Duchenne muscular dystrophy (DMD) is a degenerative muscle disease characterized by a progressive decline in muscular function, with cardiomyopathy in the later stages. We report the autopsy findings of a 29-year-old man with DMD. He had been stable with the assistance of mechanical ventilation until he was found unconscious, without known cause. External examination confirmed generalized muscular atrophy and contracture consistent with his clinical history. Histopathology revealed varying degrees of fibrofatty changes in the muscles, with the calf muscles being the most extensively affected, followed by the diaphragm and heart. The cardiac muscle showed the least involvement and the pathology was confined to the left ventricular wall and the interventricular septum, exhibiting a unique morphology of fibrosis resembling stretched springs. The cause of death was attributed to cardiac failure due to DMD progression. This case highlights the clinical course of DMD, emphasizing the need for thorough examination of both skeletal and non-skeletal muscles, including the cardiac muscles, to obtain a better understanding of the disease.

BACKGROUND: Shift work disturbs workers' biological clocks and this condition can cause various health problems including cardiovascular disease. The elevated albuminuria level has been significantly associated with the risk of the cardiovascular disease even within a normal reference range. Therefore, this study aimed to investigate the association between shift work and microalbuminuria. METHODS: Workers aged over 20 years from the fifth and sixth Korea National Health and Nutrition Examination Survey(KNHANES 2012–2014; n = 3000) were included in this analysis. The multiple logistic regression analysis was performed to determine the association between shift work and microalbuminuria stratified by gender. RESULTS: The prevalence of microalbuminuria in male subjects was higher among day workers, but the difference was not significant. However, the prevalence of microalbuminuria among females was higher in shift workers with statistical significance. For female, the Odds ratio of microalbuminuria in shift workers was significantly higher with 1.86 (95% CI 1.02–3.39) compared with day workers. After dividing into 5 subgroups of the shift work pattern, the odds ratio of microalbuminuria for fixed night shift was significantly higher at 4.68 (95% CI 1.29–17.00) compared with day workers. CONCLUSIONS: This study showed that shift work was associated with microalbuminuria in female workers. Especially we found out the association between fixed night shift and microalbuminuria in female workers.
Albuminuria ; Biological Clocks ; Cardiovascular Diseases ; Female ; Humans ; Korea ; Logistic Models ; Male ; Odds Ratio ; Prevalence ; Reference Values

Hepatocellular carcinoma (HCC) is one of the major cancers with a high incidence and mortality in Korea. A Korean multidisciplinary collaborative committee consisting of hepatologists, radiologists, epidemiologists and family medicine doctors systematically reviewed clinical practice guidelines in the world and literatures. The level of evidence for each recommendation was assessed and discussed to reach a consensus. Meta-analysis was also conducted to evaluate the grade of recommendation for the five key questions. Several randomized controlled studies and cohort studies showed a survival gain associated with surveillance for those at risk of developing HCC. The target populations for HCC surveillance were identified as hepatitis B virus or hepatitis C virus carriers and cirrhotic patients, since numerous studies revealed that these patients have significantly higher risk of HCC compared with non-infected or non-cirrhotic controls. Individual surveillance strategy according to treatment history or degree of fibrosis in patients with viral hepatitis remains to be settled. Based on several cohort and randomized studies, a surveillance interval of six months was recommend. The starting age of surveillance was determined as 40 years from the epidemiologic data. Although ultrasonography (US) is the mainstay for detection of HCC, its sensitivity is not fully accepted. Measurement of serum alpha-fetoprotein can complement US examination, increasing the sensitivity of HCC detection. The recommendation for HCC surveillance is that those with hepatitis B virus (or hepatitis C virus) infection or cirrhosis should have liver US and serum alpha-fetoprotein measurement every six months from 40 years of age or at the time of diagnosis of cirrhosis.
alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Cohort Studies ; Complement System Proteins ; Consensus ; Diagnosis ; Fibrosis ; Health Services Needs and Demand ; Hepacivirus ; Hepatitis ; Hepatitis B virus ; Hepatitis C ; Humans ; Incidence ; Korea ; Liver ; Mortality ; Ultrasonography

No abstract available.

Follow-Up Studies ; Humans ; Jaw ; Orthognathic Surgery

OBJECTIVES: Mental fitness issues have recently become a point of dispute in the field of health. Drivers are occupationally in danger of a possible accident, and are also exposed to other factors aside from accidents that threaten their mental health. The purpose of this research is to examine the level and state of post traumatic stress disorder (PTSD) and overall mental fitness in bus drivers. In addition, we wish to understand the various causes that can influence PTSD. METHODS: From April 1 to June 30, 2009, taking the region and number of workers into consideration, survey sheets were distributed to selected bus drivers who belonged to the public transportation union. The questionnaire included questions on experiences, details of accidents, the characteristics of the working environment, and the status of mental health. We used the Davidson Trauma Scale to investigate PTSD symptoms and the Center for Epidemiological Studies Depression Scale to evaluate depression. RESULTS: Regardless of the type of accident, the group of bus drivers with accident experience showed stronger signs of suffering from PTSD. It seemed that the experience of an accident that caused the death of passengers or conflict with passengers were important factors for PTSD. Within the PTSD group, we found more symptoms of depression, and also this group is more likely to take time off work. CONCLUSIONS: The experience of an accident threatens the mental health of bus drivers. Since bus drivers are responsible for the safety of many citizens, we must work towards finding ways to protect their mental health.
Depression ; Dissent and Disputes ; Epidemiologic Studies ; Mental Health ; Occupations ; Questionnaires ; Stress Disorders, Post-Traumatic ; Stress Disorders, Traumatic ; Stress, Psychological ; Transportation

INTRODUCTION: Skeletal homeostasis is normally maintained by the stability between bone formation by osteoblasts and bone resorption by osteoclasts. However, the correlation between the inflammatory reaction and osteoblastic differentiation of cultured osteoprogenitor cells has not been fully investigated. This study examined the effects of inflammatory cytokines on the osteoblastic differentiation of cultured human periosteal-derived cells. MATERIALS AND METHODS: Periosteal-derived cells were obtained from the mandibular periosteum and introduced into the cell culture. After passage 3, the periosteal-derived cells were further cultured in an osteogenic induction Dulbecco's modified Eagle's medium (DMEM) medium containing dexamethasone, ascorbic acid, and beta-glycerophosphate. In this culture medium, tumor necrosis factor (TNF)-alpha with different concentrations (0.1, 1, and 10 ng/mL) or interleukin (IL)-1beta with different concentrations (0.01, 0.1, and 1 ng/mL) were added. RESULTS: Both TNF-alpha and IL-1beta stimulated alkaline phosphatase (ALP) expression in the periosteal-derived cells. TNF-alpha and IL-1beta increased the level of ALP expression in a dose-dependent manner. Both TNF-alpha and IL-1beta also increased the level of alizarin red S staining in a dose-dependent manner during osteoblastic differentiation of cultured human periosteal-derived cells. CONCLUSION: These results suggest that inflammatory cytokines TNF-alpha and IL-1beta can stimulate the osteoblastic activity of cultured human periosteal-derived cells.
Alkaline Phosphatase ; Anthraquinones ; Ascorbic Acid ; Bone Resorption ; Cell Culture Techniques ; Cytokines ; Dexamethasone ; Durapatite ; Glycerophosphates ; Homeostasis ; Humans ; Interleukins ; Osteoblasts ; Osteoclasts ; Osteogenesis ; Periosteum ; Tumor Necrosis Factor-alpha

Adult ; Animals ; Bone Regeneration ; Bone Transplantation ; Durapatite ; Ear ; Fibrin ; Fibrin Tissue Adhesive ; Humans ; Minerals ; Osteocalcin ; Osteogenesis ; Skin ; Swine ; Transplants

Ascorbic Acid ; Bone Development ; Bone Marrow ; Dexamethasone ; Durapatite ; Fractures, Bone ; Gene Expression ; Glycerophosphates ; Humans ; Neuropilin-1 ; Osteoblasts ; Osteocalcin ; Osteogenesis ; Phenotype ; Protein Isoforms ; Receptors, Vascular Endothelial Growth Factor ; Stromal Cells ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factor Receptor-1 ; Vascular Endothelial Growth Factor Receptor-2

BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) is becoming one of the common malignant tumors worldwide, and it is characterized by its high vascularity. Caveolin is the major structural protein in caveolae, which are small omega-shaped invaginations within the plasma membrane. Caveolin has been implicated in mitogenic signaling, oncogenesis and angiogenesis. The expression of caveolin-1 and -2 in HCC and its potential relationship with angiogenesis has not been examined. METHODS: Paraffin sections of 35 HCC specimens were immunostained with caveolin-1, caveolin-2, alpha-smooth muscle actin, and CD34 antibodies. In addition, the expression of caveolin-1 and -2 mRNA in HCC was examined. The relationship between the radiological findings and the number of unpaired arteries and microvessel density (MVD) was also investigated. RESULTS: Caveolin-1 and -2 were expressed in the sinusoidal endothelial cells in 20 out of 35, and 18 out of 35 HCC specimens, respectively. Caveolin-1 and -2 were also expressed in the smooth muscle cells of the unpaired arteries in 26 out of 35, and 18 out of 35 HCC specimens, respectively. Increased expression of caveolin-1 and -2 mRNA was detected in 26.7% and 33.3% of the tumor specimens, respectively, compared with the corresponding non-tumorous adjacent liver tissues. There was a significant correlation between expression of caveolin-1, -2 in the smooth muscle cells of unpaired arteries and the number of unpaired arteries. The number of unpaired arteries in HCCs was found to be associated with the degree of contrast enhancement in the arterial phase imaging. However, it did not correlate with the degree of MVD. CONCLUSIONS: These findings suggest that the expression of caveolin-1, -2 is associated with the formation of unpaired arteries in HCC. In addition, there is a correlation between the degree of contrast enhancement of the HCC in the arterial phase image and the number of unpaired arteries.
Adult ; Aged ; Carcinoma, Hepatocellular/*blood supply/metabolism/radiography ; Caveolin 1/genetics/*metabolism ; Caveolin 2/genetics/*metabolism ; Female ; Hepatic Artery/pathology/radiography ; Humans ; Liver Neoplasms/*blood supply/metabolism/radiography ; Male ; Middle Aged ; Neoplasm Staging ; Neovascularization, Pathologic/etiology/*metabolism/radiography ; Retrospective Studies