Intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) are weakly expressed in normal glomerular cells and vascular endothelial cells, but not in tubules. Granzyme B is a cytotoxic granule present in activated cytotoxic T cells and natural killer cells. To determine the effect of ICAM-1 and VCAM-1 expression and granzyme B-positive cells on histologic grade of rejection, we performed the immunohistochemical study on 19 renal biopsy specimens and one nephrectomy specimen from 14 patients with acute renal allograft rejection using monoclonal antibodies against theses proteins. According to severity of rejection based on Banff classification, three biopsies were classified as borderline, 4 grade I, 12 grade II, and 1 grade III. In all the cases with acute rejection, ICAM-1 and VCAM-1 were expressed in the tubular epithelial cells. The numerical score of ICAM-1 in the tubular epithelial cells was 1.0 in borderline cases, 1.3 0.4 in grade I cases, 2.2 0.8 in grade II cases, and 3.0 in grade III case. The staining intensity of ICAM-1 in the tubular epithelial cells was increased in accordance with histologic rejection grade (P<0.05). The staining intensity of ICAM-1 and VCAM-1 in the renal tubular epithelial cells was increased in accordance with the number of T lymphocytes in the renal parenchyme (r=0.46; P<0.05, r=0.61; P<0.01). The number of granzyme B-positive cells was 6.4 1.6/HPF in borderline cases, 8.1 2.5 in grade I cases, 19.6 11.7 in grade II cases, and 53 in grade III case. The number of T lymphocytes and granzyme B-positive cells was also increased in accordance with histologic rejection grade (P<0.05). These results suggest that ICAM-1 and granzyme B-positive cells may play an important role in the induction of renal allograft rejection and that the grading of severity of these parameters may be useful to predict the prognosis of renal allograft.
Allografts* ; Antibodies, Monoclonal ; Biopsy ; Classification ; Endothelial Cells ; Epithelial Cells ; Granzymes* ; Humans ; Intercellular Adhesion Molecule-1 ; Killer Cells, Natural ; Nephrectomy ; Prognosis ; T-Lymphocytes ; Vascular Cell Adhesion Molecule-1

Infantile fibrosarcoma is a rare malignant soft tissue tumor occurring especially in newborn and young children under 2 years. We experienced three cases of infantile fibrosarcoma presenting in the neonatal period. Case 1 presented with a multiseptated cystic mass on his left thigh at birth that was diagnosed as lymphangioma. After picibanil injection, we noted the size of the mass doubled and a solid lesion was prominent in the magnetic resonance image. Case 2 was found to have a reddish mass on his lower back mimicking hemangioma. Over 2 weeks, the mass grew rapidly with internal hemorrhaging. Case 3 was noted to have an encircling mass around the splenic flexure, which developed into congenital bowel obstruction. All of the tumors were resected completely, but microscopic resection margin was not clear in two patients. The two patients received adjuvant chemotherapy and all patients are well without evidence of recurrence.
Chemotherapy, Adjuvant ; Child ; Colon, Transverse ; Fibrosarcoma ; Hemangioma ; Humans ; Infant, Newborn ; Lymphangioma ; Magnetic Resonance Spectroscopy ; Parturition ; Picibanil ; Recurrence ; Thigh

Glomerulosclerosis represents a pathological hallmark of progressive glomerular injury. Mesangial cell proliferation and accumulation of extracellular matrix (ECM) proteins in the mesangial area frequently precede the formation of glomerulosclerosis. To understand the role of platelet-derived growth factor (PDGF) and ECM in the development of glomerulosclerosis, we examined the expression of type IV collagen, laminin, fibronectin, and PDGF in 45 renal biopsies diagnosed with IgA nephropathy (IgAN) using a standard peroxidase antiperoxidase (PAP) technique. Normal control specimens were obtained from four nephrectomy specimens diagnosed with renal cell carcinoma. As compared with normal controls, type IV collagen increased in 68%, fibronectin in 73%, laminin in 51%, and PDGF in 36% of patients with IgA nephropathy. The staining intensity of PDGF, type IV collagen, and fibronectin increased significantly in cases with moderate to severe mesangial cell proliferation than cases without. In the areas of glomerulosclerosis, the staining intensity of type IV collagen, laminin, and PDGF decreased, whereas that of fibronectin increased. These results suggest that mesangial cell proliferation in relation to increased PDGF expression in IgAN could stimulate the expression of type IV collagen, laminin and fibronectin leading to mesangial expansion. They also suggest that ECM decreased in advanced glomerulosclerosis. Deposition of fibronectin, which originates mainly from the blood stream, increases during the course of progressive glomerulosclerosis, whereas other ECM components decrease in advanced glomeruloslresosis.
Biopsy ; Carcinoma, Renal Cell ; Collagen Type IV ; Extracellular Matrix* ; Fibronectins ; Glomerulonephritis, IGA* ; Humans ; Immunoglobulin A* ; Laminin ; Mesangial Cells ; Nephrectomy ; Peroxidase ; Platelet-Derived Growth Factor* ; Rivers

Accumulation of leukocytes within the glomerulus is a key event in the pathogenesis of glomerulonephritis. This process is mediated by pairs of adhesion molecules. We have examined the expression pattern of selectins (E and P), intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1) in 30 renal biopsies with IgA nephropathy, diffuse crescentic glomerulonephritis, and minimal change disease. Normal controls were obtained from four nephrectomy specimens with renal cell carcinoma. ICAM-1 expression was significantly increased in the glomerular endothelial and mesangial cells in cases with IgA nephropathy compared with normal controls. VCAM-1 was expressed in glomerular mesangial cells in all cases with IgA nephropathy and diffuse crescentic glomerulonephritis, but faintly expressed in 3 cases with minimal change disease and not expressed in normal controls. P-selectin was faintly expressed in the glomeruli in cases with IgA nephropathy and diffuse crescentic glomerulonephritis. E-selectin was only expressed in the vascular endothelium in one case with IgA nephropathy and in the other with diffuse crescentic glomerulonephritis. ICAM-1 and VCAM-1 were strongly expressed in the crescents. However, selectin was not expressed in the crescent. These results suggest that adhesion molecules, particularly ICAM-1 and VCAM-1, play an important role in the pathogenesis of glomerular damage and crescent formation in primary glomerular diseases.
Biopsy ; Carcinoma, Renal Cell ; E-Selectin ; Endothelium, Vascular ; Glomerulonephritis* ; Glomerulonephritis, IGA* ; Immunoglobulin A* ; Intercellular Adhesion Molecule-1 ; Leukocytes ; Mesangial Cells ; Nephrectomy ; Nephrosis, Lipoid* ; P-Selectin ; Selectins ; Vascular Cell Adhesion Molecule-1

No abstract available.
Gastroschisis* ; Hernia, Umbilical*

The effect of persistant mild hyperglycemic hyperinsulinemia on the development of the insulin resistance in rats was studied in vivo. Also, the characteristics of the insulin resistance compared with the insulin resistance of STZ diabetic rats. Persistant mild hyperglycemic hyperinsulinemic rat model was produced by ingestion of glucose polymer for 8 days. The glucose disappearance and infusion rate was measured by hyperinsulinemic euglycemic clamp to"Imique at steady state of blood glucose and insulin levels. The clamped level of blood glucose was 100 mg/dl, and the clamped levels of insulin were 70 pU/ml (physiologic condition) and 3000 pU/ml (supramaximal condition). Hepatic glucose producticon rate was calculated using measured data. And the glycogen synthetic capacity of skeletal muscle(soleus) and liver was measured after 2 hours of hyperinsulinemic euglycemic clamp study. The glucose disappearance and glucose infusion rate in glucose polymer group was decreased in the both physiological and supramaximal insulin level compared to the rate of the normal control group. The rate of STZ diabetic group wase lowest at supramaximal insulin level among two another experimental groups. The hepatic glucose production rate of glucose polymer group was decreased compared to normal control but increased in STZ diabetic group.
Animals ; Blood Glucose ; Eating ; Glucans ; Glucose ; Glucose Clamp Technique ; Glycogen ; Hyperinsulinism* ; Insulin Resistance* ; Insulin* ; Liver ; Models, Animal ; Rats*

An association of low total cholesterol in blood with psychiatric diseases and suicidal behavior has been suggested. As part of an attempt to further explore this relationship, we examine first, whether serum cholesterol levels in psychiatric patients with suicidal attempt would be lower than in non-suicidal psychiatric inpatients or normal controls, second, whether such significant difference of cholesterol levels would be present when the diagnostic groups are analyzed separately, third whether low cholesterol level would be associated with a history of serious suicidal attempts, and finally, whether low cholesterol level in suicide attempters is as state or a trait marker. We determined the serum cholesterol levels in 231 patients admitted to an emergency room following an suicidal attempt, in the same numbers of age-, sex- and diagnosis-matched non-suicidal psychiatric controls, and in the same numbers of age-, sex matched normal controls. The seriousness of an attempt was divided into 5 grades according to the degree of the resulting medical injury. Total cholesterol levels in suicide attempters were significantly lower compared with both psychiatric and normal controls, when sex, age, and nutritional status(i.e., body mass index) were controlled for. This significant relationship was observed in major depressive disorders and personality disorders, but not in schizophrenia and bipolar type I disorders. The severity of suicide by a lowering of blood cholesterol was related to the magnitude of the cholesterol reduction. After treatment of their psychiatric ailments, the cholesterol levels in suicide attempters were significantly increased. This result suggests that low cholesterol level in psychiatric patients might be a potential biological marker of suicide risk. It is hypothesized that low cholesterol levels is associated with the suicide by modifying the serotonin metabolism, the production of interleukin-2 and melatonin metabolism in psychiatric patients.
Biomarkers ; Cholesterol* ; Depression ; Depressive Disorder, Major ; Emergency Service, Hospital ; Humans ; Inpatients ; Interleukin-2 ; Melatonin ; Metabolism ; Personality Disorders ; Schizophrenia ; Serotonin ; Suicide*

Objectives: The purpose of this study was to identify the effectiveness of COVID-19 vaccinations on deaths of the COVID-19 cases in some elderly long-term care facilities (LTCF) in Gwangju Metropolitan City. Methods: The study subjects were 659 COVID-19 cases in residents of 7 elderly LTCF, Gwangju, from 21 Dec. 2021 to 28 Jan. 2022. The used variables were confirmed dates for COVID-19, demographic characteristics, co-morbidities, presentation of symptoms, death and vaccination related characteristics including type of vaccine, doses and dates. Vaccination status were classified as not vaccinated, partially and fully vaccinated. The associations of vaccination status and deaths of COVID-19 cases were tested by chi-square test and multiple logistic regression analysis. Results: The rates of not vaccinated, partially vaccinated and fully vaccinated were 19.4%, 10.2% and 70.4%, respectively. The mortality rate of the cases was 6.4%.The death rate by vaccination status was 16.4% in not vaccinated, 15.4% in partially vaccinated and 2.6% in fully vaccinated, showing a statistically significant difference. The adjusted odds ratios (ORs) (95% confidence intervals, CIs) of death compared to fully vaccinated were 7.64 (3.87-16.34) in non-vaccinated, and 6.97 (3.44-14.14) in partially vaccinated. Conclusions COVID-19 vaccination seems to work effectively in preventing deaths of COVID-19 cases of elderly LTCF residents. This finding support that fully vaccinations in high risk group such as elderly LTCF residents is very important for one of strategies of COVID-19 management.

Purpose: The objective of this study was to analyze the results of several noninvasive prenatal tests (NIPTs) from a single center and confirm their efficacy and reliability. In addition, we aimed to confirm the changes in the number of invasive tests performed after introducing NIPT. Materials and Methods: NIPT data from a large single center from March 2014 to November 2018 were analyzed. Karyotyping was confirmed based on chorionic villus sampling, amniocentesis, or postnatal cord/peripheral blood sampling. Data on maternal age, gestational age, fetal fraction, and ultrasonographic results were analyzed. As the secondary outcome, the number of amniocentesis cases before and after the introduction of NIPT was compared. Results: Overall, 1,591 single pregnancy cases that underwent NIPT were enrolled. The mean maternal age was 36.05 (22-45) years. The average gestational age and fetal fraction were 12+1 (9+3 to 27+1) weeks and 10.95% (3.6% to 31.3%), respectively. A total of 1,544 cases (97.0%) were reported to have negative NIPT results and 40 (2.5%) had positive NIPT results. The sensitivity and specificity of the overall abnormalities in NIPT were 96.29% and 99.36%, respectively. The positive predictive value (PPV) and negative predictive value were 72.22% and 99.93% respectively. The mean number of amniocentesis cases were 21.7 per month (21.7±3.9), which significantly decreased from 31.5 per month (31.5±4.8) before conducting NIPT as a screening test. Conclusion NIPT is currently a useful, powerful, and safe screening test. In particular, trisomy 21 is highly specific due to its high PPV. NIPT can reduce the potential risks of procedure-related miscarriages during invasive testing.

PURPOSE: In this single center study, we assessed the timing of presentation of necrotizing enterocolitis (NEC) diagnosed by sonography according to the gestational age. METHODS: We retrospectively reviewed the medical records of 49 newborn patients who were diagnosed with NEC (modified Bell's stage II and higher according to abdominal sonography and simple abdominal radiography) and were admitted to the neonatal intensive care unit of St. Mary's Hospital between January 2008 and December 2012. Infants were grouped according to their gestational age (GA): Group I (GA <28 weeks), Group II (GA, 28-32 weeks), Group III (GA, 33-36 weeks), and Group IV (GA > or =37 weeks); early-onset NEC was considered when NEC developed at <14 days of age and late-onset NEC was considered when NEC developed at > or =14 days of age. RESULTS: The number of infants in each group were: Group I (n = 16), Group II (n = 20), Group III (n = 11), and Group IV (n = 2). The mean age at diagnosis of NEC was: Group I (31.6 days), Group II (15.9 days), Group III (11.0 days), and Group IV (2.0 days). Early-onset NEC developed at a mean of 5.5 days of age, whereas late-onset NEC developed at a mean of 36.1 days of age. CONCLUSION: Based on early sonographic diagnosis, infants with lower gestational ages developed NEC at a more advanced postnatal age as compared to more mature infants. However, further studies are needed to understand the etiology of this disease process.
Diagnosis ; Enterocolitis, Necrotizing* ; Epidemiology ; Gestational Age* ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Medical Records ; Retrospective Studies ; Ultrasonography