PURPOSE: The aim of this study was to investigate clinicopathologic differences between prostate cancer (PCa) detected at initial and repeat transrectal ultrasound-guided prostate biopsy in a large Korean cohort. MATERIALS AND METHODS: From 2000 through 2012, a total of 7,001 patients underwent transrectal ultrasound-guided prostate biopsy at 6 centers in Daegu and Gyeongbuk provinces. Of these 7,001 patients, the initial biopsy was positive for PCa in 2,118 patients. Repeat biopsy was performed in 374 of the 4,883 patients with an initial negative finding and a persistently elevated prostate-specific antigen (PSA) level, nodules or asymmetry by digital rectal examination (DRE), high-grade prostatic intraepithelial neoplasia, or atypical small acinar proliferation. Numbers of biopsy cores varied from 6 to 12 according to center and biopsy date. RESULTS: Cancer was diagnosed in 2,118 of the 7,001 patients (30.3%) at initial biopsy and in 86 of the 374 patients (23.0%) at repeat biopsy. The repeat biopsy rate was 5.3%. Mean PSA values were 68.7+/-289.5 ng/mL at initial biopsy and 18.0+/-55.4 ng/mL at repeat biopsy (p<0.001). The mean number of cancer-positive cores per biopsy was 5.5+/-3.5 for initial biopsy and 3.0+/-2.9 for repeat biopsy (p<0.001). Mean Gleason score was 7.5+/-1.4 at initial biopsy and 6.6+/-1.3 at repeat biopsy (p<0.001). For detected cancers, the low-stage rate was higher for repeat biopsy than for initial biopsy (p=0.001). CONCLUSIONS: Cancers detected at repeat biopsy tend to have lower Gleason scores and stages than cancers detected at initial biopsy. The present study shows that repeat biopsy is needed in patients with a persistently high PSA or abnormal DRE findings.
Adult ; Aged ; Aged, 80 and over ; Endosonography/*methods ; Follow-Up Studies ; Humans ; Image-Guided Biopsy/*methods ; Incidence ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Prostatic Neoplasms/epidemiology/*pathology ; Rectum ; Reproducibility of Results ; Republic of Korea/epidemiology ; Retrospective Studies

Adoptive cell therapy with chimeric antigen receptor (CAR)-engineered T cells (CAR-Ts) has emerged as an innovative immunotherapy for hematological cancer treatment. However, the limited effect on solid tumors, complex processes, and excessive manufacturing costs remain as limitations of CAR-T therapy. Nanotechnology provides an alternative to the conventional CAR-T therapy. Owing to their unique physicochemical properties, nanoparticles can not only serve as a delivery platform for drugs but also target specific cells. Nanoparticle-based CAR therapy can be applied not only to T cells but also to CAR-natural killer and CAR-macrophage, compensating for some of their limitations. This review focuses on the introduction of nanoparticle-based advanced CAR immune cell therapy and future perspectives on immune cell reprogramming.

No abstract available.
Glomerulonephritis, Membranous* ; Lower Extremity* ; Small Cell Lung Carcinoma* ; Thrombosis*

BACKGROUND: The skin, a vital organ protecting against microorganisms and dehydration, undergoes structural decline with aging, leading to visible issues such as wrinkles and sagging. Reduced blood vessels exacerbate vulnerability, hindering optimal cellular function and compromising skin health. Polydioxanone (PDO) biomaterials address aging concerns but produce acidic byproducts, causing inflammation. Inorganic particles and nitric oxide (NO) play crucial roles in inhibiting inflammation and promoting skin regeneration. Stem cell-derived extracellular vesicles (EVs) contribute to intercellular communication, offering the potential to enhance cell functions. The study proposes a method to enhance PDO-based medical devices by incorporating inorganic particles and immobilizing EVs, focusing on facial rejuvenation, anti-inflammatory response, collagen formation, and angiogenesis.METHOD: PDO composites with inorganic particles such as magnesium hydroxide (MH) and zinc oxide (ZO) were prepared and followed by EV immobilization. Comprehensive characterization included biocompatibility, anti-inflammation, collagen formation ability, and angiogenesis ability. RESULTS: Bulk-modified PDO composites demonstrated even dispersion of inorganic particles, pH neutralization, and enhanced biocompatibility. EVs immobilized on the composite surface exhibited spherical morphology. Inflammationrelated gene expressions decreased, emphasizing anti-inflammatory effects. Collagen-related gene and protein expressions increased, showcasing collagen formation ability. In addition, angiogenic capabilities were notably improved, indicating potential for skin rejuvenation. CONCLUSION The study successfully developed and characterized PDO composites with inorganic particles and EVs, demonstrating promising attributes for medical applications. These composites exhibit biocompatibility, anti-inflammatory properties, collagen formation ability, and angiogenic potential, suggesting their utility in skin rejuvenation and tissue engineering. Further research and clinical validation are essential.

Laparoscopic cholecystectomy has resulted in various bile duct injuries. Treatment of these injuries is usually difficult and often leads to an intractable clinical course. We herein present a case of isolated right anterior sector (RAS) duct injury induced by laparoscopic cholecystectomy. The bile duct injury was successfully treated by hepatic atrophy induction. Imaging studies revealed that the RAS duct was severed, probably due to rare anatomical variations. Considering the difficulty in surgical reconstruction, atrophy induction of the involved hepatic parenchyma was attempted. This treatment consisted of embolization of the RAS portal branch to inhibit bile production, induction of heavy adhesion at the bile leak site to ensure percutaneous pigtail clamping, and sequential clamping and removal of pigtail catheters. This procedure took 3 months prior to pigtail catheter removal. She was free from other complications during the first 12 months and to date. She will be followed up for 5 years overall including surveillance for hepatobiliary complications. Although this therapeutic induction of atrophy approach is not universally applicable, it can be considered to be a feasible option in unique situations such as this one.
Atrophy ; Bile ; Bile Ducts ; Catheters ; Cholecystectomy, Laparoscopic ; Constriction ; Dietary Sucrose

The authors want to correct the title because this article.

BACKGROUND AND OBJECTIVES: Life-threatening hypotension during percutaneous coronary interventions (PCI) is devastating for the patient and is associated with fatal adverse outcomes. The aim of our study was to assess the usefulness of intracoronary epinephrine in severe hypotension unresponsive to other measures during PCI. SUBJECTS AND METHODS: We analyzed the Pusan National University Yangsan hospital cardiac catheterization laboratory database to identify patients who underwent PCI from December 2008 to July 2012. The outcomes were changes of blood pressure (BP) and heart rate (HR) before and after intracoronary epinephrine and in-hospital mortality. RESULTS: A total of 30 patients who were initially stable and received intracoronary epinephrine for severe hypotension during PCI were included. Following administration of intracoronary epinephrine (dose 181+/-24.8 microgram), systolic and diastolic BP (from 53.8+/-13.0 mm Hg up to 112.8+/-21.2 mm Hg, from 35+/-7.6 mm Hg up to 70.6+/-12.7 mm Hg, respectively) and HR (from 39.4+/-5.1 beats/min up to 96.8+/-29.3 beats/min) were increased. Additionally, 21 patients (70%) showed hemodynamically acceptable responses to intracoronary epinephrine without the intraaortic balloon pump and temporary pacemaker during the PCI. In-hospital mortality was 17% (n=5). CONCLUSION: Although our study was small, intracoronary epinephrine was found to be well tolerated and resulted in prompt and successful recovery from severe hypotension in most patients when other measures were ineffective. Intracoronary epinephrine could be a safe and useful measure in patients developing severe hypotension during PCI.
Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Epinephrine* ; Heart Rate ; Hospital Mortality ; Humans ; Hypotension* ; Percutaneous Coronary Intervention*

Intramyocardial hematoma is known to be associated with myocardial infarction, chest trauma, coronary artery bypass operation, and complication of percutaneous coronary intervention (PCI). We describe here a rare case of 50-year-old man with a huge right ventricular (RV) wall hematoma which was newly developed two hours after PCI. The patient was treated conservatively with a successful outcome. We discuss plausible mechanisms for the development of RV wall hematoma and treatment options for the case.
Coronary Artery Bypass ; Heart Ventricles ; Hematoma ; Humans ; Middle Aged ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Thorax

PURPOSE: This study was implemented to investigate the prevalence of proteinuria and its combined morbidity in apparently normal adults. METHODS: We examined the mass screening data of Health Promotion Center in Seoul National University Hospital from May 1, 1995 to February 11, 2000. The random urine samples of all screenees were examined by dipstick test. Among them 22,595 adults(men 11,737 and women 10,858) who didn't take anti- hypertensive medication and whose fasting blood sugar <126 mg/dL were included in this analysis. RESULTS: The prevalence of proteinuria was 6.7% in men and 3.6% in women. Risk factors for proteinuria by simple correlation analysis were age, sex, body weight, systolic blood pressure, diastolic blood pressure, fasting blood sugar, blood urea nitrogen, serum creatinine, total cholesterol and smoking. As the degree of proteinuria increased, the systolic and diastolic blood pressures also increased significantly and creatinine clearance significantly decreased above the '++' level of proteinuria. Probability of proteinuria was calculated at each blood pressure level graded by JNC VI. With the increase of the level of blood pressure, the probability of proteinuria increased significantly between normal and high normal, high normal and hypertension1, and hypertension 2 and hypertension 3 level. Creatinine clearance and blood pressure level showed negative correlation. When total screenees were divided to proteinuria and no proteinuria groups, proteinuria group showed significant decrease of creatinine clearance in high normal and hypertension 1 level. CONCLUSION: Our results suggest that proteinuria in the apparently normal adults is not a benign condition, and it can be accompanied by significantly increased blood pressures and decreased renal function.
Adult* ; Blood Glucose ; Blood Pressure ; Blood Urea Nitrogen ; Body Weight ; Cholesterol ; Creatinine ; Fasting ; Female ; Health Promotion ; Humans ; Hypertension ; Male ; Mass Screening ; Prevalence* ; Proteinuria* ; Risk Factors ; Seoul ; Smoke ; Smoking

Myxedema coma is the most extreme form of hypothyroidism and manifests as central nervous system dysfunction, defective thermoregulation, and cardiopulmonary decompensation. The curative treatment is based on the administration of thyroid hormones, but the dose and route of administration remain controversial. Here, we report a case of myxedema coma that was treated successfully with a large oral dose of levothyroxine
Body Temperature Regulation ; Central Nervous System ; Coma ; Hypothyroidism ; Myxedema ; Thyroid Hormones ; Thyroxine