A right-sided aortic arch (RAA) is a rare congenital anomaly, and Stanford type B dissection aneurysms involving this anomaly is also uncommon. Surgical approaches to dealing with an RAA are complicated by the unusual anatomical features of the condition. Here we report the case of a 47-year-old male who had a type B dissecting aneurysm involving an RAA with Kommerell's diverticulum. Graft replacement was successfully performed with an uneventful postoperative course.
Aneurysm, Dissecting/radiography/*surgery ; Aorta, Thoracic/*abnormalities/radiography/*surgery ; Aortic Aneurysm, Thoracic/radiography/*surgery ; Blood Vessel Prosthesis Implantation/methods ; Diverticulum/radiography/*surgery ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed

Measurable residual disease (MRD) testing, a standard procedure in B-lymphoblastic leukemia (B-ALL) diagnostics, is assessed using multiparametric flow cytometry (MFC) and next-generation sequencing (NGS) analysis of immunoglobulin gene rearrangements. We evaluated the concordance between eight-color, two-tube MFC-MRD the LymphoTrack NGS-MRD assays using 139 follow-up samples from 54 pediatric patients with B-ALL. We also assessed the effect of hemodilution in MFC-MRD assays. The MRD-concordance rate was 79.9% (N = 111), with 25 (18.0%) and 3 (2.2%) samples testing positive only by NGSMRD (MFC − NGS + MRD) and MFC-MRD (MFC + NGS − MRD), respectively. We found a significant correlation in MRD values from total nucleated cells between the two methods (r = 0.736 [0.647–0.806], P < 0.001). The median MRD value of MFC − NGS + MRD samples was estimated to be 0.0012% (0.0001%–0.0263%) using the NGS-MRD assays. Notably, 14.3% of MFC − NGS + MRD samples showed NGS-MRD values below the limit of detection in the MFC-MRD assays. The percentages of hematogones detected in MFC-MRD assays significantly differed between the discordant and concordant cases (P < 0.001). MFC and NGS-MRD assays showed relatively high concordance and correlation in MRD assessment, whereas the NGS-MRD assay detected MRD more frequently than the MFC-MRD assay in pediatric B-ALL. Evaluating the hematogone percentages can aid in assessing the impact of sample hemodilution.

Well-established standards and specifications for medical devices not only provide clarity and consistency in licensing processes but also secure device safety and effectiveness. This study reviewed regulatory standards and specifications for veterinary medical devices in Korea based on data obtained through analyses of those medical devices. General standards for electromechanical, electromagnetic, and biological safety and individual standards for 76 electric and 70 general medical device products have been established by the Korean Ministry of Food and Drug Safety. However, the first standards and specifications for veterinary medical devices were established in March 2000 for two products (disposable needle and syringe). Similar to the large number of standards for medical devices, there have been general standards for safety and individual standards for 72 veterinary medical devices (27 electric medical devices, 12 non-electric medical devices, 10 medical supplies, and 23 other types) established since 2014. These new standards considered, among other aspects, the devices' applications, usage characteristics, and industrial environment. To date, the establishment of standards and specifications for veterinary medical devices remains limited. This study suggests that improvements should be made to the regulation of general and individual standards associated with various veterinary medical instruments, supplies, and in vitro diagnostic medical reagents.
Equipment and Supplies ; Equipment Safety ; In Vitro Techniques ; Indicators and Reagents ; Korea* ; Licensure ; Magnets ; Needles

BACKGROUND: 5-aminolevulinic acid (ALA), is the precursor of heme biosynthesis and used in photodynamic therapy (PDT). When applied exogenously, it is converted to protoporphyrin IX (PpIX) that is an immediate photosensitizer. PpIX is accumulated selectively in various cells including tumor cells. Because most of photosensitizers emit fluorescence of a specific wavelength, it is very important to identify the fluorescence in the tissues and cells targeted for therapy. OBJECTIVE: This study was undertaken to identify the presence of PpIX fluorescence image and localization in various dermatologic diseases with methyl 5-aminolevulinate (MAL), that satisfactorily penetrates cutaneous lipid layers and cell membranes. METHODS: Various skin diseases such as basal cell carcinoma (6), squamous cell carcinoma (4), keratoacanthoma (6), malignant melanoma (3), extramammary Paget's disease (4), verruca (5), psoriasis vulgaris (5), rosacea (2), and acne (5) were included. We applied MAL, ALA ester, ointment to cutaneous lesions and perilesional area for at least 3 hours. After that, we identified the fluorescence image with Wood's lamp (wavelength 320~400 nm) and photographed fluorescence image. Also, we performed skin biopsies of fluorescence site and investigated the PpIX fluorescent location with a fluorescence microscope. In addition, we treated three cultured cell lines (HaCaT cells, human dermal fibroblasts, A431 cells) with MAL and investigated PpIX fluorescence. RESULTS: The PpIX fluorescence images were observed significantly in basal cell carcinoma, squamous cell carcinoma, extramammary Paget's disease, keratoacanthoma, psoriasis, rosacea, and acne. In tissues, PpIX fluorescence was expressed mainly in the pilosebaceous unit, abnormal keratinocytes, tumor cells including basal cell carcinoma, and extramammary Paget's disease. In addition, PpIX was expressed in the cytoplasm of HaCaT cells, human dermal fibroblasts, and A431 cells in vitro. CONCLUSION: In applieation of photodynamic therapy, this study is expected to be helpful in enhancement of therapeutic effectiveness and increase of indications of diseases.
Acne Vulgaris ; Aminolevulinic Acid* ; Biopsy ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cell Membrane ; Cells, Cultured ; Cytoplasm ; Fibroblasts ; Fluorescence ; Heme ; Humans ; Keratinocytes ; Keratoacanthoma ; Melanoma ; Paget Disease, Extramammary ; Photochemotherapy ; Photosensitizing Agents ; Psoriasis ; Rosacea ; Skin ; Skin Diseases ; Warts

BACKGROUND: Furosemide inhibit NaCl absorption in the thick ascending limb and produce an increase in distal delivery of Na+. We carried out semiquantitative immunoblotting and immunohistochemistry of rat kidneys to investigate whether chronic furosemide infusion is associated with compensatory increases in the abundance of Na+ transporters in distal nephron. METHODS: Osmotic minipumps were implanted into Sprague-Dawley rats to deliver 12 mg/day of furosemide(n=6) with simultaneous administration of 0.8% NaCl and 0.1% KCl in drinking water for 7 days. RESULTS: Compared with vehicle infused controls, urine volume and urine sodium amount were increased. However, there were no differences in body weight, serum aldosterone, and creatinine clearance. The abundance of Na+-K+-2Cl- cotransporter after furosemide infusion was increased in cortex (151+/-10 vs. 100+/-10%, p< 0.05) and outer medulla (122+/-5 vs. 100+/-3%, p< 0.01). In furosemide infusion group, the abundance of all three subunits of epithelial sodium channel (ENaC) was increased both in cortex (alpha: 187+/-25 vs. 100+/-17%, p< 0.05; beta: 155+/-8 vs. 100+/-15%, p< 0.05; gamma: 168+/-16 vs. 100+/-9%, p< 0.05) and outer medulla (alpha: 171+/-27 vs. 100+/-17%, p< 0.05; beta: 986+/-91 vs. 100+/-33%, p< 0.01; gamma: 242+/-24 vs. 100+/-22%, p< 0.01). Consistent with these results, ENaC beta-subuint immunohistochemistry showed a remarkable increase in immunoreactivity in the principal cells of collecting ducts with furosemide treatment. CONCLUSION: These increases in the abundance of ENaC protein may account for the generation of diuretic tolerance.
Absorption ; Aldosterone ; Animals ; Body Weight ; Creatinine ; Drinking Water ; Epithelial Sodium Channels ; Extremities ; Furosemide* ; Immunoblotting ; Immunohistochemistry ; Kidney* ; Nephrons ; Rats* ; Rats, Sprague-Dawley ; Sodium*

This study investigated the experience and practice of elementary school students on nutrition education. The data were collected from 217 male and female students attending 5-6th grade elementary schools in Seoul and Kyunggi-Do from March to June 2007, interviewing face to face by a nutrition teacher and 3 interns of a nutrition teacher. The results were as follows: 86.5% of the subjects learned about 'Table etiquette', 'Reasons for eating fruits and vegetables'(78.7%), 'Food waste and environment'(72.3%), 'Healthy snacks'(55.7%), 'Food sanitation'(52.3%), 'Food culture of foreign countries'(48.1%). Nutrition education experience was significantly different by gender. A total of 43.5% boys responded that they never learned about 'basic food preperation'(p < 0.01). They had learned 'Nutrients for body'and 'Food waste and environment'in school, 'Healthy weight loss', 'Food culture of foreign countries', 'Food circulation'on television, Most content ('Table etiquette', 'Simple cooking', 'Food sanitation', 'Eating behaviors for health', 'Reasons for eating fruits and vegetables', 'Healthy snacks') was learned from parents. The practice after nutrition education was higher in 'Table etiquette'(2.14), 'Eating fruits and vegetables'(2.07) than others compared with education experience. The most reason of non-practice on nutrition information was 'Troublesome'. In 'Nutrients for body', a boy answered 'Difficult for practice'20.0%, a girl answered 'Difficult to understand'32.6%, showing a significant difference between the gender groups (p < 0.001). They remembered the 'Nutrients for body'(49.6%), 'Food sanitation'(44.5%) because of 'important content', 'Basic food preparation'(40.6%), 'Food culture of foreign countries'(36.3%) because of 'interesting content', 'Healthy weight loss'(52.0%), 'Eating behavior for health'(44.5%) and 'Healthy snacks'(33.7%) because of 'need for my health'.
Eating ; Female ; Fruit ; Humans ; Male ; Parents ; Television

PURPOSE: Severe asthma and asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) are difficult to control and are often associated with poor clinical outcomes. However, much is not understood regarding the diagnosis and treatment of severe asthma and ACOS. To evaluate the current perceptions of severe asthma and COPD among asthma and COPD specialists, we designed an e-mail and internet-based questionnaire survey. METHODS: Subjects were selected based on clinical specialty from among the members of the Korean Academy of Asthma, Allergy and Clinical Immunology and the Korean Academy of Tuberculosis and Respiratory Diseases. Of 432 subjects who received an e-mail invitation to the survey, 95 subjects, including 58 allergists and 37 pulmonologists, responded and submitted their answers online. RESULTS: The specialists estimated that the percentage of severe cases among total asthma patients in their practice was 13.9%±11.0%. Asthma aggravation by stepping down treatment was the most common subtype, followed by frequent exacerbation, uncontrolled asthma despite higher treatment steps, and serious exacerbation. ACOS was estimated to account for 20.7% of asthma, 38.0% of severe asthma, and 30.1% of COPD cases. A history of smoking, persistently low forced expiratory volume in 1 second (FEV1), and low FEV1 variation were most frequently classified as the major criteria for the diagnosis of ACOS among asthma patients. Among COPD patients, the highly selected major criteria for ACOS were high FEV1 variation, positive bronchodilator response, a personal history of allergies and positive airway hyperresponsiveness. Allergists and pulmonologists showed different assessments and opinions on asthma phenotyping, percentage, and diagnostic criteria for ACOS. CONCLUSIONS: Specialists had diverse perceptions and clinical practices regarding severe asthma and ACOS patients. This heterogeneity must be considered in future studies and strategy development for severe asthma and ACOS.
Allergy and Immunology ; Asthma* ; Diagnosis ; Electronic Mail ; Forced Expiratory Volume ; Humans ; Hypersensitivity ; Lung Diseases, Obstructive ; Population Characteristics ; Pulmonary Disease, Chronic Obstructive ; Smoke ; Smoking ; Specialization* ; Tuberculosis

PURPOSE: Although mild to moderate asthma is much more common, the morbidity and mortality of severe asthma are much higher. This study was performed to identify and analyze the clinical characteristics of severe asthma in Korea. METHODS: We registered patients with severe refractory asthma into the Severe Asthma Registry supported by the Severe Asthma Work Group of the Korean Academy of Asthma, Allergy and Clinical Immunology. Patients were enrolled since 2010 from the 15 university hospitals nationwide in Korea. Severe asthma was defined according to modified European Respiratory Society/American Thoracic Society criteria. Information on demographics, medical history, pulmonary function tests and skin prick tests was collected; the clinical characteristics of severe asthmatics were analyzed from the collected data. RESULTS: A total of 489 patients were enrolled with a mean age of 62.3; 45% are male. Sixty percent of patients received Global Initiative for Asthma step 4 treatment, and 30% received step 5 treatment. The most common comorbidities were allergic rhinitis (58.7%). Aspirin hypersensitivity was observed in 14.0%. Approximately half (53.9%) are non-smokers. Atopy was proven in 38.5% of the patients. Regarding asthma medications, inhaled corticosteroids and long-acting β-agonist combination inhalers were most commonly prescribed (96.5%), followed by leukotriene antagonists (71.0%). A recombinant anti-immunoglobulin E monoclonal antibody (omalizumab) has been used in 1.8% of the patients. The mean forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and FEV1/FVC were 78.7%, 67.5% and 67.9% of predicted values, respectively. The mean Asthma Control Test and quality of life questionnaire scores were 16.5 out of 25 and 59.5 out of 85, respectively. CONCLUSIONS: The baseline characteristics of severe asthma patients in the Korea Severe Asthma Registry were analyzed and reported for the first time. With this cohort, further prospective studies should be performed to search for ways to improve management of severe refractory asthma.
Adrenal Cortex Hormones ; Adult* ; Allergy and Immunology ; Aspirin ; Asthma* ; Cohort Studies ; Comorbidity ; Demography ; Forced Expiratory Volume ; Hospitals, University ; Humans ; Hypersensitivity ; Korea* ; Leukotriene Antagonists ; Male ; Mortality ; Nebulizers and Vaporizers ; Prospective Studies ; Quality of Life ; Respiratory Function Tests ; Rhinitis, Allergic ; Skin ; Vital Capacity

Pediatric differentiated thyroid cancers (DTCs), mostly papillary thyroid cancer (PTC, 80-90%), are diagnosed at more advanced stages with larger tumor sizes and higher rates of locoregional and/or lung metastasis. Despite the higher recurrence rates of pediatric cancers than of adult thyroid cancers, pediatric patients demonstrate a lower mortality rate and more favorable prognosis. Considering the more advanced stage at diagnosis in pediatric patients, preoperative evaluation is crucial to determine the extent of surgery required. Furthermore, if hereditary tumor syndrome is suspected, genetic testing is required. Recommendations for pediatric DTCs focus on the surgical principles, radioiodine therapy according to the postoperative risk level, treatment and follow-up of recurrent or persistent diseases, and treatment of patients with radioiodine-refractory PTCs on the basis of genetic drivers that are unique to pediatric patients.

Differentiated thyroid cancer demonstrates a wide range of clinical presentations, from very indolent cases to those with an aggressive prognosis. Therefore, diagnosing and treating each cancer appropriately based on its risk status is important. The Korean Thyroid Association (KTA) has provided and amended the clinical guidelines for thyroid cancer management since 2007. The main changes in this revised 2024 guideline include 1) individualization of surgical extent according to pathological tests and clinical findings, 2) application of active surveillance in low-risk papillary thyroid microcarcinoma, 3) indications for minimally invasive surgery, 4) adoption of World Health Organization pathological diagnostic criteria and definition of terminology in Korean, 5) update on literature evidence of recurrence risk for initial risk stratification, 6) addition of the role of molecular testing, 7) addition of definition of initial risk stratification and targeting thyroid stimulating hormone (TSH) concentrations according to ongoing risk stratification (ORS), 8) addition of treatment of perioperative hypoparathyroidism, 9) update on systemic chemotherapy, and 10) addition of treatment for pediatric patients with thyroid cancer.