Background: We investigated whether distance max , that is, the degree of distance between the upper aerodigestive tract (UAT) mass and the farthest pathologic lymph node, was significantly associated with survival in patients with limited-stage UAT natural killer/T cell lymphoma (NKTCL). Methods: A total of 157 patients who received chemotherapy (CTx) with/without radiotherapy (RTx) were enrolled. Results: In the survival analysis, an elevated lactate dehydrogenase level [progression-free survival (PFS): hazard ratio (HR), 2.948; 95% confidence interval (CI), 1.606‒5.404; P ＜0.001; overall survival (OS): HR, 2.619; 95% CI, 1.594‒4.822; P =0.003], short distance max (PFS: HR, 0.170; 95% CI, 0.071‒0.410; P ＜0.001; OS: HR, 0.142; 95% CI, 0.050‒0.402; P ＜ 0.001), and CTx combined with RTx (HR, 0.168; 95%CI, 0.079‒0.380; P < 0.001; OS: HR, 0.193; 95% CI, 0.087‒0.429; P ＜0.001) had an independent predictive value for PFS and OS. Conclusion The evaluation of the degree of lymphatic spread and local control by CTx combined with RTx is essential in patients with limited-stage UAT NKTCL.

Background: We investigated whether distance max , that is, the degree of distance between the upper aerodigestive tract (UAT) mass and the farthest pathologic lymph node, was significantly associated with survival in patients with limited-stage UAT natural killer/T cell lymphoma (NKTCL). Methods: A total of 157 patients who received chemotherapy (CTx) with/without radiotherapy (RTx) were enrolled. Results: In the survival analysis, an elevated lactate dehydrogenase level [progression-free survival (PFS): hazard ratio (HR), 2.948; 95% confidence interval (CI), 1.606‒5.404; P ＜0.001; overall survival (OS): HR, 2.619; 95% CI, 1.594‒4.822; P =0.003], short distance max (PFS: HR, 0.170; 95% CI, 0.071‒0.410; P ＜0.001; OS: HR, 0.142; 95% CI, 0.050‒0.402; P ＜ 0.001), and CTx combined with RTx (HR, 0.168; 95%CI, 0.079‒0.380; P < 0.001; OS: HR, 0.193; 95% CI, 0.087‒0.429; P ＜0.001) had an independent predictive value for PFS and OS. Conclusion The evaluation of the degree of lymphatic spread and local control by CTx combined with RTx is essential in patients with limited-stage UAT NKTCL.

In order to investigate the antioxidant effect of alkylhydroxide peroxidase (ahpC) of Helicobacter pylori (H. pylori) 26695, an ahpC-deficient mutant (H. pylori 26695 ahpC::cat) was generated. ahpC-deficient mutant was grown slowly at lower pressure of oxygen (5% oxygen) compared to the H. pylori 26695. Whole cell proteins isolated form H. pylori 26695 and H. pylori 26695 ahpC::cat were analyzed by MALDI-TOF and tandem-MS. The expression of 15 proteins, including Ppa, HypB, GrpE, Elp, RecA, GroES, Mda66, RibE, NapA, GlnA, BioB, TrxB, Tsf, FumC and Icd, was more than doubled in H. pylori 26695 ahpC::cat. Production of 10 proteins such as UreG, FabE, Adk, Pnp, OorC, AtpA, AtpD, Nqq3, Pfr, and TagD decreased below 50% in H. pylori 26695 ahpC::cat compared to the H. pylori 26695. In microarray analysis, 9 genes including sul1, amiE, frxA, fecA, hyuA, and katA increased in transcription level in H. pylori 26695 ahpC::cat compared to H. pylori 26695. A total of 24 genes, including flaB, protein kinase C inhibitor, cag16, pabC, and sabA, reduced in transcription. 27 genes, including HP0889, showed common expression changes in ahpC, katA, and sodB-deficient mutations. As a result of this study, there were not many genes whose expression was commonly changed by the deletion of each of the three major antioxidant enzymes of H. pylori. These results showed the functions and regulation of the three antioxidant enzymes were different in H. pylori.
Antioxidants ; Helicobacter pylori ; Helicobacter ; Microarray Analysis ; Oxygen ; Peroxidase ; Protein Kinase C ; Proteome ; Ribes

Primary renal neuroendocrine tumor (NET) is an extremely rare disease with fewer than 100 reported cases to date. Among them, only three involved the renal pelvis, to our knowledge. Here, we report another rare case of primary NET in the renal pelvis of a 33-year-old man. Initial computed tomography (CT) scanning of the abdomen and pelvis revealed a necrotic mass with peritumoral infiltration at the left renal pelvis and ureteropelvic junction causing urinary tract obstruction. A follow-up CT scan revealed an intratumoral hemorrhage. The patient then underwent nephrectomy. The results of a subsequent histopathological examination were consistent with a well-differentiated NET. No lymph nodes or paraganglia were found within the tumor, and further imaging revealed no other primary or metastatic lesions. Therefore, the patient was diagnosed with primary NET in the renal pelvis. We discuss this rare case and briefly review the current NET literature.

BACKGROUND: Everolimus-eluting stent (EES) implantations have a relatively low rate of major adverse cardiac event (MACE) and target lesion revascularization (TLR) in patients with off-label use. However, the clinical outcome in the Korean population regarding EES in patients with off-label use is not well known. OBJECTS: The aim of the current analysis was to compare the clinical outcomes of on-label and off-label EES use over a 2-year follow-up period. METHODS: Using patient-level data from a stent-specific, prospective, all-comer registry, we evaluated 987 patients (1,342 lesions) who received an EES (XIENCE V®, Abbott Vascular, Santa Clara, CA, USA) implantation between February 2009 and April 2011. The primary outcome was assessed: 2-year MACE (a composite endpoint of death from any cause, spontaneous myocardial infarction (MI), and any repeat revascularization). The clinical outcomes in the on- and off-label groups were compared at 2 years. RESULTS: The majority of patients (79.0%) were treated for ≥1 off-label indication. The median duration of the clinical follow-up in the overall population was 2.0 years (interquartile range 1.9–2.1). At 2-years after the EES implantation in the enrolled patients, MACE occurred in 71 (7.9%) patients, cardiac death in 12 (1.3%), MI in 4 (0.5%), target vessel revascularization (TVR) in 33 (3.8%), TLR in 22 (2.5%), and definite or probable stent thrombosis (ST) in 1 (0.1%). Off-label EES implantations tend to increase the risk of 2-year MACE (4.7% vs. 8.8%, p = 0.063) without statistical significance. However, the rates of TLR were higher in the off-label EES implantations (0.0% vs. 3.2%, p = 0.013). In the multivariable analysis, renal failure, previous bypass surgery, previous cerebrovascular accident, and left main lesions were associated with 2-year MACE in patients with EES implantations. CONCLUSIONS: The incidence of 2-year MACE was 7.9%, which that might be acceptable in all-comer patients treated with EES implantations. Although the off-label use of EES was not statistically associated with an increased risk of MACE, the TLR rate was higher in the off-label group, suggesting that physicians need to pay attention to high risk patients with the use of EES implantations.
Coronary Artery Disease ; Death ; Drug-Eluting Stents* ; Follow-Up Studies ; Humans ; Incidence ; Myocardial Infarction ; Off-Label Use ; Prospective Studies ; Renal Insufficiency ; Stents* ; Stroke ; Thrombosis

To identify the Helicobacter pylori antigens operating during early infection in sera from infected infants using proteomics and immunoblot analysis. Two-dimensional (2D) large and small gel electrophoresis was performed using H. pylori strain 51. We performed 2D immunoglobulin G (IgG), immunoglobulin A (IgA), and immunoglobulin M (IgM) antibody immunoblotting using small gels on sera collected at the Gyeongsang National University Hospital from 4–11-month-old infants confirmed with H. pylori infection by pre-embedding immunoelectron microscopy. Immunoblot spots appearing to represent early infection markers in infant sera were compared to those of the large 2D gel for H. pylori strain 51. Corresponding spots were analyzed by matrix-assisted laser desorption/ionization time of flight-mass spectrometry (MALDI-TOF-MS). The peptide fingerprints obtained were searched in the National Center for Biotechnology Information (NCBI) database. Eight infant patients were confirmed with H. pylori infection based on urease tests, histopathologic examinations, and pre-embedding immunoelectron microscopy. One infant showed a 2D IgM immunoblot pattern that seemed to represent early infection. Immunoblot spots were compared with those from whole-cell extracts of H. pylori strain 51 and 18 spots were excised, digested in gel, and analyzed by MALDI-TOF-MS. Of the 10 peptide fingerprints obtained, the H. pylori proteins flagellin A (FlaA), urease β subunit (UreB), pyruvate ferredoxin oxidoreductase (POR), and translation elongation factor Ts (EF-Ts) were identified and appeared to be active during the early infection periods. These results might aid identification of serological markers for the serodiagnosis of early H. pylori infection in infants.
Biotechnology ; Electrophoresis ; Flagellin ; Gels ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoblotting ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Infant* ; Microscopy, Immunoelectron ; Peptide Elongation Factors ; Peptide Mapping ; Proteomics ; Pyruvate Synthase ; Serologic Tests ; Spectrum Analysis ; Urease

Orientia tsutsugamushi (O. tsutsugamushi), which is endemic to an Asia-Pacific region, has increased its incidence and caused annually around 10 thousand patients infected with scrub typhus in Korea in the past several years. In the present study, we isolated 44 O. tsutsugamushi from the patients with febrile illness accompanied with or without an eschar in Gyeongsangnam-do, Korea. These isolates were characterized by genetic analysis of the major outer membrane protein, the 56-kDa type-specific antigen (tsa56), which is unique to O. tsutsugamushi. Two types of sequences of tsa56, designated by JJ1 and JJ2, were determined from 37 and 7 isolates of the 44 isolates, respectively. JJ1 and JJ2 showed 74.7~90.8% identity in nucleotide sequence and 66.1~90.5% identity in amino acid sequence with 33 reference strains except for Boryong and Kuroki. JJ1 and JJ2 had 100 and 99.9% nucleotide identity to Boryong strain, and 99.9 and 99.8% to Kuroki, which has been known to be similar to Boryong, respectively. In addition, they showed 77.9~ 81.4% nucleotide identity with the cluster of Gilliam-related genotypes, whereas they showed higher nucleotide identity (89.6~90.8%) with the cluster of Karp-related genotypes. To our knowledge, this is the first report to isolate O. tsutsugamushi and characterize their genotype as the Boryong in Jinju and West Gyeongsangnam-do, Korea, even though it has been reported that the Boryong was the predominant genotype in isolates from chiggers, domestic rodents, and patients in the southern part of Korea. Furthermore, our isolates could be useful source to study on the pathophysiology and epidemiology of scrub typhus in Korea.
Amino Acid Sequence ; Base Sequence ; Chungcheongnam-do ; Epidemiology ; Genotype ; Gyeongsangnam-do* ; Humans ; Incidence ; Korea* ; Membrane Proteins ; Orientia tsutsugamushi* ; Rodentia ; Scrub Typhus* ; Trombiculidae

OBJECTIVE: The aim of this study was to examine whether the presence of anti-ribonucleoprotein (anti-RNP) antibodies at diagnosis is associated with systemic lupus erythematosus (SLE) flares in newly diagnosed patients during the first year of follow-up. METHODS: The medical records of 71 newly diagnosed SLE patients without other concomitant autoimmune disease, serious infection, or malignancy were reviewed retrospectively. SLE flares were defined according to the SLE Disease Activity Index 2000. Patients were divided into 2 groups according to the presence or absence of anti-RNP, and variables were compared between the groups. RESULTS: During the first year of follow-up, SLE patients with anti-RNP at diagnosis more frequently presented with mucosal ulcers (p=0.003), rash (p=0.001), and arthritis (p=0.007), compared to those without anti-RNP. The SLE flare incidence was remarkably higher in patients with anti-RNP than in those without anti-RNP (62.5% vs. 23.1%, p=0.001). SLE patients with anti-RNP at diagnosis had a significantly higher risk of ever experiencing a SLE flare during the first year of follow-up, compared to those without anti-RNP (odds ratio=8.250). CONCLUSION: In conclusion, SLE patients with anti-RNP at diagnosis were more than 8-fold more likely to experience an SLE flare during the first year of follow-up.
Antibodies ; Arthritis ; Autoimmune Diseases ; Diagnosis* ; Exanthema ; Follow-Up Studies* ; Humans ; Incidence ; Lupus Erythematosus, Systemic* ; Medical Records ; Retrospective Studies ; Ulcer

PURPOSE: The purpose of this study was to analyze the characteristics of initially missed and rebiopsy-detected prostate cancers following 12-core transrectal biopsy. METHODS: A total of 45 patients with prostate cancers detected on rebiopsy and 45 patients with prostate cancers initially detected on transrectal ultrasound-guided biopsy were included in the study. For result analysis, the prostate was divided into six compartments, and the cancer positive rates, estimated tumor burden, and agreement rates between biopsy and surgical specimens, along with clinical data, were evaluated. RESULTS: The largest mean tumor burden was located in the medial apex in both groups. There were significantly more tumors in this location in the rebiopsy group (44.9%) than in the control group (30.1%, P=0.015). The overall sensitivity of biopsy was significantly lower in the rebiopsy group (22.5% vs. 43.4%, P<0.001). The agreement rate of cancer positive cores between biopsy and surgical specimens was significantly lower in the medial apex in the rebiopsy group compared with that of the control group (50.0% vs. 65.6%, P=0.035). The cancer positive rates of target biopsy cores and premalignant lesions in the rebiopsy group were 63.1% and 42.3%, respectively. CONCLUSION: Rebiopsy-detected prostate cancers showed different spatial distribution and lower cancer detection rate of biopsy cores compared with initially diagnosed cancers. To overcome lower cancer detection rate, target biopsy of abnormal sonographic findings, premalignant lesions and medial apex which revealed larger tumor burden would be recommended when performing rebiopsy.
Biopsy ; Humans ; Image-Guided Biopsy ; Prostate* ; Prostatic Neoplasms* ; Tumor Burden ; Ultrasonography

When mouse bone marrow-derived macrophages were stimulated with serum amyloid A (SAA), which is a major acute-phase protein, there was strong inhibition of osteoclast formation induced by the receptor activator of nuclear factor kappaB ligand. SAA not only markedly blocked the expression of several osteoclast-associated genes (TNF receptor-associated factor 6 and osteoclast-associated receptor) but also strongly induced the expression of negative regulators (MafB and interferon regulatory factor 8). Moreover, SAA decreased c-fms expression on the cell surface via shedding of the c-fms extracellular domain. SAA also restrained the fusion of osteoclast precursors by blocking intracellular ATP release. This inhibitory response of SAA is not mediated by the well-known SAA receptors (formyl peptide receptor 2, Toll-like receptor 2 (TLR2) or TLR4). These findings provide insight into a novel inhibitory role of SAA in osteoclastogenesis and suggest that SAA is an important endogenous modulator that regulates bone homeostasis.
Adenosine Triphosphate/metabolism ; Animals ; Cell Differentiation ; Cell Line ; Gene Expression Regulation, Developmental ; Humans ; Macrophages/*cytology/metabolism ; Mice ; Osteoclasts/*cytology/metabolism ; RANK Ligand/*metabolism ; Receptor, Macrophage Colony-Stimulating Factor/genetics ; Receptors, Formyl Peptide/metabolism ; Serum Amyloid A Protein/*metabolism ; Toll-Like Receptor 2/metabolism ; Toll-Like Receptor 4/metabolism