Purpose: Although breast cancer is known to show a left predominance, the clinical characteristics and causes underlying this finding remain unclear. In addition, no related studies on breast cancer laterality have been conducted in patients with breast cancer in Korea. Therefore, we aimed to analyze differences in breast cancer laterality and the associated clinicopathological characteristics and prognosis among Korean patients with breast cancer. Methods: We conducted a retrospective analysis using large-scale data on clinicopathological factors and prognosis differences related to breast cancer laterality from the Korean Breast Cancer Society Registration system. The left-to-right ratio (LRR) of breast cancer was calculated through binomial distribution, and factors related to breast cancer laterality were identified through logistic regression analysis. In addition, the differences in the survival rates for left and right breast cancers were analyzed using the Kaplan-Meier method and Cox proportional hazards model. Results: In 171,500 patients, the LRR was 1.031 (95% confidence interval, 1.022–1.041; P < 0.001). Multivariate analysis showed that the ratio of left breast cancer was related to age, body mass index (BMI), location, and human epidermal growth factor receptor 2 (HER2) status. The survival rate of patients with left and right breast cancers showed no significant difference. Conclusion A large-scale analysis revealed a left predominance in breast cancer laterality in Korean patients. Over time, this predominance gradually decreased. Age, BMI, location, and HER2 status affected breast cancer laterality. However, while left breast cancer showed relatively aggressive characteristics, it was not associated with a difference in the survival rate.

Background: Complicated acute pyelonephritis (APN) is a life-threatening condition that requires immediate intervention. This study examined the characteristics of APN occurring as a complication of ureteral stone. Methods: We retrospectively reviewed 85 patients diagnosed with APN complicated by ureteral stone between December 2006 and July 2017 at our institution. Patients with concomitant renal stone, multiple ureteral stones, ureteral strictures, ureteral cancer, and urogenital anomalies, including vesicoureteral reflux were excluded. Clinical characteristics including age, sex, underlying disease, medical history, stone characteristics, initial laboratory data, and the procedure used to correct urinary obstruction were summarized, and the risk factors associated with sepsis and septic shock were analyzed. Results: Sepsis was diagnosed at initial presentation in 62 patients, 17 of whom suffered from septic shock. Disease-related death did not occur in any patient. Previous history of stone (P = 0.015), leukocytosis (P < 0.001), elevated C-reactive protein levels (P = 0.006), and low albumin (P = 0.038) were significant risk factors for progression to sepsis. The absence of hypertension (P = 0.047), thrombocytopenia (P = 0.006), decreased erythrocyte sedimentation rate (ESR) (P = 0.003), elevated blood urea nitrogen (P = 0.016), and positive blood culture (P= 0.018) were significant predictors for progression to septic shock.Multivariate analysis revealed that previous history of stone (P = 0.015) was an independent risk factor for sepsis, while the absence of hypertension (P = 0.047), thrombocytopenia (P= 0.013), and decreased ESR (P = 0.009) were risk factors for shock. Conclusion The risk factors associated with the progression from APN to sepsis differed from those associated with the progression from sepsis to septic shock. Various factors should be considered while selecting treatment options based on the severity of APN associated with ureteral stone. It should be managed with aggressive treatment and close observation, especially in the presence of risk factors.

PURPOSE: Reduction-oxidation reaction homeostasis is vital for regulating inflammatory conditions and its dysregulation may affect the pathogenesis of chronic airway inflammatory diseases such as asthma. Peroxiredoxin-6, an important intracellular anti-oxidant molecule, is reported to be highly expressed in the airways and lungs. The aim of this study was to analyze the expression pattern of peroxiredoxin-6 in the peripheral blood mononuclear cells (PBMCs) of asthmatic patients and in bronchial epithelial cells (BECs).METHODS: The expression levels and modifications of peroxiredoxin-6 were evaluated in PBMCs from 22 asthmatic patients. Phosphorylated and acetylated peroxiredoxin-6 in hydrogen peroxide-treated human BECs was detected using immunoprecipitation analysis. The expression level of peroxiredoxin-6 was also investigated in BECs treated with hydrogen peroxide. Cycloheximide and proteasome inhibitors were used to determine whether peroxiredoxin-6 is degraded by proteasomes.RESULTS: Peroxiredoxin-6 expression was significantly reduced in the PBMCs of asthmatic patients compared to control subjects. Distinct modification patterns for peroxiredoxin-6 were observed in the PBMCs of asthmatic patients using 2-dimensional-electrophoresis. The levels of phosphorylated serine and acetylated lysine in peroxiredoxin-6 were significantly increased in the BECs following hydrogen peroxide treatment. The level of peroxiredoxin-6 expression was reduced in hydrogen peroxide-stimulated BECs, presumably due to proteasomes.CONCLUSIONS: The expression of peroxiredoxin-6, which is down-regulated in the immune cells of asthmatic patients and BECs, can be modified by oxidative stress. This phenomenon may have an effect on asthmatic airway inflammation.
Asthma ; Cycloheximide ; Epithelial Cells ; Homeostasis ; Humans ; Hydrogen ; Hydrogen Peroxide ; Immunoprecipitation ; Inflammation ; Lung ; Lysine ; Oxidative Stress ; Proteasome Inhibitors ; Protein Processing, Post-Translational ; Serine

The Korean Association of Medical Colleges (KAMC) developed graduate outcomes based on “The role of Korean doctor, 2014” to serve as guidelines regarding outcome-based education in Korea. The working group in this study analyzed 65 competencies proposed in “The role of Korean doctor, 2014” according to the developmental principle that certain outcomes should be demonstrated at the point of entry into the graduate medical education. We established 34 competencies as “preliminary graduate outcomes” (PGOs). The advisory committee consisted of 11 professors, who reviewed the validity of PGOs. Ultimately, a total of 19 “revised graduate outcomes” (RGOs) were selected. We modified the RGOs based on opinions from medical schools and a public hearing. In November 2017, the KAMC announced the “graduate outcomes for basic medical education,” which serves as a guide for basic medical education for the 40 medical schools throughout Korea. Medical schools can expand the graduate outcomes according to their educational goals and modify them according to their own context. We believe that graduate outcomes can be a starting point for connecting basic medical education to graduate medical education.
Advisory Committees ; Competency-Based Education ; Education ; Education, Medical* ; Education, Medical, Graduate ; Education, Medical, Undergraduate ; Hearing ; Korea ; Physician's Role ; Republic of Korea ; Schools, Medical

BACKGROUND AND OBJECTIVES: Snoring is very common among children; however, there is a controversy regarding its effects on children. The purpose of this study is to identify risk factors and comorbidities associated with the condition collectively. SUBJECTS AND METHOD: 208 children were invited to participate in this study. Parents were surveyed for each child's snoring status, chronic rhinitis, behavior, and the parents' snoring and smoking status. Measurements were taken of each child's height, weight, waist and neck circumference, and blood pressure. X-rays and physical exams were used to record tonsil and adenoid size. All children also received an intelligence test and comprehensive blood test. Results were then compared between snoring and non-snoring children. RESULTS: Among 208 children, 175 participated in the study voluntarily. Out of the participants, 55 were snorers and 120 were non-snorers. Body mass index, neck and waist circumferences, and prevalence of chronic rhinitis were higher among the snorer. Mothers of snoring children snored more frequently. Inattention and impulsivity scores were also higher among snorers than non-snorers. There were no differences of cognition, tonsil or adenoid size, or blood test results between the two. CONCLUSION: There were some differences in physical, family-related, and behavior trait between snoring and non-snoring children.
Adenoids ; Blood Pressure ; Body Mass Index ; Child* ; Cognition ; Comorbidity ; Hematologic Tests ; Humans ; Impulsive Behavior ; Intelligence Tests ; Mothers ; Neck ; Palatine Tonsil ; Parents ; Prevalence ; Rhinitis ; Risk Factors ; Sleep Apnea Syndromes ; Smoke ; Smoking ; Snoring* ; Waist Circumference

Exposure of cells to ultraviolet B (UVB) radiation can induce production of free radicals and reactive oxygen species (ROS), which damage cellular components. In addition, these agents can stimulate the expression of matrix metalloproteinase (MMP) and decrease collagen synthesis in human skin cells. In this study, we examined the anti-photoaging effects of extracts of Tetraselmis suecica (W-TS). W-TS showed the strongest scavenging activity against 2,2-difenyl-1-picrylhydrazyl (DPPH) and peroxyl radicals, followed by superoxide anions from the xanthine/xanthine oxidase system. We observed that the levels of both intracellular ROS and lipid peroxidation significantly increased in UVB-irradiated human skin fibroblast cells. Furthermore, the activities of enzymatic antioxidants (e.g., superoxide dismutase) and the levels of non-enzymatic antioxidants (e.g., glutathione) significantly decreased in cells. However, W-TS pretreatment, at the maximum tested concentration, significantly decreased intracellular ROS and malondialdehyde (MDA) levels, and increased superoxide dismutase and glutathione levels in the cells. At this same concentration, W-TS did not show cytotoxicity. Type 1 procollagen and MMP-1 released were quantified using RT-PCR techniques. The results showed that W-TS protected type 1 procollagen against UVB-induced depletion in fibroblast cells in a dose-dependent manner via inhibition of UVB-induced MMP-1. Taken together, the results of the study suggest that W-TS effectively inhibits UVB-induced photoaging in skin fibroblasts by its strong anti-oxidant ability.
Antioxidants ; Collagen ; Fibroblasts ; Free Radicals ; Glutathione ; Humans ; Lipid Peroxidation ; Malondialdehyde ; Oxidoreductases ; Procollagen ; Reactive Oxygen Species ; Skin ; Superoxide Dismutase ; Superoxides

The integrity of blood vessels controls vascular permeability and extravasation of blood cells, across the endothelium. Thus, the impairment of endothelial integrity leads to hemorrhage, edema, and inflammatory infiltration. However, the molecular mechanism underlying vascular integrity has not been fully understood. Here, we demonstrate an essential role for A-kinase anchoring protein 12 (AKAP12) in the maintenance of endothelial integrity during vascular development. Zebrafish embryos depleted of akap12 (akap12 morphants) exhibited severe hemorrhages. In vivo time-lapse analyses suggested that disorganized interendothelial cell-cell adhesions in akap12 morphants might be the cause of hemorrhage. To clarify the molecular mechanism by which the cell-cell adhesions are impaired, we examined the cell-cell adhesion molecules and their regulators using cultured endothelial cells. The expression of PAK2, an actin cytoskeletal regulator, and AF6, a connector of intercellular adhesion molecules and actin cytoskeleton, was reduced in AKAP12-depleted cells. Depletion of either PAK2 or AF6 phenocopied AKAP12-depleted cells, suggesting the reduction of PAK2 and AF6 results in the loosening of intercellular junctions. Consistent with this, overexpression of PAK2 and AF6 rescued the abnormal hemorrhage in akap12 morphants. We conclude that AKAP12 is essential for integrity of endothelium by maintaining the expression of PAK2 and AF6 during vascular development.
A Kinase Anchor Proteins/*genetics/metabolism ; Animals ; Blood Vessels/abnormalities/*embryology/metabolism ; Cell Cycle Proteins/genetics/metabolism ; Down-Regulation ; Embryo, Nonmammalian/abnormalities/*blood supply/embryology/metabolism ; Gene Deletion ; *Gene Expression Regulation, Developmental ; Hemorrhage/*embryology/genetics/metabolism ; Human Umbilical Vein Endothelial Cells ; Humans ; Intercellular Junctions/genetics/metabolism/ultrastructure ; Kinesin/genetics/metabolism ; Myosins/genetics/metabolism ; Zebrafish/*embryology/genetics ; p21-Activated Kinases/genetics/metabolism

Tuberculosis generally affects the respiratory tract. In developing nations, the pericardium is the most common location of extrapulmonary tuberculosis; however, tuberculous pericarditis rarely appears as a localized mass or tuberculoma. We present here a case of a 62-year-old woman with pericardial tuberculoma. She had a history of effusive tuberculous pericarditis and drainage. Because she had taken regular medication over a period of six months, the pericardial mass with an adjacent lung nodule newly detected on the chest radiogram was initially suspected of being invasive lung cancer. Prior to pathologic confirmation, precise information from imaging tests, including computed tomography, magnetic resonance imaging, and positron emission tomography-computed tomography are helpful when making decisions regarding which methods should be used for surgical approach and treatment. Through imaging, our case showed typical features of pericardial tuberculoma and a favorable clinical course after two months with a change in antituberculous therapy.
Developing Countries ; Drainage ; Electrons ; Female ; Humans ; Lung ; Lung Neoplasms ; Magnetic Resonance Imaging ; Middle Aged ; Pericarditis, Tuberculous ; Pericardium ; Respiratory System ; Thorax ; Tuberculoma ; Tuberculosis

The aim of this study was to determine the in vitro anti-inflammatory effect of hot water extract from Cordyceps militaris fruiting bodies (CMWE) on lipopolysaccharide (LPS)-stimulated nitric oxide (NO) production, tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) release in RAW 264.7 cells. The treatment of macrophages with various concentrations of hot CMWE significantly reduced LPS-induced production as well as NO, TNF-alpha and IL-6 secretion in a concentration-dependent manner. These results suggest that CMWE have potent inhibitory effects on the production of these inflammatory mediators.
Cordyceps ; Fruit ; Interleukin-6 ; Macrophages ; Nitric Oxide ; Tumor Necrosis Factor-alpha ; Water

Segmental neurofibromatosis(neurofibromatosis type V) is rare disorder characterized by limitation of cafe-au-lait spots and neurofibroma or only neurofibroma on a given unilateral segment of the body. We report a case of segmental neurofibromatosis that developed in a 58-year-old male. The skin lesion was situated on the right antecubital area and wrist in the distribution of dermatomes C5 and C6. Histopathologic examination showed well-demarcated, non-encapsulated tumor of the dermis was composed of thin wavy collagenous fibers and loosely spaced spindle cells with elongated wavy nuclei. The patient was treated with surgical excision and carbon dioxide laser.
Cafe-au-Lait Spots ; Collagen ; Dermis ; Humans ; Lasers, Gas ; Male ; Middle Aged ; Neurofibroma ; Neurofibromatoses* ; Skin ; Wrist