摘要
Severely worn dentition causes various complications such as loss of tooth structure, discoloration, pulp complications and loss of function and aesthetics. In this case, the patient showed particularly severe attrition in the anterior teeth and lack of space for restoration. The amount of vertical dimension was determined based on the diagnostic wax up, and the patient’s adaptation was evaluated by using a removable occlusal splint for 6 weeks. Thereafter, the coordination of the muscular nervous system, aesthetics, temporomandibular joint were re-evaluated for 3 months by restoring the fixed provisional restoration. Through the above treatment process, the final restoration was completed with full mouth fixed prosthesis using monolithic zirconia, and functionally and aesthetically stable results were obtained.
摘要
PURPOSE: To determine the origin of epiretinal proliferation (EP), a condition that is occasionally observed in lamellar hole and macular hole cases, and EP outcomes after vitrectomy. METHODS: This is a retrospective observational case review of 17 eyes with EP that underwent vitrectomy, EP dissection, and internal limiting membrane peeling between January 2013 and December 2016. Surgical specimens of EP tissue were successfully obtained from 5 cases and they were analyzed after immunohistochemical staining. Postoperative outcomes, including best-corrected visual acuity (BCVA) and macular configuration in spectral domain-optical coherence tomography, were reviewed. RESULTS: Mean BCVA improved from 0.54 ± 0.36 logarithms of the minimum angle of resolution preoperatively to 0.32 ± 0.38 logarithms of the minimum angle of resolution postoperatively (p = 0.002). BCVA improved in 13 eyes and remained unchanged in four eyes. No cases experienced vision decline after surgery. All 17 patients' lamellar hole or macular hole were successfully closed. Despite hole closure, ellipsoid zone defects were not corrected in 11 of the 17 patients. In immunohistochemical analyses, anti-glial fibrillary acidic protein and pan-keratin (AE1/AE3) were positive, but synaptophysin, anti-α-smooth muscle actin, and anti-CD68 were negative. CONCLUSIONS: The epiretinal proliferative membrane seems to originate from Müller cells, not from the vitreous. It is unclear whether retinal pigment epithelia also contribute to EP formation. Gentle handling and preservation of the epiretinal proliferative tissue is crucial for successful surgical outcomes.
Subject(s)
Humans , Actins , Membranes , Prognosis , Retinal Perforations , Retinaldehyde , Retrospective Studies , Synaptophysin , Visual Acuity , Vitrectomy摘要
PURPOSE: This study compared the functional fitness and brake response of elderly and young drivers to confirm the correlation between the functional fitness and brake response. METHODS: This study was a cross sectional observational design. Older drivers (>65age, n=21) and young adult drivers (20–40aged, n=20) were enrolled as subjects. The functional fitness of the subjects was measured using a senior fitness test consisting of a back scratch (BS), chair sit and reach (CSR), arm curl (AC), chair stand up (CSU), foot up and go (8-FUG), and 2-minute step (2-MS). The brake response used the virtual driving simulator to measure the brake reaction time (BRT) and braking distance (BD) according to the pedestrian protection and traffic signal compliance. RESULTS: The older drivers had a lower BS (p < 0.000), CSU (p=0.040), and 8-FUG (p=0.011) than the young adult drivers. BS and 8-FUG showed a significant positive correlation with the BRT and BD of pedestrian protection and traffic signal compliance. CSU showed a significant negative correlation with the BRT of pedestrian protection and traffic signal compliance. CONCLUSION: These findings suggest that the flexibility of the upper extremity, lower extremity strength, and agility are strongly correlated with the driving performance of elderly drivers.
Subject(s)
Aged , Humans , Young Adult , Arm , Compliance , Foot , Lower Extremity , Pliability , Reaction Time , Upper Extremity摘要
BACKGROUND: Delamanid, bedaquiline, and linezolid have recently been approved for the treatment of multidrug- and extensively drug-resistant (MDR and XDR, respectively) tuberculosis (TB). To use these drugs effectively, drug susceptibility tests, including rapid molecular techniques, are required for accurate diagnosis and treatment. Furthermore, mutation analyses are needed to assess the potential for resistance. We evaluated the minimum inhibitory concentrations (MICs) of these three anti-TB drugs for Korean MDR and XDR clinical strains and mutations in genes related to resistance to these drugs. METHODS: MICs were determined for delamanid, bedaquiline, and linezolid using a microdilution method. The PCR products of drug resistance-related genes from 420 clinical Mycobacterium tuberculosis strains were sequenced and aligned to those of M. tuberculosis H37Rv. RESULTS: The overall MICs for delamanid, bedaquiline, and linezolid ranged from ≤0.025 to >1.6 mg/L, ≤0.0312 to >4 mg/L, and ≤0.125 to 1 mg/L, respectively. Numerous mutations were found in drug-susceptible and -resistant strains. We did not detect specific mutations associated with resistance to bedaquiline and linezolid. However, the Gly81Ser and Gly81Asp mutations were associated with resistance to delamanid. CONCLUSIONS: We determined the MICs of three anti-TB drugs for Korean MDR and XDR strains and identified various mutations in resistance-related genes. Further studies are needed to determine the genetic mechanisms underlying resistance to these drugs.
Subject(s)
Diagnosis , Extensively Drug-Resistant Tuberculosis , Korea , Linezolid , Methods , Microbial Sensitivity Tests , Mycobacterium tuberculosis , Polymerase Chain Reaction , Tuberculosis摘要
PURPOSE: A delta-shaped anastomosis (DA) is a widely accepted technique used for a totally laparoscopic distal gastrectomy (TLDG). Several studies have suggested various modifications to overcome the drawbacks of an original DA. We present our novel technique―a T-shaped modified delta anastomosis (TDA), and we report the early outcomes with its use in a case series. METHODS: We retrospectively reviewed the medical records of 40 patients who underwent a TLDG with TDA for early gastric cancer at OOO between February 2016 and May 2017. Perioperative outcomes, postoperative complications, and operating time were analyzed, and all data were expressed as means±standard deviation. RESULTS: We observed no major complications that required immediate postoperative intervention. Other minor and non-surgical complications were delayed gastric emptying (n=1), pneumonia (n=2), atelectasis (n=3), dumping symptom (n=1), and symptomatic bile reflux (n=1). No wound infection was reported in any patient. The total operative time was 206.5±25.4 min and the estimated blood loss was 27.8±33.5 ml. The mean time required to perform the anastomosis was 20.9±6.7 min, and the mean number of cartridges used during the operation was 4.78±0.66. CONCLUSION: We conclude that a TDA following a laparoscopic distal gastrectomy was successfully developed and showed acceptable clinical outcome.
Subject(s)
Humans , Bile Reflux , Gastrectomy , Gastric Emptying , Laparoscopy , Medical Records , Operative Time , Pneumonia , Postoperative Complications , Pulmonary Atelectasis , Retrospective Studies , Stomach Neoplasms , Wound Infection摘要
PURPOSE: Both atopy and bronchial hyperresponsiveness (BHR) are characteristic features of asthma. Several BHR studies comparing groups of atopic and nonatopic asthmatics have reported conflicting results. The aim of this study was to compare BHR to indirect stimuli, such as mannitol or exercise, between atopic and nonatopic asthmatics in children. METHODS: We performed a retrospective analysis of data from 110 children with asthma, aged 6–18 years using skin prick tests, and serum total and specific IgE levels. Atopy degree was measured using the sum of graded wheal size or the sum of the allergen-specific IgE. Bronchial provocation tests (BPTs) using methacholine were performed on all subjects. BPTs using indirect simuli, including exercise and mannitol, were also performed. RESULTS: Asthma cases were classified as atopic asthma (n=83) or nonatopic asthma (n=27) from skin prick or allergen-specific IgE test results. There was no significant difference in the prevalence of BHR to mannitol or exercise between atopic and nonatopic asthmatics. Atopic asthma had a significantly lower postexercise maximum decrease in % forced expiratory volume in 1 second (FEV1) (geometric mean [95% confidence interval]: 31.9 [22.9–40.9] vs. 14.0 [9.4–18.6], P=0.015) and a methacholine PC20 (provocative concentration of methacholine inducing a 20% fall in FEV1) than nonatopic asthmatics (geometric mean [95% confidence interval]: 1.24 [0.60–1.87] ng/mL vs. 4.97 [3.47–6.47]) ng/mL, P=0.001), whereas mannitol PD15 (cumulative provocative dose causing a 15% fall in FEV1) was not significantly different between the 2 groups. CONCLUSION: There was no significant difference in the prevalence of BHR to mannitol or exercise between atopic and nonatopic asthmatics in children.
Subject(s)
Child , Humans , Asthma , Bronchial Provocation Tests , Forced Expiratory Volume , Immunoglobulin E , Mannitol , Methacholine Chloride , Prevalence , Retrospective Studies , Skin摘要
PURPOSE: It was found that periostin and squamous cell carcinoma-related antigens (SCCAs) were strongly interleukin-13-inducible gene products. This study measures the serum periostin and SCCA levels in children suffering from atopic dermatitis (AD) and to evaluate the association between the severity of AD and their values. METHODS: Seventy AD children aged 1 month to 10 years were included in our study. Subjects were characterized as having atopic eczema (AE; n=55) or non-AE (NAE; n=15) by atopic sensitization. Serum SCCA and periostin levels were measured. RESULTS: The serum periostin levels were significantly higher in children with AE than in those with NAE (geometric mean [95% confidence interval]: 80.47 ng/mL [75.06–85.93 ng/mL] vs. 67.45 ng/mL [59.99–75.64] ng/mL, P=0.020). The serum concentrations of both SCCA1 and SCCA2 were significantly higher in children with AE than in those with NAE (geometric mean [95% confidence interval]: 1.401 [1.198–1.643] ng/mL vs. 0.969 [0.723–1.268] ng/mL, P=0.039 for SCCA1) (1.178 [0.974–1.455] ng/mL vs. 0.711 [0.540–0.994] ng/mL, P=0.025 for SCCA2). The serum periostin levels were significantly correlated with disease severity and with peripheral blood eosinophil counts. The SCCA levels were not significantly correlated with disease severity. Both SCCA1 and SCCA2 were significantly correlated with serum periostin levels and blood eosinophil counts. CONCLUSION: Serum periostin levels may be significantly correlated with disease severity and blood eosinophil counts in children with AD. Serum SCCA levels can be significantly correlated with serum periostin levels and blood eosinophil counts in children with AD.
Subject(s)
Child , Humans , Dermatitis, Atopic , Eosinophils , Epithelial Cells摘要
PURPOSE: Recently, component-resolved diagnosis (CRD) using microarray technology has been introduced to the field of clinical allergy. This study was aimed to investigate the clinical usefulness of microarray-based IgE detection for diagnosing clinical raw fruit allergy in birch pollen-sensitized children. METHODS: Thirty-one children with allergic disease who had been sensitized to pollen were studied. A pollen-sensitized patient was defined as having an allergen-specific history with concomitant positive skin-prick tests (SPTs) to natural allergen extracts or positive allergen-specific IgE. All subjects underwent SPTs for pollen and fruit. In all subjects, specific IgE to pollen and fruit were measured by ImmunoCAP. Specific IgE antibodies to allergen components were determined by a customized allergen microarray (ISAC). RESULTS: Thirteen of the 31 patients (41.9%) had a history of fruit hypersensitivity with positive SPTs. Measuring IgE to allergen components by ISAC, all the 13 patients with fruit hypersensitivity were positive to at least one of Mal d 1, Pru p 1, Pru p 3, Act d 8, and Act d 2 compared to 12 of the 13 patients (92.3%) who had at least 1 positive IgE to fruits (apple, peach, and kiwi) using ImmunoCAP. The sensitivity of ISAC microarray was 100.0% for the diagnosis of fruit hypersensitivity, but its specificity was 27.7% (5/18). The sensitivity of ImmunoCAP was 92.3%, and its specificity was 83.3%. CONCLUSION: The sensitivity of allergen components tested using microarray for the diagnosis of clinical fruit hypersensitivity in children with pollen allergy was high; however, its specificity was low.
Subject(s)
Child , Humans , Antibodies , Betula , Diagnosis , Fruit , Hypersensitivity , Immunoglobulin E , Pollen , Prunus persica , Rhinitis, Allergic, Seasonal摘要
PURPOSE: Dysregulated cysteinyl leukotriene (CysLT) synthesis is prominent in exercise-induced bronchoconstriction (EIB). Secreted phospholipase A2 (sPLA2) plays a key regulatory role in the biosynthesis of CysLTs. We previously found that serum leptin levels correlate with (EIB) in children with asthma. The aim of this study was to address the relationship between plasma sPLA2/leptin levels and EIB. METHODS: Sixty-seven prepubertal children between the ages of 6 and 10 years were included in the study. They were asthmatics with EIB (n=25), asthmatics without EIB (n=21), and healthy subjects (n=21). We measured the plasma sPLA2 and leptin levels. We also performed pulmonary function tests at baseline, after bronchodilator inhalation, and after exercise. RESULTS: The sPLA2 and leptin levels were significantly higher in asthmatics with EIB than in those without and control subjects. In addition, sPLA2 levels were significantly correlated with body mass index (Speraman correlation coefficient r=0.343, P=0.023) and leptin levels (partial correlation coefficient r=318, P=0.033). The maximum decrease in % forced expiratory volume in 1 second after exercise was significantly correlated with both PLA2 levels (r=0.301, P=0.041) and leptin levels (r=0.346, P=0.018). CONCLUSION: The sPLA2 and leptin levels were significantly higher in asthmatics with EIB than in asthmatics without EIB and control subjects. In addition, sPLA2 levels were significantly correlated with leptin levels and EIB in asthmatic children.
Subject(s)
Child , Humans , Asthma , Body Mass Index , Bronchoconstriction , Forced Expiratory Volume , Inhalation , Leptin , Phospholipases A2 , Plasma , Respiratory Function Tests摘要
PURPOSE: To evaluate choroidal blood flow changes in eyes with high myopia according to the pulsatile components of ocular blood flow analysis. METHODS: A total of 104 subjects (52 males and 52 females) were included in this study. One eye of each participant was randomly selected and assigned to one of four refractive groups, designated as, hyperopes (n = 20; refractive error, > or =+1.00 diopter [D]), emmetropes (n = 28; refractive error, +/-0.75 D), lower myopes (n = 33; refractive error, -1.00 to -4.75 D), and high myopes (n = 23; refractive error, < or =-5.00 D). Components of pulse amplitude (OBFa), pulse volume (OBFv), pulse rate (OBFr), and pulsatile ocular blood flow (POBF) were analyzed using a blood flow analyzer. Intraocular pressure and axial length were measured. RESULTS: Pulsatile components of OBFa, OBFv, and POBF showed positive correlations with refractive error and showed negative correlations with axial length (r = 0.729, r = 0.772, r = 0.781, respectively, all p < 0.001; r = -0.727, r = -0.762, r = -0.771, respectively, all p < 0.001). The correlations of refractive error and axial length with OBFr were irrelevant (r = -0.157, p = 0.113; r = 0.123, p = 0.213). High myopes showed significantly lower OBFa, OBFv, and POBF than the other groups (all p < 0.001). CONCLUSIONS: Axial length changes in high myopes potentially influence choroidal blood flow, assuming the changes are caused by narrowing of the choroidal vessel diameter and increasing rigidity of the choroidal vessel wall. These finding explains the influence of axial length on OBFa, OBFv, and POBF, but not on OBFr. Thus, changes in axial length and the possible influence of these changes on the physical properties of choroidal vessels is the mechanism believed to be responsible for putting high myopes at risk for ocular vascular diseases.
Subject(s)
Adult , Female , Humans , Male , Young Adult , Axial Length, Eye , Choroid/blood supply , Myopia/diagnosis , Regional Blood Flow/physiology摘要
PURPOSE: Epidemiological data indicate that obesity is a risk factor in asthma, however effects related to obesity and adipokines on airway inflammation and bronchial hyper-responsiveness (BHR) have not yet been demonstrated in the human airway. The aim of this study was to investigate the relationship between serum adipokine levels and BHR to mannitol in asthmatic children. METHODS: Serum adipokine levels were measured and pulmonary function tests were perfomed: baseline, postbronchodilator inhalation, methacholine inhalation, and mannitol inhalation. The response to mannitol was expressed as the dose causing a 15% decrease in forced expiratory volume in one second (FEV1) (PD15), and as the response-dose ratio (RDR) (% fall in FEV1/cumulative dose). RESULTS: Sixty-nine prepubertal children between the ages of 6 and 10 years were participated in the study. They comprised asthmatic children (n=40) and healthy (n=29). Twenty-two subjects (55.5%) with asthma had a positive mannitol bronchial provocation test (BPT) result. The body mass index (BMI) was higher in those asthmatics with positive mannitol BPTs than in asthmatics with negative mannitol BPTs and in the control group (19.30 kg/m2 vs. 17.60 kg/m2 vs. 17.93 kg/m2, P=0.035, P=0.046). Serum leptin levels were also significantly higher in asthmatics with positive mannitol BPTs than in asthmatics with negative mannitol BPTs and in the control group (10.58 ng/mL vs. 5.49 ng/mL vs. 6.75 ng/mL, P=0.002, P=0.016). Leptin values were significantly associated with a PD15 (r=-0.498, P=0.022) and RDR to mannitol (r=0.346, P=0.033) in asthmatic children after adjustment for BMI. CONCLUSION: Serum leptin levels were significantly associated with BHR to mannitol in asthmatic children.
Subject(s)
Child , Humans , Adipokines , Asthma , Body Mass Index , Bronchial Provocation Tests , Forced Expiratory Volume , Inflammation , Inhalation , Leptin , Mannitol , Methacholine Chloride , Obesity , Respiratory Function Tests , Risk Factors摘要
PURPOSE: To evaluate the efficacy of noncontact specular microscopy (NCSM) by comparing the measurement of central corneal thickness (CCT) to the measurement with anterior segment optical coherence tomography (AS-OCT) and ultrasound pachymetry (USP). METHODS: One examiner measured the CCT of 50 eyes of 50 healthy young subjects using NCSM, AS-OCT, and USP. The mean values and correlations were analyzed. RESULTS: The mean CCT value was 546.92 +/- 32.06 microm with NCSM, 535.24 +/- 30.54 microm with AS-OCT, and 546.38 +/- 30.70 microm with USP. The CCT measurements with NCSM and USP were significantly thicker than with AS-OCT (p 0.900 in all groups, p < 0.001 in all groups). CONCLUSIONS: CCT measurements of healthy eyes using NCSM are more correlated with USP than AS-OCT. The CCT measurement using NCSM is a better alternative for USP than AS-OCT.
Subject(s)
Microscopy , Tomography, Optical Coherence , Ultrasonography摘要
To report keratitis with Elizabethkingia meningoseptica, which occurred in a healthy patient after wearing contact lenses for 6 months. A 24-year-old male patient visited our hospital with ocular pain. This patient had a history of wearing soft contact lenses for 6 months, about 10 hours per day. At initial presentation, slit lamp examination showed corneal stromal infiltrations and small epithelial defect. Microbiological examinations were performed from corneal scrapings, contact lenses, and the contact lens case and solution. The culture results from contact lenses, contact lens case and solution were all positive for Elizabethkingia meningoseptica. Thus, we could confirm that the direct cause of keratitis was contamination of the contact lenses. The patient was treated with 0.3% gatifloxacin. After treatment, the corneal epithelial defect was completely healed, and a slight residual subepithelial corneal opacity was observed. We diagnosed keratitis with Elizabethkingia meningoseptica in a healthy young male wearing soft contact lenses. We conclude that Elizabethkingia meningoseptica should be considered as a rare but potential pathogen for lens-related keratitis in a healthy host.
Subject(s)
Humans , Male , Young Adult , Chryseobacterium , Contact Lenses, Hydrophilic/adverse effects , Flavobacteriaceae Infections/complications , Keratitis/etiology摘要
To report keratitis with Elizabethkingia meningoseptica, which occurred in a healthy patient after wearing contact lenses for 6 months. A 24-year-old male patient visited our hospital with ocular pain. This patient had a history of wearing soft contact lenses for 6 months, about 10 hours per day. At initial presentation, slit lamp examination showed corneal stromal infiltrations and small epithelial defect. Microbiological examinations were performed from corneal scrapings, contact lenses, and the contact lens case and solution. The culture results from contact lenses, contact lens case and solution were all positive for Elizabethkingia meningoseptica. Thus, we could confirm that the direct cause of keratitis was contamination of the contact lenses. The patient was treated with 0.3% gatifloxacin. After treatment, the corneal epithelial defect was completely healed, and a slight residual subepithelial corneal opacity was observed. We diagnosed keratitis with Elizabethkingia meningoseptica in a healthy young male wearing soft contact lenses. We conclude that Elizabethkingia meningoseptica should be considered as a rare but potential pathogen for lens-related keratitis in a healthy host.
Subject(s)
Humans , Male , Young Adult , Chryseobacterium , Contact Lenses, Hydrophilic/adverse effects , Flavobacteriaceae Infections/complications , Keratitis/etiology摘要
BACKGROUND: Wound healing process is a tissue response to trauma which leads to tissue repair through complex biological stages. Sevoflurane is a widely used inhalation anesthetic for surgery, but there has been no study about its effect on wound healing process. This study was undertaken to evaluate the effect of sevoflurane on wound healing process. METHODS: Male Sprague-Dawley rats (200-300 g) were used. Two circular full-thickness skin defects of 8 mm in diameter were made on dorsum of rats. After wound formation, the animals were divided into 4 groups: 1, 2, 4, 8 hr exposure to sevoflurane, respectively. Wound sizes and regional blood flow around the wounds were measured. The expression of basic fibroblast growth factor (bFGF), transforming growth factor beta1 (TGFbeta1), collagen 1, and collagen 3 mRNA were detected 7 days after wound formation by real-time reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: Wound size was significantly increased in 8 hr group at 3 and 7 days after wound formation. Regional blood flow was significantly decreased in 4 hr and 8 hr groups at 3 days after wound formation. The bFGF, collagen 1 and 3 mRNA expressions were significantly decreased in 8 hr exposure group. CONCLUSIONS: These results suggest that sevoflurane exposure influences the regional blood flow, wound size, expression of bFGF, and production of collagen 1 and 3 during the wound healing process.
Subject(s)
Animals , Humans , Male , Rats , Collagen , Fibroblast Growth Factor 2 , Inhalation , Methyl Ethers , Rats, Sprague-Dawley , Regional Blood Flow , RNA, Messenger , Skin , Transforming Growth Factor beta1 , Wound Healing摘要
BACKGROUND: Several studies have reported reduced pain and anxiety in smokers, and considerable evidence shows that smoking induces analgesia, which is thought to be nicotine-mediated. We investigated if smoking could reduce the development of neuropathic pain and nociceptive transmission in the spinal cord. METHODS: Sprague Dawley rats weighing 130-150 g were used for this experiment. The Animals were divided into two groups: the smoking group (S group) was exposed to cigarette smoking for 5 hours per day for 6 weeks at self-made smoking chamber: the control group (C group) was exposed to room air. After a 4-week exposure period, neuropathic pain was induced by left L5 spinal nerve ligation (SNL). Mechanical threshold and withdrawal response to 100% acetone were measured throughout the experiment. The changes in the expression of the c-fos and BDNF genes in the spinal cord were compared using real time PCR. RESULTS: Mechanical allodynia was induced after SNL in both groups, but no significant difference was observed between two groups. Cold allodynia after SNL was significantly less in S group than C group. In S group, the expression of c-fos was decreased at 5th day, but that of BDNF expression was significantly elevated at 5th day after SNL compared to C group. CONCLUSIONS: Chronic exposure to cigarette smoke reduced the cold allodynia in neuropathic rats. The decreased expression of c-fos and elevated expression of BDNF in the spinal cord after SNL may contribute to antinociception.
Subject(s)
Animals , Rats , Acetone , Analgesia , Anxiety , Brain-Derived Neurotrophic Factor , Gene Expression , Hyperalgesia , Ligation , Neuralgia , Rats, Sprague-Dawley , Real-Time Polymerase Chain Reaction , Smoke , Smoking , Spinal Cord , Spinal Nerves , Tobacco Products摘要
The diagnosis of papillary thyroid cancer is generally based on the findings of intranuclear cytoplasmic inclusions and nuclear grooves. Although anisokaryosis and poikilokaryosis, in papillary thyroid cancer, are not distinct when compared to other cancers, cytological examination can provide useful preoperative information. Our study evaluated the diagnostic role of computer-assisted image analysis for the pre-surgical assessment of papillary thyroid carcinoma. Thyroid aspirates from twenty female patients who were histologically confirmed to have both papillary carcinoma and benign nodules were studied. Different populations of 50 benign cells and 50 malignant cells were analyzed. Five morphometric parameters were selected for analysis: nuclear area, perimeter, maximum length, maximum width and intensity standard variation. The values obtained for papillary carcinomas were higher than the surrounding benign nodules as follows: nuclear area 63.5 vs. 36.1 (p=0.000), nuclear perimeter were 29.4 vs. 22.0 (p=0.000), maximum length 9.6 vs. 7.1 (p=0.000), maximum width 8.2 vs. 6.3 (p=0.000), the ratio between maximal length and maximal width 1.16 vs. 1.13 (p=0.000), the standard variation of intensity 14.9 vs. 15.9 (p=0.101) respectively. Therefore, morphometric information can be helpful for the differential cytological diagnosis of papillary thyroid carcinoma.
Subject(s)
Female , Humans , Carcinoma, Papillary , Diagnosis , Image Processing, Computer-Assisted , Inclusion Bodies , Thyroid Gland , Thyroid Neoplasms摘要
Acute hemorrhagic edema of childhood (AHEC) is a distinctive entity among the group of the leukocytoclastic vasculitides in childhood. AHEC is characterized by ecchymotic patches in a cockade pattern and a tender inflammatory edema on the face or upper extremities in children younger than 3 years old. It is usually confined to the skin and runs a benign course. We report a case of AHEC preceded by varicella. A 3-year-old boy presented with a 4-day history of medallion-like purpuric patches on both arms and the abdomen, along with varicella lesions. The purpuric lesions resolved completely without any complication after one week, following the resolution of the varicella. AHEC is an immune complex-mediated vasculitis that can be preceded by infection, and varicella might be a triggering factor in this case.
Subject(s)
Child , Child, Preschool , Humans , Male , Abdomen , Arm , Chickenpox , Edema , Skin , Upper Extremity , Vasculitis摘要
Chronic hypoxia has been associated with change in neurovascular behavior, mediated, in part, by erythropoietin (EPO). EPO, a hematopoietic growth factor, could act as a neurotrophic factor. In the present study, we investigated the characteristics of EPO and erythropoietin receptor (EPOR) expressions by cortical neuron in vivo and in vitro and tested the hypothesis that EPO serves protective functions under chronic hypoxia. E18, P5 and P7 mice for 3 days and primary cultured neurons for 6 days were incubated in hypoxic conditions consisted of a mixture of 10% O2, 5% CO2, 85% N2. To study expressions of EPO, EPOR, caspases, pAKT, pERK, and PARP, immunohistochemical stainning and western blotting were carried out. In addition to expressing EPO and EPOR under normoxic conditions, neurons increased their expression of EPO and EPOR under hypoxia. The effects of recombinant EPO appeared to be mediated via the phosphatidylinositol (PI) 3- kinase-AKT pathway, correlated directly with activation of caspase 3. Also recombinant EPO decreased expression of caspase 8, but not caspase 9. Finally, recombinant EPO decreased apoptosis of cultured neurons as evaluated by expression of PARP. These data support a role for EPO in maintenance of cortical neuron under chronic hypoxia.
Subject(s)
Animals , Mice , Hypoxia , Apoptosis , Blotting, Western , Caspase 3 , Caspase 8 , Caspase 9 , Caspases , Erythropoietin , Neurons , Phosphatidylinositols , Receptors, Erythropoietin摘要
BACKGROUND: Despite 2 years' separation of dispensary from medical practice since year of 2000, many outpatients in Korea have a lack of understanding this separation. In addition, the illegal practices of pharmacists such as medical examination have contributed to the recent problematic situation. OBJECTIVE: We performed this study to evaluate the actual situation of the separation of dispensary from medical practice in the dermatologic field. METHODS: The clinico-epidemiologic analysis of 17 months' data of 18, 230 outpatients was conducted through the available medical records and serial questionnaires. RESULTS: The medical or non-medical institutions that 18, 230 outpatients with skin diseases had chosen at first, were as follows by the order of frequency; pharmacy(78.5%), folk remedies or self-medication(9.8%), dermatologic institutions(5.5%), non-dermatologic medical clinics(3.4%), herb clinics(2.8%). Accordingly, most(94.5%, 17, 223) of the new patients did not select a dermatologic institution for the care of their skin diseases. The patterns of health care utilization of the patients mostly(72.9%) showed a fixed tendency to visit the one particular institution or formula continuously prior to final visit to the research hospitals. Most of the patients(62.8%) firstly visited a pharmacy for their disease care and did not revisit another institution. Since the first visit to a pharmacy, 9.6% of the patients repetitively utilized one or more herb clinic(s) or folk remedies in addition to one or more medical institution(s). The patients utilizing non-dermatologic measures for skin disease care at first, were mostly in their fifties(25.3%). The patients seeking herb medicine or non-dermatologic medical clinics, were in their teens(27.3% and 24.3%, respectively). Of the cases misdiagnosed as another disease or aggravated in the patients choosing non-dermatologic care, fungal infections are most common(24.0%). In front of 97.1% of the patients seeking pharmacy at first, the pharmacists practiced medicine like a physician in a wrong way instead of dispensing a prescription. CONCLUSION: In Korea, the majority of dermatologic clinics has been deprived of a position as an institution for primary care of skin diseases. It is imperative that dermatologists should be granted independent and unconstrained authority in the medical profession for the benefit of their patients.