Antiphospholipid syndrome nephropathy (APSN) is well documented in the literature as the renal involvement of the antiphospholipid syndrome (APS). A review of literature also shows that among antiphospholipid antibodies, lupus anticoagulant (LA) positivity is recognized as the strongest risk factor for APSN. In addition, APSN is also known to be associated with a poor functional outcome in the first posttransplant year. Therefore, it is a general belief that renal transplantation may be life threatening in APS patients. Furthermore, the presence of LA at the time of transplantation is particularly associated with a high rate of allograft APSN and the consequent poor transplantation outcomes. Here, we report the case that thrombotic acute kidney injury due to APSN after kidney transplantation can be successfully treated if anticoagulation therapy is timely applied with a prompt diagnosis.
Acute Kidney Injury ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome ; Humans ; Kidney ; Kidney Transplantation ; Lupus Coagulation Inhibitor ; Risk Factors ; Transplantation, Homologous ; Transplants

Background: Cancer-associated fibroblasts (CAFs) are key components of the tumor microenvironment and significantly contribute to immune evasion. We investigated the effects of CAFs on the immune function of CD4+ and CD8+ T cells in non-small cell lung cancer (NSCLC). Methods: We isolated CAFs and normal fibroblasts (NFs) from tumors and normal lung tissues of NSCLC patients, respectively. CAFs were co-cultured with activated T cells to evaluate their immune regulatory function. We investigated the effect of CAF conditioned medium (CAF-CM) on the cytotoxicity of T cells. CAFs were also co-cultured with activated peripheral blood mononuclear cells and further incubated with cyclooxygenase- 2 (COX2) inhibitors to investigate the potential role of COX2 in immune evasion. Results: CAFs and NFs were isolated from the lung tissues (n=8) and lymph nodes (n=3) of NSCLC patients. Immune suppressive markers, such as COX2 and programmed death-ligand 1 (PD-L1), were increased in CAFs after co-culture with activated T cells. Interestingly, CAFs promoted the expression of programmed death-1 in CD4+ and CD8+ T cells, and strongly inhibited T cell proliferation in allogenic and autologous pairs of CAFs and T cells. CAF-CM decreased the cytotoxicity of T cells. COX2 inhibitors partially restored the proliferation of CD4+ and CD8+ T cells, and downregulated the expression of COX2, prostaglandin E synthase, prostaglandin E2, and PD-L1 in CAFs. Conclusion CAFs promote immune evasion by suppressing the function of CD4+ and CD8+ T cells via their effects on COX2 and PD-L1 in NSCLC. The immunosuppressive function of CAFs could be alleviated by COX2 inhibitors.

Coronary artery disease (CAD) narrows vessel lumens at the sites of atherosclerosis, increasing the risk of myocardial ischemia or infarction. Early and accurate diagnosis of CAD is crucial to significantly improve prognosis and management. CT angiography (CTA) is a noninvasive imaging technique that enables assessment of vascular structure and stenosis with high resolution and contrast. Coronary CTA is useful in the diagnosis of CAD. Recently, the CAD-reporting and data system (CAD-RADS), a diagnostic classification system based on coronary CTA, has been developed to improve intervention efficacy in patients suspected of CAD. While the CADRAD is based on CTA, it includes borderline categories where interpreting the coronary artery status solely based on CTA findings may be challenging. This review introduces CTA findings that fall within the CAD-RADS categories that necessitate additional tests to decide to perform invasive coronary angiography and discusses appropriate management strategies.

Coronary artery disease (CAD) narrows vessel lumens at the sites of atherosclerosis, increasing the risk of myocardial ischemia or infarction. Early and accurate diagnosis of CAD is crucial to significantly improve prognosis and management. CT angiography (CTA) is a noninvasive imaging technique that enables assessment of vascular structure and stenosis with high resolution and contrast. Coronary CTA is useful in the diagnosis of CAD. Recently, the CAD-reporting and data system (CAD-RADS), a diagnostic classification system based on coronary CTA, has been developed to improve intervention efficacy in patients suspected of CAD. While the CADRAD is based on CTA, it includes borderline categories where interpreting the coronary artery status solely based on CTA findings may be challenging. This review introduces CTA findings that fall within the CAD-RADS categories that necessitate additional tests to decide to perform invasive coronary angiography and discusses appropriate management strategies.

Coronary artery disease (CAD) narrows vessel lumens at the sites of atherosclerosis, increasing the risk of myocardial ischemia or infarction. Early and accurate diagnosis of CAD is crucial to significantly improve prognosis and management. CT angiography (CTA) is a noninvasive imaging technique that enables assessment of vascular structure and stenosis with high resolution and contrast. Coronary CTA is useful in the diagnosis of CAD. Recently, the CAD-reporting and data system (CAD-RADS), a diagnostic classification system based on coronary CTA, has been developed to improve intervention efficacy in patients suspected of CAD. While the CADRAD is based on CTA, it includes borderline categories where interpreting the coronary artery status solely based on CTA findings may be challenging. This review introduces CTA findings that fall within the CAD-RADS categories that necessitate additional tests to decide to perform invasive coronary angiography and discusses appropriate management strategies.

No abstract available.
Gastroschisis*

PURPOSE: The aims of this study were to investigate outcomes corresponding to age at diagnosis as categorized into 5-year intervals and to explore whether endocrine-responsive tumors display clinical benefits from endocrine therapy after chemotherapy among young breast cancer patients. METHODS: A total of 1,171 patients who were under 40 years old at diagnosis between 1985 and 2007 were divided into 3 subgroups: < or =30 years (Group I, 13.3%), 31-35 years (Group II, 30.5%), and 36-40 years (Control group, 56.2%). Clinicopathological factors and outcomes were compared using a chi-square test, the Kaplan-Meier method, and Cox's hazards models. RESULTS: There were no significant differences in the characteristics and treatment patterns between the 3 groups, except for the grade, hormone receptors expression, and use of endocrine therap. Group I showed the worst survival and subsequently Group II presented worse outcomes than the Control group, mainly among hormone receptors-positive patients. Groups I and II showed increased risks of recurrence and death in multivariate analyses. Among 529 hormone receptors-positive patients who received chemotherapy, favorable outcomes for patients who were treated with endocrine agents were demonstrated, mainly in patients aged 35 years or less. However, interaction tests between the use of endocrine therapy and age at diagnosis were not significant. CONCLUSION: Age at diagnosis is an independent prognostic factor and the age of 35 years is a rational cut-off among young patients. Our subgroup analysis suggests that endocrine therapy may provide additional benefits even in young breast cancers. Therefore, further researches should be directed towards improving outcomes for this population.
Aged ; Breast ; Breast Neoplasms ; Humans ; Multivariate Analysis ; Prognosis ; Recurrence

BACKGROUND/AIMS: Mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach is an uncommon disease. Bone marrow involvement is reported even in patients with only a mucosal lesion. We evaluated the prevalence and risk factors of marrow involvement and its implications for diagnosis and treatment. METHODS: In total, 132 patients who were diagnosed with gastric MALT lymphoma at the National Cancer Center in Korea between January 2001 and December 2016 were enrolled in the study. The patient data were collected and analyzed retrospectively. RESULTS: Of the 132 patients, 47 (35.6%) were male, with a median age of 52 years (range, 17 to 81 years). The median follow-up duration was 48.8 months (range, 0.5 to 169.9 months). Helicobacter pylori infection was detected in 82 patients (62.1%). Most patients (80.3%) had stage IE1 according to the modified Ann Arbor staging system. Ninety-two patients underwent bone marrow evaluation, and four patients (4.3%) had marrow involvement. Of these patients, one presented with abdominal lymph node involvement, while the other three had stage IE1 disease if marrow involvement was disregarded. All three patients had no significant symptoms and were monitored after local treatment without evidence of disease aggravation. CONCLUSIONS: Bone marrow involvement was found in 4.3% of the patients with gastric MALT lymphoma. Bone marrow examination may be deferred because marrow involvement does not change the treatment options or outcome in gastric MALT lymphoma confined to the stomach wall.
Bone Marrow Examination ; Bone Marrow* ; Diagnosis ; Follow-Up Studies ; Helicobacter pylori ; Humans ; Korea ; Lymph Nodes ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Male ; Prevalence* ; Prognosis ; Retrospective Studies ; Risk Factors ; Stomach

BACKGROUND/OBJECTIVES: Numerous researches have studied the association between sugar intake and obesity of children in many countries. This study was undertaken to investigate the association between beverage intake and obesity of children by reviewing a database for total sugar contents established in all foods and presented in a nutrition survey by the Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: Data of 1,520 children aged 6–11 years in the 6th KNHANES (2013–2015) were analyzed for this study. A database for total sugar intake comprises the total sugar contents of all foods included in the results of a nutrition survey using the 24-hour recall method of 6th KNHANES. Beverages were categorized into carbonated beverages, fruit & vegetable drinks, other drinks, tea, and coffee. RESULTS: The average daily beverage intake of all children was 131.75 g/day, and the average daily total sugar intake in beverages was 13.76 g/day. Carbonated beverages had the highest intake rate (58.85 g/day) and also ranked highest for sugar intake (6.36 g/day). After adjusting for confounding variables, the odds ratio for obesity in children with beverage intake of ≥ 200 mL/day significantly increased by 1.83 times (95% CI, 1.11–3.00) as compared to children with beverage intake of < 200 mL/day. Also, a significant increase was observed in the odds ratio for obesity in total children (2.41 times; 95% CI, 1.35–4.33) and boys (3.15 times; 95% CI, 1.53–6.49) with carbonated beverage intake of ≥ 200 mL/day when compared with children who consumed < 200 mL/day. CONCLUSION: A positive association is observed between beverage intake and obesity in Korean children. In particular, an intake of carbonated beverages has a positive correlation with childhood obesity in boys. This study can therefore be used as scientific evidence for reducing sugar, and for the continuous management and research on beverages.
Beverages* ; Carbohydrates ; Carbonated Beverages ; Child* ; Coffee ; Confounding Factors (Epidemiology) ; Fruit ; Humans ; Korea* ; Methods ; Nutrition Surveys* ; Obesity* ; Odds Ratio ; Pediatric Obesity ; Tea ; Vegetables

Para-Bombay phenotypes are rare blood groups that have inherent defects in producing H antigens associated with FUT1 and/or FUT2. We report the first case of para-Bombay blood type in a Southeast Asian patient admitted at a tertiary hospital in Korea. A 23-year-old Indonesian man presented to the hospital with fever and was diagnosed with a disseminated nontuberculous mycobacterium infection and anemia. During blood group typing for blood transfusion, cell typing showed no agglutination with both anti-A and anti-B reagents. Serum typing showed strong reactivity against B cells and trace agglutination pattern with A1 cells. His red blood cells failed to react with anti-H reagents. Direct sequencing of FUT1 and FUT2 revealed a missense variation, c.328G>A (p.Ala110Thr, rs56342683, FUT1*01W.02), and a synonymous variant, c.390C>T (p.Asn130=, rs281377, Se³⁵⁷), respectively. This highlights the need for both forward and reverse grouping.
ABO Blood-Group System ; Agglutination ; Anemia ; Asian Continental Ancestry Group ; B-Lymphocytes ; Blood Group Antigens ; Blood Transfusion ; Erythrocytes ; Fever ; Humans ; Indicators and Reagents ; Korea ; Mycobacterium Infections, Nontuberculous ; Phenotype ; Tertiary Care Centers ; Young Adult