Many of early findings regarding intestinal stem cells (ISCs) and their niche in the human intestine have relied on colorectal cancer cell lines and labor-intensive and time-consuming mouse models. However, these models cannot accurately recapitulate the physiologically relevant aspects of human ISCs. In this study, we demonstrate a reliable and robust culture method for 3D expanding intestinal spheroids (InSexp ) mainly comprising ISCs and progenitors, which can be derived from 3D human intestinal organoids (HIOs). We did functional chararcterization of InSexp derived from 3D HIOs, differentiated from human pluripotent stem cells, and optimization culture methods. Our results indicate that InSexp can be rapidly expanded and easily passaged, and show enhanced growth rates via WNT pathway activation. InSexp are capable of exponential cell expansion and cryopreservation. Furthermore, in vitro-matured HIO-derived InSexp proliferate faster than immature HIO-derived InSexp with preservation of the parental HIO characteristics. These findings may facilitate the development of scalable culture systems for the long-term maintenance of human ISCs and provide an alternative platform for studying ISC biology.

Lupus vulgaris is most prevalent on exposed parts, especially the face but can also develop on exetremities. Lupus vulgaris originates from tuberculosis elsewhere in the body by hematogenous, lymphatic, or contiguous spread. A 19-year-old male patient came to our department. The patient had had many recurrent oozing and verrucous plaques and crusts on the left foot for one year. A skin biopsy from the lesion on the left dorsum of the foot showed scattered well defined granulomas consisting of the epithelioid cell clusters with Langerhans and foreign body type giant cells in the mid dermis. Caseation necrosis was slight. There were no bacilli on AFB staining. The multi test CMI for tuberculin was highly positive. A chest X-ray did not show any abnormal findings. The presence of Mycobacterium tuberculosis DNA was demonstrated by polymerase chain reactions (PCR) for detection of mycobacterial DNA from a routinely prepared paraffin-embedded skin specimen. Herein we report a very atypical case of lupus vulgaris confirmed by PCR.
Biopsy ; Dermis ; DNA ; Epithelioid Cells ; Foot ; Giant Cells, Foreign-Body ; Granuloma ; Humans ; Lupus Vulgaris* ; Male ; Mycobacterium tuberculosis ; Necrosis ; Polymerase Chain Reaction ; Skin* ; Thorax ; Transplants* ; Tuberculin ; Tuberculosis ; Young Adult

The prevalence of Heart failure (HF) is expected to increase worldwide with the aging population trend. The numerous symptoms of and repeated hospitalizations for HF negatively affect the patient's quality of life and increase the patient's economic burden. Up to 50% of patients with HF suffer from urinary incontinence (UI) and an overactive bladder (OAB). However, there are limited data about the relationship between UI, OAB, and HF. The association between HF and urinary symptoms may be directly attributable to worsening HF pathophysiology. A comprehensive literature review was conducted for all publications between January 2000 and November 2017 using the PubMed, Embase, and Cochrane databases. HF represents a major and growing public health problem, with an increased risk of UI and an OAB as comorbidities. Possible effects of HF on urinary problems may be mediated by the prescription of medications for symptomatic relief. Although diuretics are typically used to relieve congestion, and angiotensin-converting enzyme inhibitors and angiotensin receptor blockers improve survival, these classes of drugs have been suggested to worsen urinary symptoms in the presence of HF. Further research is required to understand the impact of UI and an OAB on the HF illness trajectory.
Aging ; Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Comorbidity ; Diuretics ; Estrogens, Conjugated (USP) ; Heart Failure* ; Heart* ; Hospitalization ; Humans ; Prescriptions ; Prevalence ; Public Health ; Quality of Life ; Urinary Bladder, Overactive* ; Urinary Incontinence

BACKGROUND: Dermatologic emergency patients who visit the emergency room increase in number every year. But there is no report about the statistical analysis of such visits. OBJECTIVES & METHODS: We reviewed 326 new dermatologic emergency patients who uisited the emergency room of Dongsan Medical Center in Taegu from 1986 to 1995 to study the age, sex, monthly and yearly distributior, arrival time, length of visit, prevalence of common dermatoses, admission rate and death rate. RESULTS: The results are summarized as follows: 1. Of 326 patients, there were 151 males and 175 females. The sex ratio of male to female was 1: 1.15. The number of patients increased with each year. 2. In age distribution, there were 23(7%) under 10;46(14%) between 11-20,55(17%) between 21-30;49(15% ) between 31-40;33(10%) between 41 50; 62(19% ) between 51-60 years,39(12% ) between 61-70 and 19(6%) between 71-80 years. 3. In monthly and arrival time distribution, the peak month incidence occurred in August(24 %), and the lowest incidence in December(1%). The peak incidence of arrival time occurred PM 6-12 hours and the lowest incidence AM 0-6 hour. 4. In the distribution about length nf visit, 73% of patients stayed more than 10 hours, 23% 5-10 hours and 4% less than 5 hours. 5. Of the most common derrnatoses, acute urticaria was seen in 124 cases(38%), and herpes zoster. in 94 cases (29%). In age distribution, acute urticaria was most preualent between the age of 0-30 and herpes zoster between 50-70. 6. The admission rate was 43%(140 cases). The death rate was 1.2%(3 cases). CONCLUSION: Our study of e nergency patients revealed that dermatologic emergency patients who visited the emergency room had increased in number every year and the distribution of patients is quite different from that of outpatients.
Age Distribution ; Daegu ; Emergencies* ; Emergency Service, Hospital* ; Female ; Herpes Zoster ; Humans ; Incidence ; Male ; Mortality ; Outpatients ; Prevalence ; Sex Ratio ; Skin Diseases ; Urticaria

PURPOSE: To report a case of conjunctival lithiasis with clinical manifestations of superior limbic keratoconjunctivitis. CASE SUMMARY: A 40-year-old male complained of pain, foreign body sensation and injection in the left eye lasting 1 month. The slit-lamp examination revealed injection of the superior bulbar conjunctiva, linear corneal band opacity, fine punctate staining and epithelial defect in the superior cornea area. After eversion of the left upper eyelid, there were many various-sized conjunctional concretions and inflammation in the superior tarsal conjunctiva. Therefore, we considered conjunctival lithiasis-induced clinical manifestations of superior limbic keratoconjunctivitis and then removed the conjunctival concretions using a 30-gauge needle. After the procedures, artificial tears, antibiotic eye drops, steroid eye drops and a therapeutic contact lens were applied. After 1 week, all symptoms and signs improved and there was no recurrence for 4 months. CONCLUSIONS: Mechanical stimulation by severe conjunctival lithiasis can induce clinical manifestations of superior limbic keratoconjunctivitis. Therefore, in patients with clinical manifestations of superior limbic keratoconjunctivitis, conjunctival lithiasis should be considered by observing the superior tarsal conjunctiva more closely.
Adult ; Conjunctiva ; Cornea ; Eyelids ; Foreign Bodies ; Humans ; Inflammation ; Keratoconjunctivitis* ; Lithiasis* ; Lubricant Eye Drops ; Male ; Needles ; Ophthalmic Solutions ; Recurrence ; Sensation

PURPOSE: The purpose of this study was to review studies that have examined the quality of life of women with urinary incontinence. MATERIALS AND METHODS: A review was conducted that used the databases PubMED, Proquest, CINAHL, and Sciencedirect. Articles were included that were published in English between 2005 and 2010 the key words use were urinary incontinence, women, and quality of life. RESULTS: A total of 18 studies were identified, and the prevalence of urinary incontinence varied depending on the definition of incontinence used and the age of the population studied. The Incontinence Quality of Life (I-QoL), Incontinence Impact Questionnaire-short form (IIQ-7), and King's Health Questionnaire (KHQ) were the most commonly used instruments. Demographic, medical, physical, psychological, health, and intervention factors were reported as influencing factors on the quality of life of women with incontinence. Age, severity of urinary incontinence, type of urinary incontinence, number of urinary incontinence episodes, body weight, stress, and help-seeking behavior were statistically significant variables influencing quality of life. CONCLUSION: Future studies are needed to identify factors related to quality of life among women with incontinence and to use validated instruments according to specific subjects.
Body Weight ; Female ; Humans ; Prevalence ; Quality of Life ; Urinary Incontinence

OBJECTIVE: to determine the frequency of the multiple consecutive rib fracture after blunt chest trauma. DESIGN, MATERIALS, AND METHODS: We retrospectively reviewed all the radiographs and medical charts of 87 patients with rib fractures after blunt chest trauma. Rib fractures were divided into single aud multiple. The multiple rib fractures were subclassified as consecutive, interrupted continuous, or random. RESULTS: Thirteen cases of single and 83 cases of multiple rib fractures were present. Among the 83 cases of multiple fractures, there were 73 cases (88%) of consecutive fractures, 5 cases (6%) of interrupted continuous fractures and 5 cases (6%) of random fractures. CONCLUSION: Among the multiple rib fractures consecutive rib fractrues are much more common than noncontiguous rib fractures. We recommend that if one find an apparently nonfractured rib between contiguously fractured upper and lower ribs, one should meticulously search for possible fracture of an apparently normal rib with high-index of suspicion.
Humans ; Retrospective Studies ; Rib Fractures* ; Ribs* ; Thorax*

PURPOSE: To assess the effectiveness and safety of intravitreal ranibizumab compared with bevacizumab for the treatment of macular edema associated with branch retinal vein occlusion (BRVO). METHODS: This was a retrospective study of 80 eyes with macular edema associated with BRVO. Patients received either 0.5 mg of ranibizumab (n = 24) or 1.25 mg of bevacizumab (n = 56) intravitreally. Both groups received three initial monthly injections followed by as-needed injections. The best-corrected visual acuity, central subfield thickness, mean number of injections, and retreatment rate were evaluated monthly for 6 months after the initial injection. RESULTS: The best-corrected visual acuity significantly improved from logarithm of the minimal angle of resolution (logMAR) 0.55 ± 0.26 at baseline to 0.24 ± 0.26 at 6 months in the ranibizumab group (p < 0.001) and from logMAR 0.58 ± 0.21 at baseline to 0.29 ± 0.25 at 6 months in the bevacizumab group (p < 0.001), which is not a statistically significant difference (p = 0.770). The mean reduction in central subfield thickness at 6 months was 236 ± 164 µm in the ranibizumab group (p < 0.001) and 219 ± 161 µm in the bevacizumab group (p < 0.001), which is not also a statistically significant difference (p = 0.698). The mean numbers of ranibizumab and bevacizumab injections were 3.25 ± 0.53 and 3.30 ± 0.53, respectively (p = 0.602). In addition, after the three initial monthly injections, the retreatment rates for ranibizumab and bevacizumab injections were 20.8% and 26.7%, respectively (p = 0.573). CONCLUSIONS: Both ranibizumab and bevacizumab were effective for the treatment of BRVO and produced similar visual and anatomic outcomes. In addition, the mean number of injections and the retreatment rates were not significantly different between the groups.
Bevacizumab* ; Humans ; Macular Edema* ; Ranibizumab* ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Retreatment ; Retrospective Studies ; Visual Acuity

PURPOSE: To evaluate the effect of periosteal fixation in patients with large-angle paralytic strabismus that was not corrected through conventional strabismus surgery. METHODS: Four eyes of three patients with large-angle paralytic strabismus who underwent periosteal fixation from June 2014 to August 2014 were examined. All patients presented with exotropia > 50 prism diopters (PD). Two of them showed exotropia caused by chronic complete oculomotor nerve palsy; the other two showed exotropia caused by medial rectus muscle injury during endoscopic sinus surgery. RESULTS: The mean preoperative exodeviation using the Krimsky test was 58 ± 29 PD. The postoperative values were 6.5 ± 9.4 PD at 1 week, and 11.25 ± 2.5 PD at 6 months. The mean surgical effect of exodeviation was 43.75 ± 21.36 PD. CONCLUSIONS: Periosteal fixation is an effective surgery for the management of paralytic strabismus that was not corrected through conventional strabismus surgery.
Exotropia ; Humans ; Oculomotor Nerve Diseases ; Strabismus