PURPOSE: To search for evidence of B cell activation and superantigen involvement in Kawasaki disease. METHODS: Peripheral lymphocytes were first isolated from Kawasaki disease patients in the acute and subacute phases. The T cell and B cell distributions were analyzed, cDNA was generated from the total RNA extracts, and PCR amplification of the cDNA for each immunoglobulin heavy chain family was performed to determine the presence of VH family-specific oligoclonal expansion. CDR3 size analysis was then conducted by two-stage PCR. RESULTS: The percentage of B cells increased significantly(P<0.05) in both the acute and subacute phases. Random utilization of diverse VH family genes was observed in the acute phase, and no family-specific expansion was detected. In 13 out of 15 Kawasaki disease patients, an increase in B cells expressing the VH3 family was seen during the acute phase, making it the most frequently utilized family. Analysis of B cell clonal expansion showed the VH6 family clone of 9 amino acids to be the most common clone, observed in 5 out of 15 Kawasaki disease patients. Analysis of the CDR3 size profile in two patients showed that in the acute phase various prominent bands appeared, some disappearing in the subacute phase, while other newly developed bands appeared. CONCLUSION: VH family-specific B cell expansion was not detected, and clonal expansion of B cells was observed, suggesting that Kawasaki disease may be caused by a conventional antigen, and the antigenic stimulation seen during the acute phase seems to be continuous, resuming after clinical resolution.
Amino Acids ; B-Lymphocytes ; Clone Cells ; DNA, Complementary ; Humans ; Immunoglobulin Heavy Chains ; Lymphocytes ; Mucocutaneous Lymph Node Syndrome* ; Polymerase Chain Reaction ; RNA

BACKGROUND: Prior reports of umbilical vein variation were strongly associated with several congenital anomalies. This suggests that the incidence of umbilical vein anomaly was more frequently seen in dead fetuses than in liveborn infants because the leading causes of stillbirth are chromosomal and/or congenital anomalies. The developing liver exerts a profound influence in modifying the primitive vitelline and umbilical veins. This study was undertaken to identify the umbilical vein variations and the associated hepatic and perihepatic structural anomalies in dead fetuses. METHODS: Dissection was done in eighteen dead fetuses who had undergone delivery at Chonbuk National University Hospital between December 1996 and February 1998. The weight ratios of the liver to the body and the right to the left hepatic lobes and the distal attachment of umbilical vein, including the presence of hepatic fissures and ligaments, were examined. According to the gestational age, the cases were divided into two groups (group 1: < 32 weeks, 13 cases; group 2: > or = 32 weeks, 5 cases). RESULTS: The gestational age of the fetuses ranged from 19 to 39 weeks. The fetal liver constituted 3.7% and 4.0% of the total fetal body weight for group 1 and 2, respectively. The mean weight ratio of the right to the left hepatic lobe was between 1:1.4 and 1:1.5. There were no gross morphologic abnormalities in 9 cases. Eighteen kinds of chromosomal and congenital anomalies, including omphalocele, anomalous hepatic segmentation, hypogenesis of the hand and the foot, syndactyly, polycystic kidney, etc., were observed in 9 dead fetuses. A case of an abnormal distal attachment of the umbilical vein was identified. The umbilical vein drained into the dilated extrahepatic portal vein directly. The hepatic segments and fissures were completely normal, but ligamentum teres was not identified in this case. A peculiar hepatic segmental anomaly due to whole organ herniation through a defect in an omphalocele was observed. CONCLUSIONS: The weight of the liver of the dead fetuses was relatively small in both groups. No weight shift of left to right was recognized. The incidence of congenital anomalies was much higherin the dead fetuses (50%) than in the live births (0.7-1.98%). There were two hepatic anomalies (11.1%), including segmentation and distal attachment of the umbilical vein. The authors reviewed all reports of umbilical vein anomalies and propose a classification for umbilical vein variations focused on the distal points of attachment. All variations of the umbilical vein tend to fall into two main groups. In the first group, the veins have distal points of attachment into portal vein systems. In the second group, the veins have distal points of attachment into systemic veins.
Classification* ; Fetal Weight ; Fetus* ; Foot ; Gestational Age ; Hand ; Hernia, Umbilical ; Humans ; Incidence ; Infant ; Jeollabuk-do ; Ligaments ; Live Birth ; Liver ; Polycystic Kidney Diseases ; Portal Vein ; Stillbirth ; Syndactyly ; Umbilical Veins* ; Veins ; Vitellins

CD10, a marker of immature B lymphocytes, is expressed in the developing epithelium of mammary glands, hair follicles, and renal tubules of human fetuses. To assess mesenchymal and stromal expression of CD10, we performed immunohistochemical assays in whole body sections from eight fetuses of gestational ages 15-20 weeks. In addition to expression in urinary tract and intestinal epithelium, CD10 was strongly expressed at both gestational ages in fibrous tissues surrounding the airways from the larynx to lung alveoli, in the periosteum and ossification center, and in the glans of external genitalia. CD10 was not expressed, however, in other cavernous tissues. These findings suggest that mesenchymal, in addition to epithelial cells at specific sites, are likely to express CD10. The glomeruli, alveoli, and glans are all end products of budding or outgrowth processes in the epithelium or skin. However, in contrast to the CD34 marker of stromal stem cells, CD10 was not expressed in vascular progenitor cells and in differentiated vascular endothelium. The alternating pattern of CD10 and CD34 expression suggests that these factors play different roles in cellular differentiation and proliferation of the kidneys, airway and external genitalia.
Endothelium, Vascular ; Epithelial Cells ; Epithelium ; Fetus* ; Genitalia ; Gestational Age ; Hair Follicle ; Humans* ; Intestinal Mucosa ; Kidney ; Larynx ; Lung ; Mammary Glands, Human ; Mesoderm ; Periosteum ; Precursor Cells, B-Lymphoid ; Skin ; Stem Cells ; Urinary Tract

BACKGROUNDS/AIMS: Pancreaticoduodenctomy (PD) is associated with high rates of postoperative morbidity and mortality. Although many studies have shown that early postoperative enteral nutrition improves postoperative outcomes, limited clinical information is available on postoperative early oral feeding (EOF) after PD. The aim of this study was to evaluate the clinical feasibility, safety, and nutritional effects of EOF after PD. METHODS: Clinical outcomes were investigated in 131 patients who underwent PD between 2003 and 2013, including 81 whose oral feeding was commenced within 48 hours (EOF group) and 50 whose oral feeding was commenced after resumption of bowel movements (traditional oral feeding [TOF] group). Postoperative complications, energy intake, and length of stay (LOS) were reviewed. RESULTS: Demographic factors were similar in the two groups. The EOF group had a significantly shorter LOS (25.9+/-8.5 days vs. 32.3+/-16.3 days; p=0.01) than the TOF group. The rates of anastomotic leak (1.2% vs. 16%, p=0.00) and reoperation (3.7% vs. 20%, p=0.01) were significantly lower in the EOF group. In the clinically acute phase from postoperative day 1 to day 5, the mean daily calorie intake (847.0 kcal vs. 745.6 kcal; p=0.04) and mean daily protein intake (42.2 g vs. 31.9 g; p=0.00) in the EOF group were significantly higher than that in the TOF group. CONCLUSIONS: Postoperative EOF is a clinically safe, feasible, and effective method of nutritional support after PD.
Anastomotic Leak ; Demography ; Energy Intake ; Enteral Nutrition ; Humans ; Length of Stay ; Mortality ; Nutritional Support ; Pancreaticoduodenectomy* ; Postoperative Complications ; Reoperation

Biohybrid artificial organs encompass all devices capable of substituting for an organ or tissue function and are fabricated from both synthetic materials and living cells. The viability of engineered tissue could be related to the viability of implanted cells. The system of viability assay for mammalian cell culture can be applied to the determination of cell viability for engineered tissue. This review explores various methods of cell viability assay which can be applied to the viability evaluation of engineered tissue. The major criteria employed in viability assays include survival and growth in tissue culture, functional assay, metabolite incorporation, structural altercation, and membrane integrity. Each viability assay method is based on different definitions of cell viability, and has inherent advantages and disadvantages. In order to be able to assess the viability of cells with one assay method, it is desirable to compare the viability measurements from various assays derived from different criteria.
Animal ; Biomedical Engineering*/methods ; Cell Division ; Cell Survival ; Human

The clinical value of the pre-(165 pts) and post-operative(149 pts) serum levels of carcinoembryogenic antigen(CEA) in 190 patients(pts) with colorectal cancer was investigated, who had a curative surgery and an abnormally elevated levels of CEA (> or=5 ng/ml) at Department of General Surgery, Chonbuk National University Hospital during 1989 to 1996. The results are as follows: 1) The preoperative positive rates of CEA level were 49(29.7%) of 165 patients, so preoperative CEA level measurement was no usefulness for screening test of colorectal cancer. The incidence of preoperatively elevated CEA levels in Dukes stages A, B, C, and D were 0, 28.6, 32.8 and 42.9% respectively, There was significant association between increased proportion of patients with preopertive serum CEA(> OR = 5 ng/ml) and the progressive stages of colorectal cancers(P<0.05). 2) There was no significant association between the frequency of abnormal CEA level and histologic differentiation of tumor. 3) The recurrence rate was 16.4% and 30.6% in patients with preoperative CEA < 5 ng/ml and > OR =5 ng/ml, respectively(p<0.05). 4) In patients with recurrence, the lymph node positive group(70.6%) was larger than the negative(29.4%)(p<0.05), and preoperative positive rate of CEA value was 44%. 5) The recurrence rate in Dukes stages A, Bl, B2, Cl, C2, and D were 0, 8.7, 12.7, 16.7, 32.3, and 90.0% respectively(p<0.01). 6) There was no significant association between the frequency of abnormal CEA level and location of tumor. 7) The recurrence rate was 12.3% and 65.7% in patients with postoperative CEA < 5 ng/ml and > OR = 5 ng/ml, respectively(p<0.01). 8) In patients with metastasis, postoperative positive rate of CEA level was 63%(p< 0.01).
Colorectal Neoplasms ; Humans ; Incidence ; Jeollabuk-do ; Lymph Nodes ; Mass Screening ; Neoplasm Metastasis ; Recurrence

Prevention of fatal postoperative complications and improved management of patients with complications are important means for achieving increased survival in gastric cancer patients. A study of 390 patients undergoing gastrectomies at the Department of Surgery, Chonbuk National University Hospital, during 6 years from 1990 to 1995 was performed to examine factors related to a high rate of postoperative complications and to compare specific and non-specific complications. Postoperative complications developed in 185 (47.4%) out of the total 390 cases undergoing gastrectomies for gastric cancer; including 107 (27.4%) specific and 78 (20.0%) non-specific. Typical complications were 46 cases of diarrhea, 20 cases of intestinal obstruction including an adhesive and paralytic ileus, 16 cases of vomiting, 7 cases of anastomotic leakage, 7 cases of hemorrhage, 6 cases of anastomosis stenosis, 2 cases of duodenal stump leakage, 1 case of acute pancreatitis, 1 case of pancreatic fistula, 1 case of enterocutaneous fistula within the category of specific complications and 22 cases of elevated hepatic enzymes, 21 cases of pulmonary disease, 2 cases of abnormal EKG, 2 cases of sepsis, 2 cases of cerebral infarction, and 1 case of renal failure within the category of non-specific complications. Multivariate analysis identified combined resection, radical resection in stage IV in operative factors, blood(PRC) transfusion of over 4 units, elevation of sGOT and sGPT, age between 50 and 65, diabetic mellitus of coexistic diseases in non-operative factors as detrimental factors with an independent influence on the postoperative complications for gastric cancer. We believe that the postoperative complications for gastric cancer did not develope because of local and operative factors, but were significantly common when general and non-operative factors were combined with gastrectomy.
Adhesives ; Alanine Transaminase ; Anastomotic Leak ; Aspartate Aminotransferases ; Cerebral Infarction ; Constriction, Pathologic ; Diarrhea ; Electrocardiography ; Gastrectomy ; Hemorrhage ; Humans ; Intestinal Fistula ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction ; Jeollabuk-do ; Lung Diseases ; Multivariate Analysis ; Pancreatic Fistula ; Pancreatitis ; Postoperative Complications ; Renal Insufficiency ; Sepsis ; Stomach Neoplasms* ; Vomiting

The ovarian hyperstimulation syndrome is a rare but serious complication of ovulation induction therapy with gonadotropin. The clinical manifestations are generalized edema, ascites with pleural effusion and may become life-threatening in severe cases. The pathophysiology is still unknown therefore, the treatment should be symptomatic and conservative. We report a case of severe OHSS with massive right pleural effusion in excess of ten liters after human menopausal gonadotropin therapy because of secondary infertility. Fluid and electrolyte imbalances were corrected and albumin was administered. A right chest tube was placed for a total of sixteen days, draining eleven liters of pleural effusion totally, resulting a dramatic decrease of pleural effusion and improvement of symptoms.
Ascites ; Chest Tubes ; Edema ; Female ; Gonadotropins ; Humans ; Infertility ; Ovarian Hyperstimulation Syndrome* ; Ovulation Induction ; Pleural Effusion*

OBJECTIVE: Ontology is becoming a core research field in the realm of medical informatics. The objective of our ongoing research is to explore the potential role of Formal Concept Analysis(FCA) in a context-based ontology building support in a medical domain. The concept hierarchy plays an important role as the backbone of ontology, but its construction is a complex and time-consuming process. We present a novel approach to the automatic acquisition of taxonomies or concept hierarchies from clinical documents. METHODS: Our approach is based on FCA, a mathematical tool used in data analysis and knowledge engineering. It provides methods to group objects and attributes into concepts, pairs of object-sets(clinical documents) and attribute-sets(fields contained in the clinical documents), such that the binary relation can be presented in a concept lattice. Based on the FCA, we have applied out approach for 8 clinical documents used in a university hospital. As a result of our experiments, we can extract 15 concepts with 7 common fields that can be shared with 8 clinical documents. RESULTS: We show how FCA can be used to classify clinical documents and acquire a concept hierarchy for the medical domain out of the clinical documents with maximal property factorization. CONCLUSION: The whole of our work is based on the concept lattice of which allows to construct a "well defined" ontological concept hierarchy. As an application of this approach, we presented some results of classification of clinical documents with maximally factorized common fields. We have shown that FCA can be useful method to classify and analyze various medical data by constructing concept hierarchy. From that concept hierarchy, we can acquire well-structured facts and knowledges in medical domain.
Classification* ; Medical Informatics ; Statistics as Topic

We have cloned a cDNA encoding a cysteine proteinase of the Acanthamoeba healyi OC-3A strain isolated from the brain of a granulomatous amoebic encephalitis patient. A DNA probe for an A. healyi cDNA library screening was amplified by PCR using degenerate oligonucleotide primers designed on the basis of conserved amino acids franking the active sites of cysteine and asparagine residues that are conserved in the eukaryotic cysteine proteinases. Cysteine proteinase gene of A. healyi (AhCP1) was composed of 330 amino acids with signal sequence, a proposed pro-domain and a predicted active site made up of the catalytic residues, Cys(25), His(159), and Asn(175). Deduced amino acid sequence analysis indicated that AhCP1 belongs to ERFNIN subfamily of C1 peptidases. By Northern blot analysis, no direct correlation was observed between AhCP1 mRNA expression and virulence of Acanthamoeba, but the gene was expressed at higher level in amoebae isolated from soil than those from clinical samples. These findings raise the possibility that Ahcp1 protein may play a role in protein metabolism and digestion of phagocytosed bacteria or host tissue debris rather than in invasion of amoebae into host tissue.
Acanthamoeba/*enzymology/genetics/pathogenicity ; Amebiasis/parasitology ; Amino Acid Sequence ; Animals ; Base Sequence ; Cathepsins/*genetics ; DNA, Protozoan/chemistry/genetics/*isolation & purification ; Encephalitis/parasitology ; Gene Expression ; Genes, Protozoan ; Humans ; Molecular Sequence Data ; Polymerase Chain Reaction ; Protozoan Proteins/chemistry/genetics/physiology ; Sequence Alignment ; Virulence