Hepatocellular carcinoma (HCC) is a highly invasive tumor with a strong tendency for metastasis. The most common sites of metastasis are the lungs, followed by lymph nodes, adrenal glands, and bones. However, metastasis of HCC to the small bowel is extremely rare. A 42-yearold female with HCC secondary to chronic hepatitis B and lung metastasis underwent a right hepatic lobectomy, followed by two wedge resections performed via video-assisted thoracic surgery, four sessions of transcatheter arterial chemoembolization, and stereotactic body radiation therapy. She was under regular follow-up for HCC, during which her alpha-fetoprotein level increased to 722.2 IU/ml. Abdominal computed tomography (CT) revealed segmental wall thickening and aneurysmal dilatation of the small bowel loops. An 18 F-fluorodeoxyglucose positron emission tomography/CT scan demonstrated a 3.3-cm hypermetabolic mass-like lesion (standardized uptake value: 11.3) in the small bowel. Surgical resection of the affected small bowel segment was performed. Histopathological examination of the specimen confirmed metastatic HCC, with immunohistochemical positivity for hepatocyte-specific antigen. The patient has remained cancer-free for 60 months post-operatively. Surgical intervention may offer favorable long-term outcomes in patients with small bowel metastasis from HCC.

Objectives: Early diagnosis of upper gastrointestinal (UGI) amyloidosis and the establishment of appropriate treatment and follow-up strategies remains challenging. This study aimed to elucidate the endoscopic characteristics and clinical courses of patients with isolated UGI amyloidosis. Methods: We retrospectively reviewed 11 patients diagnosed with isolated UGI amyloidosis at Chonnam National University Hospital and Chonnam National University Hwasun Hospital. None of the patients exhibited systemic involvement or multiple myeloma. Clinical data, including endoscopic features, presenting symptoms, and outcomes such as disease progression and mortality, were analyzed. Results: The cohort included seven males (63.6%) and four females (36.4%), with a median age of 72 (37–82) years. Isolated gastric amyloidosis was identified in four patients, and five patients had disease confined to the duodenum. Two patients (18.2%) presented with gastric or duodenal involvement. Endoscopic findings were heterogeneous, with diffuse yellowish linear lesions being the most frequently observed in four patients (36.4%). Histopathological analysis revealed AA amyloidosis in three patients, whereas five patients exhibited only amorphous deposits without amyloid A, amyloid P, or light chains. Six patients (54.5%) were asymptomatic at diagnosis, whereas gastrointestinal bleeding was observed in two patients (18.2%). Only one patient (9.1%) experienced disease progression that necessitated systemic chemotherapy. The mean follow-up duration was 20 months, and the 3-year mortality rate was 9.1%. Conclusions Isolated UGI amyloidosis is a heterogeneous condition that can be easily misdiagnosed. Familiarity with the characteristic endoscopic features and natural disease course is essential for appropriate management.

Objectives: Healthcare facilities are high-risk sites for infection. This study analyzed the epidemiological characteristics of a coronavirus disease 2019 (COVID-19) outbreak in a tertiary hospital after COVID-19 vaccination had been introduced in Republic of Korea. Vaccine effectiveness (VE) and shared anti-infection strategies are also assessed. Methods: The risk levels for 4,074 contacts were evaluated. The epidemiological characteristics of confirmed cases were evaluated using the chi-square test. The “1 minus relative risk” method was used to determine VE in preventing infection, progression to severe disease, and death. In the largest affected area (the 8th floor), a separate relative risk analysis was conducted. A multivariate logistic regression analysis (with 95% confidence interval [CIs]) was used to identify transmission risk factors with a significance level <10% via the backward elimination method. Results: In total, 181 cases of COVID-19 were confirmed, with an attack rate of 4.4%. Of those cases, 12.7% progressed to severe disease, and 8.3% died. In the cohort isolation area on the 8th floor, where 79.0% of the confirmed cases occurred, the adjusted odds ratio was 6.55 (95% CI, 2.99–14.33) and 2.19 (95% CI, 1.24–3.88) for caregivers and the unvaccinated group, respectively. VE analysis revealed that 85.8% of the cases that progressed to severe disease and 78.6% of the deaths could be prevented by administering a second vaccine. Conclusion Caregiver training for infection prevention and control is necessary to reduce infection risk. Vaccination is an important intervention to reduce the risk of progression to severe disease and death.

This study examined the subjective health recognition, motivation, selection property, consumption realties, and generalities of elderly people eating out. The ratio of women eating out in those over 60 years of ages was high and people in that age group ate out most actively. The score of convenience-oriented, gourmet-oriented, and dignity-oriented of the selection property for eating out increased with increasing frequency and expenditure for eating out. With increasing age, a negative (−) relationship with a decrease in the safety-oriented score of the selection property for eating out was predicted. As the number of days eating out increased, a positive (+) relationship with an increase in the safety-oriented score of the selection property for eating out was observed. As the scores of physical and social health perception increased, a positive (+) relationship with an increase in the gourmet oriented score was observed. Based on the results, various research on the relationship between the health recognition and eating out behavior of those over 60 years of age are required.
Aged ; Diagnostic Self Evaluation ; Eating ; Female ; Health Expenditures ; Humans ; Motivation ; Regression Analysis

STUDY DESIGN: Prospective study. OBJECTIVES: This study compared the early postoperative analgesic effects and the postoperative nausea and vomiting (PONV) associated with 3 methods of pain control after posterior spinal decompression. SUMMARY OF LITERATURE REVIEW: Spinal surgery causes severe postoperative pain. Efficient and safe methods for postoperative analgesia after spinal surgery are necessary. MATERIALS AND METHODS: To determine the clinical symptoms and to assess improvements in postoperative pain, 52 patients in whom single-level posterior lumbar decompression was planned were randomly assigned to 3 groups. For postoperative pain control, 18 patients received a preoperative single-shot epidural injection (SEI), 16 patients received a postoperative continuous epidural injection (CEI), and 18 patients received only postoperative intravenous patient-controlled analgesia (IV-PCA). Patient ratings of pain intensity (visual analog scale score from 0 [no pain] to 10 [most severe pain]), nausea (from 0 [no nausea] to 5 [severe nausea]), and vomiting (from 0 [no vomiting] to 5 [severe vomiting]) were recorded immediately after the operation and at 4 hours, 12 hours, 1 day, and 2 days postoperatively. RESULTS: The CEI group showed significantly enhanced analgesic effects, followed by the SEI group and the IV PCA group (p < 0.05). PONV due to postoperative pain control was more severe in the IV PCA group than in the other 2 groups (p < 0.05). CONCLUSIONS: Continuous epidural injection (CEI) is effective for postoperative pain control and minimizes the occurrence of PONV after posterior spinal decompression.
Analgesia ; Analgesia, Patient-Controlled ; Decompression ; Humans ; Injections, Epidural ; Methods ; Nausea ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Prospective Studies ; Spinal Stenosis ; Vomiting

OBJECTIVES: This study compared the early postoperative analgesic effects and the postoperative nausea and vomiting (PONV) associated with 3 methods of pain control after posterior spinal decompression.SUMMARY OF LITERATURE REVIEW: Spinal surgery causes severe postoperative pain. Efficient and safe methods for postoperative analgesia after spinal surgery are necessary. MATERIALS AND METHODS: To determine the clinical symptoms and to assess improvements in postoperative pain, 52 patients in whom single-level posterior lumbar decompression was planned were randomly assigned to 3 groups. For postoperative pain control, 18 patients received a preoperative single-shot epidural injection (SEI), 16 patients received a postoperative continuous epidural injection (CEI), and 18 patients received only postoperative intravenous patient-controlled analgesia (IV-PCA). Patient ratings of pain intensity (visual analog scale score from 0 [no pain] to 10 [most severe pain]), nausea (from 0 [no nausea] to 5 [severe nausea]), and vomiting (from 0 [no vomiting] to 5 [severe vomiting]) were recorded immediately after the operation and at 4 hours, 12 hours, 1 day, and 2 days postoperatively. RESULTS: The CEI group showed significantly enhanced analgesic effects, followed by the SEI group and the IV PCA group (p < 0.05). PONV due to postoperative pain control was more severe in the IV PCA group than in the other 2 groups (p < 0.05). CONCLUSIONS Continuous epidural injection (CEI) is effective for postoperative pain control and minimizes the occurrence of PONV after posterior spinal decompression.

Helicobacter pylori infection is associated with chronic gastritis, peptic ulcer, and gastric cancer. There is evidence that IL-1beta is associated with the development of gastric cancer. Therefore, downregulation of H. pylori-mediated IL-1beta production may be a way to prevent gastric cancer. Withaferin A (WA), a withanolide purified from Withania somnifera, is known to exert anti-inflammatory and anti-tumor effects. In the present study, we explored the inhibitory activity of WA on H. pylori-induced production of IL-1beta in murine bone marrow-derived dendritic cells (BMDCs) and the underlying cellular mechanism. Co-treatment with WA decreased IL-1beta production by H. pylori in BMDCs in a dose-dependent manner. H. pylori-induced gene expression of IL-1beta and NLRP3 (NOD-like receptor family, pyrin domain containing 3) were also suppressed by WA treatment. Moreover, IkappaB-alpha phosphorylation by H. pylori infection was suppressed by WA in BMDCs. Western blot analysis revealed that H. pylori induced cleavage of caspase-1 and IL-1beta, as well as increased procaspase-1 and pro IL-1beta protein levels, and that both were suppressed by co-treatment with WA. Finally, we determined whether WA can directly inhibit ac tivation of the NLRP3 inflammasome. NLRP3 activators induced IL-1beta secretion in LPS-primed macrophages, which was inhibited by WA in a dose-dependent manner, whereas IL-6 production was not affected by WA. Moreover, cleavage of IL-1beta and caspase-1 by NLRP3 activators was also dose-dependently inhibited by WA. These findings suggest that WA can inhibit IL-1beta production by H. pylori in dendritic cells and can be used as a new preventive and therapeutic agent for gastric cancer.
Blotting, Western ; Caspase 1 ; Dendritic Cells* ; Down-Regulation ; Gastritis ; Gene Expression ; Helicobacter pylori ; Helicobacter* ; Humans ; Interleukin-1beta ; Interleukin-6 ; Macrophages ; NF-kappa B* ; Peptic Ulcer ; Phosphorylation ; Stomach Neoplasms ; Withania

The purposes of this study were to determine phenolic compounds and to evaluate antioxidant activities of plums (Soldam, Oishiwase and Formosa). Soldam contains the highest amount of total phenolics among cultivars (Formosa: 4.0%, Oishiwase: 3.3%, Soldam: 6.4% for total phenolic) as well as the total flavonoids of which constituents were mainly myricetin and anthocyanidin. The antioxidant activities were measured by DPPH, ABTS radical scavenging, and SOD-like activities. The DPPH radical scavenging activity of Korean plum extracts (200 microg/mL) showed more than 43%, and the Soldam turned out to be the highest : ID50 value: 160-177 microg/mL for Formosa and Oishiwase; 58-64 microg/mL for Soldam. The ABTS radical scavenging activity of Korean plum extracts (200 microg/mL) was found to be more than 50%. The SOD-like activity of Korean plum extracts (200 microg/mL) showed more than 70%. Among three kinds of cultivars, Soldam had the highest antioxidant activity. The nitrite scavenging activity of Soldam was 61.5%, which is the highest, compared with that of the other cultivars, about 50%. From these results, Korean plums turned out to be phytochemical rich fruit as well as to show high antioxidant activities.
Anthocyanins ; Benzothiazoles ; Flavonoids ; Fruit ; Phenol ; Prunus domestica ; Sulfonic Acids ; Taiwan

BACKGROUND: Scutellaria baicalensis Georgi extract is used as a traditional herbal medicine. The efficacy of Scutellaria baicalensis Georgi extract is known for antioxidative activity, antiinflammation effect, antibacterial effect, inhibitory effect of melanin synthesis, sun protection effect, antiallergy effect, and etc. OBJECTIVE: We confirmed the cell viability or inhibitory effect of melanin synthesis in HaCaT (human keratinocyte cell line) and B16F10 (murine melanoma cell line) cells and the skin safety test through a clinical test (dermal irritation study) for Scutellaria baicalensis Georgi extract, according to the extraction methods. METHODS: We checked the cell viability, using MTT assay and inhibitory effect of melanin synthesis in B16F10 cells or HaCaT cells for thirty one Scutellaria baicalensis Georgi extract, according to the extraction methods. Then, we evaluated the skin safety for selected eight Scutellaria baicalensis Georgi extract through a primary dermal irritation test. RESULTS: Among the thirty one Scutellaria baicalensis Georgi extracts, according to the extraction methods, we selected eight Scutellaria baicalensis Georgi extracts that were not detected with cell toxicity in HaCaT cells and B16F10 cells, and could have inhibited the melanin synthesis in B16F10 cells. The selected eight Scutellaria baicalensis Georgi extracts identified the skin safety through a primary dermal irritation test. CONCLUSION: We expect clinical trials for whitening efficacy based on inhibitory effect of melanin synthesis and human skin safety for Scutellaria baicalensis Georgi extracts.
Cell Survival ; Herbal Medicine ; Humans ; Keratinocytes ; Melanins ; Melanoma ; Scutellaria ; Scutellaria baicalensis ; Skin ; Solar System

A novel synthetic hexapeptide (SFKLRY-NH2) that displays angiogenic activity has been identified by positional scanning of a synthetic peptide combinatorial library (PS-SPCL). This study was carried out to investigate the irritation of the SFKLRY-NH2 on the skin. The tests were performed on the basis of Korea Food and Drug Administration (KFDA) guidelines. In results, cell toxicity is not appeared for SFKLRY-NH2 in HaCaT cells and B16F10 cells. SFKLRY-NH2 induced no skin irritation at low concentration (10 microM), mild irritation at high concentration (10mM). We consider that this result is helpful for saying about the safety of SFKLRY-NH2 in clinical use.
Korea ; Oligopeptides ; Peptide Library ; Skin ; United States Food and Drug Administration