Purpose: The treatment of male breast cancer (MBC) has been extrapolated from female breast cancer (FBC) because of its rarity despite their different clinicopathologic characteristics. We aimed to investigate the distribution of intrinsic subtypes based on immunohistochemistry, their clinical impact, and treatment pattern in clinical practice through a multicenter study in Korea. Materials and Methods: We retrospectively analyzed clinical data of 248 MBC patients from 18 institutions across the country from January 1995 to July 2016. Results: The median age of MBC patients was 63 years (range, 25 to 102 years). Among 148 intrinsic subtype classified patients, 61 (41.2%), 44 (29.7%), 29 (19.5%), and 14 (9.5%) were luminal A, luminal B, human epidermal growth factor receptor 2, and triple-negative breast cancer, respectively. Luminal A subtype showed trends for superior survival compared to other subtypes. Most hormone receptor-positive patients (166 patients, 82.6%) received adjuvant endocrine treatment. Five-year completion of adjuvant endocrine treatment was associated with superior disease-free survival (DFS) in patients classified with an intrinsic subtype (hazard ratio [HR], 0.15; 95% confidence interval [CI], 0.04 to 0.49; p=0.002) and in all patients (HR, 0.16; 95% CI, 0.05 to 0.54; p=0.003). Conclusion Distribution of subtypes of MBC was similar to FBC and luminal type A was most common. Overall survival tended to be improved for luminal A subtype, although there was no statistical significance. Completion of adjuvant endocrine treatment was associated with prolonged DFS in intrinsic subtype classified patients. MBC patients tended to receive less treatment. MBC patients should receive standard treatment according to guidelines as FBC patients.

Background: The Baumann skin type (BST) classification provides a new approach for clinical care of dermatologic patients. Objective: To investigate the correlation of skin types with genetic factors and environmental factors that have an important influence on Korean skin by comparing and analyzing the correlation between phenotype and genotype. Methods: From July to October 2016, 774 adults who visited the one online shopping mall were subjected to skin BST questionnaire and gene single-nucleotide polymorphism (SNP) tests. Oral epithelial cells of the subjects were collected using a Genoplan DNA analysis kit, and 14 genes were analyzed by a genetic analysis agency (Genoplan Inc., Fukuoka, Japan). Results: The most abundant skin type was OSNT (oily, sensitive, non-pigmented, tight) observed in 205 participants (26.5%). Of the filaggrin (FLG) SNPs, 143 participants (18.5%) had the GG (good) SNP; 391 (50.5%), GA (normal) SNP; and 240 (31.0%), AA (poor) SNP. Among those whose FLG SNP was GG (good), 121 (84.6%) were sensitive and 22 (15.4%) were resistant. Of those whose filaggrin (FLG) SNP was GA (normal), 337 (86.2%) were sensitive and 54 (13.8%) were resistant. Of those whose FLG SNP was AA (poor), 213 (88.8%) were sensitive and 27 (11.3%) were resistant. There was also a statistically significant difference in the fruit-vegetable consumption and use of a sunbathing bed between sensitive and resistant type in the groups that classified the FLG SNP as GA. Conclusion This is the first study to investigate the association of BST with genetic factors and environmental factors.

Background/Aims: Endoscopic diagnosis of dysplasia or colitic cancer in patients with ulcerative colitis (UC) is more challenging than that of colorectal neoplasia in non-colitic patients. We aimed to evaluate the accuracy of the endo-scopic diagnosis of “nonpedunculated” dysplasia or colitic cancer in UC patients. Methods: Ten endoscopists from four countries were surveyed using photographs of 61 histologi-cally confirmed dysplastic or non-dysplastic lesions retrieved from the UC registry database of Asan Medical Center. The participants provided their assessment based on the given photographs and their intention to perform biopsy. Results: The overall diagnostic performance of the 10 participants is summarized as follows: sensitivity of 88.2% (95% confidence interval [CI], 84.3% to 91.5%), specificity of 34.8% (95% CI, 29.1% to 40.8%), positive predictive value of 63.0% (95% CI, 60.8% to 65.2%), negative predictive value of 70.2% (95% CI, 62.7% to 76.6%), and accuracy of 64.6% (95% CI, 60.7% to 68.4%). The interobserver agreement on the inten-tion to perform a biopsy was poor (Fleiss kappa=0.169). Of the three endoscopic characteristics of the lesions, includ-ing ulceration, distinctness of the borders, and pit patterns, only neoplastic pit patterns were significantly predictive of dysplasia (odds ratio, 3.710; 95% CI, 2.001 to 6.881). The diagnostic sensitivity and specificity of neoplastic pit patterns were 68.2% (95% CI, 63.0% to 73.2%) and 63.3% (95% CI,57.3% to 69.1%), respectively. Conclusions Diagnostic per-formance based on the endoscopist’s intention to perform a biopsy for nonpedunculated potentially dysplastic lesions in UC patients was suboptimal according to this survey-based study.

PURPOSE: Adherence is a major component of successful medical treatment. However, non-adherence remains a barrier to effective delivery of healthcare worldwide. METHODS: Twenty healthcare facilities (secondary or tertiary hospitals) belonging to the Korean Academy of Pediatric Allergy and Respiratory Diseases (KAPARD) participated. Questionnaires were given to patients currently receiving treatment in the form of inhalant useor oral intake or transdermal patch for mild to moderate asthma. RESULTS: A total of 1,838 patients responded to the questionnaire. Mean age was 5.98 ± 3.79 years (range: 0-18 years). With help from their caregivers, the percentage of patients that answered “taking as prescribed” was 38.04% for inhalant users, 50.09% for oral medication users and 67.42% for transdermal users. Transdermal patch users had significantly greater adherence compared to the other 2 groups (P < 0.001). The 34.15% of inhalant users, 70.33% of oral medication users and 93.00% of transdermal patch users felt that their medication delivery system was “Easy” or “Very easy” to use (P < 0.001). “Method of administration” was deemed to be the most difficult part of the treatment regimen to follow, and 76.7% of patients preferred once-daily administration (i.e., “Frequency of administration”). CONCLUSIONS: Asthma medication adherence in young children was found to be better in the transdermal patch group. This may be due to requiring fewer doses and easy to follow instructions. From an adherence point of view, the transdermal patch seems more useful for long-term asthma control in children compared to oral or inhaled medicine.
Asthma ; Caregivers ; Child ; Delivery of Health Care ; Humans ; Hypersensitivity ; Korea ; Medication Adherence ; Transdermal Patch

No abstract available.
Brain Diseases* ; Brain Stem* ; Humans ; Hypertensive Encephalopathy ; Stroke, Lacunar*

BACKGROUND: Recently, the measurement of glycated hemoglobin (HbA1c) was recommended as an alternative to fasting plasma glucose or oral glucose tolerance tests for diagnosing diabetes mellitus (DM). In this study, we analyzed HbA1c levels for diabetes mellitus screening in a Korean rural population. METHODS: We analyzed data from 10,111 subjects from a Korean Rural Genomic Cohort study and generated a receiver operating characteristic curve to determine an appropriate HbA1c cutoff value for diabetes. RESULTS: The mean age of the subjects was 56.3+/-8.1 years. Fasting plasma glucose and 2-hour plasma glucose after 75 g oral glucose tolerance tests were 97.5+/-25.6 and 138.3+/-67.1 mg/dL, respectively. The mean HbA1c level of the subjects was 5.7+/-0.9%. There were 8,809 non-DM patients (87.1%) and 1,302 DM patients (12.9%). A positive relationship between HbA1c and plasma glucose levels and between HbA1c and 2-hour plasma glucose levels after oral glucose tolerance tests was found in a scatter plot of the data. Using Youden's index, the proper cutoff level of HbA1c for diabetes mellitus screening was 5.95% (sensitivity, 77%; specificity, 89.4%). CONCLUSION: Our results suggest that the optimal HbA1c level for DM screening is 5.95%.
Cohort Studies ; Diabetes Mellitus ; Fasting ; Glucose ; Glucose Tolerance Test ; Hemoglobin A, Glycosylated ; Hemoglobins ; Humans ; Mass Screening ; Plasma ; ROC Curve ; Rural Population ; Sensitivity and Specificity

PURPOSE: PET-CT is often used to differentiate benign or malignant thyroid incidentalomas. In this retrospective study, we evaluated whether the ¹⁸F-FDG uptake pattern and PET-CT findings improved accuracy over the standardized uptake value (SUV). METHODS: ¹⁸F-FDG PET-CT was performed on 2,178 subjects from August, 2004, to October, 2007, in Sung-ae Hospital. PET-CT was performed on 806 patients (37%) with suspected or known nonthyroidal cancer and 1,372 healthy subjects (63%) without a previous history of cancer. We investigated the clinical characteristics of patients, history, standardized uptake value (SUV), ultrasonography, and hormone levels in blood. Thyroidal cancer was confirmed by ultrasonography-guided fine needle aspiration and pathology after thyroid operation. RESULTS: The prevalence of focal thyroid lesions on PET-CT was 8.8% (191/2178). Thyroid cancer confirmation was 7.9% (15/191). The maximum SUV of malignant thyroid lesions were significantly higher than that of benign lesions (7.00±3.08 vs. 4.49±1.84, P<0.001). CONCLUSION: PET-CT image interpretation that includes 18F-FDG uptake and SUV is better than PET-CT alone for differentiating benign and malignant lesions. Thyroid cancer risk increases as SUVmax levels increase.
Biopsy, Fine-Needle ; Fluorodeoxyglucose F18 ; Healthy Volunteers ; Humans ; Pathology ; Prevalence ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms ; Ultrasonography

PURPOSE: The aim of this study was to investigate changes in bronchial hyperresponsiveness, total IgE, blood total eosinophil counts and serum eosinophil cationic protein (ECP), after treatment with inhaled corticosteroids or leukotriene modifiers in children with asthma. METHODS: Methacholine bronchoprovocation tests were repeated at 12 months of follow-up in 37 children with atopic asthma and eight children with non-atopic asthma, who regularly attended the Allergy Clinic of Korea University Anam Hospital and Seoul National University Hospital over one year from their initial visit. A serum total IgE, peripheral blood eosinophil counts, and serum ECP levels were measured on their initial visits and at 12 months of follow-up. RESULTS: Following six to 12 months of inhaled corticosteroids or leukotriene modifiers treatment, the geometric mean (range of 1 SD) of methacholine PC20 was significantly changed in the atopic asthma group [2.20 mg/mL (0.41-11.82) vs. 6.69 mg/mL (1.25-35.87), P=0.000] but not in non-atopic asthma group [2.41 mg/mL (0.90-6.42) vs. 2.46 mg/mL (0.62-9.78), P=0.065]. Blood total eosinophil counts and serum ECP levels decreased significantly over one year in atopic asthma, while these changes were not observed in non-atopic asthma. Significantly higher FEV1 %predicted values (98.3+/-6.6%) were noted at 12 month follow-up compareed to the initial values (92.9+/-11.4%, P=0.023) in the non-atopic asthma group. CONCLUSION: Inhaled corticosteroids or leukotriene modifiers treatment resulted in a significantly decreased bronchial hyperresponsiveness in children with atopic asthma. This effect was reflected primarily by reduced blood eosinophilic inflammation. The persistence of bronchial hyperresponsiveness in children with non-atopic asthma might be related with genetic factors or airway remodeling other than eosinophilic inflammation.
Adrenal Cortex Hormones ; Airway Remodeling ; Asthma* ; Child* ; Eosinophil Cationic Protein ; Eosinophils ; Follow-Up Studies ; Humans ; Hypersensitivity ; Immunoglobulin E ; Inflammation ; Korea ; Methacholine Chloride ; Seoul

OBJECTIVES: To determine the synthetic risk factors of musculoskeletal disorders, and to examine effect on musculoskeletal symptoms of physical work intensity and change of work intensity. METHODS: Self-administered questionnaraire survey was conducted on 588 motor engine assembly workers, in Chanwon, Kyungnam provance, Korea, from April 1 to May 31, 2003. The contents of the questionnaire investigation included general characteristic items, workrelated characteristic items, presence of musculoskeletal symptoms, ergonomic risk factors items, job stress items, current physical work intensity and changes of work intensity items. The results underwent statistical analysis with frequency test, t-test, and logistic regression. The statistical significance level was 0.05, and SAS(v8.1) was used. RESULTS: Multiple logistic regression analysis was used to examine the relationship between risk factors and musculoskeletal symptoms. From the results, significant variables were high Quick Exposure Check (QEC) score, high job demand control, physical work intensity, change of work intensity. CONCLUSION: Among the known risk factors of musculoskeletal disorders, the outbreak of musculoskeletal symptoms was confirmed to be correlated with age, tenure, ergonomic risk factors, and job stress. Physical work intensity and the changes of work intensity were also related to musculoskeletal symptoms.
Gyeongsangnam-do ; Korea ; Logistic Models ; Plants* ; Questionnaires ; Risk Factors*

Endobronchial tuberculosis is defined as a specific inflammation of the trachea or major bronchi caused by the tubercle bacillus. It is recognized as one of the most common and serious complication of pulmonary tuberculosis. A diagnosis of endobronchial tuberculosis is difficult due to the diversity of radiological patterns. But, it is still relatively common disease in korea. Endobronchial tuberculosis as a cause of the acute respiratory distress syndrome (ARDS) is quite rare. The mortality rate of ARDS is still high in korea. The detection and early elimination of the causes for ARDS at the initial stage can result in a more favorable prognosis. So, patients with ARDS, especially due to endobronchial tuberculosis or other form of tuberculosis, should be treated with antituberculous drugs as soon as possible. We experienced a young female with complaints of sudden onset dyspnea, mild fever. In this case the clinical features, laboratory data and radiologic findings allowed an initial presentation of ARDS. The ARDS was defined by the American-Europian Consensus Conference 19921-3). The cause of ARDS was revealed endobronchial tuberculosis. We started antituberculosis medication and steroid injection quickly, which resulted in good prognosis. We emphasize the prognosis depends mainly on the early recognition and treatment of endobronchial tuberculosis.
Bacillus ; Bronchi ; Consensus ; Diagnosis ; Dyspnea ; Female ; Fever ; Humans ; Inflammation ; Korea ; Mortality ; Prognosis ; Respiratory Distress Syndrome, Adult* ; Trachea ; Tuberculosis ; Tuberculosis, Pulmonary