BACKGROUND: Clostridium difficile is the major cause of antibiotic-associated diarrhea (AAD) and pseudomembranous colitis (PMC). This study was designed to investigate predisposing factors of AAD or PMC and to evaluate the efficiency of nested PCR assay for direct detection of toxin B gene in the treatment and prognosis of these diseases. METHODS: From January to December, 2002, stool specimens from 142 patients in Kosin Medical Center, Busan, were tested for the detection of toxigenic C. difficile strains. Toxin B gene in C. difficile was detected by nested PCR. And chart review was performed to investigate the antibiotics or anticancer drug history, clinical symptoms, treatment regimens, and prognosis. RESULTS: Among 142 stool specimens, 56 specimens showed positive for the toxin B gene in C. difficile strains by PCR. Forty two percents (47/113) of stool specimens from patients with AAD and all of specimens from eight patiens with PMC were C. difficile toxin B gene positive. Administration of antibiotics or anticancer drugs was stopped in 92.7% of toxin B gene-positive cases, but those were stopped in only 48.5% of toxin B gene-negative cases. The cure rate was higher in positive cases (82%) than negative ones (71%). CONCLUSION: It is concluded that nested PCR assay for the direct detection of C. difficile toxin B gene was helpful in rapid diagnosis and treatment of AAD or PMC.
Anti-Bacterial Agents ; Busan ; Causality ; Clostridium difficile* ; Clostridium* ; Diagnosis* ; Diarrhea* ; Enterocolitis, Pseudomembranous* ; Humans ; Polymerase Chain Reaction ; Prognosis

BACKGROUND: Clostridium difficile is the major cause of antibiotic-associated diarrhea (AAD) and pseudomembranous colitis (PMC). This study was designed to investigate predisposing factors of AAD or PMC and to evaluate the efficiency of nested PCR assay for direct detection of toxin B gene in the treatment and prognosis of these diseases. METHODS: From January to December, 2002, stool specimens from 142 patients in Kosin Medical Center, Busan, were tested for the detection of toxigenic C. difficile strains. Toxin B gene in C. difficile was detected by nested PCR. And chart review was performed to investigate the antibiotics or anticancer drug history, clinical symptoms, treatment regimens, and prognosis. RESULTS: Among 142 stool specimens, 56 specimens showed positive for the toxin B gene in C. difficile strains by PCR. Forty two percents (47/113) of stool specimens from patients with AAD and all of specimens from eight patiens with PMC were C. difficile toxin B gene positive. Administration of antibiotics or anticancer drugs was stopped in 92.7% of toxin B gene-positive cases, but those were stopped in only 48.5% of toxin B gene-negative cases. The cure rate was higher in positive cases (82%) than negative ones (71%). CONCLUSION: It is concluded that nested PCR assay for the direct detection of C. difficile toxin B gene was helpful in rapid diagnosis and treatment of AAD or PMC.
Anti-Bacterial Agents ; Busan ; Causality ; Clostridium difficile* ; Clostridium* ; Diagnosis* ; Diarrhea* ; Enterocolitis, Pseudomembranous* ; Humans ; Polymerase Chain Reaction ; Prognosis

The small GTP-binding protein Rab25 is associated with tumor formation and progression. However, recent studies have shown discordant effects of Rab25 on cancer cell progression depending on cell lineage. In the present study, we elucidate the underlying mechanisms by which Rab25 induces cellular invasion. We demonstrate that Rab25 increases β1 integrin levels and subsequent activation of EGFR and upregulation of VEGF-A expression, leading to increased Snail expression, epithelial-to-mesenchymal transition and cancer cell invasiveness. Strikingly, we identify that Snail mediates Rab25-induced cancer cell invasiveness through fascin expression and that ectopic expression of Rab25 aggravates metastasis of ovarian cancer cells to the lung. We thus demonstrate a novel role of a β1 integrin/EGFR/VEGF-A/Snail signaling cascade in Rab25-induced cancer cell aggressiveness through induction of fascin expression, thus providing novel biomarkers and potential therapeutic targets for Rab25-expressing cancer cells.
Biomarkers ; Cell Lineage ; Ectopic Gene Expression ; GTP-Binding Proteins ; Lung ; Neoplasm Metastasis ; Ovarian Neoplasms ; Snails ; Up-Regulation ; Vascular Endothelial Growth Factor A

Thrombotic thrombocytopenic purpura (TTP) rarely may be seen in association with autoimmune processes such as scleroderma, rheumatoid arthritis, polyarteritis nodosa, Sj gren's syndrome, and systemic lupus erythematosusus (SLE). The diagnosis of TTP as a syndrome distinct from SLE may be challenging, because both processes may present with some or all elements of the classic pentad considered pathognomonic of the former: microangiopathic hemolytic anemia, fever, thrombocytopenia, neurological deficits, and renal abnormalities. We describe a patient with synchronous TTP and SLE, and review the literature.
Anemia, Hemolytic ; Arthritis, Rheumatoid ; Diagnosis ; Fever ; Humans ; Lupus Erythematosus, Systemic* ; Polyarteritis Nodosa ; Purpura, Thrombotic Thrombocytopenic* ; Thrombocytopenia

Hepatocellular carcinoma(HCC) of unknown origin presents unusually in the elderly as a huge abdominal mass. Though most commonly associated with viral infections, about 10% of HCC in Korea arise from an unknown cause. HCC of unknown origin has a varying clinical picture and prognosis. It is known to have relatively good reserve liver function and rarely complications with previous cirrhosis or active hepatitis. Its pathogenesis may be not associated with an inflammation-dysplasia-carcinoma sequence. We recently managed an unusual case of moderately differentiated hepatocellular carinoma of unknown origin presenting with a huge abdominal mass. The 82-year-old female patient had no history of viral hepatitis and no other metabolic diseases were diagnosed. She received palliative care.
Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; Female ; Fibrosis ; Hepatitis ; Humans ; Korea ; Liver ; Metabolic Diseases ; Neoplasms, Unknown Primary ; Prognosis

Although gallbladder (GB) perforation due to acalculous cholecystitis after kidney transplantation is rarely observed, it can be life threatening and result in cholecystectomy. Coronary artery aneurysm (CAA) is also rare and may require invasive therapy depending on its diameter. We report herein the case of a 69-year-old female who developed GB perforation due to acalculous cholecystitis after kidney transplantation and underwent cholecystectomy. The patient was later invasively treated when CCA was detected by coronary angiography.
Acalculous Cholecystitis ; Aneurysm ; Cholecystectomy ; Coronary Angiography ; Coronary Vessels ; Female ; Gallbladder ; Humans ; Kidney ; Kidney Transplantation

No abstract available.
Aged ; Anemia/diagnosis ; Bone Marrow Cells/pathology ; Chromosomes, Human, Pair 11 ; Electrophoresis ; Glomerulonephritis, IGA/complications/*diagnosis ; Hematuria/pathology ; Hemoglobin A/analysis ; Heterozygote ; Humans ; Male ; Renal Insufficiency/diagnosis ; beta-Globins/genetics ; beta-Thalassemia/*diagnosis/etiology

Retroperitoneal sarcoma is a rare tumor accounting for 1-2% of all solid malignancies. These tumors are usually large when diagnosed because of their typically silent nature and should be distinguished from other retroperitoneal masses for adequate management. In spite of an apparent complete resection which is the only potential curative treatment, the high rate of local recurrence is the major problem of retroperitoneal sarcoma; therefore, patients with high-grade tumors should undergo regular and continuous follow-ups. Postrenal acute kidney injury (AKI) results from a urinary outflow tract compression due to the mass effect of retroperitoneal sarcoma, which is one of less common causes of postrenal AKI and has not been reported in Korea. We report a case that an 81-year-old-woman with undifferentiated retroperitoneal sarcoma presented with postrenal AKI and improved after complete resection.
Accounting ; Acute Kidney Injury ; Follow-Up Studies ; Humans ; Korea ; Recurrence ; Retroperitoneal Neoplasms ; Sarcoma

PURPOSE: We planned to evaluate the toxicity and efficacy of DA-3030 to determine the recommended dose for phase III clinical trial based on the biologically active doses from phase I/II clinical trial. MATERIALS AND METHODS: Open non-randomized phase I/II study was carried out in 64 cancer patients with chemotheray-induced myelosuppression. After 1 cycle of control period (chemotherapy without DA-3030), DA-3030 was started 24 hours after the second cycle of chemotherapy to 4 groups of patients with the doses of 50 microgram/m2/day (step I), 100 microgram/m2/day (step II), 150 microgram/m2/day (step III), 200microgram/m2/day (step IV) by once-a-day subcutaneous administration for 10 days. RESULTS: Of the 64 enrolled patients, 46 patients were evaluable. Tmax reached after 2 hours of injection in step I and 4 hours in step II-IV. Terminal half life was 1.8 hours in step I and 3.2 hours in step II, 3.3 hours in step III, 3.0 hours in step IV. Area under the curve (AUC) and AUMC increased dose dependently from step I through step IV. Total clearance rate decreased in a dose dependent manner but the volume of distribution showed no differences between the steps.The mean nadir count of total WBC and neutrophil increased in all 4 steps of DA-3030 administration. Also the duration of leukopenia, equal to or less than 2,000/uL or neutropenia and the recovery time of WBC or neutrophil from nadir decreased with DA-3030 administration in all 4 steps. But no differece of DA-3030 effect was found among 4 steps. When we compared the clinical efficacy of DA-3030 with total WBC and neutrophil criteria, it was 58.3% and 58.3% in step I, 90.0% and 80.0% in step II, 91.7% and 91.7% in step III, 75.0% and 70.0% in step IV. Although the duration of antibiotics administration showed no difference between control and DA-3030 administration period in step I, it decreased with DA-3030 administration in step II-IV. Infection was found only in step I. Life-threatening side effect was not found in all steps. Only mild myalgia was found without any dose relationship. CONCLUSION: When we considered the efficacy, toxicity and pharmacokinetic parameters, we suggest that 100microgram/m2 is an appropriate dosage for the phase III clinical trial.
Anti-Bacterial Agents ; Drug Therapy* ; Half-Life ; Humans ; Leukopenia ; Myalgia ; Neutropenia* ; Neutrophils

At the end of 2019, the cause of pneumonia outbreaks in Wuhan, China, was identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In February 2020, the World Health Organization named the disease cause by SARS-CoV-2 as coronavirus disease 2019 (COVID-19). In response to the pandemic, the Korean Cancer Association formed the COVID-19 task force to develop practice guidelines. This special article introduces the clinical practice guidelines for cancer patients which will help oncologists best manage cancer patients during the COVID-19 pandemic.