Candida granuloma is a variant of chronic mucocutaneous candidasis associated with chronic infection mainly by Candida albicans in which the skin lesions are rather granulomatous and hyperkeratotic. To date a variety of defects of cell mediated immunity have been shown to be important. We describe a 2-year-old boy with cutaneous candida granuloma and immunologic dysfunction.
Candida albicans ; Candida* ; Child, Preschool ; Granuloma* ; Humans ; Immunity, Cellular ; Male ; Skin

The epidermal cell-derived thymocyte activating factor (ETAF) produced by keratinocytes and endowed with IL-1 like activities, can potentiate or stimulate a variety of immune reactionsl. In addition to stimulating thymocyte proliferation, it enhanced IL-2 production by mitogen-stimulated lymphocytes. In this study, IL-2 activity stimulated by ETAF was investigated by using peripheral lymphocytes (PBL)and LBRM33 1A5 cell lines. The expression of HLA-DR antigen and the effect of r-IFN-gamma on IL-1 production by keratinocytes were also evaluated : 1. The HLA-DR positive cultured keratinocytes were obser ved in interferon (IFN), interferon-phorbol myristic acid (IFN-PMA) and interferon-lipopolysaccharide (IFN-LPS) groups. There was no HLA-DR expression in the control. PMA. and LPS group. 2. Il-1alpha from supernatants of cultured keratinocytes were produced by all groups including control group. The amounts of IL-1alpha produced by IFN, IFN-PMA and IFN-LPS groups were higher than the other groups. 3. There were no statistical differences between total IL-1alpha from cultured keratinocytes and control or other experimental groups. 4. In experiment for positivie control, the anrounts of IL-2 production by PBL and LBRM33 1A5 cell line were increased proportional to the concentration of added rIL-1. But there was no difference between groups above 1.0 U/ml and 0.5 fmol in LBRM33 1A5 cell line. 5. the production of IL-2 by PBL were increased by phytohemagglutinin (PHA), PHAPMA and PHA-LPS groups. There were no production of IL-2 in control, IFN, LPS, only LPS added group, and IL-1alpha. The IL-2 induced by PHA-PMA group was much higher than the other groups. The production of IL-2 was stimulated by IL-1 of supernatarnts and cell lysates from the cultured keratinocytes, but here was no correlation between IL-2 production and added IL-1. 6. The production of IL-2 by LBRM33 IA5 were increased by PHA, PHA-PMA and PHA-LPS groups. There were no production of IL-2 in the other groups. In summary, the results suggest that supernatants and cell lysates from cultured keratinocytes can stimulate the IL-2 production by human PBL and LBRM33 1A5 cell line. Therefore the ETAF can potentiate or stimulate the immune reactions and enhance IL-2 production by mitogen-stimulated lymphocytes.
Cell Line ; HLA-DR Antigens ; Humans ; Interferons ; Interleukin-1* ; Interleukin-2* ; Keratinocytes* ; Lymphocytes* ; Myristic Acid ; Thymocytes

Purpose: This study evaluated real-world compliance with surgical treatment according to Korea's gastric cancer treatment guidelines. Materials and Methods: The 2018 Korean Gastric Cancer Treatment Guidelines were evaluated using the 2019 national survey data for surgically treated gastric cancer based on postoperative pathological results in Korea. In addition, the changes in surgical treatments in 2019 were compared with those in the 2014 national survey data implemented before the publication of the guidelines in 2018. The compliance rate was evaluated according to the algorithm recommended in the 2018 Korean guidelines. Results: The overall compliance rates in 2019 were 83% for gastric resection extent, 87% for lymph node dissection, 100% for surgical approach, and 83% for adjuvant chemotherapy, similar to 2014. Among patients with pathologic stages IB, II, and III disease who underwent total gastrectomy, the incidence of splenectomy was 8.08%, a practice not recommended by the guidelines. The survey findings revealed that 48.66% of the patients who underwent gastrectomy had pathological stage IV disease, which was not recommended by the 2019 guidelines. Compared to that in 2014, the rate of gastrectomy in stage IV patients was 54.53% in 2014. Compliance rates were similar across all regions of Korea, except for gastrectomy in patients with stage IV disease. Conclusions Real-world compliance with gastric cancer treatment guidelines was relatively high in Korea.

Purpose: Completion total gastrectomy (CTG) for remnant gastric cancer (RGC) is a technically demanding procedure and associated with increased morbidity. The present study aimed to evaluate postoperative complications and their risk factors following surgery for RGC after initial partial gastrectomy due to gastric cancer excluding peptic ulcer. Materials and Methods: We retrospectively reviewed the data of 107 patients who had previously undergone an initial gastric cancer surgery and subsequently underwent CTG for RGC between March 2002 and December 2020. The postoperative complications were graded using the Clavien-Dindo classification. Logistic regression analyses were used to determine the risk factors for complications. Results: Postoperative complications occurred in 34.6% (37/107) of the patients. Intraabdominal abscess was the most common complication. The significant risk factors for overall complications were multi-visceral resections, longer operation time, and high estimated blood loss in the univariate analysis. The independent risk factors were multivisceral resection (odds ratio [OR], 2.832; 95% confidence interval [CI], 1.094–7.333;P=0.032) and longer operation time (OR, 1.005; 95% CI, 1.001–1.011; P=0.036) in the multivariate analysis. Previous reconstruction type, minimally invasive approach, and current stage were not associated with the overall complications. Conclusions Multi-visceral resection and long operation time were significant risk factors for the occurrence of complications following CTG rather than the RGC stage or surgical approach. When multi-visceral resection is required, a more meticulous surgical procedure is warranted to improve the postoperative complications during CTG for RGC after an initial gastric cancer surgery.

BACKGROUND: Cardiac patients undergoing open heart surgery usually require ventilatory support that involves ICU admission in the postoperative period. We tried to find out determinants of postoperative ventilatory support time. METHODS: We reviewed the medical records of 56 open heart surgery patients retrospectively in terms of their disease, preoperative physical status, age, post-bypass arterial oxygen tension/inspired oxygen fraction (PaO2/FIO2) ratio, number of inotropics used and searched the relationship between each factor and postoperative intubation time. RESULTS: None of the factors except the number of inotropics used had an significant influence on the postoperative intubation time. CONCLUSION: In open heart surgical patients their disease, preoperative physical status, age, postbypass PaO2/FIO2 ratio do not affect postoperative intubation time rather than number of inotropics used does.
Heart* ; Humans ; Intubation* ; Medical Records ; Oxygen ; Postoperative Period ; Retrospective Studies ; Thoracic Surgery*

Patients with chronic renal failure, generally, sufferred from normocytic normochromic anemia caused by decreased level of erythropoietin. But, secondary erythrocytosis has been reported in patients with several renal diseases; renal artery stenosis or throm- bosis, polycystic kidney disease, bilateral hydronephrosis, etc. We report one case of chronic renal failure combined with polycythemia vera. The case was 32 year-old man whose chief complaints were dyspnea, back pain, itching sensation, headache. 6 month ago, the laboratory examination showed only proteinuria and hematuria without deterioration of renal function. The renal function was aggravated with an accelerated course, and bone marrow examination revealed hypercellularity (erythroid predominance), and renal biopsy showed the finding of the end stage of renal disease which may be originated from IgA nephropathy.
Adult ; Anemia ; Back Pain ; Biopsy ; Bone Marrow Examination ; Dyspnea ; Erythropoietin ; Glomerulonephritis, IGA* ; Headache ; Hematuria ; Humans ; Hydronephrosis ; Immunoglobulin A* ; Kidney Failure, Chronic* ; Polycystic Kidney Diseases ; Polycythemia Vera* ; Polycythemia* ; Proteinuria ; Pruritus ; Renal Artery Obstruction ; Sensation

The transplantation of mesenchymal stem cells (MSCs) represents a potentially effective therapy for chronic liver diseases. The potential of MSCs in the treatment of chronic liver disease is based on their ability to differentiate into multiple cell types including hepatocytes, their immunosuppressive properties, and their ability to secrete various trophic factors. This potential has been investigated in clinical and pre-clinical studies. Although the therapeutic mechanisms of MSC transplantation are still not fully characterized, accumulating evidence has revealed that various trophic factors secreted by MSCs play key therapeutic roles in regeneration. These trophic factors not only reduce inflammation, apoptosis, and fibrosis in damaged tissues but also stimulate angiogenesis and tissue regeneration in the impaired liver. In this review, we summarize the basic and therapeutic properties of MSCs, their therapeutic mechanisms of action, and potential transplantation routes for the treatment of chronic liver disease. We also discuss several risks associated with the use of MSCs in therapy, such as their fibrogenic potential and capacity to promote pre-existing tumor cell growth.
Adult Stem Cells* ; Adult* ; Apoptosis ; Cell Transplantation ; End Stage Liver Disease ; Fibrosis ; Hepatocytes ; Humans ; Inflammation ; Liver Diseases* ; Liver Regeneration ; Liver* ; Mesenchymal Stromal Cells ; Regeneration

Currently, the most effective treatment for end-stage liver fibrosis is liver transplantation; however, transplantation is limited by a shortage of donor organs, surgical complications, immunological rejection, and high medical costs. Recently, mesenchymal stem cell (MSC) therapy has been suggested as an effective alternate approach for the treatment of hepatic diseases. MSCs have the potential to differentiate into hepatocytes, and therapeutic value exists in their immune-modulatory properties and secretion of trophic factors, such as growth factors and cytokines. In addition, MSCs can suppress inflammatory responses, reduce hepatocyte apoptosis, increase hepatocyte regeneration, regress liver fibrosis and enhance liver functionality. Despite these advantages, issues remain; MSCs also have fibrogenic potential and the capacity to promote tumor cell growth and oncogenicity. This paper summarizes the properties of MSCs for regenerative medicine and their therapeutic mechanisms and clinical application in the treatment of liver fibrosis. We also present several outstanding risks, including their fibrogenic potential and their capacity to promote pre-existing tumor cell growth and oncogenicity.
Animals ; Cell Differentiation ; Cell Proliferation ; Hepatocytes/immunology/metabolism/pathology/*transplantation ; Humans ; Liver/immunology/metabolism/pathology/physiopathology/*surgery ; Liver Cirrhosis/diagnosis/immunology/metabolism/physiopathology/*surgery ; Liver Regeneration ; *Mesenchymal Stem Cell Transplantation/adverse effects ; *Mesenchymal Stromal Cells/immunology/metabolism/pathology ; Phenotype ; Regenerative Medicine/*methods ; Risk Factors ; Signal Transduction ; Treatment Outcome

BACKGROUND: Infections are usually related to the surgical patients prognosis. Therefore consultations from surgical departments to division of infectious diseases are considered very important in the aspect of improvement of surgical outcomes and control of hospital infection. This study was conducted to analyze the results of infectious disease consultation from surgical departments. MATERIALS AND METHODS: We retrospectively reviewed 624 cases of consultation to division of infectious diseases from surgical departments from March to August in the year of 2002. RESULTS: Among 624 cases, 610 were included; 292 cases (47.9%) were new and 318 cases (52.1%) were follow-up requests. More than 50% of consultations were from the department of neurosurgery and orthopedics. Overall, 558 cases (91.4%) were about infection-related conditions, and among them, common causes were soft tissue infection, respiratory tract infection, and urinary tract infection. However, those results were remarkably variable according to each surgical department. The measures taken after consultations were change of antibiotics (35.6%), maintenance of antibiotics (18.4%), discontinuance of antibiotics (10%), start of antibiotics (9.2%), and observation without antibiotics (4.3%). CONCLUSION: This is the report on analysis of infectious disease consultation from surgical departments. Through the analysis of consultations we expect to enable more efficient care of patients and infection control.
Anti-Bacterial Agents ; Communicable Diseases* ; Cross Infection ; Follow-Up Studies ; Humans ; Infection Control ; Neurosurgery ; Orthopedics ; Prognosis ; Referral and Consultation* ; Respiratory Tract Infections ; Retrospective Studies ; Soft Tissue Infections ; Urinary Tract Infections

BACKGROUND: Infections are usually related to the surgical patients prognosis. Therefore consultations from surgical departments to division of infectious diseases are considered very important in the aspect of improvement of surgical outcomes and control of hospital infection. This study was conducted to analyze the results of infectious disease consultation from surgical departments. MATERIALS AND METHODS: We retrospectively reviewed 624 cases of consultation to division of infectious diseases from surgical departments from March to August in the year of 2002. RESULTS: Among 624 cases, 610 were included; 292 cases (47.9%) were new and 318 cases (52.1%) were follow-up requests. More than 50% of consultations were from the department of neurosurgery and orthopedics. Overall, 558 cases (91.4%) were about infection-related conditions, and among them, common causes were soft tissue infection, respiratory tract infection, and urinary tract infection. However, those results were remarkably variable according to each surgical department. The measures taken after consultations were change of antibiotics (35.6%), maintenance of antibiotics (18.4%), discontinuance of antibiotics (10%), start of antibiotics (9.2%), and observation without antibiotics (4.3%). CONCLUSION: This is the report on analysis of infectious disease consultation from surgical departments. Through the analysis of consultations we expect to enable more efficient care of patients and infection control.
Anti-Bacterial Agents ; Communicable Diseases* ; Cross Infection ; Follow-Up Studies ; Humans ; Infection Control ; Neurosurgery ; Orthopedics ; Prognosis ; Referral and Consultation* ; Respiratory Tract Infections ; Retrospective Studies ; Soft Tissue Infections ; Urinary Tract Infections