OBJECTIVES: To assess innate and humoral immune responses in middle ear effusion of obese pediatric patients with otitis media with effusion (OME). METHODS: We evaluated 219 children with OME, of whom 21 were obese and 198 were non-obese. We compared the expression in middle ear effusion of mRNAs encoding toll-like receptors (TLR) 2, 4, 5, and 9; nucleotide-binding oligomerization domains (NOD) 1 and 2; retinoic acid-inducible gene (RIG)-I; interleukins (IL)-6, -10, and -12; interferon (IFN)-gamma; and tumor necrosis factor (TNF)-alpha mRNAs. We also compared the expression of immunoglobulins IgG, IgA, and IgM and the bacterial detection rate in the two groups. RESULTS: TLR2-mediated expression of IL-6 mRNA, TLR4-mediated expression of IL-6 and IL-10 mRNA, TLR5-mediated expression of IL-6, IL-10, and TNF-alpha mRNA, TLR9-mediated expression of IL-6 mRNA, and NOD2-mediated expression of IL-6, IL-12, and TNF-alpha mRNA were significantly lower in obese than in non-obese children (P<0.05). However, concentrations of IgG, IgA, and IgM in middle ear effusion were lower in obese than in non-obese children, but none of these differences was significant (P>0.05). CONCLUSION: Mean body mass index was higher and pattern-recognition receptor-mediated cytokine mRNA expression was lower in obese than in non-obese children with OME.
Bacteria ; Body Mass Index ; Child* ; Humans ; Immunity, Humoral ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Interferons ; Interleukin-10 ; Interleukin-12 ; Interleukin-6 ; Interleukins ; Obesity ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; RNA, Messenger* ; Toll-Like Receptors ; Tumor Necrosis Factor-alpha

PURPOSE: Most treatment decisions for breast cancer patients are based on an assesment of prognostic factors. Tumor markersB (p53, c-erbB2, bcl-2, Cathepsin D) have been evaluated for their prognostic factors and many studies suggest that these factors as assessed by immunohistochemistry (IHC) may be helpful for treatment decisions, while the risk group for high relapse can not be discriminated by single tumor marker alone. In order to obtain useful prognostic information, several tumor marker expressions must be combined and weighted. METHODS: The expressions of ER, PR, p53, c-erbB2, bcl-2, Cathepsin D were detected by IHC on paraffin-embedded sections from 449 primary breast cancer patients treated at Seoul National University Hospital between January 1996 and December 1998. In the present study, tumor marker expressions were analyzed along with conventional clinicopathologic factors. Additionally, correlations between various tumor marker expressions were examined and combinations of tumor marker expressions relating pathologic parameters currently in use for primary breast cancer prognosis were investigated. RESULTS: ER, PR, bcl-2, Cathepsin D expressions were related to smaller tumor size and PR was related to less axillary nodal involvement. ER, PR, bcl-2 expressions were related to good NG and HG, while p53 expression wasrelatedto poor NG and HG. ER and PR expression were related to bcl-2 expression, c-erbB2 expression was related to p53 expression and c-erbB2 expression was related to Cathepsin D expression. ER /bcl-2 was more prevalent in NG 1 and HG III tumors. ER /p53 and p53 /bcl-2 were more prevalent in NG 2/3 and HG I/II tumors. p53 /c-erbB2 was more prevalent in NG 1 tumors. CONCLUSION: Combinations of tumor marker expressions ER/bcl-2, ER/p53, p53/c-erbB2, p53/bcl2 provides more detailed information concerning cancer aggressiveness.
Breast Neoplasms* ; Cathepsin D* ; Cathepsins* ; Equidae ; Humans ; Immunohistochemistry ; Prognosis ; Recurrence ; Seoul

BACKGROUND: Procalcitonin (PCT) is a relatively new marker for bacterial infections, and its diagnostic utility has been variable across the studies. We investigated the diagnostic utility of PCT for the patients with blood culture-positive sepsis, and compared it with that of C-reactive protein (CRP). METHODS: In 1,270 consecutive blood samples, PCT and CRP were simultaneously measured and results were compared according to the five categories of PCT concentrations (<0.05 ng/mL; 0.05-0.49 ng/mL; 0.5-1.99 ng/mL; 2-9.99 ng/mL; > or =10 ng/mL). In 506 samples, they were further analyzed according to the result of blood culture. PCT and CRP were measured using enzyme-linked fluorescent assay (bioMerieux Co., France) and rate nephelometry (Beckman Coulter Co., USA), respectively. Their diagnostic utilities were compared using ROC curves. RESULTS: The mean concentrations of CRP in five categories of PCT were 15.4 mg/L, 42.1 mg/L, 101.2 mg/L, 125.0 mg/L, 167.1 mg/L, respectively (P<0.0001). Both PCT and CRP showed significant differences between the two positive and negative groups of blood culture (PCT, 8.47 vs 2.44 ng/mL, P=0.0133; CRP, 110.48 vs 59.78 mg/L, P<0.0001). The areas under the ROC curves (95% confidence interval) for PCT and CRP were 0.720 (0.644-0.788) and 0.558 (0.478-0.636), respectively, and showed a significant difference (P=0.005). CONCLUSIONS: The diagnostic utility of PCT is superior to that of CRP for the patients with blood culture-positive sepsis. PCT seems to be reliable for sepsis diagnosis, and may provide useful information for the critically ill patients.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biological Markers/blood ; C-Reactive Protein/*analysis ; Calcitonin/*blood ; Child ; Child, Preschool ; Enzyme-Linked Immunosorbent Assay ; Humans ; Infant ; Infant, Newborn ; Middle Aged ; Nephelometry and Turbidimetry ; Protein Precursors/*blood ; ROC Curve ; Reagent Kits, Diagnostic ; Sensitivity and Specificity ; Sepsis/*diagnosis

PURPOSE: Most treatment decisions for breast cancer patients are based on an assesment of prognostic factors. Tumor markersB (p53, c-erbB2, bcl-2, Cathepsin D) have been evaluated for their prognostic factors and many studies suggest that these factors as assessed by immunohistochemistry (IHC) may be helpful for treatment decisions, while the risk group for high relapse can not be discriminated by single tumor marker alone. In order to obtain useful prognostic information, several tumor marker expressions must be combined and weighted. METHODS: The expressions of ER, PR, p53, c-erbB2, bcl-2, Cathepsin D were detected by IHC on paraffin-embedded sections from 449 primary breast cancer patients treated at Seoul National University Hospital between January 1996 and December 1998. In the present study, tumor marker expressions were analyzed along with conventional clinicopathologic factors. Additionally, correlations between various tumor marker expressions were examined and combinations of tumor marker expressions relating pathologic parameters currently in use for primary breast cancer prognosis were investigated. RESULTS: ER, PR, bcl-2, Cathepsin D expressions were related to smaller tumor size and PR was related to less axillary nodal involvement. ER, PR, bcl-2 expressions were related to good NG and HG, while p53 expression was relatedto poor NG and HG. ER and PR expression were related to bcl-2 expression, c-erbB2 expression was related to p53 expression and c-erbB2 expression was related to Cathepsin D expression. ER-/bcl-2- was more prevalent in NG 1 and HG III tumors. ER+/p53- and p53-/bcl-2+ were more prevalent in NG 2/3 and HG I/II tumors. p53+/c-erbB2+ was more prevalent in NG 1 tumors. CONCLUSION: Combinations of tumor marker expressions ER/bcl-2, ER/p53, p53/c-erbB2, p53/bcl2 provides more detailed information concerning cancer aggressiveness.
Breast Neoplasms* ; Cathepsin D* ; Cathepsins* ; Equidae ; Humans ; Immunohistochemistry ; Prognosis ; Recurrence ; Seoul

PURPOSE: Most treatment decisions for breast cancer patients are based on an assesment of prognostic factors. Tumor markersB (p53, c-erbB2, bcl-2, Cathepsin D) have been evaluated for their prognostic factors and many studies suggest that these factors as assessed by immunohistochemistry (IHC) may be helpful for treatment decisions, while the risk group for high relapse can not be discriminated by single tumor marker alone. In order to obtain useful prognostic information, several tumor marker expressions must be combined and weighted. METHODS: The expressions of ER, PR, p53, c-erbB2, bcl-2, Cathepsin D were detected by IHC on paraffin-embedded sections from 449 primary breast cancer patients treated at Seoul National University Hospital between January 1996 and December 1998. In the present study, tumor marker expressions were analyzed along with conventional clinicopathologic factors. Additionally, correlations between various tumor marker expressions were examined and combinations of tumor marker expressions relating pathologic parameters currently in use for primary breast cancer prognosis were investigated. RESULTS: ER, PR, bcl-2, Cathepsin D expressions were related to smaller tumor size and PR was related to less axillary nodal involvement. ER, PR, bcl-2 expressions were related to good NG and HG, while p53 expression was relatedto poor NG and HG. ER and PR expression were related to bcl-2 expression, c-erbB2 expression was related to p53 expression and c-erbB2 expression was related to Cathepsin D expression. ER-/bcl-2- was more prevalent in NG 1 and HG III tumors. ER+/p53- and p53-/bcl-2+ were more prevalent in NG 2/3 and HG I/II tumors. p53+/c-erbB2+ was more prevalent in NG 1 tumors. CONCLUSION: Combinations of tumor marker expressions ER/bcl-2, ER/p53, p53/c-erbB2, p53/bcl2 provides more detailed information concerning cancer aggressiveness.
Breast Neoplasms* ; Cathepsin D* ; Cathepsins* ; Equidae ; Humans ; Immunohistochemistry ; Prognosis ; Recurrence ; Seoul

Bilateral femoral neck stress fractures have been rarely reported. When diagnosed, they are usually limited to athletes or military personnel. A 35-year-old man, previously healthy, visited the emergency department for right inguinal pain. On physical examination, no external wound, tenderness or limitation of motion were found in either lower extremity. Plain radiography showed normal findings but an magnetic resonance image showed a linear fracture in the femoral neck. In this case, bilateral femoral neck stress fractures were found in a young non-athlete adult with no prior medical history of related injuries. Surgery is generally not performed for stress fractures but considering the patient's early mobilization and the need for quick reintegration into society, surgery was done in this case.
Adult ; Athletes ; Early Ambulation ; Emergency Service, Hospital ; Fatigue ; Femur Neck ; Femur ; Fractures, Stress ; Humans ; Lower Extremity ; Military Personnel ; Physical Examination ; Radiography ; Wounds and Injuries ; Young Adult

Arterial thrombosis is relatively rare compared with venous thrombosis in nephrotic syndrome. However, the assessment of its pathogenesis and risk factors in individual patient with nephrotic syndrome is necessary to allow appropriate prophylactic management because it is a potentially serious problem. Hereby, with review of the literature, we report a case of a 53 yr-old man with cerebral infarction associated with nephrotic syndrome due to focal segmental glomerulosclerosis during the course of treatments with diuretics and steroid. It reveals that the hypercoagulable state in nephrotic syndrome can be associated with cerebral infarction in adults. Prophylactic anticoagulants can be considered to reduce the risk of serious cerebral infarction in nephrotic patients with risk factors such as severe hypoalbuminemia and on diuretics or steroid treatment, even in young patients regardless of types of underlying glomerular diseases.
Cerebral Infarction/epidemiology/*etiology/pathology ; Human ; Male ; Middle Aged ; Nephrotic Syndrome/*complications/epidemiology ; Risk Factors

INTRODUCTION: Mini-implant system is applicable to areas of narrow space and area requiring temporary loading support. The purpose of this study was to evaluate the clinical outcome of a mini-implant system as well as the application of mini-implant system in the dental clinical field. MATERIALS AND METHODS: The patients who had been operated from Jan 2007 to Dec 2007 in the four dental facility including Seoul National University Bundang Hospital were enrolled. To evaluate the factors associated with the clinical outcome, the patients were classified according to gender, age, area of surgery, type of implant, diameter and length of the implant, and the purpose of the mini-implant system application. RESULTS: From 147 implants, only three implants failed, one of them was for temporary loading. There were no serious surgical or prosthetic complications in this study. CONCLUSION: An analysis of the preliminary data revealed a satisfactory clinical outcome. However, more long-term evaluation of narrow ridge type as well as the patient's satisfaction on the use of a provisional type mini-implant system is needed.
Dental Facilities ; Humans ; Retrospective Studies

BACKGROUND: Tumor-associated macrophages (TAMs) play a tumorigenic role related to advanced staging and poor prognosis in many human cancers including thyroid cancers. Yet, a functional role of TAMs in papillary thyroid carcinoma (PTC) has not been established. The aim of this study was to investigate TAM expression in human PTC with lymph node (LN) metastasis. METHODS: Thirty-six patients who underwent surgery after being diagnosed with PTC with LN metastasis were included. Primary tumor tissues were immunohistochemically stained with an anti-CD68 antibody and clinical characteristics according to TAM density were evaluated. RESULTS: The TAM densities (CD68+ cells) varied from 5% to 70%, in all tumor areas, while few cells were stained in adjacent normal tissues. TAMs were identified as CD68+ cells with thin, elongated cytoplasmic extensions that formed a canopy structure over tumor cells. Comparing clinicopathologic characteristics between tumors with low (<25%) and high (25% to 70%) TAM densities, primary tumors were larger in the high density group than in the low density group (2.0+/-0.1 vs. 1.5+/-0.1; P=0.009). CONCLUSION: TAMs were identified in primary PTC tumors with LN metastasis and higher TAM densities were related to larger tumor sizes, suggesting a tumorigenic role of TAMs in human PTCs.
Carcinoma ; Cytoplasm ; Factor IX ; Humans ; Lymph Nodes ; Macrophages ; Neoplasm Metastasis ; Prognosis ; Thyroid Gland ; Thyroid Neoplasms

PURPOSE: Even though aural fullness is ubiquitous among patients presenting to otolaryngology clinics, the association between aural fullness and disease development has not yet been clearly determined. MATERIALS AND METHODS: Our study was performed on outpatients from June 2006 to February 2010 whose major complaint was "ear fullness", "aural fullness", or "ear pressure". We assessed their demographic and clinical characteristics, including sex, associated diseases, symptoms, otoscopic findings, audiology test results, and final diagnoses. RESULTS: Among 432 patients, 165 (38.2%) were males and 267 (61.8%) were females, with mean ages of 42+/-19 years and 47+/-17 years, respectively. Tinnitus, hearing disturbance, autophony (p<0.01) as well as nasal obstruction and sore throat (p<0.05) showed a statistically significant correlation with aural fullness. Among patients who complained of hearing fullness, tests and measures such as impedance audiometry, speech reception threshold, and pure tone audiometry generated statistically significant results (p<0.05). Ear fullness was most frequently diagnosed as Eustachian tube dysfunction (28.9%), followed by otitis media with effusion (13.4%) and chronic otitis media (7.2%). However, 13.4% of patients could not be definitively diagnosed. CONCLUSION: Among patients complaining of ear fullness, Eustachian tube dysfunction, otitis media with effusion, chronic otitis media were most commonly observed. Performance of otoscopy, nasal endoscopy, the Valsalva maneuver, and additional audiological tests is necessary to exclude other diseases.
Acoustic Impedance Tests ; Audiology ; Audiometry ; Diagnosis ; Ear ; Endoscopy ; Eustachian Tube ; Female ; Hearing ; Humans ; Male ; Nasal Obstruction ; Nasopharyngeal Neoplasms ; Otitis Media ; Otitis Media with Effusion ; Otolaryngology ; Otoscopy ; Outpatients ; Pharyngitis ; Tinnitus ; Valsalva Maneuver