Gastric cancer with peritoneal metastasis (GCPM) is a common and lethal manifestation of advanced gastric cancer, with a median survival of only 5-11 months. This consensus was developed by 30 experts from Asia (China, Japan, Korea, and Singapore) using the Delphi method and the GRADE evidence grading system. A total of 29 statements were formulated, covering the diagnosis and assessment of GCPM, indications for laparoscopic exploration and NIPS (normothermic intraperitoneal and systemic treatment), treatment regimens, prevention and management of complications, criteria for conversion surgery, and postoperative intraperitoneal therapy. The consensus aims to standardize clinical practice and improve the prognosis of patients with GCPM.

To investigate the prevalence of Toxoplasma gondii in pork on the market in Korea, an in-house enzyme-linked immunosorbent assay for tissue fluid (CAU-tf-ELISA) was developed using a soluble extract of T. gondii RH strain tachyzoites. As the standard positive controls, the piglets were experimentally infected with T. gondii: Group A (1,000 cysts-containing bradyzoites), Group B (500 cysts-containing bradyzoites) and Group C (1.0×103 or 1.0×104 tachyzoites). The CAU-tf-ELISA demonstrated infection intensity-dependent positivity toward tissue fluids with average cut-off value 0.15: 100% for Group A, 93.8% for Group B and 40.6% for Group C. When tissue-specific cut-off values 0.066–0.199 were applied, CAU-tf-ELISA showed 96.7% sensitivity, 100% specificity, 100% positive and 90.0% negative predictive values. When compared with the same tissue fluids, performance of CAU-tf-ELISA was better than that of a commercial ELISA kit. Of the 583 Korea domestic pork samples tested, anti-T. gondii antibodies were detected from 9.1% of whole samples and 37.9% from skirt meat highest among pork parts. In the 386 imported frozen pork samples, 1.8% (skirt meat and shoulder blade) were positive for anti-T. gondii antibodies. In Korea, prevalence of anti-T. gondii antibodies in the pork on retail markets appeared high, suggesting that regulations on pig farming and facilities are necessary to supply safe pork on the tables.
Agriculture ; Antibodies ; Enzyme-Linked Immunosorbent Assay ; Korea ; Meat ; Prevalence ; Red Meat ; Sensitivity and Specificity ; Shoulder ; Social Control, Formal ; Toxoplasma

OBJECTIVES: The purpose of this ex vivo study was to compare the antifungal activity of a synthetic peptide consisting of 15 amino acids at the C-terminus of human β-defensin 3 (HBD3-C15) with calcium hydroxide (CH) and Nystatin (Nys) against Candida albicans (C. albicans) biofilm. MATERIALS AND METHODS: C. albicans were grown on cover glass bottom dishes or human dentin disks for 48 hr, and then treated with HBD3-C15 (0, 12.5, 25, 50, 100, 150, 200, and 300 µg/mL), CH (100 µg/mL), and Nys (20 µg/mL) for 7 days at 37℃. On cover glass, live and dead cells in the biomass were measured by the FilmTracer Biofilm viability assay, and observed by confocal laser scanning microscopy (CLSM). On dentin, normal, diminished and ruptured cells were observed by field-emission scanning electron microscopy (FE-SEM). The results were subjected to a two-tailed t-test, a one way analysis variance and a post hoc test at a significance level of p = 0.05. RESULTS: C. albicans survival on dentin was inhibited by HBD3-C15 in a dose-dependent manner. There were fewer aggregations of C. albicans in the groups of Nys and HBD3-C15 (≥ 100 µg/mL). CLSM showed C. albicans survival was reduced by HBD3-C15 in a dose dependent manner. Nys and HBD3-C15 (≥ 100 µg/mL) showed significant fungicidal activity compared to CH group (p < 0.05). CONCLUSIONS: Synthetic HBD3-C15 peptide (≥ 100 µg/mL) and Nys exhibited significantly higher antifungal activity than CH against C. albicans by inhibiting cell survival and biofilm.
Amino Acids ; Biofilms ; Biomass ; Calcium Hydroxide ; Candida albicans ; Cell Survival ; Dentin ; Glass ; Humans* ; Microscopy, Confocal ; Microscopy, Electron, Scanning ; Nystatin

PURPOSE: Headache patients with an alert mental state and normal neurologic examination findings who visit the emergency department (ED) should be differentially diagnosed for the presence of cerebral vessel disease. Hence, the purpose of this study was to analyze the abnormal three-dimensional cerebral computed tomographic angiography (3D-CTA) findings of mentally alert patients presenting headache, and investigate the clinical factors predictive of an intracranial abnormality. METHODS: A total of 227 patients visiting the ED presenting headache and possessing an alert mental status were enrolled in this study and examined by 3D-CTA from January 2008 to December 2008. We compared the results of the 3D-CTA and the final clinical diagnosis for each patient. The patient participants were divided into two groups: an abnormal group, as confirmed by 3D-CTA, and a non-abnormal group. We compared the vital signs, past hypertension history, clinical manifestations, and the clinical factors predictive of abnormality between the two groups. RESULTS: Of the total patients, 44 were identified with abnormal findings by non-enhanced CT, and 61 patients were identified with abnormal findings by 3D-CTA. SAH was found in 29 patients and unruptured aneurysm was discovered in 17 patients using 3D-CTA. The time interval between onset of headache to arrival at the ED was shorter in the SAH group (p=0.012), and sudden bursting headache was observed in 22 subarachnoid hemorrhage (SAH) patients (p<0.001). Statistically significant differences were observed between the two groups for symptoms of nausea, vomiting, neck stiffness and seizure. According to the results of the multivariate logistic regression analysis, sudden bursting headache and neck stiffness were independent predictable variables that affected the abnormal 3D-CTA group. According to the results of the multivariate logistic regression analysis, sudden bursting headache and neck stiffness were independent predictable variables for the abnormal 3D-CTA group. CONCLUSION: Sudden bursting headache, neck stiffness, vomiting, and advanced age were independent predictable variables observed in the abnormal 3D-CTA group.
Aneurysm ; Angiography ; Emergencies ; Glycosaminoglycans ; Headache ; Humans ; Hypertension ; Logistic Models ; Nausea ; Neck ; Neurologic Examination ; Seizures ; Subarachnoid Hemorrhage ; Vital Signs ; Vomiting

PURPOSE: Headache patients with an alert mental state and normal neurologic examination findings who visit the emergency department (ED) should be differentially diagnosed for the presence of cerebral vessel disease. Hence, the purpose of this study was to analyze the abnormal three-dimensional cerebral computed tomographic angiography (3D-CTA) findings of mentally alert patients presenting headache, and investigate the clinical factors predictive of an intracranial abnormality. METHODS: A total of 227 patients visiting the ED presenting headache and possessing an alert mental status were enrolled in this study and examined by 3D-CTA from January 2008 to December 2008. We compared the results of the 3D-CTA and the final clinical diagnosis for each patient. The patient participants were divided into two groups: an abnormal group, as confirmed by 3D-CTA, and a non-abnormal group. We compared the vital signs, past hypertension history, clinical manifestations, and the clinical factors predictive of abnormality between the two groups. RESULTS: Of the total patients, 44 were identified with abnormal findings by non-enhanced CT, and 61 patients were identified with abnormal findings by 3D-CTA. SAH was found in 29 patients and unruptured aneurysm was discovered in 17 patients using 3D-CTA. The time interval between onset of headache to arrival at the ED was shorter in the SAH group (p=0.012), and sudden bursting headache was observed in 22 subarachnoid hemorrhage (SAH) patients (p<0.001). Statistically significant differences were observed between the two groups for symptoms of nausea, vomiting, neck stiffness and seizure. According to the results of the multivariate logistic regression analysis, sudden bursting headache and neck stiffness were independent predictable variables that affected the abnormal 3D-CTA group. According to the results of the multivariate logistic regression analysis, sudden bursting headache and neck stiffness were independent predictable variables for the abnormal 3D-CTA group. CONCLUSION: Sudden bursting headache, neck stiffness, vomiting, and advanced age were independent predictable variables observed in the abnormal 3D-CTA group.
Aneurysm ; Angiography ; Emergencies ; Glycosaminoglycans ; Headache ; Humans ; Hypertension ; Logistic Models ; Nausea ; Neck ; Neurologic Examination ; Seizures ; Subarachnoid Hemorrhage ; Vital Signs ; Vomiting

BACKGROUND: In multiple myeloma (MM), the idiotype (ID) determinant of the paraprotein has been used for immunotherapy using dendritic cells (DCs). However, ID-specific immune responses showed limited clinical responses after the Id vaccination. Therefore, an alternative approach using DCs pulsed with other tumor antigens is required. METHODS: We investigated the possibility of immunotherapy for MM using myeloma cell line-specific cytotoxic T lymphocytes (CTLs), that were stimulated in vitro by monocyte-derived DCs pulsed with the myeloma cell line ysates. CD14+ cells isolated from the peripheral blood of HLA-A0201+ healthy donors were cultured in the presence of GM-CSF and IL-4. On day 6, the immature DCs were pulsed with the myeloma cell line lysates (IM-9: HLA0201+ and ARH-77: HLA0201+), and then maturation of DCs was induced by the addition of TNF- alpha for 2 days. CTL lines were generated by a 2 time stimulation with DCs to the autologous CD3+ T cells. RESULTS: DCs pulsed with myeloma cell lysates showed the production of IL-12p70, but less than that of unpulsed DCs. CTLs lines stimulated with the DCs pulsing, for the myeloma cell line lysates, showed potent cytotoxic activities against autologous target cells, but not against HLA-A2-cell lines (RPMI-8226). Mature DCs pulsed with the myeloma cell line lysates showed a higher stimulatory capacity for autologous CTL when compared with mature non-pulsed DCs. CONCLUSION: These results suggest that DCs pulsed with the myeloma cell line lysates can generate potent myeloma cell line-specific CTLs for the myeloma cell-based immunotherapeutic approach in MM.
Antigens, Neoplasm ; Cell Line* ; Dendritic Cells* ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Immunotherapy ; Interleukin-4 ; Multiple Myeloma ; T-Lymphocytes ; T-Lymphocytes, Cytotoxic* ; Tissue Donors ; Vaccination

BACKGROUND: The aim of this study is to elucidate the relationship between the CD44s and CD44v6 expression level and the biological characteristics of a gastric carcinoma. METHODS: CD44s and CD44v6 expression was investigated in 56 gastric carcinomas, 18 dysplasias, and 22 normal mucosae by immunohischemical staining. RESULTS: The CD44s and CD44v6 expression rates in gastric carcinomas, dysplasia, and normal mucosae were 80.3% and 83.9%, 72.2% and 77.8%, and 13.6% and 4.5%, respectively. Statistical analysis showed significant difference after comparing a gastric carcinomas and dysplasia to the normal mucosae (p<0.001). The CD44s and CD44v6 expression rates in the cases with invasion to the muscle proper and serosa were 60.7% and 57.1%, and 82.4% and 88.2%, respectively. Both showed a significant statistical difference compared to the expression rates in the cases with invasion to the mucosae and submucosae. The CD44s and CD44v6 expression rates in gastric carcinomas with a lymph node metastasis showed a statistically significant difference compared to those without a lymph node metastasis (p<0.001 and p<0.01, respectively). CD44s and CD44v6 were also expressed in the normal basal cells around gastric carcinomas. CONCLUSIONS: The CD44s and CD44v6 expression showed a significant relationship with gastric carcinogenesis, toward an aggressive biologic behavior.
Carcinogenesis ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Population Characteristics ; Serous Membrane