No abstract available.
Humans ; Infant, Newborn* ; Streptococcus pneumoniae* ; Streptococcus*

BACKGROUND/AIMS: Although the mechanism of hepatocellular carcinogenesis still remains to be clarified, it has been suggested that persistent hepatic necrosis and resultant irregular regeneration might cause genetic mutations, such as activation of protooncogenes, inactivation of tumor suppressor genes and modulation of apoptosis-related genes, finally leading to hepatocellular carcinoma (HCC). To elucidate the role of cell proliferative activity and apoptosis, a major mechanism of cell death, in hepatocellular carcinogenesis, we analyzed expression of proliferation cell nuclear antigen (PCNA), p53 protein and apoptotic cells in HCC and surrounding nonneoplastic hepatic parenchyma. METHODS: We performed immunohistochemical staining to detect P CAN, p53 protein, and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labelling (TUNEL) method for the detection of apoptosis in 52 hepatocellular carcinomas and their adjacent nonneoplastic liver. We scored the expression of PCNA and p53, and apoptotic index by a 5 point scale' 0, 0%,1, 1-25%', 2, 25-50%, 3, 50-75%', 4, >76%, and analyzed the results with other clinicopathologic characteristics. RESULTS: p53 protein was expressed in 42.3% of the HCC, but was not evident in nonneoplstic liver. P53 overexpression was correlated with the histologic grade of HCC (p<0.05). PCNA labelling indices (LI) of HCC were correlated with those of liver cell dysplasia and normal liver (p<0.05). Leading edges of HCCs showed higher proliferative activity than the central part of HCC. Four cases of HCCs with high TUNEL also showed high proliferative activity. There was no difference of the TUNEL between HCC and surrounding nonneoplastic liver. Expression of p53, PCNA LI and TUNEL had no relationship with clinicopathologic parameters including viral markers, aFP elevation, tumor size and underlying cirrhosis. CONCLUSION: p53 overexpression in HCC and absence of p53 mutation in nonneoplastic liver indicates the active participation of p53 in hepatocellular carcinogenesis. Invasiveness and metastatic potential appear to be related with the strong expression of PCNA, but apoptosis in HCC has no direct implication in hepatocellular carinogensis.
Apoptosis* ; Biomarkers ; Carcinogenesis ; Carcinoma, Hepatocellular* ; Cell Death ; Fibrosis ; Genes, Tumor Suppressor ; In Situ Nick-End Labeling ; Liver* ; Necrosis ; Proliferating Cell Nuclear Antigen ; Regeneration

Hesitation wounds are tentative, superficial incised wounds around the fatal wound(s). This study aimed to investigate the frequency and characteristic features of hesitation wounds including ordinary incised wounds and knife tip injuries as hesitation marks from the autopsy cases of suicides using sharp force instruments. The subjects were 478 cases out of 3,131 suicide cases autopsied at the Department of Forensic Medicine, School of Medicine, Kyungpook National University in Daegu, from August, 2001 to 2013. 48 cases (approximately 10%) were suicides using sharp force instruments. In 27 cases (56.3%), the sharp force was successfully applied causing suicide; 17 cases (35.4%) were so called complex suicide cases, in which two or more different methods including sharp force injury were used; and the 4 remaining cases were suicides caused by other reasons. Overall hesitation wounds had a high frequency of 33/48 cases (68.8%). The frequency of cases in which knife tip injuries were found was lower, appearing in 13/33 cases (39.3%). The most preferred sites of knife tip injuries were the abdomen (9 cases), neck (4 cases), chest (3 cases), and face (1 case) in these 13 cases, including several overlapped cases. The average number of knife tip injuries was 14.6. A total of 88.2% of knife tip injuries was found near the incised hesitation wounds or fatal wounds. In conclusion, knife tip injuries may be a significant factor in identifying hesitation wounds, and they should be precisely examined and evaluated during autopsies to determine the manner of death.

Hesitation wounds are tentative, superficial incised wounds around the fatal wound(s). This study aimed to investigate the frequency and characteristic features of hesitation wounds including ordinary incised wounds and knife tip injuries as hesitation marks from the autopsy cases of suicides using sharp force instruments. The subjects were 478 cases out of 3,131 suicide cases autopsied at the Department of Forensic Medicine, School of Medicine, Kyungpook National University in Daegu, from August, 2001 to 2013. 48 cases (approximately 10%) were suicides using sharp force instruments. In 27 cases (56.3%), the sharp force was successfully applied causing suicide; 17 cases (35.4%) were so called complex suicide cases, in which two or more different methods including sharp force injury were used; and the 4 remaining cases were suicides caused by other reasons. Overall hesitation wounds had a high frequency of 33/48 cases (68.8%). The frequency of cases in which knife tip injuries were found was lower, appearing in 13/33 cases (39.3%). The most preferred sites of knife tip injuries were the abdomen (9 cases), neck (4 cases), chest (3 cases), and face (1 case) in these 13 cases, including several overlapped cases. The average number of knife tip injuries was 14.6. A total of 88.2% of knife tip injuries was found near the incised hesitation wounds or fatal wounds. In conclusion, knife tip injuries may be a significant factor in identifying hesitation wounds, and they should be precisely examined and evaluated during autopsies to determine the manner of death.
Abdomen ; Autopsy ; Daegu ; Forensic Medicine ; Gyeongsangbuk-do ; Humans ; Neck ; Suicide ; Thorax ; Wounds and Injuries

No abstract available.
Down Syndrome* ; Leukemia*

Recently xenotransplantation has been thought as a final solution for the controi of donor organ shortage in allograft. In order to be a ciinicai entity, xenotransplantation has many obstacles such as hyperacute rejection and delayed xenogratt rejection as a potent immunologic reaction, zoonosis and ethical problems. We already reported the eariy immunoiogic events occuring soon after xenograft in animal model, in which natural antibody and complement have a crucial roie in rejection response. As a further step for the prolongation of graft survival, we used anticomplement agent (cobra venom factor, CVF) in the same model. Graft survival in discordant (guinea pig-to-rat) xenogratt was extended from 30.6 minutes to 2 days following singie injection of CVF, which showed similar pattern of rejection with the concordant xenogratt in terms of time of rejection response after grafting. In this setting antibody response in the blood did not show any difference between that of pre CVF and post CVF, even though IgM response was more pronounced than IgG. The complement activity in the blood showed marked suppression following CVF injection. Intragraft complement gene (C3 mRNA) expression in CVF injected discordant showed delayed response in a similar pattern like that of concordant xenograft. Interestingly enough intragraft anticomplement gene expression showed the simiiar pattern of response with the complement. From these results we can conclude that anticomplement agent (CVF) extended the graft survival in discordant xenograft upto the level of concordant xenograft by shifting the complement activation response from that of discordant to concordant xenograft.
Rats ; Animals

PURPOSE: Speech and language development is an useful indicator of the overall development of children. Since speech and language delay can lead to emotional, social, and learning problems, the early intervention is very important. We examined 137 children with speech or language problems including 22 children of functional articulation disorders of their clinical features. METHODS: 137 children with speech or language problems in the Department of Pediatrics, Uijeongbu St. Mary's Hospital from January 2004 to December 2007 were reviewed for sex, age, developmental and language test findings retrospectively. Especially, in 22 children diagnosed with functional articulation disorders, articulation test findings were analyzed. RESULTS: 1) The mean age of 137 children was 46.8 months, the ratio of male to female was 2.5:1, and the most frequent age group was 24-35 months. The chief complaints included language delay(67.2%), mispronouncing speech sound(27%), stuttering(3.6%), learning disability(2.2%). The diagnoses of them were developmental language disorder(70.8%), functional articulation disorders(16.1%), mental retardation(5.8%), stuttering(2.9%), tongue tie(0.7%), normal language pattern(3.6%). 2) The mean age of 22 patients with functional articulation disorders was 63 months, the ratio of male to female was 1.4:1, and the most frequent age group was 60-71 months. The mean percentage of consonant correct of Picture Consonant Articulation Test was higher in older age group. In the types of phonetic errors substitutions were most common. Distortions, omissions, and additions were followed in the order of frequency. Substitutions and distortions were common in word initial and medial but omissions in word final. It is appeared that the patients had the difficulties in pronouncing alveolar fricative, palatal affricate, liquid, and velar plosive which mature lately in older children. Mainly palatal affricate, alveolar fricative, and velar plosive were substituted for alveolar plosive and the liquid and alveolar fricative were distorted as gliding. CONCLUSION: Categorizing the cause of language and speech delay is essential to make an adequate treatment plans and decrease the late complications. The future studies for the early screening, more suitable tests in Korean, treatment guidelines or prognosis are needed.
Articulation Disorders ; Child ; Early Intervention (Education) ; Female ; Humans ; Language Development ; Language Development Disorders ; Language Tests ; Learning ; Male ; Mass Screening ; Pediatrics ; Prognosis ; Retrospective Studies ; Tongue

PURPOSE: Adenoid hypertrophy is a physical alteration that may affect speech, and a speech disorder can have other negative effects on a child's life. Airway obstruction leads to constricted oral breathing and causes postural alterations of several oro-facial structures, including the mouth, tongue, and hyoid bone. The postural modifications may affect several aspects of speech production. METHODS: In this study, we compared articulation errors in 19 children with adenoid hypertrophy (subject group) to those of 33 children with functional articulation disorders independent of anatomical problems (control group). RESULTS: The mean age of the subject group was significantly higher (P=0.016). Substitution was more frequent in the subject group (P=0.003; odds ratio [OR], 1.80; 95% confidence interval [CI], 1.23-2.62), while omission was less frequent (P<0.001; OR, 0.43; 95% CI, 0.27-0.67). Articulation errors were significantly less frequent in the palatal affricative in the subject group (P=0.047; OR, 0.25; 95% CI, 0.07-0.92). The number of articulation errors in other consonants was not different between the two groups. Nasalization and aspiration were significantly more frequent in the subject group (P=0.007 and 0.014; OR, 14.77 and 0.014; 95% CI, [1.62-135.04] and NA, respectively). Otherwise, there were no differences between the two groups. CONCLUSION: We identified the characteristics of articulation errors in children with adenoid hypertrophy, but our data did not show the relationship between adenoid hypertrophy and oral motor function that has been observed in previous studies. The association between adenoid hypertrophy and oral motor function remains doubtful.
Adenoids* ; Airway Obstruction ; Articulation Disorders ; Child* ; Humans ; Hyoid Bone ; Hypertrophy* ; Mouth ; Mouth Breathing ; Odds Ratio ; Respiration ; Tongue

Although autoimmune liver diseases are common in Western countries, only sporadic cases have been reported in Korean children. Autoimmune hepatitis, primary biliary cirrhosis, autoimmune cholangiopathy and primary sclerosing cholangitis are major classes of liver diseases currently considered autoimmune. The overlap syndrome has features associated with both autoimmune hepatitis and other liver diseases. We treated a case of the overlap syndrome that included auoimmune hepatitis and cholangiopathy in a 12 year-old boy. Considering that these entities, autoimmune liver diseases or overlap syndromes, are potentially treatable diseases in children, a high index of suspicion is needed for the appropriate diagnosis.
Child* ; Cholangitis, Sclerosing ; Diagnosis ; Hepatitis* ; Hepatitis, Autoimmune ; Humans ; Liver Cirrhosis, Biliary ; Liver Diseases ; Male

Posttransplant lymphoproliferative disease(PTLD) represents a diverse lymphoproliferative disorder ranging from non-specific reactive hyperplasia to malignant immunoblastic sarcoma developed in a setting of immunosuppression following organ or cellular transplantation. It is often associated with Epstein-Barr virus infection and high dose immunosuppression. EBV detection and immunotyping including immunoglobulin clonality is crucial for prediction of prognosis and treatment modality. We report one case of PTLD developed 5 months after renal transplantation in 33 year-old man. Clinical manifestion was submandibular mass, and EBV was detected by in situ hybridization. Histology and immunotyping revealed immunoblastic lymphoma andl lambda chain monoclonality. He has been treated with reduction of immunosuppression, acyclovir and radiotherapy, and is in stable condition with normal renal function at postoperative 11months without evidence of disease reccurrence.
Acyclovir ; Adult ; Herpesvirus 4, Human ; Humans ; Hyperplasia ; Immunoglobulins ; Immunosuppression ; In Situ Hybridization ; Kidney Transplantation* ; Lymphoma ; Lymphoma, Large-Cell, Immunoblastic ; Lymphoproliferative Disorders ; Prognosis ; Radiotherapy