Hyperparathyroidism is common in patients with chronic kidney disease with reduced renal function and has been observed after kidney transplantation. The optimal treatment for cases in which hyperparathyroidism persists after kidney transplantation has not been determined. Methods: This retrospective study included 83 patients with tertiary hyperparathyroidism who underwent kidney transplantation between 2000 and 2018 at a single tertiary center in Korea. Sixty-four patients underwent parathyroidectomy and 19 patients were treated with cinacalcet following renal transplantation. Biochemical parameters and clinical outcomes were compared between the two groups. Results: Serum calcium and parathyroid hormone (PTH) levels improved in both the parathyroidectomy and cinacalcet groups. One year after treatment, parathyroidectomy resulted in a lower mean serum calcium level than cinacalcet (9.7 ± 0.7 mg/dL vs. 10.5 ± 0.7 mg/dL, p = 0.001). Regarding serum PTH, the parathyroidectomy group showed a significantly lower PTH level than the cinacalcet group at 6 months (129.1 ± 80.3 pg/mL vs. 219.2 ± 92.5 pg/mL, p = 0.002) and 1 year (118.8 ± 75.5 pg/mL vs. 250.6 ± 94.5 pg/ mL, p < 0.001). There was no statistically significant difference in the incidence of kidney transplant rejection, graft failure, cardiovascular events, fracture risk, or bone mineral density changes between the two groups. Conclusion: Parathyroidectomy appears to reduce PTH and calcium levels effectively in tertiary hyperparathyroidism. However, creatinine level and allograft rejection should be monitored closely.

Background/Aims: This study assessed the efficacy and safety of adalimumab (ADA) and explored predictors of response in Korean patients with ulcerative colitis (UC). Methods: A prospective, observational, multicenter study was conducted over 56 weeks in adult patients with moderately to severely active UC who received ADA. Clinical response, remission, and mucosal healing were assessed using the Mayo score. Results: A total of 146 patients were enrolled from 17 academic hospitals. Clinical response rates were 52.1% and 37.7% and clinical remission rates were 24.0% and 22.0% at weeks 8 and 56, respectively. Mucosal healing rates were 39.0% and 30.1% at weeks 8 and 56, respectively. Prior use of anti-tumor necrosis factor-α (anti-TNF-α) did not affect clinical and endoscopic responses. The ADA drug level was significantly higher in patients with better outcomes at week 8 (P<0.05). In patients with lower endoscopic activity, higher body mass index, and higher serum albumin levels at baseline, the clinical response rate was higher at week 8. In patients with lower Mayo scores and C-reactive protein levels, clinical responses, and mucosal healing at week 8, the clinical response rate was higher at week 56. Serious adverse drug reactions were identified in 2.8% of patients. Conclusions ADA is effective and safe for induction and maintenance in Korean patients with UC, regardless of prior anti-TNF-α therapy. The ADA drug level is associated with the efficacy of induction therapy. Patients with better short-term outcomes were predictive of those with an improved long-term response.

This study presents neuronal migration pattern of dopamine (DA) neurons generated in separate regions occupying the ventral mesencephalic territory. A single pulse 5-bromodeoxyuridine (BrdU) was administered at embryonic day (E)10-E15.Distribution of tyrosine hydroxylase (TH) positive cells was determined at E13-postnatal day 0 (P0) by immunohistochemistry. BrdU positive cells labeled at E10 were spread out uniformly in the mesencephalon from E13 to E15, migrating through dorsal and ventral routes at E17 and P0. TH expression labeled at E10 was observed at E13 in the ventromedial region and clearly formed in the ventral tegmental area (VTA) at E15. At E17, TH expression in the substantia nigra (SN) was observed in the ventrolateral region, spreading more outward of the mesencephalon at P0. Generation of TH-positive cells labeled at E13 was also observed in VTA and SN of the mesencephalon at E17 and P0. The expression of these cells labeled after E15 was markedly decreased. These results demonstrated that an almost complete primary structure of DA neuron was formed at the early embryonic stage in the ventral mesencephalon, showing the most active neuronal migration was occurred at E13-E17.

This study presents neuronal migration pattern of dopamine (DA) neurons generated in separate regions occupying the ventral mesencephalic territory. A single pulse 5-bromodeoxyuridine (BrdU) was administered at embryonic day (E)10-E15.Distribution of tyrosine hydroxylase (TH) positive cells was determined at E13-postnatal day 0 (P0) by immunohistochemistry. BrdU positive cells labeled at E10 were spread out uniformly in the mesencephalon from E13 to E15, migrating through dorsal and ventral routes at E17 and P0. TH expression labeled at E10 was observed at E13 in the ventromedial region and clearly formed in the ventral tegmental area (VTA) at E15. At E17, TH expression in the substantia nigra (SN) was observed in the ventrolateral region, spreading more outward of the mesencephalon at P0. Generation of TH-positive cells labeled at E13 was also observed in VTA and SN of the mesencephalon at E17 and P0. The expression of these cells labeled after E15 was markedly decreased. These results demonstrated that an almost complete primary structure of DA neuron was formed at the early embryonic stage in the ventral mesencephalon, showing the most active neuronal migration was occurred at E13-E17.

BACKGROUND/AIMS: Kidney transplantation (KT) reportedly provides a significant survival advantage over dialysis in diabetic patients. However, KT outcome in diabetic patients compared with that in non-diabetic patients remains controversial. In addition, owing to recent improvements in the outcomes of KT and management of cardiovascular diseases, it is necessary to analyze outcomes of recently performed KT in diabetic patients. METHODS: We reviewed all diabetic patients who received living donor KT between January 2008 and December 2011. Each patient was age- and sex-matched with two non-diabetic patients who received living donor KT during the same period. The outcomes of living donor KT were compared between diabetic and non-diabetic patients. RESULTS: Among 887 patients, 89 diabetic patients were compared with 178 non-diabetic patients. The incidence of acute rejection was not different between the diabetic and non-diabetic patients. Urinary tract infection and other infections as well as cardiovascular events occurred more frequently in diabetic patients. However, diabetes, cardiovascular disease, and infection were not significant risk factors of graft failure. Late rejection (acute rejection after 1 year of transplantation) was the most important risk factor for graft failure after adjusting for diabetes mellitus (DM), human leukocyte antigen mismatch, rejection and infection (hazard ratio, 56.082; 95% confidence interval, 7.169 to 438.702; p < 0.001). Mortality was not significantly different between diabetic and non-diabetic patients (0 vs. 2, p = 0.344 by log-rank test). CONCLUSIONS: End-stage renal disease patients with DM had favorable outcomes with living donor kidney transplantation.
Cardiovascular Diseases ; Diabetes Mellitus ; Dialysis ; Humans ; Incidence ; Kidney Failure, Chronic ; Kidney Transplantation* ; Kidney* ; Leukocytes ; Living Donors* ; Mortality ; Risk Factors ; Transplants ; Urinary Tract Infections

The aim of this study was to investigate morphological development of filiform papillae (FP) in Korean native goats by using scanning electron microscopy. Tongues were removed from goat fetuses (days 60, 90, and 120), neonates, and juveniles (days 30, 60, 90, 120, 150, and 180 after birth). During the prenatal period, primordia of FP appeared at fetal day 60 and were observed to be developed at day 90. At fetal day 120, the FP were observed like flower leaves of a double flower bud. In neonates, FP were shaped like an obliquely sectioned cylinder with secondary papillae irregularly arranged in a saw blade-like manner. In 60-day-old juvenile goats, the FP were densely distributed at the inner base of 1/3–1/2 degrees. In 90-, 120-, and 150-day-old goats, FP were compacted at the inner base of 1/2–2/3, 3/4, and 4/5 degrees, respectively. In 180-day-old goats, FP were found to be completely compacted on the inner surface with complete morphogenesis. Microridges, microplicae, and micropits were well-developed on the epithelial surface of lingual papillae from embryonic day 120 to juvenile day 180. These results indicate that FP of goats have different shapes and sizes during development both before and after birth.
Fetus ; Flowers ; Goats ; Humans ; Infant, Newborn ; Microscopy, Electron, Scanning ; Morphogenesis ; Parturition ; Tongue

The aim of this study was to investigate morphological development of filiform papillae (FP) in Korean native goats by using scanning electron microscopy. Tongues were removed from goat fetuses (days 60, 90, and 120), neonates, and juveniles (days 30, 60, 90, 120, 150, and 180 after birth). During the prenatal period, primordia of FP appeared at fetal day 60 and were observed to be developed at day 90. At fetal day 120, the FP were observed like flower leaves of a double flower bud. In neonates, FP were shaped like an obliquely sectioned cylinder with secondary papillae irregularly arranged in a saw blade-like manner. In 60-day-old juvenile goats, the FP were densely distributed at the inner base of 1/3–1/2 degrees. In 90-, 120-, and 150-day-old goats, FP were compacted at the inner base of 1/2–2/3, 3/4, and 4/5 degrees, respectively. In 180-day-old goats, FP were found to be completely compacted on the inner surface with complete morphogenesis. Microridges, microplicae, and micropits were well-developed on the epithelial surface of lingual papillae from embryonic day 120 to juvenile day 180. These results indicate that FP of goats have different shapes and sizes during development both before and after birth.

PURPOSE: This study compared the oncologic results of docetaxel chemotherapy (DOC) in castration-resistant prostate cancer (CRPC) according to continuous addition of androgen deprivation therapy (ADT) during chemotherapy. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 106 patients who received DOC in 6 medical institutes. Among them, 72 patients had a complete medical record: 28 patients with ADT (DOC+continuous ADT group) and 44 without ADT (DOC only group). We compared the progression-free survival of these groups after DOC. RESULTS: Docetaxel was administered an average of 28 months after primary ADT as the first treatment. A median number of 6 cycles of DOC was administered in both groups. In the DOC+continuous ADT group, orchiectomy was performed in 18 patients and luteinizing hormone-releasing hormone agonist was injected in 10 patients. During DOC treatment, prostate-specific antigen (PSA) progression-free survival was statistically different (6.0±4.75 months in DOC+continuous ADT group vs. 4.8±3.2 months in DOC only group, p=0.024), whereas radiologic progression-free survival was not statistically different (5.0±3.12 months in DOC+continuous ADT group vs. 5.0±2.79 months in DOC only group, p=0.387). CONCLUSIONS: In our cohort, continuous addition of ADT showed a significant benefit in PSA progression-free survival during DOC in CRPC patients. Further prospective studies are needed to confirm these observations.
Academies and Institutes ; Cohort Studies ; Disease-Free Survival ; Drug Therapy* ; Gonadotropin-Releasing Hormone ; Humans ; Medical Records ; Orchiectomy ; Prospective Studies ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Retrospective Studies

PURPOSE: The incidence of glufosinate poisoning is gradually increasing, and it can be fatal if severe poisoning occurs. However, factors useful for predicting the post-discharge neurological prognosis of patients who have ingested glufosinate have yet to be identified. Our objective was to evaluate the utility of the acute physiology and chronic health evaluation (APACHE) II score measured in the emergency department for predicting the neurological prognosis. METHODS: From April 2012 to August 2014, we conducted a retrospective study of patients who had ingested glufosinate. The outcome of the patients at discharge was defined by the Cerebral Performance Category Score (CPC). The patients were divided into a good prognosis group (CPC 1, 2) and a poor prognosis group (CPC 3, 4, 5), after which the APACHE II scores were compared. The Hosmer-Lemeshow test and the area under the receiver operating characteristic (ROC) curve from patients determined calibration and discrimination. RESULTS: A total of 76 patients were enrolled (good prognosis group: 67 vs poor prognosis group: 9). The cut-off value for the APACHE II score was 12 and the area under the curve value was 0.891. The Hosmer and Lemeshow C statistic χ2 was 7.414 (p=0.387), indicating good calibration for APACHE II. CONCLUSION: The APACHE II score is useful at predicting the neurological prognosis of patients who have ingested glufosinate.
APACHE* ; Calibration ; Discrimination (Psychology) ; Emergency Service, Hospital ; Herbicides ; Humans ; Incidence ; Poisoning ; Prognosis ; Retrospective Studies ; ROC Curve

OBJECTIVES: Neuroblastoma (NBL) predominantly affects children under 5 years of age. Through multimodal therapy, including chemotherapy, radiotherapy, surgery, and peripheral blood stem cell transplantation, the survival rate in patients with NBL have improved while treatment-related complications have also increased. Treatment-related ototoxicity, mainly from cisplatin, can result in profound hearing loss requiring cochlear implantation (CI). We analyzed the effectiveness and hearing preservation of CI recipients who had treated with multimodal therapy due to NBL. METHODS: Patients who received multimodal therapy for NBL and subsequent CIs were enrolled. A detailed review of the perioperative hearing test, speech evaluation, and posttreatment complications was conducted. Speech performance was analyzed using the category of auditory performance (CAP) score and the postoperative hearing preservation of low frequencies was also compared. Patients who were candidates for electro-acoustic stimulation (EAS) used an EAS electrode for low frequency hearing preservation. RESULTS: Three patients were identified and all patients showed improvement of speech performance after CI. The average of CAP score improved from 4.3 preoperatively to 5.8 at 1 year postoperatively. Two patients who were fitted with the Flex electrode showed complete hearing preservation and the preserved hearing was maintained over 1 year. The one remaining patient was given the standard CI-512 electrode and showed partial hearing preservation. CONCLUSION: Patients with profound hearing loss resulting from NBL multimodal therapy can be good candidates for CI, especially for EAS. A soft surgical technique as well as a specifically designed electrode should be applied to this specific population during the CI operation in order to preserve residual hearing and achieve better outcomes.
Child* ; Cisplatin ; Cochlear Implantation* ; Cochlear Implants* ; Combined Modality Therapy* ; Drug Therapy ; Electrodes ; Hearing Loss* ; Hearing Tests ; Hearing* ; Humans ; Neuroblastoma* ; Peripheral Blood Stem Cell Transplantation ; Radiotherapy ; Survival Rate