Purpose: We aimed to investigate manifestations and patterns of care for patients with brain metastasis (BM) from breast cancer (BC) and compared their overall survival (OS) from 2005 through 2014 in Korea. Materials and Methods: We retrospectively reviewed 600 BC patients with BM diagnosed between 2005 and 2014. The median follow-up duration was 12.5 months. We categorized the patients into three groups according to the year when BM was initially diagnosed (group I [2005-2008], 98 patients; group II [2009-2011], 200 patients; and group III [2012-2014], 302 patients). Results: Over time, the median age at BM diagnosis increased by 2.2 years (group I, 49.0 years; group II, 48.3 years; and group III, 51.2 years; p=0.008). The percentage of patients with extracranial metastasis was 73.5%, 83.5%, and 86.4% for group I, II, and III, respectively (p=0.011). The time interval between BC and BM was prolonged in patients with stage III primary BC (median, 2.4 to 3 years; p=0.029). As an initial brain-directed treatment, whole-brain radiotherapy alone decreased from 80.0% in 2005 to 41.1% in 2014. Meanwhile, stereotactic radiosurgery or fractionated stereotactic radiotherapy alone increased from 13.3% to 34.7% during the same period (p=0.005). The median OS for group I, II, and III was 15.6, 17.9, and 15.0 months, respectively, with no statistical significance. Conclusion The manifestations of BM from BC and the pattern of care have changed from 2005 to 2014 in Korea. However, the OS has remained relatively unchanged over the 10 years.

A human cell-based liver model capable of long-term expansion and mature hepatic function is a fundamental requirement for pre-clinical drug development. We previously established self-renewing and functionally mature human pluripotent stem cell-derived liver organoids as an alternate to primary human hepatocytes. In this study, we tested long-term prolonged culture of organoids to increase their maturity. Organoid growing at the edge of Matrigel started to deteriorate two weeks after culturing, and the expression levels of the functional mature hepatocyte marker ALB were decreased at four weeks of culture. Replating the organoids weekly at a 1：2 ratio in fresh Matrigel, resulted in healthier morphology with a thicker layer compared to organoids maintained on the same Matrigel and significantly increased ALB expression until three weeks, although, it decreased sharply at four weeks. The levels of the fetal hepatocyte marker AFP were considerably increased in long-term cultures of organoids. Therefore, we performed serial passaging of organoids, whereby they were mechanically split weekly at a 1：3∼1：5 ratio in fresh Matrigel. The organoids expanded so far over passage 55, or 1 year, without growth retardation and maintained a normal karyotype after long-term cryopreservation. Differentiation potentials were maintained or increased after long-term passaging, while AFP expression considerably decreased after passaging. Therefore, these data demonstrate that organoids can be exponentially expanded by serial passaging, while maintaining long-term functional maturation potential. Thus, hepatic organoids can be a practical and renewable cell source for human cell-based and personalized 3D liver models.

Objective: Little is known about factors influencing of hippocampal metabolism (HM) in mild cognitive impairment (MCI). Our objective was to determine whether HM in patients with amnestic MCI (aMCI) is decreased than non-amnestic MCI (naMCI). Methods: Overall, 32 MCI patients underwent 18F-fluorodeoxyglucose-positron emission tomography. They were characterized as aMCI (n=18) or naMCI (n=14) according to comprehensive neuropsychological criteria. Analysis of variances were used to assess differences on HM between aMCI and naMCI after controlling age, sex, education and Korean version of Mini Mental Status Examination. Results: We found that HM was more decreased in aMCI than naMCI. This result was not changed after controlling hippocampal volume. Conclusion Our findings suggest that aMCI is associated with decreased HM in MCI.

BACKGROUND: This study aimed to analyze correlations between depression, cognitive function, oral health state, ability to perform activities of daily living, oral dryness symptoms, and oral health-related quality of life, and determine factors influencing the latter.METHODS: This was a cross-sectional study based on questionnaires completed by 260 participants with suspected dementia, residing in South Korea. Psychiatrists, psychiatric nurses, and dental hygienists visited clinics in the participating regions for examination and questionnaire administration. General characteristics, the geriatric depression scale, ability to perform activities of daily living, cognitive function, oral health state, and oral health-related quality of life were analyzed. Independent t-tests, one-way analysis of variance (ANOVA), correlation analysis and multiple regression analysis were conducted, identifying factors affecting oral health-related quality of life. Data analysis was performed using SPSS ver. 20.0 (IBM Corp., USA), and the significance was set at p<0.05.RESULTS: Approximately 65.0% of participants were female, 63.5% were in their 70s, and 90.0% had health insurance. About 21.5%, 42.0%, and 36.5% were normal, slightly impaired, and had dementia, respectively. High cognitive impairment was associated with poor oral health. Sex, education levels, marital status, and living arrangements influenced oral health-related quality of life. According to the regression analysis, geriatric depression and oral dryness affected the Geriatric Oral Health Assessment Index scores.CONCLUSION: In conclusion, oral dryness and depression levels among elders influenced oral health-related quality of life. The results showed that to enhance elders' oral health-related quality of life, it is essential to not only improve their oral health state, but also relieve oral health problems, especially oral dryness, and take into consideration their psychological aspects.
Activities of Daily Living ; Aged ; Cognition ; Cognition Disorders ; Cross-Sectional Studies ; Dementia ; Dental Hygienists ; Depression ; Education ; Female ; Humans ; Insurance, Health ; Korea ; Marital Status ; Oral Health ; Psychiatry ; Quality of Life ; Residence Characteristics ; Statistics as Topic

Emerging evidence has emphasized the importance of cancer therapies targeting an abnormal metabolic state of tumor-initiating cells (TICs) in which they retain stem cell-like phenotypes and nicotinamide adenine dinucleotide (NAD⁺) metabolism. However, the functional role of NAD⁺ metabolism in regulating the characteristics of TICs is not known. In this study, we provide evidence that the mitochondrial NAD⁺ levels affect the characteristics of glioma-driven SSEA1⁺ TICs, including clonogenic growth potential. An increase in the mitochondrial NAD⁺ levels by the overexpression of the mitochondrial enzyme nicotinamide nucleotide transhydrogenase (NNT) significantly suppressed the sphere-forming ability and induced differentiation of TICs, suggesting a loss of the characteristics of TICs. In addition, increased SIRT3 activity and reduced lactate production, which are mainly observed in healthy and young cells, appeared following NNT-overexpressed TICs. Moreover, in vivo tumorigenic potential was substantially abolished by NNT overexpression. Conversely, the short interfering RNA-mediated knockdown of NNT facilitated the maintenance of TIC characteristics, as evidenced by the increased numbers of large tumor spheres and in vivo tumorigenic potential. Our results demonstrated that targeting the maintenance of healthy mitochondria with increased mitochondrial NAD⁺ levels and SIRT3 activity could be a promising strategy for abolishing the development of TICs as a new therapeutic approach to treating aging-associated tumors.
Glioblastoma* ; Lactic Acid ; Metabolism ; Mitochondria ; NAD ; NADP Transhydrogenases ; Phenotype ; Tics ; Up-Regulation*

OBJECTIVE: We aimed to investigate the effect of ropinirole on excessive daytime sleepiness (EDS) and depression in Parkinson’s disease (PD) with a large population. METHODS: We conducted a cross-sectional observational study at nine hospitals in Korea between April 24, 2013, and April 22, 2015. We analyzed the demographic and clinical features, other medical history, history of antiparkinsonian medication within 6 months, Hoehn and Yahr stage (HY stage), Unified Parkinson’s Disease Rating Scale (UPDRS) part II and III, Epworth Sleepiness Scale (ESS), and 30-item Geriatric Depression Scale (GDS-30). RESULTS: Four-hundred-thirteen patients with PD (mean age: 65.2 ± 9.0 years; men: 227 patients) were analyzed. Multivariate logistic regression analysis showed that age at examination, UPDRS II, and GDS-30 were independent risk factors for EDS and that sex, UPDRS II, and ESS were independent risk factors for depression. CONCLUSION: Our large group study did not find any significant associations of ropinirole with EDS and depression in Korean PD patients.
Depression* ; Humans ; Korea ; Levodopa* ; Logistic Models ; Male ; Observational Study ; Parkinson Disease* ; Risk Factors

Terlipressin has splanchnic vasoconstrictive effects, and is generally used for the management of gastroesophageal variceal bleeding secondary to liver cirrhosis. Terlipressin is a synthetic arginine vasopressin (AVP) analog containing a nonapeptide sequence. Terlipressin has increased selectivity for the V1 receptor, compared with AVP; hence, it is considered to be a safe vasoconstrictor. However, side effects such as hyponatremia and seizure, although very rare, have been reported. Hyponatremia related to terlipressin may be caused by the syndrome of inappropriate antidiuresis (SIAD), which is a disorder of sodium and water balance characterized by hypotonic hyponatremia without elevation of the antidiuretic hormone level. Here, we report a case of hyponatremic seizure induced by an infusion of terlipressin in a 52-year-old female who had isolated gastric variceal bleeding secondary to alcoholic liver cirrhosis.
Arginine Vasopressin ; Esophageal and Gastric Varices ; Female ; Hemorrhage* ; Humans ; Hyponatremia ; Liver Cirrhosis* ; Liver Cirrhosis, Alcoholic ; Middle Aged ; Receptors, Vasopressin ; Seizures* ; Sodium

PURPOSE: We review our experience using a new and easily removable ureteral catheter in patients who underwent complicated ureteral reimplantation. Our goal was to shorten hospital stay and lower anxiety during catheter removal without fear of postoperative ureteral obstruction. MATERIALS AND METHODS: Between April 2009 and September 2010, nine patients who underwent our new method of catheter removal after ureteral reimplantation were enrolled. Patients who underwent simple ureteral reimplantation were excluded from the study. Following ureteral reimplantation, a combined drainage system consisting of a suprapubic cystostomy catheter and a ureteral catheter was installed. Proximal external tubing was clamped with a Hem-o-lok clamp and the rest of the external tubing was eliminated. Data concerning the age and sex of each patient, reason for operation, method of ureteral reimplantation, and postoperative parameters such as length of hospital stay and complications were recorded. RESULTS: Of the nine patients, four had refluxing megaureter, four had a solitary or non-functional contralateral kidney and one had ureteral stricture due to a previous anti-reflux operation. The catheter was removed at postoperative week one. The mean postoperative hospital stay was 2.4 days (range 1-4 days), and the mean follow-up was 9.8 months. None of the patients had postoperative ureteral obstructions, and there were no cases of migration or dislodgement of the catheter. CONCLUSION: Our new method for removing the ureteral catheter would shorten hospital stays and lower levels of anxiety when removing ureteral catheters in patients with a high risk of postoperative ureteral obstruction.
Catheterization/*instrumentation/methods ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Length of Stay ; Male ; Postoperative Care ; Postoperative Complications/epidemiology ; Postoperative Period ; Retrospective Studies ; *Urinary Catheters ; Vesico-Ureteral Reflux/surgery

Tinea incognito (TI) is a dermatophytic infection which has lost its typical clinical appearance because of improper use of steroids or calcineurin inhibitors. The incidence of TI is increasing nowadays. We conducted retrospective review on 283 patients with TI from 25 dermatology training hospitals in Korea from 2002-2010 to investigate the demographical, clinical, and mycological characteristics of TI, and to determine the associated risk factors. More than half (59.3%) patients were previously treated by non-dermatologists or self-treated. The mean duration of TI was 15.0 +/- 25.3 months. The most common clinical manifestations were eczema-like lesion, psoriasis-like, and lupus erythematosus-like lesion. The trunk and face were frequently involved, and 91 patients (32.2%) also had coexisting fungal infections. Among 67 isolated strains, Trichophyton rubrum was the most frequently detected (73.1%). This is the largest study of TI reported to date and the first investigational report concerning TI in Korea. We suggest that doctors should consider TI when a patient has intractable eczema-like lesions accompanied by tinea pedis/unguium. Furthermore, there should be a policy change, which would make over-the-counter high-potency topical steroids less accessible in some countries, including Korea.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Demography ; Eczema/pathology ; Face/pathology ; Female ; Humans ; Lupus Erythematosus, Cutaneous/pathology ; Male ; Middle Aged ; Psoriasis/pathology ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Tinea/*diagnosis/microbiology ; Trichophyton/isolation & purification ; Young Adult

PURPOSE: To evaluate the effectiveness of digital rectal-compression immediately after transrectal prostate biopsy (P-bx) for improving the accuracy of prostate cancer (PCa) staging. MATERIALS AND METHODS: Between July 2008 and June 2010, 94 consecutive patients who had a radical prostatectomy were included in our retrospective analysis. The exclusion criteria included a history of previous P-bx and surgery, a biopsy performed in another hospital, a number of biopsy cores different from 12, or a condition interfering with bleeding assessment. The subjects were divided into two groups, compression and non-compression. All enrolled patients took magnetic resonance imaging (MRI) for PCa staging. RESULTS: The compression and non-compression groups were comparable with respect to several baseline characteristics. However, the total hemorrhage score of intraprostatic bleeding was significantly different between the groups, even with adjustment for the time from biopsy to MRI (compression:15.4+/-2.32, non-compression: 24.9+/-2.43, p<0.001). The intra-prostatic cancer location matching rate was higher in the compression group (78.0%) than in the non-compression group (70.2%) (p=0.011). Overall accuracy of staging in compression and non-compression groups was 84.7% and 77.3%, respectively. CONCLUSION: Our results demonstrate that digital rectal compression performed immediately after prostate biopsy to reduce intraprostatic hemorrhage improves the accuracy for detection of PCa using MRI.
Aged ; *Biopsy ; Biopsy, Needle ; *Digital Rectal Examination ; Hemorrhage/prevention & control ; Hemostasis ; Humans ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Staging/*methods ; Pressure ; Prostate/pathology ; Prostatic Neoplasms/*diagnosis/*pathology ; Reproducibility of Results ; Retrospective Studies