The improved survival rate of premature infants requiring intensive care, shows an increased risk for nosocomial infections such as disseminated fungal infection. Renal candidasis usually occurs secondary to systemic disease, and can Iead to obstructive uropathy by fungus ball. A male neonate was born in week 28 of the gestational period. His birth weight was 1200gm. He required mechanical ventilation and surfactant for respiratory distress syndrome, umbilical artery and vein catheterization, percutaneous central veneous catheterization(PCVC) for parenteral nutrition, steroid, aminophylline and broad spectrum anibiotics. Hypertension developed on the 29th hospital day, but was not controlled by diuretics and antihypertensive drugs. on the 40th hospital day, he had abdominal distension, anuria, and azotemia. A Renal ultrasonogram showed that the ureteropelvic junction of the left kidney was completely obstructed with fungus balls. A percutaneous nephrostorny tube, made in a pigtail shape by hand, was inserted under fluoroscopy guidance, and the obstruction of the pelvis was resolved by wire manipulation. Parenteral amphotericin B and oral flucytocine were started, and the left renal pelvis was directly drained and irrigated by percutaneous nephrostomy tube. Candida albicans(C. albicuns) was cultured from urine and a percutaneous central venous catheter tip. His general condition improved, and follow up urine culture revealed no fungus. On follow-up renal ultrasonogram, renal cortex echogenicity and fungus ball had disappeared except for mild left renal calyectasis and pelvic thickening. This report describes a case of obstructive uropathy by fungus ball in systemic candidiasis of prematurity, and reviews the related literature.
Aminophylline ; Amphotericin B ; Antihypertensive Agents ; Anuria ; Azotemia ; Birth Weight ; Candida ; Candidiasis ; Catheterization ; Catheters ; Central Venous Catheters ; Cross Infection ; Diuretics ; Fluoroscopy ; Follow-Up Studies ; Fungi ; Hand ; Humans ; Hypertension ; Infant, Newborn ; Infant, Premature ; Critical Care ; Kidney ; Kidney Pelvis ; Male ; Nephrostomy, Percutaneous* ; Parenteral Nutrition ; Pelvis ; Respiration, Artificial ; Survival Rate ; Ultrasonography ; Umbilical Arteries ; Veins

To overcome the difficulty of controlling stem cell fate and function in applications to regenerative medicine, a number of alternative approaches have been made. Recent reports demonstrate that a non-cellular niche modulating the biophysical microenvironment with chemical factors can support stem cell self-renewal. In our previous studies, early establishment was executed to optimize biophysical factors and it was subsequently found that the microgeometry of the extracellular matrix made huge differences in stem cell behavior and phenotype. We review here a three-dimensional, non-cellular niche designed to support stem cell self-renewal. The characteristics of stem cells under the designed system are further discussed.
Extracellular Matrix ; Phenotype ; Regenerative Medicine ; Stem Cells

Sinus of Valsalva aneurysms are rare cardiac anomalies and are usually caused by the separation of the aortic wall media from the valve ring tissue. These aneurysms frequently rupture into the low-pressure areas like the right ventricle and right atrium, rarely do they rupture into the left atrium, left ventricle, pericardial sac, or pulmonary artery. Cerebral infarction has been reported as a rare complication of unruptured sinus of Valsalva aneurysm. We experienced very rare two cases of Valsalva aneurysms of right coronary sinus dissecting into the interventricular septum in patients with cerebral infarction. In two cases these aneurysms ruptured into the left ventricle. These aneurysms were excised and the defect was closed with autopericardium. At the end of the surgical repair, coaptation was found to be insufficient and aortic valve replacement was undertaken.
Aneurysm* ; Aortic Valve ; Cerebral Infarction* ; Coronary Sinus ; Heart Atria ; Heart Ventricles ; Humans ; Pulmonary Artery ; Rupture ; Sinus of Valsalva*

The implatnation of malignant cells along the needle tract is an extremely rare complication after a percutaneous fine-needle aspiration biopsy(FNAB). However, it is very serious and may result in a change in the prognosis of lung cancer, especially in the curable early stage(T1-2,N0,M0). Recently, we experienced two cases of such complications. A 43 years old female underwent a fine needle aspiration biopsy and a right middle lobectomy with adjuvant chemotherapy due to an adenocarcinoma(T2N0M0). Two years later, a new tumor developed at the site of the needle aspiration biopsy. It had the same pathological findings as the previous lung cancer. Therefore, it was concluded to be an implantation metastasis, and she was treated successfully by a right pneumonectomy and a resection of the chest wall mall with adjuvant radiotherapy. In another case, a 62 years old man was diagnosed with squamous cell lung cancer by a fine needle aspiration biopsy and underwent a right upper lobectomy(T2N0M0) with adjuvant chemotherapy. eight months later, a protruding chest wall mass developed at the aspiration site. It showed the same pathological findings as the previous lung cancer. Consequently, a total excision of the mass with adjuvant radiotherapy was done. Two years after the second operation, although the right lung was intace a metachronous squamous cell lung cancer was found at the left lower lobe. The two patients were still alive 15 and 37 months after thenresection of the chest wall mass, respectively.
Biopsy ; Biopsy, Fine-Needle* ; Biopsy, Needle ; Chemotherapy, Adjuvant ; Female ; Humans ; Lung Neoplasms* ; Lung* ; Needles ; Neoplasm Metastasis* ; Pneumonectomy ; Prognosis ; Radiotherapy, Adjuvant ; Thoracic Wall* ; Thorax*

No abstract available.
Arteries* ; Atherectomy*

Objective: Recently, microRNA (miRNA) has been identified both as a powerful regulator involved in various biological processes through the regulation of numerous genes and as an effective biomarker for the prediction and diagnosis of various disease states. The objective of this study was to identify and validate miRNAs and their target genes involved in inflammation in placental tissue. Methods: Microarrays were utilized to obtain miRNA and gene expression profiles from placentas with or without inflammation obtained from nine normal pregnant women and 10 preterm labor patients. Quantitative real-time polymerase chain reaction and Western blots were performed to validate the miRNAs and differentially-expressed genes in the placentas with inflammation. Correlations between miRNA and target gene expression were confirmed by luciferase assays in HTR-8/SVneo cells. Results: We identified and validated miRNAs and their target genes that were differentially expressed in placentas with inflammation. We also demonstrated that several miRNAs (miR-371a-5p, miR-3065-3p, miR-519b-3p, and miR-373-3p) directly targeted their target genes (LEF1, LOX, ITGB4, and CD44). However, some miRNAs and their direct target genes showed no correlation in tissue samples. Interestingly, miR-373-3p and miR-3065-3p were markedly regulated by lipopolysaccharide (LPS) treatment, although the expression of their direct targets CD44 and LOX was not altered by LPS treatment. Conclusion These results provide candidate miRNAs and their target genes that could be used as placental biomarkers of inflammation. These candidates may be useful for further miRNA-based biomarker development.

PURPOSE: PTEN is a novel tumor suppressor gene located on chromosomal band 10q23.3. The detection of PTEN mutations in Cowden disease and in breast carcinoma cell lines suggests that PTEN may be involved in mammary carcinogenesis. Among several series of breast carcinomas, the frequency of loss of flanking markers around PTEN is approximately 30 to 40% and the somatic intragenic PTEN mutation frequency is less than 5%. METHODS: The expression of PTEN was stuided immunohistochemically studied in 41 invasive ductal carcinomas of the breast. We examined the correlation between PTEN expression and clinicopathologic factors such as age, tumor size, lymph node metastasis, histologic grade, nuclear grade, stage, as well as estrogen and progesteron receptors. RESULTS: Among the 41 infiltrating ductal carcinomas, studied 7 (17.1%) were immunohistochemically negative, and 19 (46.3%) demonstrated reduced expression. Among the clinicopathologic factors, tumor size, lymph node metastasis, high stage, and negative progesteron receptor displayed a significant relationship with the decrease of PTEN expression, however age, nuclear grade, and estrogen receptor had less of a relationship with PTEN expression. CONCLUSION: These results suggest that PTEN does play some role as a prognostic factor for carcinogenesis, but this hypothesis requires further study.
Breast Neoplasms ; Breast* ; Carcinogenesis ; Carcinoma, Ductal* ; Cell Line ; Estrogens ; Genes, Tumor Suppressor ; Hamartoma Syndrome, Multiple ; Lymph Nodes ; Mutation Rate ; Neoplasm Metastasis

BACKGROUND AND OBJECTIVE: A myocardial bridge(MB) is an anatomical arrangement in which an epicardial coronary artery becomes engulfed for a limited segment by myocardial fibers. Although it has generally been felt that most instance of bridge are benign. Recent reports have suggested that MB can be associated with evidence of myocardial ischemia, myocardial infarction, arrhythmia and sudden death. This study investigated clinical characteristics of myocardial bridge and significance of treadmill test(TMT). METHOD: Among 4317 consecutive coronary angiograms performed from November 1995 to June 1999, 52 patients had a myocardial bridge. For the patients with MB, the clinical data, coronary angiography and the results of treadmill tests were reviewed. RESULT: The overall prevalence of myocardial bridge was 1.22%. Stable angina, atypical chest pain, variant angina, AMI were 33(63%), 15(29%), 2(4%), 2(%) cases, respectively. Electrocardiographic finding were normal in 31 cases(59%), ST-T change in 20 cases(38%), OMI in 1 case(3%). Mean systolic stenosis of MB was 54%, Mean length of segment of MB was 11.96 4.96mm and all patients had MBs of left anterior descending(LAD) coronary artery. Among 23 cases which had been performed TMT, 17 were positive(77%). There was no significant statistical difference between TMT(+) and TMT(-) in clinical characteristic and coronary angiographic data. We divided the patients with MB into two groups [group I(34 cases): systolic compression < 50%(mean 35.1 10.7%), group II(18 cases): systolic compression 50%(mean 63.6 14.7%)] and there were no statistical difference in clinical characteristics, TMT and angiographic data. CONCLUSION: The patients with MB present variable clinical characteristics of stable angina, atypical chest pain, variant angina, acute myocardial infarction. There is no relationship between the degree of systolic compression and TMT positive in MB. We think that symptoms of MB are not developed only by mechanical compression but concerned with other variable mechanism.
Angina, Stable ; Arrhythmias, Cardiac ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Death, Sudden ; Electrocardiography ; Exercise Test ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Prevalence

PURPOSE: To determine methods tried in clinical trials to reduce the progression of myopia in children, and spectacle prescribing patterns of hospital ophthalmologists. METHODS: A multi-sectioned survey composed of Likert items relating to the methods of reducing myopia progression (orthokeratology lenses [O-K lenses], undercorrected glasses, and topical atropine) and the patterns of prescribing spectacles for children (including two cases involving a 5-year-old girl and an 8-year-old boy) were distributed to members of the Korean Ophthalmological Society, and the collected data was statistically analyzed. RESULTS: A total of 78 out of 130 ophthalmologists returned the survey. On a scale of 1 to 5, the mean rates of whether the ophthalmologists think O-K lenses arrest myopia progression, and whether they recommend their patients to wear O-K lenses if indicative, were 3.06 and 2.75, respectively. Moreover, the mean rates of whether they consider that wearing glasses which are undercorrected would slow down the progression of the myopia, or if they think topical atropine helps in arresting myopia progression in children, were 2.34 and 1.27, respectively. In response to the case studies, the majority of practitioners preferred to prescribe the full amount found in cycloplegic refraction to pediatric patients with myopia. CONCLUSIONS: Ophthalmologists in clinical practice encouraged children to wear O-K lenses more than undercorrected glasses as a way to retard myopia progression. However, the application of atropine is rarely tried in clinical trials. In managing pediatric patients with myopia (case specific), the majority of the practitioners chose to prescribe glasses with full cycloplegic correction.
Atropine/administration & dosage ; Child ; Child, Preschool ; Data Collection ; Disease Progression ; Eyeglasses/classification/*utilization ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Myopia/physiopathology/*prevention & control ; Physician's Practice Patterns ; Prescriptions/*statistics & numerical data ; Republic of Korea

PURPOSE: PTEN is a novel tumor suppressor gene located on chromosomal band 10q23.3. The detection of PTEN mutations in Cowden disease and in breast carcinoma cell lines suggests that PTEN may be involved in mammary carcinogenesis. Among several series of breast carcinomas, the frequency of loss of flanking markers around PTEN is approximately 30 to 40% and the somatic intragenic PTEN mutation frequency is less than 5%. METHODS: The expression of PTEN was stuided immunohistochemically studied in 41 invasive ductal carcinomas of the breast. We examined the correlation between PTEN expression and clinicopathologic factors such as age, tumor size, lymph node metastasis, histologic grade, nuclear grade, stage, as well as estrogen and progesteron receptors. RESULTS: Among the 41 infiltrating ductal carcinomas, studied 7 (17.1%) were immunohistochemically negative, and 19 (46.3%) demonstrated reduced expression. Among the clinicopathologic factors, tumor size, lymph node metastasis, high stage, and negative progesteron receptor displayed a significant relationship with the decrease of PTEN expression, however age, nuclear grade, and estrogen receptor had less of a relationship with PTEN expression. CONCLUSION: These results suggest that PTEN does play some role as a prognostic factor for carcinogenesis, but this hypothesis requires further study.
Breast Neoplasms ; Breast* ; Carcinogenesis ; Carcinoma, Ductal* ; Cell Line ; Estrogens ; Genes, Tumor Suppressor ; Hamartoma Syndrome, Multiple ; Lymph Nodes ; Mutation Rate ; Neoplasm Metastasis