Objective To investigate the function of myeloid dendritic cells (mDCs) from severe aplastic anemia ( SAA ) patients in stimulating allogeneic T lymphocytes proliferation in vitro and then explore the immunopathogenesis of SAA. Methods Twenty-five SAA patients ( 15 untreated and 10 recovered after immunosuppressive therapy) and 12 normal controls were enrolled in this study. Their mature mDCs were induced from their bone marrow monocytes with recombined human interleukin-4 ( rhIL-4) , recombined human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) and recombined human tumor necrosis factor (rhTNF) in vitro. Then mDCs were co-cultured with allogeneic lymphocytes (mixture lymphocyte reaction, MLR) at a ratio of 1: 100 or 1: 50. The growth rate of lymphocyte was measured with methyl thiazolyl tetrazolium ( MTT) colorimetry.The concentrations of interleukin( IL) -12 and inlerferon -y (IFNγ) in MLR supernatant were measured with EL1SA. The correlation between the growth rate and the concentration of IL-12 or IFNγ was analyzed. Results When mDCs and lymphocytes were co-cultured at the ratio of 1: 100, the growth rates of lymphocytes stimulated with mDCs from untreated, recovered SAA patients and controls were (219. 8 ±94. 0)% , (159. 1 ±66. 0)% and (160. 1 ±91. 9)% respectively. The concentrations of IL-12 in MLR supernatant were (8. 2 ± 3. 6) ng/L, (6. 5 ± 2. 8) ng/L and (6. 1 ± 2. 6) ng/L and the concentrations of IFNγ were (21. 8 ± 8. 7) ng/L, (25. 5 ± 9. 1) ng/L and (22. 6 ± 7. 8) ng/L respectively. All of them had no statistical differences among the three groups ( P > 0. 05 ). When mDCs and lymphocytes were co-cultured at the ratio of 1: 50, the growth rate of lymphocytes stimulated with mDCs from untreated patients was (322. 1 ± 171. 1)% , which was higher than that of recovered patients [ (180. 9 ±79. 1)% and controls (192. 3 ±91. 9)% ]. The concentrations of IL-12 in MLR supernatant in the three groups were (12.6 ±4.4) ng/L, (9.4 ±3.3) ng/L and (8.5 ±3.7) ng/L, and the concentrations of IFNγ were (32. 3 + 9. 2 ) ng/L, ( 27. 4 ± 6. 5) ng/L and (24. 4 ± 7. 4 ) ng/L Both of the values in untreated cases were higher than those of the recovered cases or controls (P < 0. 05 ) , but there were no statistical difference between the recovered and control groups ( P >0. 05 ). The concentration of IL-12 in MLR supernatant correlated positively with the growth rate of lymphocyte (r=0. 529,P <0. 01) and so did the concentration of IFNγ (r = 0. 381, P < 0. 05). Conclusion The function of mDCs to stimulate T lymphocytes proliferation in SAA was enhanced; it might play an important role in the immunopathogenesis of SAA.

Humans ; Occupational Diseases ; epidemiology ; Quality Control ; Risk Assessment

OBJECTIVETo study the diagnosis and treatment of varices of the vocal cord.

METHODSThe clinical data of 21 cases with varix of vocal cord were analyzed. All the patients presented hoarseness. There were 15 female and 6 male cases with their ages ranged from 23 to 68 years (median 44 years old). The varix was found on the right vocal cord in 12 cases, on the left vocal cord in 9 cases. Isolated varix existed on the vocal cord in 10 cases, varix with vocal cord polyps or nodules in 10 cases, varix with vocal cord paralysis in 1 case.

RESULTSAll the patients were diagnosed under the laryngovideoscopy. The lesions appeared on the superior surface of the vocal cord. Varices manifested as abnormally dilated capillary running in the anterior to posterior direction in 6 cases, as clusters of capillary in 3 cases, as a dot or small sheet or short line of capillary in 12 cases. The varices were disappeared in 2 of 8 cases with vocal cord varices and polyps after removed the polyps. The varices of others patients had no change after following up for more than 6 months, but one patient happened hemorrhage of the contralateral vocal cord.

CONCLUSIONSVarices are most commonly seen in female. Laryngovideoscopy is the key in determining the vocal fold varices. Management of patients with a varix includes medical therapy, speech therapy, and occasionally surgical vaporization.

Adult ; Aged ; Female ; Humans ; Laryngoscopy ; Male ; Middle Aged ; Varicose Veins ; diagnosis ; therapy ; Vocal Cords ; blood supply ; pathology ; Young Adult

Objective To explore the relationship between obstructive sleep apnea-hypopnea syndrome (OSAHS) and hypertension.Methods There were 1149 middle aged patients who were suspected to have OSAHS underwent polysomnography (PSG) from Jan,1999 to June,2011.The age of the patients ranged from 45 to 65 years. The patients were divided into 10 groups according to sleep apnea hypopnea index (AHI),group 1:AHI ＜5; group 2:5≤AHI ＜ 15; group 3:15≤AHI ＜30; group 4:30≤AHI ＜40 ; group 5:40 ≤ AHI ＜ 50 ; group 6:50 ≤ AHI ＜ 60 ; group 7:60 ≤ AHI ＜ 70 ; group 8:70 ≤ AHI ＜ 80 ;group 9:80 ≤ AHI ＜ 90; group 10:AHI ≥90.The incidence of hypertension in each group was tested using crosstabs method.The correlation between AHI,lowest oxygen saturation (LSaO2 ),age,body mass index (BMI) and hypertension were analyzed.Results Among 1149 suspected OSAHS patients,1004 were diagnosed as OSAHS by PSG.There were positive correlation between AHI and diastolic,systolic blood pressure ( r were 0.239 and 0.305,respectively,P ＜ 0.01 ). AHI was independent risk factor of hypertension(P ＜0.001 ).No statistically significant difference in the incidence of hypertension was found among group 1 and group 2,3,group 4 and group 5,group 6 to group 10 ( x2 were 3.821,0.005 and 1.325,P ＞ 0.05,respectively).There was significant difference in the incidence of hypertension among group 4 and group 1,2,3,group 5 and group 6 ( x2 were 2.615 and 4.300,P ＜0.05,respectively).There were two cutoff points at the AHI of 30 and 50.Conclusion With OSAHS exacerbations,the incidence of hypertension was significantly increased.

OBJECTIVETo observe the clinical shapes of vocal cord polyps and their pathological features.

METHODSThe laryngoscopic photographs of 156 patients with vocal cord polyps were reviewed. All patients received phonomicrosurgery. Eighty eight males and 68 females were included. Their ages ranged from 14 to 76 years (median 43.0 years). The clinical courses of the diseases were 1 to 132 months (median 6.5 months). There were 57 cases with right vocal cord polyps, 61 cases with left vocal cord polyps, 38 cases with bilateral vocal cord polyps. The vocal cord polyps with pedicles were found in 27 cases, without pedicles in 129 cases. The specimens of the vocal cord polyps were fixed in formalin solution and embedded in paraffin. Sections were cut, stained with HE method, and observed under light microscope.

RESULTSThe vocal cord polyps were classified into 5 types according to the clinical shapes of vocal cord polyps and their pathological features: edematous type in 70 cases (44.9%), vascular type in 49 cases (31.4%), fibrous type in 15 cases (9.6%), hemorrhagic or thrombotic type in 13 cases (8.3%), and amyloid type in 9 cases (5.8%). The clinical courses among the five types of vocal cord polyps had no statistic significance (P > 0.05).

CONCLUSIONSThe classification of the vocal cord polyp according to the clinical shapes of vocal cord polyps has clinical significance for the treatment. Some vocal cord polyps of edematous type, vascular type and hemorrhagic type can be cured with voice therapy. The vocal cord polyps of fibrous type and amyloid type need treatment with phonomicrosurgery. The differentiation diagnosis between amyloid type vocal cord polyps and vocal cord carcinoma should be made.

Adolescent ; Adult ; Aged ; Female ; Humans ; Laryngeal Neoplasms ; pathology ; Laryngoscopy ; Male ; Middle Aged ; Polyps ; pathology ; Vocal Cords ; pathology ; Young Adult

Objective To evaluate the clinical efficacy of a stroke unit combined with community health services for treating stroke survivors. Methods A total of 120 stroke patients were randomly divided into a " stroke unit combined with community medicine" group ( combined group) , a stroke unit group and a general treatment group. Patients in the former 2 groups were treated in a hospital stroke unit during their hospitali-zation. The general treatment group was given conventional medical treatment. After discharge, the combined group continued to receive regular rehabilitation therapy and guidance in the form of community medical services, while the stroke unit group received follow-up only. Assessment was by means of Fugl-Meyer scores, the Barthel index and self-rating on a depression scale ( SDS). The patients were assessed at admission, on discharge and 3 months after discharge. Results There were no significant differences in average limb motor function, ability in the activities of daily living ( ADL) or depressive mood among the 3 groups on admission, but at discharge, limb motor function and ADL ability in the combined group and stroke unit groups were significantly superior to those in the general therapy group. Limb motor function and ADL ability in the combined and stroke unit groups had improved further 3 months after discharge, with more significant improvements in the combined group. No significant change in depression was observed in any group at discharge, but average depression scores in the combined and stroke unit groups improved significantly in the 3 months after discharge, and there was a statistically significant difference between the combined group and the general group. Conclusion Supplementing the work of a stroke unit with community health services significantly improves stroke patients' recovery of limb motor function and ADL ability.

Objective To evaluate the value of electronic laryngoscope for transnasalesophagoscopy.Methods The electronic laryngoscope was used for transnasal esophagoscopy in 50 patientsfrom June 2009 to June 2011.There were 32 males and 18 females with their age ranged from 16 -88 years (mean 53.8 years).Before esophagoscopy,1％ ephedrine-dicaine mixture was sprayed into the nasal and pharyngeal cavities for topical anesthesia.The esophagoscopy was used for screening examination in the patients with reflux,globus sensation,dysphagia,head and neck cancer,suspected foreign body,and vocal cord paralysis,etc.Results The transnasal esophagoscopy with electronic laryngoscope was performed successfully in all the patients.Mild nausea and vomiting occurred in 4 patients,but no patient required to stop the examination.Of the 50 patients,38 patients (76％) had normal findings and 12 patients (24％)had positive findings of the esophagus.Esophageal cancer was diagnosed in one patient,esophageal foreign body in 2 patients,esophageal injury in one patient,candidal esophagitis in 3 patients,esophagitis in 3 patients,and achalasia of the cardia in 2 patients.Conclusions The electronic laryngoscope for transnasal esophagoscopy is an alternative to conventional esophagoscopy,which is useful for screening the esophagus in the patients with reflux,globus,dysphagia,head and neck cancer,and suspected foreign body,etc.

Malignant mixed mullerian tumor (MMMT) of the uterus are uncommon tumor and highly malignant containing epithelial and stromal components which is classified as homologous or heterologous based on the nature of sarcomatous component. It is highly malignant and the prognosis is poor due to frequent metastasis and recurrence, which most patients were associated with postmenopausal status. We experienced one case of malignant mixed mullerian tumor of uterus with neuroendocrine differenciation. So we report this case with a brief review of literature.
Humans ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Uterus*

PURPOSE: Primary cutaneous anaplastic large cell lymphoma is rarely encountered in the lower eyelids. We report a patient with primary cutaneous anaplastic large cell lymphoma arising from the lower eyelid. METHODS: A 39-year-old man presented with a relatively fast growing mass on the center of his left lower eyelid for one month. The mass did not respond to local injection of triamcinolone at a local clinic. The lesion appeared as a solitary reddish nodule with ulceration, was non-tender, round, crusted, and measured 13 mm x 11 mm x 5 mm. Well- developed superficial vessels were found on the surface of the nodule. An incisional biopsy was performed. RESULTS: Histologic examination revealed that the bulk of the infiltrate was in the papillary and reticular dermis. Tumor cells had abundant, well-defined cytoplasm and pleomorphic nuclei with multiple nucleoli. The majority of the neoplastic cells showed immunoreactivity for CD 30 (Ki-1) along the cell membrane. A histopathological diagnosis of primary cutaneous anaplastic large cell lymphoma was made. CONCLUSIONS: Most cases of primary cutaneous anaplastic large cell lymphoma arise from the body and extremities. However, since primary cutaneous anaplastic large cell lymphoma may occur in the eyelid, it should be differentiated from nodular and relatively fast growing inflammatory tumors despite local steroid treatment.
Adult ; Biopsy ; Cell Membrane ; Cytoplasm ; Dermis ; Diagnosis ; Extremities ; Eyelids ; Humans ; Lymphoma, Primary Cutaneous Anaplastic Large Cell* ; Triamcinolone ; Ulcer

OBJECTIVES: Recently, Korean psychiatrists have noticed the complaints from probands and family members that private health insurance companies do not pay for most psychiatric disorders. Furthermore, probands cannot even apply for insurance because of their medical record of psychiatric disorders. Authors investigated and reviewed contracts of Korean private insurance companies to find reasons for banning psychiatric disorders from insurance policies. METHODS: Authors reviewed more than 800 contracts from 48 insurance companies. RESULTS: Among all the psychiatric diagnoses, few of them-dementia and some other organic mental disorders-are guaranteed to be paid from insurance companies. Less then 10 contracts say they pay for psychiatric illnesses. Most insurance companies have contracts prohibiting F codes ; however, there are not enough reasons in these contracts. CONCLUSIONS: In the private health insurance system, psychiatric illnesses have almost no rooms. It is very urgent to add space for patients with psychiatric illnesses and psychiatrists in the insurance policies.
Diagnosis ; Humans ; Insurance* ; Insurance, Health ; Korea* ; Medical Records ; Psychiatry