PURPOSE: An increase in the prevalence of obesity and asthma over recent decades has been reported. While there is evidence of a positive association between asthma and obesity, there is no report about association between asthma and obesity in Korea. The aim of this study was to determine if obesity is more prevalent in children with asthma compared with healthy children and to determine if obesity is associated with atopy in children with asthma. METHODS: We studied 291 atopic asthmatic children, 85 nonatopic asthmatic children and 149 healthy children. BMI (kg/m2) and obesity index were calculated using height and weight which were measured on the same day of methacholine challenge test. Obesity was defined as percentile of BMI over 95 percentile. BMI, obesity index and prevalence of obesity were compared among the three groups. Association between obesity and PC20 was also assessed in asthmatics. RESULTS: The prevalence of obesity was similar for atopic asthmatic group (11.6%), nonatopic asthmatic group (11.7%) and healthy group (12.7%). The prevalence of being at risk of overweight was similar for atopic asthmatic group (18.2%), nonatopic asthmatic group (24.7%) and healthy group (18.1%). There was no difference in BMI and obesity index among the three groups. In asthmatics, obesity index was not correlated with PC20 and there was no difference in obesity index among the asthmatics classified by PC20; < 2 mg/mL, 2-8 mg/mL, 8-18 mg/mL. CONCLUSION: These results suggest that obesity is not associated with asthma. Further studies are needed to confirm these findings in general population, and a prospective study is needed to follow younger children through adolescence.
Adolescent ; Asthma* ; Child* ; Humans ; Korea ; Methacholine Chloride ; Obesity* ; Overweight ; Prevalence

We experienced two cases of Boerhaave syndrome (spontaneous esophageal rupture). The first patient was a 62-year-old male who presented epigastric pain after several violent vomitings associated with alcohol ingestion. Diagnosis was done early and promptly in our emergency center and then definitive treatment was done only after 12hrs from onset of his symptom and he was discharged in relatively good condition 256ays after his admission. The second patient was a 44-year-old male who was transfered to our emergency center with chest pain, dyspnea and fever after vomitings associated with autobicycle accident. Diagnosis was delayed due to initial trauma oriented evaluation and incidious develpement of typical clinical findings and then he was managed conservatively but he died of multiple organ failure due to sepsis. We report these cases with literature review.
Adult ; Chest Pain ; Diagnosis ; Dyspnea ; Eating ; Emergencies ; Esophageal Perforation* ; Fever ; Humans ; Male ; Middle Aged ; Multiple Organ Failure ; Sepsis

PURPOSE: Several studies have shown that increases of eosinophil markers are common findings of asthma and Mycoplasma pneumoniae infection, and eosinophil markers reflect the clinical stage of asthma. The purpose of this study was to investigate the change of eosinophil markers according to the clinical stage of Mycoplasma pneumonia. METHODS: The patient group consisted of 33 outpatient children with Mycoplasma pneumonia. Peripheral blood total eosinophil count(TEC) and serum eosinophilic cationic protein(ECP) level were measured at both acute and recovery stages and were compared between both stages. The patient group was subdivided into the wheezing(n=16) and the nonwheezing group(n=17), and the TECs and the ECPs of one group were compared with those of the other group. The correlation between Mycoplasma antibody titer and the eosinophil markers of acute stage were analyzed. RESULTS: In the whole patient group, the TECs and the ECPs of the acute stage were significantly higher than those of the recovery stage(P=0.018, P=0.005), but there were no differences in the TEC and the ECP between the wheezing and the nonwheezing group. In the wheezing group, there were no significant differences in the TEC and the ECP between acute and recovery stages. There were no correlations between acute stage Mycoplasma antibody titer and the eosinophil markers. CONCLUSION: Eosinophil markers reflect the clinical stage of Mycoplasma pneumonia and eosinophilic inflammations may continue even after the acute stage in wheezing patients with Mycoplasma pneumonia.
Asthma ; Child* ; Eosinophils* ; Humans ; Inflammation ; Mycoplasma pneumoniae* ; Mycoplasma* ; Outpatients ; Pneumonia* ; Pneumonia, Mycoplasma* ; Respiratory Sounds

BACKGROUND AND OBJECTIVES: The GFX stent is a flexible, balloon-expansible stent made of sinusoidal element of stainless steel. The adjunct high-pressure balloon dilatations after stenting were usually recommended in routine stenting procedure. The aim of this study was 1) to evaluate the immediate and long-term clinical and angiographic outcomes and 2) to investigate the necessity of high-pressure balloon during GFX stenting. MATERIAL AND METHODS: One hundred seventy two consecutive patients underwent single 12 or 18 mm GFX stent implantation in 188 native coronary lesions. Two types of stenting technique were used: 1) stent size of a final stent-to-artery ratio of 1:1 (inflation pressure > 10 atm, usually 12-14 atm: high pressure group) and 2) stent size of 0.5 mm bigger than reference vessel (inflation pressure 10 atm, usually 9 atm: low pressure group). The adjunct high-pressure balloon dilatations were done only in cases of suboptimal results. RESULTS: The adjunct high-pressure balloon dilatation were required under angiographic guidance in 11 of 83 lesions (13%) in high pressure group and 7 of 105 lesions (7%) in low pressure group (p=0.203). Procedural success rate was 100%. There were no significant differences of in-hospital and long-term clinical events between 2 group. The overall angiographic restenosis rate was 17.7%: 18.4% in high pressure group and 17.1% in low pressure group (p=0.991). CONCLUSION: GFX stent is a safe and effective device with high procedural success rate and favorable late clinical outcome for treatment of native coronary artery disease. Further randomized trials may be needed to compare stenting techniques in GFX stent implantations.
Angioplasty ; Coronary Artery Disease ; Dilatation* ; Humans ; Stainless Steel ; Stents*

PURPOSE: A new airway inflammatory marker, exhaled nitric oxide(ENO) has been reported to correlate with bronchial hyperresponsiveness(BHR) and atopy. The purpose of this study was to analyze the relationship of ENO with BHR or atopy in patients with asthma and with allergic rhinitis. METHODS: The subjects consisted of 55 children with asthma, 17 with allergic rhinitis, and 14 healthy controls. The asthma group was subdivided into the atopic asthma group(n=37) and the nonatopic asthma group(n=18) and the allergic rhinitis group into BHR group(n=7) and non-BHR group(n=10). All were investigated with spirometry and measurements of ENO concentration. The correlations between ENO concentration and both methacholine PC20(provocative concentration causing a 20% decrease in forced expiratory volume in one second) and the number of allergen skin test positivity were analyzed. RESULTS: ENO concentrations of both asthma and allergic rhinitis groups were significantly greater than that of control(P<0.01). ENO concentration of atopic asthma was significantly greater than that of nonatopic asthma(P<0.01). In allergic rhinitis, ENO concentration did not differ according to the presence or absence of BHR(P=0.50). ENO concentrations correlated significantly with the number of skin test positivity(r=0.32, P=0.02) or methacholine PC20(r=-0.38, P<0.01) in asthma group, but not in the allergic rhinitis group(r=0.42, P=0.09; r=-0.06, P=0.83). CONCLUSION: In asthma patients, some pathogenetic mechanisms associated with atopy and BHR seem to influence ENO concentration. In allergic rhinitis patients, some factors other than BHR may be important in determining ENO concentration.
Asthma* ; Child* ; Forced Expiratory Volume ; Humans ; Methacholine Chloride ; Nitric Oxide* ; Rhinitis* ; Skin Tests ; Spirometry

Background: /Aim: The COVID-19 pandemic has changed the way of traditional conference and meeting. Since social distancing rule was important issue, many conferences across the world were cancelled or postponed indefinitely. In 2020, International Conference of the Korean Pancreatobiliary Association (IC-KPBA) was held as a hybrid online and offline conference. Here, we report the result of a national survey about online and offline medical conference in Korea. Methods: The survey was performed for both online and offline participants after IC-KPBA. The contents of survey included their way to access the hybrid online-offline conference and satisfaction with the conference format. Results: Total of 78 participants answered the survey and there was no technical problem. Most offline participants were satisfied the prevention measures at conference hall as follows; very satisfied-56%; satisfied-34%. The quality of video and audio were generally satisfactory in both conference hall and virtual conference. ‘Live online lectures’ is the most preferred method of lecture delivery and personal computer with LAN network is preferred to access online conference. Eighty seven percent of offline participants and 91% of online participants answered satisfied and very satisfied, respectively. Conclusions Participants of IC-KPBA 2020 with hybrid online-offline conference showed a high level of satisfaction.

Purpose: Erlotinib has been the only targeted agent to show significantly improved outcomes in pancreatic adenocarcinoma when combined with gemcitabine. We aimed to evaluate whether the addition of oxaliplatin to a combination gemcitabine/erlotinib treatment conferred a clinical benefit in patients with locally advanced unresectable or metastatic pancreatic cancer. Materials and Methods: Chemotherapy-naïve patients with locally advanced or metastatic pancreatic cancer were randomly assigned to receive GEMOX-T [gemcitabine 1000 mg/m2 and oxaliplatin 50 mg/m2 on day 1 (D1) and D8 plus erlotinib 100 mg daily for 3 weeks] or GT (gemcitabine 1000 mg/m2 on D1 and D8 plus erlotinib 100 mg daily for 3 weeks). The primary endpoint was the overall response rate (ORR). Results: Between 2013 and 2016, 65 patients were assigned to a treatment group (33 in the GEMOX-T arm, 32 in the GT arm). The ORR was 18.2% [95% confidence interval (CI), 8.82–27.58] in the GEMOX-T arm and 6.2% (95% CI, 0.34–12.06) in the GT arm (p=0.051). The disease control rate was significantly superior in the GEMOX-T arm compared to the GT arm (72.7% vs. 43.8%, p=0.019). After a median follow-up of 19.7 months, the median progression-free survival (PFS) was 3.9 months for the GEMOX-T arm and 1.4 months for the GT arm (p=0.033). However, this did not translate to an improvement in overall survival. The most common grade 3 or higher hematologic adverse events were neutropenia (16.9%) and anemia (13.8%). Conclusion The addition of oxaliplatin to a first-line gemcitabine/erlotinib regimen demonstrated higher response rates and significantly improved PFS in patients with locally advanced or metastatic pancreatic cancer.

Purpose: Erlotinib has been the only targeted agent to show significantly improved outcomes in pancreatic adenocarcinoma when combined with gemcitabine. We aimed to evaluate whether the addition of oxaliplatin to a combination gemcitabine/erlotinib treatment conferred a clinical benefit in patients with locally advanced unresectable or metastatic pancreatic cancer. Materials and Methods: Chemotherapy-naïve patients with locally advanced or metastatic pancreatic cancer were randomly assigned to receive GEMOX-T [gemcitabine 1000 mg/m2 and oxaliplatin 50 mg/m2 on day 1 (D1) and D8 plus erlotinib 100 mg daily for 3 weeks] or GT (gemcitabine 1000 mg/m2 on D1 and D8 plus erlotinib 100 mg daily for 3 weeks). The primary endpoint was the overall response rate (ORR). Results: Between 2013 and 2016, 65 patients were assigned to a treatment group (33 in the GEMOX-T arm, 32 in the GT arm). The ORR was 18.2% [95% confidence interval (CI), 8.82–27.58] in the GEMOX-T arm and 6.2% (95% CI, 0.34–12.06) in the GT arm (p=0.051). The disease control rate was significantly superior in the GEMOX-T arm compared to the GT arm (72.7% vs. 43.8%, p=0.019). After a median follow-up of 19.7 months, the median progression-free survival (PFS) was 3.9 months for the GEMOX-T arm and 1.4 months for the GT arm (p=0.033). However, this did not translate to an improvement in overall survival. The most common grade 3 or higher hematologic adverse events were neutropenia (16.9%) and anemia (13.8%). Conclusion The addition of oxaliplatin to a first-line gemcitabine/erlotinib regimen demonstrated higher response rates and significantly improved PFS in patients with locally advanced or metastatic pancreatic cancer.