PURPOSE: Promoter methylation provides an alternative pathway for the loss of tumor suppressor gene functions. This epigenetic change is a new marker for human cancers. We herein investigated the aberrant methylation profile of bladder cancer to identify the epigenetic markers that are useful for the diagnosis of bladder cancer. MATERIALS AND METHODS: Gene promoter methylation was analyzed in 50 bladder transitional cell cancer (TCC) tissues and 30 nonmalignant bladder mucosal tissues including 21 tissue samples with normal histology and 9 tissue samples with inflammation. The methylation status of 13 tumor suppressor genes was analyzed by methylation specific polymerase chain reaction and bisulfite genomic sequencing. The methylation frequency and methylation index were comparatively analyzed in each group of tissues. RESULTS: Bladder TCC showed a high frequency of promoter hypermethylation for RASSF1A(62.0%), RARbeta2(54.0%), E-cadherin(48.0%), p16INK4A(46.0%), p14ARF(34.0%) and H-cadherin(32.0%), whereas, methylation was less common for MGMT(18.0%), DAPK(14.0%) and p15INK4B(10.0%), and methylation was rare for GSTP1(4.0%), FHIT(2.0%), APC(2.0%) and MLH1(2.0%). Benign bladder mucosa rarely showed aberrant methylation except for E-cadherin (10.0%) and RARbeta2(10.0%). The methylation index of bladder TCC(0.25) was significantly higher than that of the benign bladder mucosal tissues(0.03, p<0.01). Remarkably, all of the bladder cancer tissues showed aberrant methylation of at least one of 6 genes including RASSF1A, RARbeta2, p16INK4A, p14ARF, E-cadherin and H-cadherin, whereas only 5 of 30 (16.7%) benign bladder mucosa tissues showed the same findings. CONCLUSIONS: Aberrant promoter methylation of tumor suppressor genes may be a critical step in the development of bladder TCC. Aberrant promoter methylations of RASSF1A, RARbeta2, p16INK4A, p14ARF, E-cadherin and H-cadherin may be promising epigenetic markers for the diagnosis and follow up of bladder cancer.
Cadherins ; Diagnosis ; Epigenomics* ; Follow-Up Studies ; Genes, Tumor Suppressor ; Humans ; Inflammation ; Methylation ; Mucous Membrane ; Polymerase Chain Reaction ; Tumor Suppressor Protein p14ARF ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: The purpose of this study is to find out the risk factors of sepsis except the prematurity itself. METHODS: Seventy-seven premature infants less than 37 weeks of gestation, who were admitted to the neonatal intensive care unit of Hanyang University Kuri Hospital between July 1995 and December 1996, were enrolled in this study. All 77 premature infants, 14 patients proven to have sepsis by blood culture. They were matched with 24 controls by gestational age and date of birth. The risk factors for neonatal sepsis between the groups were compared. RESULTS: Fourteen of 77 subjects(18.2%) had culture-proven sepsis. Among them, all but one, who had confirmed sepsis on the first day of life, were late-onset >72 hours of age(16+/-6 days of life). Gestational age and birth weight of sepsis group(mean+/-SD) were similar to those of controls: 31.6+/-3.6 week vs 31.5+/-3.3 weeks; 1673+/-832g vs 1651+/-513g, and survival rate was also similar between the two groups(n=ll, 79% for sepsis group vs n=20, 77% for the control). In the analyses of risk factors of sepsis only parenteral nutrition and duration of parenteral nutrition were significantly more frequent and longer in the sepsis group compared to the control(n=8, 73% vs n=6, 30%, P=0.022; 20+/-15 days vs 7+/-4 days, P=0.0364). CONCLUSION: Incidence of neonatal sepsis in premature infants <37 weeks of gestaton admitted to neonatal intensive care unit was 18.2%. Ninty-three pevcent of the infants was late-onset sepsis. Sepsis group had more frequent use and longer duration of parenteral nutrition. In order to reduce neonatal sepsis in premature infants, use and duration of paventeral nutrition should be restricted.
Birth Weight ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal* ; Parenteral Nutrition ; Parturition ; Pregnancy ; Risk Factors* ; Sepsis* ; Survival Rate

Choanal atresia is the congenital failure of one or both posterior nasal apertures to communicate with the nasopharynx. Coexisting congenital anomalies are 20% to 50% of patients. Bilateral choanal atresia almost always presents respiratory distress, sucking difficulty and cyanosis relieved by crying in the newborn. Bilateral choanal atresia in newborns and infants carries significant morbidity and mortality, therefore, prompt correction is required. Athelia is the absence of the nipple-areola complex. It is a rare entity that can be either congenital or acquired. Congenital athelia is always associated with amastia and a syndrome. We report a case of choanal atresia associated athelia, in term baby.
Choanal Atresia* ; Crying ; Cyanosis ; Humans ; Infant ; Infant, Newborn* ; Mortality ; Nasopharynx

PURPOSE: An understanding of the immunological process is required if primary prevention of atopic diseases is to be developed in early childhood. But, it is too hard to distinguish atopy from nonatopy under the age of two clinically, because the expression of phenotype and cytokines is vague in early childhood. We evaluated DNA methylation changes at Th2 interleukin-4 gene in peripheral blood from atopic children. METHODS: We selected 15 allergic children (mild: eight, moderate to severe: seven) and seven normal controls by using family allergy scores and clinical histories. We measured Total IgE and Der f II specific IgE levels and cultured peripheral blood mononuclear cells with Der f II stimulation and extracted DNA from Der f II specific T cells. We examined the change of CpG methylation in DNA from atopic and nonatopic children. RESULTS: In T cells from normal children, IL-4 DNA were predominantly methylated; otherwise, CpG demethylation occurred in Der f II specific T cells from allergic children. CONCLUSION: IL-4 DNA methylation changes occurred in T genes from allergic children and DNA methylation assay in early childhood.
Child* ; Cytokines ; DNA Methylation* ; DNA* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Interleukin-4* ; Methylation ; Phenotype ; Primary Prevention ; T-Lymphocytes

PURPOSE:Many patients with atopic dermatitis have shown different responses to treatment or different prognosis dependenting on the kinds of offending allergens. We attempted to evaluate the difference of mechanism in allergic inflammation between food allergens and aeroallergens by measuring chemokines, including TARC (Thymus and activation regulated chemokine), MDC (Marcrophage-derived chemokine), IL-18, CCL-28 (Chemokine receptor ligand-28) and ECP (Eosinophil cationic protein), and to investigate the correlation between the clinical severity and chemokine levels induced by food allergens and aeroallergens in atopic dermatitis. METHODS:Sixty-seven children with atopic dermatitis (39 males and 28 females) were recruited. Thirteen nonatopic children without atopic dermatitis (6 males and 7 females) were selected as controls. RESULTS:We obtained SCORAD index cut-off points that were similar to those established by clinical criteria. Comparisons between the groups of mild, moderate and severe atopic dermatitis revealed significant differences in serum total IgE and ECP levels. SCORAD index significantly correlated with total IgE, TARC, MDC and ECP levels. Serum IgE levels correlated with TARC and ECP. SCORAD index and total IgE strongly correlated to HDM. While IL-18, TARC, MDC and ECP levels strongly correlated to egg white and milk. In soybean, IgE and TARC and ECP levels significantly correlated with specific IgE levels. CONCLUSION:TARC, MDC and ECP might play a crucial role in the chronic inflammatory process of food-specific atopic dermatitis. In contrast, IgE-mediated mechanisms might have implications for HDM, when compared with food specific atopic dermatitis. These results suggest that pathogenic mechanisms of atopic dermatitis might be different according to relevant allergens.
Allergens* ; Chemokine CCL17 ; Chemokines* ; Child ; Dermatitis, Atopic* ; Egg White ; Eosinophil Cationic Protein ; Humans ; Immunoglobulin E ; Inflammation ; Interleukin-18 ; Male ; Milk ; Prognosis ; Soybeans

PURPOSE: This study aimed to characterize the autonomic and chaotic control of heart rate and circadian rhythm in asymptomatic patients with postoperative tetralogy of Fallot (pTOF). METHODS: Twenty-four-hour electrocardiogram recordings were obtained in 30 asymptomatic pTOF patients and in 30 age-and sex-matched controls, aged between 6 and 11 years. The data was digitized and partitioned into sections of 30- minute'durations. For each section, time-domain and frequency-domain measures (low- and high- frequency component) of heart rate variability and three measures based on chaotic dynamics- approximate entropy, correlation dimension and Lyapunov exponent-were calculated. RESULTS: In pTOF patients, 24-hour mean values of the time domain measures, high-frequency component, and all chaotic measures were significantly lower, while 24-hour mean value and all 6-hour mean values of the low-frequency component were significantly higher; all 6- hour mean values of high-frequency component, except from 6am to midday, were significantly lower. In pTOF patients, all 6-hour mean values of all three chaotic measures were significantly lower. In pTOF patients, the day- night circadian variation seen in controls was diminished (time- domain measures) or absent (low- and high- frequency component). CONCLUSION: Even in asymptomatic patients with pTOF, who are thought to be at minimal risk of fatal arrhythmia, a sustained increase in sympathetic activity and decrease in vagal activity, abnormal circadian rhythm of the autonomic activity, and decreased cardiac chaos were found. When other arrhythminogenic risk factors are superimposed, these abnormalities may contribute to the development of fatal arrhythmia and sudden death.
Arrhythmias, Cardiac ; Child* ; Circadian Rhythm* ; Death, Sudden ; Electrocardiography ; Entropy ; Heart Rate ; Humans ; Risk Factors ; Tetralogy of Fallot*

PURPOSE: We hypothesized that phototherapy, if the total serum bilirubin (TSB) is > or = 14mg/dl, would decrease not only in frequency and duration, but complications due to phototherapy, such as weight loss, rash, temperature instability, feeding intolerance, and diarrhea, would decrease when compared to phototherapy TSB > or = 10mg/dl after 48 hours of life in healthy term newborns without hemolysis. METHODS: Forty healthy newborns born by cesarean section in Hanyang University Kuri Hospital from February, 1996 and March, 1996 were enrolled and randomly divided into two groups according to different guidelines of phototherapy after 48 hours of age; study group, phototherapy TSB > or = 14mg/dl and control group, phototherapy TSB > or = 10mg/dl. TSB and body weight were measured every 24 hours from 48 hours of life to 144 hours of life. Exclusion criteria included a positive Coombs test and any pathologic conditions. RESULTS: Eventually, 17 cases were enrolled to the study group and 16 cases to the controls. Ninety-four percent of all newborns were TSB > or = 7mg/dl and 82% TSB > or = 10mg/dl. Among the newborns who reached TSB > or = 10mg/dl, 44% of them were at 48 hours of life. Phototherapy was given in the study group less frequently and shorter than in the controls (6% vs. 82%, P<0.001; 22 hours vs. 70 +/- 49 hours, P=unaccountable). TSB (mean +/- SD, mg/dl) at 120 and 144 hours of life among the newborns who reached TSB > or = 10mg/dl were significant higher in the study group compared to the controls (11.4 +/- 1.4 vs 10.1 +/- 1.7 P=0.046; 11.2 +/- 0.7 vs 8.5 +/- 2.8, P=0.028, respectivelyy). There were no significant differences in complications of phototherapy in two groups. CONCLUSION: Phototherapy if TSB > or = 14mg/dl after 48 hours of life in healty term newborns without hemolysis decreased frequency and duration of phototherapy without any risk of kernicterus compared to phototherapy if if was at TSB > or = 10mg/dl.h
Bilirubin ; Body Weight ; Cesarean Section ; Coombs Test ; Diarrhea ; Exanthema ; Female ; Hemolysis ; Humans ; Infant, Newborn ; Infant, Newborn* ; Jaundice ; Jaundice, Neonatal* ; Kernicterus ; Phototherapy* ; Pregnancy ; Weight Loss

No abstract available.
Fetus* ; Heart Rate* ; Heart*

PURPOSE: Reports of neurologic abnormalities associated with acute diarrhea are increasing recently. It was reported that the incidence of the neurologic abnormalities related to gastroenteritis was higher in rotavirus gastroenteritis than in non-rotavirus gastroenteritis. We investigated the incidence, the manifestations and the prognosis of the neurologic abnormalities associated with rotavirus diarrhea and non-rotavirus diarrhea in Korean children. METHODS: Six hundred forty-nine children who showed acute diarrhea and whose stools were examined for rotavirus were enrolled and categorized into the rotavirus positive group(n=186) and the negative group(n=463). The medical records were reviewed retrospectively for neurologic manifestations, diagnoses and the status of follow-up. RESULTS:The incidence of neurologic abnormalities in all children with diarrhea was 9.4%. Neurologic abnormalities associated with diarrhea were more common in the rotavirus positive group than in the rotavirus negative group(16.1% vs 6.7%, P=0.0002). The neurologic diagnoses of the children ranged from simple febrile convulsion to encephalitis. The rate of patients presenting neurologic abnormalities other than seizures was relatively higher in the rotavirus positive group than in the rotavirus negative group(56.7% vs 25.8%, P=0.01). All children with neurologic abnormalities showed complete recovery. CONCLUSION: The incidence of neurologic abnormalities among patients with diarrhea was about 9%. The neurologic diagnoses in patients who showed neurologic abnormalities were diversed. In rotavirus gastroenterits, the rate of patients presenting neurologic abnormalities other than seizure was higher than in non-rotavirus gastroenteritis. The outcome of the children who showed neurologic abnormalities with diarrhea was excellent.
Child ; Diagnosis ; Diarrhea ; Encephalitis ; Follow-Up Studies ; Gastroenteritis* ; Humans ; Incidence ; Medical Records ; Neurologic Manifestations ; Prognosis ; Retrospective Studies ; Rotavirus* ; Seizures ; Seizures, Febrile

The Jarcho-Levin syndrome is a rare genetic disorder characterized by a short neck, short trunk, and a constricted thorax, and is due to multiple vertebral and rib defects. The small size of the thorax frequently leads to respiratory insufficiency and death in neonates or infants. This syndrome also combines with various kinds of anomalies, especially renal anomalies. We report an infant with Jarcho-Levin syndrome combined with fusion of both kidneys who was referred from a local obstetric clinic for cyanosis and respiratory difficulty.
Abnormalities, Multiple ; Cyanosis ; Heart Defects, Congenital ; Hernia, Diaphragmatic ; Humans ; Infant ; Infant, Newborn ; Kidney ; Neck ; Respiratory Insufficiency ; Ribs ; Thorax