BACKGROUND: Recently, a variety of cigarettes which contain a low content of nicotine are on the market and the nicotine tends to be reduced continuously. However, studies have not yet fully demonstrated that low-nicotine cigarettes are subservient to quitting smoking. This study was designed to investigate the effects of the nicotine content on smoking attitudes and on the factors associated with successful smoking cessation. METHODS: One hundred twenty-five adult smokers, who had undergone a health examination in a general hospital, had their carbon monoxide measured after responding to the questionnaire. The items of questionnaire consisted of the duration of smoking, the age of starting to smoke, the number of attempts to stop smoking, recognition of nicotine dependence, and nicotine dependence score. RESULTS: The subjects consisted of two groups. One group was low nicotine group and the nicotine content was lower than 0.35 mg per cigarette. The other group was high nicotine group and the nicotine content was over 0.35 mg per cigarette. he age was younger and duration of smoking was shorter in low nicotine group. Monthly income, last schooling and number of attempts to stop smoking were higher in low nicotine group. There was no statistical significant differences between the two groups in the frequency of alcohol drinking, the age of starting to smoke, marital status, nicotine dependence, carbon monoxide concentration and recognition of nicotine dependence. CONCLUSION: As there was no differences in smoking habits which has infl uence on achieving quit smoking of low nicotine group, we made our conclusion that low nicotine cigarette might be unhelpful in quit smoking.
Adult ; Alcohol Drinking ; Carbon Monoxide ; Hospitals, General ; Humans ; Marital Status ; Nicotine ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Products ; Tobacco Use Disorder

Inspite of the benign disease process, the management of intrahepatic duct stones is difficult because of complications such as recurrent ascending cholangitis, liver abscess, sepsis, secondary liver cirrhosis, cholangiocarcinoma, and high recurrence rates. Also they are sometimes difficult to remove completely due to their anatomical locations. The principles of their surgical management are composed of complete removal of the stone and prevention of biliary stasis. The commonly used biliary drainage procedures are transduodenal sphincteroplasty, choledochoduodenostomy, and Roux-en-Y choledochojejunostomy. The results of biliary drainage procedures in 82 patients at the Department of Surgery, Taejon St. Mary's Hospital, from January 1985 through December 1994 were reviewed, including a follow-up study. The incidence of biliary drainage procedures, including hepatic resections, was 18.9% of the 433 patients operated on for cholelithiasis. The male- to- female ratio was 1 : 1.5; the sixth decade was the most common age. The common clinical symptoms and physical signs were right upper quadrant and epigastric pain and tenderness (89.0%), jaundice (56%), and fever and chills (47.4%). Fifty-six percent of the cases involved the first incidence of a biliary operation, 34.1% a second incidence, and 9.7% a third. The biliary stones were located at only the intrahepatic area (31.7%), both the intrahepatic and the extrahepatic areas (35.3%), or both the gall bladder and the extrahepatic area (29.0%). Of the intrahepatic stones, the left lobe was involved in 45.5% of the cases, the right lobe in 9%, and both lobes in 45.5%. The indications for biliary drainage procedures were acute obstructive cholangitis (36.5%), recurrent stones (34.1%), biliary dyskinesia (21.9%), and liver abscess (7.3%). The types of biliary drainage procedures were choledochoduodenostomy (43.9%), Roux-en-Y choledochojejunostomy (21.9%), left hepatic lobectomy (14.6%), left lateral hepatic segmentectomy (8.5%), Roux-en-Y hepaticojejunostomy (8.5%), right hepatic lobectomy (1.2%), and transduodenal sphincteroplasty (1.2%). The early postoperative complications were wound infection (24.3%), pulmonary complications (19.5%), anastomosis leakage (2.4%), etc. The operative mortality was 1.2%. The late complications during the follow-up period were recurrent stones (11 cases), ascending cholangitis (8 cases), and liver abscess (5 cases).
Biliary Dyskinesia ; Chills ; Cholangiocarcinoma ; Cholangitis ; Choledochostomy ; Cholelithiasis ; Cholestasis ; Daejeon ; Drainage* ; Female ; Fever ; Follow-Up Studies ; Humans ; Incidence ; Jaundice ; Liver Abscess ; Liver Cirrhosis ; Mastectomy, Segmental ; Mortality ; Postoperative Complications ; Recurrence ; Sepsis ; Sphincterotomy, Transhepatic ; Urinary Bladder ; Wound Infection

PURPOSE: HBsAg-positive kidney recipients are at increased risk for mortality and graft failure. The aims of this study were to identify the outcomes of HBsAg-positive recipients who received preemptive antiviral agents after successful kidney transplantation and to analyze risk factors for HBV reactivation. METHODS: We retrospectively reviewed the medical records of 944 patients performed kidney transplantation between 1999 and 2010. RESULTS: HBsAg-negative recipients were 902 patients and HBsAg-positive recipients, 42. Among HBsAg-positive recipients, HBV reactivation was detected in 7 patients and well controlled by switch or combination therapy. Graft failure developed in only one patient due to chronic rejection regardless of HBV reactivation but no deaths occurred. All patients were alive at the end of follow-up and none developed end-stage liver disease or hepatocellular carcinoma. There was statistically significant difference in graft survival between HBsAg-positive recipients and HBsAg-negative. Multivariate analysis identified increased HBV DNA levels (>5 x 10(4) IU/mL) in the HBsAg-positive kidney transplant recipients as a risk factor for HBV reactivation (P = 0.007). CONCLUSION: Effective viral suppression with antiviral agents in HBsAg-positive renal transplant recipients improves patient outcome and allograft survival. Antiviral therapy may be especially beneficial in patients with high HBV DNA levels prior to transplantation.
Allografts ; Antiviral Agents ; Carcinoma, Hepatocellular ; DNA ; Follow-Up Studies ; Graft Survival ; Hepatitis B virus ; Humans ; Kidney ; Kidney Transplantation* ; Liver Diseases ; Medical Records ; Mortality ; Multivariate Analysis ; Retrospective Studies ; Risk Factors ; Transplantation ; Transplants

BACKGROUND/AIMS: Visceral larva migrans, caused by Toxocara canis and Toxocara cati, has emerged as a significant cause of eosinophilic liver abscess (ELA). Differentiation of ELA associated with toxocariasis (ELA-T) from metastasis or primary liver malignancy is sometimes difficult. However, the role of albendazole treatment remains uncertain in this condition. The aim of this study was to evaluate whether albendazole can enhance the radiologic resolution of ELA-T. METHODS: We retrospectively reviewed the medical records of the patients diagnosed with ELA-T at our institution between January 2008 and December 2011. ELA-T was diagnosed based on the imaging findings on computed tomography or magnetic resonance imaging and the presence of positive serum IgG antibody for Toxocara canis. Among a total of 163 patients, 32 patients received albendazole (albendazole group) and 131 did not (control group). Baseline characteristics and fate of liver nodules were compared between the two groups. RESULTS: Baseline characteristics (age, sex, number and maximal size of lesions, eosinophil count) were similar between the two groups. Median duration for achieving radiologic resolution in the albendazole group was significantly shorter than in the control group (207 days [range 186-228] vs. 302 days [range 224-380], p=0.023). In Cox regression analysis of the cumulative rates of radiologic resolution, the hazard ratio for albendazole treatment was 1.99 (95% confidence interval, 1.22-3.23). CONCLUSIONS: Radiologic resolution of ELA-T can be accelerated with albendazole treatment. Hence, inconvenience associated with long-term follow-up and unnecessary worries among patients can be eliminated with albendazole treatment.
Adult ; Aged ; Aged, 80 and over ; Albendazole/*therapeutic use ; Animals ; Antiprotozoal Agents/*therapeutic use ; Eosinophils/*immunology ; Female ; Humans ; Immunoglobulin G/blood ; Larva Migrans, Visceral/*drug therapy/parasitology ; Liver/enzymology/metabolism ; Liver Abscess/*etiology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Proportional Hazards Models ; Retrospective Studies ; Tomography, X-Ray Computed ; Toxocara canis/immunology/isolation & purification

BACKGROUND/AIMS: The aim of this study was to elucidate the antiviral efficacy and the predictors of entecavir treatment in nucleoside-naive chronic hepatitis B patients. METHODS: A total of 160 patients treated with entecavir (0.5 mg daily) for at least 24 weeks were consecutively enrolled. The virologic response (HBV DNA<2,000 copies/mL), biochemical response (ALT< or = upper limit of normal), and virologic breakthrough (>1 log10 copies/mL increase in HBV DNA level above nadir on two consecutive occasions) were retrospectively analyzed. RESULTS: The mean follow-up duration was 58.8 weeks, and 85 patients (53.1%) showed HBeAg positivity. The median pretreatment levels of serum ALT and HBV DNA were 99 IU/L and 7.6 log10 copies/mL, respectively. The cumulative rates at 12, 24, 48, and 72 weeks were 37.5%, 68.1%, 87.4%, and 95.8%, respectively, for the virologic response; 40.0%, 66.2%, 84.5%, and 92.7% for the biochemical response; 10.6%, 18.8%, 27.0%, and 34.5% for HBeAg loss; and 3.5%, 7.1%, 9.0%, and 13.2% for HBeAg seroconversion. There was no case of virologic breakthrough. An absence of HBeAg and a low serum HBV DNA level (<8 log10 copies/mL) at baseline were significant predictors of the virologic response in a multivariate analysis (P<0.01). CONCLUSIONS: Entecavir therapy showed excellent efficacy in nucleoside-naive chronic hepatitis B patients. The predictors of a virologic response were an absence of HBeAg and a low baseline HBV DNA level.
Adult ; Alanine Transaminase/blood ; Antiviral Agents/*therapeutic use ; DNA, Viral/blood ; Female ; Genotype ; Guanine/*analogs & derivatives/therapeutic use ; Hepatitis B e Antigens/analysis ; Hepatitis B, Chronic/*drug therapy ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Time Factors

It has been demonstrated that inhibitors of advanced glycation end products (AGE), such as aminoguanidine, can suppress peritoneal AGE in rats on peritoneal dialysis (PD). However, it is unknown whether late administration of a putative crosslink breaker, alagebrium, could reverse peritoneal AGE. We therefore compared alagebrium with aminoguanidine in their ability to reverse peritoneal AGE in rats on PD. Male Sprague-Dawley rats were randomly divided into 3 groups: group I dialyzed with 4.25% glucose solution for all exchanges; group II dialyzed with 4.25% glucose solution containing aminoguanidine, and group III dialyzed with 4.25% glucose solution containing alagebrium for last 8 weeks of 12-week dialysis period. Dialysis exchanges were performed 2 times a day for 12 weeks. Immunohistochemistry was performed using a monoclonal anti-AGE antibody. One-hour PET was performed for comparison of transport characteristics. The immunolabelling of AGE in peritoneal membrane was markedly decreased in the alagebrium group. Consistent with this, the alagebrium group exhibited significantly higher D/Do glucose and lower D/P urea, suggesting low peritoneal membrane transport. But there were no significant differences between the control and the aminoguanidine group. These results suggest that the alagebrium may be the optimal therapeutic approach, compared with treatment with inhibitors of AGE formation, in rats on PD.
Animals ; Biological Transport ; Body Weight ; Cell Membrane/metabolism ; Glycosylation End Products, Advanced/*metabolism ; Guanidines/metabolism ; Immunohistochemistry/methods ; Male ; Peritoneal Dialysis/*methods ; Peritoneum/metabolism/*pathology ; *Permeability ; Rats ; Rats, Sprague-Dawley

Objectives: Terminally ill cancer patients in hospice palliative care unit are reluctant to undergo repetitive invasive procedures due to coagulopathies and poor performance or condition, while catheter management such as regular irrigation during hospitalization is easy. The purpose of this study was to investigate the safety and efficacy of indwelling intraperitoneal (IP) catheter in hospitalized terminally ill cancer patients with recurrent ascites. Methods: A retrospective review was conducted in patients who underwent IP catheter at the hospice palliative care unit of Pusan National University Yangsan Hospital between August 2016 and June 2018. All catheters were inserted by interventional radiologists with radiological guidance. The primary end-points were functional IP catheter maintenance rate, which is catheter maintained with patency for drainage until the intended time. Results: A total of 25 terminally ill cancer patients underwent IP catheters placements during the study period. All catheters were successfully inserted without major complications, but one patient had trivial bleeding and one other patient had temporary pain. The median time from admission to catheter insertion was 5 days (range, 1 to 49 days). Twenty-one catheters were maintained with function until the intended time, three cases were maintained without function, and the last one was removed early due to obstruction and pain. Finally, the functional IP maintenance rate was 84% (21/25) and the median functional catheter life span was 15 days (95% confidence interval, 10.8 to 17.2). Conclusion Our study showed relatively favorable results for IP catheter maintenance and safety in hospitalized terminally ill cancer patients with malignant ascites.

Cytomegalovirus (CMV) disease in gastrointestinal tract is common among immunocompromised host. Ulcer, hemorrhage and perforation are manifestations of CMV infection in gastrointestinal tract and the most common site of intestinal perforation is the colon, followed by the distal ileum. Early diagnosis and preemptive therapy of CMV infection in the gastrointestinal tract should be warranted to prevent intestinal perforation, one of life-threatening complications of CMV colitis. We report a case of CMV colitis leading to colonic perforation in a patient with non-Hodgkin's lymphoma (T/NK cell lymphoma). Immunohistochemical stain of surgical specimen revealed positive, followed by positive EA-IPA and PCR for CMV antigen. He survived after successful left hemicolectomy and intravenous ganciclovir therapy.
Colitis* ; Colon* ; Cytomegalovirus ; Early Diagnosis ; Ganciclovir ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileum ; Immunocompromised Host ; Intestinal Perforation ; Lymphoma, Non-Hodgkin* ; Polymerase Chain Reaction ; Ulcer

Background: Tenofovir disoproxil fumarate (TDF, Viread® ) had been used as a standard treatment option of chronic hepatitis B (CHB). This clinical trial was conducted to evaluate the efficacy and safety of DA-2802 (tenofovir disoproxil orotate) compared to TDF. Methods: The present study was a double blind randomized controlled trial. Patients with CHB were recruited from 25 hospitals in Korea and given DA-2802 at a dose of 319 mg once daily or Viread® at a dose of 300 mg once daily for 48 weeks from March 2017 to January 2019. Change in hepatitis B virus (HBV) DNA level at week 48 after dosing compared to baseline was the primary efficacy endpoint. Secondary efficacy endpoints were proportions of subjects with undetectable HBV DNA, those with normal alanine aminotransferase (ALT) levels, and those with loss of hepatitis B envelop antigen (HBeAg), those with loss of hepatitis B surface antigen (HBsAg). Adverse events (AEs) were also investigated. Results: A total of 122 patients (DA-2802 group: n = 61, Viread® group: n = 61) were used as full analysis set for efficacy analysis. Mean age, proportion of males, laboratory results and virologic characteristics were not different between the two groups. The change in HBV DNA level at week 48 from baseline was −5.13 ± 1.40 in the DA-2802 group and −4.97 ± 1.40 log 10 copies/mL in the Viread® group. The analysis of primary endpoint using the nonparametric analysis of covariance showed statistically significant results (P < 0.001), which confirmed non-inferiority of DA-2802 to Viread® by a prespecified noninferiority margin of 1. The proportion of undetectable HBV DNA was 78.7% in the DA-2802 group and 75.4% in the Viread® group (P = 0.698). The proportion of subjects who had normal ALT levels was 75.4% in the DA-2802 group and 73.3% in the Viread® group (P = 0.795). The proportion of those with HBeAg loss was 8.1% in the DA-2802 group and 10.8% in the Viread® group (P = 1.000). No subject showed HBsAg loss. The frequency of AEs during treatment was similar between the two groups. Most AEs were mild to moderate in severity. Conclusion DA-2802 is considered an effective and safe treatment for patients with CHB.

Purpose: Although osimertinib is the standard-of-care treatment of epidermal growth factor receptor (EGFR) T790M mutation–positive non–small cell lung cancer, real-world evidence on the efficacy of osimertinib is not enough to reflect the complexity of the entire course of treatment. Herein, we report on the use of osimertinib in patients with EGFR T790M mutation–positive non–small cell lung cancer who had previously received EGFR tyrosine kinase inhibitor (TKI) treatment in Korea. Materials and Methods: Patients with confirmed EGFR T790M after disease progression of prior EGFR-TKI were enrolled and administered osimertinib 80 mg daily. The primary effectiveness outcome was progression-free survival, with time-to-treatment discontinuation, treatment and adverse effects leading to treatment discontinuation, and overall survival being the secondary endpoints. Results: A total of 558 individuals were enrolled, and 55.2% had investigator-assessed responses. The median progression-free survival was 14.2 months (95% confidence interval [CI], 13.0 to 16.4), and the median time-to-treatment discontinuation was 15.0 months (95% CI, 14.1 to 15.9). The median overall survival was 36.7 months (95% CI, 30.9 to not reached). The benefit with osimertinib was consistent regardless of the age, sex, smoking history, and primary EGFR mutation subtype. However, hepatic metastases at the time of diagnosis, the presence of plasma EGFR T790M, and the shorter duration of prior EGFR-TKI treatment were poor predictors of osimertinib treatment. Ten patients (1.8%), including three with pneumonitis, had to discontinue osimertinib due to severe adverse effects. Conclusion Osimertinib demonstrated its clinical effectiveness and survival benefit for EGFR T790M mutation–positive in Korean patients with no new safety signals.