BACKGROUND: Postoperative urinary retention is defined as the inability to void with a full bladder during the postoperative period. It affects both sexes in all ages following all types of operation, including patients who previously had no micturition problems. We investigated the incidence and risk factors of urinary retention following long spinal anesthesia for total knee replacement. METHODS: We retrospectively studied a number of factors that may be associated with urinary retention in 98 women. The outcome variable of logistic regression models are urinary retention and severe urinary retention. The potential explanatory variables are age, height, weight, history of hypertension, DM and abnormal urology, heavy bupivacaine dose, types of patient-controlled analgesia, time to regression of spinal block to sacral segments (Tregression), amount of fluid and duration of surgery. We constructed a multiple linear regression model of the time from subarachnoid injection to spontaneous voiding (Tvoiding) in relation to above variables. RESULTS: The overall rate of urinary retention and severe retention were 57.1% and 30.6%. Tregression was identified as significant explanator of an increased probability for urinary retention (P = 0.002), Tregression and DM for severe urinary retention (P <0.001, P = 0.054). In the multiple linear regression model, three variables - Tregression, age, abnormal urological history were identified to have significant t-values (3.902, 3.107, 2.284) with Tvoiding (P <0.001, P = 0.003, P = 0.025). CONCLUSION: Old age, DM, abnormal urological history, delayed recovery of spinal anesthesia are risk factors to urinary retention or delayed spontaneous voiding.
Analgesia, Patient-Controlled ; Anesthesia, Spinal ; Arthroplasty, Replacement, Knee* ; Bupivacaine ; Female* ; Humans ; Hypertension ; Incidence ; Linear Models ; Logistic Models ; Postoperative Period ; Retrospective Studies ; Risk Factors ; Urinary Bladder ; Urinary Retention* ; Urination ; Urology

Trichoderma spp. cause large crop losses of the cultivated shiitake mushroom, Lentinula edodes. We bred several shiitake strains that are resistant to Trichoderma spp. using di-mon mating to establish a useful method for controlling the greenmold disease. We examined the competitive ability of L. edodes against Trichoderma spp. using a dual culture system to select resistant strains. By screening Trichoderma-resistant strains, we found that among 11 parental strains, 4 strains, including KFRI 36, were confirmed resistant strains. They showed especially strong resistance to T. harzianum, which formed deadlock after mycelial contact and then invaded into the territory of T. harzianum. KFRI 171 also showed resistance to T. atroviride strains. Among 13 strains, which were made by hybridization of shiitake strains, 5 were confirmed to be resistant to Trichoderma, including KFRI 58-1. Their resistance was not correlated to the resistant activity of their parents' strains. Two strains lose resistance and two strains acquire resistance compared to their parents' strains. In SEM observation, the mycelium of L. edodes at the interaction zone of Lentinula-Trichoderma was rugged and swollen by T. harzianum.
Breeding ; Chimera ; Humans ; Lentinula ; Mass Screening ; Mycelium ; Parents ; Shiitake Mushrooms ; Trichoderma

Shiitake mushrooms (Lentinula edodes) containing beta-glucans may be beneficial for human health; they have been used in the treatment of cancer, hypertension, and high cholesterol levels. The objective of this study was to determine the beta-glucan content in different sections of the fruiting bodies and mycelia of ten shiitake mushroom cultivars. The measured beta-glucan content ranged from 20.06 +/- 1.76% to 44.21 +/- 0.13% in the pileus sections, and from 29.74 +/- 1.40% to 56.47 +/- 4.72% in the stipe sections. The results of this study indicate that the variance in beta-glucan content dependent on the shiitake cultivar, and that the beta-glucan content is higher in the stipe than in the pileus.
beta-Glucans ; Cholesterol ; Fruit* ; Humans ; Hypertension ; Shiitake Mushrooms*

Primary cardiac osteosarcoma is extremely rare. We herein report a case involving a 31-year-old woman with a 2-week history of left upper trunk pain and hemoptysis. She was diagnosed with primary cardiac osteosarcoma with pulmonary vein obstruction and successfully treated via surgical resection and chemotherapy.
Adult ; Drug Therapy ; Female ; Heart ; Heart Neoplasms ; Hemoptysis ; Humans ; Osteosarcoma* ; Pulmonary Veins*

Visceral larva migrans (VLM) syndrome is a clinical manifestation of systemic organ involvement by Toxocara species. VLM with involvement of the bladder and liver is a rare finding. A 62-year-old woman presented with diffuse bladder wall thickening and multiple liver masses with peripheral eosinophilia and urinary symptoms. We considered malignancy or eosinophilic cystitis through clinical manifestations and imaging findings. However, no suspicious malignant lesions were observed on cystoscopy and liver mass biopsy revealed the presence of eosinophilic necrotizing granuloma without malignant cells. Anti-Toxocara antibodies were detected by western blotting and the patient was diagnosed with VLM syndrome. After taking prednisolone, urinary symptoms disappeared. On abdominal CT scan taken after three months, the size of multiple liver masses and bladder wall thickening had decreased. VLM syndrome should be suspected in patients with an atypical imaging pattern and peripheral eosinophilia.
Antibodies ; Biopsy ; Blotting, Western ; Cystitis ; Cystoscopy ; Eosinophilia ; Eosinophils ; Female ; Granuloma ; Humans ; Larva Migrans, Visceral* ; Liver* ; Middle Aged ; Prednisolone ; Tomography, X-Ray Computed ; Toxocara ; Toxocariasis ; Urinary Bladder*

We identified single nucleotide polymorphism (SNP) markers in the laccase gene to establish a line-diagnostic system for shiitake mushrooms. A total of 89 fungal isolates representing four lines, including Korean registered, Korean wild type, Chinese, and Japanese lines, were analyzed. The results suggest that SNP markers in the laccase gene can be useful for line typing in shiitake mushrooms.
Agaricales ; Asian Continental Ancestry Group ; Humans ; Laccase* ; Polymorphism, Single Nucleotide* ; Shiitake Mushrooms*

BACKGROUND/AIMS: The aims of this study were to identify the value of inflammatory markers as pretreatment prognostic factors for patients with multiple myeloma (MM) and to estimate the value of a prognostic index including these markers at diagnosis. METHODS: A total of 273 newly diagnosed MM patients undergoing active treatment were analyzed in this study. The prognostic values for survival of the pretreatment inflammatory markers were investigated. A myeloma prognostic index (MPI) was derived using prognostic factors determined to be independently significant on multivariate analysis. RESULTS: A high pretreatment neutrophil-lymphocyte ratio (NLR), low platelet count, and high C-reactive protein (CRP) level had independently unfavorable significance for overall survival (OS). The MPI was derived based on these factors. Per the MPI, 1 point each was assigned to high NLR, low platelet count, and high CRP. Risk categories were stratified into low- (score 0), intermediate- (score 1), and high-risk (score 2 or 3) groups. The MPI demonstrated independent statistical significance for OS on multivariate analysis ([intermediate: hazard ratio (HR), 1.91; 95% confidence interval (CI), 1.12 to 3.24] and [high: HR, 3.37; 95% CI, 2.00 to 5.69]; p < 0.001). Moreover, this significance could be observed regardless of age, renal function, and exposure to novel agents. In addition, the International Staging System risk group could be further significantly stratified using the MPI. CONCLUSIONS: The MPI, consisting of pretreatment inflammatory markers, NLR, platelet count, and CRP, might be effective in predicting the survival of newly diagnosed MM patients undergoing active treatment.
C-Reactive Protein ; Diagnosis* ; Humans ; Multiple Myeloma* ; Multivariate Analysis ; Platelet Count ; Prognosis

Encapsulating peritoneal sclerosis (EPS) is a rare complication of peritoneal dialysis associated with a high mortality rate. Bacterial peritonitis (BP), a complication of EPS treatment, is uncommon, and treatments for BP are not well known. We report two patients who had undergone steroid treatment who developed BP after hemodialysis transfer. In the first case, we treated the BP with antibiotics and performed several surgical drainage procedures; however, the fluid became too thick to drain. This patient died of malnutrition and sepsis. In the second case, antibiotics and surgical enterolysis with peritonectomy were used to treat the BP. Solid food was accepted on day 7 postoperatively, and the patient was stable after 20 months. Thus, surgical enterolysis with peritonectomy may be a good treatment modality for patients with EPS and BP.
Anti-Bacterial Agents ; Drainage ; Humans ; Malnutrition ; Mortality ; Peritoneal Dialysis ; Peritoneal Fibrosis* ; Peritonitis* ; Renal Dialysis ; Sepsis

Background: CDKN2A is a tumor suppressor gene that encodes the cell cycle inhibitor protein p16. Homozygous deletion of the CDKN2A gene has been associated with shortened survival in isocitrate dehydrogenase (IDH)–mutant gliomas. This study aimed to analyze the prognostic value of p16 and to evaluate whether p16 immunohistochemical staining could be used as a prognostic marker to replace CDKN2A genotyping in diffuse gliomas. Methods: p16 immunohistochemistry was performed on tissue microarrays of 326 diffuse gliomas with diagnoses that reflected IDH-mutations and 1p/19q codeletion status. The results were divided into three groups (negative, focal expression, overexpression) according to the presence and degree of p16 expression. Survival analysis was performed to assess the prognostic value of p16 expression. Results: A loss of p16 expression predicted a significantly worse outcome in all glioma patients (n=326, p<.001), in the IDH-mutant glioma patients (n=103, p=.010), and in the IDH-mutant astrocytoma patients (n=73, p=.032). However, loss of p16 expression did not predict the outcome in the IDH-wildtype glioma patients (n=223, p=.121) or in the oligodendroglial tumor patients with the IDH-mutation and 1p/19q codeletion (n=30, p=.457). Multivariate analysis showed the association was still significant in the IDH-mutant glioma patients (p=.008; hazard ratio [HR], 2.637; 95% confidence interval [CI], 1.295 to 5.372) and in the IDH-mutant astrocytoma patients (p=.001; HR, 3.586; 95% CI, 1.649 to 7.801). Interestingly, patients who presented with tumors with p16 overexpression also had shorter survival times than did patients with tumors with p16 focal expression in the whole glioma (p< .001) and in IDH-mutant glioma groups. (p=.046). Conclusions This study suggests that detection of p16 expression by immunohistochemistry can be used as a useful surrogate test to predict prognosis, especially in IDH-mutant astrocytoma patients.

Background: Although most elderly patients with acute myeloid leukemia (AML) are ineligible for intensive chemotherapy (ICT), treatment options remain limited. CURRENT (UMIN000037786), a real-world, non-interventional, retrospective chart review, evaluated clinical outcomes, clinicopathologic characteristics, and treatment patterns in these patients.We present results from a subanalysis of Korean patients in this study. Methods: Patients were aged ≥ 18 years with primary or secondary AML ineligible for ICT who initiated first-line systemic therapy or best supportive care (BSC) between 2015 and 2018 across four centers in Korea. Primary endpoint was overall survival (OS) from diagnosis.Secondary endpoints included progression-free survival (PFS), time to treatment failure, and response rates. Data analyses were primarily descriptive, with time-to-event outcomes estimated using the Kaplan-Meier method, and Cox regression used to determine prognostic factors for survival. Results: Among 194 patients enrolled, 84.0% received systemic therapy and 16.0% received BSC. Median age at diagnosis was 74 and 78 years, and Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 was reported in 73.0% and 48.4% of patients, respectively;poor cytogenetic risk was reported in 30.1% and 16.1% of patients. Median OS was 7.83 vs.4.50 months, and median PFS was 6.73 vs. 4.50 months in the systemic therapy vs. BSC groups. Prognostic factors affecting OS included secondary AML (hazard ratio, 1.67 [95% confidence interval, 1.13–2.45]), ECOG performance status ≥ 2 (2.41 [1.51–3.83]), poor cytogenetic risk (2.10 [1.36–3.24]), and Charlson comorbidity index ≥ 1 (2.26 [1.43–3.58]). Conclusion Clinical outcomes are poor in Korean patients with AML ineligible for ICT who are prescribed current systemic therapies or BSC. There is a substantial unmet need for novel agents (monotherapy or in combination) to improve clinical outcomes in this patient population.