Microscopic polyangiitis is a systemic small-vessel vasculitis, which may involve multiple organs, but cardiac involvement is relatively rare. We report a case of microscopic polyangiitis with multiple organ involvement, in which myocardial infarction was the early manifestation of the disease. A 53-year-old man presented with sudden papulovesicular eruptions and swellings on the face, posterior neck, dorsa of both hands and fingers, and with diffuse erythematous patches on the back. He had suffered from renal dysfunction, arthralgia, and hypertension for more than 8 years. He had been admitted to the department of cardiology for acute myocardial infarction and had suffered from recurrent gastrointestinal bleeding, renal failure, acute pancreatitis and sepsis during the admission. Histopathologically, small-vessel leukocytoclastic vasculitis with out granuloma was seen. Direct immunofluorescence showed no immune deposite. A high serum level of P-ANCA was detected by ELISA.
Acute Kidney Injury ; Antibodies, Antineutrophil Cytoplasmic ; Arthralgia ; Cardiology ; Enzyme-Linked Immunosorbent Assay ; Fingers ; Fluorescent Antibody Technique, Direct ; Granuloma ; Hand ; Hemorrhage ; Humans ; Hypertension ; Microscopic Polyangiitis* ; Middle Aged ; Myocardial Infarction* ; Neck ; Pancreatitis ; Sepsis ; Vasculitis

No abstract available.
Leukemia*

STUDY DESIGN: A retrospective study. PURPOSE: To evaluate the prevalence and risk factors of asymptomatic cervical or thoracic lesions in elderly patients who have undergone surgery for lumbar spinal stenosis. OVERVIEW OF LITERATURE: Concurrent multiple spinal lesions have been reported in many studies with a varied prevalence, and described the characteristics of the disease and its treatment options. However, the cervical or thoracic lesions without apparent symptoms in patients with symptomatic lumbar stenosis had not been evaluated. METHODS: A total of 101 elderly patients (aged 65 or more), who had undergone surgery for lumbar spinal stenosis from January 2005 to December 2005, were enrolled in this study. All patients underwent lumbar magnetic resonance imaging (MRI) along with T2-weighted cervical and thoracic sagittal MRI prior to surgery. The concurrent cervical or thoracic lesions were classified according to the disease entity, and the severity of the lesions was graded from grade 0 (no lesion) to grade 4 (any lesion compressing the cord with a signal change). The prevalence of concurrent cervical and thoracic lesions was then analyzed. In addition, the risk factors for the development of concurrent lesions were evaluated, and the risk factors affecting the severity of the concurrent lesion were analyzed individually. RESULTS: Seventy-seven (76.2%) and 30 (29.7%) patients had a concurrent cervical and thoracic lesion, respectively. Twenty-six patients (25.7%) had both a cervical and thoracic lesion. There was a positive correlation between the symptom duration of lumbar stenosis and the prevalence of both cervical (p = 0.044) and thoracic (p = 0.022) lesions. CONCLUSIONS: The incidence of asymptomatic cervical or thoracic lesions is apparently high in elderly patients who have undergone surgery for lumbar spinal stenosis, particularly in those with longer symptom duration. This highlights the need for a preoperative evaluation of the cervical and thoracic spine in these patients.
Aged ; Constriction, Pathologic ; Humans ; Incidence ; Magnetic Resonance Imaging ; Prevalence ; Retrospective Studies ; Risk Factors ; Spinal Stenosis ; Spine

PURPOSE: The purpose of this study was to construct a fetal animal model of congenital diaphragmatic hernia in a lamb under domestic environments. METHODS: Left-sided diaphragmatic hernias were created in seven fetal lambs at about 85 days' gestation (experimental group). Three other fetal lambs did not receive any surgical procedure and served as control group. Four of these lambs (3 in the experimental group and 1 in the control group) were delivered after a sufficient intrauterine period. The morphological changes of lung development were compared between the two groups. RESULTS: Creation of diaphragmatic hernia resulted in marked hypoplasia in fetal lung development. In this experiment, the maternal mortality was 33.3%, and the fetal mortality was 60% which are relatively high as compared with previous reports. CONCLUSION: From this data, the authors concluded that experimental fetal diaphragmatic hernia can be established although the technique for the measurement of gestational age, anesthesia and postoperative care should be improved to overcome domestic inexperience in using the lamb as an experimental animal.
Anesthesia ; Animals ; Fetal Mortality ; Gestational Age ; Hernia, Diaphragmatic* ; Lung ; Maternal Mortality ; Models, Animal ; Postoperative Care ; Pregnancy

PURPOSE: Madl protein is known to directly repress Myc target genes and antagonize Myc function. Consequently, Madl is considered to function as a tumor suppressor. We undertook this study to investigate the regulatory effect of Madl on cancer progression in human breast cancer. MATERIALS AND METHODS: We performed immunohistochemical assay for Madl protein together with Myc in human breast cancer as well as tissues from normal and benign diseases. The protein assay data were evaluated together with clinical and biologic parameters of the patients. RESULTS: Of 66 patients with invasive ductal cancer, Madl expression was detected in 22 patients (33.3%) with breast cancer. Intensity and area of Madl expression significantly decreased in DCIS and invasive cancers, while high levels of Madl expression were persistent in benign breast lesions. Madl expression was significantly reduced in poorly differentiated tumors (p=0.0002). Expression of Madl was not associated with size of the tumors, lymph node status, and stage of the disease. We could not observe any correlation between S-phase and expression status of Myc or Madl. Madl expression was closely linked to differentiation of the cancer cells and inversely correlated with Myc expression (p=0.042). In survival analysis, Madl possessed a prognostic significance in predicting recurrence of the disease but not overall survival after CMF chemotherapy. CONCLUSIONS: In human breast cancer cells, expression of Madl seems to be downregulated while expression of Myc is amplified. Altered expression of Mad1 may play a role in malignant transformation of human mammary epithelial cells and represent an aggressive phenotype in human breast cancer.
Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Drug Therapy ; Epithelial Cells ; Genes, myc ; Humans* ; Lymph Nodes ; Phenotype ; Recurrence

While anomalies of the pancreaticobiliary system are not uncommon, drainage of the common bile duct into the bulb of the duodenum has rarely been reported. The awareness of ectopic drainage of the CBD is stressed to prevent surgical damage and improve medical management in this area. We reported one case of anomalous drainage of the CBD and pancreatic duct associated with nonvisible gallbladder or agenesis of gallbladder and cystic duct diagnosed by ERCP, ultrasonography and upper abdominal CT.
Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Cystic Duct ; Drainage* ; Duodenum ; Gallbladder ; Pancreatic Ducts* ; Tomography, X-Ray Computed ; Ultrasonography

While anomalies of the pancreaticobiliary system are not uncommon, drainage of the common bile duct into the bulb of the duodenum has rarely been reported. The awareness of ectopic drainage of the CBD is stressed to prevent surgical damage and improve medical management in this area. We reported one case of anomalous drainage of the CBD and pancreatic duct associated with nonvisible gallbladder or agenesis of gallbladder and cystic duct diagnosed by ERCP, ultrasonography and upper abdominal CT.
Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Cystic Duct ; Drainage* ; Duodenum ; Gallbladder ; Pancreatic Ducts* ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND: Cyclin D1 is known to be a key regulator in the G1 to S transition of the cell cycle in numerous cases of human neoplasia. We performed immunohistochemical assay (IHC) for cyclin D1 expression in 67 breast cancer tissues to investigate its prognostic implication in breast cancer. METHODS: Protein data for cyclin D1 expression obtained by IHC were merged with the clinical and the biological parameters of the patients, and the recurrence and the survival of the patients were analyzed according to the expression status of cyclin D1. RESULTS: Of 67 breast cancers, 16 cases (23.9%) showed strong expression of cyclin D1 protein. Cyclin D1 expression was significantly increased in larger tumors (p=0.025) but there was no evident correlation between cyclin D1 expression and the clinical and the biological parameters of the studied patients. Although cyclin D1 is a cell cycle regulator essential for the G1 to S transition of the cell cycle, we could not identify any correlation between cyclin D1 expression and the S-phase or the G0/G1 fraction measured by flow cytometry. In the survival analyses, patients with increased expression of cyclin D1 protein had an increased incidence of recurrence and poorer survival than other patients. However, the difference was not statistically significant. CONCLUSIONS: Increased expression of cyclin D1 protein was present in a certain proportion of breast cancer. Overexpression of cyclin D1 seemed to play a role in carcinogenesis and tumor growth. However, the clinical utility of cyclin D1 as a prognostic indicator in breast cancer patients have to be defined further by prospective studies with larger sample sizes.
Breast Neoplasms* ; Breast* ; Carcinogenesis ; Cell Cycle ; Cyclin D1* ; Cyclins* ; Flow Cytometry ; Humans ; Incidence ; Prognosis* ; Recurrence ; Sample Size

Background: The purpose of this study was to utilize text network analysis and topic modeling to identify interconnectedrelationships among keywords present in patent information related to oral health, and subsequently extract latent topics and visualize them. By examining key keywords and specific subjects, this study sought to comprehend the technological trends in oral health-related innovations. Furthermore, it aims to serve as foundational material, suggesting directions for technological advancement in dentistry and dental hygiene. Methods: The data utilized in this study consisted of information registered over a 20-year period until July 31st, 2023, obtainedfrom the patent information retrieval service, KIPRIS. A total of 6,865 patent titles related to keywords, such as “dentistry,” “teeth,” and “oral health,” were collected through the searches. The research tools included a custom-designed program coded specifically for the research objectives based on Python 3.10. This program was used for keyword frequency analysis, semantic network analysis, and implementation of Latent Dirichlet Allocation for topic modeling. Results: Upon analyzing the centrality of connections among the top 50 frequently occurring words, “method,” “tooth,” and “manufacturing” displayed the highest centrality, while “active ingredient” had the lowest. Regarding topic modeling outcomes, the “implant” topic constituted the largest share at 22.0%, while topics concerning “devices and materials for oral health” and “toothbrushes and oral care” exhibited the lowest proportions at 5.5% each. Conclusion Technologies concerning methods and implants are continually being researched in patents related to oral health, while there is comparatively less technological development in devices and materials for oral health. This study is expected to be a valuable resource for uncovering potential themes from a large volume of patent titles and suggesting research directions.

PURPOSE: To evaluate the clinical impact of the altered expression of cell cycle regulators in stage I and II breast cancers. MATERIALS AND METHODS: The interaction between cyclin D1/E and p27Kip1 expressions were analyzed using tissue microarray (TMA) technology in 133 breast cancers. Data from the immunohistochemical assays of 3 molecules were merged, and analyzed, with a Ki67 labeling index of the same tumors. RESULTS: Cyclin D1 was expressed in 72 breast carcinomas (54.1%) and cyclin E in 60 (45.1%) out of the 133 breast carcinomas. Expressions of cyclin D1 and cyclin E were inversely related to each other, and significantly associated with the estrogen receptor (ER) expression and differentiation of the breast carcinoma. The expression of cyclin E was significantly decreased in tumors expressing cyclin D1 (p=0.022). There was a trend for cyclin D1 expression to increase in tumors expressing p27Kip1 (p=0.053), but the expression of cyclin E did not correlate with p27Kip1 expression. The Ki67 labeling index was markedly increased in tumors expressing cyclin E, whereas it was significantly decreased in the cyclin D1 or p27Kip1 expressing-tumors. From survival analysis, cyclin E expression was the only significant variable for the prediction of poor survival. CONCLUSION: The abnormal expressions of cell cycle regulatory molecules are prevalent, and interrelated with each other in breast cancer. Integration of TMA technology allowed a high-throughput analysis for correlating molecular the in situ findings, with the clinico-pathologic information. Among the three molecules studied, the cyclin E had a prognostic implication for stage I and II breast cancer.
Breast Neoplasms* ; Breast* ; Cell Cycle ; Cyclin D1* ; Cyclin E* ; Cyclins* ; Estrogens ; Prognosis