Antibiotics induced anaphylaxis is one of the most acute and potentially fatal drug-related adverse reactions. Cefaclor, an oral second-generation cephalosporin with a beta lactam ring, is used various infectious diseases of the respiratory tract. Few cases of cefaclor anaphylaxis have been rarely reported. Here we report a case of anaphylactic reaction to cefaclor in a 40-year-old female patient. She developed systemic reaction comprised of generalized hives with itching, vomiting, abdominal pain, and hypotension. She was treated on our ER with intravenous fluids, intravenous diphenhydramine and subcutaneous epinephrine. Since four month ago, she had developed generalized pruritic eruptions with flu-like symptoms. The rash resolved the same day after treated with intravenous diphenhydramine. On detailed history taking for medication, we had known that she received a same prescription containing a cefaclor at every episode. Subsequently we tested the patient with cefaclor and conducted an intradermal skin test and an ELISA to cefaclor-HSA conjugate. She showed a positive response. Cefaclor is widely used for common infections, physicians should anticipate the possibility of anaphylactic reaction treated with this agent, particularly in cases of multiple exposure.
Abdominal Pain ; Adult ; Anaphylaxis* ; Anti-Bacterial Agents ; Cefaclor* ; Communicable Diseases ; Diphenhydramine ; Enzyme-Linked Immunosorbent Assay ; Epinephrine ; Exanthema ; Female ; Humans ; Hypotension ; Immunoglobulin E ; Prescriptions ; Pruritus ; Respiratory System ; Skin Tests ; Urticaria ; Vomiting

Secondary acute leukemia is a rare and fatal complication after the treatment of breast cancer. Recently, we experienced 2 cases of acute leukemia that had developed during the follow-up period after adjuvant therapy of breast cancer. In addition, retrospective analysis of medical records of St. Mary's hospital, the Catholic University of Korea, revealed another 5 cases of secondary leukemia following the treatment of breast cancer. Total 7 cases of secondary acute leukemia of breast cancer were reviewed and summarized according to their clinical characteristics. The mean age at diagnosis of primary breast cancer was 38.9 years (range, 16-49), and the average period from the completion of chemotherapy to the diagnosis of acute leukemia was 30.9 months (range, 11-40). The mean survival period of the 7 patients after diagnosis of leukemia was 4.6 months. Based on these findings, the risk of secondary leukemia following the treatment of breast should be considered in choosing chemotherapy and radiotherapy for the treatment of breast cancer especially in the young patients.
Breast ; Breast Neoplasms ; Follow-Up Studies ; Humans ; Korea ; Leukemia ; Medical Records ; Retrospective Studies

Secondary acute leukemia is a rare and fatal complication after the treatment of breast cancer. Recently, we experienced 2 cases of acute leukemia that had developed during the follow-up period after adjuvant therapy of breast cancer. In addition, retrospective analysis of medical records of St. Mary's hospital, the Catholic University of Korea, revealed another 5 cases of secondary leukemia following the treatment of breast cancer. Total 7 cases of secondary acute leukemia of breast cancer were reviewed and summarized according to their clinical characteristics. The mean age at diagnosis of primary breast cancer was 38.9 years (range, 16-49), and the average period from the completion of chemotherapy to the diagnosis of acute leukemia was 30.9 months (range, 11-40). The mean survival period of the 7 patients after diagnosis of leukemia was 4.6 months. Based on these findings, the risk of secondary leukemia following the treatment of breast should be considered in choosing chemotherapy and radiotherapy for the treatment of breast cancer especially in the young patients.
Breast ; Breast Neoplasms ; Follow-Up Studies ; Humans ; Korea ; Leukemia ; Medical Records ; Retrospective Studies

Eosinophils have long been recognized as a central effector cell in the lungs of asthmatic patients. They contribute to airway inflammation and remodeling through releasing several molecules such as cytokines, granule proteins, lipid mediators and extracellular traps/vesicles. Repeated evidence reveals that intense eosinophil infiltration in upper and lower airway mucosae contributes to the pathogenesis of aspirin-exacerbated respiratory disease (AERD). Persistent eosinophilia is found to be associated with type 2 immune responses, cysteinyl leukotriene overproduction and eosinophil-epithelium interactions. This review highlights recent findings about key mechanisms of eosinophil activation in the airway inflammation of AERD. In addition, current biologics (targeting type 2 immune responses) were suggested to control eosinophilic inflammation for AERD patients.

Peutz-Jeghers type hamartomatous polyp is known to be associated with Peutz-Jeghers syndrome, which shows characteristic multiple hamartomatous polyp involvement in the gastrointestinal tract, combined with mucocutaneous symptom, familial history of Peutz- Jeghers syndrome or STK11/LTB1 mutation. However, some cases showing histologic appearance of the polyps discovered in Peutz- Jeghers syndrome while lacking other diagnostic criteria of the syndrome have been reported, and these are called solitary Peutz- Jeghers type polyps. Herein, we report a case of solitary Peutz-Jeghers type polyp covered with heterotopic epithelium. The patient was 47-year-old female without any mucocutaneous symptoms nor familial history of Peutz-Jeghers syndrome. Microscopic examination revealed Peutz-Jeghers type hamartomatous polyp in duodenum covered with gastric type foveolar epithelium. Considering the definition of hamartomatous polyp, which is, the abnormal overgrowth of the indigenous epithelial component, the histological feature of current case is noteworthy in a point that it shows proliferation of heterotopic component, rather than the indigenous component.

Although some mutations are beneficial and are the driving force behind evolution, it is important to maintain DNA integrity and stability because it contains genetic information. However, in the oxygen-rich environment we live in, the DNA molecule is under constant threat from endogenous or exogenous insults. DNA damage could trigger the DNA damage response (DDR), which involves DNA repair, the regulation of cell cycle checkpoints, and the induction of programmed cell death or senescence. Dysregulation of these physiological responses to DNA damage causes developmental defects, neurological defects, premature aging, infertility, immune system defects, and tumors in humans. Some human syndromes are characterized by unique neurological phenotypes including microcephaly, mental retardation, ataxia, neurodegeneration, and neuropathy, suggesting a direct link between genomic instability resulting from defective DDR and neuropathology. In this review, rare human genetic disorders related to abnormal DDR and damage repair with neural defects will be discussed.
Aging ; Aging, Premature ; Ataxia ; Cell Cycle Checkpoints ; Cell Death ; Central Nervous System Diseases ; DNA Breaks, Double-Stranded ; DNA Breaks, Single-Stranded ; DNA Damage* ; DNA Repair ; DNA* ; Genomic Instability ; Humans* ; Immune System ; Infertility ; Intellectual Disability ; Microcephaly ; Neuropathology ; Phenotype

OBJECTIVES: This study introduced the healthy life-year(HeaLY), a composite indicator of disease burden, and used it to estimate the burden of major cancers in Korea. METHODS: We collected data from the national death certificate database, the national health insurance claims database and the abridged life table. This data was used to create a spreadsheet and estimate the burden of major cancers by sex in terms of HeaLYs. RESULTS: The burden of 10 major cancers for males was 2,248.97 person-year in terms of HeaLYs. Stomach cancer, liver cancer, and lung cancer were responsible for 75.2% of the burden of 10 major cancers The disease burden of 10 major cancers for females was estimated to be 1,567.58 person-years. About two thirds of HeaLYs lost were from stomach cancer, liver cancer, lung cancer, colorectal cancer, and breast cancer. The rankings among 10 major cancers were somewhat different in terms of both HeaLYs and deaths as the HeaLY method considers both mortality and morbidity. CONCLUSIONS: Despite the limitations of the data sources, we conclude that HeaLY can aid in setting policy priorities concerning major cancers by estimating the disease burden of these cancers. Time-series analysis of the disease burden using HeaLY and DALY will elucidate the strengths and weaknesses of both methods.
Breast Neoplasms ; Colorectal Neoplasms ; Cost of Illness ; Data Collection ; Death Certificates ; Female ; Humans ; Korea* ; Life Expectancy ; Life Tables ; Liver Neoplasms ; Lung Neoplasms ; Male ; Mortality ; National Health Programs ; Stomach Neoplasms

BACKGROUND AND OBJECTIVES: The scent survey for screening (SSS) test is a subjective olfactory questionnaire devised for this study. We demonstrated the correlation of the SSS test with other olfactory tests and the efficacy of the SSS test as an olfactory screening test compared to KVSSII. SUBJECTS AND METHOD: A total of 363 patients who visited our ORL outpatient department underwent the SSS test, VAS, and KVSS I and II. The patients were divided into two groups, a group with normal olfactory function and a group with olfactory dysfunction according to the KVSS II test. In each group, the correlations between the olfactory tests were studied, and the cut-off value of the SSS test as a screening test was investigated. RESULTS: There was positive correlation between CCSIT and KVSS I, II, T, D, and I tests and the SSS test in the total group and in the olfactory dysfunction group (p<0.05). The identification test in the KVSS II showed the highest positive correlation. While the cut-off value of normal olfactory function in the KVSS II is 28, the SSS test showed the highest specificity and sensitivity of 74 under an ROC curve. CONCLUSION: The SSS test showed very high correlation with other olfactory tests, especially in an olfactory dysfunction group. This result indicates that the SSS is appropriate as a screening test to select people with olfactory disorder.
Humans ; Mass Screening* ; Methods ; Olfaction Disorders ; Outpatients ; ROC Curve ; Sensitivity and Specificity

OBJECTIVES: The Regional Cardiocerebrovascular Center (RCCVC) Project designated local teaching hospitals as RCCVCs, in order to improve patient outcomes of acute cardiocerebrovascular emergencies by founding a regional system that can adequately transfer and manage patients within 3 hours. We investigated the effects of RCCVC establishment on treatment volume and 30-day mortality. METHODS: We constructed a panel dataset by extracting all acute myocardial infarction cases that occurred from 2007 to 2016 from the Health Insurance Review and Assessment Service claims data, a national and representative source. We then used a panel fixed-effect model to estimate the impacts of RCCVC establishment on patient outcomes. RESULTS: We found that the number of cases of acute myocardial infarction that were treated increased chronologically, but when the time effect and other related covariates were controlled for, RCCVCs only significantly increased the number of treatment cases of female in large catchment areas. There was no statistically significant impact on 30-day mortality. CONCLUSIONS The establishment of RCCVCs increased the number of treatment cases of female, without increasing the mortality rate. Therefore, the RCCVCs might have prevented potential untreated deaths by increasing the preparedness and capacity of hospitals to treat acute myocardial infarction patients.

BACKGROUND: Lidocaine spray is a local anesthetic that improves random-pattern skin flap survival. The fractional ablative carbon dioxide laser (FxCL) produces vertical microchannels that delivers topically applied drugs to the skin. In this study, we hypothesized that FxCL therapy would enhance the lidocaine effect to improve random-pattern skin flap survival in rats. METHODS: McFarlane random-pattern skin flaps were elevated in 48 rats, which were divided into four groups according to treatment: FxCL+lidocaine, FxCL, lidocaine, and nontreatment (control). On postoperative day 7, necrotic flap areas, the number of capillary vessels, and neutrophil count were evaluated. Anti-rat vascular endothelial growth factor (VEGF) and CD31 antibody activity were also evaluated by immunohistochemical staining. RESULTS: Flap survival rate was 53.41%±5.43%, 58.16%±4.80%, 57.08%±5.91%, and 69.08%±3.20% in the control, lidocaine, FxCL, and FxCL+lidocaine groups, respectively. Mean neutrophil count in the intermediate zone excluding the necrotic tissue was 41.70±8.40, 35.43±6.41, 37.23±7.15, and 27.20±4.24 cells/field in the control, lidocaine, FxCL, and FxCL+lidocaine groups, respectively. Anti-rat VEGF and CD31 antibody activity were the highest in the FxCL+lidocaine group. CONCLUSION: FxCL with lidocaine had a positive effect on random-pattern skin flap survival in rats. Thus, FxCL with lidocaine spray should be considered as a new treatment option to improve flap viability.
Animals ; Capillaries ; Carbon Dioxide ; Carbon ; Lasers, Gas ; Lidocaine ; Neutrophils ; Rats ; Skin ; Survival Rate ; Vascular Endothelial Growth Factor A