Background: A healthy microbiome helps maintain the gut barrier and mucosal immune tolerance. Previously, we demonstrated that acute kidney injury (AKI) provoked dysbiosis, gut inflammation, and increased permeability. Here, we investigated the renoprotective effects of the probiotic Bifidobacterium bifidum BGN4 and the underlying mechanisms thereof. Methods: C57BL/6 mice were subjected to bilateral renal ischemia-reperfusion injury (IRI) or sham operation. In the probiotic-treated group, BGN4 was administered by gavage once daily, starting 2 weeks before injury. Results: Administration of BGN4 significantly increased gut microbiome diversity and prevented expansion of the Enterobacteriaceae and Bacteroidetes that were the hallmarks of AKI-induced dysbiosis. Further, BGN4 administration also significantly reduced other IRI-induced changes in the colon microenvironment, including effects on permeability, apoptosis of colon epithelial cells, and neutrophil and proinflammatory macrophage infiltration. Mononuclear cells co-cultured with BGN4 expressed significantly increased proportions of CD103+/CD11c+ and CD4+ CD25+ Treg cells, suggesting a direct immunomodulatory effect. BGN4 induced Treg expansion in colon, mesenteric lymph nodes (MNL), and kidney. BGN4 also reduced CX3CR1intermediateLy6Chigh monocyte infiltration and interleukin (IL)-17A suppression in the small intestine, which may have attenuated AKI severity, kidney IL-6 messenger RNA expression, and AKI-induced liver injury. Conclusion Prior supplementation with BGN4 significantly attenuated the severity of IRI and secondary liver injury. This renoprotective effect was associated with increased Foxp3 and reduced IL-17A expression in the colon, MNL, and kidney, suggesting that BGN4-induced immunomodulation might contribute to its renoprotective effects. Probiotics may therefore be a promising strategy to reduce AKI severity and/or remote organ injury.

A mucocele is a cystic dilatation of the vermiform appendix that contains mucous material. The symptoms associated with it are not specific and the diagnosis is seldom made prior to surgery. The reported prevalence in appendectomy specimens procured during surgery is 0.2-0.3%. Recently, we experienced a case of patient with appendiceal mucocele detected by colonoscopic examination. This case did not show typical colonoscopic features of a mucocele, demonstrating protrusion of mucin, in the absence of a smooth mound with normal overlying mucosa surrounding the appendiceal orifice. The case involved a 64-year-old woman who underwent a colonoscopy. An abdominopelvic computed tomography scan suggested a normal appendix. Subsequently, we performed an appendectomy. The pathologic finding was a low-grade appendiceal mucinous neoplasm.

A mucocele is a cystic dilatation of the vermiform appendix that contains mucous material. The symptoms associated with it are not specific and the diagnosis is seldom made prior to surgery. The reported prevalence in appendectomy specimens procured during surgery is 0.2-0.3%. Recently, we experienced a case of patient with appendiceal mucocele detected by colonoscopic examination. This case did not show typical colonoscopic features of a mucocele, demonstrating protrusion of mucin, in the absence of a smooth mound with normal overlying mucosa surrounding the appendiceal orifice. The case involved a 64-year-old woman who underwent a colonoscopy. An abdominopelvic computed tomography scan suggested a normal appendix. Subsequently, we performed an appendectomy. The pathologic finding was a low-grade appendiceal mucinous neoplasm.

OBJECTIVE: The aim of the present study was to assess the frequency of germline mutations in patients with peritoneal carcinoma (PC) or the fallopian tube carcinoma (FTC), using a multi-gene panel. METHODS: Twenty-six patients diagnosed with either PC or FTC between January 2013 and December 2016 were recruited consecutively. Germline DNA was sequenced using a 6-gene next generation sequencing (NGS) panel following genetic counseling. Surgico-medical information was obtained from hospital records. Genetic variations were detected using the panel and were cross-validated by Sanger direct sequencing. RESULTS: Germline BRCA1/2 mutations were identified in 6 patients (23.1%). Four were detected in patients with PC and 2 were in FTC patients. No mutations were detected in TP53, PTEN, CDH1, or PALB2. We identified 11 variant of uncertain significance (VUS) in 9 patients; 2 in BRCA1, 3 in BRCA2, 2 in TP53, and 4 in CDH1. We also detected a CDH1 c.2164+16->A VUS in 3 patients. CONCLUSION: The prevalence of germline BRCA1/2 mutations in patients with PC or FTC is comparable to that of BRCA1/2 mutations in epithelial ovarian cancer patients.
DNA ; Fallopian Tube Neoplasms ; Fallopian Tubes* ; Female ; Genes, BRCA1 ; Genes, BRCA2 ; Genetic Counseling ; Genetic Variation ; Germ-Line Mutation ; Hospital Records ; Humans ; Ovarian Neoplasms ; Peritoneal Neoplasms ; Peritoneum* ; Prevalence*

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BACKGROUND: Malnutrition is associated with many adverse clinical outcomes. The present study aimed to identify the prevalence of malnutrition in hospitalized patients in Korea, evaluate the association between malnutrition and clinical outcomes, and ascertain the risk factors of malnutrition. METHODS: A multicenter cross-sectional study was performed with 300 patients recruited from among the patients admitted in 25 hospitals on January 6, 2014. Nutritional status was assessed by using the Subjective Global Assessment (SGA). Demographic characteristics and underlying diseases were compared according to nutritional status. Logistic regression analysis was performed to identify the risk factors of malnutrition. Clinical outcomes such as rate of admission in intensive care units, length of hospital stay, and survival rate were evaluated. RESULTS: The prevalence of malnutrition in the hospitalized patients was 22.0%. Old age (≥ 70 years), admission for medical treatment or diagnostic work-up, and underlying pulmonary or oncological disease were associated with malnutrition. Old age and admission for medical treatment or diagnostic work-up were identified to be risk factors of malnutrition in the multivariate analysis. Patients with malnutrition had longer hospital stay (SGA A = 7.63 ± 6.03 days, B = 9.02 ± 9.96 days, and C = 12.18 ± 7.24 days, P = 0.018) and lower 90-day survival rate (SGA A = 97.9%, B = 90.7%, and C = 58.3%, P < 0.001). CONCLUSION: Malnutrition was common in hospitalized patients, and resulted in longer hospitalization and associated lower survival rate. The rate of malnutrition tended to be higher when the patient was older than 70 years old or hospitalized for medical treatment or diagnostic work-up compared to elective surgery.
Cross-Sectional Studies ; Hospitalization ; Humans ; Intensive Care Units ; Korea ; Length of Stay ; Logistic Models ; Malnutrition ; Multivariate Analysis ; Nutrition Assessment ; Nutritional Status ; Prevalence ; Risk Factors ; Survival Rate

BACKGROUND: FcRgamma-deficient natural killer (NK) cells (g-NK cells) have been associated with cytomegalovirus (CMV) infection. However, the frequency of g-NK cells in a CMV-endemic area (i.e., Korea) has not yet been studied. We examined the frequency of g-NK cells and expression of CD57 on NK cells in cord blood (CB) and adult blood (AB). METHODS: Of the 24 AB samples collected, 95.8% (23/24) were CMV IgG+/IgM-, while 100% of the 13 healthy CB samples were CMV IgG+/IgM-. We performed whole-blood flow cytometry assays to analyze intracellular FcRgamma and CD3zeta expression of CD3-/CD56dim NK cells from 13 CB and 24 AB samples, and surface CD57 expression on CD3-/CD56dim/CD16+ NK cells from 13 CB and 19 AB samples. RESULTS: All CMV seropositive AB samples contained g-NK cells (23/23), and the median proportion of g-NK cells in the CD3-/CD56dim NK cell pool was 35.0% (range: 11-77%). CD57+ NK cells in the CD3-/CD56dim/CD16+ NK cell population were detected in all 19 AB samples tested, but not in any CB samples. CONCLUSIONS: Our data suggest that g-NK cells and CD57+ NK cells are present at a very high frequency in CMV-seropositive AB, but rare in CMV-naive CB.
Adult* ; Cytomegalovirus ; Fetal Blood* ; Flow Cytometry ; Humans ; Killer Cells, Natural*

BACKGROUND: Natural killer cells expanded from human peripheral blood (PB) have been used in cancer immunotherapy research. Although most research teams have access to human PB, it is necessary to find a source of blood that can be easily obtained. We have tested the possibility of using blood retained in a disposable platelet apheresis set as an alternative source, with special interest in expansion of NK cells for use in cancer immunotherapy research. METHODS: For expansion of NK cells, peripheral blood mononuclear cells (PBMCs) were isolated from an MCS+ platelet apheresis kit (Haemonetics, Braintree, USA) and PB from the same donor (n=7) and co-cultured with 100-Gy gamma ray-irradiated K562 cells expressing the 4-1BB ligand and membrane-bound IL-15 for three weeks in RPMI1640 medium in the presence of IL-2 and IL-15. Cytotoxicity was measured using WST-1 at 1:1, 2:1, and 4:1 effector-to-target (E:T) ratios for a period of four hours. RESULTS: Mean rate of expansion of NK cells was 1,097-fold and their purity was 94.4% from blood retained in a disposable platelet apheresis set; mean rate of expansion of NK cells was 953-fold and their purity was 92.0% from PB after a period of three weeks. No differences in cytotoxicity against K562, 697, Raji, and RPMI8226 were observed between NK cells expanded from two blood sources. CONCLUSION: Blood retained in a disposable platelet apheresis set is a useful and convenient source for expansion of NK cells for use in cancer immunotherapy research.
4-1BB Ligand ; Blood Component Removal ; Blood Platelets ; Humans ; Immunotherapy ; Interleukin-15 ; Interleukin-2 ; K562 Cells ; Killer Cells, Natural ; Tissue Donors

OBJECTIVE: In order to elucidate the retrogressive degeneration of orofacial cleft, the fissured tissues of prenatal and postnatal cleft lip and palate were examined by histological and immunohistochemical methods. DESIGN: Totally 42 cases of prenatal (n=17) and postnatal (n=25) cleft lip and/or palate were examined in comparison with 10 cases of normal lip and oral mucosa using immunohistochemical stainings of MMP-3, MMP-9, MMP-10, cathepsin G, PCNA, E-cadherin, TGase 2, HSP-70, vWF, and VEGF. MAIN OUTCOME MEASURES: In the fissured tissue the sebaceous glands were strongly positive for PCNA and grew into the underlying fibromuscular tissue (24/42). Some hyperplastic sebaceous glands of prenatal cleft lip produced infundibular follicular cyst (9/17). The skin and mucosal epithelia from the postnatal cleft lip and palate (10/25) showed severe basal hyperplasia (11/25) and melanocyte infiltration (7/25). RESULTS: The immunostaining of MMP-3 and HSP-70 were strongly positive in the hyperplastic sebaceous glands and nearby atrophying muscle bundles of the fissured tissue, while MMP-9, MMP-10, and cathepsin G were almost negative. The immunoreactions of the other antibodies used in this study were similar between in the fissured tissues and in the normal controls. CONCLUSIONS: These data suggest that the over-expression of MMP-3 is closely related to the sebaceous gland hyperplasia, epithelial dysplasia, and the muscle degeneration, and that the over-expression of MMP-3 in the fissured tissue may continuously aggravate the cleft condition in the later life.
Adult ; Antibodies ; Cadherins ; Cathepsin G ; Cleft Lip* ; Follicular Cyst ; Humans ; Hyperplasia ; Lip ; Melanocytes ; Mouth Mucosa ; Outcome Assessment (Health Care) ; Palate* ; Proliferating Cell Nuclear Antigen ; Sebaceous Glands ; Skin ; Vascular Endothelial Growth Factor A

PURPOSE: To analyze the overall clinical outcome, overall assessment, and patient's satisfaction rate of subtalar arthrodesis using the cannulated compression screw. MATERIALS AND METHODS: This study is based on 17 patients, 17 feet who underwent subtalar arthrodesis using the cannulated compression screw from March, 1997 to March, 2004 with at least 1 year follow-up. The average follow-up period was 33.0 months (12 to 72 months). Functional results were assessed using the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot (AOFAS) score, and Visual Analysis Scale (VAS) pain score, patients' returning to previous occupation and patients' satisfaction rate were also evaluated. RESULTS: The mean AOFAS scores at final follow-up were 80.4 points (range 66~92). The satisfactory rates were as follow. Thirteen patients (76.4%) were at least satisfied with surgical result at final follow-up. Patients' VAS pain score was average 2.8 points (1~6). Fourteen (82.3%) patients returned to previous job at mean postoperative period of 11.3 months (range 3-18 months). Patients' work efficiency after returning to previous occupation was 68.7% (range 33~100%). There were 9 complications which were 3 cases of sural nerve injury, 1 case of valgus malunion, and 5 cases of the hindfoot residual pain. CONCLUSION: We obtained the satisfactory functional results with relatively high patient satisfaction rate of 76%. So we conclude that subtalar arthrodesis using the cannulated compression screw is a reliable method for addressing the painful end-stage subtalar osteoarthritis and unreconstructible comminuted calcaneal fractures. However we also found out that average 11 months were necessary for patients to return to their job.
Ankle ; Arthrodesis* ; Follow-Up Studies ; Foot ; Humans ; Occupations ; Osteoarthritis ; Patient Satisfaction ; Postoperative Period ; Sural Nerve