Background/Aims: This study aimed to investigate whether everolimus (EVR) affects long-term survival after liver transplantation (LT) in patients with hepatocellular carcinoma (HCC). Methods: The data from 303 consecutive patients with HCC who had undergone LT from January 2012 to July 2018 were retrospectively reviewed. The patients were divided into two groups: 1) patients treated with EVR in combination with calcineurin inhibitors (CNIs) (EVR group; n=114) and 2) patients treated with CNI-based therapy without EVR (non-EVR group; n=189). Time to recurrence (TTR) and overall survival (OS) after propensity score (PS) matching were compared between the groups, and prognostic factors for TTR and OS were evaluated. Results: The EVR group exhibited more aggressive tumor biology than the non-EVR group, such as a higher number of tumors (P=0.003), a higher prevalence of microscopic vascular invasion (P=0.017) and exceeding Milan criteria (P=0.029). Compared with the PS-matched non-EVR group, the PS-matched EVR group had significantly better TTR (P<0.001) and OS (P<0.001). In multivariable analysis, EVR was identified as an independent prognostic factor for TTR (hazard ratio [HR], 0.248; P=0.001) and OS (HR, 0.145; P<0.001). Conclusions Combined with CNIs, EVR has the potential to prolong long-term survival in patients undergoing LT for HCC. These findings warrant further investigation in a well-designed prospective study.

Background/Aims: This study aimed to investigate whether everolimus (EVR) affects long-term survival after liver transplantation (LT) in patients with hepatocellular carcinoma (HCC). Methods: The data from 303 consecutive patients with HCC who had undergone LT from January 2012 to July 2018 were retrospectively reviewed. The patients were divided into two groups: 1) patients treated with EVR in combination with calcineurin inhibitors (CNIs) (EVR group; n=114) and 2) patients treated with CNI-based therapy without EVR (non-EVR group; n=189). Time to recurrence (TTR) and overall survival (OS) after propensity score (PS) matching were compared between the groups, and prognostic factors for TTR and OS were evaluated. Results: The EVR group exhibited more aggressive tumor biology than the non-EVR group, such as a higher number of tumors (P=0.003), a higher prevalence of microscopic vascular invasion (P=0.017) and exceeding Milan criteria (P=0.029). Compared with the PS-matched non-EVR group, the PS-matched EVR group had significantly better TTR (P<0.001) and OS (P<0.001). In multivariable analysis, EVR was identified as an independent prognostic factor for TTR (hazard ratio [HR], 0.248; P=0.001) and OS (HR, 0.145; P<0.001). Conclusions Combined with CNIs, EVR has the potential to prolong long-term survival in patients undergoing LT for HCC. These findings warrant further investigation in a well-designed prospective study.

To investigate the prevalence of Toxoplasma gondii in pork on the market in Korea, an in-house enzyme-linked immunosorbent assay for tissue fluid (CAU-tf-ELISA) was developed using a soluble extract of T. gondii RH strain tachyzoites. As the standard positive controls, the piglets were experimentally infected with T. gondii: Group A (1,000 cysts-containing bradyzoites), Group B (500 cysts-containing bradyzoites) and Group C (1.0×103 or 1.0×104 tachyzoites). The CAU-tf-ELISA demonstrated infection intensity-dependent positivity toward tissue fluids with average cut-off value 0.15: 100% for Group A, 93.8% for Group B and 40.6% for Group C. When tissue-specific cut-off values 0.066–0.199 were applied, CAU-tf-ELISA showed 96.7% sensitivity, 100% specificity, 100% positive and 90.0% negative predictive values. When compared with the same tissue fluids, performance of CAU-tf-ELISA was better than that of a commercial ELISA kit. Of the 583 Korea domestic pork samples tested, anti-T. gondii antibodies were detected from 9.1% of whole samples and 37.9% from skirt meat highest among pork parts. In the 386 imported frozen pork samples, 1.8% (skirt meat and shoulder blade) were positive for anti-T. gondii antibodies. In Korea, prevalence of anti-T. gondii antibodies in the pork on retail markets appeared high, suggesting that regulations on pig farming and facilities are necessary to supply safe pork on the tables.
Agriculture ; Antibodies ; Enzyme-Linked Immunosorbent Assay ; Korea ; Meat ; Prevalence ; Red Meat ; Sensitivity and Specificity ; Shoulder ; Social Control, Formal ; Toxoplasma

The use of human umbilical cord blood-derived mesenchymal stem cells for cell transplantation therapy holds great promise for repairing spinal cord injury. Here we report the first clinical trial transplantation of human umbilical cord (hUCB)-derived mesenchymal stem cells (MSCs) into the spinal cord of a dog suspected to have fibrocartilaginous embolic myelopathy (FCEM) and that experienced a loss of deep pain sensation. Locomotor functions improved following transplantation in a dog. Based on our findings, we suggest that transplantation of hUCB-derived MSCs will have beneficial therapeutic effects on FCEM patients lacking deep pain sensation.
Animals ; Cartilage Diseases/etiology/therapy/*veterinary ; *Cord Blood Stem Cell Transplantation/veterinary ; Dog Diseases/etiology/*therapy ; Dogs ; Embolism/etiology/therapy/*veterinary ; Female ; Humans ; Mesenchymal Stromal Cells/cytology/*metabolism ; Spinal Cord Diseases/etiology/therapy/*veterinary ; Treatment Outcome

Cervical cancer is characterized by a long period of preclinical dysplasia or carcinoma in situ progressing into invasive cancer. Although Papanicolaou (Pap) smear test has contributed significantly to the early detection of precursor lesions, the cytological screening has inherent problems that produce considerable false negative/positive results. Since the infection of high-risk type of human papillomavirus (HPV) is strongly associated with cervical cancer, we investigated the feasibility of an immunostaining test to detect cells infected by HPV in cervical smear. We produced monoclonal antibodies against HPV16 E7 in mice by repeated injections with the recombinant HPV16 E7. Western blot analysis and immunocytochemical assay demonstrated that the selected monoclonal antibody, mAb (130-9-7), reacts specifically with cultured cervical cancer cell lines infected by HPV16. Specific staining was observable with the HPV16-positive smear specimens obtained from the cervical cancer patients, whereas no staining was detected with the HPV-negative smear specimens. To achieve the desired sensitivity, specificity and reproducibility, we modified and optimized the conventional immunocytochemical procedure for cervical smear specimens. Our results suggest that this immunostaining method for detecting high-risk HPV in cervical smear may be used as a strategy to distinguish a high-risk group, especially those patients with low grade cytological abnormality.
Animals ; Antibodies, Monoclonal ; Antibodies, Viral ; Cell Line ; Cervix Uteri/*virology ; Female ; Human papillomavirus 16/genetics/*isolation & purification ; Humans ; Hybridomas ; Immunohistochemistry/methods ; Mice ; Oncogene Proteins, Viral/genetics/*metabolism ; Transfection ; Uterine Cervical Neoplasms/virology ; Vaginal Smears

BACKGROUND AND OBJECTIVES : Microvascular integrity has been associated with the clinical outcomes in acute myocardial infarction (AMI). The present study was conducted to determine the value of many microvascular indexes assessed by an intracoronary (IC) pressure/Doppler wire in AMI following primary PCI for detecting viable myocardium by comparing with the 18F-fluorodeoxyglucose uptake rate (%FDG uptake) on positron-emission tomography (PET). SUBJECTS AND METHODS : We studied 35 patients who had their first AMI (age: 56+/-12, male: 30). After primary PCI, the TMPG (TIMI myocardial perfusion grade) was assessed. We measured the coronary flow reserve (CFR), the diastolic deceleration time (DDT), the coronary wedge pressure (Pcw), the Pcw/ Pa (mean aortic pressure) and the hyperemic microvascular resistance index (hMVRI) by an IC Doppler/ pressure wire. 18FDG PET scan was obtained at 7 days after the primary PCI; viable myocardium was defined that the %FDG uptake was more than 50% in infarct-related myocardium. RESULTS : There were significant correlations between TMPG, CFR, Pcw, Pcw/Pa, DDT, hMVRI and %FDG uptake (r=0.651, p<0.001; r=0.386, p=0.020; r=-0.388, p=0.021; r=-0.473, p=0.004; r=0.589, p<0.001; r=-0.442, p=0.008, respectively). The best cutoff values and area under curves (AUC) of the CFR, Pcw, Pcw/Pa, DDT and hMVRI for 50% FDG uptake were 1.8 (0.737), 27 mmHg (0.600), 0.33 (0.660), 600 msec (0.802) and 2.55 mmHg.cm-1.sec (0.768), respectively. The DDT had a significantly higher AUC than that of Pcw (p=0.029) and it was an independent index to predict the myocardial viability (p=0.011). CONCLUSION : DDT was the most reliable hemodynamic microvascular index that was assessed within 24 hours following primary PCI for predicting the viable myocardium in AMI patients.
Area Under Curve ; DDT ; Deceleration ; Fluorodeoxyglucose F18 ; Hemodynamics ; Humans ; Male ; Myocardial Infarction ; Myocardium ; Perfusion ; Positron-Emission Tomography ; Pulmonary Wedge Pressure

Percutaneous arterial closure devices allow earlier mobilization and discharge of patients after arterial catheterization than manual compression for achieving puncture site hemostasis. Our case is representative of Perclose(r) associated infections; our patient had a delayed presentation of a staphylococcal arterial infection that required arterial debridement and reconstruction. Physicians should be aware of this uncommon, but serious complication to expedite the evaluation and treatment of patients with suspected infections that can arise from using these devices.
Catheterization ; Catheters ; Coronary Angiography* ; Debridement ; Endarteritis* ; Hemostasis ; Humans ; Punctures

PURPOSE: Transurethral resection of the prostate (TURP) is the gold standard treatment for symptomatic benign prostate hyperplasia, but significant complications are associated with this procedure. The aim of this study was to compare the standard TURP with the high power (80W) potassium-titanyl-phosphate laser (KTP/532; Greenlights PVTM laser system; Laserscope, San Jose, USA) to elucidate the efficacy and safety of laser treatment. MATERIALS AND METHODS: We performed comparative trials of 40 patients suffering with symptomatic bladder outlet obstruction due to benign prostatic hyperplasia from February 2005 to June 2005. Twenty patients were treated with TURP (Group I) and 20 patients were treated with KTP (Group II). All patients were assessed preoperatively and at an interval of 3 months postoperatively based on the International Prostate Symptom Score (IPSS), the quality of life (QoL) index, changes in maximum urinary flow rate (Qmax), and the postvoid residual urine (ml). The safety parameters we evaluated included the operative time (minutes), the postoperative catheterization time (day) and the blood loss (ml). The Kolmogorov- Smirnov & Shapiro-Wilk test, Student's t-test, Student's t-test (paired), and Fisher's Exact test were performed for statistical analysis. RESULTS: The mean age of each group was 68.9+/-9.9 years (group 1) and 63.9+/-9.7 years (group II), and the prostate weight was 49.5+/-15.4cc and 45.0+/-17.3cc, respectively. The mean operation time was shorter for group II (27.7+/-13.6min) than for group I (48.1+/-22.6min) (p<0.05). The mean catheterization time was 5.6+/-1.82 and 1.36+/-1.64 days, respectively, (p<0.001). The blood loss was lower in group II (11.7+/-11.4ml) than in group I (181.9+/-168.17ml, respectively) (p<0.001). CONCLUSIONS: In this preliminary short-term study, KTP Laser enucleation of the prostate was shown to be an effective alternative for treating benign prostate hyperplasia as compared with standard TURP.
Catheterization ; Catheters ; Humans ; Hyperplasia ; Laser Therapy* ; Lasers, Solid-State ; Operative Time ; Prostate* ; Prostatic Hyperplasia ; Quality of Life ; Transurethral Resection of Prostate ; Urinary Bladder Neck Obstruction

In this special article we present Korean medication algorithm development project for major psychiatric disorder (KMAP), basic plan, organization, basic principles of algorithm developments, methods of development, limitations and cautions of using this algorithm. The Korean Society of Psychopharmcology and Korean Academy of Schizophrenia as a co-worker started to make Korean algorithm project that is helpful to treat major mental disorder (schizophrenia, bipolar disorder) patients by the better psychopharmacologic treatments. In spite of many advantages of algorithm, these projects have many limitations and problems simultaneously; we needed to introduce the goal of algorithm, details of development methods in this special article. KMAP have employed the latest survey techniques and reflect only the most current clinical standards. The results are a practical reference tool not only for clinicians but also for mental health educators and other healthcare professionals involved in the care of patients who have major mental disorders. This algorithm projects can have problems and shortcomings. but we will revise this issues by correction and amendment.
Bipolar Disorder ; Delivery of Health Care ; Humans ; Mental Disorders ; Mental Health ; Schizophrenia

BACKGROUND AND OBJECTIVES: Quinolone-induced arthropathy is an unusual toxic effect observed in juvenile animals of multiple species. Such toxic effects are usually found in joint cartilages. The reports of chondrotoxic potential of quinolones in juvenile animals were mainly performed in weight bearing joints such as hips and knees. The purpose of this study was to investigate the morphological changes in the incudomalleolar joint of immature rats dosed with ciprofloxacin, and to draw relationship between the incudomalleolar joint pathology and hearing. MATERIALS AND METHODS: An experimental group of 21-day-old rats were administrated intraperitoneally with 200 mg ciprofloxacin/kg for 10 days. The hearing threshs of the control and experimental animals were determined with auditory brainstem response (ABR). Their ossicles were obtained and fixed, and we observed them with light microscopy (LM) and transmission electron microscopy (TEM). RESULTS: The ABR threshs were increased in the ciprofloxacin administrated group, and the increased latency of the first waves were identified in the ciprofloxacin administrated group, but there were no differences in the interval of wave I-III. The LM findings of incudomalleolar joint in the ciprofloxacin administrated group showed cartilage lesions such as disrupted articilar surface, irregular cellularity of the chondrocytes, matrix swelling, cleft formation, decreased matrix staining. The TEM findings of the incudomalleolar joint cartilage in the ciprofloxacin administrated group showed decreased bundle-like matrix and cell process, condensed nucleus, and vacuolated cytoplasm. CONCLUSION: From the results of recent works and the present study, we suggest that ciprofloxacin may induce morphological changes in the incudomalleolar joint, and that such morphological changes may induce conductive hearing loss.
Animals ; Cartilage ; Chondrocytes ; Ciprofloxacin* ; Cytoplasm ; Evoked Potentials, Auditory, Brain Stem ; Hearing Loss, Conductive ; Hearing* ; Hip ; Joints* ; Knee ; Microscopy ; Microscopy, Electron, Transmission ; Pathology ; Quinolones ; Rats* ; Weight-Bearing