No abstract available.

Scrub typhus, a mite-borne infectious disease, is caused by Orientia tsutsugamushi. Despite many attempts to develop a protective strategy, an effective preventive vaccine has not been developed. The identification of appropriate Ags that cover diverse antigenic strains and provide long-lasting immunity is a fundamental challenge in the development of a scrub typhus vaccine. We investigated whether this limitation could be overcome by harnessing the nanoparticle-forming polysorbitol transporter (PST) for an O. tsutsugamushi vaccine strategy.Two target proteins, 56-kDa type-specific Ag (TSA56) and surface cell Ag A (ScaA) were used as vaccine candidates. PST formed stable nano-size complexes with TSA56 (TSA56-PST) and ScaA (ScaA-PST); neither exhibited cytotoxicity. The formation of Ag-specific IgG2a, IgG2b, and IgA in mice was enhanced by intranasal vaccination with TSA56-PST or ScaA-PST. The vaccines containing PST induced Ag-specific proliferation of CD8 + and CD4 +T cells. Furthermore, the vaccines containing PST improved the mouse survival against O.tsutsugamushi infection. Collectively, the present study indicated that PST could enhance both Ag-specific humoral immunity and T cell response, which are essential to effectively confer protective immunity against O. tsutsugamushi infection. These findings suggest that PST has potential for use in an intranasal vaccination strategy.

Background and Objectives: Previous studies reported abnormalities in MRI as a poor prognostic indicator of sudden sensorineural hearing loss (SSNHL). Since abnormalities in three-dimensional (3D) fluid-attenuated inversion recovery (FLAIR) are strongly correlated with the initial hearing function, the prognostic value of the 3D FLAIR images should be carefully evaluated to avoid collinearity. We aimed to evaluate abnormalities on the 3D FLAIR images as an independent prognostic factor in the matched SSNHL groups.Subjects and Method We retrospectively reviewed medical records of 179 patients with SSNHL who underwent temporal MRI, including the 3D FLAIR sequence, between January 2015 and December 2019. Patients were divided based on the presence of cochlear abnormalities on the 3D FLAIR images. Hearing prognosis was evaluated with and without matching for initial hearing and treatment interval. Results: The groups were similar in sex (p=0.091), age (p=0.925), treatment interval (p= 0.216), and MRI interval (p=0.828). Notably, patients with cochlear abnormalities on the 3D FLAIR images showed distinctly more severe hearing loss (p<0.001) at the initial pure tone average (PTA) assessment and poorer outcomes (p<0.001) compared to those without abnormality. After matching for initial hearing and treatment interval, the hearing outcome, measured by PTA, was similar between the groups (p=0.681). Conclusion Cochlear signal abnormality in 3D FLAIR MRI was associated with poor initial hearing. However, it did not affect hearing recovery outcomes when the groups were matched.

Granulocytic sarcoma is an uncommon extramedullary tumor composed of granulocytic precursor cells such as myeloblasts or monoblasts. These tumor were originally called chloroman because of the green color imparted by the heavy concentration of the myeloperoxidase present in myelogenous leukemic cells. The tumor usually develops during the course of myelogenous leukemia or myeloproliferative disorders and may represent the initial manifestation of leukemia. Rarely, granulocytic sarcoma is recognized as an isolated tumor without any evidence of leukemia. We report a case of a 21-year-old man who was diagnosed as granulocytic sarcoma of right kidney after complete remission of acute myelocytic leukemia.
Granulocyte Precursor Cells ; Humans ; Kidney* ; Leukemia ; Leukemia, Myeloid ; Leukemia, Myeloid, Acute* ; Monocyte-Macrophage Precursor Cells ; Myeloproliferative Disorders ; Peroxidase ; Sarcoma, Myeloid* ; Young Adult

Infertile women with chronic anovulation are prone to be exposed to unopposed estrogen stimulation and have the high risk of being suffering from endometrial hyperplasia or even endometrial carcinoma. A few reports have suggested that nulliparous young women (under 40 yr of age) with endometrial carcinoma could be treated conservatively to preserve fertility and succeed the live birth. We report on a 36-yr-old woman who received conservative treatment of endometrial carcinoma (stage I, grade 1) by curettage and progestin. After megestrol medication of total 71,680 mg during 24 weeks, we found the regression of endometrial lesion by curettage and hysteroscopic examination. Then we decided to perform in vitro fertilization program. Two embryos were transferred and heterotypic pregnancy was diagnosed 27 days after embryo transfer. After right salpingectomy, she received routine obstetrical care and delivered by cesarean section at 38 weeks in gestational periods. Two years after delivery, she is healthy without any evidence of recurrent disease. The fertility preserving treatment is an option in endometrial cancer patients if carefully selected, and assisted reproductive technologies would be helpful.
Progestins/therapeutic use ; Pregnancy Outcome ; Pregnancy ; Live Birth ; Humans ; Fertilization in Vitro/*methods ; Female ; Endometrial Neoplasms/surgery/*therapy ; Adult ; Adenocarcinoma/surgery/*therapy

BACKGROUND: Color Doppler echocardiography is sensitive in detecting mitral regurgitation and useful in quantitating its severity. The presence of an eccentric regurgitant jet suggests that regurgitation is caused by prolapsing or flail leaflet of mitral valve. Until recently the direction of regurgitant jet in mitral valve prolapse has been examined in a single(parasternal short axis view) or orthogonal plane using color Doppler echocardiography, and few in the apical rotation method of a transducer. The purpose of this study was to clarify the usefullness of the apical rotation method of a transducer in detection of the direction of mitral regurgitant jet and diagnosis of the sites of mitral valve prolapse. METHODS: Twenty four patients(8 men and 16 women, mean age:47.3+/-18.8 years) with mitral valve prolapse with eccentric regurgitant jet were examined by two-dimensional and color Doppler echocardiograply using conventional parasternal long and short axis views, and four apical longitudinal planes(four chamber, vertical, two chamber and transverse views) obtained by the apical retation method of a transducer. RESULTS: Thirty one regurgitant jets were detected in twenty four patients, eighteen patients had anterior, nine patints posterior, and three patients bi-leaflet(anterior and posterior) prolapse. In eighteen patients with anterior leaflet prolapse, ten had medial, eight had middle, three had lateral, and three had two portions(two, medial and middle; one, middle and lateral) prolapse. In nine patients with posterior leaflet prolapse, five had medial, three had middle, two had lateral, and one had two(medial and middle) scallop prolapse. CONCLUSION: Color Doppler echocardiography by the apical rotation method of transducer is useful in assessment of the site of prolapse in patients with mitral valve prolapse with eccentric regurgitation.
Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Echocardiography, Doppler, Color ; Female ; Humans ; Male ; Mitral Valve Insufficiency ; Mitral Valve Prolapse* ; Mitral Valve* ; Pectinidae ; Prolapse* ; Transducers*

No abstract available.
Carcinoma, Non-Small-Cell Lung* ; Drug Therapy, Combination*

Nasal fractures are the most common type of facial fractures. Nowdays computed tomography is found to be very helpful in diagnosing nasal fracture, especially in findings the nasal septal fractures. From August 2004 to July 2005, 36 cases of nasal fracture were admited and reviewed to oral and maxillofacial surgery of Ulsan University Hospital, not including other facial bone fracture. Out of 223 cases of facial bone fractures, we treated 47 cases of nasal fractures. We reviewed and examined the 36 patients of nasal fractures 2months postoperative. The results were 28cases of male and 8cases of female. The highest age frequency was in the fourth decades group. The most frequent causes of injury were falling down and fist trauma. The 25(69%) patients were found to have septal fractures, after computed tomography findings. The treatment methods of nasal fracture were closed reduction(13cases), open reduction(20cases), ORIF(1case), non operation(2cases). Complications of nasal deformity were found in 2patients. Septoplasty was performed on 21 patients. Septal fractures in combination with nasal fracture are usually unrecognized and untreated at the time of injury, usually ended in nasal deformities. It is important to find out the exact type of nasal fractures. We will report the results of treatment of nasal fractures with a literature review.
Congenital Abnormalities ; Facial Bones ; Female ; Humans ; Male ; Surgery, Oral ; Ulsan

PURPOSE: AP DNA endonuclease (APE), an enzyme responsible for the repair of damaged DNAs, is essential for the maintenance of genetic information of cells. Deficiency of APE in certain hereditary skin tumor and senescent cells has been implicated but the regulation of APE activity as well as the expression of APE gene in response to DNA damage has not been well documented. Genotoxic agents including ultimate carcinogens that can damage DNA were treated to cultured normal and transformed human cells and adaptive response of APE gene expression to these treatments was measured in order to evaluate the role of APE in chemical carcinogenesis. MATERIALS AND METHODS: Hydroxyl radical ('OH) generated from H2O2 (60 uM) through Fenton reaction, each 100 uM of N-nitrosomethylurea (NMU), 3-methyl-4-monomethyl- aminoazobenzene (3'-MeMAB) and N-acetoxy-2-acetaminofluorene (AAAF) were treated to umbilical cord blood cells (UCBC), HepG2 cells and HL-60 cells. APEX mRNA and APEX protein contents expressed in these cells exposed to each of these agents were measured by Northern blot hybridization and Western blot immunodetection analysis. The changes of APE activity in cells exposed to these genetoxic agents were measured. RESULTS: Treatment of H2O2 (60 uM) to UCBC, HepG2, and HL-60 cells increased APE activity significantly and pretreatment of a catalytic agent for OH, FeSO4 (60 pM) to the cells prior to H2O2 exposure did not further increase the APE activity in cells. Adaptive response to H2O2 in HL-60 cells increased in proportion to the concentration of H2O2 up to 60 pM. However, further increase in H2O2 concentration had no effect on the enzyme activity. Treatment of NMU (100 pM), 3-MeMAB (100 pM) and AAAF (100 pM) to these cells brought about a slight increase in the APE activity. APEX mRNA expression in UCBC and HepG2 cells exposed to H2O2, NMU, 3-MeMAB was markedly increased in APEX mRNA expression. APEX mRNA expression was also increased in HL-60 cells exposed to H2O2 (60 pM) and 3-MeMAB (100 uM) but NMU (100 pM) exposure to the cells resulted in a slight increase of it (Fig. 2). APEX protein expression was increased in all UCBC, HepG2 and HL-60 cells exposed to these genotoxic agents (Fig. 3). CONCLUSION: These results implicate that exposure of genotoxic agents to the cultured cells may cause DNA damage and lead to adaptive increase in APE activity as well as APE gene expression. It is probable that APE gene is transcriptionally regulated in response to the exposure of H2O2 or 3-MeMAB in cultured human cells as a consequence of activation of DNA repair system for the adaptation to the crisis.
Blotting, Northern ; Blotting, Western ; Carcinogenesis ; Carcinogens ; Cells, Cultured ; Deoxyribonuclease I* ; DNA Damage ; DNA Repair ; DNA* ; Fetal Blood ; Gene Expression ; Hep G2 Cells ; HL-60 Cells ; Hominidae ; Humans ; Hydroxyl Radical ; RNA, Messenger ; Skin

Both death certificates and postmortem examination certificates are used as proof of death. These certificates sometimes contain erroneous information but how frequently they do so is unknown. In particular, only a few studies have measured the accuracy of the cause and manner of death on Korea death documents. In this study, we compared the cause and manner of death on both kinds of certificates with those on autopsy reports to determine the frequency of errors, and to identify way to improve the accuracy of these certificates. In 2012, 528 autopsies were requested of out institute, and certificates were submitted in 241 of the cases. The manner of death was classified as natural, unnatural, or unknown. The cause of death in the autopsy report matched that on the death certificate in 37 of 63 cases (58.7%), and the manner of death matched in 40 of 63 cases (63.5%). The cause of death in the autopsy report matched that on the postmortem examination certificate in 62 of 178 cases (34.8%), and the manner of death matched in 74 of 178 cases (41.6%). Death certificates and postmortem examination certificates are important documents. We identified many incorrect reports of causes and manners of death on both kinds of documents, especially the postmortem death certificates. These inaccuracies are presumably due to a lack of forensic information and education, as well as lack of interest on the part of medical doctors.
Autopsy* ; Cause of Death ; Death Certificates* ; Education ; Korea