A prospective study of vitamin B6, B12, folate, and homocysteine levels was carried out in 7 kidney transplant(KT) recipients. The first sample for the basal level was drawn on the morning of the KT day before the start of cyclosporine injection. Thereafter, serial blood samples were taken every day until the serum creatinine level decreased below 1.5 mg/dl and then every 2 or 3days until discharge. The serum creatinine level decreased to below 1.5 mg/dl within 3days except for cases 4 and 6. The homocysteine levels decreased markedly in synchronisation with serum creatinine levels increased during the first 7days and then declined together with serum creatinine levels but went up again after a few days. The levels of B6, and vitamin B12 do not continue to decrease after the levels of serum creatinine have decreased to 1.5mg/dl, while homocysteine levels go up progressively. In conclusion, contrary to our expectation, the level of homocysteine rebounds a few days after KT following a transient decline. A deficiency of folic acid, vitamin B6 and vitamin B12 does not seem to cause hyperhomocysteinemia in KT recipients. It is necessary to pay attention to hyperhomocysteinemia in KT recipients, especially when the recipients have an atherosclerosis-related complication.
Creatinine ; Cyclosporine ; Folic Acid ; Homocysteine* ; Hyperhomocysteinemia ; Kidney ; Kidney Transplantation* ; Plasma* ; Prospective Studies ; Vitamin B 12 ; Vitamin B 6

Allergic fungal sinusitis (AFS) is a benign, noninvasive form of fungal sinusitis. Histologically, AFS is characterized by allergic mucin, which consists of eosinophilic mucinous material with occasional laminar deposits of eosinophils. A diagnosis of AFS can be made when there is a demonstration of characteristic allergic mucin and an appearance of fungal hypae scattered within the mucin with no evidence of tissue invasion, or when fungi cultures yield positive results. Until now, no cases of AFS have been reported in Korea, though there have been many cases of mycetomas and a few cases of invasive fungal sinusitis. We present the first two cases of AFS in Korea. The patients demonstrated characteristic allergic mucin, fungal hypae scattered within the mucin, and no evidence of tissue invasion on histopathology. Nasal polyps, involvement of the unilateral sinuses, peripheral eosinophilia, an elevated total IgE, and hyperattenuated masses observed in the CT supported the diagnosis of AFS. The patients recovered and did not display recurrence after surgery and treatment with topical steroids and saline irrigation.
Diagnosis ; Eosinophilia ; Eosinophils ; Fungi ; Humans ; Immunoglobulin E ; Korea ; Mucins ; Mycetoma ; Nasal Polyps ; Recurrence ; Sinusitis* ; Steroids

No abstract available.
Aspergillus* ; Sinusitis*

Sesquiterpenoids are widely found in nature, while nitrobenzoyl sesquiterpenoids are relatively rare. Twelve natural nitrobenzoyl sesquiterpenoids were all derived from marine Aspergillus fungi, which are typical natural products with marine characteristics. These natural products exhibit good antitumor, antiviral, and inhibition of osteoclast differentiation activity, especially in the treatment of osteoclast-related diseases, showing good medicinal development value. This article reviews the natural product sources, chemical structure, chemical synthesis, biosynthesis, bioactivity, and pharmacological mechanisms of nitrobenzoyl sesquiterpenoids and predicts and discusses their absorption, distribution, metabolism, excretion, toxicity (ADME/T), and drug-likeness, providing a comprehensive understanding of the natural products of nitrobenzoyl sesquiterpenoids from marine sources and their potential for pharmaceutical development.

A new polyketide:3R, 5R-(-)-talaroflavone (2), along with 15 known compounds were isolated from a EtOAc extract of a sponge-derived fungus Alternaria sp. F49. Compounds 1-2 and 3-4 were separated as two pairs of enantiomers by chiral HPLC from Ⅰ and Ⅱ. The structures of compounds 1-16 were elucidated by means of NMR and MS. Furthermore, the absolute configurations of compounds 1-2 were determined by single crystal X-ray diffraction experiment and CD analyses. Compounds 6, 8-10 were isolated from this genus (Alternaria sp.) for the first time. Compound 16 showed moderate COX-2 enzyme inhibitory activity with IC₅₀of 7.3 μmol·L^-1.

Two new isomeric modified tripeptides, aspergillamides C and D (compounds 1 and 2), together with fifteen known compounds (compounds 3-17), were obtained from the marine sponge-derived fungus Aspergillus terreus SCSIO 41008. The structures of the new compounds, including absolute configurations, were determined by extensive analyses of spectroscopic data (NMR, MS, UV, and IR) and comparisons between the calculated and experimental electronic circular dichroism (ECD) spectra. Butyrolactone I (compound 11) exhibited strong inhibitory effects against Mycobacterium tuberculosis protein tyrosine phosphatase B (MptpB) with the IC being 5.11 ± 0.53 μmol·L, and acted as a noncompetitive inhibitor based on kinetic analysis.
4-Butyrolactone ; analogs & derivatives ; chemistry ; isolation & purification ; pharmacology ; Animals ; Aspergillus ; chemistry ; Chemistry Techniques, Analytical ; Dipeptides ; chemistry ; isolation & purification ; pharmacology ; Enzyme Inhibitors ; chemistry ; isolation & purification ; pharmacology ; Indoles ; chemistry ; isolation & purification ; pharmacology ; Molecular Structure ; Mycobacterium tuberculosis ; drug effects ; Peptides ; chemistry ; isolation & purification ; pharmacology ; Polyketides ; chemistry ; isolation & purification ; pharmacology ; Porifera ; microbiology ; Protein Tyrosine Phosphatases ; chemistry

PURPOSE: A pooled analysis of multi-institutional trials was performed to analyze the effect of surgical timing on tumor response by comparing short course concurrent chemoradiotherapy (CCRT) with long course CCRT followed by delayed surgery in locally advanced rectal cancer. MATERIALS AND METHODS: Three hundred patients with cT3-4N0-2 rectal adenocarcinoma were included. Long course patients from KROG 14-12 (n=150) were matched 1:1 to 150 short course patients from KROG 10-01 (NCT01129700) and KROG 11-02 (NCT01431599) according to stage, age, and other risk factors. The primary endpoint was to determine the interval between surgery and the last day of neoadjuvant CCRT which yields the best tumor response after the short course and long course CCRT. Downstaging was defined as ypT0-2N0M0 and pathologic complete response (ypCR) was defined as ypT0N0M0, respectively. RESULTS: Both the long and short course groups achieved lowest downstaging rates at < 6 weeks (long 20% vs. short 8%) and highest downstaging rates at 6-7 weeks (long 44% vs. short 40%). The ypCR rates were lowest at < 6 weeks (both long and short 0%) and highest at 6-7 weeks (long 21% vs. short 11%) in both the short and long course arms. The downstaging and ypCR rates of long course group gradually declined after the peak at 6-7 weeks and those of the short course group trend to constantly increase afterwards. CONCLUSION: It is optimal to perform surgery at least 6 weeks after both the short course and long course CCRT to obtain maximal tumor regression in locally advanced rectal adenocarcinoma.
Adenocarcinoma* ; Arm ; Chemoradiotherapy ; Humans ; Rectal Neoplasms ; Risk Factors

A fungal strain WXF1904, was isolated from a starfish sample corrected in the South China Sea. According to its internal transcribed spacer (ITS) analysis, the strain was identified as a member of the genus Aspergillus and designated as Aspergillus sp. WXF1904. One new isocoumarin containing halogennamed 6-chloro-5,7-dihydroxy-3,8-dimethylisocoumarin (1), along with six known compounds pilobolusate (2), p-hydroxybenzaldehyde (3), methyl orsellinate (4), catechol (5), vanillic acid (6), and wasabidienone E (7), were isolated from the cultures of Aspergillus sp. WXF1904 by silica gel column chromatography, ODS gel column chromatography, and high performance liquid chromatography (HPLC). Their structures were elucidated by high resolution mass spectrometry (HR-MS), nuclear magnetic resonance (NMR) as well as literature comparison. The new compound 5-chloro-6,7-dihydroxy-3,8-dimethylisocoumarin and compound 2 showed weak acetylcholinesterase inhibitory activity.

BACKGROUND: There was no practical guideline for the management of patients with central nervous system tumor in Korea for many years. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, has developed the guideline for glioblastoma. Subsequently, the KSNO guideline for World Health Organization (WHO) grade II cerebral glioma in adults is established. METHODS: The Working Group was composed of 35 multidisciplinary medical experts in Korea. References were identified by searching PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL databases using specific and sensitive keywords as well as combinations of keywords regarding diffuse astrocytoma and oligodendroglioma of brain in adults. RESULTS: Whenever radiological feature suggests lower grade glioma, the maximal safe resection if feasible is recommended globally. After molecular and histological examinations, patients with diffuse astrocytoma, isocitrate dehydrogenase (IDH)-wildtype without molecular feature of glioblastoma should be primarily treated by standard brain radiotherapy and adjuvant temozolomide chemotherapy (Level III) while those with molecular feature of glioblastoma should be treated following the protocol for glioblastomas. In terms of patients with diffuse astrocytoma, IDH-mutant and oligodendroglioma (IDH-mutant and 1p19q codeletion), standard brain radiotherapy and adjuvant PCV (procarbazine+lomustine+vincristine) combination chemotherapy should be considered primarily for the high-risk group while observation with regular follow up should be considered for the low-risk group. CONCLUSION: The KSNO's guideline recommends that WHO grade II gliomas should be treated by maximal safe resection, if feasible, followed by radiotherapy and/or chemotherapy according to molecular and histological features of tumors and clinical characteristics of patients.
Adult ; Astrocytoma ; Brain ; Central Nervous System ; Drug Therapy ; Drug Therapy, Combination ; Follow-Up Studies ; Glioblastoma ; Glioma ; Humans ; Isocitrate Dehydrogenase ; Korea ; Oligodendroglioma ; Radiotherapy ; World Health Organization

BACKGROUND: There was no practical guideline for the management of patients with central nervous system tumor in Korea in the past. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, developed the guideline for glioblastoma successfully and published it in Brain Tumor Research and Treatment, the official journal of KSNO, in April 2019. Recently, the KSNO guideline for World Health Organization (WHO) grade III cerebral glioma in adults has been established. METHODS: The Working Group was composed of 35 multidisciplinary medical experts in Korea. References were identified by searches in PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL databases using specific and sensitive keywords as well as combinations of keywords. Scope of the disease was confined to cerebral anaplastic astrocytoma and oligodendroglioma in adults. RESULTS: Whenever radiological feature suggests high grade glioma, maximal safe resection if feasible is globally recommended. After molecular and histological examinations, patients with anaplastic astrocytoma, isocitrate dehydrogenase (IDH)-mutant should be primary treated by standard brain radiotherapy and adjuvant temozolomide chemotherapy whereas those with anaplastic astrocytoma, NOS, and anaplastic astrocytoma, IDH-wildtype should be treated following the protocol for glioblastomas. In terms of anaplastic oligodendroglioma, IDH-mutant and 1p19q-codeletion, and anaplastic oligodendroglioma, NOS should be primary treated by standard brain radiotherapy and neoadjuvant or adjuvant PCV (procarbazine, lomustine, and vincristine) combination chemotherapy. CONCLUSION: The KSNO's guideline recommends that WHO grade III cerebral glioma of adults should be treated by maximal safe resection if feasible, followed by radiotherapy and/or chemotherapy according to molecular and histological features of tumors.
Adult ; Astrocytoma ; Brain ; Brain Neoplasms ; Central Nervous System ; Drug Therapy ; Drug Therapy, Combination ; Glioblastoma ; Glioma ; Humans ; Isocitrate Dehydrogenase ; Korea ; Lomustine ; Oligodendroglioma ; Radiotherapy ; World Health Organization