OBJECTIVE: The purpose of this study was to estimate the T2* relaxation time in breast cancer, and to evaluate the association between the T2* value with clinical-imaging-pathological features of breast cancer. MATERIALS AND METHODS: Between January 2011 and July 2013, 107 consecutive women with 107 breast cancers underwent multi-echo T2*-weighted imaging on a 3T clinical magnetic resonance imaging system. The Student's t test and one-way analysis of variance were used to compare the T2* values of cancer for different groups, based on the clinical-imaging-pathological features. In addition, multiple linear regression analysis was performed to find independent predictive factors associated with the T2* values. RESULTS: Of the 107 breast cancers, 92 were invasive and 15 were ductal carcinoma in situ (DCIS). The mean T2* value of invasive cancers was significantly longer than that of DCIS (p = 0.029). Signal intensity on T2-weighted imaging (T2WI) and histologic grade of invasive breast cancers showed significant correlation with T2* relaxation time in univariate and multivariate analysis. Breast cancer groups with higher signal intensity on T2WI showed longer T2* relaxation time (p = 0.005). Cancer groups with higher histologic grade showed longer T2* relaxation time (p = 0.017). CONCLUSION: The T2* value is significantly longer in invasive cancer than in DCIS. In invasive cancers, T2* relaxation time is significantly longer in higher histologic grades and high signal intensity on T2WI. Based on these preliminary data, quantitative T2* mapping has the potential to be useful in the characterization of breast cancer.
Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Female ; Humans ; Linear Models ; Magnetic Resonance Imaging ; Multivariate Analysis ; Relaxation*

OBJECTIVES: The ratio of second to fourth digit length (2D : 4D) could be a potential epigenetic marker of sexual dimorphism reflecting prenatal testosterone exposure. Testosterone is known to affect the development of the brain through an epigenetic mechanism. The purpose of this study was to investigate the effects of exposure to fetal testosterone on the metabolic syndrome based on 2D : 4D of schizophrenia patients and the relationship with the age of onset of schizophrenia. METHODS: A total of 214 schizophrenia patients participated in this study. The participant's physical and blood tests were performed according to the American National Cholesterol Education Program's Third Amendment of the Metabolic Syndrome Diagnostic Criteria, and the 2D : 4D was measured by the method designed by McFadden. Data were statistically analyzed by t-test, Pearson's correlation analysis and multiple regression model analysis. RESULTS: 2D : 4D was significantly higher in female than male in both hands, and there was a statistically significant negative correlation between 2D : 4D and the age of onset of schizophrenia in male. However, 2D : 4D did not show statistically significant correlation with metabolic factors. CONCLUSIONS: Fetal testosterone suggests the possibility of affecting the age of onset of schizophrenia through the epigenetic mechanism, but there is no clear relationship with metabolic factors.
Age of Onset* ; Brain ; Cholesterol ; Education ; Epigenomics ; Female ; Hand ; Hematologic Tests ; Humans ; Male ; Methods ; Schizophrenia* ; Testosterone

BACKGROUND/AIMS: The eradication rates of Helicobacter pylori infection have been reported to have decreased over the years due to antibiotics resistance. The aim of this study is to investigate the trend of eradication rates of first-line triple therapy for H. pylori over the past 13 year period, and to evaluate factors affecting H. pylori eradication in Daegu and Gyeongsangbuk-do, Korea. METHODS: A total of 2,982 patients with H. pylori infection who were treated with either 1 week or 2 weeks first-line therapy (proton pump inhibitor [PPI], amoxicillin, and clarithromycin) from January 1999 through December 2011 were included in this study. Data were collected by retrospectively reviewing the medical records. RESULTS: The overall H. pylori eradication rate was 87.2%. The eradication rates from 1999 to 2011 fluctuated between 78.0% and 95.7%, but no definite evidence of a decreasing tendency was seen over the 13 year period (p=0.113). Furthermore, there was no significant difference in the eradication rate according to the duration of therapy (p=0.592). However, there was a significant difference in the eradication rate among various PPIs (p<0.01). CONCLUSIONS: There was no decreasing trend in the H. pylori eradication rate over the past 13 years in Daegu and Gyeongsangbuk-do, Korea. There also was no difference in the eradication rates depending on duration of therapy. However, a significant difference was noted among various PPIs.
Adult ; Aged ; Amoxicillin/therapeutic use ; Anti-Bacterial Agents/*therapeutic use ; Clarithromycin/therapeutic use ; Disease Eradication/*trends ; Drug Administration Schedule ; Drug Therapy, Combination ; Endoscopy, Gastrointestinal ; Esomeprazole/therapeutic use ; Female ; Helicobacter Infections/*drug therapy/pathology ; *Helicobacter pylori ; Humans ; Logistic Models ; Male ; Middle Aged ; Omeprazole/therapeutic use ; Proton Pump Inhibitors/*therapeutic use ; Rabeprazole/therapeutic use ; Republic of Korea ; Retrospective Studies ; Treatment Outcome

Background/Aims: Recently, 1-L polyethylene glycol-ascorbic acid (PEG-Asc) has been used to reduce the volume of preparation agents in colonoscopy. This clinical trial aimed to compare the efficacy and safety of two types of 1-L PEG-Asc (CleanViewAL ® [Tae Joon Pharmaceutical Company, Seoul, Korea] and Plenvu ® [Norgine, Harefield, United Kingdom]) in average-aged adults. Methods: This study was a prospective, randomized, non-inferiority, open-label, phase 4 clinical trial. The primary endpoint was the efficacy evaluated using the Boston bowel preparation scale (BBPS), and the secondary endpoint was clinical safety. Results: In total, 173 patients were assigned to either the CleanViewAL ® (n=84) or Plenvu ® (n=89) group. Overall cleansing successes of 97.6% (82/84) and 98.8% (88/89) were achieved in the CleanViewAL ® group and in the Plenvu ® group, respectively, showing that CleanViewAL ® has similar bowel cleansing efficacy to Plenvu ® (95% CI, -0.052 to 0.027; p=0.207). The total BBPS score was 8.67±1.00 and 8.70±0.76 in the CleanViewAL ® group and Plenvu ® group, respectively (p=0.869). The most common adverse symptom was nausea, and no adverse symptoms requiring hospitalization were reported in either group. There were no cases of critical hypernatremia and liver dysfunction exceeding the common terminology criteria for adverse events grade I. An overall satisfaction score (scale of 1 to 10) showed no difference between the two groups (p=0.289). However, the CleanViewAL ® group showed a higher taste satisfaction score (scale of 1 to 5) than the Plenvu ® group (CleanViewAL ® : 2.90±0.91, Plenvu ® : 2.60±0.86, p=0.028). Conclusions Both types of 1-L PEG-Asc, CleanViewAL ® and Plenvu ® , are effective and safe bowel cleansing agents in average-aged adults. CleanViewAL ® was preferred in terms of taste satisfaction.

BACKGROUND/AIMS: The aim of this study was to identify the profile of rare variants associated with Crohn's disease (CD) using whole exome sequencing (WES) analysis of Korean children with CD and to evaluate whether genetic profiles could provide information during medical decision making. METHODS: DNA samples from 18 control individuals and 22 patients with infantile, very-early and early onset CD of severe phenotype were used for WES. Genes were filtered using panels of inflammatory bowel disease (IBD)-associated genes and genes of primary immunodeficiency (PID) and monogenic IBD. RESULTS: Eighty-one IBD-associated variants and 35 variants in PID genes were revealed by WES. The most frequently occurring variants were carried by nine (41%) and four (18.2%) CD probands and were ATG16L2 (rs11235604) and IL17REL (rs142430606), respectively. Twenty-four IBD-associated variants and 10 PID variants were predicted to be deleterious and were identified in the heterozygous state. However, their functions were unknown with the exception of a novel p.Q111X variant in XIAP (X chromosome) of a male proband. CONCLUSIONS: The presence of many rare variants of unknown significance limits the clinical applicability of WES for individual CD patients. However, WES in children may be beneficial for distinguishing CD secondary to PID.
Asian Continental Ancestry Group/genetics ; Carrier Proteins/genetics ; Child ; Child, Preschool ; Crohn Disease/*genetics ; *Exome ; Female ; Genetic Predisposition to Disease ; *Genetic Variation ; Humans ; Immunologic Deficiency Syndromes/genetics ; Infant ; Male ; Phenotype ; Receptors, Interleukin-17/genetics ; Republic of Korea ; Sequence Analysis, DNA/*methods ; X-Linked Inhibitor of Apoptosis Protein/genetics

Legionella species are causative agents of both community-acquired and nosocomial pneumonia. The spectrum of disease ranges from asymptomatic infection to serious disease and two specific syndromes are identified, i.e., Legionnaires' disease and Pontiac fever. Legionnaires' disease tends to occur in patients with underlying illnesses, so Legionella pneumonia should be included in the differential diagnosis of severe community-acquired pneumonia, especially in immunocompromised patients. Herein we report a case of community- acquired Legionnaires' disease in a patient with renal transplantation. A 63-year old man was admitted because of fever, chills, and dyspnea. Thirteen years ago, he had undergone kidney transplantation and he had received immu-nosuppressive agents, including deflazacort and cyclosporin A. On physical examination crackles were heard in the middle area of the right lung and the chest radiograph showed multifocal patchy consolidations on both lung fields. Serologic tests for Legionella pneumophila antibody, urinary antigen assay for L. pneumophila serogroup 1, and polymerase chain reaction for Legionella DNA fragments (5S rRNA, IPC, mip target sequence) were positive. The patient was treated with roxithromycin for twenty eight days and recovered without complication.
Asymptomatic Infections ; Chills ; Cyclosporine ; Diagnosis, Differential ; DNA ; Dyspnea ; Fever ; Humans ; Immunocompromised Host ; Kidney Transplantation ; Legionella ; Legionella pneumophila ; Legionnaires' Disease* ; Lung ; Middle Aged ; Physical Examination ; Pneumonia ; Polymerase Chain Reaction ; Radiography, Thoracic ; Respiratory Sounds ; Roxithromycin ; Serologic Tests ; Transplantation*

Pneumocystis jirovecii pneumonia (PCP) can be a life-threatening opportunistic infection after kidney transplantation, occurring most frequently in the first 12 months with the symptoms of dyspnea, cough, fever, and hypoxia. Prophylaxis for PCP is usually applied during the first 3 months to 1 year after transplantation, but late onset incidence of PCP can be detected. We report on a patient who developed PCP 9 years after renal transplantation. The patient showed indolent onset of acute respiratory distress and was treated with trimethoprim-sulfamethoxazole and corticosteroid therapy. Previous rescue treatment of acute cellular rejection with ongoing maintenance of an elevated level of immunosuppressants may have predisposed the patient to PCP.
Anoxia ; Cough ; Dyspnea ; Fever ; Humans ; Immunosuppressive Agents ; Incidence ; Kidney Transplantation ; Opportunistic Infections ; Pneumocystis jirovecii* ; Pneumocystis* ; Pneumonia ; Transplantation* ; Trimethoprim, Sulfamethoxazole Drug Combination

BACKGROUND: Since the first Korean case of human brucellosis was reported in 2002, the incidence of human brucellosis has been rapidly increasing. We performed this study to evaluate the clinical characteristics of human brucellosis occurring in South Korea. MATERIALS AND METHODS: Demographic features, clinical manifestations, and therapeutic outcomes of cases confirmed as brucellosis according to WHO diagnostic criteria were evaluated. Species of Brucella isolates were identified with 16S rRNA gene sequencing method. Serologic diagnosis was performed with standard tube agglutination test (STA). RESULTS: A total of 34 cases were enrolled from 2003 to 2006 in six hospitals. Eight cases were confirmed with the isolation of Brucella from blood and 26 cases were confirmed with titer of antibodies < or =1:160 by STA. Male (31) was predominant and most of the patients were cattle farmers. The most common transmission route was direct contact with infected or their cattle byproducts. Fever was the most prominent symptom and fatigue followed. Gastrointestinal and musculoskeletal systems were commonly complicated. Patients were treated with doxycycline and rifampin or aminoglycosides for more than 6 weeks. All patients responded well to the therapeutic regimens, but one patient relapsed 10 months after treatment. CONCLUSION: Brucellosis occurring in Korea has been caused by B. abortus, whose preferred natural host animals are cattle. Korean patients were infected through direct contact with bovine brucellosis. Clinical manifestations of brucellosis were similar to those occurring worldwide. Therapeutic outcomes were good among patients with brucellosis in Korea. In order to prevent human brucellosis, measures to eradicate bovine brucellosis should precede.
Agglutination Tests ; Aminoglycosides ; Animals ; Antibodies ; Brucella ; Brucella abortus ; Brucellosis* ; Brucellosis, Bovine ; Cattle ; Diagnosis ; Doxycycline ; Fatigue ; Fever ; Genes, rRNA ; Humans* ; Incidence ; Korea* ; Male ; Musculoskeletal System ; Rifampin

Growth charts are curves or tables that facilitate the visualization of anthropometric parameters, and are widely used as an important indicator when evaluating the growth status of children and adolescents. The latest version of the Korean National Growth Charts released in 2007 has raised concerns regarding the inclusion of data from both breastfed and formula-fed infants, higher body mass index (BMI) values in boys, and smaller 3rd percentile values in height-for-age charts. Thus, new growth charts have been developed to improve the previous version. The 2006 World Health Organization Child Growth Standards, regarded as the standard for breastfed infants and children, were introduced for children aged 0–35 months. For children and adolescents aged 3–18 years, these new growth charts include height-for-age, weight-for-age, BMI-for-age, weight-for-height, and head circumference-for-age charts, and were developed using data obtained in 1997 and 2005. Data sets and exclusion criteria were applied differently for the development of the different growth charts. BMI-for-age charts were adjusted to decrease the 95th percentile values of BMI. Criteria for obesity were simplified and defined as a BMI of ≥95th percentile for age and sex. The 3rd percentile values for height-for-age charts were also increased. Additional percentile lines (1st and 99th) and growth charts with standard deviation lines were introduced. 2017 Korean National Growth Charts are recommended for the evaluation of body size and growth of Korean children and adolescents for use in clinics and the public health sector in Korea.
Adolescent* ; Body Mass Index ; Body Size ; Child* ; Dataset ; Growth Charts* ; Head ; Humans ; Infant ; Korea ; Obesity ; Public Health ; World Health Organization

BACKGROUND: Since the first Korean case of human brucellosis was reported in 2002, the incidence of human brucellosis has been rapidly increasing. We performed this study to evaluate the clinical characteristics of human brucellosis occurring in South Korea. MATERIALS AND METHODS: Demographic features, clinical manifestations, and therapeutic outcomes of cases confirmed as brucellosis according to WHO diagnostic criteria were evaluated. Species of Brucella isolates were identified with 16S rRNA gene sequencing method. Serologic diagnosis was performed with standard tube agglutination test (STA). RESULTS: A total of 34 cases were enrolled from 2003 to 2006 in six hospitals. Eight cases were confirmed with the isolation of Brucella from blood and 26 cases were confirmed with titer of antibodies < or =1:160 by STA. Male (31) was predominant and most of the patients were cattle farmers. The most common transmission route was direct contact with infected or their cattle byproducts. Fever was the most prominent symptom and fatigue followed. Gastrointestinal and musculoskeletal systems were commonly complicated. Patients were treated with doxycycline and rifampin or aminoglycosides for more than 6 weeks. All patients responded well to the therapeutic regimens, but one patient relapsed 10 months after treatment. CONCLUSION: Brucellosis occurring in Korea has been caused by B. abortus, whose preferred natural host animals are cattle. Korean patients were infected through direct contact with bovine brucellosis. Clinical manifestations of brucellosis were similar to those occurring worldwide. Therapeutic outcomes were good among patients with brucellosis in Korea. In order to prevent human brucellosis, measures to eradicate bovine brucellosis should precede.
Agglutination Tests ; Aminoglycosides ; Animals ; Antibodies ; Brucella ; Brucella abortus ; Brucellosis* ; Brucellosis, Bovine ; Cattle ; Diagnosis ; Doxycycline ; Fatigue ; Fever ; Genes, rRNA ; Humans* ; Incidence ; Korea* ; Male ; Musculoskeletal System ; Rifampin