The KOrean College of Rheumatology BIOlogics and targeted therapy (KOBIO) registry is a nationwide observational cohort that captures detailed data on exposure of patients to biologic and targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs). This registry was launched in December 2012 with an aim to prospectively investigate clinical manifestations and outcomes of patients with rheumatoid arthritis (RA), ankylosing spondylitis, and psoriatic arthritis who initiated a biologic or targeted synthetic DMARD or switched to another. Demographic data, disease activity, current treatment, adverse events, terms based on Medical Dictionary for Regulatory Activities, and so on are registered for patients who are then followed up annually in a web-based unified platform. The KOBIO registry also recruits and collects data of patients with RA on conventional DMARDs for comparison. As of today, more than 5,500 patients were enrolled from 47 academic and community Rheumatology centers across Korea. The KOBIO registry has evolved to become a powerful database for clinical research to improve clinical outcomes and quality of treatment.

The KOrean College of Rheumatology BIOlogics and targeted therapy (KOBIO) registry is a nationwide observational cohort that captures detailed data on exposure of patients to biologic and targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs). This registry was launched in December 2012 with an aim to prospectively investigate clinical manifestations and outcomes of patients with rheumatoid arthritis (RA), ankylosing spondylitis, and psoriatic arthritis who initiated a biologic or targeted synthetic DMARD or switched to another. Demographic data, disease activity, current treatment, adverse events, terms based on Medical Dictionary for Regulatory Activities, and so on are registered for patients who are then followed up annually in a web-based unified platform. The KOBIO registry also recruits and collects data of patients with RA on conventional DMARDs for comparison. As of today, more than 5,500 patients were enrolled from 47 academic and community Rheumatology centers across Korea. The KOBIO registry has evolved to become a powerful database for clinical research to improve clinical outcomes and quality of treatment.

Angiosarcoma is a very rare form of neoplasm derived from soft tissue. It is reported even more rarely in hepatobiliary system. Because of its nonspecific symptoms and difficulty in diagnosis, angiosarcoma is often presented in a progressed state and often results in poor prognosis. To our best knowledge, there has been no report regarding angiosarcoma in common bile duct worldwide. We report a case of 77-year-old-woman presented with right upper abdominal pain diagnosed as angiosarcoma in common bile duct.
Abdominal Pain ; Common Bile Duct* ; Diagnosis ; Hemangiosarcoma* ; Prognosis

PURPOSE: The aim of the current study is to assess the spectrum of genetic variation in the BRIP1 gene among Korean high-risk breast cancer patients who tested negative for the BRCA1/2 mutation. MATERIALS AND METHODS: Overall, 235 Korean patientswith BRCA1/2 mutation-negative high-risk breast cancerwere screened for BRIP1 mutations. The entire BRIP1 gene was analyzed using fluorescent-conformation sensitive gel electrophoresis. In silico analysis of BRIP1 variants was performed using PolyPhen-2 and SIFT. RESULTS: A total of 20 sequence alterations including 12 exonic and eight intronic variantswere found. Among the 12 exonic variants, 10 were missense and two were silent mutations. No protein-truncating mutation was found among the tested patients. Among the 10 missense variants, four (p.L263F, p.L340F, p.L474P, and p.R848H) were predicted to be pathogenic by both PolyPhen-2 and SIFT, and these variants were found in five patients. Of the four missense variants, p.L263F, p.L474P, and p.R848H localize to regions between the helicase motifs, while p.L340F resides in an iron-sulfur domain of BRIP1. CONCLUSION: No protein-truncating mutation in BRIP1 was found among the tested patients. The contribution of BRIP1 variants is thought to be minor in Korean non-BRCA1/2 high-risk breast cancer.
Breast Neoplasms* ; Breast* ; Computer Simulation ; Electrophoresis ; Exons ; Genetic Variation ; Hereditary Breast and Ovarian Cancer Syndrome ; Humans ; Introns ; Korea ; Silent Mutation

Endocrine-disrupting chemicals (EDCs) are exogenous substances that alter the structure or function of the endocrine system. 4-Tert-octylphenol (OP) is one of the most representative EDCs and has estrogenic effects. In this study, we examined the effects of ethinyl estradiol (EE) and OP on the pituitary gland, placenta, and uterus of pregnant rats. Expression levels of human chorionic gonadotropin (hCG), oxytocin (OT), and contraction-associated proteins (CAPs) were determined, and uterine contractile activity was measured by uterine contraction assay. EE and OP both increased mRNA expression of OT and hCG in the pituitary gland but not the placenta. Since OT and hCG control uterine contraction, we next examined CAP expression in the uterus. Expression of 15-hydroxyprostaglandin-dehydrogenase (PGDH) was upregulated by OP, whereas expression of other CAPs was unaffected. To clarify the effect of OP on uterine contraction in pregnant rats, uterine contraction assay was performed. The 17beta-Estradiol (E2) did not affect contraction of primary uterine cells harvested from pregnant rats in a 3D collagen gel model. However, OP showed different effects from E2 by significantly reducing contraction activity. In summary, we demonstrated that OP interferes with regulation of OT and hCG in the pituitary gland as well as PGDH in the uterus, thereby reducing uterine contraction activity. This result differs from the action of endogenous E2. Collectively, these findings suggest that exposure to EDCs such as OP during pregnancycan reduce uterine contractile ability, which may result in contraction-associated adverse effects such as metratonia, bradytocia, and uterine leiomyomata.
Animals ; Chorionic Gonadotropin ; Collagen ; Endocrine System ; Estradiol ; Estrogens ; Ethinyl Estradiol ; Oxytocin* ; Pituitary Gland ; Placenta ; Rats* ; RNA, Messenger ; Uterine Contraction ; Uterus

Routine preoperative tests such as BT/CT, PT/PTT and CBC, could not test abnormal hemostasis that take drugs and health functional food. We used platelet function analyzer (PFA(R))-100, to evaluate preoperative bleeding tendencies. From November 2008 to February 2010, 306 surgical patients were tested preoperative PFA in our hospital. There are 2 tests in PFA(R)-100. The Pre Operative EPI (collagen/epinephrine) assay tests extrinsic platelet function, whereas the Pre Operative ADP (collagen/adenosine diphosphate) assay tests intrinsic platelet function. We divided normal and abnormal groups by the PFA(R)-100 assay tests. If either of results were abnormal in the two tests, the patient was divided to the abnormal group. 306 surgical patients were observed with hemorrhagic complications. All of the patients were divided normal and abnormal groups by the PFA(R)-100 test result. The normal group was made up of 286 (93.5%) patients, the abnormal group was made up of 20 (6.5%) patients. We observed each group hemorrhage complication including sever echymosis and hematoma, and analyzed each group complication rate. There were 9 (3.1%) cases of complication in the normal group. There were 3 (15.0%) cases of complication in the abnormal group. To evaluate preoperative bleeding tendency, PFA(R)-100 can be complementary examination with previous routine blood coagulation tests.
Adenosine Diphosphate ; Blood Coagulation Tests ; Blood Platelets ; Functional Food ; Hematoma ; Hemorrhage ; Hemostasis ; Herbal Medicine ; Humans ; Platelet Function Tests ; von Willebrand Diseases

Blepharoptosis patients use frontalis muscle unconsciously to widen eye, and it results in several aesthetic problems-such as forehead wrinkling and elevated eyebrow. So forehead wrinkling and elevated eyebrow can be resolved with correction of blepharoptosis. We evaluated the change of eyebrow height in 30 patients who were corrected blepharoptosis through photogrammetry. The mean age of the patients was 36.8 years old and the mean follow up periods were 6 months. Horizontal line passing medial and lateral canthal corner in both eyes was drawn in Photopshop. From the horizontal line, 3 vertical lines perpendicular to this line were drawn passing medial and lateral canthal corner and the vertically oriented center of the pupil. Eyebrow height was measured through these 3 vertical lines. The average length of decreased value of the eyebrow height were 3.64 mm in H1, 3.31 mm in H2, 2.79 mm in H3. In unilateral cases, 2.42 mm in H1, 2.86 mm in H2, 2.78 mm in H3, and in bilateral cases, the decreased values were 4.25 mm in H1, 3.53 mm in H2, 2.79 mm in H3. From this study, the author would like to introduce the method to calculate the changes of eyebrow height after blepharoptosis correction and the values objectively.
Blepharoptosis ; Eye ; Eyebrows ; Follow-Up Studies ; Forehead ; Humans ; Muscles ; Photogrammetry ; Pupil

We report on the application of a venovenous type extracorporeal membrane oxygenator (ECMO) in high-risk tracheal procedures in six cases consisting of five patients with tracheal stenosis. An ECMO should be helpful for preventing respiratory emergency during a tracheal procedure.
Emergencies ; Extracorporeal Circulation ; Extracorporeal Membrane Oxygenation ; Humans ; Membranes ; Oxygenators, Membrane ; Tracheal Stenosis

Traumatic lumbosacral spinal subdural hematoma due to anatomical and pathological causes is rare, compared to epidural hematoma. If the time of trauma cannot be determined, intracranial and intraspinal signal intensity according to lapse of time are not coincident, resulting in confusion in terms of differentiation. Fat suppression magnetic resonance image (MRI) and computed tomography (CT) are utilized for differentiation. The intention of this study is to report on a case where spinal subdural hematoma of unknown time of occurrence is differentiated from subdural lipoma by taking advantage of fat suppression MRI and CT in order to perform an early surgical decompression with auxiliary review of literature demonstrating good prognosis of the procedure.
Decompression, Surgical ; Hematoma ; Hematoma, Subdural, Spinal* ; Intention ; Lipoma* ; Magnetics ; Magnets ; Prognosis

Opioids are generally used to treat severe cancer pain. Usually, it is common to increase the dose of opioids to maintain analgesia. Opioid-induced hyperalgesia (OIH) is a paradoxical response to opioid resulting in increased perception of pain rather than antinociceptive effect. A 64-year-old female with pancreatic cancer was suffering from whole abdominal pain. She took massive opioid therapy, however, her pain had been worse and widen in the 3 months. Radiologic imaging was performed to exclude metastatic cancer. The result was negative. We suspected OIH, and reduced the amount of opioids, then, added to adjuvant analgesics. And also we performed celiac plexus neurolysis with the use of alcohol and continuous epidural catheter insertion. Her numeric rating pain scale (NRS) decreased from 9/10 to 3/10. This case suggests that adjuvant analgesics and interventional treatments can resolve a OIH patient with intractable cancer pain.
Abdominal Pain ; Analgesia ; Analgesics ; Analgesics, Opioid ; Catheters ; Celiac Plexus ; Female ; Humans ; Hyperalgesia ; Middle Aged ; Pain Management ; Pancreatic Neoplasms ; Stress, Psychological