PURPOSE: The purpose of this study was to explore the utility of autism spectrum disorder (ASD) screening tools using community network of home childcare center visiting nurses. METHODS: The design of this study is multilevel survey to find the ASD using modified checklist for autism in toddlers (M-CHAT) for first screening by childcare teachers, checklist for autism in toddlers (CHAT) for secondary screening by nurses, Autism diagnostic observation schedule (ADOS) and Autism diagnostic interview revised (ADI-R) for final diagnosis by pediatric psychiatrists. RESULTS: In first screening by using M-CHAT, 61 subjects(0.56%) were detected among 8,926 subjects. Among the first screened 61 subjects, 13 subjects were exempted for normal finding in CHAT. 24 subjects consented participation for final diagnosis and 23 of them were diagnosed ASD. CONCLUSION: In conclusion, M-CHAT and CHAT were verified their utility as screening tools for ASD in the community and the community health networks as a childcare visiting nurses can be useful network in early detection and referral of ASD.
Appointments and Schedules ; Autistic Disorder* ; Checklist ; Child ; Autism Spectrum Disorder* ; Community Networks ; Diagnosis ; Mass Screening* ; Nurses, Community Health* ; Psychiatry ; Referral and Consultation

No abstract available.
Hypertension, Pulmonary*

BACKGROUND: Cell cycle deregulation plays a major role in chemical multistage carcinogenesis.Therefore, the evaluation of cell cycle proteins is important. METHODS: In order to induce carcinogenesis in the rat urinary bladder, 0.05% N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN)was administered to male Sprague-Dawley rats for 30 weeks. Expressions of cyclin D1, A, E, and B1 were examined by immunohistochemical stainings. RESULTS: Urothelial cell hyperplasia appeared at 5 weeks, followed by papilloma at 10 weeks. Superficial carcinoma was observed at 20 weeks, and invasive carcinoma developed in 40% (4/10) of the rats at 30 weeks. Expressions of cyclin D1 and A increased sequentially from normal mucosa throughhyperplasia, papilloma, and carcinoma (p<0.01). Expressions of cyclin D1, B1 and cyclin Ewere higher in invasive carcinomas than in superficial carcinomas (p<0.01). In contrast, therewas no significant difference in the expression of cyclin B1 between hyperplasia, papillomaand superficial carcinoma. CONCLUSIONS: The present results indicate the important roles of cyclin D1 and A in the development of BBN-induced urothelial carcinoma of rats. Aberrantexpression of cyclin B1 and E may contribute to the progression from superficial to invasivebladder cancer rather than tumorigenesis.
Animals ; Carcinogenesis* ; Cell Cycle ; Cell Cycle Proteins ; Cyclin B1 ; Cyclin D1 ; Cyclins* ; Humans ; Hyperplasia ; Male ; Mucous Membrane ; Papilloma ; Rats* ; Rats, Sprague-Dawley ; Urinary Bladder*

OBJECTIVE: We studied to investigate whether nitric oxide (NO) and IL-1beta modulate MMP-2 and MMP-9 using TL cell line obtained from the normal term placenta. METHODS: After culturing TL cell line for 4 hours, we treated 0.1 mM of SNAP (NO donor) and 50 ng/ml of IL-1beta for 0, 1, 3, 6, and 12 hours, for investigating changes from time. We treated SNAP of 0, 0.01, 0.1, and 0.5 mM for 12 hours and IL-1beta of 0, 1, 10, and 50 ng/ml, for investigating changes from concentration. After extraction of total RNA, we performed reverse transcriptase-polymerase chain reaction (RT-PCR), gelatine zymography and Western blot analysis, for investigating expression of MMP-2 and MMP-9. RESULTS: MMP-9 was not observed in TL cell line. The expressions of MMP-2 mRNA and protein were gradually increased according to the culture time in SNAP treated group. The expressions of MMP-2 mRNA and protein were gradually increased according to the culture time in IL-1beta treated group. The expression of MMP-2 protein was not more increase in SNAP/IL-1beta-treated group than in IL-1beta treated group. The expression of MMP-2 protein was more reduced in SNAP/hemoglobin treated group than in SNAP treated group. MMP-2 protein activity was only increase in SNAP treated group. CONCLUSION: These results indicate that NO, rather than IL-1beta, upregulates the MMP-2 in TL cell line and furthermore may influence in the invasive process of trophoblasts.
Blotting, Western ; Cell Line* ; Gelatin ; Interleukin-1beta* ; Matrix Metalloproteinase 2* ; Nitric Oxide* ; Placenta ; RNA ; RNA, Messenger ; S-Nitroso-N-Acetylpenicillamine ; Trophoblasts

OBJECTIVE: To investigate whether the hypoxic condition influences on the expression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) mRNA in the cultured human trophoblast. METHODS: Trophoblasts were isolated from the normal placenta in early pregnancy (6-10 weeks in gestation). Isolated trophoblasts were cultured under normoxic (5% CO2, 95% humid air in incubator) and hypoxic (MERCK, 1% O2, 99% CO2) conditions for 24, 48 and 72 hours, respectively. Total RNA was extracted from the cultured trophoblasts in each culture condition. The expressions of VEGF and bFGF mRNA were determined by reverse transcription-polymerase chain reaction (RT-PCR) and Northern blot analysis. RESULTS: The expression of VEGF189 mRNA was significantly increased in the hypoxic condition compared to the normoxic condition and control after 24 hours (p<0.05, p<0.05, respectively). The expression of VEGF206 mRNA was also significantly increased in the hypoxic condition compared to the normoxic condition and control after 48 hours (p<0.05, p<0.05, respectively). However, there was no significant difference between the normoxic and hypoxic conditions in the expression of VEGF121 and VEGF165 mRNA. The expression of bFGF mRNA was significantly increased in the hypoxic condition compared to the normoxic condition and control at 24 hours and 48 hours (p<0.05, p<0.05, respectively). bFGF mRNA was more expressed than VEGF mRNA in the hypoxic condition. CONCLUSION: These findings suggest that the hypoxic condition may stimulates the expression of bFGF and VEGF mRNA, and besides bFGF may be a more potent inducer of angiogenesis rather than VEGF in early human gestation.
Anoxia* ; Blotting, Northern ; Fibroblast Growth Factor 2* ; Humans* ; Placenta ; Pregnancy ; RNA ; RNA, Messenger ; Trophoblasts* ; Vascular Endothelial Growth Factor A*

Renal agenesis is a disorder characterized by the congenital absence of one or both kidneys due to complete failure of the kidney to form. The syndrome of renal agenesis is severe oligohydramnios, amnion nodosum, flattened face, low-set and floppy ears, and bilateral pulmonary hypoplasia. Bilateral renal agenesis occurs in 0.1 to 0.3 per 1000 births and unilateral involvement occurs in 1 in 500 to 1 in 1300 live births.1,2 Bilateral renal agenesis is an invariably lethal condition, and is associated in more than half of the affected individuals with malformations of the genitourinary tract, cardiovascular system, vertebral bodies or imperforated anus.2 Accurate diagnosis in the mid-trimester permits the parents to allow elective termination. However, the nearly absent amniotic fluid makes an accurate assessment of fetal kidney difficult. We present a case of unilateral renal agenesis with contralateral renal hypoplasia, diagnosed by ultrasonography after amnioinfusion at 21 weeks gestation.
Amnion ; Amniotic Fluid ; Cardiovascular System ; Diagnosis ; Ear ; Female ; Humans ; Kidney ; Oligohydramnios ; Parents ; Parturition ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography

We experienced a case of acute myocarditis as the initial presentation of Crohn's disease. A 19-year-old woman was admitted with impaired consciousness, shock, and respiratory failure. She had suffered from frequent diarrhea and abdominal pain for several years. Cardiac troponin I and creatine kinase-MB fraction levels were elevated to 5.32 and 16.66 ng/mL, respectively. A 12-lead electrocardiogram showed sinus tachycardia, and a chest radiograph revealed interstitial pulmonary edema. An echocardiogram showed dilated ventricles with akinesia of the basal to apical inferoseptal, anteroseptal, anterior, and inferior left ventricular walls and severely impaired systolic function. Intensive care with inotropic support was effective, and her clinical condition gradually improved. Two weeks later, a colonoscopy revealed ulceration with stenosis in the terminal ileum and multiple aphthous ulcers in the rectum. A biopsy of the rectum revealed non-caseating granulomatous inflammation. She was diagnosed with Crohn's disease presenting with acute myocarditis.
Abdominal Pain ; Biopsy ; Colonoscopy ; Consciousness ; Constriction, Pathologic ; Creatine ; Crohn Disease ; Diarrhea ; Electrocardiography ; Female ; Humans ; Ileum ; Inflammation ; Myocarditis ; Pulmonary Edema ; Rectum ; Respiratory Insufficiency ; Shock ; Stomatitis, Aphthous ; Tachycardia, Sinus ; Thorax ; Troponin I ; Ulcer ; Young Adult ; Critical Care