There is no consensus for the surgical indications, as well as the surgical technique, for the treatment of inferior vena cava (IVC) invasion by pancreas head cancer. The authors experienced a case of pancreas head cancer invading the anterior wall of the IVC. We performed en bloc excision of the anterior wall of the IVC combined with pancreatoduodenectomy in this case under the assumption that only a margin-negative surgical resection could offer a chance for cure. Technically, the sequence of dissection and addressing the IVC at the end of dissection are considered to be important to secure the operative field surrounding the IVC and to achieve a margin-negative resection. There has been no recurrence up to now, 8 months after the extensive radical operation.
Consensus ; Head and Neck Neoplasms ; Pancreas ; Pancreatic Neoplasms ; Pancreaticoduodenectomy ; Recurrence ; Vena Cava, Inferior

There is no consensus for the surgical indications, as well as the surgical technique, for the treatment of inferior vena cava (IVC) invasion by pancreas head cancer. The authors experienced a case of pancreas head cancer invading the anterior wall of the IVC. We performed en bloc excision of the anterior wall of the IVC combined with pancreatoduodenectomy in this case under the assumption that only a margin-negative surgical resection could offer a chance for cure. Technically, the sequence of dissection and addressing the IVC at the end of dissection are considered to be important to secure the operative field surrounding the IVC and to achieve a margin-negative resection. There has been no recurrence up to now, 8 months after the extensive radical operation.
Consensus ; Head and Neck Neoplasms ; Pancreas ; Pancreatic Neoplasms ; Pancreaticoduodenectomy ; Recurrence ; Vena Cava, Inferior

The purpose of this study is to investigate the dietary intakes and nutritional status in total gastrectomized patients. We assessed the nutritional status by dietary intake, anthropometric data and biochemical data. And we also checked the subjective postprandial symptoms and gastrofiberscopy to detect the reflux esophagitis in 22 patients who were free of tumors for more than 1 year after total gastrectomy by the three different reconstruction methods(Loop esophagojejunostomy with A-loop tie/ Roux-en-Y esophagojejunostomy/Roux-en-Y esophagojejunostomy with Paulino pouch). Any patients were not in malnutrition status in respect to biochemical data. By assessing the dietary intake, the average daily calorie intake was 1848.2+/-440.2kcal, it was 105.9+/-23.8% of energy requirement. But there was weight loss in 21 patients of 22 patients after operation and the weight loss was 12.8% of preoperative weight(61.0+/-7.9 vs. 53.5+/-6.7kg, preoperatively vs. at the time of study). This may suggest that continuous nutritional care is necessary after total gastrectomy to promote sufficient calorie intake, keeping good nutritional state. There were no significant differences between the methods of reconstruction and dietary intakes or nutritional status. Endoscopic esophagitis was more frequently found in patients of loop esophagojejunostomy than any other reconstruction methods(p<0.001), but it didn't show any effect on the dietary intakes.
Esophagitis ; Esophagitis, Peptic ; Gastrectomy* ; Humans ; Malnutrition ; Nutritional Status* ; Stomach Neoplasms* ; Weight Loss

BACKGROUND/AIMS: Epidermal growth factors (EGF) is known to activate mitogen activated protein kinase (MAP kinase) in hepatocytes by the route of both Raf-dependent and Raf-indefendent pathways. And this is likely to play important role in normal liver cell growth and regeneration. EGF is also reported as a potent mitogen and one of the angiogenic factors. To elucidate the dynamic changes of the serum concentration of epidermal growth factor in chronic liver disease and its correlation with role of EGF and mechanism of tumor development, this study is intended to employ an ELISA in 38 biopsy-proven cases. METHODS: Sera taken out of 5 patients with chronic persistent hepatitis. 4 patients with chronic active hepatitis, 19 patients with liver cirrhosis, 10 patients with hepato-cellular carcinoma that pathological diagnosis was proven later were tested for EGF employing Quantikine ELISA Kits (R & D Systems Inc. Minneapolis, MN). The statistical analysis was evaluated by student's t-test. RESULTS: EGF concentration was 253.33+ 69.5pg/ml(Mean+ SE) in hepatocellular carcinoma, 246.60+ 91.19pg/ml(Mean+ SE) in chronic active hepatitis, 222.71+ 115.97pg/ml (Mean+ SE) in chronic persistent hepatitis, 141.15+ 23.12pg/ml(Mean+ SE) in liver cirrhosis in orders. Serum EGF concentration in hepatocellular carcinoma was significantly higher than that in liver cirrhosis(p value=0.021695). However, comparing to the remaining other groups, no significant difference was found. CONCLUSION: These results support that the reconstruction of the capillary networks in liver cirrhosis resplts in down-regulation of the EGF in comparison to chronic hepatitis. But it is suggested that revaluation of EGF stimulates MAP kinase activity eventually playing in tumorigenesis of the liver with neoangiogenesis.
Angiogenesis Inducing Agents ; Capillaries ; Carcinogenesis ; Carcinoma, Hepatocellular* ; Diagnosis ; Down-Regulation ; Enzyme-Linked Immunosorbent Assay ; Epidermal Growth Factor* ; Fibrosis* ; Hepatitis, Chronic* ; Hepatocytes ; Humans ; Liver ; Liver Cirrhosis ; Liver Diseases ; Liver Regeneration ; Phosphotransferases ; Protein Kinases ; Regeneration

No abstract available.
Cervical Ripening* ; Cervix Uteri* ; Dinoprostone* ; Female ; Misoprostol* ; Pregnancy ; Pregnancy*

This study was performed to evaluate the effect of cyclic precalcification treatment on the improvement of bioactivity of Ti-6Al-4V mini-screws. The cutted plate-shaped specimens of 10 mm × 10 mm dimensions, and a mini-screw with a diameter of 1.6 mm × 6.0 mm in length were used. Anodic oxidation treatment was carried out in a glycerol electrolyte solution containing 20 wt% H2O and 1.5 wt% NH 4F. Voltage of 20 V with current density of 20 mA/cm2 was applied for 1 hour to form a nanotube TiO2 layer. Afterwards, to improve the bioactivity, specimens were immersed in 0.5 vol% silica aqueous solution at 37 ℃ for 5 minutes, and then cyclic precalcification treatment with 0.05 M NH 4H2PO4and 0.01 M Ca(OH)2 solution at 90 ℃ was repeated with 20 times. Based on surface treatment the experimental groups were divided into three groups, namely untreated group (UT), anodized and heat-treated group (AH), and anodized, silica-treated, cyclic precalcified and heat-treated group (ASPH). There were TiO2 nanotubes completely self-aligned and formed in a dense structure on the surface after anodic oxidation treatment. A fine granular cluster layer of hydroxyapatite and octacalcium phosphate were formed on the surface after the cyclic precalcification treatment. As a result of immersion test in the simulated body fluid (SBF), bioactivity was confirmed to be improved by the precipitation of protrusions appearing at the initial stage of formation of hydroxyapatite.

Since the introduction of an alkylator to the treatment of multiple myeloma (MM), new effective agents have been developed, such as immunomodulatory drugs including thalidomide, lenalidomide, and pomalidomide; proteasome inhibitors including bortezomib, carfilzomib, and ixazomib; monoclonal antibodies including daratumumab and elotuzumab; and deacetylase inhibitors including panobinostat. Numerous regimens with these new agents have been developed and they have contributed in improving survival outcomes in MM patients. In addition, the recommended therapies for newly diagnosed MM change every year based on the results of clinical trials. This review will discusses the appropriate induction therapies based on recent clinical trials for patients with newly diagnosed MM.

Clinical presentations associated with acute human immunodeficiency virus (HIV) infection are various and nonspecific. Neurologic manifestations may accompany acute HIV infection. Aseptic meningitis has been described in several reports; however, acute encephalitis during acute HIV infection is rare. Some studies have suggested that antiretroviral therapy for treatment of symptomatic acute HIV infection could be beneficial, especially in severe cases. Encephalitis is life-threatening; therefore, early diagnosis and antiretroviral therapy may be needed. We report on a case of encephalitis associated with acute HIV infection. The patient received early antiretroviral therapy and recovered from encephalitis without neurological sequelae.
Early Diagnosis ; Encephalitis ; HIV ; HIV Infections ; Humans ; Meningitis, Aseptic ; Neurologic Manifestations

The effect of acupuncture in the treatment of young pigs with induced enteropathogenic Escherichia coli diarrhea was histopathologically evaluated by routine hematoxylin and eosin stain. Thirty two pigs weighed 4-5kg and aged 21days old were used in this study. The animals with diarrhea were treated with traditional acupuncture, or enrofloxacin. In the group treated with traditional acupuncture, acupoint GV1 (Jiaochao) was used and in the group treated with antibiotics, enrofloxacin was injected intramuscularly. Ten pigs were inoculated with E. coli, but were not treated and served as nontreated control group. At postinoculation day 6, all pigs of the acupuncture and antibiotic treated groups recovered from diarrhea. In the ascending and descending colons of the nontreated control group, severe infiltration of inflammatory cells in the lamina propria was observed and in the fundic stomach, destruction of the fundic gland architecture and necrotic lesions were observed, however, in the same sites of the acupuncture and antibiotics treated groups, the mucosae of the colon and stomach were relatively similar to those of the normal group. These results indicate that acupuncture treatment is effective in controlling induced E. coli diarrhea in pigs at its early stage.
Acupuncture ; Animals ; Colon/cytology/microbiology/pathology ; Diarrhea/therapy/*veterinary ; Escherichia coli Infections/therapy/*veterinary ; Gastric Mucosa/cytology/microbiology/pathology ; Intestinal Mucosa/cytology/microbiology/pathology ; Male ; Stomach/cytology/microbiology/pathology ; Swine ; Swine Diseases/*microbiology/therapy

BACKGROUND: FcRgamma-deficient natural killer (NK) cells (g-NK cells) have been associated with cytomegalovirus (CMV) infection. However, the frequency of g-NK cells in a CMV-endemic area (i.e., Korea) has not yet been studied. We examined the frequency of g-NK cells and expression of CD57 on NK cells in cord blood (CB) and adult blood (AB). METHODS: Of the 24 AB samples collected, 95.8% (23/24) were CMV IgG+/IgM-, while 100% of the 13 healthy CB samples were CMV IgG+/IgM-. We performed whole-blood flow cytometry assays to analyze intracellular FcRgamma and CD3zeta expression of CD3-/CD56dim NK cells from 13 CB and 24 AB samples, and surface CD57 expression on CD3-/CD56dim/CD16+ NK cells from 13 CB and 19 AB samples. RESULTS: All CMV seropositive AB samples contained g-NK cells (23/23), and the median proportion of g-NK cells in the CD3-/CD56dim NK cell pool was 35.0% (range: 11-77%). CD57+ NK cells in the CD3-/CD56dim/CD16+ NK cell population were detected in all 19 AB samples tested, but not in any CB samples. CONCLUSIONS: Our data suggest that g-NK cells and CD57+ NK cells are present at a very high frequency in CMV-seropositive AB, but rare in CMV-naive CB.
Adult* ; Cytomegalovirus ; Fetal Blood* ; Flow Cytometry ; Humans ; Killer Cells, Natural*