PURPOSE: To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. MATERIALS AND METHODS: The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. RESULTS: Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. CONCLUSION: Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.
Carcinoma, Squamous Cell ; Chemoradiotherapy ; Disease-Free Survival ; Humans ; Lymph Node Excision ; Lymphedema ; Pelvis ; Recurrence ; Retrospective Studies ; Sepsis ; Skin ; Treatment Outcome ; Vulvar Neoplasms

PURPOSE: Systemic inflammatory reaction (SIR) is an important determinant of cardiovascular (CV) mortality in CRF patients. UA is an end-product of purine metabolism, and recent studies have demonstrated that an elevated serum UA level is associated with an increased level of inflammatory mediators. Since hyperuricemia is one of the most prevalent complications in CRF and is linked to CV disease, we hypothesized hyperuricemia in CRF may play an important role in the development of CV disease by inducing SIR. METHODS: PBMCs were isolated by density gradient centrifugation in 21 CRF patients and age and sex-matched 20 healthy adults. CRP expression was evaluated by real time PCR and ELISA in PBMC stimulated with UA (0.3-12 mg/dL). RESULTS: There was no difference in constitutional CRP expression in PBMC from control and CRF patients. UA induced CRP mRNA (RT-PCR) and protein (ELISA) expression in PBMC, which was blocked by the organic anion transport inhibitor, probenecid (1 mM), suggesting entry of uric acid into cells was responsible for CRP expression. PBMC from CRF patients showed a significantly higher CRP production by UA compared to healthy control. There was no correlation between serum UA level and % increase in CRP production by UA. CONCLUSION: The exaggerated CRP expression by UA can be another mechanism of SIR and increased CV morbidity in CRF patients. Prospective studies with uric acid-lowering therapy are necessary to confirm clinical significance of these interesting in-vitro findings.
Adult ; C-Reactive Protein* ; Cardiovascular Diseases ; Centrifugation, Density Gradient ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hyperuricemia ; Inflammation ; Metabolism ; Mortality ; Probenecid ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Uric Acid*

Purpose: This study evaluated the surgical volumes and types of specific surgical procedures in a single trauma center for 3 consecutive years. Methods: From January 2014 to December 2016 there were 9,530 injury cases in the trauma registry that were reviewed. Results: There were 1,502 patients (15.8%) with an injury severity score over 15, of which 426 (28.4%) underwent an emergency operation or had an interventional radiology procedure. There were 186 craniotomies, 87 laparotomies, and 74 interventional radiology procedures performed. Conclusion The number of emergency operations by each dedicated trauma surgeon was very low therefore implementation of an acute-care surgery model is appropriate to consider together with changes to the training program for trauma surgeons.

Purpose: This study evaluated the surgical volumes and types of specific surgical procedures in a single trauma center for 3 consecutive years. Methods: From January 2014 to December 2016 there were 9,530 injury cases in the trauma registry that were reviewed. Results: There were 1,502 patients (15.8%) with an injury severity score over 15, of which 426 (28.4%) underwent an emergency operation or had an interventional radiology procedure. There were 186 craniotomies, 87 laparotomies, and 74 interventional radiology procedures performed. Conclusion The number of emergency operations by each dedicated trauma surgeon was very low therefore implementation of an acute-care surgery model is appropriate to consider together with changes to the training program for trauma surgeons.

Purpose: Cuscuta australis R. Brown (CA) is a parasitic plant that attaches to host plants and disrupts the growth, nutrient absorption, and overall development of leguminous plants.However, CA is known to contain various bioactive components, including vitamin A, β-carotene, lutein, and kaempferol, which have demonstrated pharmacological effects in immune responses. This study aims to investigate the potential benefits of CA extracts obtained using different extraction methods to explore its potential as a novel natural resource for applications in the food and pharmaceutical industries. Methods: In this study, water (CAW), ethanol (CAE), and hot water (CAHW) extracts of CA were prepared to investigate their antioxidant and anti-inflammatory effects in RAW264.7 cells. Results: The CAHW group exhibited the highest levels of antioxidant compounds, such as total polyphenols and flavonoids, resulting in a significantly higher ferric reducing antioxidant power compared to the other groups. The 1,1-diphenyl-2-picrylhydrazyl and 2,2-azino-bis-3-ethylen-benzothiazoline-6-sulfonate radical scavenging activities were also high in the CAHW and CAE groups but were lower compared to the positive control, ascorbic acid. In RAW264.7 cells, CA extracts at concentrations of 50, 100, and 200 μg/mL showed no cytotoxicity, and nitric oxide (NO) production was reduced in a dose-dependent manner.At a concentration of 200 μg/mL, all the CA extracts exhibited significant anti-inflammatory activity by modulating the nuclear factor kappa B signaling pathway, effectively resulting in the down-regulation of inflammation-related genes such as cyclooxygenase-2, inducible NO synthase, tumor necrosis factor-alpha, and interleukin-6 in RAW264.7 cells, with the CAHW extract demonstrating the most potent inhibitory effect among all the CA extract groups. Conclusion Overall, CA extraction is effective for both antioxidant and anti-inflammatory activities, with the hot water extraction method proving to be the most effective.

Purpose: Cuscuta australis R. Brown (CA) is a parasitic plant that attaches to host plants and disrupts the growth, nutrient absorption, and overall development of leguminous plants.However, CA is known to contain various bioactive components, including vitamin A, β-carotene, lutein, and kaempferol, which have demonstrated pharmacological effects in immune responses. This study aims to investigate the potential benefits of CA extracts obtained using different extraction methods to explore its potential as a novel natural resource for applications in the food and pharmaceutical industries. Methods: In this study, water (CAW), ethanol (CAE), and hot water (CAHW) extracts of CA were prepared to investigate their antioxidant and anti-inflammatory effects in RAW264.7 cells. Results: The CAHW group exhibited the highest levels of antioxidant compounds, such as total polyphenols and flavonoids, resulting in a significantly higher ferric reducing antioxidant power compared to the other groups. The 1,1-diphenyl-2-picrylhydrazyl and 2,2-azino-bis-3-ethylen-benzothiazoline-6-sulfonate radical scavenging activities were also high in the CAHW and CAE groups but were lower compared to the positive control, ascorbic acid. In RAW264.7 cells, CA extracts at concentrations of 50, 100, and 200 μg/mL showed no cytotoxicity, and nitric oxide (NO) production was reduced in a dose-dependent manner.At a concentration of 200 μg/mL, all the CA extracts exhibited significant anti-inflammatory activity by modulating the nuclear factor kappa B signaling pathway, effectively resulting in the down-regulation of inflammation-related genes such as cyclooxygenase-2, inducible NO synthase, tumor necrosis factor-alpha, and interleukin-6 in RAW264.7 cells, with the CAHW extract demonstrating the most potent inhibitory effect among all the CA extract groups. Conclusion Overall, CA extraction is effective for both antioxidant and anti-inflammatory activities, with the hot water extraction method proving to be the most effective.

Purpose: Cuscuta australis R. Brown (CA) is a parasitic plant that attaches to host plants and disrupts the growth, nutrient absorption, and overall development of leguminous plants.However, CA is known to contain various bioactive components, including vitamin A, β-carotene, lutein, and kaempferol, which have demonstrated pharmacological effects in immune responses. This study aims to investigate the potential benefits of CA extracts obtained using different extraction methods to explore its potential as a novel natural resource for applications in the food and pharmaceutical industries. Methods: In this study, water (CAW), ethanol (CAE), and hot water (CAHW) extracts of CA were prepared to investigate their antioxidant and anti-inflammatory effects in RAW264.7 cells. Results: The CAHW group exhibited the highest levels of antioxidant compounds, such as total polyphenols and flavonoids, resulting in a significantly higher ferric reducing antioxidant power compared to the other groups. The 1,1-diphenyl-2-picrylhydrazyl and 2,2-azino-bis-3-ethylen-benzothiazoline-6-sulfonate radical scavenging activities were also high in the CAHW and CAE groups but were lower compared to the positive control, ascorbic acid. In RAW264.7 cells, CA extracts at concentrations of 50, 100, and 200 μg/mL showed no cytotoxicity, and nitric oxide (NO) production was reduced in a dose-dependent manner.At a concentration of 200 μg/mL, all the CA extracts exhibited significant anti-inflammatory activity by modulating the nuclear factor kappa B signaling pathway, effectively resulting in the down-regulation of inflammation-related genes such as cyclooxygenase-2, inducible NO synthase, tumor necrosis factor-alpha, and interleukin-6 in RAW264.7 cells, with the CAHW extract demonstrating the most potent inhibitory effect among all the CA extract groups. Conclusion Overall, CA extraction is effective for both antioxidant and anti-inflammatory activities, with the hot water extraction method proving to be the most effective.

BACKGROUND: Peritoneal fibrosis is one of the major causes of technical failure in patients on peritoneal dialysis. Epithelial-to-mesenchymal transition (EMT) of the peritoneum is an early and reversible mechanism of peritoneal fibrosis. Human peritoneal mesothelial cells (HPMCs) have their own renin-angiotensin-aldosterone system (RAAS), however, it has not been investigated whether aldosterone, an end-product of the RAAS, induces EMT in HPMCs, and which mechanisms are responsible for aldosterone-induced EMT. METHODS: EMT of HPMCs was evaluated by comparing the expression of epithelial cell marker, E-cadherin, and mesenchymal cell marker, alpha-smooth muscle actin after stimulation with aldosterone (1-100nM) or spironolactone. Activation of extracellular signal-regulated kinase (ERK)1/2 and p38 mitogen-activated protein kinase (MAPK) and generation of reactive oxygen species (ROS) were assessed by western blotting and 2',7'-dichlorofluororescein diacetate staining, respectively. The effects of MAPK inhibitors or antioxidants (N-acetyl cysteine, apocynin, and rotenone) on aldosterone-induced EMT were evaluated. RESULTS: Aldosterone induced EMT in cultured HPMCs, and spironolactone blocked aldosterone-induced EMT. Aldosterone induced activation of both ERK1/2 and p38 MAPK from 1 hour. Either PD98059, an inhibitor of ERK1/2, or SB20358, an inhibitor of p38 MAPK, attenuated aldosterone-induced EMT. Aldosterone induced ROS in HPMCs from 5 minutes, and antioxidant treatment ameliorated aldosterone-induced EMT. N-acetyl cysteine and apocynin alleviated activation of ERK and p38 MAPK. CONCLUSION: Aldosterone induced EMT in HPMCs by acting through the mineralocorticoid receptor. Aldosterone-induced generation of ROS followed by activation of ERK, and p38 MAPK served as one of the mechanisms of aldosterone-induced EMT of HPMCs.
Actins ; Aldosterone* ; Antioxidants ; Blotting, Western ; Cadherins ; Cysteine ; Epithelial Cells ; Humans ; p38 Mitogen-Activated Protein Kinases ; Peritoneal Dialysis ; Peritoneal Fibrosis ; Peritoneum ; Phosphotransferases ; Protein Kinases ; Reactive Oxygen Species ; Receptors, Mineralocorticoid ; Renin-Angiotensin System ; Spironolactone

PURPOSE: The purpose of this study was to assess hygiene status of meals for poorly-fed children through microbiolo-gical quality. METHODS: Meals were provided by two social enterprises, one franchise, and one convenience store. There were a total of six meal samples; two samples (social enterprise meal 1; SEM 1, social enterprise meal 2; SEM 2) from two social enterprises, respectively, two samples (franchise meal 1; FM 1, franchise meal 2; FM 2) from one franchise, and two samples (convenience store meal 1; CSM 1, convenience store meal 2; CSM 2) from one convenience store. Microbiologi-cal analysis and assessment were performed by Korean food standards codex (KFSC). RESULTS: General bacteria and E. coli in SEM 1 were detected, but the levels were not over KFSC, and Coliform less than 9.2 x 10 CFU/g was also de-tected in seasoned bean sprouts of SEM 1. General bacteria was detected at 1.6 x 10(6) CFU/g in cabbage kimchi of SEM 2. Coliform was detected in cabbage kimchi, squid cutlet, stir-fried pork, and fried chicken of FM1 and 2, but the levels were not over KFSC. In addition, S. aureus was detected in cabbage kimchi and seasoned dried white radish of FM 1 and 2 (9.8 x 10(2) CFU/g, 9.4 x 10(3) CFU/g respectively), thus was over KFSC. B. cereus was detected in stir-fried pork and fried chicken (1.2 x 10(3) CFU/g, 1.5 x 10(3) CFU/g respectively) of FM 1 and 2, thus was over KFSC. Finally, S. aureus was detected in stir-fried dried squid, seasoned spicy chicken, and stir-fried kimchi of CSM 1 and 2, and was over KFSC too (9.5 x 10(4) CFU/g, 2.4 x 10(2) CFU/g, 1.3 x 10(3) CFU/g respectively). CONCLUSION: Results of this study suggest that systemic management of hygiene is necessary to safely providing meals to poorly-fed children.
Bacteria ; Brassica ; Chickens ; Child* ; Decapodiformes ; Humans ; Hygiene* ; Meals* ; Raphanus ; Seasons

Connective tissue growth factor (CTGF) is a potent pro-fibrotic factor, which is implicated in fibrosis through extracellular matrix (ECM) induction in diabetic cardiovascular complications. It is an important downstream mediator in the fibrotic action of transforming growth factor beta (TGFbeta) and is potentially induced by hyperglycemia in human vascular smooth muscle cells (VSMCs). Therefore, the goal of this study is to identify the signaling pathways of CTGF effects on ECM accumulation and cell proliferation in VSMCs under hyperglycemia. We found that high glucose stimulated the levels of CTGF mRNA and protein and followed by VSMC proliferation and ECM components accumulation such as collagen type 1, collagen type 3 and fibronectin. By depleting endogenous CTGF we showed that CTGF is indispensable for the cell proliferation and ECM components accumulation in high glucose-stimulated VSMCs. In addition, pretreatment with the MEK1/2 specific inhibitors, PD98059 or U0126 potently inhibited the CTGF production and ECM components accumulation in high glucose-stimulated VSMCs. Furthermore, knockdown with ERK1/2 MAPK siRNA resulted in significantly down regulated of CTGF production, ECM components accumulation and cell proliferation in high glucose-stimulated VSMCs. Finally, ERK1/2 signaling regulated Egr-1 protein expression and treatment with recombinant CTGF reversed the Egr-1 expression in high glucose-induced VSMCs. It is conceivable that ERK1/2 MAPK signaling pathway plays an important role in regulating CTGF expression and suggests that blockade of CTGF through ERK1/2 MAPK signaling may be beneficial for therapeutic target of diabetic cardiovascular complication such as atherosclerosis.
Animals ; Aorta ; Atherosclerosis ; Butadienes ; Cell Proliferation ; Collagen ; Connective Tissue ; Connective Tissue Growth Factor ; Diabetes Complications ; Extracellular Matrix ; Fibronectins ; Fibrosis ; Flavonoids ; Glucose ; Humans ; Hyperglycemia ; Muscle, Smooth, Vascular ; Nitriles ; Phosphotransferases ; Rats ; RNA, Messenger ; RNA, Small Interfering ; Transforming Growth Factor beta