Acute promyelocytic leukemia (APL), which is usually defined by the morphological features of the leukemic cells, is characterized by the t(15;17) (q22;q21) chromosomal translocation and disseminated intravascular coagulation. This specific translocation results in a new fusion transcript between the promyelocytic leukemia (PML) gene and the retinoic acid receptor-alpha (RARalpha) gene. Although the presence of this fusion gene can predict a favorable clinical response to all-trans-retinoic-acid (ATRA) treatment, APL with chromosomal translocations other than t(15;17) (q22;q21) is extremely rare and is associated with a poor prognosis. We experienced a case of APL with de novo t(11;19).
Disseminated Intravascular Coagulation ; Leukemia ; Leukemia, Promyelocytic, Acute ; Pathology, Molecular ; Prognosis ; Translocation, Genetic ; Tretinoin

We aimed to investigate the significance of microalbuminuria and its relationship with subclinical atherosclerosis in nonhypertensive and nondiabetic patients, by using coronary artery computed tomography (CT). A total of 1,318 nonhypertensive and nondiabetic subjects who had taken coronary artery CT and measured spot urine albumin to creatinine ratio (UACR) were evaluated. The atherosclerotic changes of coronary arteries were greater in subjects with microalbuminuria, reflected by coronary artery calcium score (CACS) and significant coronary artery stenosis (CACS > or = 100 in 15.3% vs 7.6% and stenosis > or = 50% in 11.5% vs 4.9% of patients with vs without microalbuminuria, P = 0.008 and P = 0.011, respectively). Among various parameters that are known as a risk factor or possible biomarkers of coronary artery disease, presence of microalbuminuria, age and Framingham risk score were significantly related to coronary artery stenosis. Among them the presence of microalbuminuria showed stronger correlation than others to the coronary artery stenosis detected by CT, even after adjusting confounding factors (OR 3.397, 95% confidence interval 1.138 to 10.140, P = 0.028). The presence of microalbuminuria by UACR was significantly associated with presence of coronary artery stenosis > or = 50% in asymptomatic, nonhypertensive and nondiabetic general population. Our study suggests that the presence of microalbuminuria may imply subclinical coronary artery disease, even in asymptomatic population.
Adult ; Age Factors ; Aged ; Albuminuria/*complications ; Blood Pressure ; Calcium/analysis ; Coronary Artery Disease/complications/*radiography ; Coronary Stenosis/complications ; Coronary Vessels/chemistry ; Creatinine/urine ; Female ; Humans ; Male ; Middle Aged ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Sex Factors ; Tomography, X-Ray Computed

Purpose: Eph receptors are differentially expressed in numerous malignant tumors. This study intended to analyze the roles of EphB receptors (EphB2, B3, and B4) in urinary bladder cancer. Materials and Methods: Tissue microarray-based immunohistochemical analysis was used to investigate the expression patterns of EphB2, EphB3, and EphB4 in 154 bladder cancer specimens. Immunohistochemical staining was conducted examining the extent of stained cells and staining intensity. EphB was considered to be highly expressed when the intensity of staining was more than moderate in >25% of cells in the tissue section. Small interfering RNA (siRNA) was used to knock down EphB expression in bladder cancer cell lines (T24, 5637) to determine the effects of EphB on tumor cell invasion, proliferation, and migration. Results: EphB receptors (B2, B3, and B4) were detected in 40.9% (EphB2, 63/154), 71.4% (EphB3, 110/154), and 53.2% (EphB4, 82/154) of bladder cancer specimens. Low expression of EphB2, B3, and B4 receptors were significantly associated with higher tumor grade (EphB2, p<0.001; EphB3, p=0.032; EphB4, p<0.001) and muscular invasion (EphB2, p=0.002; EphB3, p=0.009; EphB4, p<0.001). No obvious correlation was observed with other clinicopathological variables, such as age, sex, recurrence, lymph node involvement, metastasis, and overall survival. Inactivation of EphB receptors by siRNA transfection increased cell viability, tumor cell invasion, proliferation, and migration in comparison with untransfected cancer cells. Conclusion Low expression of EphB receptors (B2, B3, and B4) can be a predictive marker for muscular invasion of bladder cancer.

Purpose: Eph receptors are differentially expressed in numerous malignant tumors. This study intended to analyze the roles of EphB receptors (EphB2, B3, and B4) in urinary bladder cancer. Materials and Methods: Tissue microarray-based immunohistochemical analysis was used to investigate the expression patterns of EphB2, EphB3, and EphB4 in 154 bladder cancer specimens. Immunohistochemical staining was conducted examining the extent of stained cells and staining intensity. EphB was considered to be highly expressed when the intensity of staining was more than moderate in >25% of cells in the tissue section. Small interfering RNA (siRNA) was used to knock down EphB expression in bladder cancer cell lines (T24, 5637) to determine the effects of EphB on tumor cell invasion, proliferation, and migration. Results: EphB receptors (B2, B3, and B4) were detected in 40.9% (EphB2, 63/154), 71.4% (EphB3, 110/154), and 53.2% (EphB4, 82/154) of bladder cancer specimens. Low expression of EphB2, B3, and B4 receptors were significantly associated with higher tumor grade (EphB2, p<0.001; EphB3, p=0.032; EphB4, p<0.001) and muscular invasion (EphB2, p=0.002; EphB3, p=0.009; EphB4, p<0.001). No obvious correlation was observed with other clinicopathological variables, such as age, sex, recurrence, lymph node involvement, metastasis, and overall survival. Inactivation of EphB receptors by siRNA transfection increased cell viability, tumor cell invasion, proliferation, and migration in comparison with untransfected cancer cells. Conclusion Low expression of EphB receptors (B2, B3, and B4) can be a predictive marker for muscular invasion of bladder cancer.

PURPOSE: To compare the prophylactic effects of postoperative continuous positive airway pressure (CPAP) therapy plus conventional postoperatively pulmonary physiotherapy (CPP) and postoperative CPP alone on the development of pulmonary atelectasis after laparoscopic Roux-en-Y gastric bypass (LGBP) in obese patients. MATERIALS AND METHODS: Patients with BMIs>27.5 kg/m2 aged between 20 and 65 years were enrolled in the present study. All subjects received LGBP and were divided into 2 groups. Patients in the CPAP group received both CPAP and CPP therapy postoperatively, and patients in the conventional group received CPP alone. The primary outcome was the incidence of postoperative pulmonary atelectasis as determined by chest X-ray after LGBP, and the secondary outcome was duration of postoperative hospital stay (HS). RESULTS: Seventy-three patients were enrolled in this study. Fifty-seven patients received CPAP plus CPP, and 16 patients received CPP. The CPAP group had an atelectasis incidence of 40.4% (23/57) and the conventional group an incidence of 62.5% (10/16). Multivariate analysis showed the incidence of atelectasis after LGBP was significantly lower in the CPAP group (OR 0.198, 95% CI 0.045–0.874; P=0.033) and that HS was significantly correlated with the developments of atelectasis, pneumonia, and complications (partial correlation coefficients 0.271, 0.444 and 0.382; P-values 0.025, <0.05 and <0.05, respectively). CONCLUSION: Patients that received continuous positive airway pressure therapy plus conventional pulmonary physiotherapy postoperatively were at significantly less risk of developing pulmonary atelectasis after LGBP than patients that received conventional pulmonary physiotherapy postoperatively.
Continuous Positive Airway Pressure ; Gastric Bypass ; Humans ; Incidence ; Length of Stay ; Multivariate Analysis ; Pneumonia ; Postoperative Care ; Postoperative Complications ; Pulmonary Atelectasis ; Thorax

Most cystic lesions of the liver are found incidentally in imaging studies because they are not symptomatic, and generally do not require treatment. Rarely, however, symptomatic hepatic cysts may develop complications and require treatment. Here, we describe a case of a 77-year-old woman who developed biliary obstruction with abdominal pain due to compression of the bile duct by a simple hepatic cyst. We confirmed the diagnosis based on symptoms and imaging studies. The patient's symptoms improved after simple cyst ablation by sclerotherapy.
Abdominal Pain ; Aged ; Bile Ducts ; Cholestasis ; Diagnosis ; Female ; Humans ; Liver* ; Sclerotherapy

PURPOSE: The purpose of this study was to identify the attitude of nurses toward transsexuals. METHOD: The Q-methodology which provides a method of analyzing the subjectivity of each item was used. Twenty-nine nurses classified the 50 selected Q-statements into a normal distribution using a 9 point scale. The collected data was analyzed using the Quanl PC program. RESULT: Four types of attitudes toward transsexuals were identified. The first type (humanitarian acceptance) showed an attitude of respecting transsexuals as human beings and understanding and accepting their desires and difficulties. The second type (superficial understanding) understood the psychological conflicts and suffering of transsexuals but could not accept them as members of families or society. The third type (insufficient understanding) did not feel a sense of rejection toward transsexuals but showed a lack of understanding of their desires and difficulties. The fourth type (rejection) failed to understand the desires and difficulties of transsexuals and showed a sense of rejection toward them, in addition to regarding them as sexually immoral people. CONCLUSION: The results of the study indicate that different approaches of educational programs based on the four types of attitudes toward transsexuals are recommended.
Adult ; *Attitude of Health Personnel ; Demography ; Female ; Humans ; Models, Educational ; Nursing Staff/*psychology ; Q-Sort ; Questionnaires ; *Transsexualism

PURPOSE: HBV prophylaxis is necessary to prevent de novo hepatitis B infection from HBcAb positive donors. However, it is somewhat controversial in which protocol is more effective, and whether it is necessary to administer the HBV prophylaxis for HBsAb positive recipients. In this study, we attempted to elucidate whether it is necessary to administer the HBV prophylaxis for HBsAb positive patients and to evaluate the efficacy of HBIG monotherapy protocol. METHODS: From May 1996 to July 2001, 58 donors (45.3%) were HBcAb positive among 128 donors who were examined for HBcAb. Eighteen HBcAb positive grafts were transplanted to HBsAg negative recipients. Four patients died of unrelated causes were excluded. Of 14 study cases, 12 recipients were HbsAb positive, and 2 were negative. Among 12 HBsAb positive recipients, 3 were HbcAb positive simultaneously. In early period (Nov. 1997~Nov. 1998), only HBV vaccination was applied for de novo infection prophylaxis. In late period (since Dec. 1998), regardless of HBsAb positivity in recipients, HBIG was administered from the beginning of liver transplantation. RESULTS: The overall de novo HBV infection from HBcAb positive donors was 21.4 % (3/14). All 3 recipients without HBIG prophylaxis presented de novo HBV infection. Two of them were HBsAb positive postoperatively. No de novo HBV infection occurred in recipients with HBIG prophylaxis. CONCLUSION: It is necessary to administer the HBV prophylaxis even for vaccinated HBsAb positive patients and HBIG monotherapy protocol is effective to prevent de novo hepatitis B infection from HBcAb positive donors in living donor liver transplantation.
Hepatitis B Surface Antigens ; Hepatitis B* ; Hepatitis* ; Humans ; Liver Transplantation* ; Liver* ; Living Donors* ; Tissue Donors* ; Transplantation ; Transplants ; Vaccination

OBJECTIVE: The purpose of this study was to establish a minimally invasive and reproducible protocol for estimating the gastrointestinal (GI) transit time in mice using barium and radiopaque markers. MATERIALS AND METHODS: Twenty 5- to 6-week-old Balb/C female mice weighing 19-21 g were used. The animals were divided into three groups: two groups that received loperamide and a control group. The control group (n = 10) animals were administered physiological saline (1.5 mL/kg) orally. The loperamide group I (n = 10) and group II (n = 10) animals were administered 5 mg/kg and 10 mg/kg loperamide orally, respectively. Thirty minutes after receiving the saline or loperamide, the mice was administered 80 microL of barium solution and six iron balls (0.5 mm) via the mouth and the upper esophagus by gavage, respectively. Afterwards, the mice were continuously monitored with fluoroscopic imaging in order to evaluate the swallowing of the barium solution and markers. Serial fluoroscopic images were obtained at 5- or 10-min intervals until all markers had been excreted from the anal canal. For analysis, the GI transit times were subdivided into intestinal transit times (ITTs) and colon transit times (CTTs). RESULTS: The mean ITT was significantly longer in the loperamide groups than in the control group (p < 0.05). The mean ITT in loperamide group II (174.5 +/- 32.3) was significantly longer than in loperamide group I (133.2 +/- 24.2 minute) (p < 0.05). The mean CTT was significantly longer in loperamide group II than in the control group (p < 0.05). Also, no animal succumbed to death after the experimental procedure. CONCLUSION: The protocol for our study using radiopaque markers and barium is reproducible and minimally invasive in determining the GI transit time of the mouse model.
Analysis of Variance ; Animals ; Barium Sulfate/pharmacology ; Contrast Media/administration & dosage ; Female ; Fluoroscopy ; Gastrointestinal Transit/*physiology ; Iron ; Loperamide/administration & dosage ; Mice ; Mice, Inbred BALB C ; Microscopy, Electron, Scanning ; Prostheses and Implants ; Reproducibility of Results ; Sodium Chloride/administration & dosage ; Surface Properties