PURPOSE: Expression of bel-2 is associated with inhibition of apoptosis and extension of cell survival. We investigated the expression of bel-2 oncoprotein in human bladder tumor. MATERIALS AND METHODS: The expression of bel-2 oncoprotein was investigated immunohistochemically in formalin-fixed and paraffin-embedded tissue specimens from 43 patients with primary transitional cell carcinoma in urinary bladder. Thirty four were superficial bladder tumors and nine were invasive bladder tumors. In histology grade according WHO grading there were 9 grade 1,21 grade II and 13 grade III. RESULTS: Strong positive staining was 5(11.62%), positive staining 13(30%) and negative staining 25(58%). Random distribution through the cancerous epithelium presented in 3 tumors but the other 15 tumors demonstrated cystoplasmic staining restricted to basal epithelial cells. Positive immunoreaction for bel-2 was found in 3 out of 9 invasive bladder tumors, while 15 of 34 superficial tumors showed positive staining. There was no significant correlation between bel-2 expression and tumor stage(p=0.56). 6 of grade I, 9 of grade II and 3 of grade III bladder tumors showed positive staining. There was no significant correlation between bcl-2 expression and tumor grade(p=0.12). CONCLUSIONS: The findings suggest that no clear relationship was found between tumor grade, stage and bel-2 expression.
Apoptosis ; Carcinoma, Transitional Cell ; Cell Survival ; Epithelial Cells ; Epithelium ; Humans ; Negative Staining ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Isolated ACTH deficiency is a rare cause of secondary adrenocortical insufficiency. The clinical presentation can be similar to that of primary adrenal insufficiency, but most of them may be nonspecific. A female patient of 25 months of age, complainig short stature, showed hypocortisolemia without ACTH & cortisol stimulation by insulin-induced hypoglycemia test. All the other hormone state was normal. Left hand AP view revealed delayed bone age(3 month) compared with chronological age. No radiologic abnormality was found in sella MRI and adrenal CT. Here we report a case of isolated ACTH deficiency presented by short stature.
Addison Disease ; Adrenocorticotropic Hormone ; Female ; Hand ; Humans ; Hydrocortisone ; Hypoglycemia ; Magnetic Resonance Imaging

BACKGROUND AND OBJECTIVES: Low-density lipoprotein cholesterol (LDL-C), an established cardiovascular risk factor, can be generally determined by calculation from total cholesterol, high-density lipoprotein cholesterol, and triglyceride concentrations. The aim of this study was to compare LDL-C estimations using various formulas with directly measured LDL-C in a community-based group and hospital-based group among the Korean population. SUBJECTS AND METHODS: A total of 1498 participants were classified into four groups according to triglyceride concentrations as follows: <100, 100–199, 200–299, and ≥300 mg/dL. LDL-C was calculated using the Friedewald, Chen, Vujovic, Hattori, de Cordova, and Anandaraja formulas and directly measured using a homogenous enzymatic method. Pearson's correlation coefficients, intraclass correlation coefficients (ICC), Passing & Bablok regression, and Bland-Altman plots were used to evaluate the performance of six formulas. RESULTS: The Friedewald formula had the highest accuracy (ICC=0.977; 95% confidence interval 0.974-0.979) of all the triglyceride ranges, while the Vujovic formula had the highest accuracy (ICC=0.876; 98.75% confidence interval 0.668–0.951) in people with triglycerides ≥300 mg/dL. The mean difference was the lowest for the Friedewald formula (0.5 mg/dL) and the percentage error was the lowest for the Vujovic formula (30.2%). However, underestimation of the LDL-C formulas increased with triglyceride concentrations. CONCLUSION: The accuracy of the LDL-C formulas varied considerably with differences in triglyceride concentrations. The Friedewald formula outperformed other formulas for estimating LDL-C against a direct measurement and the Vujovic formula was suitable for hypertriglyceridemic samples; it could be used as an alternative cost-effective tool to measure LDL-C when the direct measurement cannot be afforded.
Cardiovascular Diseases* ; Cholesterol* ; Humans ; Lipoproteins* ; Methods ; Risk Factors ; Triglycerides

BACKGROUND AND OBJECTIVES: We investigated the inter-arm difference in blood pressure of the general Korean population to identify associated factors. SUBJECTS AND METHODS: A total of 806 participants aged 30 to 64 years without history of major cardiovascular disease were analyzed in this cross-sectional study. They participated in the Cardiovascular and Metabolic Disease Etiology Research Center cohort study that began in 2013. Brachial blood pressure was measured simultaneously for both arms using an automated oscillometric device equipped with two cuffs in seated position. After five minutes of rest, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured three times. The average of the three measurements was used for analysis. Multivariate logistic regression models were used to identify factors associated with inter-arm differences in blood pressure. RESULTS: The mean inter-arm difference was 3.3 mmHg for SBP and 2.0 mmHg for DBP. Large inter-arm differences (≥10 mmHg) in SBP and in DBP were found in 3.7% and 0.9% of subjects, respectively. A large inter-arm difference in SBP was associated with mean SBP (p=0.002) and C-reactive protein (p=0.014) while a large inter-arm different in DBP was only associated with body mass index (p=0.015). Sex, age, and anti-hypertensive medication use were not associated with differences in inter-arm blood pressure. CONCLUSION: Large inter-arm difference in blood pressure is only present in a small portion of healthy Korean adults. Our findings suggest that high SBP, chronic inflammation, and obesity may be associated with larger difference in inter-arm blood pressure.
Adult ; Arm ; Blood Pressure* ; Body Mass Index ; C-Reactive Protein ; Cardiovascular Diseases ; Cohort Studies ; Cross-Sectional Studies ; Humans ; Inflammation ; Logistic Models ; Metabolic Diseases ; Obesity ; Posture

BACKGROUND: Dermatitis occurring after ingestion of the urushiol chicken is quite common in Korea. Although many cases of the systemic contact dermatitis due to urushiol chicken have already been reported, systemic study on its epidemiology is not done yet. OBJECTIVE: To elucidate the demography of the eaters of the urushiol chicken with its general understandings in society and the incidence of the resultant systemic dermatitis. METHODS: By the help of the patients who developed the dermatitis, all the persons who ate it together with the patients were interviewed. RESULTS AND CONCLUSION: l. 171 eaters of the urushiol chicken(125 male and 46 female) were enrolled in this study(M:F= 3.1:1). The age group in 4th decade was the most common in male, the 5th decade in female. The age prevalence of the systemic contact dermatitis corresponded to the age prevalence of the eater. 2. Incidence rate of systemic contact dermatitis among the eaters was 32.2% (55/171). Incidence rate according to each age group were as follows : 0% in 2nd decade, 33.3% in the 3rd decade, 32.4% in 4th decade, 32.8% in 5th decade, 33.3% in 6th decade, 25% in the 7th decade. 3. One third (57/171) of the eaters ate the urushiol chicken to strengthen their internal organs, especially stomach, which they believed to be weak 70 persons (40.9%) ate it at home, 101 persons (59.1%) ate it at a restaurant. 4. Out of 67 persons having past history of allergic contact dermatitis to Rhus tree, 28 persons (41.8%) showed systemic contact dermatitis. Out of 104 persons without past history of allergy to Rhus, 27 persons (26.0%) showed systemic contact dermatitis.
Chickens ; Demography ; Dermatitis ; Dermatitis, Allergic Contact ; Dermatitis, Contact* ; Eating* ; Epidemiologic Studies* ; Epidemiology ; Female ; Humans ; Hypersensitivity ; Incidence ; Korea ; Male ; Prevalence ; Restaurants ; Rhus* ; Stomach ; Trees

OBJECTIVE: During the past 20 years, over 1,400 doctors have been certified as emergency physicians in Korea. The number of scientific publications in the field of emergency medicine has also increased. This study aims to evaluate the research productivity of academic emergency physicians in South Korea. METHODS: Articles published from 1996 to 2015 by authors affiliated with Korean emergency departments were retrieved using Pubmed, Embase, and Web of Science. Research productivity was analyzed quantitatively to ascertain the number of articles for publication type and year. The performance of these articles was also analyzed qualitatively using impact factor, citation number, and Hirsch index. Bibliometric analysis was performed by researching Web of Science, Scopus, and Google Scholar. RESULTS: A total of 858 articles with 293 Korean authors as the first or corresponding authors were published across 191 journals. The number of publications increased continuously. The most common publication type was original article (n=618), the most commonly studied research topic was resuscitation medicine (n=110), and the average impact factor of the original articles was 2.158. The highest h-index was 17 and, using Web of Science, the maximum number of citations was found to be 85. CONCLUSION: This study suggests that the research productivity of Korean authors in the emergency medicine field has progressed steadily during the last 10 years. However, qualitative indexes, such as the number of citations and h-index value, remain low.
Bibliometrics* ; Efficiency* ; Emergencies* ; Emergency Medicine* ; Emergency Service, Hospital ; Humans ; Journal Impact Factor ; Korea* ; Publications ; Research Personnel ; Resuscitation

Trace fear conditioning is characterized by a stimulus-free trace interval (TI) between the conditioned stimulus (CS) and the unconditioned stimulus (US), which requires an array of brain structures to support the formation and storage of associative memory. The entorhinal cortex (EC) has been proposed to provide essential neural code for resolving temporal discontinuity in conjunction with the hippocampus. However, how the CS and TI are encoded at the neuronal level in the EC is not clear. In Exp. 1, we tested the effect of bilateral pre-training electrolytic lesions of EC on trace vs. delay fear conditioning using rats as subjects. We found that the lesions impaired the acquisition of trace but not delay fear conditioning confirming that EC is a critical brain area for trace fear memory formation. In Exp. 2, single-unit activities from EC were recorded during the pretraining baseline and post-training retention sessions following trace or delay conditioning. The recording results showed that a significant proportion of the EC neurons modulated their firing during TI after the trace conditioning, but not after the delay fear conditioning. Further analysis revealed that the majority of modulated units decreased the firing rate during the TI or the CS. Taken together, these results suggest that EC critically contributes to trace fear conditioning by modulating neuronal activity during the TI to facilitate the association between the CS and US across a temporal gap.

BACKGROUND AND OBJECTIVES: To investigate age-specific and sex-specific distributions of blood cholesterol in the general Korean population. SUBJECTS AND METHODS: We analyzed data for 8284 men and 9246 women aged > or =10 years who participated in the fifth (2010-2012) Korea National Health and Nutrition Examination Survey. Age-specific means, medians, and selected percentiles were calculated for men, premenopausal women, and postmenopausal women. RESULTS: Median total cholesterol (TC) level increased with age across all age groups, from 147 to 196 mg/dL in males and from 159 to 210 mg/dL in females. Triglyceride (TG) levels increased with age in females; however, in males, TG levels rapidly increased during young adulthood, peaked at 50-54 years, and then decreased. High density lipoprotein-cholesterol (HDL-C) levels were higher in females than in males and decreased with increasing age in both males and females. Low density lipoprotein-cholesterol (LDL-C) levels increased with age across all age groups, from 89 to 127 mg/dL in males and from 82 to 113 mg/dL in females. Lipoprotein-cholesterol fraction (TC/HDL-C, LDL-C/HDL-C, TG/HDL-C, non-HDL-C) levels increased with age in females, but increased more rapidly in males during young adulthood and decreased after middle age. CONCLUSION: Blood cholesterol levels and lipoprotein-cholesterol fractions present different distributions by age, sex, and menopausal status.
Cholesterol* ; Epidemiology ; Female ; Humans ; Korea ; Male ; Middle Aged ; Nutrition Surveys ; Triglycerides

Purpose: To determine the metabolic influence of the traditional Korean diet (K-diet), which has been regarded as a healthy diet, we investigated the profile of urine organic acids that are intermediates of various types of metabolism including energy metabolism. Methods: Ten women aged 50–60 years were recruited and randomly divided into 2 diet groups, K-diet and control diet, the latter of which is a Westernized Korean diet that is commonly consumed by Koreans nowadays. Before and after the 2-week intervention, 46 urine organic acids were determined using LC/MS/MS, along with clinical parameters. Results: The average concentrations of succinate (4.14 ± 0.84 μg/mg creatinine vs. 1.49 ± 0.11, p = 0.0346) and hydroxymethylglutarate (3.67 ± 0.36 μg/mg creatinine vs. 2.97 ± 0.29, p = 0.0466), both of which are intermediates of energy metabolism, decreased in the K-diet group after the 2-week intervention, but these were not observed in the control diet group. In particular, the average concentration of succinate in the K-diet group was lower than that in the control group (3.33 ± 0.56 μg/mg creatinine vs. 1.49 ± 0.11, p = 0.0284) after 2 weeks. The concentrations of two tryptophan metabolites, 5-hydroxyindolacetate (3.72 ± 0.22 μg/mg creatinine vs. 3.14 ± 0.21, p = 0.0183) and indican (76.99 ± 8.35 μg/mg creatinine vs. 37.89 ± 10.06, p = 0.0205) also decreased only in the K-diet group. After the 2-week intervention, the concentration of kynurenate, another tryptophan metabolite, was lower in the K-diet group than that in the control diet group (3.96 ± 0.51 μg/mg creatinine vs. 2.90 ± 0.22, p = 0.0356). Interestingly, the urine level of kynurenate was positively correlated with BMI (r = 0.61424, p = 0.0003) and total cholesterol (r = 0.46979, p = 0.0088), which decreased only in the K-diet group (239.40 ± 15.14 mg/dL vs. 198.20 ± 13.25, p = 0.0163). Conclusion The K-diet alters the urinary excretion of organic acids involved in energy metabolism and tryptophan metabolism, suggesting the influence of the K-diet on these types of metabolism. Urine organic acids changed by the K-diet may serve as biomarkers in future studies.

OBJECTIVE: To evaluate the clinical characteristics, therapeutic interventions, and outcomes of patients with septic shock admitted to the emergency department (ED). METHODS: This study was a preliminary, descriptive analysis of a prospective, multi-center, observational registry of the EDs of 10 hospitals participating in the Korean Shock Society. Patients aged 19 years or older who had a suspected or confirmed infection and evidence of refractory hypotension or hypoperfusion were included. RESULTS: A total of 468 patients were enrolled (median age, 71.3 years; male, 55.1%; refractory hypotension, 82.9%; hyperlactatemia without hypotension, 17.1%). Respiratory infection was the most common source of infection (31.0%). The median Sepsis-related Organ Failure Assessment score was 7.5. The sepsis bundle compliance was 91.2% for lactate measurement, 70.3% for blood culture, 68.4% for antibiotic administration, 80.3% for fluid resuscitation, 97.8% for vasopressor application, 68.0% for central venous pressure measurement, 22.0% for central venous oxygen saturation measurement, and 59.2% for repeated lactate measurement. Among patients who underwent interventions for source control (n=117, 25.1%), 43 (36.8%) received interventions within 12 hours of ED arrival. The in-hospital, 28-day, and 90-day mortality rates were 22.9%, 21.8%, and 27.1%, respectively. The median ED and hospital lengths of stay were 6.8 hours and 12 days, respectively. CONCLUSION: This preliminary report revealed a mortality of over 20% in patients with septic shock, which suggests that there are areas for improvement in terms of the quality of initial resuscitation and outcomes of septic shock patients in the ED.
Central Venous Pressure ; Compliance ; Emergency Service, Hospital ; Humans ; Hyperlactatemia ; Hypotension ; Lactic Acid ; Male ; Mortality ; Oxygen ; Patient Care Bundles ; Prospective Studies ; Resuscitation ; Sepsis ; Shock* ; Shock, Septic*