We describe S100 protein positive dendritic cells (S100+DCs) in various liver diseases including chronic viral hepatitis B and C (20 cases), liver cirrhosis (3 cases), hepatocellular carcinoma (2 cases), hepatolithiasis (6 cases), primary biliary cirrhosis (PBC) (2 cases), liver allograft rejection (9 cases), bile duct paucity (1 case), and Wilson's disease (1 case). By immunohistochemical analysis, S100+DCs were absent in fetal and normal livers, while they were variably present in inflammatory liver diseases. In chronic hepatitis and active cirrhosis, S100+DCs were most frequently located in periportal area, at lymphoid follicles within the portal tract, and at foci of spotty necrosis within the lobule. Frequency and intensity of S100+DCs were not related to etiologies of liver diseases, but they were correlated with the activity of hepatitis. In PBC, S100+DCs were found between biliary epithelial cells of the septal bile ducts, as well as, the periductal area of the portal tracts. A posttransplantation liver with features of moderate acute rejection revealed many S100+DCs in polymorphous portal infiltrates. In hepatocellular carcinomas, many S100+DCs were scattered between tumor cells. In the case of the Wilson's disease, S100+DCs were not noted. Presence of S100+DCs in various inflammatory liver diseases indicates that they play a central role as antigen presenting cells in immune responses of inflammatory liver diseases.
Allografts ; Antigen-Presenting Cells ; Bile Ducts ; Carcinoma, Hepatocellular ; Dendritic Cells* ; Epithelial Cells ; Fibrosis ; Hepatitis ; Hepatitis B ; Hepatitis, Chronic ; Hepatolenticular Degeneration ; Liver Cirrhosis ; Liver Cirrhosis, Biliary ; Liver Diseases* ; Liver* ; Necrosis

The incidence of severe hepatitis A virus (HAV) infection has been increasing. However, clinicopathologic features of severe HAV infection that lead to liver transplantation (LT) have not been reported in Korea. We retrieved 16 LT cases with HAV infection during the last 3 years at Asan Medical Center, Seoul, Korea. Fifteen cases progressed to hepatic encephalopathy. Thirteen cases survived with or without complications, and three patients died of sepsis. The explanted liver showed massive or zonal necrosis with moderate to severe cholestasis. The zonal distribution of necrosis was frequently associated with endothelialitis of portal and/or central veins. Degenerative changes of hepatocytes were various in degree and distribution. Viral inclusions were suspected in two cases. Although HAV infection is usually confirmed by serological tests, significant venulitis of central and/or portal veins and viral inclusions, which are rarely observed, can suggest an HAV infection as a cause of massive hepatic necrosis of unknown mechanism.
Cholestasis ; Fluconazole ; Hepatic Encephalopathy ; Hepatitis ; Hepatitis A ; Hepatitis A virus ; Hepatocytes ; Humans ; Incidence ; Korea ; Liver ; Liver Transplantation ; Massive Hepatic Necrosis ; Necrosis ; Portal Vein ; Sepsis ; Serologic Tests ; Veins

OBJECTIVES: The purpose of the study was to compare intake of energy nutrients, physical characteristics, and the prevalence of metabolic syndrome according to protein intake group. METHODS: Subjects were 827 men aged 40-65 years. The results presented were based on data from the 2012-2013 National Health and Nutrition Examination Survey and analyzed using SPSS. The odds ratio (OR) of metabolic syndrome was assessed according to the protein intake group and intake pattern of protein-rich foods. RESULTS: The mean of protein intake was 73.96 ± 0.71 g. According to level of protein intake, four groups (deficient, normal, excess 1, excess 2) were created and their percentages were 8.3%, 39.6%, 37.1%, and 15.0% respectively. The mean of daily energy intake was 2,312.33 ± 24.08 kcal. It was higher in excess group 2 than in the deficiency group (p < 0.001). Moreover, the intake of all energy nutrients increased significantly with protein intake group (p < 0.001). The main contribution to daily protein included mixed grains (10.96 ± 0.32 g), milled rice (7.14 ± 0.30 g), chicken (3.50 ± 0.21 g), and grilled pork belly (3.04 ± 0.16 g). With regard to physical characteristics, and blood pressure and blood test results, only body mass index increased significantly according to protein intake groups (p < 0.05). The prevalence of metabolic syndrome in subjects was 38.5%, and there was no significant correlation with protein intake group. The OR of metabolic syndrome increased with protein intake, and was higher 4.452 times in excess group 2 than in the normal group (p < 0.05). Conversely, the OR of metabolic syndrome according to the frequency of protein-rich food intake did not show a significant correlation. CONCLUSIONS: The results of this study can be used as significant supporting data to establish guidelines for protein intake in middle-aged men.
Blood Pressure ; Body Mass Index ; Chickens ; Eating ; Energy Intake ; Hematologic Tests ; Humans ; Male ; Nutrition Surveys* ; Odds Ratio ; Prevalence ; Red Meat

To investigate the development of the reticular network of the thymus with aging and under pathologic conditions, we performed reticulin stains on the following samples; 5 fetal thymi (22 to 33 weeks of gestational age) and 35 postnatal thymi (less than 1 month to 33 years of age). The latter included 1 hyperplastic thymus, 4 pathologically involuted thymi and 1 physiologically involuted thymus as well as 29 normal thymi. Reticulin fibers were invariably seen along the capsule and interlobular septae of all the thymi. In fetal thymi, reticulin fibers circumscribed only cortical blood vessels and Hassall's corpuscles. Postnatal thymi from the children aged less than 1 month showed discontinuous reticulin fibers along the blood vessels of the corticomedullary junction. With aging, the amount of reticulin fibers increased and formed a "fibroreticular network(FRN)" from the branching point of the interlobular septae along the corticomedullary junction. It completely circumscribed the outer medulla in fully developed thymi. In the hyperplastic thymus, the reticular network retained its original structure. Both pathologically and physiologically involuted thymi revealed irregularly collapsed reticulin fibers. These findings suggest that the reticular network of the thymus consists of FRNs as well as capsule and interlobular septae and matures with aging before involution.
Adult ; Aging/*pathology ; Child ; Child, Preschool ; Female ; Humans ; Hyperplasia ; Infant ; Infant, Newborn ; Pregnancy ; Thymus Gland/cytology/*pathology

OBJECTIVES: This study was conducted to investigate the effects of the sources of vitamin D (duration of exposure to sunlight, intake of major food sources for vitamin D or vitamin D supplements) on the serum 25-(OH) D3 levels, and the physical growth of a child. METHODS: Subjects were 296 children aged 1 to 5 years who visited S hospital located in Changwon City. Survey data collection was carried out by direct interview method, and the biochemical data were collected using hospital records. RESULTS: The study subjects were divided into three groups according to their levels of serum 25-(OH) D3 (deficient, relatively insufficient, sufficient) and their percentage were 48.3%, 44.3% and 7.4% respectively. The average concentration of serum 25-(OH) D3 was 20.41 +/- 6.55 ng/mL, which was relatively insufficient. The average duration of exposure to sunlight was 58.86 +/- 49.18 minutes/day. A total score of vitamin D major food sources was 46.71 points (full marks 153), and the most frequently consumed food items were milk, eggs, and cheese. Thirty-four percent of the subjects took vitamin D supplements and their dose were 11.96 microg/day. Three vitamin D sources in sufficient group were higher than deficient or relatively insufficient group significantly. Intake of vitamin D supplements showed positive relation (+) and high explanation power (R2= 0.288) on serum 25-(OH) D3 concentration, but intake of vitamin D major food sources (+) and the duration of exposure to sunlight (+) had a low explanation power (R2= 0.068). The relations between serum 25-(OH) D3 concentration and physical growth (height and weight) were shown as negative (??, and their explanation powers were low as 7.3% and 5.9% respectively. CONCLUSIONS: This study results can be useful when discussing the intake standard of vitamin D and the effective intake method for children. In addition, it will be helpful to build the children's nutrition policy and to plan the nutrition education program to improve the vitamin D status in children.
Cheese ; Child ; Child, Hospitalized* ; Surveys and Questionnaires ; Education ; Eggs ; Gyeongsangnam-do ; Hospital Records ; Humans ; Milk ; Nutrition Policy ; Ovum ; Sunlight ; Vitamin D*

To characterize thymic epithelial cells of SCID (severe combined immunodeficiency) mice in comparison with those of Balb C mice, we did an immunohistochemical study using cortical and medullary epithelial cell specific monoclonal antibodies (MoAbs), Th-3 and Th-4, as well as gel electrophoresis and immunoblotting. The thymi of SCID mice were composed of epithelial cells and a few lymphocytes. Most epithelial cells were immunostained diffusely with Th-3, which indicated that they might be "cortical-type" epithelial cells. There were a few clusters of stellate cells with dendritic processes which were negative with Th-3 but stained strongly with Th-4. Cortical type epithelial cells and most of the Th-4 reacting cells were strongly immunostained with cytokeratin antibody MNF116. By immunoblotting, cytokeratin polypeptides No. 10 and 18 were detected in both SCID and Balb C mice; however, the relative amounts of each cytokeratin polypeptides were different. With immunohistochemical and immunoblotting results, we conclude; 1) Th-3 and Th-4 are reliable markers for cortical and medullary thymic epithelial cells in SCID mice; 2) disorganization of cells thymic structure is mostly due to maldevelopment of medullary epithelial and T lymphocytes; and 3) the composition of cytokeratin subfamilies of SCID mice thymi may represent a phenotypic marker of the maldevelopment of medullary epithelial cells.
Animals ; Antibodies, Monoclonal ; Electrophoresis, Polyacrylamide Gel ; Epithelium/pathology ; Immunoblotting ; Keratins/analysis ; Mice ; Mice, Inbred BALB C ; Mice, SCID ; Severe Combined Immunodeficiency/*pathology ; Thymus Gland/*pathology

Heart transplantation was first performed in 1967. It is now regarded as a well-established treatment modality for end-stage cardiac diseases. Once the transplantation is performed, endomyocardial biopsy(EMB) is the examination of choice in monitoring the transplanted heart. We analyzed the pathological findings of follow-up EMB of 6 heart transplant patients. All patients have been suffered from severe heart failure. Four patients were adult male and two were adult females. All the hearts, except for one, displayed characteristic features of dilated cardiomyopathy. The remaining heart was diagnosed as having giant cell myocarditis. Post-transplantion EMBs were performed according to the protocol and standard cardiac biopsy grading of ISHT (1990). The standards were applied for grading of cellular rejection. In five patients, there were one or two episodes of biopsy proven acute rejection, grade II or IIIA without any clinical symptoms of rejection. Immediate "pulse therapy" was performed and follow-up biopsies were done. All episodes of rejection were cleared in subsequent biopsies. All patients are doing well without evidence of cardiac problem. The postoperative monitoring of acute rejection is critical since clinical signs of rejection are usually absent. At present, EMB is regarded as the most reliable method for diagnosis and grading of acute rejection and is an efficient guide to the monitoring of the cardiac recipients. Our experience of post-transplantation EMB corresponds with previously published reports.
Adult ; Male ; Female ; Humans ; Biopsy

The recurrence of viral hepatitis B or C after liver transplantation is almost universal but their clinical courses and outcomes are vary widely. We investigated four cases of rapidly progressive and fatal recurrent viral hepatitis following liver transplantation, which were rapidly progressive and fatal. Case 1 was a 58-year-old male, who developed recurrent viral hepatitisC. Case 2, 3, and 4 were a 59-year-old female, a 42-year-old male, and a 50-year-old male, respectively, who developed recurrent viral hepatitis B. In cases 1 and 2, the histopathological features of the first liver biopsies were prominent ballooning degeneration of the hepatocytes but later biopsies revealed significant lobular activity. Case 3 began with a marked fatty change and mild lobular and porto-periportal activity and progressed to severe lobular activity and septal fibrosis. In case 4, the first liver biopsy revealed minimal lobular activity but the second biopsy revealed severe lobular activity.
Adult ; Biopsy ; Female ; Fibrosis ; Hepatitis B ; Hepatitis* ; Hepatocytes ; Humans ; Liver Transplantation* ; Liver* ; Male ; Middle Aged ; Recurrence

Autoimmune sera have been used in the diagnosis of autoimmune diseases as well as the analysis of nuclear substructures. In an attempt to study the biological characteristics of the nuclear matrix, we screened human sera using immunofluorescent staining and immunoblot. We detected antibodies against nuclear matrix (NM), a remnant nonchromatin protein compartment after the treatment of detergent, salt and nuclease, in 212 out of 284 tested sera (74.6%) by immunoblot. Peptides with molecular weights of 70 kDa, 50 kDa and 25 kDa were detected in the order of frequency. Clinical informations of 198 out of 212 cases were available and went as follows: 38 cases were autoimmune diseases, such as systemic lupus erythematosus and rheumatoid arthritis; 132 non-autoimmune and non-neoplastic diseases; 16 neoplastic diseases and 12 cases unclassified. The immunofluorescent staining intensity by anti-nuclear matrix protein (NMP) antibodies decreased variably, but fibrillogranular, speckled and nucleolar immunolocalization patterns were retained after in situ fractionation. Ku70 and La protein were detected by anti-NMP antibodies. Immunolocalization by anti-NMP antibodies indicates that the NMPs constitute a variety of characteristic nuclear substructures and may serve as autoantigens in diverse human diseases. In addition, the presence of Ku70 and La protein as NMPs suggests that the NM can be functionally active in association with DNA or RNA.
Autoantigens/analysis* ; Autoimmune Diseases/immunology ; Autoimmune Diseases/blood ; Base Sequence ; DNA, Complementary ; DNA-Binding Proteins/analysis* ; Fluorescent Antibody Technique, Indirect ; Hela Cells ; Human ; Immunoblotting ; Molecular Sequence Data ; Nuclear Matrix/immunology ; Nuclear Proteins/analysis* ; Ribonucleoproteins/analysis* ; Tumor Cells, Cultured

In February 2018, the Withdrawal of the Life-sustaining Treatment (WLST) Decision Act was legalized in Korea. Donation after circulatory death (DCD) after WLST was classified as DCD category III. We report the first case of successful organ donation after WLST in Korea. A 52-year-old male who experienced cerebral hemorrhage was a potential brain-dead donor with donation consent. During the first brain death examination, Babinski reflex was present, which disappeared two days later. Then, electroencephalography was performed five times at intervals of 2 to 3 days, according to the recommendation of a neurologist.The patient was transferred to the OR at 19:30 July 3, 2020. At 20:00, an intensive care unit specialist performed extubation and discontinued vasopressors. Oxygen saturation fell to < 70% in 1 minute, which signaled the beginning of functional warm ischemia. At 20:15, asystole was confirmed; after 5 minutes of “no-touch time,” circulatory death was declared.Organ procurement surgery was initiated, with surgeons performing the recipient surgery ready in the adjacent OR. Through the first successful DCD case, we expected that DCD will be actively implemented in Korea, saving the lives of patient waiting for transplantation and resolving the imbalance between organ receipt and donation.