PURPOSE: Little data is currently available on the use of the impulse oscillometry system (IOS) parameter in analyzing the lung function of young children with cough-variant asthma (CVA) and classic asthma. The aims of this study were to evaluate the bronchial responsiveness between patients with CVA and those with classic asthma using dose-response slope and various cutoff values. METHODS: A methacholine challenge test and a pulmonary function test were performed in 43 children with classic asthma and 26 children with CVA using IOS, and the respiratory resistance (Rrs) and reactance (Xrs) were obtained. The bronchial responsiveness were assessed by provocative concentration causing an 80% fall from baseline in reactance at 5 Hz (PC80_Xrs5) and a 40% increase in resistance at 5 Hz (PC40_Rrs5) and calculating from the degree of dose-response slope (DRS) for airway resistance and reactance. RESULTS: There was no significant difference in base lung function between the two groups. However, the mean DRS_Xrs5 and the number who showed more than an 80% fall in reactance were significantly higher in classic asthma group than those in CVA group (P=0.040 and P=0.040, respectively). CONCLUSION: The use of DRS in oscillatory reactance at 5 Hz is useful for the differential diagnosis of classic asthma and CVA based on bronchial hyperresponsiveness.
Airway Resistance ; Asthma* ; Bronchial Hyperreactivity ; Child* ; Cough ; Diagnosis, Differential ; Humans ; Lung ; Methacholine Chloride ; Oscillometry ; Respiratory Function Tests

Hyalinizing trabecular adenoma of the thyroid gland is a distinctive benign epithelial lesion exhibiting a prominent trabecular arrangement and stromal hyalinization. We recently recognized a hyalinizing trabecular adenoma of the thyroid that displayed potentially misleading features of papillary and medullary carcinomas. However the immunohistochemical features, i.e. thyroglobulin-positive and calcitonin-negative as well as its trabecular arrangement and surrounding abundant hyaline materials confirmed our diagnosis.
Adenoma* ; Carcinoma, Medullary ; Diagnosis ; Hyalin* ; Thyroid Gland*

Rare autosomal dominant disorders associated with various tumors and cysts, and several kinds of pancreatic lesions have been described in patients with von Hippel- Lindau (VHL) disease, but there have been few studies concerned with the variations of the pancreatic duct. We experienced a case of pancreatic dual Wirsung ducts in a patient with VHL disease. Computed tomography scans showed that multiple cysts had nearly completely replaced the pancreas, there was a solid tumor on the uncinate process of the pancreas and a left renal mass suggested renal cell carcinoma. ERCP shows that the Santorini duct and Wirsung duct were fused in a normal fashion, and another Wirsung duct had shrub-like branches that are commonly seen in pancreatic divisum.
Carcinoma, Renal Cell ; Cholangiopancreatography, Endoscopic Retrograde ; Humans ; Pancreas ; Pancreatic Ducts ; von Hippel-Lindau Disease

Vasculitis, characterized by inflammation of vessel walls, is comprised of heterogeneous clinicopathological entities, and thus poses a diagnostic challenge. The most widely used approach for classifying vasculitides is based on the International Chapel Hill Consensus Conference (CHCC) nomenclature system. Based on the recently revised CHCC 2012, we propose computed tomography (CT) features of vasculitides and a differential diagnosis based on location and morphological characteristics. Finally, vasculitis mimics should be differentiated, because erroneous application of immunosuppressive drugs on vasculitis mimics may be ineffective, even deteriorating. This article presents the utility of CT in the diagnosis and differential diagnosis of vasculitides.
Classification* ; Consensus* ; Diagnosis ; Diagnosis, Differential ; Inflammation ; Vasculitis*

PURPOSE: To investigate whether causes of anaphylaxis vary according to regions and seasons in Korean adults. METHODS: Based on previous retrospective studies of anaphylaxis between 2007 and 2011 at the 15 university hospitals. Regions were classified into 4 groups: region I, Seoul; region II, Gyeonggi; region III, Chungcheong; and region IV, Chonnam and Busan. The cases induced by 5 major allergens including drugs, food, bee sting, radiocontrast media, and exercise, were analyzed in the present study. RESULTS: Among a total of 1,661 cases reported (53% male, 45.9+/-16.0 years), 367 (22.2%), 706 (42.5%), 319 (19.2%), and 269 cases (16.2%) were enrolled in regions I, II, III, and IV, respectively. Of the 5 major allergens, drugs (37.3%) were the most frequently reported, followed by food (25.7%), bee sting (17.9%), radiocontrast media (12.9%), and exercise (6.2%). There was no significant difference in the total occurrence of anaphylaxis in 4 seasons (374 in spring, 460 in summer, 460 in autumn, and 367 in winter). Multiple logistic regression analysis revealed that drug-induced anaphylaxis was significantly associated with the winter season (odds ratio [OR] 1.0 vs. OR 0.597, P<0.05 for spring; OR 1.0 vs. OR 0.481, P<0.01 for summer; OR 1.0 vs. OR 0.653, P<0.05 for autumn). Food-associated anaphylaxis was mainly reported in region I, whereas the frequency of insect sting was relatively higher in regions II, III, and IV than in region I. Older age and female gender were significantly associated with drug-induced anaphylaxis. CONCLUSION: Specific causative allergens of anaphylaxis in adults may vary according to age, gender, region, and season in Korea.
Adult* ; Allergens ; Anaphylaxis* ; Bees ; Bites and Stings ; Busan ; Contrast Media ; Female ; Geographic Locations ; Gyeonggi-do ; Hospitals, University ; Humans ; Insect Bites and Stings ; Jeollanam-do ; Korea ; Logistic Models ; Male ; Retrospective Studies ; Seasons* ; Seoul

PURPOSE: Differences in definitions of the condition, relevant triggers, and the geographical locations of study centers, cause estimates of the prevalence of anaphylaxis to vary. Recent epidemiological data indicate that the incidence of anaphylaxis is rising. METHODS: To investigate the causes and clinical features of anaphylaxis in Korean adults, factors associated with the severity of the condition, and serious outcomes, a retrospective medical record review was performed on adult patients diagnosed with anaphylaxis between 2007 and 2011 in 15 University Hospitals of South Korea. RESULTS: A total of 1,806 cases (52% male, age 16-86 years) were reported. Cutaneous symptoms (84.0%), combined with respiratory (53.9%) and/or cardiovascular (55.4%) symptoms, were the most frequent presentations. Using a recognized grading system, 1,776 cases could be classified as either mild, 340; moderate, 690; or severe, 746. Although eliciting factors varied significantly by age, gender, and regional and seasonal factors, drugs (46.5%; including nonsteroidal anti-inflammatory drugs, antibiotics, and radiocontrast media) were the most common cause of anaphylaxis, followed by foods (24.2%), insect stings (16.4%), exercise (5.9%), and unknown etiology (7.0%). All of age, multi-organ involvement, a history of allergic disease, and drug-induced anaphylaxis, were significant predictors of serious outcomes requiring hospital admission or prolongation of hospital stay. Epinephrine auto-injectors were prescribed for 7.4% of reported cases. CONCLUSIONS: The principal causes of anaphylaxis in Korean adults were drugs, food, and insect stings. Drug-associated anaphylaxis, a history of allergic disease, multi-organ involvement, and older age, were identified as predictors of serious outcomes.
Adult* ; Anaphylaxis* ; Anti-Bacterial Agents ; Epidemiology ; Epinephrine ; Hospitals, University ; Humans ; Incidence ; Insect Bites and Stings ; Korea ; Length of Stay ; Male ; Medical Records ; Prevalence ; Retrospective Studies* ; Seasons

Currently, the expanding recreational use of synthetic cannabinoids (SCBs) threatens public health. SCBs produce psychoactive effects similar to those of tetrahydrocannabinol, the main component of cannabis, and additionally induce unexpected pharmacological side effects. SCBs are falsely advertised as legal and safe, but in reality, SCB abuse has been reported to cause acute intoxication and addictive disorders. However, because of the lack of scientific evidence to elucidate their dangerous pharmacological effects, SCBs are weakly regulated and continue to circulate in illegal drug markets. In the present study, the intravenous self-administration (IVSA) paradigm was used to evaluate the abuse potential of three SCBs (AM-1248, CB-13, and PB-22) in rats. All three SCBs maintained IVSA with a large number of infusions and active lever presses, demonstrating their reinforcing effects.The increase of active lever presses was particularly significant during the early IVSA sessions, indicating the reinforcementenhancing effects of the SCBs (AM-1248 and CB-13). The number of inactive lever presses was significantly higher in the SCB groups (AM-1248 and CB-13) than that in the vehicle group, indicating their impulsive effects. In summary, these results demonstrated that SCBs have distinct pharmacological properties and abuse potential.

Currently, the expanding recreational use of synthetic cannabinoids (SCBs) threatens public health. SCBs produce psychoactive effects similar to those of tetrahydrocannabinol, the main component of cannabis, and additionally induce unexpected pharmacological side effects. SCBs are falsely advertised as legal and safe, but in reality, SCB abuse has been reported to cause acute intoxication and addictive disorders. However, because of the lack of scientific evidence to elucidate their dangerous pharmacological effects, SCBs are weakly regulated and continue to circulate in illegal drug markets. In the present study, the intravenous self-administration (IVSA) paradigm was used to evaluate the abuse potential of three SCBs (AM-1248, CB-13, and PB-22) in rats. All three SCBs maintained IVSA with a large number of infusions and active lever presses, demonstrating their reinforcing effects.The increase of active lever presses was particularly significant during the early IVSA sessions, indicating the reinforcementenhancing effects of the SCBs (AM-1248 and CB-13). The number of inactive lever presses was significantly higher in the SCB groups (AM-1248 and CB-13) than that in the vehicle group, indicating their impulsive effects. In summary, these results demonstrated that SCBs have distinct pharmacological properties and abuse potential.

PURPOSE: Of the hypothetical models of the carcinogenesis of breast cancer, the horizontal progression is most acceptable at the present time. According to the hypothesis, there are genetically different pathways among pure invasive ductal carcinoma (IDC), non-high grade IDC with ductal carcinoma in situ (DCIS), and high grade IDC with DCIS. The purpose of this study is to determine if there is any heterogeneity in biological behavior among these three categories. METHODS: With reversed Black nuclear grade (RBNG) in IDC component and the association of DCIS, we divided 184 breast cancer patients, who had underwent curative operations, into three groups. The patients with pure IDC were included in Group 1, non-high grade (RBNG 1 and 2) IDC with DCIS in Group 2, and high grade (RBNG 3) IDC with DCIS in Group 3. And we retrospectively analyzed and compared three groups with mean age, menopausal status, T stage, N stage, the expression rate of ER, PR, p53, and c-erbB-2, and cumulative metastasis-free survival. RESULTS: The percentage of the postmenopausal patients was significantly smaller in Group 3 (14.0%, P=0.025) than Group 1 and 2 (36.1% and 30.6%). There were significantly higher expression rates of ER and PR in Group 2 with 78.3% and 68.3%, respectively (P=0.000 and P=0.030). The 5-year metastasis- free survival rate were 70.4% in Group 1, 85.2% in Group 3, and 87.5% in Group 2. The Log Rank test in Kaplan-Meier cumulative survival curve showed the statistically significant differences among three groups (P= 0.041). CONCLUSION: We can say that there would be clinical heterogeneity among three groups classified by histopathologic findings. To apply this classification to the multi-disciplinary therapeutic modality of breast cancer, further study using a new biologic marker, which is associated with invasiveness and metastagenicity and can discrminate the three categories of breast cancers in any kind of specimen biopised preoperatively, is needed.
Biomarkers ; Breast ; Breast Neoplasms ; Carcinogenesis ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating ; Classification* ; Humans ; Population Characteristics ; Retrospective Studies ; Survival Rate

In order to assess changes in the activity of immunecompetency present in Crassostrea gigas infected with Marteilioides chungmuensis (Protozoa), the total hemocyte counts (THC), hemocyte populations, hemocyte viability, and phagocytosis rate were measured in oysters using flow cytometry. THC were increased significantly in oysters infected with M. chungmuensis relative to the healthy appearing oysters (HAO) (P<0.05). Among the total hemocyte composition, granulocyte levels were significantly increased in infected oysters as compared with HAO (P<0.05). In addition, the hyalinocyte was reduced significantly (P<0.05). The hemocyte viability did not differ between infected oysters and HAO. However, the phagocytosis rate was significantly higher in infected oysters relative to HAO (P<0.05). The measurement of alterations in the activity of immunecompetency in oysters, which was conducted via flow cytometry in this study, might be a useful biomarker of the defense system for evaluating the effects of ovarian parasites of C. gigas.
Animals ; Cell Count ; Cell Survival ; Cercozoa/*immunology/*pathogenicity ; Crassostrea/*immunology ; Flow Cytometry ; Granulocytes/immunology ; Hemocytes/immunology ; Phagocytosis