Antineoplastic Agents ; Cardiovascular Diseases ; Cohort Studies ; Comorbidity ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; Humans ; Incidence ; Male ; Morinda ; Multivariate Analysis ; Myocardial Ischemia ; National Health Programs ; Observational Study ; Passive Cutaneous Anaphylaxis ; Prostate ; Prostatic Neoplasms ; Social Class

Adult ; Classification ; Diagnosis ; Humans ; Malaysia ; Malocclusion ; Passive Cutaneous Anaphylaxis ; Retrospective Studies

BACKGROUND: Thoracic interfascial plane block is useful as a component of multimodal analgesia in patients undergoing mastectomy. However, multimodal analgesia tends not to be provided during lumpectomy as it is one of the less aggressive procedures among breast cancer surgeries. Therefore, we investigated the effects of thoracic interfascial plane block as more effective analgesia after breast lumpectomy. METHODS: Forty six patients (20–80 years old, female) with breast cancer scheduled to undergo lumpectomy were randomly assigned to two groups. Postoperative pain control in the control group consisted only of intravenous patient-controlled analgesia (PCA). In the block group, intravenous PCA was used after serratus intercostal fascial plane block and pecto-intercostal fascial plane block. The primary outcome was the 24 h cumulative postoperative fentanyl consumption. Pain severity, additional rescue analgesic requirement, side effects, and patient satisfaction were also evaluated. RESULTS: Postoperative fentanyl consumption in the block group was significantly reduced compared with the control group (median, 88.8 [interquartile range, 48.0, 167.6] vs. 155.2 [88.8, 249.2], P = 0.022). The pain score was significantly lower in the block group only in the post-anesthesia care unit (2.9 ± 1.8 vs. 4.3 ± 2.3, P = 0.022). There were no differences in the incidence of postoperative nausea and vomiting and the requirement for additional analgesics between the groups. The satisfaction score was significantly higher in the block group. CONCLUSIONS: Thoracic interfascial plane block after lumpectomy reduces opioid usage and increases patient satisfaction with postoperative pain control. Thoracic interfascial plane block is useful for multimodal analgesia after lumpectomy.
Analgesia ; Analgesia, Patient-Controlled ; Analgesics ; Analgesics, Opioid ; Breast Neoplasms ; Breast ; Fentanyl ; Humans ; Incidence ; Mastectomy ; Mastectomy, Segmental ; Nerve Block ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Patient Satisfaction ; Postoperative Nausea and Vomiting

Mast cells are the most prominent effector cells of Type 1 hypersensitivity immune responses. CYC116 [4-(2-amino-4-methyl-1,3-thiazol-5-yl)-N-[4-(morpholin-4-yl)phenyl] pyrimidin-2-amine] is under development to be used as an anti-cancer drug, but the inhibitory effects of CYC116 on the activation of mast cells and related allergy diseases have not reported as of yet. In this study, we demonstrated, for the first time, that CYC116 inhibited the degranulation of mast cells by antigen stimulation (IC₅₀, ∼1.42 µM). CYC116 also inhibited the secretion of pro-inflammatory cytokines including TNF-α (IC₅₀, ∼1.10 µM), and IL-6 (IC₅₀, ∼1.24 µM). CYC116 inhibited the mast cell-mediated allergic responses, passive cutaneous anaphylaxis (ED50, ∼22.5 mg/kg), and passive systemic anaphylaxis in a dose-dependent manner in laboratory experiments performed on mice. Specifically, CYC116 inhibited the activity of Fyn in mast cells and inhibited the activation of Syk and Syk-dependent signaling proteins including LAT, PLCγ, Akt, and MAP kinases. Our results suggest that CYC116 could be used as an alternative therapeutic medication for mast cell-mediated allergic disorders, such as atopic dermatitis and allergic rhinitis.
Anaphylaxis ; Animals ; Cytokines ; Dermatitis, Atopic ; Hypersensitivity ; Interleukin-6 ; Mast Cells ; Mice ; Passive Cutaneous Anaphylaxis ; Phosphotransferases ; Rhinitis, Allergic

Trichomoniasis is the most common curable sexually-transmitted infection. Most Trichomonas vaginalis-infected men are asymptomatic and can remain undiagnosed and untreated, and this has been thought to result in chronic persistent prostatic infection. Chronic inflammation is regarded as the major factor in the pathogenesis and progression of benign prostatic hyperplasia (BPH) and prostatic cancer (PCa). The aim of this study is to identify seropositivity to T. vaginalis in men with prostate tumors (BPH or PCa) visited to Hanyang University Hospital. A total of 183 men were enrolled between October 2013 and November 2014. They consisted of 139 with BPH (mean age: 64.0±0.07) and 44 with prostate cancer (mean age: 73.3±0.18). We carried out ELISA to identify the seropositivity to T. vaginalis. Mixed lysate antigen extracted from 8 strains of T. vaginalis was used in the ELISA. Also 58 male outpatients visited to Health Promotion Center in Hanyang University Hospital were evaluated for comparing group. As a results, seropositivity to T. vaginalis in patients with prostatic diseases was 19.7% (BPH: 18.7%, PCa: 22.7%) and it was significantly higher than the 1.7% of the comparing healthy group (P=0.001). Therefore, prostatic tumor showed higher seropositivity against T. vaginalis than normal men. As far as we know, this is the first report about seroprevalence in prostatic tumor in Korea.
Enzyme-Linked Immunosorbent Assay ; Health Promotion ; Humans ; Inflammation ; Korea ; Male ; Outpatients ; Passive Cutaneous Anaphylaxis ; Prostate ; Prostatic Diseases ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Seroepidemiologic Studies ; Trichomonas vaginalis ; Trichomonas

PURPOSE: Radical prostatectomy (RP) is one of main treatments for prostate cancer (Pca). The prevalence of Pca has been decreasing in recent reports. However, no study has reported trends in Pca prevalence or RP rate according to age structural changes. The objective of this study was to investigate trends in Pca prevalence and frequency of RP according to age structural change. MATERIALS AND METHODS: We evaluated trends in Pca prevalence and RP rate using National Health Insurance Data from 2005 to 2015. Relationships for Pca prevalence and RP rate with age structural change were also determined. Primary outcomes included trends in Pca prevalence and RP rates according to age groups, comparing those before and after 2011. RESULTS: Pca prevalence tended to increase before 2011 and decreased after 2011 in persons in the 60-years age group. RP rate increased pattern before 2011 and decreased after 2011 in age groups of 50s, 60s, and over 70s. Pca prevalence and age structural change showed a significantly positive relationship in all age groups, except for the age group under 40 years. RP rate and age structural change also showed a significantly positive relationship in all age groups. CONCLUSION: Age structural change can affect the decreasing trend in Pca prevalence and RP rate in South Korea. Future studies are needed to validate this result.
Humans ; Korea ; National Health Programs ; Passive Cutaneous Anaphylaxis ; Prevalence ; Prostate ; Prostatectomy ; Prostatic Neoplasms

PURPOSE: To evaluate changes in the expression of androgen receptor (AR) and its variants (ARVs) in human prostate cancer (PCa) tissues according to disease status, and its prognostic significance following radical prostatectomy (RP). MATERIALS AND METHODS: A total of 282 PCa cases were evaluated, which included 252 localized PCa, 8 metastatic castration resistant prostate cancer (CRPC), and 22 benign prostatic hyperplasia (BPH) cases. Samples were collected from patients who underwent RP or transurethral resection and were stored in ethically approved tissue banks. Quantitative real-time polymerase chain reaction, Western blotting, and immunohistochemistry were performed for AR and ARVs. Each tissue was confirmed as cancerous (greater than 80%) using hematoxylin and eosin staining. AR and ARVs expression was compared according to disease status. The biochemical recurrence free survival (BCRFS) rates in men with localized PCa was analyzed according to AR and ARV7 expression using the Kaplan-Meier curve. RESULTS: Only 58 of the 252 localized PCa were included in the analysis because of insufficient cancer tissue. AR and ARV7 mRNA expression was higher in the CRPC tissue than in the localized PCa tissue (p=0.025, p=0.002, respectively). In localized PCa tissue, high AR mRNA and protein level was associated with a low BCRFS rate (log-ranked, p=0.019, p < 0.001, respectively). CONCLUSIONS: Overall AR and ARV7 mRNA expression levels were increased in CRPC tissues compared to localized PCa and BPH tissues. High AR protein and mRNA expression in the tumor tissue may be considered a predictive factor of BCRFS following RP.
Blotting, Western ; Castration ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans* ; Immunohistochemistry ; Male ; Passive Cutaneous Anaphylaxis ; Prostate* ; Prostatectomy ; Prostatic Hyperplasia ; Prostatic Neoplasms* ; Real-Time Polymerase Chain Reaction ; Receptors, Androgen* ; Recurrence ; RNA, Messenger ; Tissue Banks

PURPOSE: To compare the clinical outcomes of single injection adductor canal block (SACB), continuous adductor canal block (CACB), and the concomitant use of transdermal buprenorphine after total knee arthroplasty (TKA). MATERIALS AND METHODS: A total of 125 patients who underwent TKA were divided into three groups and the clinical results were retrospecitively compared. Group I was comprised of patients with pain controlled by SACB (n=41). Group II consisted of patients with pain controlled by both SACB and transdermal buprenorphine (10 µg/h) (n=44). Group III contained patients with pain controlled by CACB (n=40). The visual analogue scale (VAS) was used as the pain control indicator and the patients were measured on a VAS for resting on the bed (VAS-Rest) at 12 hours, 24 hours, and 48 hours after surgery. The VAS while doing continuous passive motion (VAS-CPM) on the first and second postoperative day was also measured. In addition, the total amount of medications used (Butopahn, Tridol, and Ketorac) for the intravenous patient controlled analgesia (PCA) was counted for 48 hours after surgery. As the indicator of the functional recovery outcome, the incidence of nausea and vomiting was observed for 48 hours after surgery. The maximum knee joint flexion range and maximum walking distance on the first and second postoperative day, and the total length of stay at the hospital were compared. RESULTS: The VAS-Rest was similar in the three groups at 12 hours after surgery, but at 24 hours and 48 hours after surgery, group II and III a lower VAS-CPM and total amount of medications used for PCA than group I (p<0.05). The three groups showed a low incidence of nausea and vomiting, maximum knee joint flexion range, and similar walking distance and total length of stay at the hospital. CONCLUSION: The combination of SACB and transdermal buprenorphine has great pain control effect initially. On the other hand, it is not associated with catheter complications and it is convenient to use and safety toward the renal function. Therefore, the concomitant use of SACB and transdermal buprenorphine can be an effective pain control method after TKA.
Analgesia, Patient-Controlled ; Arthroplasty, Replacement, Knee ; Buprenorphine ; Catheters ; Hand ; Humans ; Incidence ; Knee Joint ; Length of Stay ; Methods ; Nausea ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Vomiting ; Walking

PURPOSE: Endotype in chronic rhinosinusitis (CRS) has been established in the last decade. However, the exact immunologic profile of CRS still has controversy because it has a considerable immunologic heterogeneity. Therefore, we investigated various inflammatory mediators according to different nasal tissues in chronic rhinosinusitis and compared them within the same subject. METHODS: We collected uncinate process mucosa (UP) and nasal polyp (NP) tissues from controls, CRS without NP (CRSsNP) and CRS with NP (CRSwNP). Expression levels of 28 inflammatory mediators including T helper (Th) 1, Th2, Th17, proinflammatory cytokines and remodeling markers were determined by multiplex immunoassay and were analyzed using paired tests as well as principal component analysis (PCA) to investigate endotype in each subtype of CRS. RESULTS: Signature inflammatory mediators are interleukin (IL)-5, C-C motif chemokine ligand (CCL)-24, monocyte chemoattractant protein (MCP)-4, and vascular cell adhesion molecule (VCAM)-1 in eosinophilic NP, whereas IL-17A, IL-1β, and matrix metallopeptidase (MMP)-9 were detected as signature inflammatory markers in non-eosinophilic NP. Despite differences in inflammatory cytokine profile between eosinophilic and non-eosinophilic NP, the common upregulation of IL-5, CCL-11, IL-23, IL-2Rα, VCAM-1, MMP-3 and MMP-9 were shown in NP compared to UP within the same subject. In the PCA, we observed that Th2 immune response was helpful in discriminating between nasal tissues in subtypes of CRS and that there was a partial overlap between non-eosinophilic NP and eosinophilic NP in terms of Th2 mediators. CONCLUSIONS: Commonly upregulated mediators in NP were Th2-associated, compared with UP regardless of CRS subtypes, whereas signature markers were distinct in each NP subtype. These findings imply that Th2 inflammatory responses may play a role in the development of NP regardless of CRSwNP subtypes.
Cytokines ; Eosinophils ; Immunoassay ; Interleukin-17 ; Interleukin-23 ; Interleukin-5 ; Interleukins ; Monocytes ; Mucous Membrane ; Nasal Polyps ; Passive Cutaneous Anaphylaxis ; Population Characteristics ; Principal Component Analysis ; Rhinitis ; Sinusitis ; Up-Regulation ; Vascular Cell Adhesion Molecule-1

BACKGROUND: Postoperative nausea and vomiting (PONV) frequently occurs following bimaxillary orthognathic surgeries. Compared to opioids, Nefopam is associated with lower incidences of PONV, and does not induce gastrointestinal tract injury, coagulopathy, nephrotoxicity, or fracture healing dysfunction, which are common side effects of Nonsteroidal anti-inflammatory drugs. We compared nefopam- and fentanyl-induced incidence of PONV in patients with access to patient-controlled analgesia (PCA) following bimaxillary orthognathic surgeries. METHODS: Patients undergoing bimaxillary orthognathic surgeries were randomly divided into nefopam and fentanyl groups. Nefopam 120 mg or fentanyl 700 µg was mixed with normal saline to a final volume of 120 mL. Patients were given access to nefopam or fentanyl via PCA. Postoperative pain intensity and PONV were measured at 30 minutes and 1 hour after surgery in the recovery room and at 8, 24, 48, and 72 hours after surgery in the ward. The frequency of bolus delivery was compared at each time point. RESULTS: Eighty-nine patients were enrolled in this study, with 48 in the nefopam (N) group and 41 in the fentanyl (F) group. PONV occurred in 13 patients (27.7%) in the N group and 7 patients (17.1%) in the F group at 8 hours post-surgery (P = 0.568), and there were no significant differences between the two groups at any of the time points. VAS scores were 4.4 ± 2.0 and 3.7 ± 1.9 in the N and F groups, respectively, at 8 hours after surgery (P = 0.122), and cumulative bolus delivery was 10.7 ± 13.7 and 8.6 ± 8.5, respectively (P = 0.408). There were no significant differences in pain or bolus delivery at any of the remaining time points. CONCLUSION: Patients who underwent bimaxillary orthognathic surgery and were given nefopam via PCA did not experience a lower rate of PONV compared to those that received fentanyl via PCA. Furthermore, nefopam and fentanyl did not provide significantly different postoperative pain control.
Analgesia, Patient-Controlled ; Analgesics, Opioid ; Fentanyl ; Fracture Healing ; Gastrointestinal Tract ; Humans ; Incidence ; Nefopam ; Orthognathic Surgery ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Prospective Studies ; Recovery Room