Background: Percutaneous renal cyst sclerotherapy (PRCS) as a treatment for renal cysts is usually performed with a high concentration of ethanol (≥ 90%). This study reviewed cases in which a lower concentration of ethanol (83%) was used for the procedure in dogs. Methods: Records of cases of renal cysts treated by sclerotherapy using 83% ethanol in dogs were reviewed. Outcomes of the treatment were evaluated by comparing volumes of renal cysts before the procedure and the volumes after treatment, using ultrasound images with the volume reduction rates classified as follows: < 50% of initial volume (failed); ≥ 50% but < 80% of initial volume (partial success); ≥ 80% but < 95% of initial volume (great success); ≥ 95% of initial volume (complete success). Results: Out of nine dog kidneys, renal cysts sclerotherapy with 83% ethanol achieved partial success in one kidney, great success in four, and complete success in the other four. No side effect was observed. The mean of the volume-reduction rates was 90.00 ± 11.00 while the minimum and maximum reduction rates were 65% and 100%, respectively. Conclusions The lower ethanol concentration (83%) is good for disinfecting kidneys in PRCS.

The goal of this research was to determine the relationship between the stage of chronic periodontitis and the presence of six bacterial pathogens (Aggregatibacter actinomycetemcomitans: AA, Fusobacterium nucleatum: FN, Porphyromonas gingivalis: PG, Prevotella intermedia: PI, Enterococcus faecalis: EF, and Parvimonas micra: PM). Forty-six chronic periodontitis patients visiting a dental hospital were included in this investigation. They were classified into four chronic periodontitis stages based on the sulcus bleeding index value and the probing depth. The tissue samples from the periodontal surgery were used for a direct PCR detection assay. A total of 49 samples from 46 patients were collected and classified into four chronic periodontitis groups (N: 6, P1: 13, P2: 18, P3: 12). The PCR assay showed that FN, PI, and PM were involved from the beginning of chronic periodontitis (P1), while AA and PG existed regardless of the disease stages. EF was strongly linked to the P3 stage of the disease. In order to assess the effect of dental treatments on patients with chronic periodontitis, EF should be a critical marker for P3 patients, while FN, PI, and PM would be good indicators for chronic periodontitis.
Chronic Periodontitis* ; Enterococcus faecalis ; Fusobacterium nucleatum ; Hemorrhage ; Humans ; Polymerase Chain Reaction ; Porphyromonas gingivalis ; Prevotella intermedia

PURPOSE: The incidence of gastrointestinal stromal tumors (GISTs) harboring platelet-derived growth factor receptor alpha (PDGFRA) mutations is low, therefore further investigation of the efficacy of imatinib in this subgroup was needed. MATERIALS AND METHODS: Patients with PDGFRA-mutant GISTs who received imatinib as primary therapy for advanced disease between January 2000 and June 2012 were identified from the GIST registry of Asan Medical Center, Seoul, Korea. RESULTS: KIT and PDGFRA genotyping in 823 patients identified 18 patients (2%) with PDGFRA mutations who were treated with first-line imatinib. Exon 18 D842V substitution, non-D842V exon 18 mutations, and exon 12 mutations were detected in nine (50%), four (22%), and five (28%) patients, respectively. Objective response rate differed significantly between patients with the D842V mutation and those with non-D842V mutations (0% [0/5] vs. 71% [5/7], p=0.03). In all patients, median progression-free survival (PFS) and overall survival (OS) was 24.8 months (95% confidence interval [CI], 0.0 to 57.2) and 51.2 months (95% CI, 37.1 to 65.3), respectively. Significantly, poorer PFS was observed for patients with D842V-mutant GISTs than those with non-D842V PDGFRA-mutant GISTs: median 3.8 months (95% CI, 1.4 to 6.3) versus 29.5 months (95% CI, 18.3 to 40.7) (p < 0.001). Patients with the D842V mutation had poorer OS than those with non-D842V PDGFRA mutations: median 25.2 months (95% CI, 12.7 to 37.8) versus 59.8 months (95% CI, 43.0 to 76.5) (p=0.02). CONCLUSION: Imatinib is active against non-D842V PDGFRA-mutant GISTs, whereas GISTs harboring the D842V mutation are primarily resistant to imatinib.
Chungcheongnam-do ; Disease-Free Survival ; Exons ; Gastrointestinal Stromal Tumors ; Humans ; Incidence ; Korea ; Platelet-Derived Growth Factor* ; Receptors, Platelet-Derived Growth Factor* ; Seoul

BACKGROUND: The vanA gene is the most frequently encountered gene among isolates, causing vancomycin-resistant Enterococci (VRE) infections in humans, and it is part of the transposable element Tn1546. Knowledge of the diversity of Tn1546 is important to distinguish between the dissemination of a single VRE clone and the transmission of a particular Tn1546 type through a genetically divergent population of enterococci. Recently, we studied molecular diversity of Tn1546-related elements in enterococci isolated in one hospital to facilitate understanding of the molecular epidemiology of vancomycin resistance. METHODS: Nineteen VanA-type VRE clinical isolates, collected in one university hospital during 1997 and 1999, were investigated for characteristics such as antibiotic resistance, structure of vanA gene cluster and genomic DNA type by means of antibiotic susceptibility test, PCR amplified length polymorphism of vanA gene cluster and pulse-field gel electrophoresis (PFGE), respectively. RESULTS: Nine (A, B1 to B5, C, D and E) different vanA gene cluster types were identified. Three isolates were grouped into vanA gene cluster type A, similar to that of Tn1546 prototype, and twelve isolates were grouped into type B that has an insertion of IS1216V at vanX-Y intergenic region. Type B was further subdivided into B1 to B5 according to the size variation of vanX-Y intergenic region, which was resulted from the insertion of IS1216V and deletions associated with the insertion. Both vanY and vanZ were deleted in three isolates, suggesting that these genes are not essential for vancomycin resistance. Notably, three E. faecalis and three E. faecium strains isolated during the same period were shown to carry the same vanA gene cluster, showing intergenic transmission of vancomycin resistance. CONCLUSION: The presence of variable types of vanA gene cluster among VRE strains isolated in one hospital suggests that several evolutionary changes of vanA gene clusters have occurred during the horizontal spread of resistance gene in the hospital environment. This approach may be useful for monitoring the evolution of VanA resistance.
Clone Cells ; DNA ; DNA Transposable Elements ; DNA, Intergenic ; Drug Resistance, Microbial ; Electrophoresis ; Humans ; Molecular Epidemiology ; Multigene Family* ; Polymerase Chain Reaction ; Vancomycin Resistance

BACKGROUND: The vanA gene is the most frequently encountered gene among isolates, causing vancomycin-resistant Enterococci (VRE) infections in humans, and it is part of the transposable element Tn1546. Knowledge of the diversity of Tn1546 is important to distinguish between the dissemination of a single VRE clone and the transmission of a particular Tn1546 type through a genetically divergent population of enterococci. Recently, we studied molecular diversity of Tn1546-related elements in enterococci isolated in one hospital to facilitate understanding of the molecular epidemiology of vancomycin resistance. METHODS: Nineteen VanA-type VRE clinical isolates, collected in one university hospital during 1997 and 1999, were investigated for characteristics such as antibiotic resistance, structure of vanA gene cluster and genomic DNA type by means of antibiotic susceptibility test, PCR amplified length polymorphism of vanA gene cluster and pulse-field gel electrophoresis (PFGE), respectively. RESULTS: Nine (A, B1 to B5, C, D and E) different vanA gene cluster types were identified. Three isolates were grouped into vanA gene cluster type A, similar to that of Tn1546 prototype, and twelve isolates were grouped into type B that has an insertion of IS1216V at vanX-Y intergenic region. Type B was further subdivided into B1 to B5 according to the size variation of vanX-Y intergenic region, which was resulted from the insertion of IS1216V and deletions associated with the insertion. Both vanY and vanZ were deleted in three isolates, suggesting that these genes are not essential for vancomycin resistance. Notably, three E. faecalis and three E. faecium strains isolated during the same period were shown to carry the same vanA gene cluster, showing intergenic transmission of vancomycin resistance. CONCLUSION: The presence of variable types of vanA gene cluster among VRE strains isolated in one hospital suggests that several evolutionary changes of vanA gene clusters have occurred during the horizontal spread of resistance gene in the hospital environment. This approach may be useful for monitoring the evolution of VanA resistance.
Clone Cells ; DNA ; DNA Transposable Elements ; DNA, Intergenic ; Drug Resistance, Microbial ; Electrophoresis ; Humans ; Molecular Epidemiology ; Multigene Family* ; Polymerase Chain Reaction ; Vancomycin Resistance

BACKGROUND: Abbreviated chemotherapy followed by radiotherapy or full cycles of chemotherapy is recommended as a standard treatment for limited-stage (LS) diffuse large B-cell lymphoma (DLBCL). After complete resection of tumors, however, Burkitt and childhood B-cell Non-Hodgkin lymphoma show favorable outcomes, even after abbreviated chemotherapy of only 2 or 3 cycles. We investigated the effectiveness of abbreviated chemotherapy in patients with LS DLBCL after complete tumor resection. METHODS: We retrospectively reviewed 18 patients with LS DLBCL who underwent complete tumor resection followed by either 3 or 4 cycles of chemotherapy between March 2002 and May 2010. RESULTS: With a median follow-up period of 57.9 months (range, 31.8-130.2 months), no patients experienced disease relapse or progression; however, 1 patient experienced secondary acute myeloid leukemia during follow-up. The 5-year progression-free survival rate and overall survival rate were 93.3% and 94.1%, respectively. CONCLUSION: These results warrant further investigation into abbreviated chemotherapy as an alternative treatment for patients who have undergone complete resection of LS DLBCL.
B-Lymphocytes ; Disease-Free Survival ; Drug Therapy* ; Follow-Up Studies ; Humans ; Leukemia, Myeloid, Acute ; Lymphoma, B-Cell* ; Lymphoma, Non-Hodgkin ; Radiotherapy ; Recurrence ; Retrospective Studies ; Survival Rate

BACKGROUND: Histologically, nonalcoholic steatohepatitis (NASH) is categorized into adult-type (type 1) and pediatric-type (type 2). The origination of the histological difference between the two types and how they differ clinically remain uncertain. We aimed to understand the incidence and clinical characteristics of the two types of NASH in Korean children, and to investigate the association between their pathological type and clinical characteristics, using anthropometric and laboratory data. METHODS: In 38 children with confirmed NASH, we investigated hepatic pathological findings, and correlating factors between pathological type and laboratory and anthropometric data (weight percentile, body mass index (BMI) z-score, and blood pressure percentile). Adult-type NASH was noted in 21 patients and pediatric-type in 17 patients. RESULTS: Age, sex, BMI, transaminase levels, and insulin resistance were not significantly different between the two groups. Triglyceride (TG) levels were higher in adult-type NASH (P = 0.033). Hematocrit and albumin levels were lower in adult-type NASH (P = 0.016 and 0.013, respectively). Hepatic fibrosis was more common in pediatric-type. The fibrosis scores in patients with adult-type were mostly 0 and 1, whereas the score was 3 in patients with pediatric-type (P = 0.024, 0.004, and < 0.010, respectively). Anthropometric data, liver function, and insulin resistance scores did not differ between the two pathological NASH types. TG, hematocrit, and albumin may be potential factors to predict pathological types. Fibrosis was observed more frequently in pediatric-type NASH. CONCLUSION: Monitoring children with pediatric-type NASH for progression to fibrosis or cirrhosis is recommended.
Blood Pressure ; Body Mass Index ; Child ; Fibrosis ; Hematocrit ; Humans ; Incidence ; Insulin Resistance ; Liver ; Non-alcoholic Fatty Liver Disease ; Pathology ; Triglycerides

Background/Aims: Patients with liver cirrhosis (LC) have low levels of branchedchain amino acids (BCAAs). There is accumulating evidence that BCAAs have anti- fibrotic effects in cirrhosis. This study is aimed to evaluate the effect of BCAAs on the function and phenotype of activated hepatic stellate cells (HSCs). Methods: LX-2, an immortalized human stellate cell line, was used in in vitro experiments. LX-2 cells were exposed to transforming growth factor β1 (TGF-β1) and BCAAs or to valine, leucine, and isoleucine, which are components of BCAAs. Activation of the TGF-β signaling pathway in LX-2 cells was observed using real- time quantitative polymerase chain reaction and Western blotting. Results: The increased expression of snail family transcriptional repressor 1 (SNAI1) was observed in LX-2 cells activated by TGF-β1. After BCAA treatment, its expression was significantly decreased at the mRNA level. The increased expression of Col1α1 and TIMP2 at the mRNA level and alpha smooth muscle actin at the protein level in activated LX-2 cells decreased after BCAA treatment. Among the BCAA components, leucine and valine significantly abrogated TGF-β-induced activation of LX-2 cells. BCAA treatment led to the decreased phosphorylation of Smad2 and p38 proteins, which are markers for Smad and Smad-independent p38 mitogen-activated protein kinase signaling pathways, respectively. Conclusions BCAA treatment can improve hepatic fibrosis by directly affecting the activated state of hepatic stellate cells through inhibition of the TGF-β signaling pathway. Among BCAA components, leucine and valine mainly abrogated TGF-β-induced activation of HSCs. Our results suggest that BCAA may be used to attenuate the progression of liver fibrosis.

Background: and Purpose The purpose of this study was to determine the cardiac and pulmonary management status of patients with Duchenne muscular dystrophy (DMD) in South Korea based on the Korean National Health Insurance database. Methods: This study used data of patients with code G71.0 in the National Health Information database, and also those with the special case of code V012. Cardiac function was assessed based on whether echocardiography and 24-h electrocardiography were performed, as well as the frequency of these investigations. Furthermore, information on the use of angiotensin-converting enzyme inhibitors (ACEi), angiotensin II receptor blockers (ARB), and beta blockers (BB) in the drug benefit list was checked. Medical charge records were also checked regarding the prescription of respiratory functional assessments and treatments. Results: The diagnostic criteria were met by 479 patients, with 41% of these patients receiving a cardiac evaluation, 29.8% being prescribed ACEi at 14.4±3.7 years of age, 59.5% undergoing pulmonary function tests, and 42.1% received pulmonary rehabilitation. The age at receiving ventilator support was 19.4±2.7 years. The frequency of cardiac and respiratory function tests increased with age, but the interval between tests was longer than the recent DMD care recommendations. The trend of taking ACEi, ARB, and BB for cardiac management in South Korea did not change during the study analysis period. Conclusions The findings of this study will contribute to recognizing the current status and the importance of applying an anticipatory approach to cardiopulmonary function in DMD patients.

Background: Tuberculosis (TB) exposure in congregate settings related to neonates is a serious medical and social issue. TB exposure happens during the neonatal period, but contact investigations for exposed infants are usually conducted after the neonatal period.Generally, recommendations for screening and managing close contact are different for neonates and children. Thus, there are challenges in contact investigations. We aimed to report contact investigations with a single tuberculin skin test (TST) on infants exposed to infectious TB in a postpartum care center. Methods: The index case was a healthcare worker with active pulmonary TB: sputum acidfast bacilli smear negative, culture positive, and no cavitary lesion. All exposed infants underwent medical examinations and chest X-ray. After TB disease was ruled out, contacts received window period prophylaxis with isoniazid (INH) until three months after the last exposure. TST was performed only once after completing the prophylaxis. Results: A total of 288 infants were selected as high-priority contacts. At the initial contact investigation, the age of infants ranged from 8 to 114 days. None of these exposed infants had TB disease. The prevalence of latent TB infection (LTBI) was 25.3% (73/288; 95% confidence interval [CI], 20.7–30.7). There were no serious adverse events related to the window period prophylaxis or LTBI treatment with INH. During the 1-year follow-up period, no infants progressed to overt TB disease. The size of TST induration in infants vaccinated with percutaneous Bacillus Calmette-Guérin (BCG) vaccine was significantly larger than that of infants vaccinated with intradermal BCG vaccine (median, 8 mm vs. 5 mm; P = 0.002). In multiple logistic regression analysis, independent factors associated with TST positivity (≥ 10 mm induration) were male (adjusted odds ratio [aOR], 2.98; 95% CI, 1.6–5.64), percutaneous BCG vaccination (aOR, 3.30; 95% CI, 1.75–6.48), TST reading between 60 and 72 hours after injecting purified protein derivative (aOR, 2.87; 95% CI, 1.53–5.49), and INH prophylaxis more than four weeks (aOR, 0.49; 95% CI, 0.25–0.94). Conclusion A single TST at three months after the last TB exposure with INH prophylaxis could be used as a main protocol in contact investigations for infants exposed to infectious TB during the neonatal period in congregate settings in Korea.