No abstract available.
Democratic People's Republic of Korea*

The pathogenesis of hepatocellular carcinoma (HCC) is a complex process. During the last decade, advances in genomic technologies enabled delineation of the genomic landscape of HCC, resulting in the identification of the common underlying molecular alterations. The tumor microenvironment, regulated by inflammatory cells, including cancer cells, stromal tissues, and the surrounding extracellular matrix, has been extensively studied using molecular data. The integration of molecular, immunological, histopathological, and clinical findings has provided clues to uncover predictive biomarkers to enhance responses to novel therapies. Herein, we provide an overview of the current HCC genomic landscape, previously identified gene signatures that are used routinely to predict prognosis, and an immune-specific class of HCC. Since biomarker-driven treatment is still an unmet need in HCC management, translation of these discoveries into clinical practice will lead to personalized therapies and improve patient care, especially in the era of targeted and immunotherapies.
Biomarkers ; Carcinoma, Hepatocellular ; Extracellular Matrix ; Humans ; Immunotherapy ; Pancreatic Pseudocyst ; Pancreatitis ; Patient Care ; Prognosis ; Stromal Cells ; Tumor Microenvironment

BACKGROUND: Although there have been many studies on the risk factors for coronary artery disease, the etiology and risk factor of coronary artery spasm has not yet been determined. The objective of this study was to examine the risk factors for coronary vasospasm through a comparison of patients with angiographically determined vasospastic angina and patients without vasospasm and normal coronary artery. METHODS: Intracoronary injection of acetylcholine in order (20microg, 50microg, 100microg) were administered to all patients (Total 81:34 males, 47 females : mean age 50 years) who had a history of chest pain with normal or near normal coronary arteriographic fingings. After documentation of vasospasm in major epicardial coronary arteries by acetylcholine (Ach)-provocated dcoronary angiography, various risk factors (smoking, hypertension, diabetes, drinking and hyperlipidemia) were compared between patients with vasospasm and patients without vaspasm. RESULTS: 24 patients showed significant luminal narrowing (> or =75%)(Vasospasm group) and 57 patients showed no significant change (Control). Vasospasm group were suffered from typical chest pain in 92% of patients but control complained typical chest pain in 51% of subjects. The sites of vasoconstriction induced by Ach were LAD (11 cases), LCX (4 cases), RCA (11 cases) and vasoconstriction occurred 2 vessels (LAD and LCx) at the same time in two cases. The amount of Ach to provocate vasoconstriction was 20~50microg (90%) and there were no difference between left and right coronary arteries. The ratio of smoker was more frequent in the vasospasm group than control (58.3% vs 30.4%, p=0.046). But total cholesterol, low density lipoprotein, high density lipoprotein, triglycerides, apolipoprotein A, apolipoprotein B, lipoprotein (a), diabetes and body mass index, drinking were not statistically significant between two groups. CONCLUSION: Smoking appears to be a major risk factor for vasospastic angina by endotheilal dysfunction without significant coronary artery narrowing. But other fisk for coronary artery disease may not contribute to coronary vasospasm.
Acetylcholine* ; Angiography ; Apolipoproteins ; Body Mass Index ; Chest Pain ; Cholesterol ; Coronary Artery Disease ; Coronary Vasospasm ; Coronary Vessels* ; Drinking ; Female ; Humans ; Hypertension ; Lipoprotein(a) ; Lipoproteins ; Male ; Phenobarbital ; Risk Factors* ; Smoke ; Smoking ; Spasm* ; Triglycerides ; Vasoconstriction

PURPOSE: This study analyzed and evaluated the demographic, clinical, and cytogenetic data [G-banded karyotyping and array-based comparative genomic hybridization (array CGH)] of patients with unexplained developmental delay or intellectual disability at a single Korean institution. MATERIALS AND METHODS: We collected clinical and cytogenetic data based on retrospective charts at Ajou University Medical Center, Suwon, Korea from April 2008 to March 2012. RESULTS: A total of 190 patients were identified. Mean age was 5.1+/-1.87 years. Array CGH yielded abnormal results in 26 of 190 patients (13.7%). Copy number losses were about two-fold more frequent than gains. A total of 61.5% of all patients had copy number losses. The most common deletion disorders included 22q11.2 deletion syndrome, 15q11.2q12 deletion and 18q deletion syndrome. Copy number gains were identified in 34.6% of patients, and common diseases among these included Potocki-Lupski syndrome, 15q11-13 duplication syndrome and duplication 22q. Abnormal karyotype with normal array CGH results was exhibited in 2.6% of patients; theses included balanced translocation (n=2), inversion (n=2) and low-level mosaicism (n=1). Facial abnormalities (p<0.001) and failure to thrive were (p<0.001) also more frequent in the group of patients with abnormal CGH findings. CONCLUSION: Array CGH is a useful diagnostic tool in clinical settings in patients with developmental delay or intellectual disability combined with facial abnormalities or failure to thrive.
Adolescent ; Adult ; Child ; Child, Preschool ; Comparative Genomic Hybridization/*methods ; Female ; Gene Dosage/genetics ; Humans ; Infant ; Intellectual Disability/*genetics ; Karyotype ; Male ; Republic of Korea ; Retrospective Studies ; Tertiary Healthcare/statistics & numerical data ; Young Adult

OBJECTIVE: To evaluate the predictive factors associated with the success of medical abortion by misoprostol monotherapy within 24 hours in the first trimester of pregnancy. METHODS: The records of 228 women with miscarriage up to 11 weeks of gestational age who underwent medical abortion by intravaginal misoprostol monotherapy were reviewed. Success of abortion was defined as complete expulsion of the conceptus without the need for surgical intervention. Outcomes of interest were success of abortion within 24 hours following administration of misoprostol. RESULTS: Among 222 women who continued the process of medical abortion for 24 hours, 209 (94.1%) had a successfully completed abortion. Multivariate logistic regression showed that serum β-human chorionic gonadotropin (β-hCG) above 40,000 mIU/mL is significantly associated with failed medical abortion within 24 hours (odds ratio [OR], 7.13; 95% confidence interval [CI], 1.60–37.32; P=0.011). The area under the receiver operating characteristic curve of β-hCG level associated with successful abortion within 24 hours was 0.705 (95% CI, 0.63–0.77; P=0.007). Previous vaginal delivery seems to be significantly associated with successful abortion within 24 hours on univariate analysis (P=0.037), but the association was lost in multivariate analysis. CONCLUSION: Misoprostol monotherapy has a high success rate for first trimester abortion. Women with serum β-hCG less than 40,000 mIU/mL are likely to achieve a successful abortion within 24 hours after intravaginal administration of misoprostol.
Abortion, Spontaneous ; Administration, Intravaginal ; Chorionic Gonadotropin ; Female ; Gestational Age ; Humans ; Logistic Models ; Misoprostol* ; Multivariate Analysis ; Pregnancy ; Pregnancy Trimester, First ; ROC Curve

OBJECTIVE: We compared the prevalence of injury and poisoning in the agricultural and fishery population with that of the general population. METHODS: The national health insurance data and agricultural and fishery qualification data were used for this study. The age-adjusted standardized morbidity ratio was used to compare the prevalence of all injuries and poisonings of the agricultural and fishery population with that of the general population for the year 2002, as well as the prevalence of certain injuries and poisonings common to the agricultural and fishery population. The age-adjusted standardized morbidity ratio and 95% confidence intervals were attained by using the general population as the standard population group. RESULTS: The age-adjusted standardized morbidity ratio of total injuries and poisonings was significantly high in the agriculture and fishery population. The standardized morbidity ratio was 137.6 in the male agriculture and fishery population and 123.3 in the female agriculture and fishery population. In terms of injuries and poisonings common to the agriculture and fishery population, the age-adjusted standardized morbidity ratio was significantly high regarding the dislocations and strains of lumbar spine/pelvis, shoulder and neck, the fracture of rib/thoracic spine/sternum and pesticide poisoning. CONCLUSIONS: The overall prevalence of injury/poisoning was significantly higher in the agriculture and fishery population than in the general population. Various forms of research should be conducted on the injuries of the agriculture and fishery population in the future. In order to compare the differences in the prevalence rates of injuries according to time and region, standard definitions of injuries and occupation related injuries are required.
Agriculture ; Dislocations ; Female ; Fisheries ; Humans ; Male ; National Health Programs ; Neck ; Occupations ; Prevalence ; Shoulder

Retrobulbar hemorrhage and permanent visual loss are rare presentations following traumatic asphyxia. In this case, bilateral permanent visual disturbance developed in a woman after chest-crushing trauma without direct trauma to the orbits. A computed tomography scan confirmed bilateral retrobulbar hemorrhages. An ophthalmologic exam revealed bilateral subconjunctival hemorrhages and severe lid edema. Despite high-dose steroid therapy, visual recovery was limited, and optic nerve atrophy developed. Ischemia of the optic nerve associated with retrobulbar hemorrhage may be postulated as one of the causes of permanent visual impairment following traumatic asphyxia.
Asphyxia/*complications/*etiology ; Female ; Humans ; Ischemia/complications ; Middle Aged ; Optic Nerve/blood supply ; Retrobulbar Hemorrhage/*complications/*etiology/radiography ; Thoracic Injuries/*complications ; Tomography, X-Ray Computed ; Vision Disorders/*etiology

Brain computed tomography (CT) is a useful tool for evaluating the pathologic findings in the brains of children with neurologic abnormalities. Brain CT investigation and the Munchner Funtionelle Entwicklungs Diagnostik (MFED) developmental assessment was performed in 88 patients with spastic cerebral palsy. The incidence of abnormal brain CT findings in patients with spastic cerebral palsy was 69.3%. The group with pathologic CT findings had a greater possibility of having developmental delay than the group with normal CT findings (p < 0.05). However, there was no significant relationship between the specific MFED categories and the types of brain CT abnormalities. Pathological CT findings could offer important prognostic information indicating a higher risk concerning the grade of developmental delay.
Adolescence ; Adult ; Atrophy ; Brain/radiography* ; Cerebral Palsy/radiography* ; Cerebral Palsy/physiopathology* ; Cerebral Palsy/complications ; Child ; Child Development/physiology* ; Developmental Disabilities/etiology ; Female ; Human ; Male ; Middle Age ; Muscle Spasticity/radiography ; Muscle Spasticity/physiopathology ; Time Factors ; Tomography, X-Ray Computed*

In vitro ethylene-diamine-tetra-acetic acid (EDTA) dependent satellitism and phagocytosis of platelets by neutrophils have been considered to be rare phenomena. It is associated with pseudothrombocytopenia, abnormal histogram of platelets and pseudoleukocytosis on complete blood cell count (CBC) by automated blood cell counter, but these findings are not found in heparinized or sodium citrated blood. It has no clinical significance such as bleeding tendency or abnormal platelet function. EDTA dependent platelet satellitosis and phagocytosis must be differentiated from true thrombocytopenia. We report a case of EDTA dependent platelet phagocytosis by neutrophils in a 68 year-old male patient who was diagnosed as mycosis fungoides. His EDTA blood smear showed frequent phagocytosis of platelets by neutrophils and occasional platelet satellitism. The bood cell counts were within normal limits without pseudothrombocytopenia. Phagocytized platelets were confirmed by immunohistochemistry using GpIIb/IIIa antibody and transmission electron micrographs.
Aged ; Blood Cell Count ; Blood Platelets* ; Cell Count ; Edetic Acid* ; Hemorrhage ; Heparin ; Humans ; Immunohistochemistry ; Male ; Mycosis Fungoides* ; Neutrophils* ; Phagocytosis* ; Sodium ; Thrombocytopenia

Bone marrow necrosis is infrequently diagnosed during life, and its presence often signifies a poor prognosis. It has been associated with a variety of disease, including acute and chronic leukemia, carcinoma, malignant lymph oma, infection and sickle cell disease. About 5-26% of acute myeloid leukemia has been reported to express lymphoid differentiation markers, of which CD7 is ex pressed very early during T-cell ontogeny. A 46-year-old male complaining severe bone pain had pancytopenia, leukoerythroblastosis and bone marrow necrosis. Peripheral blood immature cells expressed CD7 as well as myeloid markers such as CD13 and CD33 on immunophenotypic studies. We report a case of CD7 positive acute myeloid leu kemia associated with bone marrow necrosis, confirmed by bone marrow biopsy and immunophenotypic study.
Anemia, Sickle Cell ; Antigens, Differentiation ; Biopsy ; Bone Marrow* ; Humans ; Leukemia ; Leukemia, Myeloid, Acute* ; Male ; Middle Aged ; Necrosis* ; Pancytopenia ; Prognosis ; T-Lymphocytes