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Background: Although HLA-B*58:01 is a well-known risk factor for the development of allopurinol-induced severe cutaneous adverse reactions (SCARs), most of the HLA-B*58:01 carriers do not suffer from SCARs despite a long-term use of allopurinol. This suggests that there are other risk factors that determine the fate of HLA-B*58:01 carriers., Objective: The aim of this study was to investigate the additional genetic factors that increase the risk of allopurinol-induced SCARs in HLA-B*58:01 carriers., Methods: The incidence of allopurinol-induced SCARs was investigated according to coexisting HLA alleles in all subjects with HLA-B*58:01 who took allopurinol between 2003 and 2017. The allopurinol tolerant group was defined as a group who took allopurinol for more than 60 days without developing hypersensitivity and was compared with the allopurinol-induced SCAR group., Results: Among the retrospective cohort consisting of 367 HLA-B*58:01 carriers treated with allopurinol, 11 (3.0%) were diagnosed with allopurinol-induced SCARs. When HLA-B75, DR13 homozygosity, or DR14 was present, the incidence of SCARs increased up to 22.2% (odds ratio [OR], 19.568; P = .015), 20.0% (OR, 38.458; P = .001), and 10.7% (OR, 19.355; P = .004), respectively. Among the 153 HLA-B*58:01 carriers with chronic renal insufficiency (CRI), the incidence of SCARs doubled to 6.5% and further increased to 40%, 30%, and 37.5% in the presence of HLA-B75, DR13 homozygosity, or DR14, respectively., Conclusions: Secondary screening with HLA-B75, DR13 homozygosity, and DR14 in addition to primary screening with HLA-B*58:01 would enable a more accurate prediction of SCAR occurrence, especially in patients with CRI., (Copyright © 2018 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)

Background: Oxaliplatin-related hypersensitivity reactions (HSRs), which can be life threatening, have introduced a dilemma regarding the use of chemotherapeutic agents. Because repeated exposure to oxaliplatin may increase the risk of sensitization, patients with a history of prior asymptomatic exposure require risk-stratified care., Objective: This study aimed to elucidate the incidence and risk of oxaliplatin HSRs in patients with a history of asymptomatic prior exposure., Methods: We performed a prospective observational study of patients who completed oxaliplatin-based chemotherapy between March 2013 and January 2015. Prior exposure to oxaliplatin, the oxaliplatin-free interval, reaction severity, eosinophil counts, and premedication were reviewed to assess the risk factors., Results: A total of 793 patients were enrolled, among whom 148 (18.7%) experienced an HSR. The HSR incidence was 15.2% among oxaliplatin-naive patients but increased to 31.9% among those with a history of asymptomatic exposure and 75.0% among those with a history of oxaliplatin HSRs during the previous exposure, despite prophylaxis. The mean HSR onset cycle was earliest in the previous HSR group, followed by the previous asymptomatic exposure and nonexposure groups. The HSR severity also differed according to the previous exposure history and HSRs. In the multivariate analysis, prior exposure to oxaliplatin (odds ratio [OR], 3.78; 95% confidence interval [CI], 2.46-5.79) and a longer oxaliplatin-free interval (≥36 months; OR, 4.85; 95% CI, 1.60-14.37) were independent risk factors for HSRs., Conclusions: Previous exposure to oxaliplatin is a risk factor for earlier HSR onset and more severe and frequent HSR episodes, even if prior therapy was well tolerated., (Copyright © 2018 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)

An interhemispheric hydrologic seesaw--in which latitudinal migrations of the Intertropical Convergence Zone (ITCZ) produce simultaneous wetting (increased precipitation) in one hemisphere and drying in the other--has been discovered in some tropical and subtropical regions. For instance, Chinese and Brazilian subtropical speleothem (cave formations such as stalactites and stalagmites) records show opposite trends in time series of oxygen isotopes (a proxy for precipitation variability) at millennial to orbital timescales, suggesting that hydrologic cycles were antiphased in the northerly versus southerly subtropics. This tropical to subtropical hydrologic phenomenon is likely to be an initial and important climatic response to orbital forcing. The impacts of such an interhemispheric hydrologic seesaw on higher-latitude regions and the global climate system, however, are unknown. Here we show that the antiphasing seen in the tropical records is also present in both hemispheres of the mid-latitude western Pacific Ocean. Our results are based on a new 550,000-year record of the growth frequency of speleothems from the Korean peninsula, which we compare to Southern Hemisphere equivalents. The Korean data are discontinuous and derived from 24 separate speleothems, but still allow the identification of periods of peak speleothem growth and, thus, precipitation. The clear hemispheric antiphasing indicates that the sphere of influence of the interhemispheric hydrologic seesaw over the past 550,000 years extended at least to the mid-latitudes, such as northeast Asia, and that orbital-timescale ITCZ shifts can have serious effects on temperate climate systems. Furthermore, our result implies that insolation-driven ITCZ dynamics may provoke water vapour and vegetation feedbacks in northern mid-latitude regions and could have regulated global climate conditions throughout the late Quaternary ice age cycles.

Objectives: The aim of this study was to investigate whether a medium to high degree of total physical activity and indoor physical activity were associated with reduced all-cause and cardiovascular mortality among elderly Korean women., Methods: A prospective cohort study was done to evaluate the association between physical activity and mortality. The cohort was made up of elderly (≥ 65 years of age) subjects. Baseline information was collected with a self-administered questionnaire and linked to death certificates retrieved from a database. Cox proportional hazard models were used to estimate the hazard ratios (HRs) with 95% confidence interval (CI) levels., Results: Women who did not suffer from stroke, cancer, or ischemic heart disease were followed for a median of 8 years (n=5079). A total of 1798 all-cause deaths were recorded, of which 607 (33.8%) were due to cardiovascular disease. The group with the highest level of total physical activity and indoor physical activity was significantly associated to a reduced all-cause mortality (HR, 0.60; 95% CI, 0.51 to 0.71 and HR, 0.58; 95% CI, 0.50 to 0.67, respectively) compared to the group with the lowest level of total physical activity and indoor physical activity. Additionally, the group with the highest level of total physical activity and indoor physical activity was significantly associated to a lower cardiovascular disease mortality (HR, 0.53; 95% CI, 0.40 to 0.71 and HR, 0.51; 95% CI, 0.39 to 0.67, respectively) compared to the group with the lowest level of total physical activity and indoor physical activity., Conclusions: Our study showed that regular indoor physical activity among elderly Korean women has healthy benefits.

We experienced a case of primary pulmonary biphasic synovial sarcoma, which was confirmed by immunohistochemistry and molecular testing of SYT-SSX2 fusion transcripts. The patient was a 61-year-old man who presented with a well-defined mass in the left upper lung field on chest radiography. Left upper lobectomy with lymph node dissection was performed. Histological and immunophenotypic features were consistent with biphasic synovial sarcoma. Reverse transcriptase polymerase chain reaction, performed using RNA extracted from frozen tumor samples for the detection of SYT-SSX fusion gene, amplified a single 331-bp fragment that was characteristic of the SYT-SSX2 fusion transcripts. We report a case of primary pulmonary biphasic synovial sarcoma, which was confirmed by SYT-SSX2 fusion transcripts, and present a brief review of the literature on Korean cases.

The Toll-like receptor 4 (TLR4) has a wide spectrum of bacteria recognition receptors that may be involved in the signaling of the immune responses in the prostate. A few association studies have assessed the relationship between the risk of prostate cancer (PC) and the polymorphism in the TLR4 gene in European-ancestry populations. To evaluate the association of TLR4 polymorphisms and the risk for PC in Korean men, we genotyped five single-nucleotide polymorphisms (SNPs) of the TRL4 gene (rs11536858, rs1927914, 1927911, rs11536891, and rs11536897) by PCR-restriction fragment length polymorphism from unrelated 157 PC patients and 143 age-matched controls. The rs1927911 SNP increased the risk of PC (adjusted odds ratio ORadj=2.73, 95% CI=1.54-4.87 for the TC genotype; ORadj=6.68, 95% CI=3.27-13.66 for the CC genotype). The GG genotype of the rs11536858 SNP also carried increased risk (ORadj=2.296, 95% CI=1.07-4.93). There was no statistically significant correlation between any of the SNPs of TRL4 and such PC prognostic factors as Gleason grade, initial prostate-specific antigen level, or tumor stage. In conclusion, inherited differences in the TLR4 gene influence the risk of PC in Korean men.

Background: We evaluated the impact of stress urinary incontinence (SUI) and overactive bladder (OAB) on health-related quality of life (HRQOL) and sexual function., Methods: A total of 245 women (SUI; n = 123 and OAB; n = 122) from 21 to 79 years old (mean 50.4) were included in the primary analyses. To obtain HRQOL and sexual function assessments, patients were asked to fill in the 'Bristol Female Lower Urinary Tract Symptoms (BFLUTS)' and the 'Medical Outcomes Study Short Form (SF-36)' questionnaires., Results: Of the eight domains in the SF-36 questionnaire, only 'general health' was significantly different between the groups. Patients with SUI had a better general health than those with OAB (P = 0.016). When comparing the BFLUTS scores in the two groups, the score for 'BFLUTS-filling symptoms' was higher in the OAB group (P = 0.002) but that for 'BFLUTS-incontinence symptoms' was higher in the SUI group (P < 0.001). The score for 'BFLUTS-sex' was higher in the SUI group than in the OAB group but this was not statistically significant (P = 0.096). Of the 169 patients who had a sex life, the SUI group had experienced pain (P = 0.033) and leakage (P = 0.056) more frequently during intercourse than the OAB group., Conclusion: Both SUI and OAB have a detrimental impact on patient HRQOL in Korean women. In addition, our findings suggest that women with SUI had more frequently experienced pain during intercourse and coital incontinence than those with OAB.

Asian women are known to have a larger amount of abdominal fat (AF) for the same level of BMI compared with Caucasian and African-American women. This study was aimed to determine whether waist circumference (WC) could be useful as an index of AF compared with AF measured by dual energy x-ray absorptiometry (DXA) before and after a weight-loss program in Asian women. Thirty-eight healthy, pre-menopausal obese Korean women (body fat percent>30%) were enrolled and followed during a 6-week weight-loss program including herbal formula, calorie restriction, and exercise. Anthropometry and DXA measurements were performed before and after weight-loss. A specific region of interest (ROI, L2-iliac crest) by DXA was correlated with anthropometry at baseline: WC (gamma=0.91)>BMI (gamma=0.87)>Waist-Height ratio (WHtR, gamma=0.82)>WHR (gamma=0.46); and after weight loss: BMI (gamma=0.88)>WC (gamma=0.84)>WHtR (gamma=0.82), all p<0.01. The change in DXA ROI showed a reasonable correlation with change in anthropometry: BMI (gamma=0.63, p<0.01)>WC (gamma=0.39, p<0.05)>WHtR (gamma=0.37, p<0.05). A stepwise multiple regression analysis revealed that 83% of the variance in DXA derived AF was explained by WC at baseline, WC and BMI at follow-up, respectively. This study suggests that WC could be a good predictor of AF for Korean pre-menopausal women.

The purpose of this study was to evaluate the prevalence of urinary incontinence (UI) in a Korean national community sample of female adults aged 30-79 years. During April 2003, a national Korea telephone survey using quota sampling methods was conducted. The clinically validated computer-assisted telephone interview approach was used in the survey. Of the 1,500 subjects contacted, 1,303 were successfully interviewed (response rate 86.9%). Overall, UI was reported by 40.8%, and 22.9, 3.1, and 14.9% reported pure stress, urge, and mixed UI, respectively. The prevalence of stress, urge, and mixed UI generally did not increase with age. Urge and mixed UI had a greater impact than stress UI on daily tasks (P < 0.001), social life (P < 0.001), depression or anxiety due to UI (P < 0.001), worry about UI (P < 0.001), sex life (P < 0.001), wear protection due to UI (P = 0.011), and quality of life (P < 0.001). In subjects with pure stress UI, 28.3% reported impaired quality of life compared with 43.9% and 43.8% of subjects with urge and mixed UI. Of those individuals with stress, urge, and mixed UI, 19.1, 20.0, and 25.8% had the willingness to seek medical consultation. This study is the first to examine the prevalence of UI in Korean women. The present study revealed that there was a high prevalence of UI in this population. Our descriptive research provides a valuable insight into the need for tailored education to this population about UI.

The dopamine transporter gene (DAT1) is of particular interest in the genetic study of attention deficit hyperactivity disorder (ADHD), because psychostimulants interact directly with the dopamine transporter protein. Association between ADHD and the 10-repeat allele of a 40 base pair (bp) variable number of tandem repeats (VNTR) polymorphism of DAT1 was first reported in 1995 [Cook et al. (1995); Am J Hum Genet 56:993-998]. Subsequently, several investigators have also confirmed this association, although others reported conflicting results. We analyzed the DAT1 polymorphism in a sample of 33 Korean probands with a Diagnostic and Statistical Manual of Mental Disorders version IV (DSM-IV) diagnosis of ADHD and found evidence of increased transmission of the 10-repeat allele using transmission disequilibrium test (TDT) (P = 0.001; OR = 7.88, CI = 2.20-28.29). These data support the role of DAT1 in ADHD susceptibility among Asian populations., (Copyright 2006 Wiley-Liss, Inc.)

The aim of the study was to investigate in premenopausal women whether the relationship between percentage body fat (PBF) and body mass index (BMI; in kg/m2) differs between Korean Asians (Ko-As) living in Seoul, South Korea, and Caucasians (Ca) living in New York City. Healthy premenopausal women (50 Ko-As; 38 Ca), ages 22-50 yr, were studied. Weight, height, and PBF by dual-energy X-ray absorptiometry were measured. Total body dual-energy X-ray absorptiometry data were collected using GE-Lunar systems (Prodigy-Korea and DPXL-New York), and all scan analyses were performed by one technician in New York. Similar soft tissue phantoms were used for daily instrument calibrations at both sites. The relationship between PBF and BMI was assessed by multiple regression analysis with race, age, reciprocal of BMI (1/BMI), and a race-by-age interaction as the final independent variables. Race (P = 0.003) and 1/BMI (P < 0.001) were significantly related to PBF in this model. A significant race-by-age interaction (P = 0.039) indicated that the slope of the lines for PBF vs. age differed between Ko-As and Ca. This study demonstrates in a Ko-As sample that the BMI-fat relationship differs significantly from that in a comparable group of Caucasian women. Investigators who use BMI as an index of fatness should be aware of the well documented differences in the relationship of BMI and fatness across race/ethnic groups.

Escherichia coli O157:H7/NM (E. coli O157) is now recognized as an important cause of diarrhea, hemorrhagic colitis and hemolytic-uremic syndrome worldwide. There have been several cases of human E. coli O157 infection in Korea since it was first isolated from a patient with hemolytic-uremic syndrome in 1998. Meat, other foods, and recreational and drinking water contaminated with animal feces are probably the major sources of the E. coli O157 infection. In this study, we investigated the prevalence of E. coli O157 in fecal and meat samples of cattle, pigs and chicken in Korea from April 2000 to July 2002. Eighty-six (3.03%) of 2843 samples were positive for E. coli O157. Most of the E. coli O157 strains were isolated from fecal samples of beef and dairy cattle from May to October of each year. Of 86 E. coli O157 isolates, 73 were serotype O157:H7 and 13 were serotype O157:NM. Polymerase chain reaction (PCR) analysis of E. coli O157 virulence markers revealed that all O157:H7/NM isolates were positive for EhlyA, eaeA and rfb(O157), and 77 isolates were positive for stx1 and/or stx2. Cytotoxicity analysis revealed that many of the E. coli O157 isolates showed high cytotoxicity on Vero cells. Our data suggest that the majority of Korean E. coli O157 isolates from food animals can cause serious diseases in humans.