Mutations in the transmembrane inner ear (Tmie) gene, which encodes the Tmie protein, have been attributed to deafness autosomal recessive 6 (DFNB6), an autosomal nonsyndromic recessive hearing loss disorder. Although the Tmie gene was identified a few years ago, little is known about subcellular localization of the Tmie protein. In order to address this, we developed a stable cell line expressing Tmie protein. The expression of Myc-tagged Tmie protein was confirmed by Western blot analysis using an anti-Myc antibody and localization of the Tmie protein was confirmed by immunostaining, using the anti-Myc antibody as well as the anti-tmie antibody. Our study demonstrates that the Tmie protein is localized mostly in the cellular membrane and to a lesser extent in cytoplasm. These results suggest that our Tmie expressing stable cell line provides a suitable in vitro model to explore Tmie synthesis and functions.
Blotting, Western ; Cell Line ; Cytoplasm ; Deafness ; Ear, Inner ; Hearing Loss ; Membranes

Pneumatosis intestinalis (PI) is a rare condition characterized by multiple pneumocysts in the submucosa or subserosa of the bowel. Here, we report a rare case of asymptomatic PI after chemotherapy induction in an 18-yr-old man with B lymphoblastic leukemia with recurrent genetic abnormalities. The patient was treated conservatively and recovered without complications. The possibility of PI should be considered as a complication during or after chemotherapy for hematologic malignancies. Conservative treatment should be considered unless there are complications, including peritonitis, bowel perforation, and severe sepsis.
Adolescent ; Hematologic Neoplasms ; Humans ; Peritonitis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Sepsis

BACKGROUND/AIMS: The well-organized study to support that increased cholelithiasis and bile duct dilatation can occur after gastrectomy has not been reported. The aim of this study was to determine the incidence of cholelithiasis and the degree of common bile duct (CBD) dilatation in patients undergoing subtotal gastrectomy, compared to those undergoing endoscopic treatment for gastric cancer. METHODS: Patients who diagnosed with gastric cancer and received treatment at six academic referral centers were investigated for the incidence and time of cholelithiasis and the degree of CBD dilatation after treatment by analysis of 5-year follow-up CTs. The operation group underwent subtotal gastrectomy without vagotomy, while in the control group endoscopic treatment was administered for gastric cancer. RESULTS: A total of 802 patients were enrolled in 5-year analysis (735 patients in the operation group and 67 patients in the control group). Cholelithiasis occurred in 47 patients (6.39%) in the operation group and 3 patients (4.48%) in the control group (p=0.7909). The incidences of cholelithiasis were 4.28% in Billoth-I and 7.89% in Billoth-II (p=0.0487). The diameter of proximal CBD and distal CBD increased by 1.11 mm and 1.41 mm, respectively, in the operation group, compared to 0.4 mm and 0.38 mm, respectively, in the control group (p<0.05). Patients with increased CBD dilatation more than 5 mm showed statistically significant increases in alkaline phosphatase and gamma-glutamyltransferase. CONCLUSIONS: The incidence of cholelithiasis was not increased due to subtotal gastrectomy without vagotomy, but the incidence was higher after Billoth-II compared to Billoth-I. In addition, significant change in the CBD diameter was observed after subtotal gastrectomy.
Aged ; Alanine Transaminase/analysis ; Aspartate Aminotransferases/analysis ; Bilirubin/analysis ; Case-Control Studies ; Cholelithiasis/*diagnosis/epidemiology ; Common Bile Duct/diagnostic imaging/*physiopathology ; Endoscopy, Gastrointestinal ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Incidence ; Male ; Middle Aged ; Odds Ratio ; Stomach Neoplasms/*surgery ; Tertiary Care Centers ; Tomography, X-Ray Computed

BACKGROUND/AIMS: Oxygen free radicals play an important role in acute pancreatitis. Pantoprazole as a proton pump inhibitor (PPI) has pancreatic anti-secretory effect and a pronounced inhibitory reactivity towards hydroxyl radicals. The objective of the study was to investigate the effect of pantoprazole on the course of acute pancreatitis. METHODS: We conducted a prospective randomized trial involving 40 patients with acute pancreatitis. Patients were divided into two groups. One group received PPI and the other group did not receive PPI. In the PPI group, patients received pantoprazole 40 mg intravenously twice a day for fasting time, and then 40 mg orally twice a day until discharge. RESULTS: There were no significant differences in baseline characteristics and laboratory markers between two groups. In the pantoprazole group, mean hospital stay was 7.4 days, time to start oral intake was 69.0 hours, and time to pain relief was 59.7 hours. Acute physiology and chronic health evaluation (APACHE) II score was 3.15 at admission day and 2.35 at discharge. On the other hand, in the non-pantoprazole group, mean hospital stay was 7.6 days, time taken to start oral intake was 71.4 hours, and time taken to pain relief was 61.8 hours. APACHE II score was 4.4 at admission and 2.85 at discharge. However, there were no significant differences between two groups. CONCLUSIONS: Treatment with pantoprazole did not have influence on the clinical course of acute pancreatitis. But, considering it was a pilot study, large scale prospective trials will be needed.
2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use ; APACHE ; Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alcohol Drinking ; Eating ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Pain Management ; Pancreatitis/*drug therapy/etiology ; Pilot Projects ; Prospective Studies ; Proton Pump Inhibitors/*therapeutic use ; Young Adult

BACKGROUND/AIMS: Metabolic syndrome, comprising diabetes, hypertension, central obesity, and dyslipidemia, is increasingly prevalent worldwide. We aimed to study the relationship between metabolic syndrome and the risk of liver fibrosis in patients with chronic hepatitis B (CHB) and chronic hepatitis C (CHC). METHODS: In total, 954 patients (CHB, 850; CHC, 104 patients) with liver biopsy were included in the retrospective analysis. Extensive clinical and histological data were available. Metabolic syndrome was defined using the International Diabetes Federation definition of metabolic syndrome, 2006 criteria. Histological lesions were evaluated according to the histology activity index system. RESULTS: Metabolic syndrome was present in 6% of patients and significantly more prevalent in patients with CHC than in patients with CHB (5% vs 13%, p<0.001). Patients with metabolic syndrome were older among patients with CHB and patients with CHC, and, as expected, were mainly overweight or obese. Fibrosis was significantly more severe in patients with metabolic syndrome than in those without, regardless of whether they had CHB and CHC (CHB, 3.3+/-2.1 vs 2.4+/-1.3, p=0.025; CHC, 2.6+/-1.5 vs 1.3+/-0.7, p=0.006). Liver fibrosis (stages 3 to 4) was independently associated with increased age, higher transaminase level and metabolic syndrome (odds ratio, 2.421; p=0.017). CONCLUSIONS: Metabolic syndrome is associated independently with severe fibrosis in patients with chronic viral hepatitis B and C.
Biopsy ; Dyslipidemias ; Fibrosis ; Hepatitis ; Hepatitis B ; Hepatitis B, Chronic ; Hepatitis C ; Hepatitis C, Chronic ; Humans ; Hypertension ; Liver ; Liver Cirrhosis ; Obesity, Abdominal ; Overweight ; Retrospective Studies

BACKGROUND/AIMS: Hepatitis B core antigen is known to be a major target for virus-specific T cells and also reflects the progression of liver dissease and viral replication. Hepatitis B core antigen expression in hepatocytes leads to altered histological activity, viral replication, and immune response. The purpose of this study is to evaluate whether the topographical distribution of hepatitis B core antigen expression can predict the viral response to entecavir in patients with chronic hepatitis B. METHODS: We enrolled 91 patients with treatment-naive chronic hepatitis B. All the patients underwent liver biopsy, and the existence and pattern of hepatitis B core antigen evaluated by immunohistochemistry. All patients received 0.5 mg of entecavir daily following a liver biopsy. We checked the viral response at 3, 6, and 12 months during antiviral therapy. RESULTS: Of the 91 patients, 64 (70.3%) had hepatitis B core antigen expression. Of the subcellular patterns, the mixed type was dominant (n=48, 75%). The viral response was significantly higher in the hepatitis B core antigen-negative group than in the hepatitis B core antigen-positive group (88.9% and 54.7%, respectively; p=0.001) after 12 months of entecavir therapy. CONCLUSIONS: Chronic hepatitis B patients who are hepatitis B core antigen-negative have a better response to entecavir therapy than do hepatitis B core antigen-positive patients.
Biopsy ; Guanine ; Hepatitis ; Hepatitis B ; Hepatitis B Core Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Hepatocytes ; Humans ; Immunohistochemistry ; Liver ; T-Lymphocytes

Endoscopic retrograde cholangiopancreatography (ERCP) fails occasionally due to a surgically altered anatomy, periampullary diverticulum, difficult cannulation, or poor general condition of the patient. In these cases, alternative treatment options are necessary, including percutaneous transhepatic biliary drainage (PTBD) or percutaneous transhepatic gallbladder biliary drainage (PTGBD). Here, we report a case of cholangitis treated with percutaneous transhepatic gallbladder papillary balloon dilatation (PTGBPBD). A 61-year-old male was admitted for cholangitis associated with biliary sludge. ERCP cannulation had failed due to the position of the papilla within a large periampullary diverticulum, and PTBD had failed due to a non-dilated intrahepatic bile duct. Following PTGBD, papillary balloon dilatation was completed successfully through the PTGBD tract. The patient tolerated the procedure and was discharged without complications. We conclude that PTGBPBD is an acceptable and safe procedure in a patient with cholangitis who underwent failed ERCP or PTBD procedures.
Bile ; Bile Ducts, Intrahepatic ; Catheterization ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Dilatation* ; Diverticulum ; Drainage ; Gallbladder* ; Humans ; Male ; Middle Aged

Endoscopic retrograde cholangiopancreatography (ERCP) fails occasionally due to a surgically altered anatomy, periampullary diverticulum, difficult cannulation, or poor general condition of the patient. In these cases, alternative treatment options are necessary, including percutaneous transhepatic biliary drainage (PTBD) or percutaneous transhepatic gallbladder biliary drainage (PTGBD). Here, we report a case of cholangitis treated with percutaneous transhepatic gallbladder papillary balloon dilatation (PTGBPBD). A 61-year-old male was admitted for cholangitis associated with biliary sludge. ERCP cannulation had failed due to the position of the papilla within a large periampullary diverticulum, and PTBD had failed due to a non-dilated intrahepatic bile duct. Following PTGBD, papillary balloon dilatation was completed successfully through the PTGBD tract. The patient tolerated the procedure and was discharged without complications. We conclude that PTGBPBD is an acceptable and safe procedure in a patient with cholangitis who underwent failed ERCP or PTBD procedures.
Bile ; Bile Ducts, Intrahepatic ; Catheterization ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Dilatation* ; Diverticulum ; Drainage ; Gallbladder* ; Humans ; Male ; Middle Aged

Hemorrhagic cystitis is a common complication in hematopoietic stem cell transplant recipients. We report a case of hemorrhagic cystitis after unrelated cord blood transplantation associated with adenovirus infection. Despite hydration, hematuria and large clots persisted. We instilled cidofovir into the bladder, which resulted in clearance of the adenovirus and significant clinical improvement. Our case emphasizes the effectiveness of intravesical cidofovir treatment for viral hemorrhagic cystitis.
Adenoviridae ; Adenoviridae Infections ; Cord Blood Stem Cell Transplantation ; Cystitis ; Cytosine ; Fetal Blood ; Hematopoietic Stem Cells ; Hematuria ; Organophosphonates ; Transplants ; Urinary Bladder

Hypercalcemia commonly occurs because of primary hyperparathyroidism and metastatic malignancies, such as multiple myeloma, breast cancer and lung cancer; these causes account for 90% of cases. The other causes of hypercalcemia are numerous, and immobilization is an under-appreciated etiology. The mechanisms underlying immobilization-induced hypercalcemia are uncertain. However, an overall increased osteoclastic bone resorption and decreased osteoblastic bone formation can induce hypercalciuria and hypercalcemia. Additionally, hypercalcemia can induce and be associated with acute kidney injury, but it is rarely reported in immobilization hypercalcemia. We report here a 58-year-old man with suspected immobilization hypercalcemia associated with acute kidney injury and treated successfully with glucocorticoids.
Acute Kidney Injury ; Bone Resorption ; Breast Neoplasms ; Glucocorticoids ; Humans ; Hypercalcemia ; Hypercalciuria ; Hyperparathyroidism, Primary ; Immobilization ; Lung ; Middle Aged ; Multiple Myeloma ; Osteoblasts ; Osteoclasts ; Osteogenesis