Associations Between Phthalate, Eosinophil, and Aeroallergen Sensitization in Schoolchildren

Background@#Phthalates and bisphenol A (BPA) are endocrine-disrupting chemicals and may cause immunological disorders in children. Therefore, according to the region, we investigated urinary phthalates and BPA levels and the relationship between urinary phthalate, aeroallergen sensitization, and eosinophil count during the coronavirus disease 2019 pandemic. @*Methods@#In total, 203 schoolchildren (134 residential and 69 industrial) aged 7–10 years were enrolled between July 2021 and July 2022. The BPA, metabolites of four high-molecularweight phthalates (Σ4HMWP) and three low-molecular-weight phthalates (Σ3LMWP), were measured in the urine samples. Total eosinophil count and transepidermal water loss (TEWL) were also measured along with the skin prick test. @*Results@#The two groups had no differences in terms of BPA. The industrial group had significantly more plastic container usage, and there was a difference in the Σ3LMWP (P < 0.001) between the two groups but no difference in the Σ4HMWP (P = 0.234). The quartiles of urinary Σ4HMWP and Σ3LMWP (P < were not associated with the total eosinophil count, vitamin D level, or TEWL. After adjusting for cofactors, the quartiles of urinary Σ4HMWP and Σ3LMWP were significantly associated with total eosinophil count (P < 0.001) but not with aeroallergen sensitization or vitamin D. @*Conclusion@#Exposure to phthalates was significantly associated with eosinophil count but not with aeroallergen sensitization or vitamin D. Therefore, reducing the use of plastic containers may effectively prevent exposure to phthalates and reduce Th2 cell-mediated inflammation in children.

Effect of the Computerized Emergency Consultation System on Communication Between Medical Staff for Emergency Care / 의료커뮤니케이션

Purpose@#: In emergency department(ED), emergency consultation is often omitted or delayed, resulting in an increase of the length of stay for patients. The present study investigated the emergency consultation computerized system designed for prompt and accurate communication can shorten the time for consultation care. In addition, we tried to confirm how users’ satisfaction with communication for emergency consultation changed before and after using the system. @*Methods@#: We divided the period from arrival to exit of the emergency department into 4 stages, and the time taken for each stage was measured. In addition, the present study conducted a satisfaction survey on the convenience and accuracy of communication among users. @*Results@#: After using the computerized system, the median value of time for emergency consultation treatment decreased significantly from 78 minutes to 39 minutes (p<0.001). In terms of communication convenience, more than two-thirds of the users responded positively. @*Conclusion@#: The system that computerized the initial communication shortened the time required for emergency consultation and increased satisfaction in terms of convenience of communication between medical staff.

Novel Cell Permeable Peptide Based on Multi Basic Furin-dependent Cleavage Site of Respiratory Syncytial Virus Fusion Protein

Cell permeable peptide (CPP) is able to transport itself or conjugated molecules such as nucleotides, peptides, and proteins into cells. Since short peptide of human immunodeficiency virus-1 Tat has been discovered as CPP, it has been continuously studied for their ability to transport heterologous cargoes into cells. In this study, we have focused on the fusion protein of respiratory syncytial virus (RSV), which has six basic amino acids in multi basic furin-dependent cleavage site (MBFCS) required to be cationic CPP. To develop more efficient CPP, the sequence, which linked two MBFCS, was synthesized (called RS-CPP). To assess cell permeable efficiency of RS-CPP or MBFCS, the peptides was conjugated with fluorescein isothiocyanate, and cell permeable efficiency was measured by fluorescence-activated cell sorting. Cell permeability of RS-CPP or MBFCS was increased in a dose-dependent manner, but RS-CPP showed more efficient cell permeability than MBFCS in MDCK, HeLa, Vero E6, and A549 cells. To evaluate whether RS-CPP can transport its conjugated functional peptide (VIVIT) in CD8+ T cell, it was confirmed that IL-2 and β-galactosidase expression were significantly inhibited through selective block of nuclear factor activated T-cell. To investigate endocytic pathways, Cre-mediated DNA recombination (loxP-STOP-loxP-LacZ reporter system) was investigated with divergent endocytosis inhibitors in TE671 cells, and RS-CPP endocytosis is occurred via binding cell surface glycosaminoglycan and clathrin-mediated endocytosis, or macropinocytosis. These results indicated that RS-CPP could be a novel cationic CPP, and it would help understanding for delivery of biologically functional molecules based on viral basic amino acids.

Thyroid Tuberculosis Diagnosis by Core Needle Biopsy Associated with Lymph Node Enlargement / 계명의대학술지

Tuberculosis of thyroid gland is rare. We experienced a case of tuberculosis of the thyroid gland with contralateral lymph node enlargement in a 45-year-old female patient. She had no clinical respiratory symptom and no weight change. Thyroid sonography demonstrated 5.4 × 3.8 mm sized round low echogenic mass on lower pole of left thyroid gland and right cervical lymph node enlargement. Core needle biopsy of thyroid showed epithelioid chronic granuloma in the caseous necrosis. She was administrered anti-tuberculosis therapy for 24 weeks. After medication, thyroid sonographic finding improved and thyroid mass and right cervical lymph node enlargement disappeared.

A Case of Gastritis Cystica Profunda Presenting with a Submucosal Cystic Tumor / 대한소화기내시경학회지

Gastritis cystica profunda (GCP) is a lesion characterized by elongation of the gastric foveolae with hyperplasia and cystic dilatation of the gastric glands that extends into the submucosal layer. In most cases, gastritis cystica profunda develops in patients who have undergone a gastroenterostomy, with or without gastric resection. GCP may present not only as a submucosal tumor or as solitary or diffuse polyps, but GCP is also rarely seen as a giant gastric mucosal fold. A patient arrived at our hospital with dyspepsia. Gastroduodenoscopy (EGD) showed the presence of a submucosal tumor measuring 3 cm in the widest diameter in the body of the stomach. A CT scan demonstrated the cystic nature of the lesion and endoscopic ultrasound (EUS) depicted a homogeneous hypoechoic, unilocular cystic mass without any internal solid component. EGD, CT and EUS findings suggested that the lesion was more likely to be benign than malignant. The lesion was treated with an endoscopic mucosal resection (EMR), and the lesion was finally diagnosed as gastritis cystica profunda. A follow-up EGD demonstrated that all mucosal surfaces were well healed four weeks after the EMR.

A Case of Intravenous Immunoglobulin-Resistant Kawasaki Disease Treated with Methotrexate

Kawasaki disease, an acute febrile vasculitis of unknown etiology, is usually treated with high doses of immunoglobulin (IVIG) and aspirin. However, 20% of children show persistent or recurrent fever despite IVIG, and coronary artery aneurysm progression. In such cases of resistance to IVIG treatment, repeated IVIG administration or the initiation of steroid therapy, and the use of cyclophosphamide have been reported. We aimed to show in this study that methotrexate (MTX) may be used as a treatment for Kawasaki disease resistant to IVIG treatment. We report the case of a 6-year old boy who was admitted at another hospital with an initial complaint of a fever for 5 days and skin rashes for 3 days. The patients fever persisted despite three courses of IVIG (2 gm/kg, 1 gm/kg, 1 gm/kg, respectively) over a 14-day period. On day 14 of his illness he showed a dilated right coronary artery, and on day 19 dexamethasone, at a daily dose of 0.3 mg/kg, was given but this resulted in defervescence. However, upon stopping the dexamethasone treatment, his fever recurred and he was transferred to our hospital. On days 31 and 38 of his illness, IVIG (400 mg/kg for 5 days, twice) was administered and from day 38 onwards the patient was given dexamethasone (0.6 mg/kg, daily) and MTX (10 mg/BSA, once weekly) whereupon his fever subsided and did not recur. On day 48 dexamethasone was replaced with prednisolone, which was subsequently tapered. The patient is now taking MTX and being observed on an outpatient basis. We report the case of a boy with IV-globulin resistant Kawasaki disease, who after repeated infusions of IVIG and steroid therapy showed fever recruuence, which that subsided after MTX treatment.

Screening Guidelines for Retinopathy of Prematurity in Extremely Low Birth Weight Infants

PURPOSE: The ophthalmologic screening examination in extremely low birth weight (ELBW) infants shoud be done at a postconceptional age (PCA) of 31 to 33 weeks or the chronological age (CA) of 4 to 6 weeks. If the first ophthalmologic examination in ELBW infants is perfomed at 31 to 33 weeks PCA, there is a risk of threshold retinopathy of prematurity (ROP) having already developed on the first examination. The risk of a visual loss is high if threshold ROP has already developed before the initial screening examination of ROP. Therefore, we investigated the ideal timing of the initial ophthalmologic screening examination based on PCA and CA in ELBW infants. SUBJECTS: The medical records of 38 ELBW infants (<1000 g at birth) admitted to neonatal intensive care unit of Severance hospital between January 1991 and December 2000, whose follow-up ophthalmologic examinations were available, were reviewed retrospectively. We investigated the PCA and CA at the diagnosis of prethreshold ROP and threshold ROP. RESULTS: Sixty-five percent of subjects was diagnosed with prethreshold ROP and 64% of the infants progressed to threshold ROP. The median time of progression from prethreshold ROP to threshold ROP was 14 days (2-33). Twenty-four percent was diagnosed with prethreshold ROP on the first eye examination. Prethreshold ROP was diagnosed as early as 33 weeks PCA and threshold ROP was diagnosed as early as 35 weeks PCA. Prethreshold ROP was diagnosed as early as 4 weeks CA and threshold ROP was diagnosed as early as 6 weeks CA. CONCLUSION: We suggest that the initial screening examination for ROP should be performed by CA or PCA in ELBW infants, whichever is earlier, to detect prethreshold ROP before its progression to threshold ROP.

Effect of 21-aminosteroid U74389G on the Extent of Brain Damage and Edema in the Newborn Rats with Hypoxic-ischemic Injury

PURPOSE: To investigate the effect of 21-aminosteroid U74389G (U) on the extent of brain damage and edema formation in the newborn rats with hypoxic ischemic (HI) brain injury. METHODS: This is a randomized, placebo-controlled, experimental study. The subjects were 113 seven-days-old rats with HI injury. Pups were treated with 3, 10, or 20 mg/ kg of U intraperitoneally 30 minutes before hypoxia (Group 1, 2, 3: n=10, 13, 11), 10 mg/kg of U immediately after hypoxia (n=11) (Group 4), 10 mg/kg of U 30 minutes before and after hypoxia (n=n=13) (Group 5), or vehicle (n=12) (Group C). We expressed the degree of brain infarction and brain edema in % atrophy (Left hemisphere-Right hemisphere/Left hemispherex100) and water content % (wet weight-dry weight/wet weightx100) RESULTS: There were significant reductions in the diameters of right hemisphere compared with those of left hemisphere in vehicle and U treated animals (P<0.05). As to the cortical thickness, group 2, 3 and 5 pups showed no significant reductions in the right side compared with the left side implicating that U treatment in these groups was of benefit in attenuating HI cortical injury, while there was significant difference between the right and left side in group 1, 4 and C animals (P<0.001). There was a significant difference (P< 0.01) in % atrophy of group 2, 3, 5 versus group C, but the mean % atrophy was similar in groups 1, 4 and C. There was a significant (P<0.05) increase of water content in right hemisphere compared with left hemisphere both in U and vehicle treated groups. CONCLUSION: Pre-treatment and prepost-treatment at moderate doses (10 or more mg/kg) of 21-aminosteroid U74389G reduced the extent of perinatal hypoxic-ischemic brain damages, especially in the cortex, but do not affect the extent of brain edema.

A Case of Neonatal Alloimmune Thrombocytopenia Related to HLA Antibody

Neonatal alloimmune thrombocytopenia(NAIT) is a very rare disease caused by maternal alloantibodies' response to neonatal platelet antigens. Because the most common cause of NAIT is incompatibility for platelet-specific antigens, NAIT cases due to anti-HLA antibodies are very exceptional. The patient was a second born female. She had no petechia or purpura at birth. But her platelet count was 55,000/mm3 and other laboratory findings were normal. On family history, the first baby had thrombocytopenia at birth too without petechia or other abnormal symptoms and his platelet count became spontaneously normal later. The mother's platelet count was normal and she had no history of idiopathic thrombocytopenic purpura(ITP) or bleeding tendency. Platelet crossmatching test showed positive between citric acid untreated paternal platelets and maternal serum, but negative to citric acid treated paternal platelets. These findings suggest maternal serum which contain anti-HLA antibodies to attack neonatal platelets and paternal platelets. Therefore this report documents a patient with neonatal thrombocytopenia induced by maternal anti HLA antibody.

Interaction between HIV-1 Nef and LyF-1, the T Cell Specific Transcription Factor

No Abstract Available.

Histological Grading and Staging of Chronic Hepatitis Standardized Guideline Proposed by the Korean Study Group for the Pathology of Digestive Diseases

The terms chronic active hepatitis (CAH), chronic persistent hepatitis (CPH), and chronic lobular hepatitis (CLH) should be discontinued in favor of etiologic terminology. The activity of necro-inflammation and the degree of fibrosis should be evaluated for grading the severity and for the stage of disease. Members of the Korean Study Group for the Pathology of Digestive Diseases reviewed 30 cases of chronic hepatitis and reached the following consensus: 1) The pathology report of the biopsy samples with features of chronic hepatitis should include the etiology, grade and stage. 2) Grade and stage should be semiquantitatively evaluated as none, minimal, mild, moderate and severe. 3) For grading, lobular activity and periportal activity should be evaluated, separately. 4) To avoid confusion with other grading systems, simple report using descriptive terms rather than numerical records is recommended in daily practice. Criteria for each grade and stage should be presented and discussed. Histologic grading and staging of chronic hepatitis by new standardized guidelines will give more information about the prognosis as well as the present status of hepatitis. The terms CAH, CPH and CLH may be used in parentheses to facilitate relearning.

A comparative study on aberrations of chromosome 17 and proliferating cell fraction in lung cancer

To better understand the relationship between specific chromosome changes found in human lung tumors and their phenotypic consequences a the tissue level, an in situ hybridization (ISH) procedure of chromosome 17 and immunohistochemistry of proliferating cell nuclear antigen (PCNA) were done. The deparaffinized sections were stained with pericentromeric probes for chromosome 17 and an immunohistochemical study of a monoclonal antibody against PCNA were performed. The numbers of chromosome signals were than compared with the positivity of PCNA expression. The mean numbers of chromosome were 1.62 in normal lymphocytes and 2.48 in lung cancer cells. Tumors showed a high mean positivity of PCNA of 43.4%. Mean PCNA expression was higher in squamous carcinomas than in adenocarcinomas (p<0.05). A linear correlation between numbers of ISH signals and PCNA expression was not demonstrated, but there was a tendency of increasing PCNA positivity according to increasing numbers of ISH signals in adenocarcinomas of the lung and the tumor tissues which were over 50% positive PCNA expression. There was no linear correlation between numbers of ISH signals, PCNA positivity and tumor stages, and keratinization of squamous cell lung cancer. These results suggest that ISH will prove to bo an important tool for determining the underlying genetic basis for tissue phenotypic heterogeneity by allowing genetic determinations to be made on paraffin-embedded tissue sections where histologic architecture is preserved, and immunohistochemical nuclear staining with anti-PCNA on routinely processed tissue is a simple technique for the assessment of proliferation in non-small cell lung carcinoma.

Pulmonary Lymphangiomyomatosis: A case report

Pulmonary lymphangiomyomatosis is a rare disease of haphazard overproliferation of smooth muscle from perilymphatics, peribronchial and perivascular regions of the lung that leads to chylous effusion, hemoptysis, spontaneous pneumothorax and pulmonary insufficiency. The disease only affects women of child-bearing age. There is presently no successful therapy and most of the patients die within 10 years of diagnosis. We experienced a case of pulmonary lymphangiomyomatosis in a 30-year-old woman who had suffered from three episodes of spontaneous pneumothorax for 4 years. Open lung biopsy was performed. Microscopically, abnormal excess proliferation of smooth muscle tissue was identified in the wall of perivascular lymphatic channels as well as around small bronchi, and more distal air spaces. Varying sized cytic spaces Iined by cuboidal cells were also present. Tamoxifen, given if February 1991, did not influence the course of her disease. She died of respiratory failure at age of 31 in April 1991.

Immunopathologic Study and Clinical Correlation of Non-Hodgkin's Lymphoma

In Korea, the proportion of B-cell and T-cell lymphomas has not yet been clearly estimated. In the present study, we analysed clinicopathologic and immunophenotypic findings in 60 cases of non-Hodgkin's lymphomas(NHL) and in 17 cases of polymorphic reticulosis. Immunohistochemical studies for monoclonal antibodies, such as MB2, UCHL-1, Kappa/Lambda light chains, and IgG/IgM/IgD heavy chains were performed on formaldehyde-fixed paraffin embedded tissue sections. Among 60 cases of NHL, 28 cases(46.7%) expressed B-cell markers, 29 cases(48.3%) T-cell markers, and 3 cases(5.0%) lacked detectable markers, whereas 16 of 17 cases(94.2%) of polymorphic reticulosis reacted with T-cell markers. The mean survival of the 16 cases of T-cell lymphoma group was shorter than that of the lymphoma group positive for B-cell markers.

Malignant Fibrous Histiocytoma of the Heart: A case report

A case of a 58-year-old man with malignant fibrous histiocytoma (MFH) of the right ventricle is reported light and electron microscopically. This is the first case of MFH of the heart in the Korean literature. A tendency for malignant fibrous histiocytoma of the heart to occur in the left atrium of young women is suggested; this sarcoma's usual location is in the soft tissue of elderly men. The tumor consisted of spindle cells arranged in a focal storiform patterns, clusters or sheets of histocyte-like cells, benign and malignant giant cells, inflammatory cells, scattered mitotic figures and anaplasia of stromal cells. In ultrastructure the constituent of cells of the tumor are primitive mesenchymal cells, histiocytoid cells and fibroblast like cells including giant cells.

Adrenocortical Adenoma: A report of 7 Cases

Primary tumors of the adrenal cortex are comparatively rare. In the medical literature they are most frequently reported as single case. Because of their infrequent occurence some features of their clinical behavior and pathologic anatomy are not widely known. For this reason the recording of the 7 cases from the Department of Pathology, School of Medicine, Chungnam National University is thought to be worth while. Of the seven tumors, five were associated with primary aldosteronism, one Cushing's syndrome, and the remaing one virilizing syndrome. All were benign. Females were affected more frequently than males. Adrenocortical adenomas tend to be small, weighing less than 42 gm. The tumors associated with primary aldosteronism were composed of zona fasciculata-like cells and "hybrid" cells. The tumor with Cushing's syndrome consisted of zona reticularis-like cells. The tumor with virilizing syndrome consisted of zone reticularis-like cells.

The Clinical Study on 100 Cases of Congenital Syphillis

No abstract available.