PURPOSE: This study was carried out to evaluate the expression of p53 and bcl-2 protein in the adenocarcinoma of gallbladder. MATERIALS AND METHODS: Thirty three cases of adenocarcinoma of gallbladder were immunohistochemically stained for p53 and bcl-2 protein. RESULTS: p53 protein was expressed in 51.5%(17/33) of adenocarcinoma. p53 protein expression was not significantly correlated with histologic grade of adenocarcinoma, depth of invasion, lymph node metastasis, distant metastasis and TNM stage, respectively(p>0.05). bcl-2 protein was expressed in 12.1%(4/33) of adenocarcinoma. bcl-2 protein expression was not significantly correlated with tumor size, histologic grade, depth of invasion, lymph node metastasis, distant metastasis and TNM stage, respectively(p>0.05). There is no correlation between expression of p53 and bcl-2 in gallbladder adenocarcioma(p > 0.05). CONCLUSION: This study suggest that p53 gene mutation plays an important role in carcinogenesis of gallbladder adenocarcinoma. The role of bcl-2 protein in gallbladder adenocarcinoma may be not significant.
Adenocarcinoma* ; Apoptosis ; Carcinogenesis ; Gallbladder* ; Genes, p53 ; Lymph Nodes ; Neoplasm Metastasis

Objectives: Physicians experience high occupational stress due to heavy workload, responsibility and stressful situations in the medical field. Although occupational stress decreases productivity and increases medical accidents, occupational stress on Korean psychiatrists is not well studied. In this study, we investigated the occupational stress and career satisfaction of Korean psychiatrists. Methods: Electronic surveys were conducted via e-mail, and a total of 266 psychiatrists fully answered the surveys. The surveys consisted of the Korean Occupational Stress Scale (KOSS), career satisfaction and stress inventory for the health professional. Results: The mean KOSS score of Korean psychiatrists was lower than the score of other Korean professions (43.99 vs. 46.03). There are significant differences in the sub-items of KOSS, depending on the lifestyle, the career and the hospital on duty. Psychiatric residents scored significantly higher in job control and occupational climate than psychiatrists. On the other hand, workplace relationships and job insecurity scored significantly higher in psychiatrists. Psychiatrists working in general and university hospitals had higher stress in job demand than psychiatrists working at private psychiatric hospitals. Job control and lack of reward scores were high in psychiatrists working in national psychiatric hospitals, and 21.8% of psychiatrists answered that they would not become a psychiatrist again. Conclusion This study showed the overall job stress level of psychiatrists in Korea, and they were experiencing high job stress in different areas depending on factors, such as position, working environment and living habits.

PURPOSE: We performed acute phase reactants (APR) test to evaluate as an appropriate screening test for the early detection of neonatal bacterial infection. METHODS: We selected 174 neonates and divided into two groups; sepsis group and well-baby group. We performed APR test. RESULTS: There are no significant difference in total leukocyte count, immature to mature rentrophil ratio, toxic granules, and platelet count between two groups. Number over two and one point of APR score in group I were significantly high compared to group II. Over two point and one point of APR score in neonatal infection had sensitivity of 58.7% and 92.3%, respectively the specificity of 95.7% and 70.0%, respectively Twenty-four cases of three point and 37 cases of two point of APR score were proved neonatal sepsis. Twenty-eight cases of over two point of APR score were positive in blood culture. CONCLUSION: APR score could be regarded as an useful test method for early detection of neonatal bacterial infection.
Acute-Phase Proteins* ; Bacterial Infections* ; Humans ; Infant, Newborn ; Leukocyte Count ; Mass Screening ; Platelet Count ; Sensitivity and Specificity ; Sepsis

PURPOSE: We designed a retrospective study to measure the accuracy of the ICD-10 (International Classification of Disease-10) code for trauma patients. We also analyzed the error of the ICISS (International Classification of Disease based Injury Severity Score) due to a missing or an incorrect ICD-10 code. METHODS: For the measuring the accuracy of the ICD-10 code for trauma patients in a tertiary teaching hospital's emergency department, two board certified emergency physician performed a retrospective chart review. The ICD-10 code was classified as a main code or a sub-code. The main code was defined as the code of the main department of treatment, and the sub-code was defined as a code other than the main code. We calculated and compared two ICISS for each patient one by using both the existing code and the other by using a corrected code. We compared the proportions of severe trauma (defined as an ICISS less than 0.9) between when the existing code and the corrected code was used respectively. RESULTS: We reviewed the records of 4287 trauma patients who had been treated from July 2008 to November 2008. The accuracy of the main code, the sub-code of emergency department, main-code, the subcode of hospitalized patients were 97.1%, 59.8%, 98.2% and 57.0%, respectively. Total accuracy of the main and sub-code of emergency department and of hospitalized patients were 91.4% and 58.6%. The number of severe trauma patients increased from 33 to 49 when the corrected code was used in emergency department and increased from 35 to 60 in hospitalized patients. CONCLUSION: The accuracy of the sub-code was lower than that of the main code. A missing or incorrect subcode could cause an error in the ICISS and in the number of patients with severe trauma.
Emergencies ; Humans ; International Classification of Diseases ; Retrospective Studies

PURPOSE: There are no reports on amusement-park-related injuries in Korea. Thus, the objective of this study was to describe traumatic injury patterns that occurring in an amusement park. METHODS: The medical records of an infirmary were retrospectively reviewed. From January 1, 2008, to December 31 2008, patients who were transferred to the nearest emergency departments of hospitals for the purpose of further test and treatment were enrolled. Demographics, injury types and involved parts of the body were analyzed. RESULTS: A total of 3,608 patients visited an infirmary for traumatic injury and about two-thirds had soft tissue injuries. Of those, 191 patients (5.3%) were transferred to the emergency department of a hospital. Of the patients who were transferred to a hospital, laceration and contusion were the responsible injuries for about half. Laceration was the most common injury in pediatric patients, and a sprain or a strain was the most common in adult patients. The most commonly injured parts of the body were the extremities in adult patients. However, in pediatric patients, injuries of the head, face and neck were similar to injuries of the extremities. CONCLUSION: Soft tissue injury was the most common amusement-park-related injury. Laceration was the most common reason to transfer a patient to a hospital. There were differences in injury type and injured part of the body between adult and pediatric patients.
Adult ; Contusions ; Demography ; Emergencies ; Extremities ; Head ; Humans ; Korea ; Lacerations ; Medical Records ; Neck ; Retrospective Studies ; Soft Tissue Injuries ; Sprains and Strains

A novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in December 2019 in China. The mutated coronavirus spread worldwide, and some patients infected with SARS-CoV-2 developed coronavirus disease 2019 (COVID-19) manifested with upper respiratory infection, pneumonia, or respiratory distress. Since the SARS-CoV-2 pandemic was declared with surging confirmed cases and mortality of COVID-19 worldwide, it has reshaped our way of living and how to manage patients with allergic diseases. The medical staff, including allergy specialists, has been at the forefront of fighting against the SARSCoV-2 pandemic and is struggling to guarantee safety to themselves and their patients. Thanks to vigorous research into the relationship between SARS-CoV-2 and allergic diseases, we have become able to treat allergic patients with the best of evidence to date. The clinician should make a careful decision on each clinical situation with regard to patient characteristics, local and national circumstances as well as the knowledge we have, since it is still limited. We hope further efforts to identify the nature of SARS-CoV-2 and COVID-19 clearer and effective SARS-CoV-2 vaccination will soon remove the grim picture of the worldwide pandemic and bring us back to normal.

In 1955 Gasser and his associates describe the hemolytic uremic syndrome, which is characteristics of clinical manifestation such as microangiopathic hemolysis, thrombocytopenia, acute renal failure. The etiology of the syndrome remains unclear. Typical form of syndrome occures mainly in children in association with gastrointestinal infection or upper respiratory infection. In adults, the syndrome is seen atypically in connection with malignant tumor, pregnancy, postpartum and oral contraceptives, chemotherapeutic agent such as Mitomycin-C, immunosuppressive agent including cyclosporin. The treatment of this syndrome has remains controversial. But recently some cases were reported that plasma exchange with fresh frozen plasma has favorable improvement of prognosis in atypical syndrome. Pasquale C, Noam L have reported the case of hemolytic uremic syndrome associated with pregnancy or abortion but in Korea, such cases have not reported yet. Then we report a case of hemolytic uremic syndrome which developed after voluntary abortion at sixth weeks of pregnancy and was treated with plasma exchange with fresh frozen plasma.
Acute Kidney Injury ; Adult ; Child ; Contraceptives, Oral ; Cyclosporine ; Hemolysis ; Hemolytic-Uremic Syndrome* ; Humans ; Korea ; Mitomycin ; Plasma ; Plasma Exchange ; Postpartum Period ; Pregnancy* ; Prognosis ; Thrombocytopenia

Pyodermatitis-pyostomatitis vegetans (PD-PSV) is a rare, benign pustular and vegetating mucocutaneous dermatosis with a tendency to affect the oral mucosa and the skin of the groin and axilla. The cutaneous lesions begin as crusted erythematous papulopustules, which coalesce to form large vegetating plaques, usually in the axillae, genital area and scalp. PD-PSV is known to be frequently associated with inflammatory bowel diseases (IBD), such as ulcerative colitis and Crohn's disease. We report a rare case of PD-PSV, which showed typical clinical and istopathological features, but was not accompanied by inflammatory bowel disease.
Axilla ; Colitis, Ulcerative ; Crohn Disease ; Groin ; Inflammatory Bowel Diseases ; Mouth Mucosa ; Scalp ; Skin ; Skin Diseases

BACKGROUND: Detection of antibodies to extractable nuclear antigens (ENAs) and dsDNA is needed for the diagnosis of and predicting prognosis in systemic autoimmune diseases. Recently introduced line immunoassay (LIA) has the advantage of detecting several autoantibodies simultaneously, and we evaluated its usefulness in the diagnosis of autoimmune diseases in comparison with enzyme-linked immunosorbent assay (ELISA). METHODS: Samples were collected from 437 patients referred by rheumatologists. FANA (fluorescent antinuclear antibody) test and LIA for the detection of 13 different autoantibodies, including 6 ENAs and dsDNA were performed. LIA-positive samples for ENA or dsDNA antibodies were further tested with ELISA. Final diagnosis was made by rheumatologists according to the diagnostic criteria. Agreement of results between LIA and ELISA was analyzed in 53 selected patients with systemic autoimmune diseases. RESULTS: The LIA detected antibodies to ENA and dsDNA in 118 and 22 patients, respectively, and ELISA detected 70.3% (83/118) and 45.5% (10/22) of LIA positive samples. Especially, 60.2% (71/118) of patients with positive ENA antibody on LIA was diagnosed as systemic autoimmune diseases. Patients having strong FANA titer and homogenous/speckled pattern showed higher prevalence of autoantibodies, but a small proportion of FANA negative patients also showed positive reactivity (LIA 10.8%, ELISA 5.2%). LIA showed a good agreement with ELISA for the anti-ENA antibodies (> or =80%), and a lower agreement for the anti-dsDNA antibody (67.9%). CONCLUSIONS: LIA detecting several autoantibodies simultaneously might replace ELISA for anti-ENA antibodies, but not for anti-dsDNA antibodies. When LIA is performed considering clinical manifestations and FANA, it could contribute to the diagnosis of systemic autoimmune disease.
Antibodies, Antinuclear/*analysis ; Antigens, Nuclear/immunology ; Autoimmune Diseases/*diagnosis ; DNA/*immunology ; Enzyme-Linked Immunosorbent Assay ; Female ; Fluorescent Antibody Technique, Indirect ; Humans ; *Immunoassay ; Male ; Middle Aged ; Reagent Kits, Diagnostic ; Reproducibility of Results

Polyethylene glycols (PEGs) are believed to be chemically inert agents, but larger PEG polymers could have immunogenicity. A 39-year-old man was referred to emergency room for loss of consciousness and dyspnea after taking of PEG-3350 (Colyte®). In laboratory findings, the initial serum tryptase level was increased to 91.9 mg/L (normal range: 0.00-11.40 mg/L) without any other laboratory abnormalities. The intradermal test with 10 mg/mL Colyte® showed a 5 × 5 mm wheal, but basophil activation and histamine releasability tests were negative. PEG-3350 is widely used as an osmotic laxative due to its lack of absorption from the gastrointestinal tract. However, the loss of mucosal integrity at gastrointestinal membrane such as diverticulitis may be a predisposing factor for anaphylaxis to Colyte®. We report a case of anaphylaxis induced by the ingestion of PEG-3350 in a patient with diverticulitis which might be a risk factor of anaphylaxis.
Absorption ; Adult ; Anaphylaxis* ; Basophils ; Causality ; Diverticulitis* ; Dyspnea ; Eating ; Emergency Service, Hospital ; Gastrointestinal Tract ; Histamine ; Humans ; Intradermal Tests ; Membranes ; Polyethylene Glycols* ; Polyethylene* ; Polymers ; Risk Factors ; Tryptases ; Unconsciousness