADRs (52.1%) were observed in cancer patients. The mean age of cancer patients was 60.8 years (range, 17–90 years), and 45.9% were male. The most prevalent clinical features were gastrointestinal abnormalities (32.6%), such as nausea and vomiting, followed by skin (28.5%) and neurologic manifestations (26.0%). Fifty-one (6.2%) and 296 cases (36.0%) were classified as severe and moderate, respectively. The most common causative agents were parenteral nutrition (PN) supplements (40.4%), followed by antibiotics (17.8%), analgesics (16.7%), iodinated contrast media (ICM, 10.6%), and vitamins (3.9%). Antineoplastic agents were responsible for 2.9% of cases. PN supplements were commonly associated with severe reactions. Conclusion Although it is well known that antibiotics, ICM, and analgesics induce ADRs, PN supplements, vitamins, and antineoplastic agents should also be considered as common causes of ADRs in cancer patients. Further investigation and monitoring to determine the causality associated with these agents is required.

BACKGROUND AND OBJECTIVES: This study aimed to investigate the characteristics of tinnitus in patients who acquired the condition during military service. We also investigated the discomfort patients felt due to tinnitus and its relationship to depression. SUBJECTS AND METHOD: Research participants included 295 victims of tinnitus, who acquired it during military service. The subjects completed a structured questionnaire designed to investigate socio-demographic characteristics, tinnitus characteristics, and health effects of the condition. The Tinnitus Handicap Inventory (THI) was used to evaluate the social and psychological discomfort caused by tinnitus. When the center for epidemiological studies-depression scale score was 25 or higher, the subjects were considered positive for depression. RESULTS: Severe tinnitus affected 76.6% of subjects, with THI scores of at least 58 indicating effects on everyday life, and 35.6% of subjects showing depression. Depression showed a significant relationship with past history of ear diseases, hearing loss, loudness of tinnitus, tinnitus handicap, and effects on health due to tinnitus. In the multiple logistic regression analysis, hearing loss, loudness of tinnitus, and tinnitus handicap significantly affected the occurrence of depression. The adjusted odds ratios were as follows: 2.39 (95% CI, 1.36-4.21) with hearing loss, 2.51 (95% CI, 1.14-5.54) for high loudness of tinnitus, and 5.04 (95% CI, 1.98-12.79) for high tinnitus handicap. CONCLUSION: Relevant countermeasures are needed due to the high risk of depression observed among patients with high tinnitus handicap with hearing loss that affect everyday life.
Depression ; Ear Diseases ; Hearing Loss ; Humans ; Logistic Models ; Military Personnel ; Noise ; Odds Ratio ; Surveys and Questionnaires ; Tinnitus

A ventriculo-peritoneal shunt is a standard surgical management for hydrocephalus, but complications may impede the management of this disease. Obstruction of the catheter is one of the most common complications and manifests clinically in various ways. Intraparenchymal cyst development after shunt malfunction has been reported by several authors, but the underlying mechanism and optimal treatment methods are debatable. The authors report a case of intraparenchymal cyst formation around a proximal catheter in a premature infant after a ventriculo-peritoneal shunt and discuss its pathogenesis and management.
Catheters ; Humans ; Hydrocephalus ; Infant, Newborn ; Infant, Premature ; Ventriculoperitoneal Shunt

Acute generalized exanthematous pustulosis (AGEP) is a rare disease characterized by multiple acute, small, non-follicular, sterile pustules on an erythematous background, usually accompanied by fever and leukocytosis. AGEP is attributed to systemic drugs, mainly beta-lactam and macrolide antimicrobials, in more than 90% of cases. Systemic contact dermatitis is not rare after ingesting lacquer broth, but few reported cases of AGEP have occurred after the ingestion of lacquer chicken broth without a past history of drugs, viral infection, or contact allergy to mercury. Here, we report a rare case of AGEP with a pattern of septic shock induced by the intake of lacquer chicken in a 40-year-old male patient. He developed a generalized pustular lesion with high fever and hypotension. Histologic examination showed subcorneal neutrophilic pustules, papillary dermal edema, and lymphohistiocytic perivascular infiltrates with some eosinophils and neutrophils. The patient was treated with empirical antibiotics and systemic steroids, and the pustular lesions improved 2 weeks later without recurrence.
Acute Generalized Exanthematous Pustulosis ; Adult ; Anti-Bacterial Agents ; Chickens ; Dermatitis, Contact ; Eating ; Edema ; Eosinophils ; Fever ; Humans ; Hypersensitivity ; Hypotension ; Lacquer ; Leukocytosis ; Male ; Neutrophils ; Rare Diseases ; Recurrence ; Shock, Septic ; Steroids

BACKGROUND AND OBJECTIVES: Efonidipine hydrochloride, an L- and T-type dual calcium channel blocker, is suggested to have a heart rate (HR)-slowing action in addition to a blood pressure (BP)-lowering effect. The aim of this study was to determine the effect of efonidipine on HR and BP in patients with mild-to-moderate hypertension. SUBJECTS AND METHODS: In a multi-center, prospective, open-labeled, single-armed study, we enrolled 53 patients who had mild-to-moderate hypertension {sitting diastolic BP (SiDBP) 90-110 mmHg}. After a 2-week washout, eligible patients were treated with efonidipine (40 mg once daily for 12 weeks). The primary end point was the change in HR from baseline to week 12. The secondary end-point included the change in trough sitting BP and 24-hour mean BP between baseline and week 12. Laboratory and clinical adverse events were monitored at each study visit (4, 8, and 12 weeks). RESULTS: Fifty-two patients were included in the intention-to-treat analysis. After 12 weeks of treatment with efonidipine, the resting HR decreased significantly from baseline to week 12 {from 81.5+/-5.3 to 71.8+/-9.9 beats/minute (difference, -9.9+/-9.0 beats/minute), p<0.0001}. The trough BP {sitting systolic blood pressure (SiSBP) and SiDBP} and 24-hour mean BP also decreased significantly (SiSBP: from 144.6+/-8.2 to 132.9+/-13.5 mmHg, p<0.0001; SiDBP: from 96.9+/-5.4 to 88.3+/-8.6 mmHg, p<0.0001, 24-hour mean systolic BP: from 140.4+/-13.5 to 133.8+/-11.6 mmHg, p<0.0001; 24-hour mean diastolic BP: from 91.7+/-8.7 to 87.5+/-9.5 mmHg, p<0.0001). CONCLUSION: Efonidipine was effective in controlling both HR and BP in patients with mild-to-moderate hypertension.
Blood Pressure ; Calcium ; Calcium Channel Blockers ; Calcium Channels ; Dihydropyridines ; Heart ; Heart Rate ; Humans ; Hypertension ; Nitrophenols ; Organophosphorus Compounds ; Prospective Studies

BACKGROUND: Delayed neuronal injury after cerebral ischemia came major neurologic complication after stroke or cardiac arrest. Apoptosis formation after ischemia may be one of a mechanism of delayed neuronal injury. This study was conducted to evaluate the effect of moderate hypothermia on apoptosis formation after one hour of middle cerebral artery degrees Cclusion in rats. METHODS: Ten Sprague-Dawley rats (300 g) were freely fed till just before operation. Anesthesia was induced with 4 vol% isoflurane in oxygen and then maintained with 2 vol% isoflurane in oxygen. Middle cerebral artery degrees Cclusion (MCAO) was induced by intraluminal monofilament nylon with blunted tip. All rats were divided randomly into two groups. In group 1 (n=5), rectal temperature was maintained at 38 degrees C. In group 2 (n=5), rectal temperature was maintained at 32 degrees C. Rectal temperature was monitored during experiment. After 60 minutes of MCAO, intraluminal monofilament was removed and all rats were returned to cages. Brain were quickly removed and cerebral hemispheres were separated after 23 hours reperfusion. Apoptosis formation were counted with TUNEL stain. RESULTS: In group 1, after 60 minutes of MCAO and 23 hours reperfusion, 51 3.6% of hipp degrees Campal neurons were TUNEL-positive stained apoptotic cells. In group 2, TUNEL-positve neurons were 26.1 6.5% and significantly less than those of group 1 (p<0.05). CONCLUSIONS: Sixty minutes of MCAO and 23 hours reperfusion induce hipp degrees Campal neuronal apoptosis. Moderate hypothermia of 32 degrees C reduces apoptosis of hipp degrees Campal neurons after 60 minutes of MCAO and 23 hours reperfusion.
Anesthesia ; Animals ; Apoptosis* ; Brain ; Brain Ischemia* ; Cerebrum ; Heart Arrest ; Hypothermia* ; In Situ Nick-End Labeling ; Ischemia ; Isoflurane ; Middle Cerebral Artery ; Neurons ; Nylons ; Oxygen ; Rats* ; Rats, Sprague-Dawley ; Reperfusion ; Stroke

BACKGROUND: Intravenous anesthetics such as propofol and ketamine have been known to have neuroprotective effects. However, the combination of these drug is not known. This study was conducted to determine the neuroprotective effects of propofol, ketamine or both after transient forebrain ischemia. METHODS: Twenty Sprague-Dawley rats (250-300 gm) were used. Anesthesia was induced with 4% isoflurane in oxygen and then maintained with 1 - 2% isoflurane in oxygen. Ischemic injury was induced by 10 minutes of both common carotid artery ligation and hypotension (MAP < 50 mmHg). All rats were randomly divided into four groups: group I; control group; group II; ketamine 10 mg/kg was administered 10 minutes before injury; group III; propofol (1 mg/kg/min) was administered until EEG isoelectricity; and group IV; ketamine 10 mg/kg and propofol 1 mg/kg/min was administered. The Rectal temperature was maintained at 38oC. After forebrain ischemia, neurologic scores were estimated at 1 hr, 2 hrs, 1 day and 2 days after recovery. The brain was removed 3 days after and stained with H-E stain. RESULTS: Neurologic and histologic scores of group II, III, IV were significantly lower than that of group I. However, there were no significant difference between group II, III and IV. CONCLUSIONS: Ketamine and propofol have neuroprotective effects in transient forebrain ischemia in rats. However, the combination of propofol and ketamine did not show any synergistic or additive effects.
Anesthesia ; Anesthetics, Intravenous ; Animals ; Brain ; Carotid Artery, Common ; Electroencephalography ; Hypotension ; Ischemia* ; Isoflurane ; Ketamine* ; Ligation ; Neuroprotective Agents* ; Oxygen ; Propofol* ; Prosencephalon* ; Rats* ; Rats, Sprague-Dawley

The pathogenetic mechanism of nonatopic asthma has not yet been defined. The idea of a possible involvement of autoimmunity in the pathogenesis of nonatopic asthma has been proposed by earlier studies. To evaluate the possible involvement of autoimmune response against bronchial epithelial cell in the pathogenesis of nonatopic asthma, we measured circulating autoantibodies to cultured human bronchial epithelial cell (BEAS-2B cell line) using enzyme-linked immunosorbent assay. We used stored serum samples form 38 age-matched healthy controls, 26 adult patients with atopic asthma, 16 adult patients with nonatopic asthma, and 12 adult patients with systemic lupus erythematosus. Levels of IgG autoantibodies to bronchial epithelial cell were significantly higher in patients with nonatopic asthma (mean+/-SD of absorbance values; 0.135+/-0.030) and systemic lupus erythematosus (0.293+/-0.181) than in healthy controls (0.112+/-0.016) and patients with atopic asthma (0.116+/-0.031) (p<0.05). This study showed that levels of circulating IgG autoantibodies to bronchial epithelial cell were increased in adult patients with nonatopic asthma. Further studies are needed to evaluate the possible involvement of autoimmune mechanism in the pathogenesis of nonatopic asthma.
Adult ; Asthma/*immunology ; Autoantibodies/*blood ; Bronchi/*immunology ; Cells, Cultured ; Epithelial Cells/immunology ; Human ; Hypersensitivity/immunology ; IgG/blood

PURPOSE: To determine the best MR sequence for evaluation of the anatomical structures of normal kidney. MATERIALS AND METHODS: Twenty normal volunteers (M:F=15:5) took part in this study, and for each, seven sequences were performed. The T1 weighted sequences were conventional spin echo T1 (Conv-SET1), turbo spin echo T1 (TSET1), and fast low angle shot (FLASH), while the T2 weighted sequences were turbo spin echo T2 (TSET2), half-Fourier acquisition single-shot turbo spin echo (HASTE), true-fast imaging with steady-state precession (True-FISP), and echoplanar imaging (EPI). The study involved quantitative and qualitative analysis. In quantitative analysis, CNRs between cortex and adjacent fat tissue, and between cortex and medulla were calculated from SNR (signal to noise ratio), and the CNRs of sequences were statistically compared. In quantative analysis, three radiologists collectively evaluated kidney outline, corticomedullary division, the renal vessels, the pelvis/ureter, and artifacts. For each sequence a grade was assigned, and for each parameter the grades were compared. RESULTS: Between cortex and adjacent fat, the highest CNR was shown by TSET1, followed by Conv-SET1,while among T2 sequences, the CNR shown by TSET2 was highest. Between cortex and medulla, the CNR demonstrated by the three T1 sequences showed no statistically significant difference. Among T2 sequences, however, HASTE showed the highest CNR, followed by EPI, and statistically, the findings for these two were significantly different from those of other T2 sequences. Among T1 sequences, FLASH provided the best kidney outline, though among T2-sequences there was no statistically significant difference. FLASH was also the best for cortico-medullary distinction, while for this purpose the best T2 sequence was HASTE. True-FISP was best for the evaluation of renal vessels, and HASTE for evaluating the pelvis and ureter. Artifacts were most prominent on Conv SET1. CONCLUSION: For evaluating the shape of the kidney, the best T2 sequence was TSET2, but the best T1 sequence could not be determined. For cortico-medullary differentiation, the best T1 sequence was FLASH and the best T2 sequence was HASTE. For the evaluation of renal vessels, True-FISP was best, and for the pelvis and ureter, HASTE. Artifacts were most prominent on Conv-SET1.
Artifacts ; Echo-Planar Imaging ; Healthy Volunteers ; Kidney ; Noise ; Pelvis ; Ureter

PURPOSE: To evaluate normal human gastric wall layers in vitro using magnetic resonance*(MR) imaging, to correlate the results with the histologic findings, and to determine the optimal technique for evaluation of the gastric wall. MATERIALS AND METHODS: Forty-one normal resected gastric specimens obtained from 25 patients were dissected and placed in a polyethylene tube filled with normal saline. MR imaging with four MR sequences, T1-weighted FLASH*(T1FLASH), fat-saturated T1-weighted FLASH, T2-weighted TSE*(T2TSE), and True-FISP, was performed. The number of gastric wall layers and signal intensity of each layer were determined, and after correlating MR images with the histologic findings, the conspicuity of each layer*(mucosa, submucosa, and muscle), the distinction between each layer, and overall image quality were assessed. RESULTS: The gastric wall was shown by TIFLASH to have two (n=6, 14-6%), three (n=31, 75.6%) and four layers (n=4, 9.8%); by fat-saturated TIFLASH to have two (n=6, 14.6%) and three (n=35, 85.4%) ; by T2TSE to have three (n=24, 58.5%), four (n=11, 26.8%), and five (n=6, 14.6%); and by True-FISP to have one (n=2, 4.9%), two (n=8, 19.5%), three (n=23, 56%), four (n=4, 9.8%), and five (n=4, 9.8%) . The signal intensity of each layer at T1FLASH and fat-saturated T1FLASH was high-intermediate from the lumen in two-layer cases, high-low-high/intermediate in three-layer cases, and high-low-high-intermediate in four-layer cases. The signal intensity of each layer at T2TSE was intermediate/high-low-intermediate in three-layer cases, intermediate low-high-intermediate/low in four-layer cases, and low-high-low-high-low in five-layer cases. Three-layered gastric wall corresponded mostly to mucosa, submucosa, and muscle from the inner to outer layers, respectively. T1FLASH, fat-saturated T1FLASH, and T2TSE were superior to True-FISP in evaluating the gastric wall. T1FLASH and fat-saturated T1FLASH were the best sequences for demonstrating mucosa (p<0.05), and T2TSE was the best for submucosa and the distinction between this and muscle (p<0.05). Both T1FLASH and T2TSE provided the best overall image quality (p<0.05). CONCLUSION: In-vitro MR imaging is an excellent technique for the evaluation of layers of normal gastric wall. T2TSE is the sequence which best demonstrates the conspicuity of submucosa, the distinction between submucosa and muscle, and overall image quality.
Humans ; Magnetic Resonance Imaging* ; Mucous Membrane ; Polyethylene