No abstract available.
Child* ; Hip Joint* ; Hip* ; Humans ; Synovitis*

Among the precancerous lesions, dysplasia of the uterine cervix and adenoma of the colon have been widely studied in terms of genetic alterations. However, little has been performed regarding phenotypic alterations of the precancerous lesions. We investigated the relationship among cellular proliferation, clonality, immortality and histopathologic grading of the squamous epithelial lesions of the uterine cervix. Proliferation index (PI) was calculated based on the ratio of the epithelial cells positive for proliferating cell nuclear antigen to the total epithelial cells. Clonality was assayed by X-linked HUMARA polymorphism. For immortality assay, PCR-based TRAP (telomeric repeat amplification protocol) was done and telomerase processivity was calculated by comparison with the positive control. PI increased gradually as the lesions advanced from dysplasia to invasive carcinoma. Among informative case, all of the carcinoma in situ showed monoclonal pattern (7 of 7). Among invasive squamous cell carcinoma, 6 cases showed monoclonal pattern and 2 cases polyclonal pattern. TRAP reaction was positive in 92.6% (25 of 27) of dysplasia (high grade: 14 of 15; low grade: 11 of 12), 95.0% (19 of 20) of carcinoma in situ, 100% (9 of 9) of microinvasive carcinoma, and 92.9% (13 of 14) of invasive carcinoma. It was also positive in 12 of 12 samples of chronic cervicitis or squamous metaplasia near the lesions of dysplasia. There was no difference in TRAP positivity among the dysplasia, carcinoma in situ and invasive carcinoma, whereas telomerase processivity showed significant correlation. These results suggest that proliferative activity and telomerase processivity may be progressive events in oncogenesis, although telomerase activation may be an early event.
Adenoma ; Carcinogenesis ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Cell Proliferation ; Cervix Uteri ; Colon ; Epithelial Cells ; Female ; Metaplasia ; Proliferating Cell Nuclear Antigen ; Telomerase ; Uterine Cervicitis

No abstract available in English.
Clinical Study ; Humans ; Low Back Pain ; Psychological Tests

Hypertrophic cardiomyopathy (HCMP) is characterized myofiber hypertrophy and structural remodeling with changes in the proportion of the muscular, vascular, and interstitial compartments. A study was done to determine the structural remodeling patterns and the role of microvasculature of hearts in HCMP. Forty-two postmortem hearts were analyzed including 14 from patients who died of HCMP (group 1), 8 patients with HCMP but who died from extracardiac causes (group 2), 10 patients with ischemic heart disease (group 3), and 10 normal adult hearts (group 4). Macro- and microscopic examination, immunohistochemical study using CD34 antibody, and morphometric studies using image analyzer were performed. Mean cardiac weight and wall thickness were significantly higher in the HCMP group. Myocardial hypertrophy, and a variety of myocardial disarray and fibrosis involved the whole area of the left ventricles with HCMP. The percentage areas of microvessels were 6.40 0.7 in group 1, 5.90 0.6 in group 2, 4.98 0.3 in group 3, 4.85 0.4 in group 4, respectively, and the numbers of microvessels were 198.0 20.7 in group 1, 230.0 22.3 in group 2, 211.7 11.2 in group 3, and 236.4 11.4 in group 4, respectively (mean SE). The percentage area of microvessels was significantly higher in group 1 than in other groups. However, the number of microvessels in that group was lower than in the other groups, although it was statistically insignificant. Since flow-dependent vasodilation is preserved in HCMP, we considered flow-dependent vasodilation the cause of the discrepancy between the area and the number of microvessels. Ischemic changes observed in chronic HCMP and related heart failure were considesed to be due to the relative deficiency of the coronary flow compared to the increasing cardiac mass.
Adult ; Cardiomyopathy, Hypertrophic* ; Fibrosis ; Heart ; Heart Failure ; Heart Ventricles ; Humans ; Hypertrophy ; Microvessels ; Myocardial Ischemia ; Vasodilation

In this article, first author's name was misspelled unintentionally.

PURPOSE: This study examines changes in developmental profiles of children with language delay over time and the clinical significance of assessment conducted at age 2-3 years. METHODS: We retrospectively reviewed the medical records of 70 children (62 male, 8 female), who had visited the hospital because of delayed language development at 2-3 years, and were reassessed at ages 5-6. Language and cognitive abilities were assessed using multiple scales at the initial and follow-up visits. RESULTS: At the initial test, 62 of the 70 children had mental development index (MDI) below 70 of Bayley Scales of Infant Development Test II. Of the 62 children in the follow-up assessment, 30 children (48.4%) remained within the same cognitive range (full-scale intelligence quotient, FSIQ<70 of Wechsler preschool and primary scale of intelligence), 12 had borderline intellectual functioning (FSIQ, 70-85), 6 improved to average intellectual functioning (FSIQ>85), and 5 had specific language impairment, 9 had autism spectrum disorders. At the initial test, 38 of the 70 children had cognitive developmental quotients (C-DQ) below 70. Of the 38 children in the follow-up assessment, 23 children (60.5%) remained within the same cognitive range (FSIQ<70). The correlation coefficient for MDI and FSIQ was 0.530 (P<0.0001) and that for C-DQ and FSIQ was 0.727 (P<0.0001). There was a strong correlation between C-DQ and FSIQ, and a moderate correlation between MDI and FSIQ. CONCLUSION: Low MDI scores reflect a specific delay in cognitive abilities, communication skills, or both. The C-DQ, receptive language development quotient, and social maturity quotient also help to distinguish between children with isolated language delay and children with cooccurring cognitive impairment. Moreover, changes in the developmental profile during preschool years are not unusual in children with language delay. Follow-up reassessments prior to the start of school are required for a more accurate diagnosis and intervention.
Child ; Child Development ; Autism Spectrum Disorder ; Child, Preschool* ; Cognition ; Diagnosis ; Follow-Up Studies ; Humans ; Intelligence ; Language Development Disorders ; Language Development* ; Male ; Medical Records ; Retrospective Studies ; Weights and Measures

We report a case of severe hypothyroidism with nongoitrous, autoimmune thyroiditis and pituitary hyperplasia in a 13-year-old boy, who presented with sudden palsy on the left side of his face. Prednisolone and antiviral medication was administered. However, the facial palsy did not improve completely. The medications were replaced with thyroxine, and the facial palsy recovered. Endocrinological testing showed severe hypothyroidism as follows: thyroid stimulating hormone (TSH) level >100 microIU/mL, T4 of 1.04 microg/dL, T3 of 0.31 ng/mL, and free T4 of 0.07 ng/dL. Level of serum antithyroid peroxidase antibodies was 1,933.39 IU/mL, and that of antithyroglobulin antibodies was 848.16 IU/mL. Level of TSH receptor antibodies was >40 IU/L. Bioassay result for TSH receptor stimulating antibodies was negative. Thyroid sonography revealed no increase in the size or vascularity of the bilateral gland. Thyroid scintigraphy with 99mTc showed decreased uptake, and magnetic resonance imaging demonstrated an enlarged pituitary gland.
Adolescent ; Antibodies ; Biological Assay ; Facial Paralysis* ; Humans ; Hyperplasia ; Hypothyroidism ; Magnetic Resonance Imaging ; Male ; Paralysis ; Peroxidase ; Pituitary Gland ; Prednisolone ; Radionuclide Imaging ; Receptors, Thyrotropin ; Thyroid Gland ; Thyroiditis, Autoimmune* ; Thyrotropin ; Thyroxine

BACKGROUND: The Spectra Optia (SPO) is a novel continuous-flow centrifugal apheresis system based on the COBE Spectra (CSP) platform. There have been few attempts to validate the advantages of the SPO. We performed a retrospective study comparing the two cell separators for therapeutic plasma exchange (TPE) procedures in kidney transplant (KT) patients and seeing efficacy and safety. METHODS: We analyzed 720 TPE procedures performed between August 2012 and July 2014. Procedures included desensitization TPE before KT and TPE for the management of acute and chronic antibody-mediated graft rejection. Demographic characteristics, operational TPE variables, and laboratory data were analyzed. RESULTS: Demographic characteristics for the SPO (n=389) and CSP (n=331) groups did not differ significantly. The procedure time to exchange one plasma volume was 94.2+/-10.3 min in the SPO group and 100.4+/-11.2 min in the CSP group (P<0.001). The plasma removal efficiency (PRE) was 92.5+/-4.9% in the SPO group and 83.2+/-3.7% in the CSP group (P<0.001). There were no significant differences across the two apheresis systems for changes in hematologic parameters. CONCLUSIONS: Compared with the CSP, the SPO was associated with an improved PRE and a shorter procedure time to exchange one plasma volume. Our results in KT patients show that the SPO is superior to the CSP in TPE procedures.
Blood Component Removal ; Graft Rejection ; Humans ; Kidney ; Kidney Transplantation ; Plasma ; Plasma Exchange* ; Plasma Volume ; Retrospective Studies

Sleep disturbance and restless legs syndrome (RLS) among uremic patients is known to be high, but data on the prevalence, clinical significance, and causative factors are limited. A semiquantitative sleep and RLS questionnaire was distributed to 62 chronic hemodialysis(HD) patients. 74.5N had sleep complaints and frequent awakening was the most frequent specific sleep complaints followed by daytime sleepiness. Presence of diabetes mellitus(DM), RLS, depres- sion, high CRP level, low intact parathyroid hormone level, low subjective global assessment score, and short HD duration were associated with more sleep complaints. 58.3N had RLS and presence of DM, low serum albumin level were also associated with more severe RLS. But Kt/V, protein catabolic rate, hematocrit, plasma bicarbonate level, use of erythropoietin and sleep medication were not associated with sleep complaints and RLS. Sleep problems and RLS are comrnon in HD patients and seem to be associated with malnutrition. Presence of DM, de- pression, and RLS are likely to contribute the high prevalence of sleep disturbance.
Erythropoietin ; Hematocrit ; Humans ; Malnutrition ; Parathyroid Hormone ; Plasma ; Prevalence ; Renal Dialysis* ; Restless Legs Syndrome ; Serum Albumin ; Surveys and Questionnaires

Thoracoabdominal aortic aneurysm (TAAA) involving the roots of the celiac, superior mesenteric and both renal arteries is a rare, but potentially lethal disease. The overall postoperative mortality rate is high even when the intact TAAA is electively repaired. Furthermore, the postoperative complications are often serious and they include acute renal failure, paraplegia, respiratory distress and intestinal ischemia. The inclusion technique using a visceral-aortic patch (VAP) is considered the gold standard method for visceral artery revascularization for the treatment of TAAA. However, the inclusion technique is not feasible for patients with Marfan syndrome or for those patients with inappropriate anatomy for VAP. In such cases, separate visceral revascularization is a useful alternative and this may decrease the visceral ischemic time. Herein we report on 3 cases of TAAA, and the patients all underwent successful separate visceral revascularization, including one patient with Marfan syndrome.
Acute Kidney Injury ; Aortic Aneurysm, Thoracic ; Arteries ; Humans ; Ischemia ; Marfan Syndrome ; Paraplegia ; Postoperative Complications ; Renal Artery