The common data model (CDM) has found widespread application in healthcare studies, but its utilization in cancer research has been limited. This article describes the development and implementation strategy for Cancer Clinical Library Databases (CCLDs), which are standardized cancer-specific databases established under the Korea-Clinical Data Utilization Network for Research Excellence (K-CURE) project by the Korean Ministry of Health and Welfare. Fifteen leading hospitals and fourteen academic associations in Korea are engaged in constructing CCLDs for 10 primary cancer types. For each cancer type-specific CCLD, cancer data experts determine key clinical data items essential for cancer research, standardize these items across cancer types, and create a standardized schema. Comprehensive clinical records covering diagnosis, treatment, and outcomes, with annual updates, are collected for each cancer patient in the target population, and quality control is based on six-sigma standards. To protect patient privacy, CCLDs follow stringent data security guidelines by pseudonymizing personal identification information and operating within a closed analysis environment. Researchers can apply for access to CCLD data through the K-CURE portal, which is subject to Institutional Review Board and Data Review Board approval. The CCLD is considered a pioneering standardized cancer-specific database, significantly representing Korea’s cancer data. It is expected to overcome limitations of previous CDMs and provide a valuable resource for multicenter cancer research in Korea.

The common data model (CDM) has found widespread application in healthcare studies, but its utilization in cancer research has been limited. This article describes the development and implementation strategy for Cancer Clinical Library Databases (CCLDs), which are standardized cancer-specific databases established under the Korea-Clinical Data Utilization Network for Research Excellence (K-CURE) project by the Korean Ministry of Health and Welfare. Fifteen leading hospitals and fourteen academic associations in Korea are engaged in constructing CCLDs for 10 primary cancer types. For each cancer type-specific CCLD, cancer data experts determine key clinical data items essential for cancer research, standardize these items across cancer types, and create a standardized schema. Comprehensive clinical records covering diagnosis, treatment, and outcomes, with annual updates, are collected for each cancer patient in the target population, and quality control is based on six-sigma standards. To protect patient privacy, CCLDs follow stringent data security guidelines by pseudonymizing personal identification information and operating within a closed analysis environment. Researchers can apply for access to CCLD data through the K-CURE portal, which is subject to Institutional Review Board and Data Review Board approval. The CCLD is considered a pioneering standardized cancer-specific database, significantly representing Korea’s cancer data. It is expected to overcome limitations of previous CDMs and provide a valuable resource for multicenter cancer research in Korea.

The common data model (CDM) has found widespread application in healthcare studies, but its utilization in cancer research has been limited. This article describes the development and implementation strategy for Cancer Clinical Library Databases (CCLDs), which are standardized cancer-specific databases established under the Korea-Clinical Data Utilization Network for Research Excellence (K-CURE) project by the Korean Ministry of Health and Welfare. Fifteen leading hospitals and fourteen academic associations in Korea are engaged in constructing CCLDs for 10 primary cancer types. For each cancer type-specific CCLD, cancer data experts determine key clinical data items essential for cancer research, standardize these items across cancer types, and create a standardized schema. Comprehensive clinical records covering diagnosis, treatment, and outcomes, with annual updates, are collected for each cancer patient in the target population, and quality control is based on six-sigma standards. To protect patient privacy, CCLDs follow stringent data security guidelines by pseudonymizing personal identification information and operating within a closed analysis environment. Researchers can apply for access to CCLD data through the K-CURE portal, which is subject to Institutional Review Board and Data Review Board approval. The CCLD is considered a pioneering standardized cancer-specific database, significantly representing Korea’s cancer data. It is expected to overcome limitations of previous CDMs and provide a valuable resource for multicenter cancer research in Korea.

Purpose: High-dose radiotherapy (RT) for localized prostate cancer requires careful consideration of target position changes and adjacent organs-at-risk (OARs), such as the rectum and bladder. Therefore, daily monitoring of target position and OAR changes is crucial in minimizing interfractional dosimetric uncertainties. For efficient monitoring of the internal condition of patients, we assessed the feasibility of an auto-segmentation of OARs on the daily acquired images, such as megavoltage computed tomography (MVCT), via a commercial artificial intelligence (AI)-based solution in this study. Materials and Methods: We collected MVCT images weekly during the entire course of RT for 100 prostate cancer patients treated with the helical TomoTherapy system. Based on the manually contoured body outline, the bladder including prostate area, and rectal balloon regions for the 100 MVCT images, we trained the commercially available fully convolutional (FC)-DenseNet model and tested its auto-contouring performance. Results: Based on the optimally determined hyperparameters, the FC-DenseNet model successfully auto-contoured all regions of interest showing high dice similarity coefficient (DSC) over 0.8 and a small mean surface distance (MSD) within 1.43 mm in reference to the manually contoured data. With this well-trained AI model, we have efficiently monitored the patient's internal condition through six MVCT scans, analyzing DSC, MSD, centroid, and volume differences. Conclusion We have verified the feasibility of utilizing a commercial AI-based model for auto-segmentation with low-quality daily MVCT images. In the future, we will establish a fast and accurate auto-segmentation and internal organ monitoring system for efficiently determining the time for adaptive replanning.

The germinal center reaction is a key event of humoral immunity, providing long-lived immunological memory. Follicular helper T (T(FH)) cells are a specialized subset of CD4⁺ T cells located in the follicles, which help B cells and thus control the germinal center reaction. T(FH) cell development is achieved by multi-step processes of interactions with dendritic cells and B cells along with the coordination of various transcription factors. Since the T helper cell fate decision program is determined by subtle changes in regulatory molecules, fine tuning of these dynamic interactions is crucial for the generation functional T(FH) cells. MicroRNAs (miRNAs) have emerged as important post-transcriptional regulatory molecules for gene expression, which consequently modulate diverse biological functions. In the last decade, the miRNA-mediated regulation network for the germinal center reaction has been extensively explored in T cells and B cells, resulting in the identification of several key miRNA species and their target genes. Here, we review the current knowledge of the miRNA-mediated control of the germinal center reaction, focusing on the aspect of T cell regulation in particular. In addition, we highlight the most important issues related to defining the functional target genes of the relevant miRNAs. We believe that the studies that uncover the miRNA-mediated regulatory axis of T(FH) cell generation and functions by defining their functional target genes might provide additional opportunities to understand germinal center reactions.
B-Lymphocytes ; Dendritic Cells ; Gene Expression ; Germinal Center ; Immunity, Humoral ; Immunologic Memory ; MicroRNAs ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer* ; Transcription Factors

PURPOSE: Gallstone disease has been presumed to be a sequellae of gastrectomy. To know correlation between gallbladder disease and gastrectomy, we check anatomical and functional status of gallbladder with ultrasonogram in our study. METHODS: Gallbladder motility after gastrectomy was studied by means of measuring fasting and postprandial gallbladder volume using real time ultrasonography in 50 gastrectomized patients and in 28 controls (healthy but not operated gastric cancer patients) were selected as study subjects. RESULTS: Mean fasting and postprandial gallbladder volume was significantly increased in gastrectomized patient group (FV: 37.63+/-20.70 ml, PV: 11.50+/-10.26 ml) than control group (FV: 22.17+/-10.35 ml, PV: 5.44+/-3.67 ml, p<0.01). The ejection fraction of gallbladder in gastrectomized patient group (69.05+/-14.57%)was significantly smaller than control group (75.57+/-10.26%, p<0.05). CONCLUSION: The risk of gallbladder disease was independent of age, sex, and post-operative duration in our study. Gastrectomy may have the possibility of increasing the risk of gallbladder disease by causing gallbladder dysmotility and bile stasis. So, gallbladder motility evaluation would be helpful for prevention and understanding gallstone formation. Further study will be needed about the clinical benefits of prophylactic cholecystectomy during gastrectomy.
Bile ; Cholecystectomy ; Fasting ; Gallbladder Diseases ; Gallbladder* ; Gallstones* ; Gastrectomy* ; Humans ; Stomach Neoplasms* ; Ultrasonography

In diabetic and diabetic renal failure patients on continuous ambulant peritoneal dialysis(CAPD) treatment, the peritoneal membrane and vascular beds are continuously exposed to the high glucose concentration contained in the dialysate and blood. This may lead to the local generation of advanced glycosylated end-products(AGEs), formed from nonenzymatic glycation of proteins and lipids with reducing sugars and have been implicated in many diabetic complications. AGEs is cross linked to the circulating proteins resulting in peritoneal dysfunction and vascular thickening. To elucidate the deposition of AGEs in diabetic rats(n=10) induced by streptozotocin(STZ, 75mg/kg) injection via tail vein and those of age-matched control rats(n=10), peritoneums were examined light microscopically and immunohistochemically with monoclonal antibody specific for AGEs after 5 weeks of disease. Histologically, the peritoneum of the STZ diabetic rats showed mild interstitial fibrosis and no mesothelial alteration, vascular proliferation, compared with age-matched, non-diabetic control group. Immunohistochemical staining with AGEs demonstrated that weakly accumulation in the submesothelial layer, but it was not different from comparison with control group. We speculate that the peritoneum of the STZ-induced diabetic rat did not stain with monoclonal antibody against AGEs after 5 weeks of disease, but long-term experiments may demonstrate significant functional and morphological alterations of peritoneum.
Animals ; Carbohydrates ; Diabetes Complications ; Fibrosis ; Glucose ; Humans ; Membranes ; Peritoneum* ; Rats* ; Renal Insufficiency ; Streptozocin* ; Veins

Malignant fibrous histiocytoma (MFH) is recognized as the most common soft tissue sarcoma in adult. But it is very rare in head and neck region with less than 100 cases reported in literature. Treatment of choice for MFH is surgery. For wide surgical excision, usually carotid artery resection is unavoidable. For preventing neurologic sequelae we did preoperative carotid artery balloon occlusion test with EEG monitoring. Greater saphenous vein was used for interposition graft.
Adult ; Balloon Occlusion ; Carotid Arteries* ; Electroencephalography ; Head* ; Histiocytoma, Malignant Fibrous* ; Humans ; Neck* ; Saphenous Vein ; Sarcoma ; Transplants

BACKGROUND: It is already known that the cranial pinning causes a sudden increment of blood pressure and heart rate which is harmful especially in brain surgery patient. These changes may be reduced by local infiltration at the sites of cranial pinning. This study was designed to investigate the hemodynamic effects of nerve block by cranial pinning and compare them with the effects of local infiltration at the pinning site. METHODS: Forty patients of brain surgery with cranial pinning were involved. After general anesthesia with isoflurane and 50% N2O, they were divided into 2 groups randomly: the control group (n = 20), had local infiltration at each pinning site with 1% lidocaine 2 ml, and the study group (n = 20), had nerve block of the supraorbital, and supratrochlear, and postauricular branches of the great auricular nerve with lidocaine 2 ml, the auriculotemporal nerve with lidocaine 2.5 ml, and the greater and lesser occipital nerves with lidocaine 2.5 ml. The hemodynamic variables(systolic, diastolic, mean blood pressure, and heart rate) were measured at the 3 different points just before cranial pinning, and 1 min and 5 min after cranial pinning. RESULTS: The values of hemodynamic variables at 1 min after cranial pinning increased in both groups when compared with just before cranial pinning, but there was no difference between the two groups. The increased values at 1 min were not high clinically, and returned to the levels recorded before cranial pinning by the 5 min recording time in both groups. CONCLUSION: From these results, we concluded that nerve block could also reduced the harmful hemodynamic effect of cranial pinning.
Anesthesia, General ; Blood Pressure ; Brain* ; Heart ; Heart Rate ; Hemodynamics* ; Humans ; Isoflurane ; Lidocaine ; Nerve Block*

Rhabdomyolysis is a syndrome characterized by muscle necrosis and release of intracellular muscle constituents into the circulation. Rhabdomylosis can be precipitated by different causes, such as trauma, extraordinary physical exer- tion, metabolic disorder, drugs, toxins, infection, or endocrinopathy. Salmonellosis is another rare cause of rhabdomyolysis. We report a 62-year-old male who developed severe diarrhea and vomitting, one day after boiled pork & raw octopus ingestion. The diagnosis of rhabdomyolysis was established primarily by the elevated serum CPK and myoglobin level. There were no other traumatic, metabolic, toxic, or enzymatic causes for the rhabdomyolysis. Stool cultures received at the first day of hospitalization yielded Salmonella Group C. Salmonella sp. is suggested to cause muscle damage by direct bacterial invasion as well as by decreasing the oxidative and glycolytic enzyme activity of skeletal muscles and by activating lysosomal enzymes. We wish to draw attention to these serious complication of salmonella gastroenteritis, and to institute of prompt measures for preventing the development of ATN. We report a case of acute renal failure associated with rhabdomyolysis and gastroenteritis caused by salmonella Group C with review of literatures.
Acute Kidney Injury* ; Diagnosis ; Diarrhea ; Eating ; Gastroenteritis* ; Hospitalization ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; Myoglobin ; Necrosis ; Octopodiformes ; Rhabdomyolysis* ; Salmonella Infections ; Salmonella*