This case study explores the effectiveness of autologous cytokine-induced killer (CIK) cell-based immunotherapy in a 49-year-old male patient with inoperable stage IIIb cholangiocarcinoma, characterized by high levels of the sodium-dependent vitamin C transporter-2 (SVCT2) in immune cells. Despite an initial lack of tumor reduction following chemotherapy, the patient showed a significant decrease in tumor markers and stabilization of the tumor after undergoing radiation and proton therapy. Subsequently, CIK cell therapy, combined with high-dose vitamin C, was administered 52 times over 6 years. The patient’s tumor size reduced, and no cancer activity was detected for 7 years and 10 months post-diagnosis, indicating a successful long-term outcome without recurrence. This study suggests that CIK cell therapy, particularly in patients with elevated SVCT2 levels, may offer a promising adjuvant treatment for cholangiocarcinoma and potentially other cancers. Further research is needed to validate SVCT2 as a biomarker for the effectiveness of CIK cell therapy.

This case study explores the effectiveness of autologous cytokine-induced killer (CIK) cell-based immunotherapy in a 49-year-old male patient with inoperable stage IIIb cholangiocarcinoma, characterized by high levels of the sodium-dependent vitamin C transporter-2 (SVCT2) in immune cells. Despite an initial lack of tumor reduction following chemotherapy, the patient showed a significant decrease in tumor markers and stabilization of the tumor after undergoing radiation and proton therapy. Subsequently, CIK cell therapy, combined with high-dose vitamin C, was administered 52 times over 6 years. The patient’s tumor size reduced, and no cancer activity was detected for 7 years and 10 months post-diagnosis, indicating a successful long-term outcome without recurrence. This study suggests that CIK cell therapy, particularly in patients with elevated SVCT2 levels, may offer a promising adjuvant treatment for cholangiocarcinoma and potentially other cancers. Further research is needed to validate SVCT2 as a biomarker for the effectiveness of CIK cell therapy.

This case study explores the effectiveness of autologous cytokine-induced killer (CIK) cell-based immunotherapy in a 49-year-old male patient with inoperable stage IIIb cholangiocarcinoma, characterized by high levels of the sodium-dependent vitamin C transporter-2 (SVCT2) in immune cells. Despite an initial lack of tumor reduction following chemotherapy, the patient showed a significant decrease in tumor markers and stabilization of the tumor after undergoing radiation and proton therapy. Subsequently, CIK cell therapy, combined with high-dose vitamin C, was administered 52 times over 6 years. The patient’s tumor size reduced, and no cancer activity was detected for 7 years and 10 months post-diagnosis, indicating a successful long-term outcome without recurrence. This study suggests that CIK cell therapy, particularly in patients with elevated SVCT2 levels, may offer a promising adjuvant treatment for cholangiocarcinoma and potentially other cancers. Further research is needed to validate SVCT2 as a biomarker for the effectiveness of CIK cell therapy.

This case study explores the effectiveness of autologous cytokine-induced killer (CIK) cell-based immunotherapy in a 49-year-old male patient with inoperable stage IIIb cholangiocarcinoma, characterized by high levels of the sodium-dependent vitamin C transporter-2 (SVCT2) in immune cells. Despite an initial lack of tumor reduction following chemotherapy, the patient showed a significant decrease in tumor markers and stabilization of the tumor after undergoing radiation and proton therapy. Subsequently, CIK cell therapy, combined with high-dose vitamin C, was administered 52 times over 6 years. The patient’s tumor size reduced, and no cancer activity was detected for 7 years and 10 months post-diagnosis, indicating a successful long-term outcome without recurrence. This study suggests that CIK cell therapy, particularly in patients with elevated SVCT2 levels, may offer a promising adjuvant treatment for cholangiocarcinoma and potentially other cancers. Further research is needed to validate SVCT2 as a biomarker for the effectiveness of CIK cell therapy.

The frequency of diagnosing bronchiectasis is increasing around the world. Cystic fibrosis is the most common inherited cause of bronchiectasis, but there is increasing recognition of significant numbers of patients with bronchiectasis from various causes. With increasing awareness of bronchiectasis, a significant number of research, concerning the causes and treatments, were published over the past few years. Investigation of the underlying cause of bronchiectasis is the most important key to effective management. The purpose of this report is to review the immunological abnormalities that cause bronchiectasis in those that the cystic fibrosis has been excluded, identify the available evidences of current management, and discuss several controversies in the treatment of this disorder.
Bronchiectasis ; Cystic Fibrosis ; Humans ; Immunologic Deficiency Syndromes

Hepatocellular carcinoma (HCC) is a highly lethal cancer with limited treatment options and poor prognosis. Carbon ion radiotherapy (CIRT) has emerged as a promising treatment modality for HCC due to its unique physical and biological properties. CIRT uses carbon ions to target and destroy cancer cells with a high precision and efficacy. The Bragg Peak phenomenon allows precise dose delivery to the tumor while minimizing damage to healthy tissues. In addition, the high relative biological effectiveness of carbon ions can be shown against radioresistant and hypoxic tumor areas. CIRT also offers a shorter treatment schedule than conventional radiotherapy, which increases patient convenience and compliance. The clinical outcomes of CIRT for HCC have shown excellent local control rates with minimal side effects. Considering its physical and biological properties, CIRT may be a viable option for complex clinical scenarios such as patients with poor liver function, large tumors, re-irradiation cases, and tumors close to critical organs. Further research and larger studies are needed to establish definitive indications for CIRT and to compare its efficacy with that of other treatment modalities. Nevertheless, CIRT offers a potential breakthrough in HCC management, providing hope for improved therapeutic outcomes and reduced treatment-related toxicities.

Hepatopulmonary syndrome (HPS) is characterized by a defect in arterial oxygenation that's induced by pulmonary vascular dilatation in the setting of liver disease. Some studies have shown the relationship between the presence of the HPS and the severity of liver disease, but there are only rare cases of HPS inpatient with Child-Pugh class A liver cirrhosis. We report here on a case of a 58 years-old male who suffered from progressive dyspnea for the previous few years. He was diagnosed with alcoholic liver cirrhosis 5 years previously. There was no significant abnormality on the chest radiograph and transthoracic echocardiography, but the arterial blood gas analysis revealed severe hypoxemia. Contrast-enhanced transesophageal echocardiograpy with agitated saline demonstrated a delayed appearance of microbubbles in the left cardiac chambers. Thus, he was finally diagnosed with HPS. This case suggests that we should consider HPS when a patient with compensated liver cirrhosis has unexplained dyspnea.
Anoxia ; Blood Gas Analysis ; Dihydroergotamine ; Dilatation ; Dyspnea ; Echocardiography ; Hepatopulmonary Syndrome ; Humans ; Inpatients ; Liver ; Liver Cirrhosis ; Liver Cirrhosis, Alcoholic ; Liver Diseases ; Liver Transplantation ; Male ; Microbubbles ; Oxygen ; Thorax

OBJECTIVES: Purpose of this study is investigation the influence of intravenous and oral bisphosphonate to bone union and clinical results in patient treated with plate fixation in an osteoporotic distal radius fracture. MATERIALS AND METHODS: The medical records of 160 patients with an osteoporotic distal radius fracture treated with plate fixation in our hospital between January 2008 and April 2012 were reviewed retrospectively. The patients were classified by 3 groups; who did not administrate bisphosphonate after surgery as Group I (n=69), administrated oral bisphosphonate after surgery as Group II (n=44), and administrated intravenous bisphosphonate as Group III (n=47). After surgery, bone union, radiologic parameters, disabilities of the DASH score and range of motion of wrist were assessed. RESULTS: Mean time of bone union was 6.7 weeks in Group I, 6.8 weeks in Group II, and 7.1 weeks in Group III. There was no significant difference between three groups (P=0.571). Bone union rate on 6weeks shows no significant differences between three groups (P=0.16). Three groups also have no significant differences in all radiologic and clinical parameters. CONCLUSION: This study shows that early initiation of oral and Intravenous bisphosphonate did not affect bone union and clinical results compared to group who did not administrate bisphosphonate result in patient treated with plate fixation in an osteoporotic distal radius fracture.
Humans ; Medical Records ; Osteoporosis ; Radius Fractures ; Radius ; Range of Motion, Articular ; Retrospective Studies ; Wrist

Although pulmonary arterial hypertension (PAH) is an orphan disease with high mortality and for which there is no cure, current treatment have led to considerable gains in the outcomes of these patients. Oral anticoagulation is proposed for most patients; diuretic treatment and supplemental oxygen are indicated in cases of fluid retention and hypoxemia. High doses of calcium-channel blockers are indicated only in the minority of patients who respond to acute vasoreactivity testing. Nonresponders to acute vaoreactivity testing or who remain in World Health Organization (WHO) functional class III, should be considered candidates for treatment with either an oral phophodiesterase-5 inhibitor or an oral endothelin-receptor antagonist. Continuous intravenous administration of epoprostenol remains the treatment of choice in WHO functional class IV patients. Combination therapy is recommended for patients treated with PAH monotherapy who remain in WHO functional class III. The pharmacologic management of PAH is rapidly evolving as newer therapeutic targets that stabilize or reverse pulmonary vascular disease and as clinical practice pattern shift in favor of earlier diagnosis and aggressive treatment. Questions about preferred first-line therapy and when to institute combination therapies remain. Future drug development targeting other molecular pathways of PAH is essential for definitively improving patient survival. The search for novel treatment continues, with promising new concepts arising from a better understanding of the pathobiology of PAH.
Administration, Intravenous ; Anoxia ; Epoprostenol ; Humans ; Hypertension ; Hypertension, Pulmonary ; Oxygen ; Phosphodiesterase 5 Inhibitors ; Physician's Practice Patterns ; Rare Diseases ; Retention (Psychology) ; Vascular Diseases ; World Health Organization

Background: This study aimed to examine the association of serum uric acid levels with incident cardiovascular disease and mortality in Korean adults without gout. Methods: This large longitudinal cohort study included adults aged > 19 years who had serum uric acid levels measured at least once at the National Health Insurance Service Ilsan Hospital from January 1, 2006 to December 31, 2015. Longitudinal data on person-level cardiovascular disease and cardiovascular mortality were linked to the National Health Insurance Service claims database and National Death Index. Results: Among a total of 92,454 study participants with a median follow-up of 4.7 years, 7,670 (8.3%) composite events of cardiovascular disease or cardiovascular mortality were observed. Multivariable Cox proportional-hazards models revealed that each 1 mg/dL increment in uric acid level was associated with a 6% higher risk of composite outcomes.Compared with that for the uric acid level category of 4.0 to < 5.0 mg/dL, adjusted hazard ratios (95% confidence interval) for uric acid level categories of 5.0 to < 6.0, 6.0 to < 7.0, and ≥ 7.0 mg/dL were 1.10 (1.04–1.18), 1.20 (1.11–1.30), and 1.36 (1.25–1.47), respectively. In the secondary analyses for cardiovascular disease or cardiovascular mortality examined separately, a higher uric acid level was similarly associated with a higher risk of each adverse outcome. These associations were generally consistent across clinically relevant subgroups. Conclusion A graded association was noted between serum uric acid levels and cardiovascular risk, suggesting that higher uric acid levels may adversely affect cardiovascular health and survival in individuals without gout.