BACKGROUND: Although the association of hyperuricemia with an increased risk of mortality has been demonstrated in the context of acute exacerbation of chronic obstructive pulmonary disease (COPD), the long-term outcomes of hyperuricemia have not been studied in the case of stable COPD.METHODS: We retrospectively analyzed baseline data of 240 men with stable COPD enrolled in the Korea Obstructive Lung Disease cohort. We evaluated associations between serum uric acid levels and clinical parameters, risk factors for all-cause mortality, and acute exacerbation of COPD.RESULTS: The mean age of subjects was 66.4 ± 7.7 years, and the median follow-up time was 5.9 years. We identified no significant difference in terms of lung function or laboratory findings between patients with hyperuricemia and those without. Serum uric acid level was negatively associated with systemic inflammation indicated by neutrophil–lymphocyte ratio (r = −0.211, P = 0.001). Univariate Cox regression analysis revealed hyperuricemia to not be associated with an increased risk of all-cause mortality in men with stable COPD (hazard ratio [HR], 0.580; 95% confidence interval [CI], 0.250–1.370; P = 0.213). In the multivariate Cox regression model, hyperuricemia was not an independent predictor of acute exacerbation (HR, 1.383; 95% CI, 0.977–1.959; P = 0.068).CONCLUSION: Among men with stable COPD, hyperuricemia is not an independent predictor of all-cause mortality or future acute exacerbation of COPD. These results differ from those of previous studies on patients with acute exacerbation of COPD.
Cohort Studies ; Follow-Up Studies ; Humans ; Hyperuricemia ; Inflammation ; Korea ; Lung ; Lung Diseases, Obstructive ; Male ; Mortality ; Pulmonary Disease, Chronic Obstructive ; Retrospective Studies ; Risk Factors ; Uric Acid

BACKGROUND: Although the association of hyperuricemia with an increased risk of mortality has been demonstrated in the context of acute exacerbation of chronic obstructive pulmonary disease (COPD), the long-term outcomes of hyperuricemia have not been studied in the case of stable COPD. METHODS: We retrospectively analyzed baseline data of 240 men with stable COPD enrolled in the Korea Obstructive Lung Disease cohort. We evaluated associations between serum uric acid levels and clinical parameters, risk factors for all-cause mortality, and acute exacerbation of COPD. RESULTS: The mean age of subjects was 66.4 ± 7.7 years, and the median follow-up time was 5.9 years. We identified no significant difference in terms of lung function or laboratory findings between patients with hyperuricemia and those without. Serum uric acid level was negatively associated with systemic inflammation indicated by neutrophil–lymphocyte ratio (r = −0.211, P = 0.001). Univariate Cox regression analysis revealed hyperuricemia to not be associated with an increased risk of all-cause mortality in men with stable COPD (hazard ratio [HR], 0.580; 95% confidence interval [CI], 0.250–1.370; P = 0.213). In the multivariate Cox regression model, hyperuricemia was not an independent predictor of acute exacerbation (HR, 1.383; 95% CI, 0.977–1.959; P = 0.068). CONCLUSION Among men with stable COPD, hyperuricemia is not an independent predictor of all-cause mortality or future acute exacerbation of COPD. These results differ from those of previous studies on patients with acute exacerbation of COPD.

OBJECTIVE: To investigate whether computed tomography (CT) and fluorine-18-labeled fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) may be applied to distinguish thymic epithelial tumors (TETs) from benign cysts in the anterior mediastinum. MATERIALS AND METHODS: We included 262 consecutive patients with pathologically proven TETs and benign cysts 5 cm or smaller who underwent preoperative CT scans. In addition to conventional morphological and ancillary CT findings, the relationship between the lesion and the adjacent mediastinal pleura was evaluated qualitatively and quantitatively. Mean lesion attenuation was measured on CT images. The maximum standardized uptake value (SUVmax) was obtained with FDG-PET scans in 40 patients. CT predictors for TETs were identified with multivariate logistic regression analysis. For validation, we assessed the diagnostic accuracy and inter-observer agreement between four radiologists in a size-matched set of 24 cysts and 24 TETs using a receiver operating characteristic curve before and after being informed of the study findings. RESULTS: The multivariate analysis showed that post-contrast attenuation of 60 Hounsfield unit or higher (odds ratio [OR], 12.734; 95% confidence interval [CI], 2.506–64.705; p = 0.002) and the presence of protrusion from the mediastinal pleura (OR, 9.855; 95% CI, 1.749–55.535; p = 0.009) were the strongest CT predictors for TETs. SUVmax was significantly higher in TETs than in cysts (5.3 ± 2.4 vs. 1.1 ± 0.3; p < 0.001). After being informed of the study findings, the readers' area under the curve improved from 0.872–0.955 to 0.949–0.999 (p = 0.066–0.149). Inter-observer kappa values for protrusion were 0.630–0.941. CONCLUSION: Post-contrast CT attenuation, protrusion from the mediastinal pleura, and SUVmax were useful imaging features for distinguishing TETs from cysts in the anterior mediastinum.
Humans ; Logistic Models ; Mediastinum ; Multivariate Analysis ; Pleura ; Positron-Emission Tomography ; ROC Curve ; Thymus Neoplasms ; Tomography, X-Ray Computed

OBJECTIVE: In a proof of concept study, we compared no-touch radiofrequency ablation (NtRFA) in bipolar mode with conventional direct tumor puncture (DTP) in terms of local tumor control (LTC), peritoneal seeding, and tumorigenic factors, in the rabbit VX2 subcapsular hepatic tumor model. MATERIALS AND METHODS: Sixty-two rabbits with VX2 subcapsular hepatic tumors were divided into three groups according to the procedure: DTP-RFA (n = 25); NtRFA (n = 25); and control (n = 12). Each of the three groups was subdivided into two sets for pathologic analysis (n = 24) or computed tomography (CT) follow-up for 6 weeks after RFA (n = 38). Ultrasonography-guided DTP-RFA and NtRFA were performed nine days after tumor implantation. LTC was defined by either achievement of complete tumor necrosis on histopathology or absence of local tumor progression on follow-up CT and autopsy. Development of peritoneal seeding was also compared among the groups. Serum hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) were measured via ELISA (Elabscience Biotechnology Co.) after RFA for tumorigenic factor evaluation. RESULTS: Regarding LTC, there was a trend in NtRFA (80%, 20/25) toward better ablation than in DTP-RFA (56%, 14/25) (p = 0.069). Complete tumor necrosis was achieved in 54.5% of DTP-RFA (6/11) and 90.9% of NtRFA (10/11). Peritoneal seeding was significantly more common in DTP-RFA (71.4%, 10/14) than in NtRFA (21.4%, 3/14) (p = 0.021) or control (0%). Elevations of HGF, VEGF or IL-6 were not detected in any group. CONCLUSION: No-touch radiofrequency ablation led to lower rates of peritoneal seeding and showed a tendency toward better LTC than DTP-RFA.
Autopsy ; Biotechnology ; Catheter Ablation* ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies ; Hepatocyte Growth Factor ; Interleukin-6 ; Necrosis ; Punctures ; Rabbits* ; Vascular Endothelial Growth Factor A

A Middle East respiratory syndrome (MERS) - coronavirus (CoV) cluster that attacked Korea in May 2015 revealed several weaknesses in Korea's health care system in the face of the crisis of an emerging infectious disease and its public health implications. This experience has shown that is necessary to prepare comprehensive countermeasures through the cooperation of civil and public agencies to prevent a second or even third MERS outbreak and to control future crises of infectious disease and public health. The MERS Policy Committee of the Korean Medical Association has thus proposed a master plan for reform of the national infectious disease prevention and management system to prepare a new framework for national infectious disease prevention and control. The specific targets of the master plan are improvement of the system of usage of medical services and of the medical culture among national health insurance subscribers, improvement of the emergency room management system to prevent the spread of infectious disease, the establishment of a support system to promote effective voluntary infectious disease prevention activities among medical institutions, the building of a public health crisis communication system in collaboration with medical organizations, the establishment of an independent Ministry of Health and capacity building of the Korea Centers for Disease Control (KCDC), the securing of an advanced research and development system in the field of prevention and control of infectious disease, and the capacity building of professional epidemiologists and personnel needed to prevent and control infectious disease. The five core strategies of the master plan have been planned by medical experts in this order of priority: the reform of the healthcare delivery system, the independence of the Ministry of Health and capacity building of the KCDC, fundraising for a public infection management fund, enforcement of medical organization infection control, and improvement of the emergency room management system.
Capacity Building ; Centers for Disease Control and Prevention (U.S.) ; Communicable Diseases* ; Communicable Diseases, Emerging ; Cooperative Behavior ; Coronavirus ; Coronavirus Infections ; Delivery of Health Care ; Emergency Service, Hospital ; Financial Management ; Infection Control ; Korea* ; Middle East ; National Health Programs ; Public Health

BACKGROUND/AIMS: Colorectal cancer (CRC) has been one of the major causes of death and has become a major public health concern. The incidence of CRC has been increasing regardless of gender in Korea. Until now, however, the studies on gender-based clinicopathological characteristics of CRC focused on pathology have never been reported. Therefore, we aimed to evaluate the difference in clinicopathological characteristics of CRC according to gender in Korea. METHODS: Medical records of 342 patients with advanced CRC who underwent surgical resection at Kyung Hee University Hospital at Gangdong from June 2006 to December 2011 were retrospectively analyzed. The data of the clinicopathological characteristics of CRC by gender difference were compared. RESULTS: Of these 341 patients, 203 (60%) patients were male and 138 (40%) patients were female. The male preponderance was noted in all age groups for total CRC and left-sided CRC. However, for right-sided colon cancer, this male preponderance was significantly decreased with increasing age groups (P=0.025) and was finally reversed in elderly groups (age > or =60 years). The microsatellite instability represented by negative staining for hMLH1 and hMSH2 was more frequently detected in women than men (P=0.037). CONCLUSIONS: The male preponderance in right-sided colon cancer decreased with increasing age groups and finally reversed in age groups more than 60 years. Microsatellite instability with immunohistochemical staining was more frequently detected in women. However, further studies with a large number of patients are warranted on this issue.
Aged ; Cause of Death ; Colonic Neoplasms ; Colorectal Neoplasms ; Female ; Gender Identity ; Humans ; Incidence ; Korea ; Male ; Medical Records ; Microsatellite Instability ; Negative Staining ; Public Health ; Retrospective Studies

A phytobezoar is the most common type of bezoar, which is a gastrointestinal mass composed of vegetable. A persimmon is a common cause of a phytobezoar. The majority of bezoars are found in the stomach, with the small intestine being the next most commonly involved site. The colon is a rare site for a bezoar. Recently, we experienced a colonic bezoar that caused colonic obstruction in a 66-year-old female patient who took persimmons regularly. The patient came to the hospital because of abdominal pain and distension. To differentiate a tumor or other problems that can cause intestinal obstruction, we performed an abdominal computed tomography scan and found an ovoid intraluminal mass with a mottled gas pattern in the distal descending colon. A large impacted bezoar was seen in the sigmoid colon, which was completely obstructed, and it was successfully removed by using colonoscopy.
Abdominal Pain ; Aged ; Bezoars ; Colon ; Colon, Descending ; Colon, Sigmoid ; Colonoscopy ; Diospyros ; Female ; Humans ; Intestinal Obstruction ; Intestine, Small ; Porphyrins ; Stomach ; Vegetables

PURPOSE: We purpose to determine the correlation of HER-2/neu and paxillin expression in ductal carcinoma in situ (DCIS), invasive ductal carcinoma with ductal carcinoma in situ (IDC with DCIS) and mucinous carcinoma. METHODS: To evaluate the expression of HER-2/neu and paxillin, the immunohistochemical staining was performed for 13 cases of DCIS, 13 cases of IDC with DCIS and 6 cases of mucinous carcinoma. RESULTS: The DCIS and IDC were associated with infiltration of the inflammatory cells, especially in the comedo type and solid type of tumor. In cases with infiltration of the inflammatory cells, HER-2/neu and paxillin were strongly expressed. When comparing the expression level of HER-2/neu from adjacent normal tissue between DCIS and IDC with DCIS, expression of HER-2/neu was similar to that of normal tissue adjacent to DCIS. However, in the adjoining normal ductal epithelial cells, paxillin was highly expressed in cells of all of the tumor types, and especially for IDC with DCIS. HER-2/neu and paxillin were not expressed in mucinous carcinoma cells in all cases. CONCLUSION: HER-2/neu in the DCIS and IDC with infiltration of inflammatory cells shows higher expression than non-inflammatory DCIS and IDC. If normal duct epithelial cells show a high level of HER-2/neu expression, the epithelial cells have a high probability of transformation into anaplastic cells. However, paxillin appears to have no value as a prognostic factor. The difference of expression of HER-2/neu between IDC with DCIS and DCIS suggests a different origin of tumor cells. The growth pattern of mucinous carcinoma cell is different from the that of DCIS or IDC cell, which grow slowly.
Adenocarcinoma, Mucinous ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Epithelial Cells ; Mucins ; Paxillin

BACKGROUND AND OBJECTIVES: There is a reported association between the increased levels of specific IgE and Staphylococcus aureus exotoxins (SE) and eosinophilic inflammation in nasal polyp tissue. However, the role of IgE to SE in allergic rhinitis has not been known definitely. We sought to find whether the specific IgE to SE has a correlation with the allergic rhinitis. SUBJECTS AND METHOD: Nasal mucosa and serum were obtained from 30 patients undergoing submucous turbinectomy of inferior turbinates for allergic rhinitis and 20 control patients undergoing septoplasty. Nasal culture was performed for each patient. Specific IgE levels for S. aureus exotoxin A (SEA), S. aureus exotoxin B (SEB), and toxic shock syndrome toxin 1 (TSST-1) were measured using ImmunoCAP method in both nasal mucosa and serum. RESULTS: The culture rate for S. aureus was 13.3% for allergic rhinitis and 10% for the control. The specific IgE for S. aureus in serum was significantly expressed in allergic rhinitis (30%) compared to in the control (10%). In nasal mucosa of allergic rhinitis patients, the specific IgE has shown higher expression rate (20%) than the control (0%). CONCLUSION: Our results demonstrated that there is a correlation between allergic rhinitis and specific IgE to S. aureus exotoxin in both nasal mucosa and serum. These results suggest that S. aureus exotoxin can act as a traditional allergen and induce the development of allergic rhinitis.
Eosinophils ; Exotoxins ; Humans ; Immunoglobulin E ; Inflammation ; Mucus ; Nasal Mucosa ; Nasal Polyps ; Rhinitis ; Rhinitis, Allergic, Perennial ; Shock, Septic ; Staphylococcus ; Staphylococcus aureus ; Statistics as Topic ; Turbinates

BACKGROUND AND OBJECTIVES: Staphylococcus aureus (S. aureus) exotoxins (SE) have been implicated in the pathogenesis of chronic sinusitis with nasal polyposis (CRSwNP). The aim of this study was to identify the contribution of S. aureus exotoxin as allergen in the development of nasal polyp. MATERIALS AND METHOD: Nasal polyp and serum were obtained from 30 patients who underwent endoscopic sinus surgery for CRSwNP and 10 control turbinate mucosae were used. Nasal culture was done for each patients. Specific IgE levels for S. aureus exotoxin A (SEA), S. aureus exotoxin B (SEB), and toxic shock syndrome toxin 1 (TSST-1) were measured using ImmunoCAP method in nasal tissue and serum. The patients were divided into three groups : A, nasal polyp (+)/culture (+) ; B, nasal polyp (+)/culture (-) ; C, nasal polyp (-)/culture (-). RESULTS: The culture for S. aureus was 27% in CRSwNP when compared to 10% in control. The specific IgE for S. aureus in serum was significantly expressed in nasal polyp (30%) compared to control (0%). Also the Group A showed a significant high rate of specific IgE (63%) compared to Group B (18%) and Group C (0%) in serum. In nasal polyp tissue, the specific IgE has showed no specific difference between nasal polyp (7%) and control (10%). However, it was also increased in Group A (25%), compared to Group B (0%) and Group C (11%). CONCLUSION: Our results demonstrated that there was a correlation between nasal polyp and specific IgE levels to S. aureus exotoxin. These results suggest that S. aureus exotoxin can act as a traditional allergen and induce the inflammatory reaction in CRSwNP. Background and Objectives : Staphylococcus aureus (S. aureus) exotoxins (SE) have been implicated in the pathogenesis of chronic sinusitis with nasal polyposis (CRSwNP). The aim of this study was to identify the contribution of S. aureus exotoxin as allergen in the development of nasal polyp.
Exotoxins* ; Humans ; Immunoglobulin E* ; Mucous Membrane ; Mucus* ; Nasal Polyps ; Shock, Septic ; Sinusitis ; Staphylococcus aureus* ; Staphylococcus* ; Statistics as Topic* ; Turbinates