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.

BACKGROUND: A drug-eluting stent (DES) is a highly beneficial medical device used to widen or unblock narrowed blood vessels. However, the drugs released by the implantation of DES may hinder the re-endothelialization process, increasing the risk of late thrombosis. We have developed a tacrolimus-eluting stent (TES) that as acts as a potent antiproliferative and immunosuppressive agent, enhancing endothelial regeneration. In addition, we assessed the safety and efficacy of TES through both in vitro and in vivo tests. METHODS: Tacrolimus and Poly(lactic-co-glycolic acid) (PLGA) were applied to the metal stent using electrospinning equipment. The surface morphology of the stent was examined before and after coating using a scanning electron microscope (SEM) and energy dispersive X-rays (EDX). The drug release test was conducted through high-performance liquid chromatography (HPLC). Cell proliferation and migration assays were performed using smooth muscle cells (SMC).The stent was then inserted into the porcine coronary artery and monitored for a duration of 4 weeks. RESULTS: SEM analysis confirmed that the coating surface was uniform. Furthermore, EDX analysis showed that the surface was coated with both polymer and drug components. The HPCL analysis of TCL at a wavelength of 215 nm revealed that the drug was continuously released over a period of 4 weeks. Smooth muscle cell migration was significantly decreased in the tacrolimus group (54.1% ± 11.90%) compared to the non-treated group (90.1% ± 4.86%). In animal experiments, the stenosis rate was significantly reduced in the TES group (29.6% ± 7.93%) compared to the bare metal stent group (41.3% ± 10.18%). Additionally, the fibrin score was found to be lower in the TES group compared to the group treated with a sirolimus-eluting stent (SES). CONCLUSION Similar to SES, TES reduces neointimal proliferation in a porcine coronary artery model, specifically decreasing the fibrins score. Therefore, tacrolimus could be considered a promising drug for reducing restenosis and thrombosis.

BACKGROUND AND OBJECTIVES: With the present methods for assessing speech, there are procedures that make effective diagnostics possible for voice disorders. One such procedure is cepstrum. Spectrum is produced by Fourier transformation of sound waves, and if Fourier transformation is performed again about the spectrum, cepstrum is produced. This study compared cepstrum to jitter, shimmer, and noise-to-harmonic ratio (NHR) for assessment of its usefulness. Cepstrum was measured by Cepstral Peak Prominence (CPP) calculated by the Hillenbrand method and Cepstral Mean Values (CMV) calculated using the Computerized Speech Laboratory software. SUBJECTS AND METHOD: We included in the study 30 patients with vocal nodule and unilateral vocal cord palsy who were diagnosed in Kangbuk Samsung Hospital between March 2010 and May 2011, and 30 normal controls. Phonation of sustained vowel /a/ sample and running speech was subjected to acoustic analysis using CMV and CPP. Then we compared the correlation of cepstrum with other acoustic methods. RESULTS: The measured values of CPP-a were 14.16, 17.25, 20.00 and the age adjusted CPP-s values were 11.21, 12.85, 15.00 for vocal cord palsy, vocal nodule and normal group, respectively. There was significant correlation with perceptions of dysphonia (p<0.001), but in CMV-a, CMV-s, there was no significant correlation. When jitter, shimmer, and NHR were compared with cepstrum, the result showed negative correlation among the three groups but CPP values showed significant difference (p<0.001). CONCLUSION: In the assessment of voice disorders, cepstrum may be used as a reliable method for comparing other complementary analysis tools. For the acoustic analysis of voice by cepstrum, however, CPP has more reliable correlations with dysphonia than CMV.
Acoustics ; Dysphonia ; Fourier Analysis ; Hoarseness ; Humans ; Phonation ; Running ; Sound ; Vocal Cord Paralysis ; Voice ; Voice Disorders

BACKGROUND AND OBJECTIVES: It is necessary to establish the most efficient diagnostic and therapeutic method for benign paroxysmal positional vertigo (BPPV), which is appropriate for Korean healthcare system. We aimed to evaluate current state of Korean clinician's diagnostic and therapeutic approaches for BPPV. MATERIALS AND METHODS: A 16-item survey was emailed to the members of dizziness department of Otology Research Interest Group in the Korean Otologic Society (n=68). 43 were returned and analyzed. RESULTS: All respondents (100%) used Dix-Hallpike test as a diagnostic tool for vertical canal-BPPV. Supine roll test was used for diagnosing lateral canal BPPV in nearly all the respondents (97.7%). Epley maneuver was chosen as otolith repositioning maneuver (ORM) for posterior canal BPPV in all respondents and barbecue rotation (BBQ) was used for treating lateral canal BPPV with geotropic nystagmus in 95.3% of respondents. Extreme variation was noted for therapeutic approach of lateral canal BPPV with ageotropic nystagmus BBQ, with 4 kinds of ORM and adjunctive measures to liberate otolith from cupula, while BBQ was again the most commonly used ORM (76.7%). CONCLUSION: The development of practical and efficient ORM for lateral canal BPPV with ageotropic nystagmus is necessary.
Surveys and Questionnaires ; Delivery of Health Care ; Dizziness ; Electronic Mail ; Korea ; Otolaryngology ; Otolithic Membrane ; Public Opinion ; Vertigo

This study surveyed the prevalence of traumatic reticular diseases (TRD) of slaughter cattle in Korea, the typology of the causative foreign bodies and the effects on beef quality and carcass weight. The overall prevalence of TRD in 3,121 slaughter cattle was 5.5%. However, the prevalence was significantly higher in Korea indigenous cattle Hanwoo (5.8%, p < 0.05) and female cattle (20.75%, p < 0.001). The prevalence significantly increased in aged cattle (p < 0.001). Major lesions related to foreign bodies were reticulitis (96%) and peritonitis (86%). Most causative foreign bodies were made of iron including nails, wires, steel rods, screw nails, and syringe needles. Cattle affected with TRD produced significantly lower grade quality of beef compared to normal cattle (p < 0.0001), but TRD did not affect carcass weight. The data will be useful in the management of TRD, with the aim of increasing beef productivity in Korea.
Aged ; Animals ; Cattle ; Efficiency ; Female ; Foreign Bodies ; Humans ; Iron ; Korea ; Nails ; Needles ; Peritonitis ; Prevalence ; Steel ; Syringes

The bladder is involved in less than 4% of inguinal hernias. Inguinoscrotal bladder hernias are difficult to diagnose, and less than 7% are diagnosed preoperatively. Inguinoscrotal bladder hernias are usually asymptomatic. However, they can result in significant complications, such as bladder necrosis or acute renal failure. Accurate diagnosis is crucial to avoid bladder injury during surgery and other complications. Here we report the case of a 64-year-old man who presented with a scrotal mass. Ultrasonography of the scrotal mass showed a nonspecific cystic mass. During surgery, the mass was revealed to be a herniated bladder.
Acute Kidney Injury ; Cystocele ; Hernia ; Hernia, Inguinal ; Humans ; Middle Aged ; Necrosis ; Prostatic Hyperplasia ; Urinary Bladder

PURPOSE: To compare the dose distributions between three-dimensional (3D) and four-dimensional (4D) radiation treatment plans calculated by Ray-tracing or the Monte Carlo algorithm, and to highlight the difference of dose calculation between two algorithms for lung heterogeneity correction in lung cancers. MATERIALS AND METHODS: Prospectively gated 4D CTs in seven patients were obtained with a Brilliance CT64-Channel scanner along with a respiratory bellows gating device. After 4D treatment planning with the Ray Tracing algorithm in Multiplan 3.5.1, a CyberKnife stereotactic radiotherapy planning system, 3D Ray Tracing, 3D and 4D Monte Carlo dose calculations were performed under the same beam conditions (same number, directions, monitor units of beams). The 3D plan was performed in a primary CT image setting corresponding to middle phase expiration (50%). Relative dose coverage, D95 of gross tumor volume and planning target volume, maximum doses of tumor, and the spinal cord were compared for each plan, taking into consideration the tumor location. RESULTS: According to the Monte Carlo calculations, mean tumor volume coverage of the 4D plans was 4.4% higher than the 3D plans when tumors were located in the lower lobes of the lung, but were 4.6% lower when tumors were located in the upper lobes of the lung. Similarly, the D95 of 4D plans was 4.8% higher than 3D plans when tumors were located in the lower lobes of lung, but was 1.7% lower when tumors were located in the upper lobes of lung. This tendency was also observed at the maximum dose of the spinal cord. Lastly, a 30% reduction in the PTV volume coverage was observed for the Monte Carlo calculation compared with the Ray-tracing calculation. CONCLUSION: 3D and 4D robotic radiotherapy treatment plans for lung cancers were compared according to a dosimetric viewpoint for a tumor and the spinal cord. The difference of tumor dose distributions between 3D and 4D treatment plans was only significant when large tumor movement and deformation was suspected. Therefore, 4D treatment planning is only necessary for large tumor motion and deformation. However, a Monte Carlo calculation is always necessary, independent of tumor motion in the lung.
Four-Dimensional Computed Tomography ; Humans ; Lung ; Lung Neoplasms ; Organothiophosphorus Compounds ; Population Characteristics ; Prospective Studies ; Spinal Cord ; Tumor Burden

Flavonoids have been shown to affect calcium signaling in neurons. However, there are no reports on the effect of apigenin on glutamate-induced calcium signaling in neurons. We investigated whether apigenin affects glutamate-induced increase of free intracellular Ca2+concentration ([Ca2+]i) in cultured rat hippocampal neurons, using fura-2-based digital calcium imaging and microfluorimetry. The hippocampal neurons were used between 10 and 13 days in culture from embryonic day 18 rats. Pretreatment of the cells with apigenin (1micrometerto 100micrometer for 5 min inhibited glutamate (100 micrometer 1 min) induced [Ca2+]i increase, concentration-dependently. Pretreatment with apigenin (30micrometer for 5 min significantly decreased the [Ca2+]i responses induced by two ionotropic glutamate receptor agonists, alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic (AMPA, 10 micrometer 1 min) and N-methyl-D-aspartate (NMDA, 100 micrometer 1 min), and significantly inhibited the AMPA-induced peak currents. Treatment with apigenin also significantly inhibited the [Ca2+]i response induced by 50 mM KCl solution, decreased the [Ca2+]i responses induced by the metabotropic glutamate receptor agonist, (S)-3,5-dihydroxyphenylglycine (DHPG, 100micrometer 90 s), and inhibited the caffeine (10 mM, 2 min)-induced [Ca2+]i responses. Furthermore, treatment with apigenin (30micrometer significantly inhibited the amplitude and frequency of 0.1 mM [Mg2+o-induced [Ca2+]i spikes. These data together suggest that apigenin inhibits glutamate-induced calcium signaling in cultured rat hippocampal neurons.
Animals ; Apigenin ; Caffeine ; Calcium ; Calcium Signaling ; Glutamic Acid ; N-Methylaspartate ; Neurons ; Rats ; Receptors, Glutamate ; Receptors, Metabotropic Glutamate

OBJECTIVE: The authors present the effect of VEGF upon neuronal and glial response following transient global ischemia of the rat METHODS: We studied the effect of VEGF in 36 rats subjected to 15 minutes of transient global ischemia. Animals were devided into control group(transient global ischemia only: day-3, day-7, day-14, respectively n=6) and VEGF-treated group(transient global ischemia with intraventricular injection of 100 micro gram VEGF: day-3, day-7, day-14, respectively n=6). These animals were sacrificed at 3 days, 7 days and 14 days after induction of ischemia. Nissle stain and immunohistochemistry of GFAP(glial fibrillary acidic protein), OX-42, and ED1 were done for assessment of neuronal and glial responses. RESULTS: In the CA1 hippocampus, there was a significant reduction of pyramidal cell damage in VEGF-treated group as compared with control group in post-ischemia 3, 7, 14 days(p<0.05). In the CA3 hippocampus which is relatively resistant to ischemia, reduction of pyramidal cell damage was significant in post-ischemia 7 days(p<0.05), not significant in post-ischemia 3, 14 days(p>0.05). In the assessment of CA1 hippocampus with GFAP stained areas, there was significant reduction of reactivity in post-ischemia 3, 7 days(p<0.05), not significant in post-ischemia 14 days(p>0.05). In the CA3 hippocampus, reduction of GFAP reactivity was significant in post-ischemia 3, 7 days(p<0.05), not significant in post-ischemia 14 days(p>0.05). In the assessment of CA1 hippocampus with OX-42 stained areas, there was significant reduction of reactivity in post-ischemia 3, 7, 14 days(p<0.05). But in the CA3 hippocampus, the difference was not significant in post-ischemia 3, 7 days(p<0.05). In the assessment of of CA1 hippocampus with ED1 stained areas, there was significant reduction of reactivity in post-ischemia 3, 7, 14 days(p<0.05). But in the CA3 hippocampus, the difference was significant in post-ischemia 3 days only(p<0.05). CONCLUSION: These results suggest that VEGF can reduce neuronal damage in transient global ischemia, thus have protective effect on ischemic brain injury. In our experiment, the reduction of glial response with VEGF seems to be related to the secondary neuroprotective effect of VEGF. However, the proliferation of endothelial cells and new vessel formation take days to months, the thus neuroprotective effect of VEGF against ischemia seems to related to a certain mechanism rather than angiogenesis.
Animals ; Astrocytes ; Brain Injuries ; Endothelial Cells ; Hippocampus ; Immunohistochemistry ; Injections, Intraventricular ; Ischemia* ; Microglia ; Neurons* ; Neuroprotective Agents ; Pyramidal Cells ; Rats* ; Vascular Endothelial Growth Factor A*

No abstract available.
Asian Continental Ancestry Group* ; Humans