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1.
Article in English | WPRIM | ID: wpr-915542

ABSTRACT

Background@#Atopic dermatitis (AD) is a heterogeneous disease with different age of onset, disease course, clinical symptoms, severity, and risk of comorbidity. The characteristics of children with AD also vary by age or country. However, little is known about the clinical characteristics of AD in Korean school-aged children and adolescents. Furthermore, there are few studies on phenotypic differences according to onset age. This study aimed to explore the clinical characteristics and phenotypes according to onset age and severity of AD in children and adolescents in Korea. @*Methods@#AD patients aged 6–18 years who presented to 18 hospitals nationwide were surveyed.The patients were examined for disease severity by pediatric allergy specialists, and data on history of other allergic diseases, familial allergy history, onset age, trigger factors, lesion sites,treatment history and quality of life were collected. The results of the patient’s allergy test were also analyzed. The patients were classified into infancy-onset (< 2 years of age), preschoolonset (2–5 years of age), and childhood-onset (≥ 6 years of age) groups. Study population was analyzed for clinical features according to onset-age groups and severity groups. @*Results@#A total of 258 patients with a mean age of 10.62 ± 3.18 years were included in the study. Infancy-onset group accounted for about 60% of all patients and presented significantly more other allergic diseases, such as allergic rhinitis and asthma (P = 0.002 and P = 0.001, respectively). Food allergy symptoms and diagnoses were highly relevant to both earlier onset and more severe group. Inhalant allergen sensitization was significantly associated with both infancy-onset group and severe group (P = 0.012 and P = 0.024, respectively). A family history of food allergies was significantly associated with infancyonset group (P = 0.036). Severe group was significantly associated with a family history of AD, especially a paternal history of AD (P = 0.048 and P = 0.004, respectively). Facial (periorbital, ear, and cheek) lesions, periauricular fissures, hand/foot eczema, and xerosis were associated with infancy-onset group. The earlier the onset of AD, the poorer the quality of life (P = 0.038). Systemic immunosuppressants were used in only 9.6% of the patients in the severe group. @*Conclusion@#This study analyzed the clinical features of AD in Korean children and adolescents through a multicenter nationwide study and demonstrated the phenotypic differences according to onset age and severity. Considering the findings that the early-onset group is more severe and accompanied by more systemic allergic diseases, early management should be emphasized in young children and infants.

2.
Article in English | WPRIM | ID: wpr-926837

ABSTRACT

BACKGROUND/OBJECTIVES@#Hydrolyzed formula is often fed to infants with gastrointestinal or immune issues, such as malabsorption or cow's milk allergy, because enzymatic treatment has rendered it more digestible and less allergenic than standard cow's milk formula (SF). Partially hydrolyzed formula (PHF) should be considered for those infants who are intolerant to extensively hydrolyzed formula. However, there are concerns about the nutritional insufficiencies of PHF. We aimed to evaluate the effects of PHF on the growth and health indicators in infants who were at high-risk of allergic disease and potential candidates for consuming PHF. @*SUBJECTS/METHODS@#A total of 83 infants aged 0–2 mon with a family history of allergies were assigned to consume either PHF or SF until 24 weeks of age. Anthropometric measures were obtained at baseline, 12 weeks, and 24 weeks; blood samples were drawn and evaluated at the end of the study. @*RESULTS@#No significant differences were observed in weight, height, and weight-for-height at any time point in each sex between the PHF and SF groups. At 24 weeks of age, the weightfor-age and height-for-age z-scores of the SF group were higher than those of the PHF group, but there was no significant difference in the weight-for-height z-score. There were no significant differences in levels of white blood cells, hemoglobin, ferritin, protein, albumin, aspartate aminotransferase, alanine aminotransferase, eosinophil cationic protein, and immunoglobulin E. @*CONCLUSIONS@#In this study, there were no differences in growth and blood panels between the infants consuming PHF or SF. Therefore, infants who are unable to tolerate SF can be fed PHF without nutritional concerns about growth.

3.
Article in English | WPRIM | ID: wpr-925381

ABSTRACT

Purpose@#In food allergy, significant component antigens can be assessed by using the microarray. The purpose of this study was to evaluate the diagnostic value of component resolved diagnosis (CRD) in young children with kiwifruit allergy. @*Methods@#Through a retrospective review of medical records, we evaluated the clinical characteristics of 12 children who underwent measurement of serum immunoglobulin E concentrations to kiwifruit (kiwi-sigE) and were diagnosed as kiwifruit allergy. We applied ImmunoCAP ISAC-CRD 112 using the residual sera of patients at the initial visit. @*Results@#The median age of kiwifruit allergic children was 33.5 months (range, 13 to 84 months), and the proportion of systemic reactions, including 2 anaphylaxis cases, was 66.7%. Four had localized reactions on the lips. A total of 11 (91.7%) were sensitized to Act d 1; among them, 8 were mono-sensitized to Act d 1 and 3 were sensitized to ≥ 2 kiwifruit components. There was no significant difference in CRD results between those with systemic reactions and those with local reactions. @*Conclusion@#Act d 1 is the major allergenic component in Korean young children with clinical kiwifruit allergy. The additional diagnostic value of the CRD in diagnosing and predicting the severity of kiwifruit allergy is expected to be low in young children.

4.
Article in English | WPRIM | ID: wpr-925380

ABSTRACT

Purpose@#Perilla seed (PS) is the most common cause of seed-induced anaphylaxis in Korean children, but the reports on PS allergy, including phenotype and cross-reactivity, are rare. The aim of this study is to assess the clinical characteristics of PS allergy and investigate cross-reactivity with sesame seed (SS). @*Methods@#Through a retrospective medical record review, patients with clinical PS allergy were identified in a single tertiary hospital. Clinical characteristics of allergic reaction upon exposure to PS and SS, results of skin prick test (SPT) to PS and SS, and the levels of serum SS-specific immunoglobulin E (SS-sIgE) were investigated. Cross-reactivity between PS and SS was studied using IgE enzymelinked immunosorbent assay (ELISA) inhibition. @*Results@#The median age of 34 PS-allergic children was 41.5 months (range, 10 months to 12 years), and the proportion of anaphylaxis upon exposure to PS was 29.4% (n = 10). The PS SPT was positive in 94.1% (n = 32) with the median wheal size of 6.25 mm. Among PS-allergic children, the percentages of patients with positive symptoms, negative symptoms, and indeterminate symptoms upon exposure to SS were 8.8%, 41.2%, and 50%, respectively. Out of 14 PS-allergic children who were tolerant to SS, positive sensitization to SS was noticed in 78.6% by serum SS-sIgE, and 57.1% by SS SPT. Partial cross-reactivity between PS and SS was identified in IgE ELISA inhibition. @*Conclusion@#This study reported the clinical profiles and SPT results in a relatively large number of PS-allergic children and identified the partial cross-reactivity between PS and SS for the first time.

5.
Article in English | WPRIM | ID: wpr-925098

ABSTRACT

Thyroid hormones have an important physiological role in maintaining adult bone structure and strength. Therefore, thyroid dysfunction is inevitably associated with various degrees of skeletal consequences. Endogenous overt hyperthyroidism is an established cause of high bone turnover with accelerated bone loss, resulting in osteoporosis and an increased risk of fractures. Hyperthyroidism induced by thyroid stimulating hormone suppression therapy in patients with differentiated thyroid cancer also has emerged as a contributing factor to osteoporosis and fragility fractures. While, there is lack of evidence that hypothyroidism negatively affects bone health. Although there is growing clinical evidence of the importance of bone health in hyperthyroidism, clinical guidelines on how to evaluate and manage bone health in these diseases have not yet been published worldwide. The Task Force from the Korean Thyroid Association Committee of Clinical Practice Guideline has developed this position statement for the evaluation and management of bone health in patients with thyroid diseases, particularly focused on endogenous hyperthyroidism and thyroid stimulating hormone suppression therapyassociated hyperthyroidism in patients with differentiated thyroid cancer.

6.
Article in English | WPRIM | ID: wpr-875137

ABSTRACT

With the increase in the number of cases of silicone implant insertion either for cosmetic surgery or breast reconstruction after mastectomy, it is not unusual to encounter patients with silicone implants in clinical settings. Recently, the first case of breast implant-associated anaplastic large cell lymphoma was reported in Korea. In addition to previously known complications, such as implant rupture or contracture, the number of implant-associated imaging examinations has also increased. Considering this background, radiologists should have sufficient knowledge about the type of examination required in patients who have undergone implant insertion and imaging findings to correctly identify implant-associated complications. In this article, various complications of silicone implants are discussed, including various imaging findings, which radiologists should know.

7.
Article in English | WPRIM | ID: wpr-902085

ABSTRACT

Background@#The diagnosis of food allergies needs to be confirmed through an oral food challenge (OFC). However, specific immunoglobulin E (sIgE) concentrations analyzed by serological tests are also helpful in determining OFC items and predicting the presence of allergic reactions. Unfortunately, there is a limit to the number of antigens that can be simultaneously evaluated at one time. The purpose of this study was to analyze the possibility of detecting sIgE antibodies against food using clues in self-reported food allergy symptoms. @*Methods@#Medical records of 377 patients aged 3 years or younger were collected for egg white-, cow’s milk-, walnut- and soybean-sIgE sensitization, and related clinical history. Each clinical history was classified into class 1: direct- isolated intake resulting in anaphylaxis or hives with consistent clincical history; class 2a: class 1 with inconsistency; class 2b: indirect-mixed intake resulting in anaphylaxis or hives regardless of consistency; class 2c: direct/indirect- isolated/mixed intake resulting in itching without hives, vomiting, or diarrhea with consistent clincical history; or class 3: class 2c with inconsistency or asymptomatic to direct, isolated exposure. @*Results@#The area under the curve (AUC) of class 1 for cow’s milk was 0.790, and the accuracy was 78.0%. The AUC of class 1 and 2 for egg white was better than that of class 1 (0.750), and the accuracy rate was 77.6%. The AUCs of class 1 for walnut and soybean were 0.775 and 0.662, respectively. @*Conclusion@#In conclusion, sIgE sensitization to foods could be predicted by the combination of exposure and selfreported symptoms in children under 3 years of age.

8.
Article in English | WPRIM | ID: wpr-898749

ABSTRACT

Background and Objectives@#Fine needle aspiration cytology (FNAC) combined with washout thyroglobulin (Tg) measurement is the gold standard for the evaluation of metastatic lymph nodes (LNs) in thyroid cancer. However, few studies have assessed the clinical outcomes of discordant results between FNAC and washout Tg based on surgery status and follow-up imaging in real-world practice. @*Materials and Methods@#A total of 707 LNs in 512 patients who underwent FNAC and washout Tg measurements from 2015 to 2017 were analyzed. The final LN outcomes were confirmed through postoperative histology, or through metastatic FNAC findings combined with high washout Tg level, follow-up imaging studies, or repeat FNA, if LNs were not dissected. @*Results@#The cut-off values of washout Tg for indicating LN metastasis in preoperative and postoperative LNs were 9.6 ng/mL and 2.1 ng/mL. The diagnostic accuracy was improved by applying washout Tg according to surgery status and the results of discordant rate was reduced, Discordant between results of FNAC with washout Tg and final outcome were 9.2% (27/295) of preoperative LNs and 8.7% (36/412) of postoperative LNs. Due to inconclusive results, unnecessary neck dissection can occur in 13.9% (36/259 dissected cases). @*Conclusion@#To improve diagnostic accuracy, cut-off values of washout Tg should be applied depending on surgery status. New biomarkers in washout fluid is necessary to resolve discordant findings.

9.
Article in English | WPRIM | ID: wpr-894381

ABSTRACT

Background@#The diagnosis of food allergies needs to be confirmed through an oral food challenge (OFC). However, specific immunoglobulin E (sIgE) concentrations analyzed by serological tests are also helpful in determining OFC items and predicting the presence of allergic reactions. Unfortunately, there is a limit to the number of antigens that can be simultaneously evaluated at one time. The purpose of this study was to analyze the possibility of detecting sIgE antibodies against food using clues in self-reported food allergy symptoms. @*Methods@#Medical records of 377 patients aged 3 years or younger were collected for egg white-, cow’s milk-, walnut- and soybean-sIgE sensitization, and related clinical history. Each clinical history was classified into class 1: direct- isolated intake resulting in anaphylaxis or hives with consistent clincical history; class 2a: class 1 with inconsistency; class 2b: indirect-mixed intake resulting in anaphylaxis or hives regardless of consistency; class 2c: direct/indirect- isolated/mixed intake resulting in itching without hives, vomiting, or diarrhea with consistent clincical history; or class 3: class 2c with inconsistency or asymptomatic to direct, isolated exposure. @*Results@#The area under the curve (AUC) of class 1 for cow’s milk was 0.790, and the accuracy was 78.0%. The AUC of class 1 and 2 for egg white was better than that of class 1 (0.750), and the accuracy rate was 77.6%. The AUCs of class 1 for walnut and soybean were 0.775 and 0.662, respectively. @*Conclusion@#In conclusion, sIgE sensitization to foods could be predicted by the combination of exposure and selfreported symptoms in children under 3 years of age.

10.
Article in English | WPRIM | ID: wpr-891045

ABSTRACT

Background and Objectives@#Fine needle aspiration cytology (FNAC) combined with washout thyroglobulin (Tg) measurement is the gold standard for the evaluation of metastatic lymph nodes (LNs) in thyroid cancer. However, few studies have assessed the clinical outcomes of discordant results between FNAC and washout Tg based on surgery status and follow-up imaging in real-world practice. @*Materials and Methods@#A total of 707 LNs in 512 patients who underwent FNAC and washout Tg measurements from 2015 to 2017 were analyzed. The final LN outcomes were confirmed through postoperative histology, or through metastatic FNAC findings combined with high washout Tg level, follow-up imaging studies, or repeat FNA, if LNs were not dissected. @*Results@#The cut-off values of washout Tg for indicating LN metastasis in preoperative and postoperative LNs were 9.6 ng/mL and 2.1 ng/mL. The diagnostic accuracy was improved by applying washout Tg according to surgery status and the results of discordant rate was reduced, Discordant between results of FNAC with washout Tg and final outcome were 9.2% (27/295) of preoperative LNs and 8.7% (36/412) of postoperative LNs. Due to inconclusive results, unnecessary neck dissection can occur in 13.9% (36/259 dissected cases). @*Conclusion@#To improve diagnostic accuracy, cut-off values of washout Tg should be applied depending on surgery status. New biomarkers in washout fluid is necessary to resolve discordant findings.

11.
Ultrasonography ; : 265-273, 2021.
Article in English | WPRIM | ID: wpr-919492

ABSTRACT

Purpose@#This study aimed to identify useful shear wave elastography (SWE) parameters for differentiating breast cancer and predicting associated immunohistochemical factors and subtypes. @*Methods@#From November 2018 to February 2019, a total of 211 breast lesions from 190 patients who underwent conventional breast ultrasonography and SWE were included. The Breast Imaging Reporting and Data System categories and qualitative and quantitative SWE parameters for each lesion were obtained. Pathologic results including immunohistochemical factors were evaluated. The diagnostic performance of each parameter and its correlation with histological characteristics, immunohistochemical factors, and subtypes of breast cancer were analyzed using analysis of variance, the independent t test, the Fisher exact test, logistic regression analysis, and the DeLong method. @*Results@#Among 211 breast lesions, 82 were malignant, and 129 were benign. Of the SWE parameters, Emax showed the highest area under the curve (AUC) for differentiating malignant from benign lesions (AUC, 0.891; cut-off>50.85). Poor tumor differentiation and progesterone receptor-negativity were correlated with higher SDmean and Emax (P<0.05). Ki-67-positive breast cancer showed higher SDmean and a heterogeneous color distribution (P<0.05). Ki-67 and cytokeratin 5/6-positive breast cancers showed higher Emax/Efat ratios (P<0.05). Luminal B, human epidermal growth factor receptor 2-enriched, and triple-negative (non-basal) subtypes showed somewhat higher SDmean values than the luminal A and triple-negative (basal) subtypes (P=0.028). @*Conclusion@#Emax is a reliable parameter for differentiating malignancies from benign breast lesions. In addition, high stiffness and SDmean values in tumors measured on SWE could be used to predict poorly differentiated, progesterone receptor-negative, or Ki-67-positive breast cancer.

12.
Article in English | WPRIM | ID: wpr-915454

ABSTRACT

Background@#Early recognition and prompt intramuscular epinephrine administration are critical for the treatment of anaphylaxis. The special emergency medical service team (SEMST) is a reorganization plan that incorporates first-level emergency medical technicians (EMTs) and nurses from Korea to give the authority to administer epinephrine. This study evaluates the experience of SEMST and aims to investigate further needs in the pre-hospital management of anaphylaxis. @*Methods@#An online survey of 29 questions on the Gangwon-do 119 EMST was conducted.IBM SPSS Statistics ver. 20.0 (IBM Co., Armonk, NY, USA) and R ver.4.0.3. were used for statistical analysis. @*Results@#A total of 428 (44.6%) participants responded to the questionnaire, and 55.6% (238/428) experienced anaphylaxis. The common presumed cause was insect sting/animal bites at 84.5% (201/238), followed by food (7.6%, 18/238), and drugs (6.3%, 15/238). The frequency of occurrence was highest for tourist attractions (58.6%, 167/285), followed by homes (31.9%, 91/285) and workplace (3.5%, 10/285). Among 136 medical personnel (31.8%) who were currently active or had been active as the SEMST, 95 (70.0%) experienced anaphylaxis, and 58 (61.1%) used epinephrine, which was significantly lower in the nonSEMST group (n = 36, 25.2%). The biggest difficulty in pre-hospital treatment was the limitation of drug administration authority (23.4%, 22/95). The lack of experience and tricky treatment are the chief difficulties in pediatric anaphylaxis. The percentage of correct answers regarding anaphylaxis awareness was significantly higher in the educated (n = 374) than in the non-educated group (n = 54), both for diagnosis (24.9% vs. 11.1%) and treatment (73.5% vs. 37.0%). @*Conclusion@#Proper administration of epinephrine is particularly important for pre-hospital anaphylaxis management in rural areas. Expanding SEMST and conducting periodic education using virtual experiences is necessary.

13.
Article in English | WPRIM | ID: wpr-875509

ABSTRACT

Background/Aims@#Thyroid hormones are involved in wide range of glucose metabolism functions. Overt thyroid dysfunctions are related to altered glucose homeostasis. However, it is not conclusive as to whether subtle changes in thyroid hormones within normal ranges can induce alterations in glucose homeostasis. The aim of this study was to evaluate the association between thyroid hormone and glucose homeostasis parameters in subjects without overt thyroid dysfunction based on nationwide population data. @*Methods@#In the Sixth Korea National Health and Nutrition Examination Survey 2015 (n = 7,380), data were collected from subjects with insulin and thyroid function measurements who were older than 19-years-old. After the exclusion of 5,837 subjects, a total of 1,543 patients were included in the analysis. Subjects were categorized into the quartiles of the free thyroxine (FT4). Fasting glucose, insulin, homeostatic model assessment of insulin resistance and hemoglobin A1c (HbA1c) levels were considered to be glucose homeostasis parameters. @*Results@#Subjects with the highest FT4 quartile showed significantly lower fasting insulin and HbA1c levels. A significant inverse correlation FT4 and HbA1c levels was observed (β = –0.261, p = 0.025). In the logistic regression analysis, the highest quartile of FT4 was demonstrated to lower the risk of HbA1c to a greater degree than the median by approximately 40%, after adjusting for confounders, compared to the lowest quartile (p = 0.028). @*Conclusions@#We demonstrated subjects with a lower FT4 quartile exhibited high risk of HbA1c levels above the median value in a representative Korean population. Subjects with the lowest FT4 quartile should be cautiously managed in terms of altered glucose homeostasis.

15.
Article in English | WPRIM | ID: wpr-899796

ABSTRACT

BACKGROUND@#Barley is a grain that is consumed in various forms in Asia. Studies on barley allergy are limited to a few case reports about hypersensitivity reactions to beer, but there is no barley allergy study in children. This study aimed to identify the phenotype and immunologic findings in Korean children with barley allergy.@*METHODS@#Forty-two participants with a history of ingesting barley who underwent serum specific immunoglobulin E to barley (barley-sIgE) assay at the Department of Pediatrics in Ajou Medical Center were enrolled through a retrospective analysis of medical records from March 2008 to February 2018. The demographic characteristics, symptoms, and immunologic parameters of the patients were assessed.@*RESULTS@#Twenty subjects presented with clinical barley allergy (B-allergic group), and 22 were atopic controls without allergic reactions after the ingestion of barley (B-tolerant group). The median ages of the B-allergic and B-tolerant groups were 1 and 3 years, respectively. In the B-allergic group, the cutaneous system (90.0%) was most frequently affected, followed by the respiratory system (40.0%). Anaphylaxis was observed in 35.0% of the B-allergic group. The median level of barley-sIgE was 13.90 kU(A)/L (range, 0.14–101.00 kU(A)/L) in the B-allergic group, and this value was significantly higher (P < 0.001) than that of the B-tolerant group (0.30 kU(A)/L; range, 0.01–24.40 kU(A)/L), with an optimal cutoff level of 1.24 kU(A)/L (sensitivity, 85.0%; specificity, 86.4%). A positive correlation was found between the serum levels of barley-sIgE and wheat-sIgE in the B-allergic group with clinical wheat allergy.@*CONCLUSION@#Barley is an important allergen for children in Korea. This study showed the clinical characteristics of barley allergy and suggested optimal cut-off levels of barley-sIgE for clinical barley allergy. Clinically, cross-reactivity or co-sensitization is often observed between barley and wheat.

16.
Article in English | WPRIM | ID: wpr-892092

ABSTRACT

BACKGROUND@#Barley is a grain that is consumed in various forms in Asia. Studies on barley allergy are limited to a few case reports about hypersensitivity reactions to beer, but there is no barley allergy study in children. This study aimed to identify the phenotype and immunologic findings in Korean children with barley allergy.@*METHODS@#Forty-two participants with a history of ingesting barley who underwent serum specific immunoglobulin E to barley (barley-sIgE) assay at the Department of Pediatrics in Ajou Medical Center were enrolled through a retrospective analysis of medical records from March 2008 to February 2018. The demographic characteristics, symptoms, and immunologic parameters of the patients were assessed.@*RESULTS@#Twenty subjects presented with clinical barley allergy (B-allergic group), and 22 were atopic controls without allergic reactions after the ingestion of barley (B-tolerant group). The median ages of the B-allergic and B-tolerant groups were 1 and 3 years, respectively. In the B-allergic group, the cutaneous system (90.0%) was most frequently affected, followed by the respiratory system (40.0%). Anaphylaxis was observed in 35.0% of the B-allergic group. The median level of barley-sIgE was 13.90 kU(A)/L (range, 0.14–101.00 kU(A)/L) in the B-allergic group, and this value was significantly higher (P < 0.001) than that of the B-tolerant group (0.30 kU(A)/L; range, 0.01–24.40 kU(A)/L), with an optimal cutoff level of 1.24 kU(A)/L (sensitivity, 85.0%; specificity, 86.4%). A positive correlation was found between the serum levels of barley-sIgE and wheat-sIgE in the B-allergic group with clinical wheat allergy.@*CONCLUSION@#Barley is an important allergen for children in Korea. This study showed the clinical characteristics of barley allergy and suggested optimal cut-off levels of barley-sIgE for clinical barley allergy. Clinically, cross-reactivity or co-sensitization is often observed between barley and wheat.

17.
Article in Korean | WPRIM | ID: wpr-913280

ABSTRACT

Purpose@#Anaphylaxis is life-threatening, so early recognition and proper response are critical. This study evaluated the awareness of anaphylaxis in Korean community including teachers, 119 rescue team, and doctors in public service. @*Methods@#A questionnaire of anonymously structured 9 items about anaphylaxis was administered to the teachers working in kindergartens or elementary schools, 119 rescue team, and public health physicians in Gangwon province in 2017. Additional questionnaire about knowledge on anaphylaxis management was administered to the physicians. @*Results@#A total of 415 people participated in the survey. About 4% of child care and health teachers experienced anaphylaxis within 1 year, but the overall awareness of anaphylaxis was very low, regardless of the educational level of anaphylaxis. 119 rescue teams experienced more anaphylactic patients, but they lacked knowledge of epinephrine administration and epinephrine autoinjector (EAI), independent of the educational level of anaphylaxis. Public health physicians had good knowledge of early treatment for anaphylaxis, but there was a lack of knowledge for epinephrine injection sites, observation plan, and EAI. @*Conclusion@#The awareness of anaphylaxis among community and emergency responders seems likely to be inadequate. Systematic and continuous education by anaphylaxis specialists is necessary for community health care providers.

18.
Experimental Neurobiology ; : 93-105, 2020.
Article | WPRIM | ID: wpr-832449

ABSTRACT

Prion diseases are a group of neurodegenerative and fatal central nervous system disorders. The pathogenic mechanism involves the conversion of cellular prion protein (PrPC) to an altered scrapie isoform (PrPSc), which accumulates in amyloid deposits in the brain. However, no therapeutic drugs have demonstrated efficacy in clinical trials. We previously reported that BMD42-29, a synthetic compound discovered in silico , is a novel anti-prion compound that inhibits the conversion of PrPC to protease K (PK)-resistant PrPSc fragments (PrPres). In the present study, 14 derivatives of BMD42-29 were obtained from BMD42-29 by modifying in the side chain by in silico feedback, with the aim to determine whether they improve anti-prion activity. These derivatives were assessed in a PrPSc-infected cell model and some derivatives were further tested using real timequaking induced conversion (RT-QuIC). Among them, BMD42-2910 showed high anti-prion activity at low concentrations in vitro and also no toxic effects in a mouse model. Interestingly, abundant PrPres was reduced in brains of mice infected with prion strain when treated with BMD42- 2910, and the mice survived longer than control mice and even that treated with BMD42-29. Finally, high binding affinity was predicted in the virtual binding sites (Asn159, Gln 160, Lys194, and Glu196) when PrPC was combined with BMD-42-2910. Our findings showed that BMD42-2910 sufficiently reduces PrPres generation in vitro and in vivo and may be a promising novel anti-prion compound.

19.
Article | WPRIM | ID: wpr-832333

ABSTRACT

Background@#Some patients admitted to hospitals for glycemic control experience hypoglycemia despite regular meals and despite adhering to standard blood glucose control protocols. Different factors can have a negative impact on blood glucose control and prognosis after discharge. This study investigated risk factors for hypoglycemia and its effects on glycemic control during the hospitalization of patients in the general ward. @*Methods@#This retrospective study included patients who were admitted between 2009 and 2018. Patients were provided regular meals at fixed times according to ideal body weights during hospitalization. We categorized the patients into two groups: those with and those without hypoglycemia during hospitalization. @*Results@#Of the 3,031 patients, 379 experienced at least one episode of hypoglycemia during hospitalization (HYPO group). Hypoglycemia occurred more frequently particularly in cases of premixed insulin therapy. Compared with the control group, the HYPO group was older (61.0±16.8 years vs. 59.1±16.5 years, p=0.035), with more females (60.4% vs. 49.6%, p<0.001), lower body mass index (BMI) (23.5±4.2 kg/m 2 vs. 25.1±4.4 kg/m 2 , p<0.001), and higher prevalence of type 1 diabetes mellitus (6.1% vs. 2.6%, P< 0.001), They had longer hospital stay (11.1±13.5 days vs. 7.6±4.6 days, p<0.001). After discharge the HYPO group had lower glycosylated hemoglobin reduction rate (−2.0%±0.2% vs. −2.5%±0.1%, p=0.003) and tended to have more frequent cases of cardiovascular disease. @*Conclusion@#Hypoglycemia occurred more frequently in older female patients with lower BMI and was associated with longer hospital stay and poorer glycemic control after discharge. Therefore, clinicians must carefully ensure that patients do not experience hypoglycemia during hospitalization.

20.
Article in English | WPRIM | ID: wpr-740161

ABSTRACT

PURPOSE: The aim of this study was to evaluate the diagnostic performance of a computer-aided detection (CAD) system used with automated breast ultrasonography (ABUS) for suspicious lesions detected on breast MRI, and CAD-false lesions. MATERIALS AND METHODS: We included a total of 40 patients diagnosed with breast cancer who underwent ABUS (ACUSON S2000) to evaluate multiple suspicious lesions found on MRI. We used CAD (QVCAD™) in all the ABUS examinations. We evaluated the diagnostic accuracy of CAD and analyzed the characteristics of CAD-detected lesions and the factors underlying false-positive and false-negative cases. We also analyzed false-positive lesions with CAD on ABUS. RESULTS: Of a total of 122 suspicious lesions detected on MRI in 40 patients, we excluded 51 daughter nodules near the main breast cancer within the same quadrant and included 71 lesions. We also analyzed 23 false-positive lesions using CAD with ABUS. The sensitivity, specificity, positive predictive value, and negative predictive value of CAD (for 94 lesions) with ABUS were 75.5%, 44.4%, 59.7%, and 62.5%, respectively. CAD facilitated the detection of 81.4% (35/43) of the invasive ductal cancer and 84.9% (28/33) of the invasive ductal cancer that showed a mass (excluding non-mass). CAD also revealed 90.3% (28/31) of the invasive ductal cancers measuring larger than 1 cm (excluding non-mass and those less than 1 cm). The mean sizes of the true-positive versus false-negative mass lesions were 2.08 ± 0.85 cm versus 1.6 ± 1.28 cm (P < 0.05). False-positive lesions included sclerosing adenosis and usual ductal hyperplasia. In a total of 23 false cases of CAD, the most common (18/23) cause was marginal or subareolar shadowing, followed by three simple cysts, a hematoma, and a skin wart. CONCLUSION: CAD with ABUS showed promising sensitivity for the detection of invasive ductal cancer showing masses larger than 1 cm on MRI.


Subject(s)
Breast Neoplasms , Breast , Hematoma , Humans , Hyperplasia , Magnetic Resonance Imaging , Nuclear Family , Sensitivity and Specificity , Shadowing Technique, Histology , Skin , Ultrasonography, Mammary , Warts
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