BackgroundThere has been no report on the clinical features or natural history of autoimmune hemolytic anemia (AIHA) in the Korean adult population. This study retrospectively analyzed the clinical characteristics and long-term outcomes of AIHA in the Korean adults.MethodsPatients newly diagnosed with AIHA between January 1994 and December 2010 at Chungnam National University Hospital were enrolled. Patient characteristics at diagnosis, response to treatment, and the natural course of the disease were documented.ResultsThirty-two patients (31 females and 1 male) with a median age of 48 years (range, 17-86) were enrolled. Of these, 21.9% were initially diagnosed with secondary AIHA. Thirteen patients (40.6%) were initially diagnosed with Evans' syndrome. Of the 29 patients who were placed on therapy, 27 (93.1%) showed a partial response or better. Nevertheless, 1 year after initiating treatment, 80% of the patients were still treatment-dependent. During follow-up (median length 14 months; range, 0.5-238), 14 of 25 patients (56.0%) who were initially diagnosed with primary warm antibody AIHA were found to have systemic lupus erythematosus (SLE). Median time to conversion to SLE was 8.0 months (95% CI, 4.3-11.7), and the probabilities of conversion at 12 and 24 months were 63% and 91%, respectively. Younger age (<60 years) and a positive fluorescent anti-nuclear antibody test were associated with a higher probability of SLE conversion (P=0.01 and P<0.001, respectively).ConclusionPrimary AIHA is rare. Regular, vigilant testing for SLE is required in patients initially diagnosed with AIHA.

The chemokine receptor CXCR7 has been suggested to play important roles in the progression of several types of cancers. However, few studies have investigated the biological roles of CXCR7 in head and neck squamous cell carcinoma (HNSCC). CXCR7 expression and its clinical implications were examined in 103 HNSCC tissues using immunohistochemistry (IHC). The biological roles and mechanisms of CXCR7-mediated signaling pathways were investigated in HNSCC cells through CXCR7 overexpression in vitro and in vivo. High expression of CXCR7 was significantly associated with tumor size (P = 0.007), lymph node metastasis (P = 0.004), and stage (P = 0.020) in HNSCC. Overexpression of CXCR7 in HNSCC cells enhanced cell migration and invasion in vitro and promoted lymph node metastasis in vivo. CXCR7 also induced epithelial-mesenchymal transition through PI3K/AKT. CXCR7 increased secretion of transforming growth factor-β1 (TGF-β1) and promoted EMT through phosphorylated Smad2/3. Taken together, our results provide functional and mechanistic roles of CXCR7 as a master regulator of oncogenic TGF-β1/Smad2/3 signaling in HNSCC, suggesting that CXCR7 might be a therapeutic target for the treatment of HNSCC.Head and neck squamous cell cancer (HNSCC) constitutes a heterogeneous group of cancers. HNSCC is an epithelial malignancy with primary sites in the lip, oral cavity, pharynx, larynx, and paranasal sinuses 1,2 . High cure rates are achieved for localized HNSCC using surgery, radiation, and chemoradiation. However, recurrence after curative resection is common, and survival rates for recurrent/metastatic disease remain poor, with a 10% 5-year overall survival rate 3 . Therefore, an understanding of the molecular mechanisms of cancer progression is necessary to advance the treatment of HNSCC.In the tumor microenvironment, chemokine signaling systems play critical roles in tumor progression, invasion, migration, and metastasis 4 . Chemokines and chemokine receptors are differentially expressed in various malignant tumors 5,6 . Growing evidence shows that CXCR7 plays a crucial role in the development of tumors 7 . Furthermore, upregulation of CXCR7 serves as an oncogene in various cancers, such as breast and lung cancer 5,8 .Tumors metastasize through decreased cell adhesion, basement membrane perforation, migration by circulation, immune escape, and formation of colonies at distant sites 9 . Epithelial-mesenchymal transition (EMT) is essential for initiation and progression of metastasis 10,11 . Transforming growth factor (TGF)-β signaling is known to induce EMT through various intracellular messengers. Recent studies have shown that TGF-β promotes tumor progression and metastasis by regulating chemokines or chemokine receptors in the tumor MethodsPatients and tumor samples. A total of 103 HNSCC tissues were recruited from the Chungnam National University Hospital. All samples used in the study were approved by the ethics committee of Chungnam National University Hospital. Written informed consent was obtained from all the patients. ...

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Background/AimsAntiphospholipid antibodies (aPL) have been detected in various proportions of patients with primary immune thrombocytopenia (ITP), but the clinical significance of this is debatable. The present study aimed to determine the frequency and clinical implications of elevated aPL in adult patients with ITP.MethodsWe prospectively studied newly diagnosed adult patients with ITP who were enrolled between January 2003 and December 2008 at Chungnam National University Hospital. They were evaluated for the presence of lupus anticoagulant (LA) and anticardiolipin antibodies (aCL) at diagnosis and were followed for the development of thrombosis.ResultsSeventy consecutive patients with ITP (median age, 48 years; range, 18 to 79) were enrolled. Twenty patients (28.5%) were positive for aPL at the time of diagnosis: aCL alone in 15 (75%), aCL and LA in two (10%), and LA alone in three (15%). Patients who had platelet counts < 50,000/µL were administered oral prednisolone with or without intravenous immune globulin. No difference was found between the aPL-positive and -negative groups regarding gender, initial platelet count, and response to the therapy. After a median follow-up of 20 months (range, 2 to 68), two of 20 patients who were aPL-positive (10%) developed thrombosis, whereas no thrombotic event was found among those who were aPL-negative.ConclusionsOur data suggest that aPL levels should be determined at the initial presentation of ITP and that patients found to be aPL-positive should receive closer follow-up for thrombotic events.

In this study, we classify four horse gaits (walk, sitting trot, rising trot, canter) of three breeds of horse (Jeju, Warmblood, and Thoroughbred) using a neuro-fuzzy classifier (NFC) of the Takagi-Sugeno-Kang (TSK) type from data information transformed by a wavelet packet (WP). The design of the NFC is accomplished by using a fuzzy c-means (FCM) clustering algorithm that can solve the problem of dimensionality increase due to the flexible scatter partitioning. For this purpose, we use the rider’s hip motion from the sensor information collected by inertial sensors as feature data for the classification of a horse’s gaits. Furthermore, we develop a coaching system under both real horse riding and simulator environments and propose a method for analyzing the rider’s motion. Using the results of the analysis, the rider can be coached in the correct motion corresponding to the classified gait. To construct a motion database, the data collected from 16 inertial sensors attached to a motion capture suit worn by one of the country’s top-level horse riding experts were used. Experiments using the original motion data and the transformed motion data were conducted to evaluate the classification performance using various classifiers. The experimental results revealed that the presented FCM-NFC showed a better accuracy performance (97.5%) than a neural network classifier (NNC), naive Bayesian classifier (NBC), and radial basis function network classifier (RBFNC) for the transformed motion data.