Frimpong, Paul;Amponsah, Emmanuel Kofi;Abebrese, Jacob;Kim, Soung Min
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.43
no.1
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pp.29-36
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2017
Objectives: Acquired immunodeficiency syndrome (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus (HIV). People with AIDS are much more vulnerable to infections, including opportunistic infections and tumors, than people with a healthy immune system. The objective of this study was to correlate oral lesions associated with HIV/AIDS and immunosuppression levels by measuring clusters of differentiation 4 (CD4) cell counts among patients living in the middle western regions of Ghana. Materials and Methods: A total of 120 patients who visited the HIV clinic at the Komfo Anokye Teaching Hospital and the Regional Hospital Sunyani of Ghana were consecutively enrolled in this prospective and cross-sectional study. Referred patients' baseline CD4 counts were obtained from medical records and each patient received an initial physician assessment. Intraoral diagnoses were based on the classification and diagnostic criteria of the EEC Clearinghouse, 1993. After the initial assessment, extra- and intraoral tissues from each enrolled patient were examined. Data analyses were carried out using simple proportions, frequencies and chi-square tests of significance. Results: Our study included 120 patients, and was comprised of 42 (35.0%) males and 78 (65.0%) females, ranging in age from 21 to 67 years with sex-specific mean ages of 39.31 years (males) and 39.28 years (females). Patient CD4 count values ranged from 3 to 985 cells/mL with a mean baseline CD4 count of 291.29 cells/mL for males and 325.92 cells/mL for females. The mean baseline CD4 count for the entire sample was 313.80 cells/mL. Of the 120 patients we examined, 99 (82.5%) were observed to have at least one HIV-associated intraoral lesion while 21 (17.5%) had no intraoral lesions. Oral candidiasis, periodontitis, melanotic hyperpigmentation, gingivitis and xerostomia were the most common oral lesions. Conclusion: From a total of nine oral lesions, six lesions that included oral candidiasis, periodontitis, melanotic hyperpigmentation, gingivitis, xerostomia and oral hairy leukoplakia were significantly correlated with declining CD4 counts.
Specific endometrial preparation should occur during periimplantation period. That is a progress of serial differentiation and is absolute in implantation of embryo and successful pregnancy. Remodeling of tissues shown during embryogenesis is regulated by various factors including extracellular matrix (ECM). Marked changes during pregnancy are including embryo migration, decidual response, and differentiation of placenta in placental animals including human. These changes to successful implantation in embryo and uterus have to prepare the competence for attachment of embryo and uterus, and invasion defense of uterus. During these changes, ECM dramatically changes for maintaining the uterine and embryonic functions. The major component of most connective tissue is collagens. It is very complex and hard to explore the mechanisms for ECM modulation. Recently using high throughput methodology, PCR-select cDNA subtraction method, microarray, many candidate genes have been identified. Steroid hormones have fundamental role in implantation and maintenance of pregnancy. Dermatopontin, a regulator of collagen accumulation, is regulated spatio-temporally in the uterus by primarily progesterone through progesterone receptors at the time of implantation. Modulation of extracellular matrix is critically regulated by cascade of gene net-works which are regulated by cascade of sex steroid hormones. Pathological regulation of uterine extracellular matrix reported in diabetic patients. To know the extracellular modulation is essential to understanding implantation, feto-placental development and overcome the paths involved in female reproduction. Though ECM composed with very various components and it is complex, the present review focused on the fate of collagens during periimplantation period.
Limb bud (LB) and central nerve system (CNS) cells were prepared from 12.5 day old pregnant female Crj:CD (SD) rats and treated with olaquindox and vitamin A. Cytotoxicity and inhibition on differentiation were measured in each cell. Three doses of olaquindox (4, 21 and 100 mgkg), and 0.2 and 75 mg/kg of vitamin A were administered to pregnant rat for 11 days from $6^{th}$ to $16^{th}$ of pregnancy. $IC_{50}$ values of olaquindox for proliferation and differentiation in CNS cell were 22.74 and $28.32\;{\mu}g/ml$ and 79.34 and $23.29\;{\mu}g/ml$ in LB cell and those values of vitamin A were 8.13 and $5.94\;{\mu}g/ml$ in CNS cell and 0.81 and $0.05\;{\mu}g/ml$ in LB cell, respectively. Mean body weights of pregnant rats were decreased at high dose of olaquindox (110 mg/kg) but relative ovary weight, number of corpus lutea, and number of implantation were not changed. Resorption and dead fetus were increased at high dose of olaquindox, and relative ovary weight, the number of corpus lutea and implantation, and sex ratio of male to female were not significantly changed in all dose of olaquindox. Mean fetal and placenta weights were significantly (p < 0.01) decreased in rats of high group. Seven fetuses out of 103 showed external anomaly like bent tail, and 10 out of 114 fetuses showed visceral anomalies at high group. The ossification of sternebrae and metacarpals were significantly (p < 0.01) increased by low and middle dose of olaquindox but it was significantly (p < 0.01) prohibited by high dose of olaquindox. In rats treated with vitamin A, the resorption and dead fetus were increased by high dose. Mean fetal weights were significantly (p < 0.01) increased by low dose but significantly (p < 0.01) decreased by high dose. Thirty four fetuses out of 52 showed external anomaly; bent tail (1), cranioarchschisis (14), exencephaly (14), dome shaped head (22), anophthalmia (15), brcahynathia (10) and others (19). Forty five fetuses out of 52 showed soft tissue anomaly; cleft palate (42/52) and anophthalmia (22/52) by high dose of vitamin A. Sixty one fetuses out of 61 (85.2%) showed skull anomaly; defect of frontal, partial and occipital bone (21/61), defect of palatine bone (52/61) and others (50/61). In summary, we support that vitamin A is strong teratogen based on our micromass and in vivo data, and olaquindox has a weak teratogenic potential in LB cell but not in CNS cell. We provide the in vivo evidence that a high dose of olaquindox could have weak embryotoxic potential in rats.
Biliary atresia (BA) is very difficult to distinguish from neonatal hepatitis (NH) and its prognosis depends on the age at the time of Kasai operation. Therefore early differentiation between these two conditions is very important. Although various clinical and laboratory tests have been reported to differentiate between them, they are still of limited value. From 1980 to 1999, forty-five infants were referred to our pediatric surgical unit for operation for suspected BA. Eight patients underwent Kasai operation immediately because of late diagnosis. These were excluded from the study. The clinical history, physical findings. radiologic and laboratory examinations of 37 cases were analyzed retrospectively. The average age of BA (n=20) was $55.1{\pm}16.7$ days, and that of NH (n=17) was $55.8{\pm}15.6$ days. The sex ratio of BA was 13:7, and that of NH was 14:3. All the patients had obstructive jaundice and acholic stool except 4 BA and 6 NH patients. Acholic stool with yellow component was more frequent in NH. Onset of jaundice was within 2 weeks after birth in 85 % of BA, and in 65% of NH. The onset of acholic stool was within 2 weeks after birth in 60 % of BA, and in 23.5 % of NH. The duration of jaundice and acholic stool of BA were $50.9{\pm}16.6$ days and $41.3{\pm}18.4$ days and those of NH were $40.1{\pm}23.1$ days and $26.6{\pm}25.4$ days respectively. The ultrasonogram and hepatobiliary scan were useful, but not a definitively reliable method for the differentiation of these two diseases. There was no difference in laboratory data. Seventeen cases had NH among 45 referred cases for Kasai operation with the clinical impression of BA, and 4 cases of 17 NH cases needed to be explored to rule out BA. In conclusion. false positive rate of clinical impression of BA was 37.8 %. and negative exploration rate was 8.9 %, Therefore. careful clinical observation for 1-2 weeks by an experienced pediatric surgeon was very important to avoid unnecessary operation to rule out NH up to the age of 8 - 10 weeks. so long as the stool had yellow component.
Oh, Jeong Min;Eom, Tae Min;Choi, Koh Eun;Heo, Jong Won;Kim, Hyun Tae;Jo, Hyun Kyung;Yoo, Ho Rhyong;Seol, In Chan;Kim, Yoon Sik
Journal of Physiology & Pathology in Korean Medicine
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v.29
no.5
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pp.378-385
/
2015
Dizziness is one of the most common symptoms in clinical practice. The purpose of this study was to investigate the characteristics of patients with dizziness who visited Korean medicine hospital. This study analyzed 328 patients with dizziness who visited Dunsan Korean Medicine Hospital of Dae-Jeon University from Nov. 1st, 2012 to Oct. 31st, 2014. We gathered the data of the patients based on the medical charts. The patients were divided into 4 gorups ; central dizziness group, peripheral dizziness group, presyncope dizziness group, functional dizziness group, In the distribution according to sex, the number of female patients was higher than the male patients in all the types of dizziness except the presyncope group. The average age of the central group was higher than any other types. The peripheral and central group were most frequently admitted. The average hospitalization period were categorized as follows : central group 37.31, presyncope group 17, functional group 14.21, peripheral group 13.5 days. The following numbers of patients showed the distribution of each syndrome differentiation ; deficiency of qi and blood(氣血兩虛) 58.8%, plegm-dampness syndrome(濕痰中阻) 18.0%, hyperactivity of liver yang(肝陽上亢) 14.3%, deficiency of kidney essence(腎精不足) 8.8%. The distribution of herbal medicine for dizziness were categorized as follows ; Jaeumkeonbi-tang(Ziyinjianpi-tang, 滋陰健脾湯) 50.4%, Banhabaekchulcheonma-tang(Banxiabaishutianma-tang, 半夏白朮天麻湯) 10.2% and Bojungikgi-tang(Buzhongyiqi-tang, 補中益氣湯) 4.1%. The 86.0% of patients with dizziness has improved. The peripheral showed highest rate of improvement(100%). This report would serve as a reference data for further study about patients with dizziness in the clinical field of Korean medicine.
Objectives : To assess the characteristics of electropyography(EMG) and heart rate variability(HRV) values in idiopathic facial palsy inpatients of different Sasang constitutions. Methods : Medical records of 103 idiopathic facial palsy inpatients who underwent facial EMG testing and HRV testing were retrospectively reviewed. All subjects had been consulted to the department of Sasang constitution for constitution differentiation. The Sasang constitutional and age distribution were initially analyzed, and axonal loss percentage values on EMG were correlated with Sasang constitution and sex. HRV results were also correlated with Sasang constitution and sex. Results : 1. 24.4 percent of idiopathic facial palsy inpatients were of the Soyang constitution, 52.4 percent were of the Taeum, and 23.3 percent were of the Soeum. Patients in their fifties were most common in all constitutions(27.8%). 2. Mean axonal loss values for the temporal, zygomatic, and buccal branches were all statistically significantly lower in the Taeum constitution compared with Soyang or Soeum(p<0.05). 3. Mean axonal loss values for the temporal, zygomatic, and buccal branches were all statistically significantly lower in men than women(p<0.05). 4. The mean LF/HF ratio was significantly lower in idiopathic facial palsy inpatients of the Soeum constitution compared with Soyang and Taeum(p<0.05), but there was no statistically significant difference in mean MHRT, SDNN, TP, VLF, LF, and HF of different constitutions. 5. The mean SDNN was significantly lower in women inpatients compared with men(p<0.05), but there was no statistically significant difference in mean MHRT, TP, VLF, LF, HF, and LF/HF ratio. Conclusions : The Sasang constitutional composition of idiopathic facial palsy inpatients closely adheres to the composition proposed in Dong-eui-su-se-bo-won, but the Taeum and Soeum proportion is slightly larger and the Soyang proportion slightly smaller. Axonal loss value on EMG was significantly lower in the Taeum constitution, and in men(p<0.05, <0.05). Mean LF/HF ratio was significantly lower in the Soeum constitution compared with Soyang and Taeum(p<0.05), and mean SDNN was significantly lower in women(p<0.05).
Background: Registry data from four major public hospitals indicate trends in clinical care and survival from colorectal cancer over three decades, from 1980 to 2010. Materials and Methods: Kaplan-Meier productlimit estimates and Cox proportional hazards models were used to investigate disease-specific survival and multiple logistic regression analyses to explore first-round treatment trends. Results: Five-year survivals increased from 48% for 1980-1986 to 63% for 2005-2010 diagnoses. Survival increases applied to each ACPS stage (Australian Clinico-Pathological Stage), and particularly stage C (an increase from 38% to 68%). Risk of death from colorectal cancer halved (hazards ratio: 0.50 (0.45, 0.56)) over the study period after adjusting for age, sex, stage, differentiation, primary sub-site, health administrative region, and measures of socioeconomic status and geographic remoteness. Decreases in stage were not observed. Survivals did not vary by sex or place of residence, suggesting reasonable equity in service access and outcomes. Of staged cases, 91% were treated surgically with lower surgical rates for older ages and more advanced stage. Proportions of surgical cases having adjuvant therapy during primary courses of treatment increased for all stages and were highest for stage C (an increase from 5% in 1980-1986 to 63% for 2005-2010). Radiotherapy was more common for rectal than colonic cases. Proportions of rectal cases receiving radiotherapy increased, particularly for stage C where the increase was from 8% in 1980-1986 to 60% in 2005-2010. The percentage of stage C colorectal cases less than 70 years of age having systemic therapy as part of their first treatment round increased from 3% in 1980-1986 to 81% by 1995-2010. Based on survey data on uptake of adjuvant therapy among those offered this care, it is likely that all these younger patients were offered systemic treatment. Conclusions: We conclude that pronounced increases in survivals from colorectal cancer have occurred at major public hospitals in South Australia due to increases in stage-specific survivals. Use of adjuvant therapies has increased and the patterns of change accord with clinical guideline recommendations. Reasons for sub-optimal use of radiotherapy for rectal cases warrant further investigation, including the potential for limited rural access to impede uptake of treatments at metropolitan-based radiotherapy centres.
The purpose of this study was to describe perimenstrual symptom severity levels and perimenstrual distress patterns of women. The study performed the discriminant analysis in which included seven factors : age, pariety, social support, menstrual socialization(mother's symptom, sister's symptom, and menstrual effect), attitude of sex role and depression. The subjects were 283 women that they were not pregnant or lactating, had at least one period in past three months, would understand the purpose of study and willingly accepted the participation. The data analysis was done by pc-SAS program after data collection from Nov. 20, 1997 to Dec. 18, 1997. The descriptive analysis was done to explore general characteristics of the subjects and the stepwise discriminant analysis was done to verify factors in relation to perimenstrual symptom severity levels(severe vs mild menstrual symptom group) and perimenstrual distress patterns(spasmodic vs congestive menstrual symptom group). The instruments were selected for this study from Interpersonal Support Evaluation List(ISEL) by Cohen and Hoberman(1983), Center for Epidemic Studies Depression(CES-D) by Radloff(1977), and Sex Role Attitude Scale by Yunok Suh(1995), Mother's symptom and sister's symptom measurements by Woods, Mitchell & Lentz(1995), and menstrual effect by Brooks-Gun & Ruble(1980). The major findings of this study are as follows : 1. Of the 283 women, 93 women(32.9%) were assessed to severe perimenstrual symptom group and 190 women(67.1%) were assessed to mild perimenstrual symptom group. Results from the stepwise discriminant analysis showed three factors, such as depression, menstrual effect, and age, significantly related to perimenstrual symptom severity and they explained 20% of the total variance. The linear discriminant equation included three factors related to perimenstrual symptom groups was showed(Z=1.445 depression+0.174 menstrual effect-0.054 age). The cutting score(Z) was 2.809. We classified the severe perimenstrual symptom group by more than the cutting score 2.809 and the mild perimenstrual symptom by less or equal than the cutting score 2.809. The correctedness of posterior probability from discriminant equation was 72% as two perimenstrual symptom group classifications. 2. Of the 264 women, 139 women(52.7%) were assessed to spasmodic perimenstrual distress group and women(47.3%) were assessed to congestive perimenstrual distress group. Results from the stepwise discriminant analysis showed two factors, such as depression, age, significantly related to perimenstrual distress groups and they explained 8% of the total variance. The linear discriminant equation included two factors related to perimenstrual distress group was showed(Z=-0.084 age-0.776 depression). The cutting score(Z) was -3.759. We classified the spasmodic perimenstrual distress group by more than cutting score -3.759 and the congestive perimenstrual distress group by less or equal than cutting score -3.759. The correctedness of posterior probability from discriminant equation was 65% as two perimenstrual distress group classifications.
Amphibians are the world's most threatened group of animals, with approximately 41% facing extinction. Contrary to this global trend, the number of amphibian species in Korea has increased by approximately 53.3% over the past 20 years. In particular, salamanders within the genus Hynobius showed even greater diversity, with the number increasing three-fold from two species to seven. However, morphological and ecological traits required for the clear differentiation of these animals are yet to be determined, leading to much confusion. In this study, we investigated the validity of using size traits for species identification, as this method is currently considered a rule of thumb when differentiating Geoje salamanders (Hynobius geojeensis), cryptic Uiryeong salamanders (H. perplicatus), and Korean small salamanders (H. unisacculus). Our study revealed that sex, study period, and habitat were all factors associated with significant differences in snout-vent length, head width, and body weight. Differences in these size traits were evident both between and within species. Our results show that body size traits applied in the recent classification of the three new salamander species could not be seen as a suitable criterion. Such identification methods based solely on body size not only cause great confusion in the field but will also limit future research on Korean Hynobius salamanders.
Objectives: Expression of vascular endothelial growth factor C (VEGF-C)and vascular endothelial growth factor feceptor-3 (VEGFR-3) in laryngeal squamous carcinoma and its relationship to lymph node metastasis were investigated. Methods: VEGF-C and VEGFR-3 gene expression in 30 cases of normal laryngeal mucosa tissue (NLM), primary laryngeal carcinoma cell carcinomas (PLC) and cervical lymph nodes (CLN) was examined by reverse transcription polymerase chain reaction (RT-PCR). Protein levels of VEGF-C expression were determined by immunohistochemical staining in 60 cases of PLC. Results: Expression of VEGF-C and VEGFR-3 different among NLM, PLC and CLN in the same patient. In PLC, expression was significantly higher in lymph node positive group than in the lymph node negative group and associated with histological grade of differentiation; Expression of VEGF-C and VEGFR-3 was not linked with age, sex, site or T stage. Conclusions: A close correlation was found between VEGF-C/VEGFR-3 expression and lymph node metastasis in PLC, suggesting a role in metastasis of laryngeal carcinomas.
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