Recent studies have shown that circulating microRNAs are a potential biomarker in various types of malignancies. The aim of this study was to investigate the feasibility of using serum exosomal microRNAs as novel serological biomarkers for hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). We measured the serum exosomal microRNAs and serum circulating microRNAs in patients with CHB (n=20), liver cirrhosis (LC) (n=20) and HCC (n=20). Serum exosomal microRNA was extracted from 500 mul of serum using an Exosome RNA Isolation kit. The expression levels of microRNAs were quantified by real-time PCR. The expression levels of selected microRNAs were normalized to Caenorhabditis elegans microRNA (Cel-miR-39). The serum levels of exosomal miR-18a, miR-221, miR-222 and miR-224 were significantly higher in patients with HCC than those with CHB or LC (P<0.05). Further, the serum levels of exosomal miR-101, miR-106b, miR-122 and miR-195 were lower in patients with HCC than in patients with CHB (P=0.014, P<0.001, P<0.001 and P<0.001, respectively). There was no significant difference in the levels of miR-21 and miR-93 among the three groups. Additionally, the serum levels of circulating microRNAs showed a smaller difference between HCC and either CHB or LC. This study suggests that serum exosomal microRNAs may be used as novel serological biomarkers for HCC.
Adult ; Aged ; Biomarkers, Tumor/blood/genetics ; Carcinoma, Hepatocellular/blood/diagnosis/*genetics ; Exosomes/genetics ; Female ; Gene Expression Profiling ; Humans ; Liver/pathology ; Liver Neoplasms/blood/diagnosis/*genetics ; Male ; MicroRNAs/blood/*genetics ; Middle Aged

PURPOSE: We aimed to evaluate the use and safety of double dose oseltamivir for patients manifesting severe respiratory symptoms or showing no improvement of clinical symptoms after 72 hours' treatment with the usual oseltamivir dosage. METHODS: We analyzed the clinical features of 2009 influenza A H1N1 inpatients who had been admitted to a university hospital's Department of Pediatrics between August 2009 and January 2010. The Influenza A H1N1 diagnoses were confirmed by real-time reverse transcriptase polymerase chain reaction. RESULTS: The study participants numbered 157 (mean age, 5.0 years; male-to-female ratio, 1.1:1). Among them, twenty (mean age, 5.2 years) were administered double dose oseltamivir. This double dose group showed higher peak body temperatures and more abnormal radiologic results than the other, usual-dose group. The mean time duration between high fever and afebrile status after initiation of double-dose oseltamivir administration was 2.1 days, whereas that within the usual-dose group was 1.7 days. There were no adverse effects in the patients treated with double-dose oseltamivir. CONCLUSION: Double-dose oseltamivir was well tolerated in patients with severe 2009 influenza A H1N1 infection.
Body Temperature ; Diagnosis ; Fever ; Humans ; Influenza A virus ; Influenza, Human* ; Inpatients ; Oseltamivir* ; Pandemics* ; Pediatrics ; Reverse Transcriptase Polymerase Chain Reaction ; Severity of Illness Index

PURPOSE: Carotid artery intima-media thickness (cIMT) has been reported as the predictive factor of mortality of cardiovascular disease in dialysis patients but only a few reports are available on the patients with earlier stages. We compared cIMT according to the stage of chronic kidney disease, and analyzed the data in association with cardiovascular risk factors. METHODS: Study subjects were 88 patients with chronic kidney disease less than 60 ml/min/1.73m2 of glomerular filtration rate. cIMT was measured by means of high- resolution B-mode ultrasonography. Cardiovascular risk factors and cIMT were analyzed and compared with 30 subjects with normal renal function. RESULTS: cIMT was significantly increased with the stage of chronic kidney disease. When the stage was increased from 3 to 5, cIMT was increased (p=002). cIMT was further increased in all stages of chronic kidney disease than in patients with normal kidney function. But association of diabetic chronic kidney disease with non-diabetic chronic kidney disease was not significant (p=0.127). Multiple regression analysis showed that cIMT in patients with chronic kidney disease was significantly correlated to age, glomerular filtration rate, and the stage of chronic kidney disease. CONCLUSION: We suggest that carotid atherosclerosis could increase in no dialysis patients with early stage of chronic kidney disease. Carotid artery intima-media thickness was correlated with age, glomerular filtration rate, and the stage of chronic kidney disease.
Atherosclerosis ; Cardiovascular Diseases ; Carotid Arteries ; Carotid Artery Diseases ; Dialysis ; Glomerular Filtration Rate ; Humans ; Kidney ; Renal Insufficiency, Chronic ; Risk Factors

Otosclerosis is a localized disorder of bone metabolism involving the endochondral bone of the otic and labyrinthine capsule. Both "advanced" and "very advanced" otosclerosis refer to the state of otosclerotic involvement of the otic capsule, which has progressed to result in profound deafness with undetectable bone and air conduction thresholds. Shea et al. estimated that 1.6% of patients with otosclerosis had developed profound hearing losses, and that hearing improvements after stapes surgeries in these patients were lower than the case of "not-advanced" otosclerosis. Stapedectomy and hearing aid amplification could be tried, but cochlear implantation is an established intervention for patients with profound sensorineural hearing loss due to otosclerosis. Although the reported results of cochlear implantations in otosclerosis patients are not significantly different from those of other cochlear implantees not affected by otosclerosis, in former conditions, potential ossification of cochlea, facial nerve stimulation, and instability of the results might take place. We report a case of otosclerosis histologically diagnosed for the first time here in Korea, and for which cochlear implantation was successfully performed.
Cochlea ; Cochlear Implantation ; Cochlear Implants ; Deafness ; Facial Nerve ; Hearing ; Hearing Aids ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Hypogonadism ; Korea ; Mitochondrial Diseases ; Ophthalmoplegia ; Otosclerosis ; Stapes Surgery

OBJECTIVE: Our purpose was to investigate transglutaminase 2 (TGM2) mRNA and protein expressions in term placentas and fetal membranes delivered with labor compared to no labor. METHODS: Samples were obtained from five cases delivered with labor and five cases delivered without labor after 38 weeks of gestation. Each sample was collected from amnion, chorion, central and peripheral portion of the basal plate of placenta. Real time polymerase chain reaction (RT-PCR) was done to analyze mRNA expression of TGM2. Western blot was done and TGM2 protein level was detected. Mann-Whitney U test was used for statistic analysis. RESULTS: In labor group, TGM2 mRNA expressions were decreased compared to no labor group in 3 sampling sites except chorion (0.66+/-0.10 vs 1.29+/-0.12 in peripheral placenta, 0.67+/-0.23 vs 1.02+/-0.02 in central placenta, 0.70+/-0.16 vs 1.04+/-0.05 in amnion in contrast with 1.62+/-0.64 vs 1.56+/-0.21 in chorion). TGM2 protein expressions of four differential portions were decreased in all labor groups (1.05+/-0.35 vs 1.27+/-0.19 in peripheral placenta, 0.69+/-0.84 vs 0.84+/-0.31 in central placenta, 0.33+/-0.15 vs 0.39+/-0.33 in amnion, 0.96+/-0.18 vs 1.77+/-0.61 in chorion). CONCLUSIONS: This result suggests that TGM2 might involve in labor progress of term pregnancy.
Amnion ; Blotting, Western ; Chorion ; Extraembryonic Membranes ; Gene Expression ; GTP-Binding Proteins ; Placenta ; Pregnancy ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Transglutaminases

OBJECTIVE: This study was designed to detect genes specifically expressed in severe preeclamptic placentas. METHODS: Placenta tissues were collected immediately after delivery from 5 preeclamptic patients and 5 normal pregnant women. Total RNAs of each placenta were extracted and hybridized for a cDNA microarray. Of the microarray data, four up-regulated genes (DSCR4, GPA, PCDHGB1, Hemogen) and four down-regulated genes (IL1R2, MGST1, GAS1 GREB1) were selected and reverse transcriptase-polymerase chain reaction was used to confirm the results of cDNA microarray. RESULTS: The expression fold for each up-regulated gene was 2.2 times for DSCR4, 2.7 times for PCDHGB1, 3.5 times for Hemogen, 5.2 times for GPA on the cDNA microarray. The expression fold for each down-regulated gene was 3.3 times for IL1R2, 4.2 times for MGST1, 4.9 times for GAS1 and 2.3 times for GREB1 on the cDNA microarray. The expression fold for each up- regulated gene was 5.21 times for DSCR4, 3.01 times for PCDHGB1, and 4,53 times for Hemogen and 2.2 times for GPA on RT-PCR. The expression fold for each down-regulated gene was 2.7 times for IL1R2, 2.22 times for MGST1, 2.53 times for GAS1 and 1.83 times for GREB1 on the RT-PCR. CONCLUSION: DSCR4, PCDHGB1, Hemogen and GPA as the up-regulated genes and IL1R2, MGST1, GAS1 and GREB1 as the down-regulated genes, which were found and selected by the cDNA microarray, might be considered to be novel biomarkers for preeclampsia.
Biomarkers ; Chimera ; Female ; Gene Expression ; Humans ; Microarray Analysis ; Oligonucleotide Array Sequence Analysis ; Placenta ; Pre-Eclampsia ; Pregnant Women ; RNA

OBJECTIVE: The aim of this study was to examine the effects of maternal age on perinatal and obstetric outcomes with respect to maternal age older than 40 years. METHODS: A retrospective review of maternal and newborn medical records of women who delivered their babies in the hospitals of the Catholic University of Korea between January 1, 2000 and July 1, 2005 was conducted to compare pregnancy complications and perinatal outcomes in three age groups; women aged 25~29 years (group A; n=214), those aged 35~39 years (group B; n=276), and those aged 40 years and older (group C; n=347). RESULTS: The incidences of GDM (gestational diabetes mellitus), preterm birth and cesarean section in group C were by far the greatest among the three groups. The incidence of postterm delivery in group A was the highest among the three groups. Previous cesarean section and elderly gravida were the most frequent causes of cesarean section in group C. The incidences of low birth weight (<2,500 g) and the NMICU(neonatal medical intensive care unit) admission rate in group C were higher than those in group B, but not significantly different from those in group A. CONCLUSION: Maternal ages of 35~39 years do not appear to be associated with adverse perinatal and obstetrical outcomes. Maternal ages of over 40 years influence the incidences of PIH (pregnancy induced hypertension), GDM, preterm birth, cesarean section, placenta previa, low birth weight and NMICU admission.
Aged ; Cesarean Section ; Female ; Humans ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Critical Care ; Korea ; Maternal Age* ; Medical Records ; Placenta Previa ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome* ; Pregnancy* ; Premature Birth ; Retrospective Studies

OBJECTIVE:cDNA microarray technology was used to comprehensively analyze the gene expression in the placenta of term women with labor compared to without labor. METHODS:Placental tissue was obtained from patients in spontaneous labor (n=5) and those not in labor (n=5) during Cesarean section of full term pregnancy. mRNA levels were examined through cDNA microarray using Agilent GeneSpringGX 7.3 (Agilent technology, USA). SPSS 11.0 was used for statistical analysis. RESULTS:Among total 38,467 genes, 2,374 genes were detected to be up-regulated in labor samples, while 12 genes were down-regulated. 40 genes of them were identified as significantly up-regulated in levels of expression (up-regulated > or =5.0 fold, p<0.05). According to gene ontology analysis, they are associated with variable cell biologic functions including apoptosis, signal transduction, metabolic process, immune response, and transcription, etc. CONCLUSION:This study suggests that our results could provide interesting clues to understanding the initiation and the process of normal labor and might lead to further studies in a more targeted fashion.
Apoptosis ; Cesarean Section ; DNA, Complementary* ; Female ; Gene Expression Profiling ; Gene Expression* ; Gene Ontology ; Humans ; Metabolism ; Oligonucleotide Array Sequence Analysis* ; Placenta* ; Pregnancy ; Pregnant Women* ; RNA, Messenger ; Signal Transduction

One of the most interesting congenital malformations is a conjoined twin. Conjoined twins are a rare occurrence in obstetric practice. More commonly known as Siamese twins, this phenomenon is shrouded in mystery and considered a curiosity by general public. Current technology is providing a basis for earlier diagnosis and a better prognosis. Frequently, the twins are born dead, but there are a few cases in which the twins survive. We present a case of thoraco-omphalophagus with omphalocele in 35 years old woman at 25weeks 5 days gestation by 3-D ultrasonography and MRI.
Adult ; Diagnosis ; Exploratory Behavior ; Female ; Hernia, Umbilical* ; Humans ; Magnetic Resonance Imaging* ; Pregnancy ; Prognosis ; Twins, Conjoined ; Ultrasonography*

OBJECTIVE: The aim of our study was to identify graft, obstetric and maternal outcomes of pregnancies in renal transplant recipients at our center. METHODS: A 14-year retrospective study between January 1990 and December 2003, 224 women 15 to 45 years of age had transplantation and were analyzed the outcomes of pregnancies, obstetric complications and graft function. RESULTS: Thirty-four pregnancies occurred in 21 of 224 patients. The mean age at the time of conception was 29.5 years (21 to 36 years) with a mean interval of 61.9 months (one to 162 months). In the pregnancy outcome, there were the 23 live births (67.6%) included 13 preterm and 10 term deliveries, 3 spontaneous abortions (8.8%), 7 artificial abortions (20.5%) and one case of ectopic pregnancy (2.9%). Obstetric complications were; preeclampsia (39.1%), preterm labor (43.4%), urinary tract infections (38.2%) and gestational diabetes (8.6%). Nine pregnancies within 2 years of transplantation had the permissible obstetric outcomes comparing with the others after 2 years (spontaneous abortion: p=0.77, artificial abortion: p=0.88, live birth: p=0.36). In twelve pregnancies appearing renal dysfunction associated with pregnancy, the abortion rate was increased comparing the others with stable renal function (p=0.006). Pre-pregnancy serum creatinine > or =1.4 mg/dl was associated with increased preterm delivery, but not significant (50.0% vs 28.5%, p=0.30). In graft function, serum creatinine 3~6 postpartum was significantly increased comparing pre-pregnancy levels (p=0.04). Five cases of 7 patients with acute rejection episode associated with pregnancy conceived after 4 years of transplantation. Two-year graft survival after delivery was 95.2% (20/21) and chronic rejection and graft failure was diagnosed in one case at postpartum 14 months. CONCLUSION: These findings suggest that, if the graft function is stable, pregnancy within 2 years after renal transplantation might be safe. Pregnancy does not appear to have adverse effects on long term graft survival.
Abortion, Induced ; Abortion, Spontaneous ; Creatinine ; Diabetes, Gestational ; Female ; Fertilization ; Graft Survival ; Humans ; Kidney Transplantation ; Live Birth ; Obstetric Labor, Premature ; Postpartum Period ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Pregnancy, Ectopic ; Retrospective Studies* ; Transplantation* ; Transplants ; Urinary Tract Infections