Background: Visceral pleural invasion (VPI) is a poor prognostic factor that contributes to the upstaging of early lung cancers. However, the preoperative assessment of VPI presents challenges. This study was conducted to examine intraoperative pleural carcinoembryonic antigen (pCEA) level and maximum standardized uptake value (SUVmax) as predictive markers of VPI in patients with clinical T1N0M0 lung adenocarcinoma. Methods: A retrospective review was conducted of the medical records of 613 patients who underwent intraoperative pCEA sampling and lung resection for non-small cell lung cancer. Of these, 390 individuals with clinical stage I adenocarcinoma and tumors ≤30 mm were included. Based on computed tomography findings, these patients were divided into pleural contact (n=186) and non-pleural contact (n=204) groups. A receiver operating characteristic (ROC) curve was constructed to analyze the association between pCEA and SUVmax in relation to VPI. Additionally, logistic regression analysis was performed to evaluate risk factors for VPI in each group. Results: ROC curve analysis revealed that pCEA level greater than 2.565 ng/mL (area under the curve [AUC]=0.751) and SUVmax above 4.25 (AUC=0.801) were highly predictive of VPI in patients exhibiting pleural contact. Based on multivariable analysis, pCEA (odds ratio [OR], 3.00; 95% confidence interval [CI], 1.14–7.87; p=0.026) and SUVmax (OR, 5.25; 95% CI, 1.90–14.50; p=0.001) were significant risk factors for VPI in the pleural contact group. Conclusion In patients with clinical stage I lung adenocarcinoma exhibiting pleural contact, pCEA and SUVmax are potential predictive indicators of VPI. These markers may be helpful in planning for lung cancer surgery.

Background: Catheter-associated urinary tract infections (CAUTIs) account for a large proportion of healthcare-associated infections and have a significant impact on morbidity, length of hospital stay, and mortality. Adherence to the recommended infection prevention practices can effectively reduce the incidence of CAUTIs. This study aimed to assess the characteristics of CAUTIs and the efficacy of prevention programs across hospitals of various sizes. Methods: Intervention programs, including training, surveillance, and monitoring, were implemented. Data on the microorganisms responsible for CAUTIs, urinary catheter utilization ratio, rate of CAUTIs per 1,000 device days, and factors associated with the use of indwelling catheters were collected from 2017 to 2019. The incidence of CAUTIs and associated data were compared between university hospitals and small- and medium-sized hospitals. Results: Thirty-two hospitals participated in the study, including 21 university hospitals and 11 small- and medium-sized hospitals. The microorganisms responsible for CAUTIs and their resistance rates did not differ between the two groups. In the first quarter of 2018, the incidence rate was 2.05 infections/1,000 device-days in university hospitals and 1.44 infections/1,000 device-days in small- and medium-sized hospitals. After implementing interventions, the rate gradually decreased in the first quarter of 2019, with 1.18 infections/1,000 device-days in university hospitals and 0.79 infections/1,000 device-days in small- and medium-sized hospitals. However, by the end of the study, the infection rate increased to 1.74 infections/1,000 device-days in university hospitals and 1.80 infections/1,000 device-days in small- and medium-sized hospitals. Conclusion We implemented interventions to prevent CAUTIs and evaluated their outcomes. The incidence of these infections decreased in the initial phases of the intervention when adequate support and personnel were present. The rate of these infections may be reduced by implementing active interventions such as consistent monitoring and adherence to guidelines for preventing infections.

Background: Orthotopic liver transplantation is the only option for patients with end-stage liver disease and hepatocellular carcinoma. Post-transplant immunosuppressive therapy is important to prevent graft failure. We investigated the effectiveness of tacrolimus (FK506) and their mechanisms for liver transplant immune tolerance in an outbred rat LT model. Results: To investigate the therapeutic effect of the FK506 on outbred rat LT model, FK506 and postoperative therapy were administered subcutaneously once or twice daily to transplanted rats. Histopathological and immunohistochemical analyses were conducted for all groups. The regulation of inflammatory cytokine signaling in the spleen was analyzed by flow cytometry. FK506 attenuated allograft rejection and increased survival in rat orthotopic liver transplantation models. The FK506-treated group had reduced serum levels of alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase. Furthermore, FK506 decreased the expression of inflammatory cytokines and the activation of pathogenic Th1 and Th17 cells in the liver. Conclusions Taken together, we revealed that FK506 ameliorated strong allograft rejection in outbred liver transplantation model by anti-inflammatory effect and inhibitory peroperty of pathogenic T cells.

Resin-bonded fixed partial denture (RBFPD)as known as Maryland bridge is is a well-known conservative method for its minimized invasion of the teeth for an anterior single tooth edentulous area. Despite of its various advantages, RBFPD was not widespread because of its high debonding rates, non-esthetic look or weak structure for material property. Currently, with the introduction of zirconia to dental material for RBFPD, Maryland bridge entered upon a new phase. Zirconia surmounts poor esthetics of metal framework, having proper strength, and overcomes ceramic’s structural weakness, being sufficiently esthetic. In this case, edentulous area of maxillary left lateral incisor was restored using zirconia resin-bonded fixed partial denture. Restoration of missing tooth in anterior area was achieved using non-invasive and esthetic prosthesis, then we report this case as satisfactory results were obtained for both the operator and the patient.

Background: The number of revision total knee arthroplasty (TKA) has been increasing. Although many studies have analyzed the causes of revision TKA in Western countries, a limited number of studies have analyzed changes in causes of or trends in revision TKA in Asia. This study analyzed and determined the frequency and causes of failures after TKA in our hospital. We also analyzed the differences and trends over the past 17 years. Methods: A total of 296 revision TKAs performed in a single institution from 2003 to 2019 were analyzed. During the 17-year study period, patients who had undergone primary TKA between 2003 and 2011 were classified into a past group, while those who had undergone primary TKA from 2012 to 2019 were classified into a recent group. A revision performed within 2 years after primary TKA was defined as early revision. Further, differences in causes of revision TKA according to the interval from primary TKA to revision TKA were determined. The causes of revision TKA were analyzed through a comprehensive analysis of patients’ medical records. Results: Overall, infection was the most common cause of failure (151/296 cases, 51.0%). Compared to the past group, the recent group had a relatively higher proportion of patients undergoing revision TKA for mechanical loosening (past group, 19.1% vs.recent group, 31.9%) and instability (11.2% vs. 13.5%) and a relatively lower proportion of patients undergoing revision TKA for infection (56.2% vs. 48.8%), polyethylene (PE) wear (9.0% vs. 2.9%), osteolysis (2.2% vs. 1.9%), and malalignment (2.2% vs. 1.0%).On comparison according to the interval from primary TKA to revision TKA, the rate of infection relatively decreased, whereas the rate of mechanical loosening and instability relatively increased in the late revision TKA compared to the early revision TKA. Conclusions Infection and aseptic loosening were the most common reasons of revision TKA in both past and recent groups.Compared to the past, revision TKA due to PE wear has decreased significantly and revision TKA due to mechanical loosening has relatively increased recently. Orthopedic surgeons need to be aware of recent trends in mechanisms of failure and should try to recognize and address the probable causes in TKA

The tongue is one of the most common sites of oral cancer. Glossectomy is known as the gold standard for tongue cancer treatment. However, surgical removal can lead to reduced mobility of the tongue and the patients may have difficulty performing normal oral functions like swallowing and pronunciation. Therefore, additional prosthetic consideration to supplement the function of the impaired tongue is needed for oral rehabilitation of such patients. Palatal augmentation prosthesis helps the tongue to reach the palate by lowering the position of the palatal polished surface. The oral functions of the patients with limited tongue mobility can be improved by the prosthesis. In this case, palatal augmented maxillary denture and conventional mandibular denture were fabricated for the completely edentulous patient with reduced tongue mobility after glossectomy due to tongue cancer. As a result, the oral functions of the patient were improved with the prosthesis.

Malaria continues to be one of the most crucial infectious burdens in endemic areas worldwide, as well as for travelers visiting malaria transmission regions. It has been reported that 8-aminoquinolines are effective against the Plasmodium species, particularly primaquine, for anti-hypnozoite therapy in P. vivax malaria. However, primaquine causes acute hemolytic anemia in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Therefore, G6PD deficiency testing should precede hypnozoite elimination with 8-aminoquinoline. Several point-of-care devices have been developed to detect G6PD deficiency. The aim of the present study was to evaluate the performance of a novel, quantitative G6PD diagnostics based on a metagenomic blue fluorescent protein (mBFP). We comparatively evaluated the sensitivity and specificity of the G6PD diagnostic modality with standard methods using 120 human whole blood samples. The G6PD deficiency was spectrophotometrically confirmed. The performance of the G6PD quantitative test kit was compared with that of a licensed control medical device, the G6PD strip. The G6PD quantitative test kit had a sensitivity of 95% (95% confidence interval (CI): 89.3-100%) and a specificity of 100% (95% CI: 94.3-100%). This study shows that the novel diagnostic G6PD quantitative test kit could be a cost-effective and time-efficient, and universally mandated screening tool for G6PD deficiency.

Staphylococcus aureus (S. aureus ) is known to induce apoptosis of host immune cells and impair phagocytic clearance, thereby being pivotal in the pathogenesis of atopic dermatitis (AD). Adipose-derived stem cells (ASCs) exert therapeutic effects against inflammatory and immune diseases. In the present study, we investigated whether systemic administration of ASCs restores the phagocytic activity of peripheral blood mononuclear cells (PBMCs) and decolonizes cutaneous S.aureus under AD conditions. AD was induced by injecting capsaicin into neonatal rat pups. ASCs were extracted from the subcutaneous adipose tissues of naïve rats and administered to AD rats once a week for a month. Systemic administration of ASCs ameliorated AD-like symptoms, such as dermatitis scores, serum IgE, IFN-γ+/IL-4+ cell ratio, and skin colonization by S. aureus in AD rats. Increased FasL mRNA and annexin V+/7-AAD+ cells in the PBMCs obtained from AD rats were drastically reversed when co-cultured with ASCs. In contrast, both PBMCs and CD163+ cells bearing fluorescent zymosan particles significantly increased in AD rats treated with ASCs. Additionally, the administration of ASCs led to an increase in the mRNA levels of antimicrobial peptides, such as cathelicidin and β-defensin, in the skin of AD rats. Our results demonstrate that systemic administration of ASCs led to decolonization of S. aureus by attenuating apoptosis of immune cells in addition to restoring phagocytic activity. This contributes to the improvement of skin conditions in AD rats. Therefore, administration of ASCs may be helpful in the treatment of patients with intractable AD.