Background/Aims: We evaluated the feasibility and long-term efficacy of the combination of cytarabine, idarubicin, and all-trans retinoic acid (ATRA) for treating patients with newly diagnosed acute promyelocytic leukemia (APL). Methods: We included 87 patients with newly diagnosed acute myeloid leukemia and a t(15;17) or promyelocytic leukemia/retinoic acid receptor alpha (PML-RARα) mutation. Patients received 12 mg/m2/day idarubicin intravenously for 3 days and 100 mg/m2/day cytarabine for 7 days, plus 45 mg/m2/day ATRA. Clinical outcomes included complete remission (CR), relapse-free survival (RFS), overall survival (OS), and the secondary malignancy incidence during a 20-year follow-up. Results: The CR, 10-year RFS, and 10-year OS rates were 89.7%, 94.1%, and 73.8%, respectively, for all patients. The 10-year OS rate was 100% for patients that achieved CR. Subjects were classified according to the white blood cell (WBC) count in peripheral blood at diagnosis (low-risk, WBC < 10,000/mm3; high-risk, WBC ≥ 10,000/mm3). The low-risk group had significantly higher RFS and OS rates than the high-risk group, but the outcomes were not superior to the current standard treatment (arsenic trioxide plus ATRA). Toxicities were similar to those observed with anthracycline plus ATRA, and higher than those observed with arsenic trioxide plus ATRA. The secondary malignancy incidence after APL treatment was 2.7%, among the 75 patients that achieved CR, and 5.0% among the 40 patients that survived more than 5 years after the APL diagnosis. Conclusions Adding cytarabine to anthracycline plus ATRA was not inferior to anthracycline plus ATRA alone, but it was not comparable to arsenic trioxide plus ATRA. The probability of secondary malignancy was low.

Background: Nilotinib is a tyrosine kinase inhibitor approved by the Ministry of Food and Drug Safety for frontline and 2nd line treatment of Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML). This study aimed to confirm the safety and efficacy of nilotinib in routine clinical practice within South Korea. Methods: An open-label, multicenter, single-arm, 12-week observational post-marketing surveillance (PMS) study was conducted on 669 Korean adult patients with Ph + CML from December 24, 2010, to December 23, 2016. The patients received nilotinib treatment in routine clinical practice settings. Safety was evaluated by all types of adverse events (AEs) during the study period, and efficacy was evaluated by the complete hematological response (CHR) and cytogenetic response. Results: During the study period, AEs occurred in 61.3% (410 patients, 973 events), adverse drug reactions (ADRs) in 40.5% (271/669 patients, 559 events), serious AEs in 4.5% (30 patients, 37 events), and serious ADRs in 0.7% (5 patients, 8 events). Furthermore, unexpected AEs occurred at a rate of 6.9% (46 patients, 55 events) and unexpected ADRs at 1.2% (8 patients, 8 events). As for the efficacy results, CHR was achieved in 89.5% (442/494 patients), and minor cytogenetic response or major cytogenetic response was achieved in 85.8% (139/162 patients). Conclusion This PMS study shows consistent results in terms of safety and efficacy compared with previous studies. Nilotinib was well tolerated and efficacious in adult Korean patients with Ph + CML in routine clinical practice settings.

Since laparoscopic liver resection was first introduced in 2001, Korean surgeons have chosen a laparoscopic procedure as one of the treatment options for benign or malignant liver disease. We distributed and analyzed a nationwide questionnaire to members of the Korean Laparoscopic Liver Surgery Study Group (KLLSG) in order to evaluate the current status of laparoscopic liver resection in Korea. Questionnaires were sent to 24 centers of KLLSG. The questionnaire consisted of operative procedure, histological diagnosis of liver lesions, indications for resection, causes of conversion to open surgery, and postoperative outcomes. A laparoscopic liver resection was performed in 416 patients from 2001 to 2008. Of 416 patients, 59.6% had malignant tumors, and 40.4% had benign diseases. A total laparoscopic approach was performed in 88.7%. Anatomical laparoscopic liver resection was more commonly performed than non-anatomical resection (59.9% vs 40.1%). The anatomical laparoscopic liver resection procedures consisted of a left lateral sectionectomy (29.3%), left hemihepatectomy (19.2%), right hemihepatectomy (6%), right posterior sectionectomy (4.3%), central bisectionectomy (0.5%), and caudate lobectomy (0.5%). Laparoscopy-related serious complications occurred in 12 (2.8%) patients. The present study findings provide data in terms of indication, type and method of liver resection, and current status of laparoscopic liver resection in Korea.
*Hepatectomy/statistics & numerical data ; Humans ; *Laparoscopy/statistics & numerical data ; Liver/*surgery ; Liver Diseases/pathology/surgery ; Liver Neoplasms/pathology/surgery ; Postoperative Complications/epidemiology ; Questionnaires ; Republic of Korea

We analyzed parasitic diseases diagnosed by tissue biopsy specimens at KyungHee Medical Center (KMC) from 1984 to 2005. The total number of parasite infection cases was 150 (0.07%) out of the total 211,859 biopsy specimens submitted for histopathological examinations. They consisted of 62 cysticercosis, 23 sparganosis, 16 paragonimiasis, 15 amebiasis, 11 anisakiasis, 11 clonorchiasis, 3 ascariasis, 2 scabies, 2 enterobiasis, 2 trichuriasis, 1 leishmaniasis, 1 taeniasis, and 1 thelaziasis. Out of 62 cysticercosis cases, 55 were detected in subcutaneous tissues or the central nerve system. Eighteen out of 23 sparganosis cases were involved in muscular and subcutaneous tissues. In most anisakiasis cases, the involved organ was the stomach. The lung and the pleura were the most common site of paragonimiasis. The incidence of parasitic diseases during the first 5 years (1984-1988) was the highest of all observed periods. After 1989, similar incidences were shown throughout the period. Whereas cysticercosis was diagnosed in 34 cases during 1984-1988, no case has been diagnosed since 2000. In the case of sparganosis, the chronological incidence was almost uniform throughout the period 1984-2005. Paragonimiasis showed a similar tendency to cysticercosis. In gender and age distribution of parasitic diseases, men showed higher incidence rates than females, and the age groups of the 40s or older indicated higher infection frequencies than other age groups. Therefore, these results are a significant report to appear the tendency of human parasitic disease diagnosed by tissue biopsy in association with parasitosis at KMC in Seoul.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; *Biopsy ; Child ; Child, Preschool ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Parasitic Diseases/*diagnosis/*epidemiology ; Republic of Korea/epidemiology ; Sex Factors ; Young Adult

We report here a human case probably mixed-infected with Clonorchis sinensis and Fasciola sp. who was diagnosed by computed tomography (CT) scan, serological findings, and/or fecal examination. The patient was a 43-year-old Korean female and was admitted to Kyung Hee University Hospital with the complaints of fever and abdominal pain. On admission, marked eosinophilia was noted in her peripheral blood. CT scan showed specific lesions for clonorchiasis and fascioliasis in the liver, along with lesions suggestive of amebic abscess. Micro-ELISA revealed positive results for the 2 helminthic infections. Eggs of C. sinensis and trophozoites of Entamoeba histolytica were observed in the stool. Treatment with praziquantel followed by metronidazole and tinidazole reduced abnormalities in the liver and eosinophilia. This is the first case report of a possible co-infection with 2 kinds of liver flukes in the Republic of Korea.

Lemierre syndrome is a rare clinical condition that is characterized by anaerobic oropharyngeal infections leading to septic thrombophlebitis of the internal jugular vein and frequent secondary metastatic infections. The accurate diagnosis and treatment, for early stage disease, is important because it may be associated with a high mortality rate if untreated. We present the case of a 34-year-old man who presented with a history of typical for the diagnosis of Lemierre syndrome. Supportive care with antibiotics did not improve the clinical condition. The clinical course improved after treatment with IV anticoagulant and surgical thrombectomy. In addition, he had the antiphospholipid syndrome, which is known to be a common cause of acquired arterial or venous thrombosis. Therefore, in this patient the associated antiphospholipid syndrome might precipitate an internal jugular venous thrombophlebitis after an oropharyngeal infection or might account for the poor response to medical treatment.
Adult ; Anti-Bacterial Agents ; Antiphospholipid Syndrome ; Empyema ; Humans ; Jugular Veins ; Lemierre Syndrome ; Pneumonia ; Thrombectomy ; Thrombophlebitis ; Venous Thrombosis

Recombinant DNA vaccines, based on plasmid vectors expressing an antigen under the control of a strong promotor, have several advantages over traditional vaccines. They have been shown to induce a full spectrum of immune responses for humoral and cellular systems and to secure the higher safety and the simplicity of administration. Thus, establishment of DNA vaccines against Newcastle disease virus (NDV) in poultry has been widely investigated using various virus strains and vector systems. In this study, the F and HN genes of NDV CBP-1 strains isolated from diseased pheasants and attenuated by serial passages in egg embryos were cloned using pSLIA vector and constructed two recombinants of pSLIA-tsF and pSLIA-tsHN. The recombinant plasmids were transfected into COS-7 cell and the expression of HN and F proteins were verified by immunofluorescence, SDS-PAGE and Western blot. The recombinant plasmids were injected intramuscularly and intradermally into C57B/6 mouse and a significant increment of HN and F antibodies was detected by ELISA. According to the results, it was implicative that the recombinant DNA could be utilized for development of recombinant DNA vaccine for NDV.
Animals ; Antibodies ; Blotting, Western ; Clone Cells ; COS Cells ; DNA, Recombinant* ; Electrophoresis, Polyacrylamide Gel ; Embryonic Structures ; Enzyme-Linked Immunosorbent Assay ; Fluorescent Antibody Technique ; Mice ; Newcastle disease virus* ; Newcastle Disease* ; Ovum ; Plasmids ; Poultry ; Serial Passage ; Vaccines ; Vaccines, DNA

Swine hepatitis E virus (HEV) has been reported as a new zoonotic agent due to its close genomic resemblance to the human HEV. Recently this virus is indicated as one of the important pathogens in xenotransplantation that uses pig as a donor animal. We carried out to investigate the prevalence of HEV infections among the pigs and human population in Chungnam region using a nested RT-PCR for detection of a part of HEV ORF2 gene. The sequences of the amplified DNA were analyzed and the genetical divergency were characterized. A total of 18 HEV strains, comprising 16 strains from pig and 2 strains from human, were genetically isolated from the fecal and serum samples. Among the isolates, 5 strains (2.5%) were detected from 200 swine sera and 2 strains (2.0%) from 100 human sera. All of the 16 swine strains were isolated from the pigs at 3 month of age, but none of age groups revealed the positive for swine HEV RNA. In comparison of the nucleotide sequence between 16 swine HEV and 2 human HEV isolates, the range of identities was 91.5% to 100%. Two human HEV isolates shared 99.7% homology. In phylogenetic analysis, all of the isolates were classified into genotype III, and the 18 isolates were also closely related to the prototype of swine HEV and human HEV strains isolated in the United States and others recently identified from swine in Japan and Netherland.
Animals ; Base Sequence ; Chungcheongnam-do* ; DNA ; Genotype ; Hepatitis E virus* ; Hepatitis E* ; Hepatitis* ; Humans* ; Japan ; Korea* ; Prevalence ; RNA ; Swine* ; Tissue Donors ; Transplantation, Heterologous ; United States

Swine hepatitis E virus (HEV) has been reported as a new zoonotic agent due to its close genomic resemblance to the human HEV. Recently this virus is indicated as one of the important pathogens in xenotransplantation that uses pig as a donor animal. We carried out to investigate the prevalence of HEV infections among the pigs and human population in Chungnam region using a nested RT-PCR for detection of a part of HEV ORF2 gene. The sequences of the amplified DNA were analyzed and the genetical divergency were characterized. A total of 18 HEV strains, comprising 16 strains from pig and 2 strains from human, were genetically isolated from the fecal and serum samples. Among the isolates, 5 strains (2.5%) were detected from 200 swine sera and 2 strains (2.0%) from 100 human sera. All of the 16 swine strains were isolated from the pigs at 3 month of age, but none of age groups revealed the positive for swine HEV RNA. In comparison of the nucleotide sequence between 16 swine HEV and 2 human HEV isolates, the range of identities was 91.5% to 100%. Two human HEV isolates shared 99.7% homology. In phylogenetic analysis, all of the isolates were classified into genotype III, and the 18 isolates were also closely related to the prototype of swine HEV and human HEV strains isolated in the United States and others recently identified from swine in Japan and Netherland.
Animals ; Base Sequence ; Chungcheongnam-do* ; DNA ; Genotype ; Hepatitis E virus* ; Hepatitis E* ; Hepatitis* ; Humans* ; Japan ; Korea* ; Prevalence ; RNA ; Swine* ; Tissue Donors ; Transplantation, Heterologous ; United States

Porcine circovirus type 2 (PCV-2) has been nowadays recognized as a major agent causing postweaning multisystemic wasting syndrome (PMWS) in pigs worldwide. PMWS most commonly affects the weaned piglets, being of increasing importance to the pig industry in Korea. Seven commercial farms affected with PMWS and 2 farms free from PMWS, located in the southern part of Gyeonggi province, were selected for this study. The peripheral mononuclear cells were tested for the presence of ORF2 gene by PCR, and 54 (68.4%) of 79 samples were positive. All of 9 herds tested included the positive cases. The positive rates by herds were 50 to 100% in the PMWS-affected herds and 40 to 62.5% in the PMWS-free herd. The nucleotide and amino acid sequences of ORF2 gene of 6 strains were characterized. Homologies among 6 strains revealed 92.1 to 100% in the nucleotide and 92.3 to 100% in the amino acid. The overall ranges of homologies for 25 strains comprised 2 Korean and 23 foreign strains were 91.1 to 100% in the nucleotide and 89.7 to 100% in the amino acid. Three regions of greater heterogeneity were found in immunorelevant epitopes of the capsid protein, and the sequences between 57 to 80 aa revealed higher mutation than other areas. In the phylogenetic tree analysis, KOR 71 strain was clustered together with Korean strains previously isolated in Korea. The remaining 5 strains were closely clustered with other European and Asian strains. The results will be valuable for improving our understanding of the molecular epidemiology of PCV-2 in Korea and development of preventive measures for PMWS.
Amino Acid Sequence ; Asian Continental Ancestry Group ; Capsid Proteins ; Circovirus* ; Epitopes ; Gyeonggi-do ; Humans ; Korea* ; Molecular Epidemiology ; Polymerase Chain Reaction ; Population Characteristics ; Swine* ; Wasting Syndrome