No abstract available.
Leukemia, Promyelocytic, Acute* ; Melphalan* ; Multiple Myeloma* ; Plasma Cells* ; Plasma*

Pleuroperitoneal communication (PPC) is a rare mechanical complication of peritoneal dialysis (PD), which causes dialysate to move from the peritoneal cavity to the pleural cavity, resulting in pleural effusion. Typically, PPC is discovered through pleural effusion in PD patients who are not in volume overload status. A unique characteristic of the pleural effusion caused by PPC is that it is not resolved by increasing ultrafiltration by dialysis. In this report, we present a 7-year-old girl with PD after birth with the history of various infectious PD-related complications, presenting with fever ongoing for 6 months. PPC-associated pleuritis was suspected as the cause of fever, which eventually developed after long-term PD and induced complicated pleural effusion, lung inflammation, and prolonged fever for 6 months.

Tumor necrosis factor-alpha antagonists include monoclonal antibodies, infliximab, adalimumab, etanercept and golimumab. Clinical trials of these agents have shown that they are remarkably effective for psoriasis, but cutaneous adverse reactions of these agents including paradoxical aggravation of psoriasiform eruption have been also reported. We present a case of psoriasiform eruption triggered by golimumab therapy in a patient with rheumatoid arthritis. A 53-year-old woman presented with a skin lesion on the sole. She had been treated by golimumab every 4 weeks for rheumatoid arthritis from September 2006. 16 weeks after the treatment, she developed a erythematous and scaly patch on the sole. She had a history of palmoplantar pustulosis, but the skin lesions had not appeared for a long time, recurring when she started golimumab treatment. The skin lesion improved with topical steroid treatment, but as golimumab was re-administrated, the skin lesion exacerbated.
Antibodies, Monoclonal ; Antibodies, Monoclonal, Humanized ; Arthritis, Rheumatoid ; Female ; Humans ; Immunoglobulin G ; Middle Aged ; Psoriasis ; Receptors, Tumor Necrosis Factor ; Skin ; Tumor Necrosis Factor-alpha ; Adalimumab ; Infliximab ; Etanercept

PURPOSE: To determine the clinical manifestations and outcomes of patients with tracheoesophageal fistula (TEF) and esophageal atresia (EA) born at a single neonatal intensive care unit. METHODS: A retrospective analysis was conducted for 97 patients with confirmed TEF and EA who were admitted to the neonatal intensive care unit between 1990 and 2007. RESULTS: The rate of prenatal diagnosis was 12%. The average gestational age and birth weight were 37(+2) weeks and 2.5+/-0.7 kg, respectively. Thirty-one infants were born prematurely (32%). Type C was the most common. The mean gap between the proximal and distal esophagus was 2 cm. Esophago-esophagostomy was performed in 72 patients at a mean age of 4 days after birth; gastrostomy or duodenostomy were performed in 8 patients. Forty patients exhibited vertebral, anorectal, cardiac, tracheoesophageal, renal, limb (VACTERL) association with at least 2 combined anomalies, and cardiac anomaly was the most common. The most common post-operative complications were esophageal stricture followed by gastroesophageal reflux. Balloon dilatation was performed for 1.3 times in 26 patients at a mean age of 3 months. The mortality and morbidity rates were 24% and 67%, respectively, and the most common cause of death was sepsis. The weight of approximately 40% patients was below the 10th percentile at 2 years of age. CONCLUSION: Mortality and morbidity rates of patients with TEF and EA are high as compared to those of infants with other neonatal surgical diseases. Further efforts must be taken to reduce mortality and morbidity and improve growth retardation.
Anal Canal ; Birth Weight ; Cause of Death ; Dilatation ; Duodenostomy ; Esophageal Atresia ; Esophageal Stenosis ; Esophagus ; Extremities ; Gastroesophageal Reflux ; Gastrostomy ; Gestational Age ; Heart Defects, Congenital ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Kidney ; Limb Deformities, Congenital ; Prenatal Diagnosis ; Retrospective Studies ; Sepsis ; Spine ; Trachea ; Tracheoesophageal Fistula

Eccrine angiomatous hamartoma (EAH) is a benign, uncommon cutaneous lesion, often localized to the distal extremities of children. It usually presents as a solitary, asymptomatic lesion that appears as a nodule or plaque, but sometimes it can occur as multiple lesions. Varying degrees of hyperhidrosis and pain have been reported. The histological feature is characterized by a proliferation of eccrine sweat glands and angiomatous channels. Occasionally, other elements are involved, such as mucin-secreting cells, adipose tissue, bony structures, apocrine glands or hair structures. We describe a case of eccrine angiomatous hamartoma with unusual lipomatous involvement.
Adipose Tissue ; Apocrine Glands ; Child ; Extremities ; Hair ; Hamartoma ; Humans ; Hyperhidrosis ; Sweat Glands

PURPOSE: To determine whether the amount of intracellular superparamagnetic iron oxide (SPIO) in macrophages influences MR signal intensity during in vivo celluar tracking. MATERIALS AND METHODS: Peritoneal macrophages harvested from thioglycolate-treated mice were labeled with SPIO using concentrations of 112, 56, and 28 microgramFe/ml, and different incubation times of 3h, 6h, 12h, 24h and 48 h, respectively. The iron concentration was quantified with the use of absorption spectrophotometry. Each group of macrophages labeled with different concentrations of SPIO was intravenously injected into 18 mice, after inoculation with S. aureus to the thigh. The relative signal intensity (SI) of the abscess wall (SI of the abscess wall/SI of muscle) was measured on MR and was analyzed by the use of the Kruskal-Wallis test. RESULTS: A higher concentration of SPIO in the labeling solution and a longer incubation time resulted in a higher concentration of SPIO in the macrophages. The relative SI of the abscess wall (0.63 for 112 microgramFe/mL; 0.67 for 56 microgramFe/ml; 0.89 for 28 microgramFe/mL) significantly decreased with an increase of SPIO concentration (k2=10.53, p < 0.005). CONCLUSION: The amount of intracellular SPIO influences the MR signal intensity by the susceptibility effect, and it is recommended to use sufficient iron-oxide label as long as it does not affect cellular function and viability.
Abscess ; Absorption ; Animals ; Ferric Compounds ; Iron ; Macrophages ; Macrophages, Peritoneal ; Mice ; Spectrophotometry ; Thigh ; Track and Field

PURPOSE: Local anesthetic wound infusion has been previously investigated in postoperative pain management. However, a limited number of studies have evaluated its use in laparoscopic colorectal surgery. This study aims to evaluate whether ropivacaine wound infusion is effective for postoperative pain management after laparoscopic surgery in patients with colorectal cancer. METHODS: This prospective study included 184 patients who underwent laparoscopic surgery for colorectal cancer between July 2012 and June 2013. The patients were grouped as the combined group (intravenous patient-controlled analgesia [IV-PCA] plus continuous wound infusion with ropivacaine, n = 92) and the PCA group (IV-PCA only, n = 92). Efficacy and safety were assessed in terms of numeric rating scale (NRS) pain score, opioid consumption, postoperative recovery, and complications. RESULTS: The total quantity of PCA fentanyl was significantly less in the combined group than in the PCA group (P < 0.001). The NRS score of the combined group was not higher than in the PCA group, despite less opioid consumption. There were no differences between groups for postoperative recovery and most complications, including wound complications. However, the rate of nausea and vomiting was significantly lower in the combined group (P = 0.022). CONCLUSION: Ropivacaine wound infusion significantly reduced postoperative opioid requirements and the rate of nausea/vomiting. This study showed clinical efficacy of ropivacaine wound infusion for postoperative pain control in colorectal cancer patients undergoing laparoscopic surgery.
Analgesia, Patient-Controlled ; Anesthetics, Local ; Colorectal Neoplasms ; Colorectal Surgery* ; Fentanyl ; Humans ; Laparoscopy ; Nausea ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Prospective Studies ; Treatment Outcome ; Vomiting ; Wounds and Injuries*

Diagnosis ; Focus Groups ; Health Occupations ; Humans ; Information Dissemination ; Korea ; Methods ; Precision Medicine ; Qualitative Research ; Surveys and Questionnaires

Sequestosome 1 (SQSTM1, p62), a ubiquitin binding protein, plays a role in cell signaling, oxidative stress, and autophagy. However, its functional role in inflammatory signaling is controversial. Recent studies have shown that p62 is negatively implicated in inflammatory responses. But, the precise molecular mechanisms by which p62 regulates inflammatory responses remain unclear. In this study, we report on a new regulatory role for p62 in TLR4-mediated signaling. p62 overexpression led to the suppression of NF-κB activation and the production of pro-inflammatory cytokines, TNF-α, IL-6, and IL-1β in response to TLR4 stimulation. In contrast, p62(−/−) mouse embryonic fibroblast (MEF) cells exhibited marked enhancement of NF-κB activation and production of pro-inflammatory cytokines by TLR4 stimulation, compared to p62(+/+) MEF cells. Additionally, the TLR4-induced activation of signal transduction was significantly augmented in p62(−/−) MEF cells, indicating that p62 was negatively implicated in TLR4-mediated signaling. Biochemical studies revealed that p62 interacted with the internal domain of evolutionarily conserved signaling intermediate in Toll pathways (ECSIT), which is critical for associating with the TNF receptor associated factor 6 (TRAF6)-ECSIT complex to activate NF-κB in TLR4 signaling. Interestingly, p62-ECSIT interaction inhibited the interaction between TRAF6 and ECSIT and attenuated the ubiquitination of ECSIT. Furthermore, upon LPS challenge, the mortality of p62(−/−) (p62-knockout) mice was markedly enhanced compared to p62(+/+) (p62 wild-type) mice. Taken together, our data demonstrate that p62 negatively regulated TLR4 signaling via functional regulation of the TRAF6-ECSIT complex.
Animals ; Autophagy ; Carrier Proteins ; Cytokines ; Fibroblasts ; Interleukin-6 ; Mice ; Mortality ; Oxidative Stress ; Signal Transduction ; TNF Receptor-Associated Factor 6 ; Toll-Like Receptor 4 ; Ubiquitin ; Ubiquitination

Methods: This is a post hoc analysis of a prospective, controlled, randomized, unblinded study with 78 Korean hemodialysis patients receiving intravenous (n = 40) or subcutaneous (n = 38) erythropoietin therapy. We evaluated hemoglobin variability by calculating the frequency of hemoglobin measurements outside the target range during all visits. The high-frequency group was defined by those with hemoglobin variability over the median value (25%) while the low-frequency group was defined by those with hemoglobin variability of <25%. Results: In this analysis, 37 patients (51.1%) were men, and the mean age was 50.6 ± 12.5 years. Twenty-five patients (35.2%) had diabetes mellitus. The frequency of the value being outside the target hemoglobin range was higher in the subcutaneous group compared to the intravenous group (0.36 ± 0.19 vs. 0.27 ± 0.12/visit, p = 0.03). The low-frequency group required significantly lower erythropoietin doses compared to the high-frequency group. In the adjusted Cox analysis, the parameter high-frequency group was a significant independent risk factor for cardiovascular events (hazard ratio, 3.53; 95% confidence interval, 1.15–10.83; p = 0.03). Conclusion The risk of missing the target hemoglobin range increased with subcutaneous administration compared with intravenous erythropoietin administration in hemodialysis patients. An increased frequency of the value being outside the target hemoglobin range was also associated with an increased risk of cardiovascular events.