Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)induces apoptosis in some cancer cells such as breast,prostate,lung,and colon cancer cells,but not normal cells.However,because the effects of TRAIL in gastric cancer cells is unclear,we undertook this study to clarify the effects of TRAIL and its mechanism. To assess the cytotoxicity of TRAIL,two human gastric cancer cell lines,SNU-484 and SNU601,were treated with TRAIL (0-200 ng/mL)in the presence or absence of cycloheximide (1 microgram/mL)for 24 h.Both SNU-484 and SNU-601 were sensitive to TRAIL-induced cell death in a dose-dependent manner.The combination of TRAIL (100 ng/mL)and cycloheximide (1 microgram/mL)for 24 h enhanced cell death and PARP cleavage by promoting activations of caspase-8, caspase-9,and caspase-3,relative to that of TRAIL alone.We further examined the expressions of death receptor 4 (DR4),death receptor 5 (DR5),and FLICE inhibitory protein (FLIP).Although DR4 and DR5 were expressed in both cell lines,the expression of long form (FLIPL )and short form (FLIPS )of FLIP were detected at the low levels. Overexpression of FLIPL or FLIPS in both cell lines rendered the cells resistant to TRAIL.Taken together,our results suggest that FLIP promotes human gastric cancer cell survival against TRAIL-induced apoptosis and is important modulator for TRAIL-induced cell death in human gastric cancer cells.
Apoptosis ; CASP8 and FADD-Like Apoptosis Regulating Protein ; Caspase 8 ; Cell Death ; Cell Line ; Cell Survival ; Colonic Neoplasms ; Cycloheximide ; Humans* ; Necrosis* ; Receptors, TNF-Related Apoptosis-Inducing Ligand ; Stomach Neoplasms*

Primary vesicoureteral reflux is a common genetically determined condition that is associated with varying degrees of renal scarring and represents one of the main causes of chronic kidney disease in children. Usually vesicoureteral reflux is common in urinary tract infection patient under 5 years of age. However, we report a rare case of high-grade vesicoureteral reflux and chronic kidney disease in a 10-year-old boy who was referred to the pediatric department for incidentally detected asymptomatic bacteriuria. Our case demonstrated that high grade vesicoureteral reflux patient with reduced renal function, bladder and bowel dysfunction at presentation is more likely to progress to chronic kidney disease.

Primary vesicoureteral reflux is a common genetically determined condition that is associated with varying degrees of renal scarring and represents one of the main causes of chronic kidney disease in children. Usually vesicoureteral reflux is common in urinary tract infection patient under 5 years of age. However, we report a rare case of high-grade vesicoureteral reflux and chronic kidney disease in a 10-year-old boy who was referred to the pediatric department for incidentally detected asymptomatic bacteriuria. Our case demonstrated that high grade vesicoureteral reflux patient with reduced renal function, bladder and bowel dysfunction at presentation is more likely to progress to chronic kidney disease.

BACKGROUND: Invasive Streptococcus agalactiae (group B streptococcus, GBS) infection most commonly occurs in infants; however, cases of GBS infection in adults, particularly in the elderly with significant underlying diseases, are being increasingly reported. We analyzed the serotype specific opsonophagocytic antibodies (the major mechanism of protection against GBS) in infants, adults, and the elderly. METHODS: The opsonization indices (OIs) of antibodies against serotype Ia, Ib, II, III, and V GBS were studied in 89 infants, 35 adults (age, 30–50 years), and 62 elderly individuals (age, 65–85 years) according to the University of Alabama at Birmingham GBS opsonophagocytic killing assay protocol (www.vaccine.uab.edu). RESULTS: In infants, adults, and elderly groups respectively, geometric mean of OI against GBS serotype Ia were 3, 7, and 32; against GBS serotype Ib were 7, 242, and 252; against serotype II were 93, 363, and 676; against serotype III were 8, 212, and 609; and against serotype V were 4, 639, and 610. The seropositive rate (% of subjects with OI ≥ 4) increased significantly in older age group for all five serotypes. CONCLUSION: During infancy, only a limited proportion of infants have functional immunity against serotype Ia, Ib, II, III, and V GBS. Furthermore, a lack of opsonic activities against GBS observed in some adults and the elderly might predispose such individuals to the risk of invasive GBS infection. Epidemiological monitoring and development of suitable vaccine for these populations are needed.
Adult ; Aged ; Alabama ; Antibodies* ; Epidemiological Monitoring ; Homicide ; Humans ; Infant ; Prevalence ; Seroepidemiologic Studies* ; Serogroup* ; Streptococcus agalactiae ; Streptococcus*

Non-sexually acquired genital ulceration, also known as Lipschutz ulcer, is a rare condition that typically occurs in prepubertal and pubertal girls. It can be misdiagnosed as a sexually transmitted disease or even a sign of child abuse, causing great anxiety for patients and their families. It is often accompanied by systemic symptoms such as fever, myalgia, or lymphadenopathy. Several viruses such as Epstein-Barr virus, cytomegalovirus, and mumps virus have been associated with this entity. Furthermore, Mycoplasma pneumonia has rarely been linked to such ulcers in the literature. We present a case of Lipschutz ulcer in a sexually inactive 11-year-old girl.

Non-sexually acquired genital ulceration, also known as Lipschutz ulcer, is a rare condition that typically occurs in prepubertal and pubertal girls. It can be misdiagnosed as a sexually transmitted disease or even a sign of child abuse, causing great anxiety for patients and their families. It is often accompanied by systemic symptoms such as fever, myalgia, or lymphadenopathy. Several viruses such as Epstein-Barr virus, cytomegalovirus, and mumps virus have been associated with this entity. Furthermore, Mycoplasma pneumonia has rarely been linked to such ulcers in the literature. We present a case of Lipschutz ulcer in a sexually inactive 11-year-old girl.

OBJECTIVE: This study analyzed the relationship between prognosis and multiple clinical factors of ruptured middle cerebral artery (MCA) aneurysm with intracerebral hemorrhage (ICH), to aid in predicting the results of surgical treatment. METHODS: Enrolled subjects were 41 patients with ruptured MCA aneurysm with ICH who were treated with surgical clipping. Clinical factors such as gender, age, and initial Glasgow coma scale were assessed while radiological factors such as the volume and location of hematoma, the degree of a midline shift, and aneurysm size were considered retrospectively. Prognosis was evaluated postoperatively by Glasgow outcome scale. RESULTS: Age and prognosis were correlated only in the groups with ICH over 31 mL or ICH at the frontal lobe or sylvian fissure. When initial mental status was good, only patients with ICH on the temporal lobe had a better prognosis. If the midline shift was less than 4.5 mm, the probability of better prognosis was 95.5% (21 of 22). If the midline shift was more than 4.5 mm, the probability of poor prognosis was 42.1% (8 of 19). Patients with ICH less than 31 mL had higher survival rates, whereas if the ICH was more than 31 mL, 41.2% (7 of 17) had a poor clinical pathway. CONCLUSION: Even if the initial clinical condition of the patient was not promising, by carefully examining and taking into account all factors, neurosurgeons can confidently recommend surgical treatment for these patients.
Aneurysm ; Cerebral Hemorrhage ; Frontal Lobe ; Glasgow Coma Scale ; Hematoma ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Middle Cerebral Artery ; Prognosis ; Retrospective Studies ; Surgical Instruments ; Survival Rate ; Temporal Lobe

Purpose: Pediatric diabetes is a common health burden worldwide. This study aimed to investigate the prevalence of fasting hyperglycemia in Korean youth aged 10–18 years and to evaluate its association with metabolic indicators. Methods: To assess the risk of diabetes in domestic children and adolescents, the prevalence of fasting hyperglycemia was calculated, a trend was evaluated using multi-year Korea National Health and Nutrition Examination Survey (KNHANES) data, and multivariate analysis was performed to evaluate the relationships between hyperglycemia and metabolic factors. Results: The prevalence of fasting hyperglycemia, defined as impaired fasting glucose (fasting glucose level > 100 mg/dL and < 125 mg/dL), or diabetes mellitus (fasting glucose ≥ 126 mg/dL) was estimated in Korean teenagers. The prevalence increased from the fourth (2007–2009) to the fifth (2010–2012), sixth (2013–2015), and seventh (2016–2018) KNHANES surveys, from 5.39 to 4.79, 10.03, and 11.66 per 100 persons, respectively. In multivariate analysis, systolic blood pressure and serum triglycerides were higher in the fasting hyperglycemia group; systolic blood pressures were 109.83 mmHg and 112.64 mmHg and serum triglycerides were 81.59 mg/dL and 89.60 mg/dL in the normal blood glucose and fasting hyperglycemia groups, respectively. Conclusion The prevalence of fasting hyperglycemia among children and adolescents has increased over the past decade, and this increase is potentially associated with metabolic abnormalities such as hypertension and hypertriglyceridemia. Effort is urgently required to reduce this chronic medical burden in adolescence.

PURPOSE: To investigate the retinal nerve fiber layer (RNFL) thickness concordance when measured by spectral domain (SD) and swept source (SS) optical coherence tomography (OCT), and to compare glaucoma-discriminating capability. METHODS: RNFL thicknesses were measured with the scan circle, centered on the optic nerve head, in 55 healthy, 41 glaucoma suspected, and 87 glaucomatous eyes. The RNFL thickness measured by the SD-OCT (sdRNFL thickness) and SS-OCT (ssRNFL thickness) were compared using the t-test. Bland-Altman analysis was performed to examine their agreement. We compared areas under the receiver operating characteristics curve and examined sdRNFL and ssRNFL thickness for discriminating glaucomatous eyes from healthy eyes, and from glaucoma suspect eyes. RESULTS: The average ssRNFL thickness was significantly greater than sdRNFL thickness in healthy (110.0 ± 7.9 vs. 100.1 ± 6.8 µm, p < 0.001), glaucoma suspect (96.8 ± 9.3 vs. 89.6 ± 7.9 µm, p < 0.001), and glaucomatous eyes (74.3 ± 14.2 vs. 69.1 ± 12.4 µm, p = 0.011). Bland-Altman analysis showed that there was a tendency for the difference between ssRNFL and sdRNFL to increase in eyes with thicker RNFL. The area under the curves of the average sdRNFL and ssRNFL thickness for discriminating glaucomatous eyes from healthy eyes (0.984 vs. 0.986, p = 0.491) and glaucoma suspect eyes (0.936 vs. 0.918, p = 0.132) were comparable. CONCLUSIONS: There was a tendency for ssRNFL thickness to increase, compared with sdRNFL thickness, in eyes with thicker RNFL. The ssRNFL thickness had comparable diagnostic capability compared with sdRNFL thickness for discriminating glaucomatous eyes from healthy eyes and glaucoma suspect eyes.
Glaucoma ; Nerve Fibers* ; Optic Disk ; Retinaldehyde* ; ROC Curve ; Tomography, Optical Coherence*

PURPOSE: After the introduction of Haemophilus influenzae type b (Hib) vaccine in 1995 in Korea, it was included in the national immunization program in 2013. In the post-Hib vaccine era, some studies in other countries reported that invasive Hib disease affects adults, especially the elderly and immunocompromised persons, more often than it affects children. To evaluate disease susceptibility, quantitative and qualitative analysis of anti-polyribosylribitol phosphate (PRP) antibodies were carried out in Korean adults aged 20 to 85 years. METHODS: Sera were collected from 39 healthy adults (20 to 50 years of age) and from 30 elderly adults (75 to 85 years of age) who did not have immune-compromising conditions. The concentration of anti-PRP immunoglobulin G (IgG) and serum bactericidal indices (SBIs) were measured by enzyme-linked immunosorbent assay and serum bactericidal assay. RESULTS: Geometric mean concentrations of anti-PRP IgG and geometric mean SBIs were 0.88 µg/mL (95% confidence interval [CI], 0.17 to 3.85) and 354 (95% CI, 50 to 2,499) in young adults and 1.67 µg/mL (95% CI, 0.53 to 5.24) and 449 (95% CI, 146 to 1,376) in elderly adults, respectively. When the threshold of seropositivity for anti-PRP IgG was applied as 0.15 or 1.0 µg/mL, which is the protective antibody level in children, seropositive rates were 87.2% or 53.8% in young adults and 100% or 60% in elderly adults. The seropositivity rates of the SBI (SBI ≥4) were 82.1% and 100% in the groups, respectively. CONCLUSIONS: Most subjects in the adult and elderly adult groups display immunity to Hib based on quantitative and qualitative antibody levels, but not all. Because high immunization and low Hib circulation rates may reduce the natural Hib immunity in the population, monitoring Hib immunity as well as disease are needed continuously.
Adult* ; Aged ; Antibodies* ; Child ; Disease Susceptibility ; Enzyme-Linked Immunosorbent Assay ; Haemophilus influenzae type b* ; Haemophilus influenzae* ; Haemophilus* ; Humans ; Immunization ; Immunization Programs ; Immunoglobulin G ; Korea ; Young Adult