Emerging evidence has emphasized the importance of cancer therapies targeting an abnormal metabolic state of tumor-initiating cells (TICs) in which they retain stem cell-like phenotypes and nicotinamide adenine dinucleotide (NAD⁺) metabolism. However, the functional role of NAD⁺ metabolism in regulating the characteristics of TICs is not known. In this study, we provide evidence that the mitochondrial NAD⁺ levels affect the characteristics of glioma-driven SSEA1⁺ TICs, including clonogenic growth potential. An increase in the mitochondrial NAD⁺ levels by the overexpression of the mitochondrial enzyme nicotinamide nucleotide transhydrogenase (NNT) significantly suppressed the sphere-forming ability and induced differentiation of TICs, suggesting a loss of the characteristics of TICs. In addition, increased SIRT3 activity and reduced lactate production, which are mainly observed in healthy and young cells, appeared following NNT-overexpressed TICs. Moreover, in vivo tumorigenic potential was substantially abolished by NNT overexpression. Conversely, the short interfering RNA-mediated knockdown of NNT facilitated the maintenance of TIC characteristics, as evidenced by the increased numbers of large tumor spheres and in vivo tumorigenic potential. Our results demonstrated that targeting the maintenance of healthy mitochondria with increased mitochondrial NAD⁺ levels and SIRT3 activity could be a promising strategy for abolishing the development of TICs as a new therapeutic approach to treating aging-associated tumors.
Glioblastoma* ; Lactic Acid ; Metabolism ; Mitochondria ; NAD ; NADP Transhydrogenases ; Phenotype ; Tics ; Up-Regulation*

BACKGROUND: Transverse abdominis plane (TAP) block can be recommended as a multimodal method to reduce postoperative pain in laparoscopic abdominal surgery. However, it is unclear whether TAP block following local anesthetic infiltration is effective. We planned this study to evaluate the effectiveness of the latter technique in laparoscopic totally extraperitoneal hernia repair (TEP). METHODS: We randomly divided patients into two groups: the control group (n = 37) and TAP group (n = 37). Following the induction of general anesthesia, as a preemptive method, all of the patients were subjected to local anesthetic infiltration at the trocar sites, and the TAP group was subjected to ultrasound-guided bilateral TAP block with 30 ml of 0.375% ropivacaine in addition before TEP. Pain was assessed in the recovery room and post-surgery at 4, 8, and 24 h. Additionally, during the postoperative 24 h, the total injected dose of analgesics and incidence of nausea were recorded. RESULTS:: On arrival in the recovery room, the pain score of the TAP group (4.33 +/- 1.83) was found to be significantly lower than that of the control group (5.73 +/- 2.04). However, the pain score was not significantly different between the TAP group and control group at 4, 8, and 24 h post-surgery. The total amounts of analgesics used in the TAP group were significantly less than in the control group. No significant difference was found in the incidence of nausea between the two groups. CONCLUSIONS: TAP block following local infiltration had a clinical advantage only in the recovery room.
Analgesics ; Anesthesia, General ; Hernia ; Herniorrhaphy* ; Humans ; Incidence ; Nausea ; Pain, Postoperative ; Recovery Room ; Surgical Instruments ; Ultrasonography

We report here a case of oral myiasis in the Republic of Korea. The patient was a 37-year-old man with a 30-year history of Becker's muscular dystrophy. He was intubated due to dyspnea 8 days prior to admission to an intensive care unit (ICU). A few hours after the ICU admission, 43 fly larvae were found during suction of the oral cavity. All maggots were identified as the third instars of Lucilia sericata (Diptera: Calliphoridae) by morphology. We discussed on the characteristics of myiasis acquired in Korea, including the infection risk and predisposing factors.
Adult ; Animals ; Diptera/anatomy & histology/*classification ; Humans ; Larva/anatomy & histology/classification ; Male ; Mouth/*parasitology ; Myiasis/*diagnosis/*parasitology ; Republic of Korea

The purpose of this study is to assess the relationship between left atrial (LA) size and outcome after acute myocardial infarction (AMI) in patients undergoing primary percutaneous coronary intervention (PCI) and to evaluate dynamic changes in LA size during long-term follow-up. Echocardiographic analyses were performed on 253 AMI patients (174 male and 79 female, 65.4 +/- 13.7 yr) undergoing PCI. These subjects were studied at baseline and at 12 months. Clinical follow-up were done at 30.8 +/- 7.5 months. We assessed LA volume index (LAVI) at AMI-onset and at 12-month. Change of LAVI was an independent predictor of new onset of atrial fibrillation or hospitalization for heart failure (P = 0.002). Subjects who survived the 12-month period displayed an increased LAVI mean of 1.86 +/- 4.01 mL/m2 (from 26.1 +/- 8.6 to 28.0 +/- 10.1 mL/m2, P < 0.001). The subject group that displayed an increased LAVI correlated with a low left ventricular ejection fraction, large left ventricle systolic and diastolic dimensions and an enlarged LA size. In conclusion, change of LAVI is useful parameter to predict subsequent adverse cardiac event in AMI patients. Post-AMI echocardiographic evaluation of LAVI provides important prognostic information that is significantly greater than that obtained from clinical and laboratory parameters alone.
Aged ; *Angioplasty, Balloon, Coronary ; Echocardiography ; Female ; Follow-Up Studies ; Heart Atria/pathology/physiopathology/ultrasonography ; Humans ; Male ; Middle Aged ; Myocardial Infarction/*pathology/physiopathology/*therapy/ultrasonography ; Prognosis ; Time Factors

A variety of benzylidenethiazole analogs have been demonstrated to inhibit 5-lipoxygenase (5-LOX). Here we report the anti-atherogenic potential of 5-(4-hydroxy-2,3,5-trimethylbenzylidene) thiazolidin-2,4-dione (HMB-TZD), a benzylidenethiazole analog, and its potential mechanism of action in LDL receptor-deficient (Ldlr-/-) mice. HMB-TZD Treatment reduced leukotriene B4 (LTB4) production significantly in RAW264.7 macrophages and SVEC4-10 endothelial cells. Macrophages or endothelial cells pre-incubated with HMB-TZD for 2 h and then stimulated with lipopolysaccharide or tumor necrosis factor-alpha (TNF-alpha) displayed reduced cytokine production. Also, HMB-TZD reduced cell migration and adhesion in accordance with decreased proinflammatory molecule production in vitro and ex vivo. HMB-TZD treatment of 8-week-old male Ldlr-/- mice resulted in significantly reduced atherosclerotic lesions without a change to plasma lipid profiles. Moreover, aortic expression of pro-atherogenic molecules involved in the recruitment of monocytes to the aortic wall, including TNF-alpha , MCP-1, and VCAM-1, was downregulated. HMB-TZD also reduced macrophage infiltration into atherosclerotic lesions. In conclusion, HMB-TZD ameliorates atherosclerotic lesion formation possibly by reducing the expression of proinflammatory molecules and monocyte/macrophage recruitment to the lesion. These results suggest that HMB-TZD, and benzylidenethiazole analogs in general, may have therapeutic potential as treatments for atherosclerosis.
Animals ; Atherosclerosis/*drug therapy ; Cell Adhesion/drug effects ; Cell Line ; Cell Movement/drug effects ; Chemokine CCL2/metabolism ; Dinoprostone/metabolism ; Enzyme-Linked Immunosorbent Assay ; Humans ; Leukotriene B4/metabolism ; Macrophages/cytology/drug effects ; Male ; Mice ; Monocytes/cytology/*drug effects ; Random Allocation ; Receptors, LDL/deficiency/genetics ; Thiazolidinediones/*therapeutic use ; Tumor Necrosis Factor-alpha/pharmacology

Autoimmune pancreatitis (AIP) has two distinct subsets. Type 1 AIP or lymphoplasmacytic sclerosing pancreatitis is systemic disease with the elevation in serum levels of the IgG4. Type 2 AIP, also called duct-centric pancreatitis, features granulocyte epithelial lesions with duct obstruction in the pancreas without systemic involvement. Here, we report a case of type 2 AIP diagnosed by pathology, which is the first report in Korea. The case is a 56-year-old woman who presented with anorexia and vomiting. Computed tomography revealed mass-like lesion in the pancreatic head and the compression of the distal common bile duct and the head portion of the main pancreatic duct. Serum levels of the IgG4 were normal. Histologic examination revealed a dense neutrophil infiltration in the pancreatic parenchyme associated with extensive fibrosis, thereby confirming the diagnosis of type 2 AIP. The abnormalities in the clinical, laboratory, and radiological findings improved after oral steroid treatment.
Autoimmune Diseases/blood/immunology/*pathology ; Female ; Fibrosis ; Humans ; Immunoglobulin G/blood ; Magnetic Resonance Imaging ; Middle Aged ; Neutrophils/immunology ; Pancreas/pathology ; Pancreatitis/*drug therapy/immunology/pathology ; Steroids/*therapeutic use ; Tomography, X-Ray Computed

PURPOSE: Whole-body CT is a very attractive diagnostic tool to clinicians, especially, in trauma. It is generally accepted that trauma patients who are not alert require whole-body CT. However, in alert trauma patients, the usefulness is questionable. METHODS: This study was a retrospective review of the medical records of 146 patients with blunt multiple trauma who underwent whole body CT scanning for a trauma workup from March 1, 2008 to February 28, 2009. We classified the patients into two groups by patients' mental status (alert group: 110 patients, not-alert group: 36 patients). In the alert group, we compared the patients' evidence of injury (present illness, physical examination, neurological examination) with the CT findings. RESULTS: One hundred forty six(146) patients underwent whole-body CT. The mean age was 44.6+/-18.9 years. One hundred four (104, 71.2%) were men, and the injury severity score was 14.0+/-10.38. In the not-alert group, the ratios of abnormal CT findings were relatively high: head 23/36(63.9%), neck 3/6(50.0%), chest 16/36(44.4%) and abdomen 9/36(25%). In the alert group, patients with no evidence of injury were rare (head 1, chest 6 and abdomen 2). Nine(9) patients did not need any intervention or surgery. CONCLUSION: Whole-body CT has various disadvantages, such as radiation, contrast induced nephropathy and high medical costs. In multiple trauma patients, if they are alert and have no evidence of injury, they rarely have abnormal CT findings, and mostly do not need invasive treatment. Therefore, we should be cautious in performing whole-body CT in alert multiple trauma patients.
Abdomen ; Head ; Humans ; Injury Severity Score ; Male ; Medical Records ; Multiple Trauma ; Neck ; Physical Examination ; Radiation Injuries ; Retrospective Studies ; Thorax

PURPOSE: The purpose of this study is to investigate the factors that predict using mechanical ventilation for patients with organophosphate intoxication. METHODS: We retrospectively reviewed the medical records of 111 patients with acute organophosphate intoxication and who were treated in our emergency center from January 2000 to December 2008. We compared the toxicologic characteristics, the laboratory findings and the APACHE II scores between the Mechanical Ventilation group (MV group) and the non-Mechanical Ventilation group (the non MV group). RESULTS: Sixty three patients were in the MV group and 48 patients were in the non MV group. In the MV group, the patients had an older age (p<0.001), a larger amount of ingestion (p<0.001), a lower initial serum cholinesterase level (p=0.003), a higher APACHE II score (p<0.001) and they ingested a more toxic agent (p=0.001). There were no significant differences in gender, the type of visit and the arrival time between the MV group and the non MV group. CONCLUSION: We suggest that the patient's age, the amount of organophosphate ingestion, the toxicity of the agent, the initial serum cholinesterase level and the APACHE II score are important factors to determine if mechanical ventilation will be applied for patients with organophosphate intoxication.
APACHE ; Cholinesterases ; Eating ; Emergencies ; Humans ; Medical Records ; Respiration, Artificial ; Retrospective Studies ; Ventilation

PURPOSE: To compare the result of failed internal fixation of intertrochanteric fractures treated with arthroplasty and 95degrees angled blade plate. MATERIALS AND METHODS: From June 2000 to may 2003, there were 12 cases with failed internal fixation of intertrochanteric fractures among 185 cases treated with dynamic hip screw and followed up for more than 1 year. The 4 cases were treated with bipolar hemiarthroplasty, 1 case with total hip arthroplasty, and other 7 cases were treated with 95degrees angled blade plate with allograft, evaluated clinically the operation times, blood loss, walking ability and complication. RESULTS: In the 7 cases, which treated with 95degrees angled blade plate, the average operation time was 109 minutes, the average blood loss was 431 ml. The result of keeping abreast of 1 year, no aid ambulation was 4 cases, the cane ambulation was 2 cases, the walker ambulation was 1 case, and there was no pain in 3 cases, mild pain in 4 cases, and no moderate pain. In the 5 cases, which treated with arthroplasty, the average operation time was 157 minutes, the average blood loss was 618 ml. During 1 year, no aid ambulation was 3 cases, the cane ambulation was 1 case, the walker ambulation was 1 case, and no pain in 2 cases, mild pain in 1 case, moderate pain in 1 case. CONCLUSION: Both 95degrees angled blade plate and arthroplasty can be useful for failed internal fixation of intertrochanteric fractures, and the choice of implant must be determined with caution, considering the surgical conditions of patient, as well as benefits of each devices
Allografts ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Canes ; Femur* ; Hemiarthroplasty ; Hip ; Hip Fractures* ; Humans ; Walkers ; Walking

PURPOSE: An attempt was made to determine if the pre-LASIK operative BAC-STAT LASIK Ring plays a role in reducing postoperative infection. METHODS: Candidates for this study were 72 eyes of 36 patients, scheduled to undergo LASIK operation. Eyes were divided into two groups: right eyes with preoperative BAC-STAT bacteriostatic LASIK Ring (BAC-STAT LASIK Ring: American Optisurgical Inc., Lake Forest, California, U.S.A.) and one minute of irrigation (experimental group), and left eyes with only preoperative BSS irrigation (control group). The authors tried to demonstrate a difference of identified pathogens between the two groups after a growth of bulboconjunctival lesion in blood agar plate (BAP), MacConkey agar plate (MCA), Thioglycolate medium broth (TG), and Ogawa egg medium. RESULTS: Among the patients receiving only BSS irrigation, pathogens were identified in eight eyes before surgery and in four eyes after surgery in BAP and MCA medium. Among the patients receiving BAC-STAT LASIK Ring and irrigation, pathogens were identified in nine eyes before surgery and in three eyes after surgery in BAP and MCA culture medium. In addition, among the control population, pathogens were found in 21 eyes both before and after surgery in TG culture medium. However, among the experimental population, pathogens were grown in 23 eyes before surgery but in only 14 eyes after surgery. No growth of pathogens was reported in all patients before and after surgery in a 4-week Ogawa egg culture medium. CONCLUSIONS: This study suggests that preoperative BAC-STAT LASIK Ring insertion followed by irrigation decreases the incidence of postoperative infection.
Agar ; California ; Humans ; Incidence ; Keratomileusis, Laser In Situ* ; Lakes ; Ovum ; Thiram