PURPOSE: There has been little research regarding the effectiveness of oseltamivir for influenza B infections. We sought to identify the different clinical manifestations between patients treated with and without oseltamivir. METHODS: We retrospectively studied the medical records of 72 inpatients or outpatients from two medical centers diagnosed with influenza B infections by either a rapid antigen test or multiplex reverse transcriptase PCR between January 2012 and July 2012. We compared gender, age, past medical history, admission period, total fever duration, fever duration after hospitalization, post-oseltamivir medication peak temperature, laboratory test, chest X-ray, antibiotic medication, and the presence of concomitant viral or bacterial infections. RESULTS: The number of subjects in our study was 72 who were diagnosed with influenza B pneumonia, acute bronchitis, acute bronchiolitis, croup, and mean age was 3.6+/-2.8 year old. The demographic characteristics and clinical manifestations of oseltamivir and the non-oseltamivir groups, including hospitalization period (4.18+/-2.10 vs 4.79+/-1.49 days, P=.17) and total fever duration (5.32+/-2.07 vs 6.41+/-3.25 days, P=.09), demonstrated no significant differences. Notably, the oseltamivir group did have significantly reduced usage of antibiotic treatment than the non-oseltamivir group (P=.04). When we limited our patient group to patients under the age of three, similar results were seen. The group prescribed oseltamivir within 48 hours of fever onset had less antibiotic usage, in addition to a shorter fever duration. CONCLUSION: Oseltamivir appeared to have no benefit in improving the clinical course. However, if it is prescribed within the first 48 hours of symptoms, it may be more effective.
Bacterial Infections ; Bronchiolitis ; Bronchitis ; Child* ; Croup ; Fever ; Hospitalization ; Hospitals, University* ; Humans ; Influenza B virus* ; Influenza, Human ; Inpatients ; Medical Records ; Oseltamivir* ; Outpatients ; Pneumonia ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Thorax

Adenocarcinoma of the ciliary epithelium is a rare tumor, usually occuring in elderly patients who have a history of severe ocular trauma or chronic inflammation. We report an adenocarcinoma of the nonpigmented ciliary epithelium found within the phthisical globe of a 36-year-old female whose eye had been loss of vision since infancy. The mass, measured 4.0 x 4.0 cm, was relatively limited by sclera but had invasion to posterior portion. Histologically, the tumor was a compact mass which consisted of tubular and papillary structures with foci of the pleomorphic area. Strands of cells and individual cells were invested with thick basement membrane that have positivity for periodic acid-Schiff stain. Immunohistochemical staining showed strong reactivity for cytokeratin and epithelial membrane antigen, and focal for neuron-specific enolase and S-100 protein.
Adenocarcinoma ; Adenocarcinoma, Papillary* ; Adult ; Aged ; Basement Membrane ; Epithelium* ; Female ; Humans ; Inflammation ; Keratins ; Mucin-1 ; Phosphopyruvate Hydratase ; S100 Proteins ; Sclera

The Mainz classification for renal cell tumors was introduced in 1986 and it's utility has been reported in several histogenetic and genetic studies of renal cell tumors. We present a study of 127 cases of renal cell tumors with clinicopathologic correlation, DNA content analysis, and histogenesis studied by histochemical and immunohistochemical staining. The 127 renal cell tumors classified by the Mainz classification were 87 clear cell, 17 chromophilic, 13 chromophobe and 3 sarcomatoid renal cell carcinomas, 5 oncocytomas and 2 adenomas. These subtypes showed significant correlation not with age, sex, Robson's stage, DNA ploidy or tumor recurrence but with nuclear grade (p=0.001) and tumor size (p=0.001). Hall's colloidal iron (p=0.002) and carbonic anhydrase II (p=0.013) stains, representing the origin of distal nephron especially of collecting duct, were significantly correlated with specific subtypes of renal cell tumors, especially chromophobe cell renal carcinoma. This study demonstrates that the Mainz classification suggests several morphologically different subtypes and variants of renal cell tumors and that some of them may have originated from the distal nephron, particularly from the collecting duct.
Adenoma ; Adenoma, Oxyphilic ; Carbonic Anhydrase II ; Carcinoma, Renal Cell ; Classification* ; Colloids ; Coloring Agents ; DNA* ; Iron ; Nephrons ; Ploidies ; Recurrence

We report 13 chromophobe renal cell carcinomas (10.8%) observed among 120 renal cell carcinomas in adults. The average age was 53 (range: 34-72) years old, and 6 were males and 7 females. The mean tumor size was 10 (range: 5-17) cm, mean nuclear grade 2.4, and mean Robson's stage was 1.9. There were two distinct histologic variants; typical variant (n=9) and eosinophilic variant (n=4). Both of them showed typical light microscopic features and positive reaction with Hale's colloidal iron and carbonic anhydrase II, a marker protein of intercalated cells of renal collecting ducts. A strong positive immunoreactivity for epithelial membrane antigen was noted in the cytoplasm in 12 of 13 tumors. Numerous microvesicles, 180~440 nm in diameter, were identified ultrastructurally. DNA aneuploidy was found in 3 out of 10 cases. Neither local recurrence nor metastasis have been identified during the following period of 4~144 (mean 48) months.
Adult ; Aneuploidy ; Carbonic Anhydrase II ; Carcinoma, Renal Cell* ; Colloids ; Cytoplasm ; DNA ; Eosinophils ; Female ; Humans ; Iron ; Male ; Mucin-1 ; Neoplasm Metastasis ; Recurrence

No abstract available.
Animals ; Lordosis*

In allogeneic transplantation, including the B6 anti-BALB.B settings, H60 and H4 are two representative dominant minor histocompatibility antigens that induce strong CD8 T-cell responses. With different distribution patterns, H60 expression is restricted to hematopoietic cells, whereas H4 is ubiquitously expressed. H60-specific CD8 T-cell response has been known to be dominant in most cases of B6 anti-BALB.B allo-responses, except in the case of skin transplantation. To understand the mechanism underlying the subdominance of H60 during allogeneic skin transplantation, we investigated the dynamics of the H60-specific CD8 T cells in B6 mice transplanted with allogeneic BALB.B tail skin. Unexpectedly, longitudinal bioluminescence imaging and flow cytometric analyses revealed that H60-specific CD8 T cells were not always subdominant to H4-specific cells but instead showed a brief dominance before the H4 response became predominant. H60-specific CD8 T cells could expand in the draining lymph node and migrate to the BALB.B allografts, indicating their active participation in the anti-BALB.B allo-response. Enhancing the frequencies of H60-reactive CD8 T cells prior to skin transplantation reversed the immune hierarchy between H60 and H4. Additionally, H60 became predominant when antigen presentation was limited to the direct pathway. However, when antigen presentation was restricted to the indirect pathway, the expansion of H60-specific CD8 T cells was limited, whereas H4-specific CD8 T cells expanded significantly, suggesting that the temporary immunodominance and eventual subdominance of H60 could be due to their reliance on the direct antigen presentation pathway. These results enhance our understanding of the immunodominance phenomenon following allogeneic tissue transplantation.
Animals ; Antigen Presentation ; Antigen-Presenting Cells/immunology/metabolism ; CD8-Positive T-Lymphocytes/*immunology ; Epitopes, T-Lymphocyte/*immunology ; Female ; Graft Rejection/*immunology ; Interferon-gamma ; Lymphocyte Activation/immunology ; Lymphocyte Count ; Mice ; Minor Histocompatibility Antigens/*immunology/metabolism ; *Skin Transplantation ; Transplantation, Homologous

Postobstructive pulmonary edema (POPE) is associated with upper airway obstruction and has two different types of mechanism. Type 1 POPE is due to acute airway obstruction and is related to forceful respiratory efforts leading to extremely negative intrathoracic pressure. Type 2 POPE is caused by chronic airway obstruction and occurs after sudden relief of obstruction which drop in airway pressure that can lead to pulmonary edema. We report a case of postobstructive pulmonary edema in a child who has peripharyngeal abscess.
Abscess* ; Airway Obstruction ; Child* ; Humans ; Pulmonary Edema*

PURPOSE: Predicting life expectancy of terminally ill cancer patients is very important. In many studies, ferritin is detected at higher levels in the sera of cancer patients, and higher ferritin level correlates with aggressiveness of disease and poor outcomes of patients. This study evaluated a prognostic role of serum ferritin levels in terminally ill cancer patients. METHODS: This study enrolled 65 terminally ill cancer patients from March through June 2012. We assessed routine laboratory findings including serum ferritin levels as well as demographic and clinical characteristics of the patients. To examine the association between serum ferritin levels and patient's characteristics, we used Spearman's correlation analysis, Wilcoxon's rank sum test or Kruskal-Wallis test, as appropriately. For multivariate analysis, Cox's proportional hazard regression model was used to evaluate significance of serum ferritin levels as a prognostic factor. RESULTS: A negative correlation between serum ferritin levels and survival time was found. After adjusting for sex, age, performance status, creatinine levels and white blood cell counts, serum ferritin levels were significantly associated with survival time. CONCLUSION: Even at the very end of life of terminal cancer patients, serum ferritin levels were an independent prognostic factor for survival.
Creatinine ; Ferritins* ; Humans ; Leukocyte Count ; Life Expectancy ; Multivariate Analysis ; Prognosis ; Terminally Ill*

BACKGROUND: Inter-observer and intra-observer variation in histologic tumor grading are well documented. To determine whether histologic disorderliness in the arrangement of tumor cells may serve as an objective criterion for grading, we tested the hypothesis the degree of disorderliness is related to the degree of tumor differentiation on which tumor grading is primarily based. METHODS: Borrowing from the statistical thermodynamic definition of entropy, we defined a novel mathematical formula to compute the relative degree of histologic disorderliness of tumor cells. We then analyzed a total of 51 photomicrographs of normal colorectal mucosa and colorectal adenocarcinoma with varying degrees of differentiation using our formula. RESULTS: A one-way analysis of variance followed by post hoc pairwise comparisons using Bonferroni correction indicated that the mean disorderliness score was the lowest for the normal colorectal mucosa and increased with decreasing tumor differentiation. CONCLUSIONS: Disorderliness, a pathologic feature of malignant tumors that originate from highly organized structures is useful as an objective tumor grading proxy in the field of digital pathology.
Adenocarcinoma ; Colonic Neoplasms ; Entropy ; Humans ; Mucous Membrane ; Neoplasm Grading ; Observer Variation ; Pathology ; Proxy ; Thermodynamics

PURPOSE:The aim of this study was to compare the perinatal outcome of preterm infants born to severe pregnancy induced hypertension (PIH) mothers according to the presence or absence of HELLP syndrome. METHODS:A retrospective analysis was done in 314 premature live infants born to 302 severe PIH mothers who admitted at Chonnam National University Hospital from January 2002 to May 2008. Maternal and neonatal characteristics and their outcome were compared between the groups. Statistical analysis was performed by SPSS program using Student's t test, Chi-square analysis, Fisher's exact test, and logistic regression test. RESULTS:Among 302 severe PIH mothers (single pregnancy 270, twin pregnancy 32), 84 (27.8%) were associated with HELLP syndrome. Among their 334 fetuses (singleton 270, twins 64), total 20 (6.0%) resulted in fetal death and the rate of fetal death was higher in HELLP syndrome group compared to the control group (12.2% vs. 3.4%, P=0.006). Among the 314 live premature infants, 86 (27.4%) were born to severe PIH with HELLP syndrome (study group) and 228 (72.6%) were born to the control group. There were no differences in maternal and neonatal characteristics, maternal death, neonatal morbidity and neonatal death between the groups. However, the duration of mechanical ventilation (12.2+/-14.5 vs. 7.6+/-9.9 days, P=0.019) and hospitalization (25.6+/-12.3 vs. 13.0+/-10.5 days, P=0.013) were longer in the study group. CONCLUSION:Most of severe PIH mothers complicated by preterm birth, and especially combined with HELLP syndrome showed higher fetal and perinatal death than without HELLP syndrome. Moreover, their live-born premature infants needed longer duration of mechanical ventilation and hospitalization. These results indicate that careful fetal monitoring and delivery with the co-operations of obstetricians and neonatologists is essential to improve the perinatal outcome.
Female ; Fetal Death ; Fetal Monitoring ; Fetus ; HELLP Syndrome ; Hospitalization ; Humans ; Hypertension, Pregnancy-Induced ; Infant ; Infant, Newborn ; Infant, Premature ; Logistic Models ; Maternal Death ; Mothers ; Pregnancy ; Pregnancy, Twin ; Premature Birth ; Respiration, Artificial ; Retrospective Studies ; Twins