Umbilical vein varix has diverse clinical features and an unpredictable course during the pregnancy and/or perinatal period. We report a rare case of isolated fetal varix of the intra-abdominal umbilical vein, which was associated with fetal cardiomegaly. After birth, the umbilical vein varix remained with continuous blood flow through the patent ductus venosus. In addition, persistent cardiomegaly was complicated with an atrial septal defect.
Cardiomegaly ; Heart Septal Defects, Atrial* ; Parturition ; Pregnancy ; Prenatal Diagnosis ; Umbilical Veins* ; Varicose Veins*

Chronic actinic dermatitis is a rare disease worldwide and also in Korea. However there has been no clinicohistologic and photobiological analysis of chronic actinic dermatitis in Korea. We examined 11 patients who were diagnosed as chronic actinic dermatitis and the results of this study were compared with previous reports. Most patients were elderly men who had erythematous papules or lichenified plaques on sun-exposed areas such as the face, neck, and dorsum of the hands with severe itching sensation. All patients had severe sensitivity to UVB and biopsied specimens showed findings of chronic eczema. Five patients had positive photopatch test materials. The patients were treated with systemic and topical steroid, cyclosporine and antihistamine.
Adult ; Aged ; Chronic Disease ; Female ; Human ; Male ; Middle Age ; Photosensitivity Disorders/pathology ; Photosensitivity Disorders/etiology* ; Photosensitivity Disorders/drug therapy ; Ultraviolet Rays/adverse effects

Nestin, a type VI intermediate filament,is a marker for stem cells.Although it is expressed abundantly in various organs during development,its expression in adults is restricted to certain types of cells.However,nestin is reinduced in activated cells involved in the regeneration and survival of injured tissues.We investigated the expression of nestin in the ischemia-reperfusion injured rat kidney by immunohistochemistry using anti-nestin antiserum. Kidneys were preserved from normal adults and at 1,3,5,7 and 14 d after ischemia-reperfusion injury,and processed using pre-embedding.In the normal adult kidney,nestin was expressed strongly in the glomerular podocyte.Capillary endothelial cells,except for those of the glomeruli,showed nestin positivity.Fibroblast-like interstitial cells were also nestin positive except for lipid-laden interstitial cells of the inner medulla.After ischemia-reperfusion injury,the renal expression of nestin increased progressively to 7 d and then returned almost to a normal level by 14 d.These changes of nestin expression were attributed mainly to changes in the number and staining intensity of immunostained interstitial cells.The podocytes and endothelial cells showed no change in immunoreactivity throughout any stage in the experimental animals.Interestingly,nestin-positive tubular cells,which were nestin negative in normal kidney,were observed from 3 to 14 d.Nestin immunostained cells were increased in the interstitium around these nestin-positive tubules.These results suggest that nestin is induced in both interstitial cells and regenerating tubular cells and that it can be used as a histological marker related to epithelial-mesenchymal transformation in the injured kidney.
Adult ; Animals ; Endothelial Cells ; Epithelial-Mesenchymal Transition ; Humans ; Immunohistochemistry ; Kidney* ; Nestin* ; Podocytes ; Rats* ; Regeneration ; Reperfusion Injury*

Herein, we report a rare case of hemolytic anemia with reticulocytopenia following intravenous immunoglobulin therapy in a young infant treated for Kawasaki disease. A 2-month-old boy presented with fever lasting 3 days, conjunctival injection, strawberry tongue, erythematous edema of the hands, and macular rash, symptoms and signs suggestive of incomplete Kawasaki disease. His fever resolved 8 days after treatment with aspirin and high dose infusion of intravenous immunoglobulin. The hemoglobin and hematocrit decreased from 9.7 g/dL and 27.1% to 7.4 g/dL and 21.3%, respectively. The patient had normocytic hypochromic anemia with anisocytosis, poikilocytosis, immature neutrophils, and nucleated red blood cells. The direct antiglobulin test result was positive, and the reticulocyte count was 1.39%. The patient had an uneventful recovery. However, reticulocytopenia persisted 1 month after discharge.
Anemia ; Anemia, Hemolytic* ; Anemia, Hypochromic ; Aspirin ; Coombs Test ; Edema ; Erythrocytes ; Exanthema ; Fever ; Fragaria ; Hand ; Hematocrit ; Hemolysis ; Humans ; Immunization, Passive* ; Immunoglobulins* ; Infant* ; Male* ; Mucocutaneous Lymph Node Syndrome* ; Neutrophils ; Reticulocyte Count ; Reticulocytes ; Tongue

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: Landmark indicators have not yet to be developed to detect the regression of cervical intraepithelial neoplasia (CIN). We propose that quantitative viral load and indicative histological criteria can be used to differentiate between atypical squamous cells of undetermined significance (ASCUS) and a CIN of grade 1. MATERIALS AND METHODS: We collected 115 tissue biopsies from women who tested positive for the human papilloma virus (HPV). Nine morphological parameters including nuclear size, perinuclear halo, hyperchromasia, typical koilocyte (TK), abortive koilocyte (AK), bi-/multi-nucleation, keratohyaline granules, inflammation, and dyskeratosis were examined for each case. Correlation analyses, cumulative logistic regression, and binary logistic regression were used to determine optimal cut-off values of HPV copy numbers. The parameters TK, perinuclear halo, multi-nucleation, and nuclear size were significantly correlated quantitatively to HPV copy number. RESULTS: An HPV loading number of 58.9 and AK number of 20 were optimal to discriminate between negative and subtle findings in biopsies. An HPV loading number of 271.49 and AK of 20 were optimal for discriminating between equivocal changes and obvious koilocytosis. CONCLUSION: We propose that a squamous epithelial lesion with AK of >20 and quantitative HPV copy number between 58.9-271.49 represents a new spectrum of subtle pathological findings, characterized by AK in ASCUS. This can be described as a distinct entity and called "regressing koilocytosis".
Biopsy* ; Cervical Intraepithelial Neoplasia ; Female ; Humans* ; Inflammation ; Logistic Models ; Methods ; Papilloma* ; Viral Load ; Viruses*

BACKGROUND: Fentanyl, which is a potent synthetic micron-opioid receptor agonist, is one of the most widely used opioids in anesthesia and pain control. However, the pharmacodynamics of fentanyl show wide inter-individual variability. Therefore, this study was conducted to evaluate the influence of the blood-brain barrier transporter protein, p-glycoprotein, and micron-opioid receptor genetic polymorphism on fentanyl pharmacodynamics. METHODS: Seventy-nine patients who underwent posterior lumbar interbody fusion (PLIF) were included in this study. Postoperatively, the patients received fentanyl via an intravenous patient controlled analgesia device. The cumulative fentanyl doses and other pharmacodynamic data were then recorded at 2 h, 6 h, 12 h, 24 h and 48 h after the operation. In addition, genomic DNA was isolated from the patient's peripheral leukocytes and then evaluated for the presence of OPRM1 A118G and ABCB1 C3435T genetic polymorphism using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). RESULTS: The results of this study indicated that ABCB1 C3435T genetic polymorphism may be related to the cumulative fentanyl requirement for postoperative pain control. However, these findings were not statistically significant (P = 0.09). In addition, no relationship was observed between OPRM1 A118G and the cumulative postoperative fentanyl requirement. However, the cumulative postoperative fentanyl requirement was lower in the TTAA group (ABCB1 3435 TT, OPRM1 118 AA) than in the CCGG group (ABCB13435 CC, OPRM1 118 GG). CONCLUSIONS: The ABCB1 C3435T polymorphism may affect fentanyl pharmacodynamics. However, further studies are required to confirm the relationship between p-glycoprotein and fentanyl.
Analgesia, Patient-Controlled ; Analgesics, Opioid ; Anesthesia ; Blood-Brain Barrier ; DNA ; Fentanyl ; Humans ; Leukocytes ; P-Glycoprotein ; Pain, Postoperative ; Pharmacogenetics ; Polymorphism, Genetic

Our previous research demonstrated that calponin-immunoreactivity was localized in myofibroblasts of the periglomerular region of human kidney specimens obtained at the time of transplantation from organ recipients. In the present study we examined calponin expression in two chronic nephropathy models, puromycin aminonucleoside (PAN) nephropathy and subtotal nephrectomy (SNx), to investigate the role of calponin in chronic renal injury. Male Sprague-Dawley rats were used, and both nephropathy models were established at 1, 2, 4, and 8 weeks after surgery. There were no periglomerular calponin-positive cells in sham, PAN 1 and 2 week, and SNx 1, 2, and 4 week groups. In SNx 8 week and PAN 4 and 8 week groups, only a few glomeruli with periglomerular calponin-reactivity, which covered half or a very small part of the periglomerular space, were observed. All glomeruli with periglomerular calponin-reactivity showed sclerotic changes, especially thickening of parietal epithelial cells (PECs). In conjunction with our previous report, this data represents the first documentation of the expression of calponin in renal myofibroblasts. We suggest that interactions between PECs and calponin-positive myofibroblasts may play a key role in the late stage of glomerulosclerosis.
Animals ; Calcium-Binding Proteins ; Epithelial Cells ; Humans ; Immunohistochemistry ; Kidney ; Kidney Failure, Chronic ; Male ; Microfilament Proteins ; Myofibroblasts ; Nephrectomy ; Puromycin Aminonucleoside ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; Transplants

PURPOSE: The purposes of this study were to analyze visitors' food needs and identify the Push-Pull factor in Jeonju Hanok Village. METHODS: A questionnaire was developed based on previous research to survey Korean adults who visited Jeonju city. A total of 580 questionnaires were used for the analysis. RESULTS: Most of the subjects who visited Jeonju Hanok Village had food purchase experiences in Jeonju Hanok Village (96.4%). ‘Traditional Korean food (26.5%)’ was the most purchased food, followed by ‘foreign food (25.8%)’ and ‘Korean food combined with foreign food (16.8%)’. Satisfaction of food purchases (3.35 points) was higher than average. The primary reason for satisfaction was ‘the food is delicious (23.0%)’, and the reason for dissatisfaction was ‘the food is expensive (48.1%)’. In the push and pull factor analysis for identifying visit motivation, ‘local food seeking’, ‘experience seeking’, ‘relaxation seeking’, and ‘friendship seeking’ were push factors while ‘traditional culture’, ‘facility convenience’, ‘experience activity’, and ‘food experience’ were pull factors. There was a significant correlation between the push and pull factors. Regression analysis showed that all push factors influenced satisfaction. However, among pull factors, only ‘food experience’ and ‘traditional culture’ influenced satisfaction. CONCLUSION: In conclusion, this study indicates that food-related factors are destination characteristics (Pull factor) influencing intrinsic visit motivation (Push factor) and satisfaction. It is necessary to develop various food tourism products to satisfy visitors' needs and continuous visits in Jeonju Hanok Village. This study suggests the importance of research on food factors and provides useful basic data to establish positioning strategies for food cultural development in Jeonju Hanok Village.
Adult ; Humans ; Jeollabuk-do* ; Motivation

BACKGROUND: We are continually exposed to low-dose radiation (LDR) in the range 0.1 Gy from natural sources, medical devices, nuclear energy plants, and other industrial sources of ionizing radiation. There are three models for the biological mechanism of LDR: the linear no-threshold model, the hormetic model, and the threshold model. OBJECTIVE: We used keratinocytes as a model system to investigate the molecular genetic effects of LDR on epidermal cell differentiation. METHODS: To identify keratinocyte differentiation, we performed western blots using a specific antibody for involucrin, which is a precursor protein of the keratinocyte cornified envelope and a marker for keratinocyte terminal differentiation. We also performed quantitative polymerase chain reaction. We examined whether LDR induces changes in involucrin messenger RNA (mRNA) and protein levels in calcium-induced keratinocyte differentiation. RESULTS: Exposure of HaCaT cells to LDR (0.1 Gy) induced p21 expression. p21 is a key regulator that induces growth arrest and represses stemness, which accelerates keratinocyte differentiation. We correlated involucrin expression with keratinocyte differentiation, and examined the effects of LDR on involucrin levels and keratinocyte development. LDR significantly increased involucrin mRNA and protein levels during calcium-induced keratinocyte differentiation. CONCLUSION: These studies provide new evidence for the biological role of LDR, and identify the potential to utilize LDR to regulate or induce keratinocyte differentiation.
Blotting, Western ; Cell Differentiation ; Keratinocytes* ; Molecular Biology ; Nuclear Energy ; Polymerase Chain Reaction ; Radiation, Ionizing ; RNA, Messenger