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Osteosarcoma is the most frequent primary malignant bone tumor with higher incidences in children and adolescents. Despite clinical evolutions, patients with osteosacoma have had a poor prognosis. There has been increasing evidence that cancer is a stem cell disease. This study sought to isolate and characterize cancer stem cells from human osteosarcoma with relevant literature reviews. Here we show that the emerging evidence suggests osteosarcoma should be regarded as a differentiation disease such as stem cell disease. Two human osteosarcoma cell lines were cultured in non-adherent culture conditions as sarcospheres. Sarcospheres were observed using histomorphology and alkaline phosphatase (ALP) staining. Expression of the embryonic stem cell marker was analyzed with use of reverse transcriptase-PCR. Sarcospheres could be reproduced consistently throughout multiple passages and produced adherent osteosarcoma cell cultures. Expression of stem cell-associated genes such as those encoding Nanog, octamer-binding transcription factor 3/4, sex determining region Y box 2 , c-Myc and ALP indicated pluripotent stem-like cells. These results support the extension of the cancer stem cell theory to include osteosarcoma. Understanding the cancer stem cell derived from human osteosarcoma could lead to the evolution of diagnosis and treatment for osteosarcoma patients.
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Rheumatoid nodules are the most common extra-articular presentations of rheumatoid arthritis. Although rheumatoid nodules can develop anywhere in the body, they develop most commonly in the subcutaneous region, where they are easily exposed to repetitive trauma or pressure. However, an infrascapular presentation has not yet been reported. We report a case of giant bilateral rheumatoid nodules that developed in the infrascapular area, complicating its distinction from elastofibroma dorsi on radiological examination.
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Objective@#We aimed to develop a deep neural network for segmenting lung parenchyma with extensive pathological conditions on non-contrast chest computed tomography (CT) images. @*Materials and Methods@#Thin-section non-contrast chest CT images from 203 patients (115 males, 88 females; age range, 31–89 years) between January 2017 and May 2017 were included in the study, of which 150 cases had extensive lung parenchymal disease involving more than 40% of the parenchymal area. Parenchymal diseases included interstitial lung disease (ILD), emphysema, nontuberculous mycobacterial lung disease, tuberculous destroyed lung, pneumonia, lung cancer, and other diseases. Five experienced radiologists manually drew the margin of the lungs, slice by slice, on CT images. The dataset used to develop the network consisted of 157 cases for training, 20 cases for development, and 26 cases for internal validation. Two-dimensional (2D) U-Net and three-dimensional (3D) U-Net models were used for the task. The network was trained to segment the lung parenchyma as a whole and segment the right and left lung separately. The University Hospitals of Geneva ILD dataset, which contained high-resolution CT images of ILD, was used for external validation. @*Results@#The Dice similarity coefficients for internal validation were 99.6 ± 0.3% (2D U-Net whole lung model), 99.5 ± 0.3% (2D U-Net separate lung model), 99.4 ± 0.5% (3D U-Net whole lung model), and 99.4 ± 0.5% (3D U-Net separate lung model).The Dice similarity coefficients for the external validation dataset were 98.4 ± 1.0% (2D U-Net whole lung model) and 98.4 ± 1.0% (2D U-Net separate lung model). In 31 cases, where the extent of ILD was larger than 75% of the lung parenchymal area, the Dice similarity coefficients were 97.9 ± 1.3% (2D U-Net whole lung model) and 98.0 ± 1.2% (2D U-Net separate lung model). @*Conclusion@#The deep neural network achieved excellent performance in automatically delineating the boundaries of lung parenchyma with extensive pathological conditions on non-contrast chest CT images.
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Purpose@#This study investigated whether shear wave elastography (SWE) could be used to estimate the chronicity of supraspinatus tendon (SST) tears. @*Methods@#A retrospective study was performed. From November 2015 to July 2016, 113 patients (52 men, 61 women; age range, 21 to 79 years) with persistent shoulder pain underwent 119 rotator cuff tendon examinations by routine B-mode ultrasonography, while SST elasticity was measured using SWE. Following the exclusion of eight suboptimal examinations, four examinations with missing SST measurements, and 27 examinations of patients with other conditions, 80 examinations were analyzed. A torn SST was found in 54 examinations (27 with a partial-thickness tear and 27 with a full-thickness tear). Elasticity values were compared in multiple ways. The results were analyzed using the Mann-Whitney U test or Kruskal-Wallis test. @*Results@#No statistically significant difference in elasticity values (in kPa) was found between normal (median, 94.65; interquartile range [IQR], 87.43 to 105.47) and torn SSTs (median, 96.79; IQR, 86.71 to 108.56) or between full-thickness tears (median, 93.80; IQR, 82.50 to 108.33) and partial-thickness tears (median, 96.83; IQR, 90.60 to 112.20). However, there was a statistically significant difference in elasticity according to whether the duration of symptoms was 1 year or less (median, 92.20; IQR, 84.01 to 104.38) or longer than 1 year (median, 105.10; IQR, 100.41 to 116.03; P=0.032). @*Conclusion@#Elasticity values were significantly higher in torn SSTs in patients with chronic shoulder pain that had persisted for more than 1 year. Further studies with larger samples seem warranted to determine whether elasticity values measured by SWE can be used preoperatively as a surrogate marker of the chronicity of a rotator cuff tendon tear.
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Invasive pulmonary aspergillosis (IPA) has been known to occur in immunocompromised patients, but has been rarely reported in immunocompetent patients. In immunocompetent patients, pulmonary fungal infections are not initially considered. This results in diagnosis and treatment delays, as well as poor prognosis. We report a case and serial CT findings of IPA in an immunocompetent 29-year-old male after congenital heart disease surgery.
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Objective@#Habitual snoring is a common problem in children. We evaluated the association between a high risk for sleep-disordered breathing and attention deficit/hyperactivity symptoms. @*Methods@#Parents of 13,560 children aged 6 to 12 years responded to questionnaires including items on habitual snoring and the Korean attention deficit/hyperactivity disorder rating scale. The snoring score comprised the number of “yes” responses to habitual-snoring items, and a high risk for sleep-disordered breathing was defined as a snoring score ≥ 2. @*Results@#The odds ratio (OR) of a high risk for sleep-disordered breathing was significantly higher in boys (OR = 1.47; p ＜ 0.001), overweight children (OR = 2.20; p ＜ 0.001), and children with current secondhand-smoking exposure (OR = 1.38; p ＜ 0.001). The Korean attention deficit/hyperactivity disorder rating scale score increased significantly with the snoring score (0 vs. 1, B = 1.56, p ＜ 0.001; 0 vs. 2, B = 2.44, p＜ 0.001; 0 vs. 3, B = 2.48, p＜ 0.001; 0 vs. 4, B = 3.95; p ＜ 0.001). @*Conclusion@#Our study confirms several risk factors of sleep-disordered breathing, namely male sex, overweight, and exposure to tobacco smoking, and found a positive association between habitual snoring and attention deficit/hyperactivity symptoms.
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Objective@#Bisphenol A (BPA) is a widely produced synthetic chemical used to manufacture polycarbonate plastics and epoxy resins. We aimed to investigate the association between exposure to BPA and behavioral and cognitive function in children with attention-deficit/hyperactivity disorder (ADHD) and healthy controls. @*Methods@#The study included 444 children aged from 6 to 10 years. The ADHD and control groups included 195 and 249 children, respectively. BPA levels were assessed via urinalysis, while behavior was assessed using the Korean version of the ADHD Rating Scale (K-ARS) and the Behavior Assessment System for Children (BASC-2). Cognitive function was assessed using the Continuous Performance Test (i.e., ADHD Diagnostic System [ADS]). Participants were categorized into tertile groups based on urinary BPA concentration. @*Results@#Scores on the K-ARS and the hyperactivity, aggression, anxiety, and depression subscales of the BASC-2 were significantly different among tertile groups for urinary BPA levels. Scores on visual omission error, commission error, response time variability, and auditory commission error of the ADS were significantly different among three BPA groups. Subgroup analysis revealed that these differences of behavior and cognition among three BPA groups were observed in only boys and normal controls. @*Conclusion@#Exposure to BPA was associated with unfavorable behavioral and cognitive outcomes. Our study extends the findings of previous studies regarding the association between BPA exposure and behavior/cognitive function by including children with ADHD. Further studies are required to determine the mechanisms underlying sex- and group-based differences in these associations.
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Coronavirus disease (COVID-19) has threatened public health as a global pandemic. Chest CT and radiography are crucial in managing COVID-19 in addition to reverse transcription-polymerase chain reaction, which is the gold standard for COVID-19 diagnosis. This is a review of the current status of the use of chest CT and radiography in COVID-19 diagnosis and management and anㄷ introduction of early representative studies on the application of artificial intelligence to chest CT and radiography. The authors also share their experiences to provide insights into the future value of artificial intelligence.
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Coronavirus disease (COVID-19) has threatened public health as a global pandemic. Chest CT and radiography are crucial in managing COVID-19 in addition to reverse transcription-polymerase chain reaction, which is the gold standard for COVID-19 diagnosis. This is a review of the current status of the use of chest CT and radiography in COVID-19 diagnosis and management and anㄷ introduction of early representative studies on the application of artificial intelligence to chest CT and radiography. The authors also share their experiences to provide insights into the future value of artificial intelligence.
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Rhabdomyosarcoma is the most common pediatric soft tissue malignancy, however, extraperitoneal origin of the tumor is rare and prenatal onset of the tumor is even more rare. In this article, we report a radiologic finding of a case of embryonal rhabdomyosarcoma at the extraperitoneal pelvic space in a newborn.
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A 27-year-old female presented with repeated seizures. As the left frontal lobe volume was enlarged in comparison with the right frontal lobe, hemimegalencephaly was suggested. Abnormal white matter fiber tracts running from the left frontal lobe to the fornix and hippocampus were found on diffusion tensor imaging (DTI). We performed quantitative measurements of brain volume and confirmed hemimegalencephaly. DTI and MRI-based volumetry techniques could be useful to objectively diagnose hemimegalencephaly.
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Lateral epicondylitis, also known as ‘tennis elbow’, is a degenerative rather than inflammatory tendinopathy, causing chronic recalcitrant pain in elbow joints. Although most patients with lateral epicondylitis resolve spontaneously or with standard conservative management, few refractory lateral epicondylitis are candidates for alternative non-operative and operative modalities. Other than standard conservative treatments including rest, analgesics, non-steroidal anti-inflammatory medications, orthosis and physical therapies, nonoperative treatments encompass interventional therapies include different types of injections, such as corticosteroid, lidocaine, autologous blood, platelet-rich plasma, and botulinum toxin, which are available for both short-term and long-term outcomes in pain resolution and functional improvement. In addition, newly emerging biologic enhancement products such as bone marrow aspirate concentrate and autologous tenocyte injectates are also under clinical use and investigations. Despite all non-operative therapeutic trials, persistent debilitating pain in patients with lateral epicondylitis for more than 6 months are candidates for surgical treatment, which include open, percutaneous, and arthroscopic approaches. This review addresses the current updates on emerging non-operative injection therapies as well as arthroscopic intervention in lateral epicondylitis.
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OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in elementary school children. The present study investigated the characteristics of ADHD in Korean elementary school children using the Korean version of the ADHD Rating Scale (K-ARS). The data was compared with those obtained from a comparable American population. METHODS: Participants included 29,914 elementary school children, aged 6–12 years, from a medium-sized city. The parents completed the home version of the K-ARS. The total and subscale-specific normative data and sex- and age-related mean score differences were analyzed. These data were compared with those obtained from the American population using independent t-tests. RESULTS: Mean total and subscale K-ARS scores were significantly higher among boys (vs. girls) and younger children aged equal to or less than 8 years old (vs. older children). Mean scores on the hyperactivity-impulsivity subscale were lower than those of American children, but similar to another Korean sample. CONCLUSION: Our data characterized ADHD symptoms in Korean children. However, further studies are needed to identify the cultural differences underlying ratings of ADHD symptom severity.
Subject(s)
Child , Humans , Child Psychiatry , Cross-Cultural Comparison , Impulsive Behavior , Neurodevelopmental Disorders , ParentsABSTRACT
OBJECTIVE: We aimed to investigate symptom trajectory of attention-deficit hyperactivity disorder (ADHD) in Korean school-age children. METHODS: Four hundred fifty six elementary school children were enrolled when they were in 1st grade and assessed once per year until 4th grade. Symptom severity was assessed by parents using the Korean version of the ADHD rating scale (K-ARS). High-risk was defined as a K-ARS score >18; 377, 325, and 284 children participated in the subsequent assessments. Symptom trajectory was analyzed using a mixed-model approach consistent with the longitudinal nature of the present study including missing data. RESULTS: K-ARS scores demonstrated significant main effects of time (F=35.33; p < 0.001), sex (F=20.77; p < 0.001), and first-year high-risk group (F=240.90; p<0.001). It also demonstrated a significant time×first-year high-risk group interaction effect (F=38.14; p < 0.001), but not a time×sex interaction effect. CONCLUSION: K-ARS scores demonstrated a tendency to decline with aging. Individuals in the high-risk group demonstrated earlier declining tendency than those in the non-high risk group. Although total K-ARS scores differed significantly between the sexes at all assessments, the declining pattern between both sexes did not differ significantly. Further studies including larger sample sizes, diagnostic interviews, and complete data sets are needed to confirm findings of the present study.
Subject(s)
Child , Humans , Aging , Dataset , Parents , Sample SizeABSTRACT
The aim of this study was to determine the prevalence of attention deficit hyperactivity disorders (ADHD) in children according to socio-demographic factors and the distribution of ADHD subtypes in a community in Korea. A screening survey using the Korean version of ADHD Rating Scale (K-ARS) was conducted between 2007 and 2008, and clinical interviews by a pediatric psychiatrist were performed for selected children between 2009 and 2010. A total of 49,573 elementary school students, between ages of 7 and 12, constituted the target population, among which 38,365 students (77.2%) and respective parents gave consent to participate. Of the participants, 200 screened children were clinically examined to confirm the diagnosis of ADHD. We estimated the prevalence of ADHD and its comorbidity in the population, after adjusting for nonresponse and nonparticipation. The prevalence of ADHD was 11.7% in boys and 5.2% in girls, with an overall prevalence of 8.5%. The combined type of inattentive and hyperactive was the most frequent at 4.7% of the whole population. Children were more likely to have ADHD if their parents were separated and had less education. Most commonly combined comorbidity was autism spectrum disorder (ASD) (10.1%). The prevalence of ADHD in the school-aged population is an essential information for improving the quality of public health mental services for evaluation and treatment of ADHD.
Subject(s)
Child , Female , Humans , Attention Deficit Disorder with Hyperactivity , Autism Spectrum Disorder , Comorbidity , Diagnosis , Education , Health Services Needs and Demand , Korea , Mass Screening , Parents , Prevalence , Psychiatry , Public HealthABSTRACT
This study aimed to obtain basic regional data of legal autopsy cases observed in the Jeollabuk-do province concerning causes and manner of death. We investigated 170 autopsy cases (114 males [67.0%] and 56 females [33%]) performed at the Department of Forensic Medicine, Chonbuk National University Medical School, in 2016. Of these, seven (4.1%) were children aged <10 years. Regarding the manner of death, there were 95 unnatural deaths (55.9%), 69 natural deaths (40.6%), and six deaths from unknown causes (3.5%). Among the 95 unnatural deaths, 29 suicides (30.5%), 10 homicides (10.5%), 52 accidental deaths (54.7%), and four undetermined deaths (4.2%) were recorded. Concerning causes of unnatural death, there were 39 traumatic injury-related deaths (41.2%), 10 asphyxiations (10.5%), 25 poisonings (26.3%), 13 thermal injury-related deaths (13.7%), and eight deaths due to drowning (8.4%). The most common cause of unnatural death was injury from falls (n=15), followed by agrochemical poisoning (n=12), traffic injury (n=12), and death from fire (n=11). Of 69 natural deaths, 31 were from cardiac diseases (44.9%), eight from cerebral or vascular diseases (11.6%), 12 from digestive system diseases (17.4%), one from respiratory system disease (1.4%), five from endocrine/metabolic/nutritional disorders (7.2%), and nine due to causes of unknown origin (including sudden manhood and sudden infant death syndromes) (13.1%).
Subject(s)
Child , Female , Humans , Male , Accidental Falls , Autopsy , Cause of Death , Digestive System Diseases , Drowning , Fires , Forensic Medicine , Heart Diseases , Homicide , Korea , Poisoning , Respiratory System , Schools, Medical , Sudden Infant Death , Suicide , Vascular DiseasesABSTRACT
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease in South Korea with clinical features similar to those of scrub typhus. Infected patients with these two diseases usually visited the emergency department (ED) complaining of fever that was not responsive to treatment in a local clinic. Aggressive management of SFTS is required in order to prevent rapid progression and human-to-human transmission, thus rapid and accurate differential diagnosis of the two diseases in the ED is important. We reported three laboratory confirmed cases of SFTS during 2013-2014 in a single center, with fever, skin lesions, and history of outdoor activities in order to help in differential diagnosis between SFTS and scrub typhus in the ED.
Subject(s)
Humans , Communicable Diseases, Emerging , Diagnosis, Differential , Emergency Service, Hospital , Fever , Korea , Scrub Typhus , Skin , ThrombocytopeniaABSTRACT
Severe fever with thrombocytopenia syndrome (SFTS) is a newly emerging infectious disease, caused by a novel species of Phlebovirus of Bunyaviridae family, in China, South Korea, and Japan. SFTS is primarily known as a tick-borne disease, and human-to-human transmission is also possible in contact with infectious blood. Common clinical manifestations include fever, thrombocytopenia, and leukopenia as initial symptoms, and multiple organ dysfunction and failure manifest with disease progression. Whereas disease mortality is reported to be 12% to 30% in China, a recent report of cumulative SFTS cases indicated 47% in Korea. Risk factors associated with SFTS were age, presence of neurologic disturbance, serum enzyme levels, and elevated concentrations of certain cytokines. Diagnosis of SFTS is based on viral isolation, viral identification by polymerase chain reaction, and serologic identification of specific immunoglobulin G. Therapeutic guideline has not been formulated, but conservative management is the mainstream of treatment to prevent disease progression and fatal complications.
Subject(s)
Humans , Bunyaviridae , China , Communicable Diseases, Emerging , Cytokines , Diagnosis , Disease Progression , Fever , Immunoglobulin G , Japan , Korea , Leukopenia , Mortality , Phlebovirus , Polymerase Chain Reaction , Risk Factors , Thrombocytopenia , Tick-Borne DiseasesABSTRACT
The legend of Figure 5 was given incorrectly.