Background: /Aim: Abdominal ultrasonography (USG) is recommended as a surveillance test for high-risk groups for hepatocellular carcinoma (HCC). This study aimed to analyze the current status of the national cancer surveillance program for HCC in South Korea and investigate the effects of patient-, physician-, and machine-related factors on HCC detection sensitivity. Methods: This multicenter retrospective cohort study collected surveillance USG data from the high-risk group for HCC (liver cirrhosis or chronic hepatitis B or C >40 years of age) at eight South Korean tertiary hospitals in 2017. Results: In 2017, 45 experienced hepatologists or radiologists performed 8,512 USG examinations. The physicians had a mean 15.0±8.3 years of experience; more hepatologists (61.4%) than radiologists (38.6%) participated. Each USG scan took a mean 12.2±3.4 minutes. The HCC detection rate by surveillance USG was 0.3% (n=23). Over 27 months of follow-up, an additional 135 patients (0.7%) developed new HCC. The patients were classified into three groups based on timing of HCC diagnosis since the 1st surveillance USG, and no significant intergroup difference in HCC characteristics was noted. HCC detection was significantly associated with patient-related factors, such as old age and advanced fibrosis, but not with physician- or machine-related factors. Conclusions This is the first study of the current status of USG as a surveillance method for HCC at tertiary hospitals in South Korea. It is necessary to develop quality indicators and quality assessment procedures for USG to improve the detection rate of HCC.

The global burden of chronic liver disease (CLD) is substantial. Due to the limited indication of and accessibility to antiviral therapy in viral hepatitis and lack of effective pharmacological treatment in nonalcoholic fatty liver disease, the beneficial effects of antidiabetics and non–antidiabetics in clinical practice have been continuously investigated in patients with CLD. In this narrative review, we focused on non-antidiabetic drugs, including ursodeoxycholic acid, silymarin, dimethyl4,4’-dimethoxy-5,6,5’,6’-dimethylenedixoybiphenyl-2,2’-dicarboxylate, L-ornithine L-aspartate, branched chain amino acids, statin, probiotics, vitamin E, and aspirin, and summarized their beneficial effects in CLD. Based on the antioxidant, anti-inflammatory properties, and regulatory functions in glucose or lipid metabolism, several non–antidiabetic drugs have shown beneficial effects in improving liver histology, aminotransferase level, and metabolic parameters and reducing risks of hepatocellular carcinoma and mortality, without significant safety concerns, in patients with CLD. Although the effect as the centerpiece management in patients with CLD is not robust, the use of these non-antidiabetic drugs might be potentially beneficial as an adjuvant or combined treatment strategy.

We report 17 patients with human granulocytic anaplasmosis between January 2015 and September 2018 at two tertiary university hospitals in Korea. Monthly incidence peaked in May and June. Among these patients, we identified three who were co-infected with scrub typhus, and one patient with hemorrhagic fever with renal syndrome.
Anaplasmosis ; Animals ; Coinfection ; Hemorrhagic Fever with Renal Syndrome ; Hospitals, University ; Humans ; Incidence ; Korea ; Scrub Typhus

IL-12 is a secretory heterodimeric cytokine composed of p35 and p40 subunits. IL-12 p35 and p40 subunits are sometimes produced as monomers or homodimers. IL-12 is also produced as a membrane-bound form in some cases. In this study, we hypothesized that the membrane-bound form of IL-12 subunits may function as a costimulatory signal for selective activation of TAA-specific CTL through direct priming without involving antigen presenting cells and helper T cells. MethA fibrosarcoma cells were transfected with expression vectors of membrane-bound form of IL-12p35 (mbIL-12p35) or IL-12p40 subunit (mbIL-12p40) and were selected under G418-containing medium. The tumor cell clones were analyzed for the expression of mbIL-12p35 or p40 subunit and for their stimulatory effects on macrophages. The responsible T-cell subpopulation for antitumor activity of mbIL-12p35 expressing tumor clone was also analyzed in T cell subset-depleted mice. Expression of transfected membrane-bound form of IL-12 subunits was stable during more than 3 months of in vitro culture, and the chimeric molecules were not released into culture supernatants. Neither the mbIL-12p35-expressing tumor clones nor mbIL-12p40-expressing tumor clones activated macrophages to secrete TNF-alpha. Growth of mbIL-12p35-expressing tumor clones was more accelerated in the CD8+ T cell-depleted mice than in CD4+ T cell-depleted or normal mice. These results suggest that CD8+ T cells could be responsible for the rejection of mbIL-12p35-expressing tumor clone, which may bypass activation of antigen presenting cells and CD4+ helper T cells.
Animals ; Antigen-Presenting Cells ; Clone Cells ; Corynebacterium ; Fibrosarcoma ; Interleukin-12 ; Interleukin-12 Subunit p35 ; Interleukin-12 Subunit p40 ; Macrophages ; Mice ; Rejection (Psychology) ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer ; Tumor Necrosis Factor-alpha

Rapid and accurate detection of norovirus is essential for the prevention and control of norovirus outbreaks. This study compared the effectiveness of a new immunochromatographic assay kit (SD BIOLINE Norovirus; Standard Diagnostics, Korea) and real-time reverse transcription-PCR (RT-PCR) for detecting norovirus in fecal specimens. Compared with real-time RT-PCR, the new assay had sensitivity, specificity, positive predictive value, and negative predictive value of 76.5% (52/68), 99.7% (342/343), 98.1% (52/53), and 95.5% (342/358), respectively. The sensitivity of the assay was 81.8% (18/22) for GII.3 and 75.7% (28/37) for GII.4. None of the 38 enteric virus-positive specimens (3 for astrovirus, 5 for enteric adenovirus, and 30 for rotavirus) tested positive in the cross-reactivity test performed by using this assay. The new immunochromatographic assay may be a useful screening tool for the rapid detection of norovirus in sporadic and outbreak cases; however, negative results may require confirmatory assays of greater sensitivity.
Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Caliciviridae Infections/*diagnosis ; Child ; Child, Preschool ; Feces/*virology ; Gastroenteritis/*diagnosis/virology ; Humans ; *Immunoassay ; Infant ; Middle Aged ; Norovirus/*genetics/isolation & purification ; RNA, Viral/analysis ; Reagent Kits, Diagnostic ; Reverse Transcriptase Polymerase Chain Reaction ; Sensitivity and Specificity

Dendritic cells (DCs) are potent antigen-presenting cells. OK432 (Picibanil(R)) was introduced as a potent stimulator of DC maturation in combination with prostaglandin-E2 and interferon-alpha. We compared the efficacy of a DC-prostate cancer vaccine using early-mature DCs stimulated with OK432, PGE2 and INF-alpha (OPA) with that of vaccines using other methods. On days 3 or 7 of DC culture, TNF-alpha (T), TNF-alpha and LPS (TL) or OPA were employed as maturation stimulators. DU145 cells subjected to heat stress were hybridized with mature DCs using polyethyleneglycol. T cells were sensitized by the hybrids, and their proliferative and cytokine secretion activities and cytotoxicity were measured. The yields of early-mature DCs were higher, compared to yields at the conventional maturation time (P<0.05). In the early maturation setting, the mean fusion ratios, calculated from the fraction of dual-positive cells, were 13.3%, 18.6%, and 39.9%, respectively (P=0.051) in the T only, TL, and OPA-treated groups. The function of cytotoxic T cells, which were sensitized with the hybrids containing DCs matured early with OPA, was superior to that using other methods. The antitumor effects of DC-DU145 hybrids generated with DCs subjected to early maturation with the OPA may be superior to that of the hybrids using conventional maturation methods.
Cancer Vaccines/*immunology ; Cell Line, Tumor ; Dendritic Cells/cytology/drug effects/*immunology ; Dinoprostone/*pharmacology ; Humans ; Immunologic Factors/*pharmacology ; Interferon-alpha/*pharmacology ; Lipopolysaccharides/toxicity ; Male ; Neoplasms, Hormone-Dependent/*immunology ; Phenotype ; Picibanil/*pharmacology ; Prostatic Neoplasms/*immunology ; T-Lymphocytes, Cytotoxic/immunology

Formalin is a water-soluble, colorless, pungent, irritating and highly reactive gas. A 40% solution of formaldehyde in water, also known as formalin, is used as a disinfectant, antiseptic, deodorant, tissue fixative and embalming fluid. Ingestion can lead to immediate deleterious effects on almost all systems of the body including gastrointestinal tract, central nervous system, cardiovsacular system and hepato-renal system, causing gastrointestinal hemorrhage, cardiovsacular collapse, unconsciousness or convulsions, severe metabolic acidosis and acute respiratory distress syndrome. We treated a 39-year-old woman who ingested 300 ml formalin in a suicidal attempt. Despite hemodialysis, death occurred after 23 h.
Acidosis ; Adult ; Central Nervous System ; Deodorants ; Eating ; Embalming ; Female ; Formaldehyde ; Gastrointestinal Hemorrhage ; Gastrointestinal Tract ; Humans ; Renal Dialysis ; Respiratory Distress Syndrome, Adult ; Seizures ; Unconsciousness

PURPOSE: This study was designed to evaluate the communication gap between Korean medical oncologists and cancer patients on complementary and alternative medicine (CAM). MATERIALS AND METHODS: Cross sectional studies utilized the responses of 59 medical oncologists and 211 patients. To understand the communication gap, perceived reasons and nondisclosure of CAM use, reactions of physicians to disclosure, and expectations for CAM were analyzed. Data were compared with use of the chi- squared test. RESULTS: Both medical oncologists and patients were in accord that CAM use would privde the patients with a feeling of hope. The medical oncologists believed more often than patients to attribute CAM use for control over medical care decisions, for the treatment of an incurable disease or as a nontoxic approach (p<0.05). Regarding reasons for nondisclosure, medical oncologists were morelikely to think that physicians would not understand the use of CAM, discontinue treatment or disapprove of the use of CAM (p<0.0001). Patients attributed nondisclosure mainly to the lack of questioning about CAM. Medical oncologists were more likely to warn of the risks with CAM use and less likely to encourage the use of CAM than perceived by patients (p=0.01). Patients expected that CAM could cure disease, extend survival, relieve symptoms and improve the immune system or quality of life more often than medical oncologists (p<0.05). CONCLUSION: Given the discrepant views of medical oncologists and patients on the use of CAM, medical oncologists should be aware of the discrepancies and attempt to resolve any differences.
Complementary Therapies ; Cross-Sectional Studies ; Disclosure ; Humans ; Immune System ; Quality of Life

OBJECTIVE: The aim of this study was to investigate the relationship between emotional traits and schizotypal symptoms and to establish a hypothetical model for the causal relationship between them. METHODS: Schizotypal symptoms were assessed using the Schizotypal Personality Questionnaire (SPQ), and a total of seven emotional traits considered to be potential risk factors for schizotypy were categorized as emotional disturbances, emotional attenuators or emotional amplifiers. A total of 502 undergraduate students completed the SPQ and other scales. RESULTS: The result of the present study suggested that the high levels of emotional disturbance in individuals who are prone to schizotypy or psychosis are amplified by their intensity and fluctuation. However, if their emotion attenuating abilities function well, these disturbances can be controlled and the schizotypal symptoms and progression to psychosis can be contained. Discriminant analysis showed that 69.0% of the subjects with many schizotypal symptoms and 80.7% of the subjects with few schizotypal symptoms were correctly classified. CONCLUSION: The present study suggests the possibility of using emotional traits to identify the risk factors for psychosis.
Affective Symptoms ; Humans ; Psychotic Disorders ; Surveys and Questionnaires ; Risk Factors ; Weights and Measures

BACKGROUND: The significance of ER expression and hormone manipulation in gastric cancer is not established. There have been several reports supporting the role of the ER gene as tumor suppressor gene in carcinogenesis. The ER-alpha gene is located on chromosome 6q25.1. Deletions of the long arm of chromosome 6 are common in gastric carcinoma, suggesting the presence of tumor suppressor genes in this region. The proportion of ER-positive gastric cancers ranges between 0% and 67% depending on the method of detection. Epigenetic inactivation might explain the loss of ER-alpha gene expression in gastric cancer. There is no information available regarding the methylation status of the ER-alpha gene promoter region in gastric cancer so far. The aim of this study was to assess the expression of ER-alpha in gastric cancer cell lines and determine whether methylation of the 5' promoter region is associated with loss of ER-alpha expression in gastric cancer. METHODS: We investigated such methylation in 13 gastric cancer cell lines. Western blot analysis, reverse transcription-polymerase chain reaction (PCR), methylation-specific PCR (MS-PCR) and bisulfite sequencing analyses were used. Immunohistochemical staining for the ER-alpha gene was dome for forty-two paraffin embedded tissues from gastric cancer patients. RESULTS: ER-alpha protein was not detected in any cell line, ER-alpha mRNA was expressed in only Kato III cell line. MS-PCR and bisulfite sequencing showed all thirteen gastric cancer cell lines had methylated CpG regions in their ER-alpha gene promoters. Immunohistochemical staining of ER-alpha showed no positivity in any of examined samples. CONCLUSION: Inactivation of ER-alpha gene expression in gastric cancer cell lines appears associated with CpG island methylation near the TGA initiation codon of the ER-alpha gene.
Arm ; Blotting, Western ; Carcinogenesis ; Cell Line ; Chromosomes, Human, Pair 6 ; Codon, Initiator ; CpG Islands ; Epigenomics ; Estrogens* ; Gene Expression ; Genes, Tumor Suppressor ; Humans ; Methylation ; Paraffin ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; RNA, Messenger ; Stomach Neoplasms*