Multiple myeloma (MM), a hematological malignancy, is characterized by malignant plasma cell proliferation in the bone marrow. Recent treatment advances have significantly improved patient outcomes associated with MM.In this study, we aimed to develop comprehensive, evidence-based guidelines for the diagnosis, prognosis, and treat‑ ment of MM. We identified 12 key clinical questions essential for MM management, guiding the extensive literature review and meta-analysis of the study. Our guidelines provide evidence-based recommendations by integrating patient preferences with survey data. These recommendations include current and emerging diagnostic tools, thera‑ peutic agents, and treatment strategies. By prioritizing a patient-centered approach and rigorous data analysis, these guidelines were developed to enhance MM management, both in Korea and globally.

Colorectal cancer is the third most common cancer in Korea and the third leading cause of death from cancer. Treatment outcomes for colon cancer are steadily improving due to national health screening programs with advances in diagnostic methods, surgical techniques, and therapeutic agents.. The Korea Colon Cancer Multidisciplinary (KCCM) Committee intends to provide professionals who treat colon cancer with the most up-to-date, evidence-based practice guidelines to improve outcomes and help them make decisions that reflect their patients’ values and preferences. These guidelines have been established by consensus reached by the KCCM Guideline Committee based on a systematic literature review and evidence synthesis and by considering the national health insurance system in real clinical practice settings. Each recommendation is presented with a recommendation strength and level of evidence based on the consensus of the committee.

PURPOSE: We investigated the clinical outcome of bone marrow (BM) involvement in patients with diffuse large B-cell lymphoma (DLBCL) who received rituximab-based therapy. MATERIALS AND METHODS: A total of 567 consecutive patients with newly diagnosed DLBCL treated with rituximab-CHOP (RCHOP) between November 2001 and March 2010 were included in the current study. All of the patients underwent a BM study at the initial staging and the clinical characteristics and prognosis of these patients with or without BM involvement were analyzed retrospectively. RESULTS: The total cohort included 567 patients. The overall incidence of BM involvement was 8.5%. With a median follow-up duration of 33.2 months (range, 0.1 to 80.7 months) for patients who were alive at the last follow-up, the five-year overall survival (OS) and event-free survival (EFS) rate in patients without BM involvement (76.3% and 67.5%, p<0.001) was statistically higher than that in patients with BM involvement (44.3% and 40.1%, p<0.001). In multivariate analysis, among total patients, BM involvement showed a significant association with OS and EFS. In univariate and multivariate analyses, even among stage IV patients, a significant association with worse EFS was observed in the BM involvement group. CONCLUSION: BM involvement at diagnosis affected the survival of patients with DLBCL who received RCHOP. Although use of RCHOP can result in significant improvement of the therapeutic effect of DLBCL, BM involvement is still a negative prognostic factor of DLBCL patients in the era of rituximab.
Antibodies, Monoclonal, Murine-Derived ; B-Lymphocytes ; Bone Marrow ; Cohort Studies ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Lymphoma, B-Cell ; Multivariate Analysis ; Prognosis ; Rituximab

The aim of the present study was to assess the clinical and histopathological findings in a canine model of ischemic stroke. Cerebral ischemic stroke was induced by middle cerebral artery occlusion in four healthy beagle dogs using silicone plugs. They showed neurological signs of forebrain dysfunction such as reduced responsiveness, head turning, circling, postural reaction deficits, perceptual deficits, and hemianopsia. These signs gradually regressed within 4 weeks without therapy. On magnetic resonance imaging, T2 hyperintensity and T1 hypointensity were found in the cerebral cortex and basal ganglia. These lesions were well-defined and sharply demarcated from adjacent brain parenchyma with a homogenous appearance. No abnormalities of the cerebrospinal fluid were observed. At necropsy, atrophic and necrotic lesions were observed in the cerebral cortex. The cerebral cortex, basal ganglia, and thalamus were partially unstained with triphenyl-tetrazolium chloride. Histopathologically, typical features of infarction were identified in cortical and thalamic lesions. This study demonstrates that our canine model resembles the conditions of real stroke patients.
Animals ; Behavior, Animal/physiology ; Brain/metabolism/pathology ; Cerebral Infarction/*etiology/*pathology ; Cerebrospinal Fluid/chemistry/cytology ; Disease Models, Animal ; *Dogs ; Infarction, Middle Cerebral Artery/*complications/*pathology ; Magnetic Resonance Imaging ; Male

We describe an unusual case of extragastrointestinal stromal tumor (EGIST) presenting as a scrotal mass. A 71-year-old man presented with a gradually enlarging scrotal mass with a 20-year duration. Physical examination revealed a huge (as large as volleyball), round, nontender mass occupying the whole scrotum, which was resected completely. Clinical and radiological findings did not comply with any other primary site disease. Under histological examination, the tumor showed a spindle cell pattern with low cellularity, absence of necrotic and mitotic features. immunohistochemical analysis revealed the tumor reactive for CD117 and CD34, while negative for smooth muscle actin, desmin and S-100 protein. To our knowledge, this is the first reported case of an EGIST involving the scrotum.
Aged ; Antigens, CD34 ; analysis ; Gastrointestinal Stromal Tumors ; diagnosis ; Humans ; Immunohistochemistry ; Male ; Proto-Oncogene Proteins c-kit ; analysis ; Scrotum ; pathology ; Sex Cord-Gonadal Stromal Tumors ; chemistry ; pathology

BACKGROUND: The changes in the pulmonary function observed in burn patients with an inhalation injury are probably the result of a combination of airway inflammation, chest wall and muscular abnormalities, and scar formation. In addition, it appears that prolonged ventilatory support and an episode of pneumonia contribute to the findings. This study investigated the changes in the pulmonary function in patients with inhalation injury at the early and late post-burn periods. METHODS: From August 1, 2002, to August 30, 2005, surviving burn patients who had an inhalation injury were enrolled prospectively. An inhalation injury was identified by bronchoscopy within 48hours after admission. Spirometry was performed at the early phase during admission and the recovery phase after discharge, and the changes in the pulmonary function were compared. RESULTS: 37 patients (M=28, F=9) with a total burn surface area (% TBSA), ranging from 0 to 18%, were included. The initial PaO2/FiO2ratio and COHb were 286.4+/-129.6 mmHg and 7.8+/-6.6 %. Nine cases (24.3%) underwent endotracheal intubation and 3 cases (8.1%) underwent mechanical ventilation. The initial X-ray findings revealed abnormalities in, 18 cases (48.6%) with 15 (83.3%) of these being completely resolved. However, 3 (16.7%) of these had residual sequela. The initial pulmonary function test, showed an obstructive pattern in 9 (24.3%) with 4 (44.4%) of these showing a positive bronchodilator response, A restrictive pattern was also observed in 9 (24.3%) patients. A lower DLco was observed in only 4 (17.4%) patients of which 23 had undergone DLco. In the follow-up study, an obstructive and restrictive pattern was observed in only one (2.7%) case each. All the decreased DLco returned to mormal. CONCLUSIONS: Most surviving burn patients with an inhalation injury but with a small burn size showed initial derangements in the pulmonary function test that was restored to a normal lung function during the follow up period.
Bronchoscopy ; Burns ; Cicatrix ; Follow-Up Studies ; Humans ; Inflammation ; Inhalation* ; Intubation, Intratracheal ; Lung ; Pneumonia ; Prospective Studies ; Respiration, Artificial ; Respiratory Function Tests* ; Spirometry ; Thoracic Wall

BACKGROUND: The efficient collection of peripheral blood stem cells (PBSC) from donors who donate for allogeneic transplants as well as from patients undergoing autologous transplants is essential for a successful transplant. Recently, the Amicus cell separator and the associated MNC collection computer software program for PBSC collection were introduced in Korea. METHODS: Two apheresis machines (Amicus, Baxter Healthcare; and CS-3000 plus, Baxter Healthcare) were compared retrospectively. A total number of 144 procedures were performed on 14 donors and 28 patients. The pre- and post-apheresis complete blood cell (CBC) counts and the number of hematopoietic progenitor cells (HPC) were determined in the peripheral blood from the subjects. The CBC, HPC, CD34+ cell counts and the level of colony-forming unit-granulocyte-macrophages (CFU-GM) were measured in the PBSC product collected from both machines. RESULTS: Both machines collected a similar number of CD34+ cells from the donors and patients. On the other hand, the Amicus collected significantly more nucleated cells, MNCs, HPCs and CFU-GM in the patients with significantly less RBC contamination than those with CS-3000 plus. The decrease in the peripheral blood platelet counts in the donors and patients was more prominent after apheresis using the CS-3000 plus (117.00+/-42.75 x 10(3)/microliter, 61.22+/-43.62 x 10(3)/microliter) than Amicus (26.04+/-18.68 x 10(3)/microliter, 22.15+/-28.66 x 10(3)/microliter)(p<0.05). CONCLUSION: PBSC collection can be performed successfully using CS-3000 plus and Amicus. Amicus is superior to CS-3000 plus in avoiding apheresis-induced thrombocytopenia, and is expected to prevent unnecessary platelet transfusion.
Autografts ; Blood Cells ; Blood Component Removal ; Cell Count ; Delivery of Health Care ; Granulocyte-Macrophage Progenitor Cells ; Hand ; Hematopoietic Stem Cells ; Humans ; Korea ; Platelet Count ; Platelet Transfusion ; Retrospective Studies ; Stem Cells* ; Thrombocytopenia ; Tissue Donors

Nonsyndromic cleft lip and/or palate (NSCLP) is one of the most common congenital deformities and its prevalence in Far East Asia, such as within Korean and Japanese populations, is relatively high. However, in the eastern part of Europe, clefts are relatively rare situations. These ethnic differences infer a genetic background of the disease. The objective of this study was to compare the frequency of single nucleotide polymorphism (SNP) in TGF-beta3 between Korean and Romanian cleft families. Korean cleft families samples were collected from twenty-six families (n=78) and Romanian cleft families samples were collected from eighteen families (n=41). For sequencing, the blood or saliva of the subjects was sampled. A single nucleotide plolymorphism was observed in the intron 5 of TGF-beta3 (A18141G). The frequency of each allele was significantly different between the Korean and Romanian samples. The AA allele was present in 18 out of 78 Korean samples (23.1%) and in 27 out of 41 Romanian samples (65.9%). The AG was present in 27 (34.6%) out of 78 Koreans and in 13 (31.7%) out of 41 Romanians. The GG was found in 33 (42.3%) Koreans and in 1 (2.4%) Romanian. The difference between the groups was significant (p<0.001). In conclusion, the frequency of observed SNP was significantly different between the two countries. SNP in TGF-beta3 in the Korean population seemed to have a higher possibility of occurrence for nonsyndromic cleft palate than the Romanian population
Alleles ; Asia ; Asian Continental Ancestry Group ; Cleft Lip ; Cleft Palate* ; Congenital Abnormalities ; Europe ; Far East ; Humans ; Introns ; Palate ; Polymorphism, Single Nucleotide ; Prevalence* ; Saliva ; Transforming Growth Factor beta3

This study was designed to clarify the cytotoxic effects of 5, 7-dihydroxytryptamine (5, 7-DHT) on the serotonergic neurons in the dorsal raphe nucleus, and to investigate the glial reaction during the neurodegenerative changes by light and electron microscopy. Adult male rats (Sprague-Dawley strain) weighing from 250 g to 350 g each were used as experimental animal. 5, 7-DHT (200 microgram dissolved in 0.9% NaCl) was injected into the lateral ventricle of the rat brain with the Hamiton syringe fixed on stereotaxic apparatus. The control rats were given with the similar volume of 0.9% NaCl. The rats were sacrified on the 1st, 3rd, 5th, 10th and 20th day after the injection of 5, 7-DHT. The results were as follows : The cytotoxicity of 5, 7-DHT resulted in severe neurodegenerations of the serotonergic neurons. Most degenerated cells mainly showed necrotic findings, but a few of them exhibited apoptotic features. That is, in early stage of this experiment, the degenerated cells showed edematic changes of cytoplasm, but their nuclei were relatively seen intact. In late stage, the cells showed dark degenerative changes both in their cytoplasm and nuclei. Thereafter the cells were autolysed or phagocytosed by neighboring glial cells. Based on the results, author thought that 5, 7-DHT act as a specific neurotoxin to serotonergic neurons in DRN, and induces severe neurodegenerative changes. The glial reactions in DRN are activated during the neurodegerative changes, and show characteristic patterns of glial reactions.
Adult ; Animals ; Brain ; Cytoplasm ; Humans ; Lateral Ventricles ; Male ; Microscopy, Electron ; Neuroglia ; Raphe Nuclei* ; Rats* ; Serotonergic Neurons* ; Syringes

This study was designed to clarify the cytotoxic effects of 5, 7-dihydroxytryptamine (5, 7-DHT) on the serotonergic neurons in the dorsal raphe nucleus, and to investigate the glial reaction during the neurodegenerative changes by light and electron microscopy. Adult male rats (Sprague-Dawley strain) weighing from 250 g to 350 g each were used as experimental animal. 5, 7-DHT (200 mg dissolved in 0.9% NaCl) was injected into the lateral ventricle of the rat brain with the Hamiton syringe fixed on stereotaxic apparatus. The control rats were given with the similar volume of 0.9% NaCl. The rats were sacrified on the 1st, 3rd, 5th, 10th and 20th day after the injection of 5, 7-DHT. The results were as follows : Glial reactions induced by 5, 7-DHT were also observed in DRN. In early experimental stage, microglial reactions prevailed, whereas astroglial reactions were prevailing in later stage. In addition, microglial cells phagocytosed and removed the degenerated cells. However, astrocytes in DRN did not show phagocytotic activities such as microglial cells. Based on the results, author thought that 5, 7-DHT act as a specific neurotoxin to serotonergic neurons in DRN, and induces severe neurodegenerative changes. The glial reactions in DRN are activated during the neurodegerative changes, and show characteristic patterns of glial reactions.
Adult ; Animals ; Astrocytes ; Brain ; Humans ; Lateral Ventricles ; Male ; Microglia ; Microscopy, Electron ; Neuroglia* ; Raphe Nuclei* ; Rats* ; Serotonergic Neurons ; Syringes