No abstract available.
Breech Presentation* ; Female ; Fetus* ; Pregnancy

Rheumatoid arthritis (RA) and osteoarthritis (OA), two common types of arthritis, affect the joints mainly by targeting the synovium and cartilage. Increasing evidence indicates that a significant network connects synovitis and cartilage destruction during the progression of arthritis. We recently demonstrated that hypoxia-inducible factor (HIF)-2alpha causes RA and OA by regulating the expression of catabolic factors in fibroblast-like synoviocytes (FLS) or chondrocytes. To address the reciprocal influences of HIF-2alpha on FLS and chondrocytes, we applied an in vitro co-culture system using a transwell apparatus. When co-cultured with HIF-2alpha-overexpressing chondrocytes, FLS exhibited increased expression of matrix metalloproteinases and inflammatory mediators, similar to the effects induced by tumor-necrosis factor (TNF)-alpha treatment of FLS. Moreover, chondrocytes co-cultured with HIF-2alpha-overexpressing FLS exhibited upregulation of Mmp3 and Mmp13, which is similar to the effects induced by interleukin (IL)-6 treatment of chondrocytes. We confirmed these differential HIF-2alpha-induced effects via distinct secretory mediators using Il6-knockout cells and a TNF-alpha-blocking antibody. The FLS-co-culture-induced gene expression changes in chondrocytes were significantly abrogated by IL-6 deficiency, whereas TNF-alpha neutralization blocked the alterations in gene expression associated with co-culture of FLS with chondrocytes. Our results further suggested that the observed changes might reflect the HIF-2alpha-induced upregulation of specific receptors for TNF-alpha (in FLS) and IL-6 (in chondrocytes). This study broadens our understanding of the possible regulatory mechanisms underlying the crosstalk between the synovium and cartilage in the presence of HIF-2alpha, and may suggest potential new anti-arthritis therapies.
Animals ; Arthritis/genetics/*immunology/pathology ; Arthritis, Rheumatoid/genetics/immunology/pathology ; Basic Helix-Loop-Helix Transcription Factors/genetics/*immunology ; Cells, Cultured ; Chondrocytes/immunology/metabolism/*pathology ; Coculture Techniques ; Fibroblasts/immunology/metabolism/*pathology ; Gene Expression Regulation ; Interleukin-6/genetics/*immunology ; Male ; Mice ; Mice, Inbred C57BL ; Osteoarthritis/genetics/immunology/pathology ; Synovial Membrane/immunology/metabolism/*pathology ; Tumor Necrosis Factor-alpha/genetics/*immunology ; Up-Regulation

Transglutaminase2 (TGM2) is a multi-functional calcium dependent enzyme that affects angiogenesis, apoptosis, differentiation, attachment, and changes in the extracellular matrix. However, its function in periodontal tissue has not yet been studied. The aim of this study was to investigate the association of the TGM2 expression and the modulation of inflammatory mediators in inflamed periodontal ligament (PDL) cells induced by pro-inflammatory cytokines such as Interleukin-1β and the Tumor necrosis factor-α. The expression of TGM2 was increased in the inflamed periodontal tissue and PDL cells. Over-expressed TGM2 in the PDL cells increased expression of MMP1, MMP3, IL-6, CXCL8, and PTGS2. Conversely, inhibition of TGM2 activity using LDN27219, a TGM2 inhibitor, resulted in decreased expression of MMP1, MMP3, IL-6, and CXCL8. The mRNA expression was confirmed by RT-PCR and quantified by qRT-PCR. Protein levels were also confirmed by immunofluoroscence staining. These results suggest that TGM2 plays an important role in the regulation of inflammatory mediators which exacerbate tissue damage in inflamed periodontal tissue.
Apoptosis ; Calcium ; Cyclooxygenase 2 ; Cytokines ; Extracellular Matrix ; Inflammation ; Interleukin-6 ; Necrosis ; Periodontal Ligament* ; Periodontitis ; RNA, Messenger

Benign endobronchial tumors are rare diseases with an incidenced of between 1 and 5% of all lung tumors. An endobronchial fibroepithelial polyp is an extremely rare form of benign bronchial tumor. Clinically, an endobronchial fibroepithelial polyp causes an airway obstruction and obstructive pneumonitis as does other endobronchial tumors. Therefore, it is important to differentiate an endobronchial fibroepithelial polyp pathologically from other benign endobronchial tumors and bronchogenic carcinomas. Here, we report a case of an endobronchial fibroepithelial polyp, in a 25-year-old man who had suffered from chest discomfort upon deep breathing with a brief review of the relevant literature.
Adult ; Airway Obstruction ; Carcinoma, Bronchogenic ; Humans ; Lung ; Pneumonia ; Polyps* ; Rare Diseases ; Respiration ; Thorax

Acinar cell carcinoma (ACC) is a very rare type of pancreatic cancer that makes up less than 1% of all pancreatic cancers. The prognosis of ACC is very poor and the mean survival interval is only 18-19 months. The only effective treatment is currently early radical resection. MATERIALS AND METHODS: To determine ACC`s clinical characteristics and the treatment efficacy, we conducted a retrospective chart review to study the clinical characteristics, laboratory findings, pathology and treatment responses of 10 ACC patients among 3042 pancreatic cancer patients who were diagnosed in Severance Hospital and Kangnam Severance Hospital of Yonsei University, College of Medicine from 1988.01.01 to 2008.12.31. RESULTS: The 10 ACC patients were 6 males and 4 females. The mean age of the 10 ACC patients was 53.2 years. The most of the patients (7/10) complained the pain on the epigastric area and there was no jaundice in 8 patients (80%). Unfortunately, regional or distant metastases were founded in 8 patients (80%) at the time of the first diagnosis. The initial mean CA19-9 level was increased to 73.5 U/ml (range: 0.1~350.0 U/ml). Six of 10 patients underwent radical surgery and 4 of 10, including 1 with open and closure, were treated with conservative treatment. The median survival interval was 22.4 months with operative treatment and 1.5 months with conservative treatment. The median overall survival interval was 19.4 months. The median disease free survival was 17 months. The liver was the most common recurrent site (3 cases). CONCLUSIONS: An early radical resection is currently the best and only treatment for ACC, but in rare cases, post-operative adjuvant chemotherapy shows hopeful results and so this requires more study.
Acinar Cells ; Carcinoma, Acinar Cell ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Humans ; Jaundice ; Liver ; Male ; Neoplasm Metastasis ; Pancreas ; Pancreatic Neoplasms ; Prognosis ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: The objective of this study is to estimate gestational age by using FHR parameters after linear and nonlinear analysis of FHR data. Linear spectral decomposition has a limit to describe and analyze the nonlinear and complex physiological nature. Random processing and chaotic analysis assist to quantify some patterned energies, interaction of the physiological system in body system, which the constancy is preserved, and complexity of physical cardiovascular system. But there are no great development of new device which notify fetal age. METHODS: From March 1995 to December 2000, 2,548 cases who received NST during antenatal visit were included in this study. Among these cases, 1000 cases were sampled randomly. We divided this cases into a study and a control group, 500 cases for model building set and the other 500 cases for validation set. Each FHR parameters such as baseline FHR, variability (AMP, MMR), acceleration & deceleration (15 bpm-15 seconds), loss of signal, the number of fetal movement were analysed by using our own computerized HYFM-I, II software system. The linear and non-linear analysis of FHR were done after extracting approximate entropy (ApEn) value. Finally, we performed regression analysis and extract an equation for estimation of gestational weeks using bootstrap method. RESULTS: We extract a following equation using above study method: Log(GA)=5.870-0.051(Sloss*)-0.065(Mean FHR*)+0.049(Mean FHR*)2-0.058(FM*)+0.048(AMP*)2+0.121(A1515*)-0.031(A1515*)2+0.036(ApEn*)2. CONCLUSIONS: Accurate dating of pregnancy, namely gestational week is very important for antenatal diagnosis in the field of perinatal medicine. This study will propose scientific research results which are useful for studying normal and morbid generating physiological fetal condition. We extract an appropriate equation for estimation of gestational weeks only using FHR parameters. We hope to compare our result with other authors' results in the near future.
Acceleration ; Cardiovascular System ; Deceleration ; Entropy ; Female ; Fetal Heart* ; Fetal Movement ; Gestational Age* ; Heart Rate, Fetal* ; Hope ; Pregnancy ; Prenatal Diagnosis

OBJECTIVE: The objective of this study is to estimate gestational age by using FHR parameters after linear and nonlinear analysis of FHR data. Linear spectral decomposition has a limit to describe and analyze the nonlinear and complex physiological nature. Random processing and chaotic analysis assist to quantify some patterned energies, interaction of the physiological system in body system, which the constancy is preserved, and complexity of physical cardiovascular system. But there are no great development of new device which notify fetal age. METHODS: From March 1995 to December 2000, 2,548 cases who received NST during antenatal visit were included in this study. Among these cases, 1000 cases were sampled randomly. We divided this cases into a study and a control group, 500 cases for model building set and the other 500 cases for validation set. Each FHR parameters such as baseline FHR, variability (AMP, MMR), acceleration & deceleration (15 bpm-15 seconds), loss of signal, the number of fetal movement were analysed by using our own computerized HYFM-I, II software system. The linear and non-linear analysis of FHR were done after extracting approximate entropy (ApEn) value. Finally, we performed regression analysis and extract an equation for estimation of gestational weeks using bootstrap method. RESULTS: We extract a following equation using above study method: Log(GA)=5.870-0.051(Sloss*)-0.065(Mean FHR*)+0.049(Mean FHR*)2-0.058(FM*)+0.048(AMP*)2+0.121(A1515*)-0.031(A1515*)2+0.036(ApEn*)2. CONCLUSIONS: Accurate dating of pregnancy, namely gestational week is very important for antenatal diagnosis in the field of perinatal medicine. This study will propose scientific research results which are useful for studying normal and morbid generating physiological fetal condition. We extract an appropriate equation for estimation of gestational weeks only using FHR parameters. We hope to compare our result with other authors' results in the near future.
Acceleration ; Cardiovascular System ; Deceleration ; Entropy ; Female ; Fetal Heart* ; Fetal Movement ; Gestational Age* ; Heart Rate, Fetal* ; Hope ; Pregnancy ; Prenatal Diagnosis

Periodontitis is an inflammatory disease of the supportive tissues surrounding the teeth, and is characterized by irreversible destruction of the gingiva, periodontal ligament (PDL), and alveolar bone, which results in the loss of teeth. In the present study, we elucidated the correlation between periodontitis and apelin (APLN), an adipokine and a regulatory peptide, respectively, which are involved in inflammation and bone remodeling. The expression of APLN is negatively correlated with periodontitis progression in gingival tissue. In addition, treatment with TNF-α downregulated the expression of APLN in PDL cells and gingival fibroblasts, indicating the protective role played by APLN against periodontitis progression. The overexpression of APLN or treatment with exogenous APLN suppressed the TNF-α-mediated catabolic gene expression of MMP1, IL6, and PTGS2 in PDL cells. Moreover, the inhibition of the APLN-APJ axis by ML221, an APJ inhibitor, induced catabolic gene expression in PDL cells. Thus, the results of this study provided evidence to support APLN as a regulatory factor of the inflammatory response during periodontitis.

PURPOSE: To determine predictive factors for stent failure-free survival in patients treated with a retrograde ureteral stent for a malignant ureteral obstruction. MATERIALS AND METHODS: We retrospectively reviewed 71 patients who underwent insertion of a cystoscopic ureteral stent due to a malignant ureteral obstruction between May 2004 and June 2011. Performance status, type of cancer, hydronephrosis grade, location of the obstruction, presence of bladder invasion, C-reactive protein (CRP), serum albumin, and inflammation-based prognostic score (Glasgow prognostic score, GPS) were assessed using a Cox proportional regression hazard model as predicting factors for stent failure. RESULTS: A univariate analysis indicted that hypoalbuminemia (<3.5 g/dL; hazard ratio [HR], 2.43; 95% confidence interval [CI], 1.21 to 4.86; p=0.012), elevated CRP (> or =1 mg/dL; HR, 4.79; 95% CI, 2.0 to 11.1; p=0.001), and presence of a distal ureter obstruction (HR, 3.27; 95% CI, 1.19 to 8.95; p=0.021) were associated with stent failure-free survival. A multivariate analysis revealed that the presence of a mid and lower ureteral obstruction (HR, 3.27; 95% CI, 1.19 to 8.95; p=0.007), GPS > or =1 (HR, 7.22; 95% CI, 2.89 to 18.0; p=0.001), and elevated serum creatinine before ureteral stent placement (>1.2 mg/dL; HR, 2.16; 95% CI, 1.02 to 4.57; p=0.044) were associated with stent failure-free survival. CONCLUSIONS: A mid or lower ureteral obstruction, GPS > or =1, and serum creatinine before ureteral stent insertion >1.2 mg/dL were unfavorable predictors of stent failure-free survival. These factors may help urologists predict survival time.
C-Reactive Protein ; Creatinine ; Humans ; Hydronephrosis ; Hypoalbuminemia ; Multivariate Analysis ; Neoplasm Metastasis ; Proportional Hazards Models ; Retrospective Studies ; Serum Albumin ; Stents ; Ureter ; Ureteral Obstruction ; Urinary Bladder