The telomerase reverse transcriptase (TERT) gene, which is repressed in most differentiated human cells, can be reactivated by somatic TERT alterations and epigenetic modulations. Moreover, the recruitment, accessibility, and binding of transcription factors also affect the regulation of TERT expression. Reactivated TERT contributes to the development and progression of cancer through telomere lengthening-dependent and independent ways. In particular, because of recent advances in high-throughput sequencing technologies, studies on genomic alterations in various cancers that cause increased TERT transcriptional activity have been actively conducted. TERT reactivation has been reported to be associated with poor prognosis in several cancers, and TERT promoter mutations are among the most potent prognostic markers in thyroid cancer. In particular, when a TERT promoter mutation coexists with the BRAFV600E mutation, these mutations exert synergistic effects on a poor prognosis. Efforts have been made to uncover the mechanisms of these synergistic interactions. In this review, we discuss the role of TERT reactivation in tumorigenesis, the mechanisms of TERT reactivation across all human cancers and in thyroid cancer, and the mechanisms of interactions between BRAFV600E and TERT promoter mutations.

OBJECTIVE: To evaluate the association of maternal age with occurrence of fetal chromosomal abnormalities in Korean pregnant women of advanced maternal age (AMA). METHODS: A retrospective review of the amniocentesis or chorionic villous sampling (CVS) database at Gangnam and Bundang CHA Medical Centers, between January 2001 and February 2012, was conducted. This study analyzed the incidence of fetal chromosomal abnormalities according to maternal age and the correlation between maternal age and fetal chromosomal abnormalities in Korean pregnant women > or =35 years of age. In addition, we compared the prevalence of fetal chromosomal abnormalities between women of AMA only and the others as the indication for amniocentesis or CVS. RESULTS: A total of 15,381 pregnant women were selected for this study. The incidence of aneuploidies increased exponentially with maternal age (P<0.0001). In particular, the risk of trisomy 21 (standard error [SE], 0.0378; odds ratio, 1.177; P<0.001) and trisomy 18 (SE, 0.0583; odds ratio, 1.182; P=0.0040) showed significant correlation with maternal age. Comparison between women of AMA only and the others as the indication for amniocentesis or CVS showed a significantly lower rate of fetal chromosomal abnormalities only in the AMA group, compared with the others (P<0.0001). CONCLUSION: This study demonstrates that AMA is no longer used as a threshold for determination of who is offered prenatal diagnosis, but is a common risk factor for fetal chromosomal abnormalities.
Amniocentesis ; Aneuploidy ; Chorion ; Chromosome Aberrations ; Down Syndrome ; Female ; Humans ; Incidence ; Maternal Age ; Odds Ratio ; Pregnant Women ; Prenatal Diagnosis ; Prevalence ; Retrospective Studies ; Risk Factors ; Trisomy

One-hundred ninty five cases with Kawasaki disease who were diagnosed and treated at the Department of Pediatrics, Kyung Hee University Hospital from January 1985 to June 1993, were investigated for their clinical manifestations and laboratory findings, and cardiac complications. The results are as follows: 1) Most patients (92.8%) were under 5 years of the age. 2) Boys were more prevalent than girls, as a ratio of 2.3 : l 3) The incidence of principal symptoms and signs were fever over 5 days (89.8%), bilateral conjunctival injection (78.5%), changes of oral mucosa and lip (82.3%), skin eruption (72.8%), changes in extremities (58.5%), and cervical lymphadenopathy (47.2%). 4) The main laboratory findings observed were anemia (29.2%), leukocytosis (90.8%), thrombocytosis (89.7%), increased ESR (85.1%), positive CRP (100%), increased sGOT (33.3%), increased sGPT (34.9%), pyuria (41.5%), proteinuria (5.6%), microscopic hematuria (9.7%), and abnormalities of EKG (23.5%). 5) Abnormal findings of the heart were found in 27.2% by echocardiogram and coronary aneurysm and dilatation were present in 19.7%. 6) Among 147 cases assessed by echocardiogram, the abnormalities of coronary artery were present in 16 of 92 cases (17.4%) in the aspirin and intravenous gammaglobulin treated group, as compared with 13 of 55 cases (23.6%) in the aspirin treated group.
Alanine Transaminase ; Anemia ; Aspartate Aminotransferases ; Aspirin ; Coronary Aneurysm ; Coronary Vessels ; Dilatation ; Electrocardiography ; Extremities ; Female ; Fever ; Heart ; Hematuria ; Humans ; Incidence ; Leukocytosis ; Lip ; Lymphatic Diseases ; Mouth Mucosa ; Mucocutaneous Lymph Node Syndrome ; Pediatrics ; Proteinuria ; Pyuria ; Skin ; Thrombocytosis

PURPOSE: We tried to clarify perinatal risk factors that are related to the occurrence of threshold retinopathy of prematurity in preterm infants with bronchopulmonary dysplasia. METHODS: We enrolled 40 infants with bronchopulmonary dysplasia who had received ophthalmologic examination between April 1995 and May 2001. The patients were categorized into two groups; "threshold retinopathy of prematurity" group as study (n=18), and "no retinopathy of prematurity" and "prethreshold retinopathy of prematurity" group as control population (n=22), and we compared the perinatal risk factors between the two. RESULTS: Out of total 40 preterm infants with bronchopulmonary dysplasia, only prethreshold retinopathy of prematurity occurred in 6 infants (15%) and threshold retinopathy of prematurity developed in 18 infants(45%). The incidence of threshold retinopathy of prematurity decreased with longer gestation and higher birth weight. Mean gestational age was 26.3 weeks in the study group vs 29.4 weeks in control group, and mean birth weight was 868 g and 1,413 g, respectively. An increased risk of reaching threshold retinopathy of prematurity was found associated with apnea, longer use of aminophylline, hyperglycemia, and higher SNAP scores during the first 24 hours from admission to the NICU. The incidence of threshold retinopathy of prematurity was not influenced by duration of oxygen therapy, ventilator therapy, total parenteral nutrition, phototherapy, hospitalization, intraventricular hemorrhage, pneumonia, pulmonary hemorrhage, sepsis, patent ductus arteriosus, air leak syndrome, necrotizing enterocolitis, frequency of transfusion, and longer use of dexamethasone. CONCLUSION: An increased risk of reaching threshold retinopathy of prematurity in preterm infants with bronchopulmonary dysplasia was found associated with lower birth weight, younger gestational age, apnea, longer use of aminophylline, hyperglycemia, and higher SNAP scores during the first 24 hours from admission to the NICU.
Aminophylline ; Apnea ; Birth Weight ; Bronchopulmonary Dysplasia* ; Dexamethasone ; Ductus Arteriosus, Patent ; Enterocolitis, Necrotizing ; Gestational Age ; Hemorrhage ; Hospitalization ; Humans ; Hyperglycemia ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature* ; Oxygen ; Parenteral Nutrition, Total ; Phototherapy ; Pneumonia ; Pregnancy ; Retinopathy of Prematurity* ; Risk Factors* ; Sepsis ; Ventilators, Mechanical

PURPOSE: This study explored the feasibility of a 12 week self-efficacy based exercise intervention for overweight and obese college students. METHOD: A repeated measure, 4-group randomized controlled design was used. Students were recruited from two universities, in Seoul, Korea using: (1) flyers either on the campus bulletin boards or in campus restrooms; (2) advertisement on campus e-board; and (3) self-referral. Inclusion criteria were: (1) Korean college students aged 18 to 29; (2) BMI >23; (3) viscerally obese; and (4) accessible to a phone and a computer. Participants completed three self-reported questionnaires: socio-demographic questionnaire (at the baseline), Exercise Self-Efficacy Scale (at the baseline and 12th week), and Physical Fitness sub-subscale (at the baseline and 12th week). Additionally, physiological data (height, weight, blood pressure) were collected at the baseline and 12th week. Descriptive statistics and a two-way mixed ANOVA were performed using SPSS12.0. RESULTS: No significant group difference was observed. However, students with increased exercise self-efficacy during the program showed better physical fitness in the 12th week. When students' physical fitness was enhanced, the physiological factors were improved. CONCLUSIONS: Self-efficacy based exercise intervention may be applicable and acceptable to the college students. It is necessary to conduct a replicated study with a larger sample and an elongated intervention period.
Feasibility Studies* ; Humans ; Korea ; Obesity ; Overweight* ; Physical Fitness ; Self Efficacy ; Seoul ; Surveys and Questionnaires

No abstract available.
Pregnancy* ; Ultrasonography*

PURPOSE: This study attempted to describe the essential structure of the lived experience of a students transferring into the nursing program. METHOD: The data was collected from 14 graduates and undergraduates who enrolled in nursing school as transfer students. The analysis of the data was made by phenominological analytic method suggested by Colaizzi(1978). RESULT: In this study, 6 essential themes were extracted: 'Constant anxiety of being a stranger', 'Feeling of constant burden', 'Thankfulness of a clinical practice group', 'Being supportive with each other between transferring students', 'Pleasure of studying a desired major', 'Feeling the responsibility of own choice of a new major'. CONCLUSION: With rapidly increasing number of transferring students, the significance of this study in the field of nursing is that by understanding the transferring experience of nursing students, it describes the need of systematic and emotional support for transferring students.

BACKGROUND: In recent years, estrogen has also been shown to modulate the development and function of the brain, bur not exclusively in areas involved with sexual behavior. Among the most novel and fascinating effects of estrogen are those on cognitive function and memory process and their alterations during aging and neurodegenarative disease like Alzheimer. Estrogen receptors distributed not only in the hypothalamus but many different areas, like cerebral cortex, hippocampus, basal forebrain, midbrain, spinal cord, and the diverse action of estrogen is supported by this fact. Numerous studies suggest thai estrogen may be beneficial in preserving cognitive function, but it is not clear yet. PURPOSE: In this study, we perform the immunohistochemical staining in the hippocampus of normal aged rat, and show the distribution of estrogen receptor compared with the neonatal rat. METHODS: we have used antibodies against a estrogen receptor(ER)-alpha to determine their distribution in neonatal and aged SD rat hippocampus. RESULTS: In neonatal rat hippocampus, ER-alpha immunoreactivity was observed in the nucleus of Purkinje cells, whereas in aged rat hippocampus, ER-a immunoreactivity was found mainly in the cytoplasm of Purkinje cells. CONCLUSION: We showed the age related intracellular differential distribution of ER-alpha immunoreactivity in the rat hippocampus. But, further investigations are required to establish whether functional relations like cognitive ability exist with this different intracellular expression of ER-alpha immunoreactivity.
Aging ; Animals ; Antibodies ; Asian Continental Ancestry Group ; Brain ; Cerebral Cortex ; Cytoplasm ; Estrogens* ; Hippocampus* ; Humans ; Hypothalamus ; Memory ; Mesencephalon ; Prosencephalon ; Purkinje Cells ; Rats* ; Receptors, Estrogen ; Sexual Behavior ; Spinal Cord

Between August 1994 and June 1995, seventeen patients diagnosed as having partial or complete ruptures of the anterior cruciate ligament on MRI were managed by non-operative methods. Among them four patients were excluded due to operation during follow-up and the results were evaluated at a one year follow-up. We selected the patients prospectively for non-operative care using the selection criteria of age, degree of instability, activity level and patient compliance. The average age of them was 37.7 years. Initially knee stress test and MRI were checked, and Cybex study and Lysholm knee scoring were done at post-trauma one year follow-up. They were managed conservatively by ROM and muscle strengthening exercises and a brace fitting schedule for three months. Among them, six cases had partial tears and seven had a complete tear initially. At the one year follow-up, five of six cases who had shown partial ruptures, and two of seven cases with complete tears, recovered continuity of the ruptured ACL on MRI. Their Lysholm knee score was 84.4, and the Cybex test showed no difference in muscle power between the injured and uninjuried side. Those patients who had loss of continuity on follow-up MRI showed Lysholm score of 57.4 and decreased muscle power on Cybex study. Although there are still controversies about the adequate management of ACL injuries, our study suggests that conservative management is a viable alternative to surgery as long as the patients are selected prudently. For more concrete results, however, careful analysis based on a longer follow up period is necessary.
Anterior Cruciate Ligament* ; Appointments and Schedules ; Braces ; Exercise ; Exercise Test ; Follow-Up Studies ; Humans ; Knee ; Magnetic Resonance Imaging ; Patient Compliance ; Patient Selection ; Prospective Studies ; Rupture*

Hip fusion has provided disease eradication, stabilization, pain relief and strenuous activity, but the possible complication of pseudarthrosis as well as loss of all motion is a drawback. Total hip replacement arthroplasty has not been a good procedure for active young patients. This study was perforrned to clarify the indications, the best position, the functional results of hip fusion and the effect of hip fusion on the adjacent joint. The authors reviewed 32 cases of hip fusion performed at the Department of Orthopedic Sugery, Seoul National University Hospital during the period of 11 years from April 1973 to June 1984 and the following results were obtained. 1. The average age of the patients at the time of operation was 20.3 years. 2. Tuberculosis of the hip was the most common cause (56.2%). 3. The satisfactory fusion was obtained in 26 cases (81,2 %). 4. The average position of fusion was 20±9 degrees of flexion, 1±5 degrees of abduction and 10±4 degrees of external rotation. 5. Although there was a disability due to limitation of motion after hip fusion, leg length discrepancy was reduced from 3cm (preoperative) to 2.5cm (postoperative) and scoliosis was decreased from 18' of Cobbs angle (preoperative) to 12' of Cobbs angle (postoperative). 6. After hip fusion, walking capacity was increased and back pain was reduced. 7. Age was barely correlated with absolute clinical scores, but better functional results were obtained in younger patients than in older patients. 8. The results were excellent or good in 24 cases (75%).
Arthroplasty ; Arthroplasty, Replacement, Hip ; Back Pain ; Disease Eradication ; Hip ; Humans ; Joints ; Leg ; Orthopedics ; Pseudarthrosis ; Scoliosis ; Seoul ; Tuberculosis ; Walking