Purpose: Although basophils are major effector cells involved in asthma, their pathophysiological role in asthma remains uncertain. In this study, we investigated the relationship between blood basophils, clinical features in asthmatics, and cytokines in exhaled breath condensate (EBC) which could be noninvasively obtained. Methods: A total of 13 adult asthmatics were prospectively enrolled. We obtained information on demographics, asthma control levels, history of acute exacerbation as well as the asthma control test and Quality of Life Questionnaire for Adult Korean Asthmatics (QLQAKA) scores. Peripheral blood and EBC samples were collected, and pulmonary function test was also performed. The association between blood basophil count and clinical feature and severity of asthma or inflammatory cytokines in EBC was analyzed. Results: The percentage of blood basophils was positively correlated with that of blood eosinophils (Spearman r=0.665, P=0.013). The number of acute exacerbations was significantly larger (1.2±0.6 vs. 5.3±5.8, P=0.049) in the group with blood basophils ≥50 cells/μL, while the QLQAKA score was lower (68.8±7.9 vs. 49.0±12.0, P=0.028). There were no significant differences in age, atopy status, smoking history, and forced expiratory volume in 1 second according to blood basophil count. Blood basophil count was positively correlated with interleukin-33 (IL-33) (r=0.651, P=0.016) and IL-17 (r=0.732, P=0.004) in EBC. Conclusion Blood basophils may be associated with frequent asthma exacerbations and lower quality of life due to asthma. IL-33 and IL-17 may be the key mediators that stimulate basophils to participate in the pathogenesis of asthma.

Bee pollen is a mixture of pollen, nectar collected by honeybees, and digestive enzymes secreted from honeybees, which is consumed as a dietary supplement. We experienced a case of anaphylaxis after ingestion of bee pollen in a patient with seasonal allergic rhinitis and oral allergy syndrome caused by watermelons, Korean melons, peaches, and plums. The skin prick test was positive for bee pollen, dandelion, ragweed, and mugwort, and specific IgE to honeybee venom was negative. According to the literature, bee pollen causing systemic allergic reactions mainly consists of the plant family Compositae, including dandelion, ragweed, and mugwort. Thus, ingestion of bee pollen should be closely monitored in patients with allergic rhinitis worsening in autumn, especially those with oral allergy syndrome for foods that cross-react with weed pollen.

Purpose: The aim of this study was to evaluate the physiological and behavioral effects of auditory stimulation with their own parent’s voice on heart rate and sleep states of very-low-birth-weight infants (VLBWIs) in neonatal intensive care unit. Methods: The data of 28 VLBWIs at the Ewha Womans University Mokdong Hospital between October 2016 and May 2017 was analyzed. They were exposed to sounds similar to those of mothers’ heartbeat they had heard in the uterus and their own parent’s voice. Heart rate was assessed as the physiological responses and sleep state of infants as behavioral response. The sleep states were categorized into six states. The music intervention program was provided twice a week. Results: Twenty-eight babies with an average gestational age of 28 weeks (average birth weight of 1.09 kg) had undergone the sessions (average of 16 times) average of 16 times. During the initial period, there were no meaningful differences of the heart rates measured by the physiological functions before and after the sessions. However, as we move to the adaptive phase, the average heart rate was 156.96±12.22, and the pre-discharge was 149.11±12.01, which indicates meaningful differences (P<0.05). Infants’ behavioral function was statistically insignificant. Conclusion The music intervention techniques in the neonatal intensive care unit environment in Korea have provided positive influence to VLBWIs' physiological reactions. We were not able to come up with the relevant indicators during this phase of the study but we do plan to announce the future study results after indexing the observation results.

Purpose: The aim of this study was to evaluate the physiological and behavioral effects of auditory stimulation with their own parent’s voice on heart rate and sleep states of very-low-birth-weight infants (VLBWIs) in neonatal intensive care unit. Methods: The data of 28 VLBWIs at the Ewha Womans University Mokdong Hospital between October 2016 and May 2017 was analyzed. They were exposed to sounds similar to those of mothers’ heartbeat they had heard in the uterus and their own parent’s voice. Heart rate was assessed as the physiological responses and sleep state of infants as behavioral response. The sleep states were categorized into six states. The music intervention program was provided twice a week. Results: Twenty-eight babies with an average gestational age of 28 weeks (average birth weight of 1.09 kg) had undergone the sessions (average of 16 times) average of 16 times. During the initial period, there were no meaningful differences of the heart rates measured by the physiological functions before and after the sessions. However, as we move to the adaptive phase, the average heart rate was 156.96±12.22, and the pre-discharge was 149.11±12.01, which indicates meaningful differences (P<0.05). Infants’ behavioral function was statistically insignificant. Conclusion The music intervention techniques in the neonatal intensive care unit environment in Korea have provided positive influence to VLBWIs' physiological reactions. We were not able to come up with the relevant indicators during this phase of the study but we do plan to announce the future study results after indexing the observation results.

We report a case of concurrent medullary and papillary microcarcinoma of the thyroid gland. We also found a nonrecurrent laryngeal nerve in the right side. The nonrecurrent laryngeal nerve is an unusual and potentially serious postoperative complication. A 36-year-old female underwent right hemithyroidectomy for follicular neoplasm, diagnosed by fine needle aspiration biopsy. The histopathologic report demonstrated a medullary microcarcinoma in one nodule with lymph node metastasis and papillary thyroid micocarcinoma in other two lesions. Incidentally, we also found an aberrant right subclavian artery by computed tomography and confirmed nonrecurrent laryngeal nerve in surgery. We performed completion thyroidectomy with central and lateral neck lymph nodes dissection. We could not find any more carcinoma on the pathologic examination. The patient was given radioactive iodine therapy for remnant thyroid ablation. The patient is scheduled to check serum calcitonin and CEA level every 3 months.
Adult ; Biopsy ; Biopsy, Fine-Needle ; Calcitonin ; Female ; Humans ; Iodine ; Laryngeal Nerves* ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Postoperative Complications ; Subclavian Artery ; Thyroid Gland* ; Thyroidectomy

Lay public's concerns around health and health information are increasing. In response, governments and government agencies are establishing websites to address such concerns and improve health literacy by providing better access to validated health information. Since 2011, the Korean government has constructed the National Health Information Portal (NHIP) website run in collaboration with the Korean Academy of Medical Sciences (KAMS). This study therefore aimed to 1) examine consumer use of NHIP, with respect to the usage patterns, evaluation on health information provided, and perceived effectiveness of the site; and 2) identify factors that may impact perceived effectiveness of the site. An online survey was conducted with 164 NHIP users, recruited through a popup window on the main screen of the portal website from October to November 2015. The significant predicting factors supported by the data include the relevance of health information on the site, the usefulness of information in making health decisions, and the effective visualization of information. These factors can inform future efforts to design more effective health information websites, possibly based on metadata systems, to further advance the lay public's information seeking and health literacy.
Cooperative Behavior ; Government Agencies ; Health Literacy ; Internet

Background: Despite the advances in neonatology, the incidence of bronchopulmonary dysplasia (BPD) is increasing. It is important to prevent the development of BPD in the first place. The online BPD outcome estimator from National Institute of Children Health and Human Development and Neonatal Research Network is available. However, it is not applicable for Asians. Moreover, limits are set for birth weight and gestational weeks excluding those who may still have BPD. The aim of this study was to develop a prediction model for BPD using first hour perinatal and neonatal factors in Korean very low birth weight infants (VLBWIs). Methods: Data were collected for 8,022 VLBWIs with gestational age (GA) ≥ 22 weeks who were born between January 1, 2013 and December 31, 2016, and admitted to the neonatal intensive care units of the KNN. Multiple logistic regression models reanalyzed by stepwise selection with significant clinical indicators for BPD. PROC package was used to calculate the area under curve (AUC) and corresponding 95% confidence intervals. Moreover, it was used to search the best cut-off value. External validation was performed with the 2017 Korean neonatal network (KNN) data. Results: After all missing data were excluded, 4,600 VLBWIs were included in the training dataset of the prediction model. Predictability of presence of BPD was 90.8% and prediction P value cut off was 0.550. Five-minute Apgar score, birth weight, GA, sex, surfactant use were significant indicators. Predictability of severe BPD was 81.5% and prediction P value cut off was 0.160. Five-minute Apgar score, birth weight, maternal PIH, chronic maternal hypertension, GA, sex, respiratory distress syndrome, need of resuscitation at birth were significant indicators. After external validation, sensitivity and specificity did not change significantly. Conclusion From this study, high predictability was obtained using clinical parameters obtained within one hour of life. P value for prediction of each grade of BPD and equation for calculation was presented. It can be helpful for the early prediction of BPD in Korean VLBWI. This study will contribute to the prediction of BPD in Asians especially Korean VLBWIs, not currently included in the NICHD BPD online BPD predictor. In addition, the predictive power may be continuously increased with the cumulative data of KNN.

Background: Despite the advances in neonatology, the incidence of bronchopulmonary dysplasia (BPD) is increasing. It is important to prevent the development of BPD in the first place. The online BPD outcome estimator from National Institute of Children Health and Human Development and Neonatal Research Network is available. However, it is not applicable for Asians. Moreover, limits are set for birth weight and gestational weeks excluding those who may still have BPD. The aim of this study was to develop a prediction model for BPD using first hour perinatal and neonatal factors in Korean very low birth weight infants (VLBWIs). Methods: Data were collected for 8,022 VLBWIs with gestational age (GA) ≥ 22 weeks who were born between January 1, 2013 and December 31, 2016, and admitted to the neonatal intensive care units of the KNN. Multiple logistic regression models reanalyzed by stepwise selection with significant clinical indicators for BPD. PROC package was used to calculate the area under curve (AUC) and corresponding 95% confidence intervals. Moreover, it was used to search the best cut-off value. External validation was performed with the 2017 Korean neonatal network (KNN) data. Results: After all missing data were excluded, 4,600 VLBWIs were included in the training dataset of the prediction model. Predictability of presence of BPD was 90.8% and prediction P value cut off was 0.550. Five-minute Apgar score, birth weight, GA, sex, surfactant use were significant indicators. Predictability of severe BPD was 81.5% and prediction P value cut off was 0.160. Five-minute Apgar score, birth weight, maternal PIH, chronic maternal hypertension, GA, sex, respiratory distress syndrome, need of resuscitation at birth were significant indicators. After external validation, sensitivity and specificity did not change significantly. Conclusion From this study, high predictability was obtained using clinical parameters obtained within one hour of life. P value for prediction of each grade of BPD and equation for calculation was presented. It can be helpful for the early prediction of BPD in Korean VLBWI. This study will contribute to the prediction of BPD in Asians especially Korean VLBWIs, not currently included in the NICHD BPD online BPD predictor. In addition, the predictive power may be continuously increased with the cumulative data of KNN.

Most of temporal arteritis occurs in the older patient over 50 years old, and the histopathologic finding shows a granulomatous inflammation, so this called giant cell arteritis. However, the young patients also present with a nodular lesion in their temple, and juvenile temporal arteritis (JTA) should be considered as one of the differential diagnosis, although it is very rare. For both diagnosis and treatment of JTA, excisional biopsy is essential. The pathologic finding of the temporal artery shows panarteritis with lymphoeosinophilic infiltrates, but no giant cell or granulomatous lesion. JTA is a localized disease with low level of systemic inflammatory marker, so the symptom is usually relieved by excision of affected lesion. Peripheral blood eosinophilia present in some cases of JTA, but its relation with clinical course and prognosis is not yet been known. Herein, we report the case of a 24-year-old man diagnosed with concurrent JTA and hypereosinophilic syndrome. We also reviewed the literature of JTA focusing on the impact of combined peripheral eosinophilia on the course of the disease. Combined peripheral eosinophilia may increase the risk of recurrence of JTA after local treatment such as excision only.
Biopsy ; Diagnosis ; Diagnosis, Differential ; Eosinophilia ; Giant Cell Arteritis ; Giant Cells ; Humans ; Hypereosinophilic Syndrome ; Inflammation ; Prognosis ; Recurrence ; Temporal Arteries ; Young Adult

BACKROUND/AIMS: Bismuth-based quadruple therapy for second-line eradication treatment achieves the eradication rate ranging from 70% to 81% due to antimicrobial resistance and poor compliance. The aim of this study was to compare the eradication rate of levofloxacin-based triple therapy with that of bismuth-based quadruple therapy in second-line Helicobacter pylori (H. pylori) eradication therapy. METHODS: Seventy-six outpatients with persistent H. pylori infection after first-line triple therapy were enrolled in this prospective randomized trial. The subjects were randomized to receive levofloxacin 300 mg, amoxicillin 1 g, and pantoprazole 20 mg, given twice daily for 7 days (LAP group), or metronidazole 500 mg twice, tetracycline 500 mg four times, and pantoprazole 20 mg twice, bismuth subcitrate 600 mg twice daily for 7 days (MTPB group). Eradication was confirmed with 13C-urea breath test or rapid urease test 4 weeks after the cessation of therapy. RESULTS: Among Seventy-six patients initially included, eleven were lost during follow-up. The eradication rates, expressed as intention to treat (ITT) and per protocol (PP) analyses, were 51.6% and 53.3% in the LAP group, and 48.9% and 62.9% in the MTPB group, respectively. There was no significant difference in H. pylori eradication rates between the two groups (p=0.815 by ITT, p=0.437 by PP). LAP regimen was better tolerated than MTPB regimen with lower incidence of side effects (10.0% versus 31.4%, p=0.03). CONCLUSIONS: H. pylori eradication rates of levofloxacin-based triple therapy and bismuth-based quadruple therapy were not significantly different in second-line H. pylori eradication therapy, and low incidence of side effects was observed in levofloxacin-based triple therapy.
2-Pyridinylmethylsulfinylbenzimidazoles/administration & dosage ; Adult ; Antacids/administration & dosage ; Anti-Bacterial Agents/*administration & dosage ; Anti-Ulcer Agents/administration & dosage ; Data Interpretation, Statistical ; Drug Therapy, Combination ; Female ; Helicobacter Infections/*drug therapy/microbiology ; *Helicobacter pylori ; Humans ; Male ; Middle Aged ; Ofloxacin/*administration & dosage ; Organometallic Compounds/administration & dosage ; Time Factors ; Treatment Outcome