Chemokine (C-X3-C motif) ligand 1 (CX₃CL1, also known as fractalkine) and its receptor chemokine (C-X3-C motif) receptor 1 (CX₃CR1) are widely expressed in immune cells and non-immune cells throughout organisms. However, their expression is mostly cell type-specific in each tissue. CX₃CR1 expression can be found in monocytes, macrophages, dendritic cells, T cells, and natural killer (NK) cells. Interaction between CX3CL1 and CX₃CL1 can mediate chemotaxis of immune cells according to concentration gradient of ligands. CX₃CL1 expressing immune cells have a main role in either pro-inflammatory or anti-inflammatory response depending on environmental condition. In a given tissue such as bone marrow, brain, lung, liver, gut, and cancer, CX₃CL1 expressing cells can maintain tissue homeostasis. Under pathologic conditions, however, CX₃CL1 expressing cells can play a critical role in disease pathogenesis. Here, we discuss recent progresses of CX3CL1/CX₃CL1 in major tissues and their relationships with human diseases.
Bone Marrow ; Brain ; Chemokine CX3CL1 ; Chemotaxis ; Dendritic Cells ; Homeostasis ; Humans ; Ligands ; Liver ; Lung ; Macrophages ; Monocytes ; Organ Specificity ; T-Lymphocytes

Carbon monoxide poisoning is common cause of fatal intoxication. When carbon monoxide is absorbed into the blood, it interferes with the oxygen supply to the cells, causing damage to tissues and organs. Delayed neuropsychiatric sequelae (DNS) manifested by cognitive dysfunction, motor disorder, micturition disorder are widely known complication of carbon monoxide intoxication. But neuromuscular complication is a rare DNS of carbon monoxide intoxication. We herein report a 42-year-old patient with multifocal neuropathies, rhabdomyolysis, and dermal change due to carbon monoxide intoxication.

We recently encountered an interesting case of acute inferior ST segment elevation myocardial infarction (STEMI). This patient had a rare anatomic variation, single coronary artery. The right coronary artery originate from the left circumflex proper artery, not from aorta, was totally obstructed with thrombi. Though it took more time to figure out the patient's coronary anatomy and the culprit lesion, we successfully performed primary percutaneous coronary intervention within the guideline-recommended time period. We performed left coronary angiography at the beginning. This strategy could be helpful in determining the culprit lesion and preventing unnecessary procedural delay in acute inferior STEMI.
Anatomic Variation ; Aorta ; Arteries ; Coronary Angiography ; Coronary Vessel Anomalies ; Coronary Vessels* ; Humans ; Myocardial Infarction* ; Percutaneous Coronary Intervention

Choledochoscopic lithotomy with the aid of electrohydraulic lithotripsy ( EHL ) was performed in 12 patients at the Department of Surgery, College of Medicine, the Catholic University of Korea, St. Vincent Hospital between January 1996 and March 1998. This retrospective analysis include 4 patients with common bile duct (CBD) stones, 5 patients with intrahepatic duct (IHD) stones, and 3 patients with CBD & IHD stones. The male to female ratio was 1 to 2. The peak incidence of age was the fifty. As a route for the choledochoscopy, a T-tube tract was used in 9 patients, while percutaneous biliary drainage followed by dilatation of the tract was established in 3 patients. The largest stones measured 22mm (by 5mm), the average is 10.3mm. Average number of session which performed for IHD stones was 3.7, while that of CBD stones was 2.7. Complete removal of the stones was achieved in 7 of 12 patients. Retained stones of CBD were removed completely in all cases. We could not removed retained stones completely in cases of multiple, impacted stones in peripheral ducts, associated stricture and acute angulation of IHD & CHD which choledochoscopic manipulation make difficult. Minor complications were bleeding from the bile duct mucosa in 1 patient and postprocedure chills and fever in 1 patient. In conclusion, choledochoscopic lithotomy with electrohydraulic lithotripsy is efficient and will be useful to remove biliary calculi in patients who have poor surgical risks.
Bile Ducts* ; Bile* ; Chills ; Common Bile Duct ; Constriction, Pathologic ; Dilatation ; Drainage ; Female ; Fever ; Gallstones ; Hemorrhage ; Humans ; Incidence ; Korea ; Lithotripsy* ; Male ; Mucous Membrane ; Retrospective Studies

Purpose: Periprosthetic fractures of a tumor prosthesis are rare but have difficulties in achieving sound fixation because of the poor bone quality, which increases the risk of loosening or re-fracture, even after bone union. A cortical strut onlay allograft was adopted for peri-prosthetic fractures after hip arthroplasty into the periprosthetic fracture of a tumor prosthesis, assuming that it would assist in firm fixation, shorten the time to union, and increase the bone stock, thereby, lower the chance of loosening and re-fracture. Materials and Methods: This study reviewed 27 patients (30 cases) of periprosthetic fracture of tumor prosthesis. Sixteen cases (allograft group) had augmentation with an onlay allograft, while 14 cases (conventional group) had internal fixation or conservative treatment.The following were assessed; mode of periprosthetic fracture, difference in the time to union between a strut cortical onlay allograft and without it, and survival of prosthesis, complication, and functional outcome between the two groups. Results: According to the unified classification system (UCS), 21 cases were type B (70.0%; B1, 14; B2, 1; B3, 6) and 9 cases were type C.The five-, 10-year survival of the 30 reconstructions by Kaplan–Meier plot was 84.5%±4.18% and 42.2%±7.83%, respectively. The average time to bone union of the entire cohort was 5.1 months (range, 2.0–11.2 months). The allograft group (3.5 months) showed a shorter period for union than the conventional group (7.2 months) (p<0.0001). All four cases of major complications occurred in the conventional group. Two cases with loosening and anterior angulation were treated with a change of prosthesis, and another with infection underwent amputation. The remaining case with loosening had conservative management. At the final follow-up, the average Musculosketal Tumor Society score of the allograft group (26.1) was better than that of the conventional group (20.9). Conclusion Bone union in periprosthetic fractures of a tumor prosthesis can be achieved, but the minimization of complications is important. An onlay allograft facilitates firm fixation and increases the bone stock with a shortened time to union. This simple method can minimize the risk of loosening, joint contracture, and re-fracture.

Epigenetic alterations are common features of human solid tumors, though global DNA methylation has been difficult to assess. Restriction Landmark Genomic Scanning (RLGS) is one of technology to examine epigenetic alterations at several thousand Notl sites of promoter regions in tumor genome. To assess sequence information for Notl sequences in RLGS gel, we cloned 1,161 unique Notl-linked clones, compromising about 60% of the spots in the soluble region of RLGS profile, and performed BLAT searches on the UCSC genome server, May 2004 Freeze. 1,023 (88%) unique sequences were matched to the CpG islands of human genome showing a large bias of RLGS toward identifying potential genes or CpG islands. The cloned Notl-loci had a high frequency (71%) of occurrence within CpG islands near the 5' ends of known genes rather than within CpG islands near the 3' ends or intragenic regions, making RLGS a potent tool for the identification of gene-associated methylation events. By mixing RLGS gels with all Notl-linked clones, we addressed 151 Notl sequences onto a standard RLGS gel and compared them with previous reports from several types of tumors. We hope our sequence information will be useful to identify novel epigenetic targets in any types of tumor genome.
Bias (Epidemiology) ; Clone Cells* ; Cloning, Organism* ; CpG Islands ; DNA Methylation ; DNA* ; Epigenomics ; Gels ; Genome ; Genome, Human* ; Hope ; Humans ; Humans* ; Methylation ; Promoter Regions, Genetic

The left main coronary artery branches to form the left anterior descending and left circumflex arteries and supplies the entire myocardium of the left ventricle. Treatment guidelines recommend coronary artery bypass grafting in left main coronary artery disease. However, some recent studies have demonstrated that, although the target vessel revascularization rate is relatively high, percutaneous coronary intervention (PCI) has a comparable mortality rate to coronary artery bypass grafting in left main disease. In this case, an 80-year-old male with a recent ST elevation myocardial infarction of the right coronary artery (RCA) was transferred to our hospital for second-stage PCI for left main artery stenosis, which was found incidentally at the time of primary PCI of the RCA. Although he had severely depressed left ventricular function, a drug-eluting stent was implanted successfully in his left main coronary artery with percutaneous cardiopulmonary support.
Aged, 80 and over ; Angioplasty, Balloon, Coronary ; Arteries ; Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Vessels ; Drug-Eluting Stents ; Equipment and Supplies ; Extracorporeal Circulation ; Glycosaminoglycans ; Heart Ventricles ; Humans ; Infarction ; Male ; Myocardial Infarction ; Myocardium ; Percutaneous Coronary Intervention ; Stents ; Ventricular Function, Left

High-throughput genomic technologies (HGTs), including next-generation DNA sequencing (NGS), microarray, and serial analysis of gene expression (SAGE), have become effective experimental tools for cancer genomics to identify cancer-associated somatic genomic alterations and genes. The main hurdle in cancer genomics is to identify the real causative mutations or genes out of many candidates from an HGT-based cancer genomic analysis. One useful approach is to refer to known cancer genes and associated information. The list of known cancer genes can be used to determine candidates of cancer driver mutations, while cancer gene-related information, including gene expression, protein-protein interaction, and pathways, can be useful for scoring novel candidates. Some cancer gene or mutation databases exist for this purpose, but few specialized tools exist for an automated analysis of a long gene list from an HGT-based cancer genomic analysis. This report presents a new web-accessible bioinformatic tool, called CaGe, a cancer genome annotation system for the assessment of candidates of cancer genes from HGT-based cancer genomics. The tool provides users with information on cancer-related genes, mutations, pathways, and associated annotations through annotation and browsing functions. With this tool, researchers can classify their candidate genes from cancer genome studies into either previously reported or novel categories of cancer genes and gain insight into underlying carcinogenic mechanisms through a pathway analysis. We show the usefulness of CaGe by assessing its performance in annotating somatic mutations from a published small cell lung cancer study.
Gene Expression ; Genes, Neoplasm ; Genome ; Genomics ; Sequence Analysis, DNA ; Small Cell Lung Carcinoma

PURPOSE: To evaluate predictors of severe or moderate coronary artery disease (CAD) in individuals with zero or very low (<10) coronary artery calcium (CAC) scores. MATERIALS AND METHODS: The 1175 asymptomatic persons with zero or very low (<10) CAC scores were analyzed for CAD stenosis using coronary computed tomography angiography. Moderate and severe CADs were defined as having more than 50% and more than 70% stenosis in any of the major coronary arteries, respectively. Age, gender, body mass index, hypertension, type II diabetes, dyslipidemia, lipid profile, creatinine, and smoking status were evaluated as predictors for moderate and severe CAD. RESULTS: In the study population, moderate and severe CADs were found in 7.5% and 3.3%, respectively. Among evaluated risk factors, age [odds ratio (OR) 1.04, 95% confidence interval (CI) 1.02−1.07, p<0.001], current smoking status (OR 3.12, 95% CI 1.82−5.34, p<0.001), and CAC 1−9 (OR 1.80, 95% CI 1.08−3.00, p=0.024) were significantly associated with moderate CAD. Meanwhile, age (OR 1.05, 95% CI 1.02−1.08, p=0.003), low high density lipoprotein (HDL) (OR 0.96, 95% CI 0.93−0.99, p=0.003), and current smoking status (OR 2.34, 95% CI 1.14−5.30, p=0.022) were found to be significantly associated with severe CAD. Improvement of discrimination power for predicting severe CAD was observed when smoking and HDL cholesterol were serially added into the age model. CONCLUSION: Smoking showed significant correlations with moderate or severe CAD, and low HDL cholesterol also proved to be a predictor of severe CAD in asymptomatic individuals with extremely low CAC scores.
Angiography ; Asymptomatic Diseases ; Body Mass Index ; Calcium ; Cholesterol, HDL ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Vessels ; Creatinine ; Discrimination (Psychology) ; Dyslipidemias ; Humans ; Hypertension ; Lipoproteins ; Risk Factors ; Smoke ; Smoking

BACKGROUND AND OBJECTIVES: The relationship between operator volume and outcomes of percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI) has not been fully investigated. We aimed to investigate the relationship between operator PCI volume and in-hospital outcomes after primary PCI for STEMI. METHODS: Among the total of 44,967 consecutive cases of PCI enrolled in the Korean nationwide, retrospective registry (K-PCI registry), 8,282 patients treated with PCI for STEMI by 373 operators were analyzed. PCI volumes above the 75th percentile (>30 cases/year), between the 75th and 25th percentile (10–30 cases/year), and below the 25th percentile (<10 cases/year) were defined as high, moderate, and low-volume operators, respectively. In-hospital outcomes including mortality, non-fatal myocardial infarction (MI), stent thrombosis, stroke, and urgent repeat PCI were analyzed. RESULTS: The average number of primary PCI cases performed by 373 operators was 22.2 in a year. In-hospital mortality after PCI for STEMI was 571 cases (6.9%). In-hospital outcomes by operator volume showed no significant differences in the death rate, cardiac death, non-fatal MI, and stent thrombosis. However, the rate of urgent repeat PCI tended to be lower in the high-volume operator (0.6%) than in the moderate-(0.7%)/low-(1.5%) volume operator groups (p=0.095). The adjusted odds ratios for adverse in-hospital outcomes were similar in the 3 groups. Multivariate analysis also showed that operator volume was not a predictor for adverse in-hospital outcomes. CONCLUSIONS In-hospital outcomes after primary PCI for STEMI were not associated with operator volume in the K-PCI registry.