PURPOSE: Nebulizers are commonly used to treat children with asthma. Some pulmonary infections associated with contaminated nebulizer units have been reported. The aims of this study were to determine whether home nebulizers are repositories of bacteria and to ascertain how asthmatic patients use and maintain their nebulizers at home. METHODS: Fifty-five children with asthma aged 2 to 6 years were enrolled in this study. The parents were asked to bring their child's nebulizer units to regular follow-up visits. Bacterial samples which were obtained from the masks(or mouthpieces), nebulizer chambers and throat swabs were inoculated to blood agar, chocolate agar, and McConkey agar. Cultures were incubated at 5 percent CO2 incubator and observed after 24 hours. Parents completed a questionnaire regarding nebulizer usage and care in their child. RESULTS: Bacterial contamination was found in samples from 27(49.1%) of the 55 masks(or mouthpieces) and 24(43.6%) of the 55 chambers. The predominant microorganisms isolated were Acinetobacter baumannii, Bacillus subtilis, Klebsiella pneumoniae, Staphylococcus aureus, and Candida albicans. The questionnaire revealed that 40 parents cleaned the nebulizer units with tap water(and soap) and dried then, as they had received cleaning and drying instructions from a medical staff member. Seven organisms from nebulizer units were indistinguishable from the patient's throat isolates. CONCLUSION: We have demonstrated that home nebulizers in these asthmatic children were frequently contaminated with aerobic bacteria. Aerosolization might transmit these bacteria to their upper respiratory tracts. The education and training of home caregivers should include the principles of cleaning and maintenance of their child's nebulizer units.
Acinetobacter baumannii ; Agar ; Asthma ; Bacillus subtilis ; Bacteria ; Bacteria, Aerobic ; Cacao ; Candida albicans ; Caregivers ; Child* ; Education ; Follow-Up Studies ; Humans ; Incubators ; Inhalation ; Klebsiella pneumoniae ; Medical Staff ; Nebulizers and Vaporizers* ; Parents ; Pharynx ; Surveys and Questionnaires ; Respiratory System ; Staphylococcus aureus

PURPOSE: We measured and compared the uPA, plasminogen activator inhibitor-1 (PAI-1) and uPA receptor (uPAR) levels in breast cancer tissues and blood of the patients to evaluate their clinical relevance for biotherapy. MATERIALS AND METHODS: uPA, PAI-1 (Monozyme, Netherland), uPAR (American Diagnostics, USA) levels were measured by ELISA assay in 192 breast cancer tissues, in 18 normal breast tissues and in 163 blood from breast cancer patients. RESULTS: There was a tendency of uPA increment from ductal carcinoma in situ while increment of PAI-1 and uPAR occurred from Ti. With the progression of cancer, uPA, PAI-1, uPAR tended to decrease; however, the uPA/uPAR, uPA/PAI-1 ratios remained unchanged. There was a correlation of uPA expression between normal and cancer tissues ( r(2)= 0.49). Correlation of uPA and PAI-1 was found in normal tissue and stage I cancer tissue while correlation of uPAR and PAI-1 was found with cancer progression. Between cancer tissue and blood significant correlations were found in uPA, PAI-1, uPAR levels. CONCLUSION: uPA, PAI-1, uPAR levels in cancer tissue elevated from the early stage maintaining correlative expressions with cancer progression. A positive correlation between cancer tissue and blood level suggested the applicability of the levels of uPA, PAI-1 or uPAR for detecting patients for biotherapy.
Biological Therapy* ; Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Enzyme-Linked Immunosorbent Assay ; Humans ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators* ; Plasminogen* ; Urokinase-Type Plasminogen Activator*

Mediastinal ectopic thyroid is a very rare condition, with few reported cases in the literature and no reported cases in Korea. This report describes an asymptomatic 65-year-old man with a right paratracheal mass compressing the superior vena. Additionally, the epidemiology, clinical manifestation, diagnosis, and management of mediastinal ectopic thyroids are discussed. A mediastinal ectopic thyroid should be considered in the differential diagnosis of all mediastinal masses. Surgical excision is recommended for both the diagnosis and treatment of this condition, because of its potential for malignancy and compression of mediastinal structures. This case demonstrates the clinical importance of mediastinal etopic thyroid.
Aged ; Choristoma/*diagnosis ; Humans ; Incidental Findings ; Male ; Mediastinal Diseases/*diagnosis ; *Thyroid Gland

PURPOSE: This study was conducted to investigate the immune responses of children with moderate and severe novel influenza A virus (H1N1) pneumonia, and to compare their clinical and immunological findings with those of control subjects. METHODS: Thirty-two admitted patients with H1N1 pneumonia were enrolled in the study. The clinical profiles, humoral and cell-mediated immune responses of the 16 H1N1 pneumonia patients who were admitted to the pediatric intensive care unit (severe pneumonia group), 16 H1N1 pneumonia patients admitted to the pediatric general ward (moderate pneumonia group) and 13 control subjects (control group) were measured. RESULTS: Total lymphocyte counts were significantly lower in patients with H1N1 pneumonia than in the control group (P=0.02). The number of CD4+ T lymphocytes was significantly lower in the severe pneumonia group (411.5+/-253.5/microL) than in the moderate pneumonia (644.9+/-291.1/microL, P=0.04) and control (902.5+/-461.2/microL, P=0.01) groups. However, the number of CD8+ T lymphocytes was significantly higher in the severe pneumonia group (684.2+/-420.8/microL) than in the moderate pneumonia (319.7+/-176.6/microL, P=0.02) and control (407.2+/-309.3/microL, P=0.03) groups. The CD4+/CD8+ T lymphocytes ratio was significantly lower in the severe pneumonia group (0.86+/-0.24) than in the moderate pneumonia (1.57+/-0.41, P=0.01) and control (1.61+/-0.49, P=0.01) groups. The serum levels of IgG, IgM and IgE were significantly higher in the severe pneumonia group than in the 2 other groups. CONCLUSION: The results of this study suggest that increased humoral immune responses and the differences in the CD4+ and CD8+ T lymphocyte profiles, and imbalance of their ratios may be related to the severity of H1N1 pneumonia in children.
Child ; Humans ; Immunity, Humoral ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulin M ; Influenza A virus ; Influenza, Human ; Intensive Care Units ; Lymphocyte Count ; Lymphocytes ; Pandemics ; Patients' Rooms ; Pneumonia ; T-Lymphocytes

A 40-year-old man who had been treated for multiple myeloma, complained of decreased visual acuity of the left eye on the 30th day of admission. The nucleotide sequences of a fungal PCR product from vitreous fluid showed 99% homology with Aspergillus fumigatus (AY373851). Aspergillus spp. was isolated from vitreous fluid culture, also. Rapid diagnosis and intervention are critical elements for the Aspergillus endophthalmitis; therefore, it would be helpful to combine the fungal PCR with conventional fungus culture for clinically indicated specimens.
Adult ; Aspergillus fumigatus ; Aspergillus* ; Base Sequence ; Diagnosis ; Endophthalmitis* ; Fungi ; Humans ; Multiple Myeloma* ; Polymerase Chain Reaction ; Visual Acuity

BACKGROUND AND OBJECTIVES: The acute effect of alcohol is well known. However, although many authors have studied the effect of alcohol on equilibrium and found a deteriorated balancing capacity, objective studies of deteriorated balancing capacity have rarely been reported. The object of this study is to assess the effect of alcohol on vestibular function impairment by dynamic posturography. MAERIALS AND METHODS: Twelve healthy male volunteers aged 23-27 years (mean 25years) were assessed by dynamic posturography 30 min, 60 min and 90 min before and after the ingestion of alcohol. Alcohol levels were measured by blood samples 30, 60 and 90 min before, at and after ingestion. The samples were analyzed for alcohol by chromatography (SIGMA diagnostics). Each condition in SOT and latencies in MCT were used to estimate the effect of alcohol. RESULTS: The obtained results were as follows: 1) The time when serum alcohol concentration reach the maximum was 60 minute (50%). 2) Conditions 4, 5, 6 and composite scores showed statistically significant lower equilibrium scores (p<0.05). 3) Fourty-one percent showed normal SOT pattern, 33.3% showed generalized lower scores for all the conditions, 16.7% showed lower scores for the conditions 4, 5, and 6, and 8.3% showed lower scores for the conditions 5 and 6. 4) No significant effects were found for the latencies of MCT (p>0.05). CONCLUSION: Acute alcohol ingestion influences impairment of vestibular and visual input on equilibrium.
Chromatography ; Eating ; Humans ; Male ; Volunteers

Our previous study revealed that mutations of the p53 gene were detected by cDNA sequencing in one of four (25%) primary gastric tumors and in five of six (83%) gastric cancer cell lines. It was of interest that all five cell lines established from metastatic lesions had p53 gene mutations, while the single cell line established from a primary tumor lacked an abnormality. Thus, the current study was initiated to determine the frequency of p53 mutations in 10 pairs of samples from primary gastric carcinomas and their lymph node metastases, in addition to morphologically normal gastric mucosa. In addition, we correlated the findings with other relevant molecular markers including the metastasis associated nm23-H1 gene and loss of heterozygosity (LOH) using multiple polymorphic markers for chromosome 17p and sequencing the entire open reading frame (ORF) of the p53 gene. Five of ten (50%) patients were constitutionally heterozygous for one or more 17p and/or p53 probes (pYNZ 22, BamHI RFLP; pMct35.1, Mspl RFLP; php53cl, Bg/II RFLP), while none had LOH at the 17p and/or p53. A Bg/II RFLP for analysis of possible nm23-H1 somatic allelic deletion revealed no LOH out of four informative cases. One paired sample demonstrated the substitution of valine for isoleucine at codon 41 (GTT to ATT) in both primary gastric tumor and metastasis. Another metastatic sample demonstrated the substitution of proline for threonine at codon 278 (CCT to C/ACT) in addition to a non-mutated codon, while only the wild-type p53 sequence was present in the paired primary gastric tumor tissue.(ABSTRACT TRUNCATED AT 250 WORDS)
Base Sequence ; Chromosome Deletion ; DNA, Complementary/chemistry ; *Genes, p53 ; Humans ; Molecular Sequence Data ; Mutation ; Neoplasm Metastasis/*genetics ; Polymorphism, Restriction Fragment Length ; RNA, Messenger/analysis ; Stomach Neoplasms/*genetics/pathology/secondary

PURPOSE: We studied the telomerase activity in normal and cancer tissues of the breast and then compared it to the clinical parameters. MATERIALS AND METHODS: 36 paired normal and cancerous breast tissues were assayed for telomerase activity by PCR-based TRAP assay (telomeric repeat amplification protocol). In 17 cancer tissues, flow cytometric analysis for S-phase fraction was done. RESULTS: None of the normal breast tissue expressed telomerase activity while 23 out of 26 breast cancer tissue expressed telomerase activity (92%). Clinical parameters such as T-factor, tumor grade, hormone receptor expression, mitosis, S-phase fraction did not correlate with telomerase expression. However, telomerase acitvity increased with cancer progression such as; in a state of lymph node metastasis and in an advanced pathological stage. CONCLUSION: Telomerase activity was expressed only from cancer tissues. And this expression increased with cancer progression suggesting a possible therapeutic target in breast cancer.
Breast Neoplasms* ; Breast* ; Lymph Nodes ; Mitosis ; Neoplasm Metastasis ; Telomerase*

Immune checkpoint inhibitors (ICIs) including an anti-cytotoxic T-lymphocyte-associated antigen 4 inhibitor, anti-programmed cell death protein 1 (PD-1) inhibitors, and anti-PD-ligand 1 inhibitors are representative therapeutics for various malignancies. In oncology, the application of ICIs is currently expanding to a wider range of malignancies due to their remarkable clinical outcomes. ICIs target immune checkpoints which suppress the activity of T-cells that are specific for tumor antigens, thereby allowing tumor cells to escape the immune response. However, immune checkpoints also play a crucial role in preventing autoimmune reactions. Therefore, ICIs targeting immune checkpoints can trigger various immune-related adverse events (irAEs), especially in endocrine organs. Considering the endocrine organs that are frequently involved, irAEs associated endocrinopathies are frequently life-threatening and have unfavorable clinical implications for patients. However, there are very limited data from large clinical trials that would inform the development of clinical guidelines for patients with irAEs associated endocrinopathies. Considering the current clinical situation, in which the scope and scale of the application of ICIs are increasing, position statements from clinical specialists play an essential role in providing the appropriate recommendations based on both medical evidence and clinical experience. As endocrinologists, we would like to present precautions and recommendations for the management of immune-related endocrine disorders, especially those involving the adrenal, thyroid, and pituitary glands caused by ICIs.

Since the first outbreak of coronavirus disease 2019 (COVID-19), ongoing efforts have been made to discover an efficacious vaccine against COVID-19 to combat the pandemic. In most countries, both mRNA and DNA vaccines have been administered, and their side effects have also been reported. The clinical course of COVID-19 and the effects of vaccination against COVID-19 are both influenced by patients’ health status and involve a systemic physiological response. In view of the systemic function of endocrine hormones, endocrine disorders themselves and the therapeutics used to treat them can influence the outcomes of vaccination for COVID-19. However, there are very limited data to support the development of clinical guidelines for patients with specific medical backgrounds based on large clinical trials. In the current severe circumstances of the COVID-19 pandemic, position statements made by clinical specialists are essential to provide appropriate recommendations based on both medical evidence and clinical experiences. As endocrinologists, we would like to present the medical background of COVID-19 vaccination, as well as precautions to prevent the side effects of COVID-19 vaccination in patients with specific endocrine disorders, including adrenal insufficiency, diabetes mellitus, osteoporosis, autoimmune thyroid disease, hypogonadism, and pituitary disorders.