Cancer cell heterogeneity is a serious problem in the control of tumor progression because it can cause chemoresistance and metastasis. Heterogeneity can be generated by various mechanisms, including genetic evolution of cancer cells, cancer stem cells (CSCs), and niche heterogeneity. Because the genetic heterogeneity of CSCs has been poorly characterized, the genetic mutation status of CSCs was examined using Exome-Seq and RNA-Seq data of liver cancer.Here we show that different surface markers for liver cancer stem cells (LCSCs) showed a unique propensity for genetic mutations. Cluster of differentiation 133 (CD133)-positive cells showed frequent mutations in the IRF2, BAP1, and ERBB3 genes. However, leucine-rich repeat-containing G protein-coupled receptor 5-positive cells showed frequent mutations in the CTNNB1, RELN, and ROBO1 genes. In addition, some genetic mutations were frequently observed irrespective of the surface markers for LCSCs. BAP1 mutations was frequently observed in CD133-, CD24-, CD13-, CD90-, epithelial cell adhesion molecule-, or keratin 19-positive LCSCs. ASXL2, ERBB3, IRF2, TLX3, CPS1, and NFATC2 mutations were observed in more than three types of LCSCs, suggesting that common mechanisms for the development of these LCSCs. The present study provides genetic heterogeneity depending on the surface markers for LCSCs. The genetic heterogeneity of LCSCs should be considered in the development of LCSC-targeting therapeutics.

PURPOSE: Coronary artery diseases (CADs) are the leading causes of death in the world. Recent studies have reported that differentially expressed microRNAs (miRNAs) are associated with prognosis or major adverse cardiac events (MACEs) in CAD patients. In a previous meta-analysis, the authors made serious mistakes that we aimed to correct through an updated systematic review and meta-analysis of the prognostic value of altered miRNAs in patients with CADs. MATERIALS AND METHODS: We performed a systematic search of MEDLINE (from inception to May 2017) and EMBASE (from inception to May 2017) for English-language publications. Studies of CADs with results on miRNAs that reported survival data or MACEs were included. Data were extracted from each publication independently by two reviewers. RESULTS: After reviewing 515 articles, a total eight studies were included in this study. We measured pooled hazard ratios (HRs) and 95% confidence intervals (CIs) of miRNA 133a with a fixed-effect model (pooled HR, 2.35; 95% CI, 1.56–3.55). High expression of miRNA 133a, 208b, 126, 197, 223, and 122-5p were associated with high mortality. Additionally, high levels of miRNA 208b, 499-5p, 134, 328, and 34a were related with MACEs. CONCLUSION: The present study confirmed that miRNA 133a, which was associated with high mortality in CAD patients, holds prognostic value in CAD. More importantly, this study corrected issues raised against a prior meta-analysis and provides accurate information.
Cause of Death ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; MicroRNAs* ; Mortality ; Prognosis ; Publications

Transportation between the cytoplasm and the nucleoplasm is critical for many physiological and pathophysiological processes including gene expression, signal transduction, and oncogenesis. So, the molecular mechanism for the transportation needs to be studied not only to understand cell physiological processes but also to develop new diagnostic and therapeutic targets. Recent progress in the research of the nuclear transportation (import and export) via nuclear pore complex and four important factors affecting nuclear transport (nucleoporins, Ran, karyopherins, and nuclear localization signals/nuclear export signals) will be discussed. Moreover, the clinical significance of nuclear transport and its application will be reviewed. This review will provide some critical insight for the molecular design of therapeutics which need to be targeted inside the nucleus.
Active Transport, Cell Nucleus* ; Carcinogenesis ; Cell Physiological Processes ; Cytoplasm ; Gene Expression ; Karyopherins ; Nuclear Localization Signals ; Nuclear Pore ; Nuclear Pore Complex Proteins ; Signal Transduction ; Transportation

BACKGROUND: Small cell lung cancer (SCLC) is an extremely aggressive tumor with a poor clinical course. Although many efforts have been made to improve patients' survival rates, patients who survive longer than 2 years after chemotherapy are still very rare. We examined the baseline characteristics of patients with long-term survival rates in order to identify the prognostic factors for overall survivals. METHODS: A total of 242 patients with cytologically or histologically diagnosed SCLC were enrolled into this study. The patients were categorized into long- and short-term survival groups by using a survival cut-off of 2 years after diagnosis. Cox's analyses were performed to identify the independent factors. RESULTS: The mean patient age was 65.66 years, and 85.5% were males; among the patients, 61 of them (25.2%) survived longer than 2 years. In the multivariate analyses, CRP (hazard ratio [HR], 2.75; 95% confidence interval [CI], 1.25-6.06; p=0.012), TNM staging (HR, 3.29; 95% CI, 1.59-6.80; p=0.001), and progression-free survival (PFS) (HR, 11.14; 95% CI, 2.98-41.73; p<0.001) were independent prognostic markers for poor survival rates. CONCLUSION: In addition to other well-known prognostic factors, this study discovered relationships between the long-term survival rates and serum CRP levels, TNM staging, and PFS. In situations with unfavorable conditions, the PFS would be particularly helpful for managing SCLC patients.
Diagnosis ; Disease-Free Survival* ; Drug Therapy ; Humans ; Male ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Small Cell Lung Carcinoma* ; Survival Rate

Atypical adenomatous hyperplasia (AAH) has been considered to be a precursor lesion of bronchioloalveolar carcinoma (BAC) and pulmonary adenocarcinoma. It usually coexists with BAC and/or an adenocarcinoma. Chest computed tomography reveals multiple well-defined nodules with ground-glass opacity. Usually, AAH does not exceed 10 mm in size. AAH with extensive involvement on one side of the lung field or one that is larger than 2 cm has not been previously reported. We herein report a case of a 71-year-old nonsmoking female with lung AAH of larger than 2 cm.
Adenocarcinoma ; Adenocarcinoma, Bronchiolo-Alveolar ; Female ; Humans ; Hyperplasia ; Lung ; Precancerous Conditions ; Thorax

BACKGROUND: Using long-term (more than 30 years) data from a single center, this retrospective study evaluated changes of independent risk factors affecting renal allograft survival by transplant era. METHODS: Of 3,000 cases of kidney transplantation, 2,708 (90.3%), including their follow-up observations, were reviewed. Transplant era was classified according to immunosuppressive regimens as either early group (transplant serial No. 1~1,500) or recent group (transplant serial No. 1,501~3,000). RESULTS: There was a significant difference observed in pre-transplant clinical manifestations between the early and recent groups. The number of elderly recipients and donors, number of deceased donors, and cases related to pre-transplant diabetes, pre-emptive transplantation, and retransplantation were differed relative to transplant era. The short- and long-term graft survival rate of the recent group improved significantly, and the effect of human leukocyte antigen mismatching and living donor type disappeared in the recent group. Moreover, pre-emptive transplantation and retransplantation were effective only in the recent group. However, non-immunological factors such as elderly recipients and donors, and immunologic factors such as episodes of acute rejection and types of immunosuppressive regimen were persistent independent risk factors affecting graft survival rate. CONCLUSIONS: According to the retrospective survival analysis of a large number of recipients in a single center, risk factors for kidney transplant patients differed by transplant era. However, the independent risk factors associated with elderly recipients and donors (non-immunologic), and episodes of acute rejection, and types of immunosuppressive regimen (immunologic) persisted regardless of transplant era.
Aged ; Follow-Up Studies ; Graft Survival ; Humans ; Immunologic Factors ; Kidney ; Kidney Transplantation ; Leukocytes ; Living Donors ; Rejection (Psychology) ; Retrospective Studies ; Risk Factors ; Tissue Donors ; Transplantation, Homologous ; Transplants

PURPOSE: This study aimed to identify contents and trends of Korean nursing doctoral dissertations in terms of research methodology and theoretical characteristics. METHODS: The design of the study was descriptive study and a total of 1,089 quantitative studies completed between 1982 and 2010 were reviewed using the analytical framework developed by the researchers. RESULTS: The majority of studies utilized the experimental design (51.5%) and the others were survey design (38.8%) and methodological design (5.0%). Study subjects were shown as patients (45%), care givers (11.2%), ordinary persons (40.6%) and others (3.2%). There were growing trends in experimental design and patients as subjects. The prevailing data collection settings were hospitals (45.8%) and community (27.8%). The theoretical frameworks that studies were based on were the existing theories (37%) and a newly developed theoretical framework by a researcher (25.2%). a framework derived from other studies by the researcher (25.2%). Majority of studies (78.5%) employed a single theory as a theoretical framework. However, 31.8% of studies had no theoretical framework based on. CONCLUSION: Findings of this study provided the opportunities to shed new light on the current status of Korean doctoral dissertation and to deliberate on the future direction of nursing studies in Korea.
Caregivers ; Databases, Factual ; Dissertations, Academic as Topic ; *Education, Nursing, Graduate ; Hospitals ; Humans ; Nursing Research/*trends ; Patients ; Republic of Korea ; Research Design/trends ; Residence Characteristics ; Schools

BACKGROUND/AIMS: A significant proportion of elderly patients who have lung cancer do not receive treatment even though they may benefit from it. The aims of this study were to analyze the clinical characteristics of elderly patients with lung cancer, especially those aged 76 years and older. METHODS: In this retrospective study, we analyzed clinical data from 341 patients with lung cancer who were diagnosed at Chungnam National University Hospital from January 2003 to September 2010. RESULTS: The median age of patients was 79 years (76-91), and 39.6% (n = 135) of the total sample were older than 80. Squamous cell carcinoma was the most common type of lung cancer, and the performance status (Eastern Cooperative Oncology Group [ECOG] 0-1) of 40.6% (n = 116) of the sample was good. Of the 293 non small cell lung cancer (NSCLC) patients, 53.6% were untreated. About 68% of all patients knew about their disease (n = 232). CONCLUSIONS: Our data indicated that many elderly patients with lung cancer were undertreated. Elderly patients with lung cancer should receive education to help them understand their disease and to encourage them to receive appropriate treatment.
Aged ; Carcinoma, Squamous Cell ; Humans ; Lung ; Lung Neoplasms ; Retrospective Studies ; Small Cell Lung Carcinoma

Non-small cell lung cancer (NSCLC) is the leading cause of cancer related deaths. Most patients were presented with advanced disease at the time of diagnosis. In advanced NSCLC, it is almost impossible to anticipate complete remission by using only cytotoxic chemotherapy or molecularly targeted agents. In our case, two patients were diagnosed as advanced NSCLC and received chemotherapy. They achieved complete response (CR). After finishing treatment, disease recurred. They were retreated with the same regimens and achieved second CR. Until now, they have received each regimen, continuously, and the CR state has been maintained.
Carcinoma, Non-Small-Cell Lung ; Humans ; Maintenance Chemotherapy ; Remission Induction ; Retreatment

PURPOSE: This study was done to examine the level of use of essential oriental nursing terms and related characteristics among nurses in oriental medicine (OM) hospitals. METHOD: A cross-sectional survey design with convenience sampling was employed. Questionnaires were used to collect data from 315 nurses in seven university-affiliated OM hospitals. The questionnaire included 174 oriental nursing terms about actions, tests, drugs, and theories. Multiple regression analysis was performed to determine factors associated with the level of use. RESULTS: The response rate was 98.1% (n=309). Overall mean score for use of essential oriental nursing terms was 2.7(+/-0.7) on a five-point Likert scale. Significant factors associated with the level of use were workplace and knowledge of oriental nursing theory terms. Nurses who worked in nursing care wards and those who had a higher level of knowledge of oriental nursing theories had a higher level of use. CONCLUSIONS: These findings indicate that level of use of essential oriental nursing terms were below average. Educational programs to enhance knowledge of oriental nursing theories need to be implemented for nurses in OM hospitals, considering their workplace, in order to facilitate nursing data sharing and communication among healthcare providers.
Cross-Sectional Studies ; Health Personnel ; Humans ; Information Dissemination ; Medicine, East Asian Traditional ; Medicine, Korean Traditional ; Nursing Care ; Nursing Theory ; Surveys and Questionnaires