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1.  Effects of Substrate to Inoculum Ratio on the Biochemical Methane Potential of Piggery Slaughterhouse Wastes 
The aim of this study was to assess the effect of substrate to inoculum ratio (S/I ratio) on the biochemical methane potential (BMP) and anaerobic biodegradability (Ddeg) of different piggery slaughterhouse wastes, such as piggery blood, intestine residue, and digestive tract content. These wastes were sampled from a piggery slaughterhouse located in Kimje, South Korea. Cumulative methane production curves for the wastes were obtained from the anaerobic batch fermentation having different S/I ratios of 0.1, 0.5, 1.0, and 1.5. BMP and anaerobic biodegradabilities (Ddeg) of the wastes were calculated from cumulative methane production data for the tested conditions. At the lowest S/I ration of 0.1, BMPs of piggery blood, intestine residue, and digestive tract content were determined to be 0.799, 0.848, and 1.076 Nm3 kg−1-VSadded, respectively, which were above the theoretical methane potentials of 0.539, 0.644, and 0.517 Nm3 kg−1-VSadded for blood, intestine residue, and digestive tract content, respectively. However, BMPs obtained from the higher S/I ratios of 0.5, 1.0, and 1.5 were within the theoretical range for all three types of waste and were not significantly different for the different S/I ratios tested. Anaerobic biodegradabilities calculated from BMP data showed a similar tendency. These results imply that, for BMP assay in an anaerobic reactor, the S/I ratio of anaerobic reactor should be above 0.1 and the inoculum should be sufficiently stabilized to avoid further degradation during the assay.
doi:10.5713/ajas.2013.13537
PMCID: PMC4093537  PMID: 25049994
S/I Ratio; Biochemical Methane Potential; Piggery Slaughterhouse Waste; Anaerobic Digestion
2.  Oncologic impact of pathologic response on clinical outcome after preoperative chemoradiotherapy in locally advanced rectal cancer 
Purpose
Downstaging after chemoradiotherapy (CRT) for rectal cancer usually occurs. The present study aimed to evaluate pathologic y-stage (yp-stage) and its influence on local recurrence and systemic recurrence in rectal cancer patients treated with CRT followed by surgical resection.
Methods
We retrospectively analyzed 261 patients underwent preoperative CRT and radical resection for rectal cancer between August 2004 and December 2010. Patients received preoperative CRT consisting of 5-fluorouracil and leucovorin delivered with concurrent pelvic radiation of 45.0-50.4 Gy, followed by radical surgery at 6-8 weeks after CRT.
Results
Of the 261 patients, 24 (9.2%) had yp-stage 0, 83 (31.8%) had yp-stage I, 86 (32.9%) had yp-stage II, and 68 (26.1%) had yp-stage III. Patients with yp-stage III had a greater prevalence of preoperative CEA, poorly differentiated tumor, lymphovascular invasion (LVI) and perineural invasion (PNI) than patients with lower yp-stages. We found that yp-stage, preoperative CEA, LVI, PNI and tumor regression grade were significant prognostic factors for both local and systemic recurrence. In multivariate analysis, yp-stage, LVI and PNI were significant factors for local and systemic recurrence. During the median follow-up of 37.5 months, the five-year local recurrence-free survival rate was 100.0%, 95.0%, 89.3%, and 80.6% of yp-stage 0-III, respectively. The five-year systemic recurrence-free survival was 95.8%, 75.3%, 71.4%, and 48.8% of yp-stages 0-III, respectively.
Conclusion
The yp-stage after preoperative CRT for rectal cancer is closely correlated with local and systemic recurrence-free survival. Therefore, yp-stage should be considered as a prognostic factor for rectal cancer patients having a course of preoperative CRT.
doi:10.4174/astr.2015.88.1.15
PMCID: PMC4279989  PMID: 25553320
Rectal neoplasms; Chemoradiotherapy; Pathologic y-staging
3.  Very Late Stent Thrombosis after Sole Stent-Assisted Coiling at the Paraclinoid Giant Aneurysm : Could Prophylactic Antiplatelet Therapy Be Ceased at the Only 1 Year after Procedure? 
Stent thrombosis is a major limitation of stent-assisted coiling, which is an effective method for treating wide-necked aneurysms. Although early in-stent thrombosis has been reported, very late stent thrombosis (VLST) (>1 year) has not been reported following implantation of a single self-expandable stent designed for coiling. Herein, the authors present a case of VLST that occurred 14 months after single stent implantation in a large paraclinoid aneurysm with an ultra-wide neck involving the parent artery circumferentially. This case indicates the need for establishing guidelines regarding the optimal duration of prophylactic antiplatelet therapy following stent-assisted coiling, which remains undefined in the neuroendovascular field.
doi:10.3340/jkns.2014.56.4.344
PMCID: PMC4219194  PMID: 25371786
Aneurysm; Antiplatelet; Stent; Stent-assisted coiling; Very late stent thrombosis
4.  Effects of Residual Hypochlorite Ion on Methane Production during the Initial Anaerobic Digestion Stage of Pig Slurry 
The hypochlorite ion (OCl−) is a widely used disinfecting agent in pig rearing in Korea, but its residual effect on CH4 production from pig slurry is unclear. The objective of this study was to investigate the inhibition effects of residual OCl− on CH4 production during the initial anaerobic digestion stage of pig slurry. Three organic concentrations (9.9, 26.2 and 43.7 g/L) of volatile solids (VS) were tested with the addition of 52.3 mg/L OCl−, ten times of the typical concentration used in Korea, or without OCl− (Control) in anaerobic batch culture. The culture was run under mesophilic (38°C) conditions for 20 d. At the lowest organic concentration with OCl−, the VS degradation was 10.3% lower (p<0.05) than Control, while at the higher organic concentration with OCl−, it did not differ from Control. CH4 yields were higher in the control treatments than their OCl− counterpart cultures, and CH4 yields of Control and OCl− treatments at the organic concentrations of 9.9, 26.2 and 43.7 g/L differed in the probability level (p) of 0.31, 0.04, and 0.06, respectively. Additionally, CH4 concentration increased steeply and reached 70.0% within 4 d in the absence OCl−, but a gradual increase up to 60.0% was observed in 6 d in the OCl− treated cultures. The Rm (the maximum specific CH4 production rate) and λ (lag phase time) of 9.9 g/L with OCl− were 8.1 ml/d and 25.6 d, while the Rm was increased to 15.1 ml/d, and λ was reduced to 11.4 d in PS-III (higher organic concentration) with OCl−. The results suggest that a prolonged fermentation time was necessary for the methanogens to overcome the initial OCl− inhibitory effect, and an anaerobic reactor operated with high organic loadings was more advantageous to mitigate the inhibitory effect of residual hypochlorite ion.
doi:10.5713/ajas.2012.12515
PMCID: PMC4093056  PMID: 25049714
Anaerobic Digestion; Hypochlorite; Pig Slurry; Disinfecting Agent; Methane Production
5.  Iatrogenic Intraspinal Epidermoid Cyst 
Korean Journal of Spine  2014;11(3):195-197.
Epidermoid cyst is generally regarded as congenital disease, and commonly related to other congenital spinal anomalies. However, it also develops iatrogenically. We report one rare case of epidermoid cyst that we experineced among intradural extramedullary tumors. A 21-year-old female patient was admitted to the hospital due to low back pain with radiating pain into a right lower extremity that initiated about a month ago. She complained sensory lose and motor weakness (grade 4+) on her right extremity as well as urinary dysfunction and sphincter dysfunction. She had a lumbar puncture three times due to Pneumococcal meningitis when she was 13 years old. The well-circumscribed intradural extramedullary mass of 1.8×1.6×4 cm size was found on the L4-5 in a magnetic resonance image. Gross total tumor removal was garried out after the total laminectomy L5 and partial laminectomy L4. The tumor mass was gray-colored and so fragile that it was easy to be removed. The histological diagnosis confirmed epidermoid cyst without malignancy. After the operation, the patient progressively showed remarkable neurological recovery. In this case, the cause of epidermoid cyst is considered iatrogenic concerning history of several times of lumbar puncture as meningitis.
doi:10.14245/kjs.2014.11.3.195
PMCID: PMC4206976  PMID: 25346768
Epidermoid cyst; Lumbar puncture; Iatrogenic
6.  Efficacy of the Disappearance of Lateral Spread Response before and after Microvascular Decompression for Predicting the Long-Term Results of Hemifacial Spasm Over Two Years 
Objective
The purpose of this large prospective study is to assess the association between the disappearance of the lateral spread response (LSR) before and after microvascular decompression (MVD) and clinical long term results over two years following hemifacial spasm (HFS) treatment.
Methods
Continuous intra-operative monitoring during MVD was performed in 244 consecutive patients with HFS. Patients with persistent LSR after decompression (n=22, 9.0%), without LSR from the start of the surgery (n=4, 1.7%), and with re-operation (n=15, 6.1%) and follow-up loss (n=4, 1.7%) were excluded. For the statistical analysis, patients were categorized into two groups according to the disappearance of their LSR before or after MVD.
Results
Intra-operatively, the LSR was checked during facial electromyogram monitoring in 199 (81.5%) of the 244 patients. The mean follow-up duration was 40.9±6.9 months (range 25-51 months) in all the patients. Among them, the LSR disappeared after the decompression (Group A) in 128 (64.3%) patients; but in the remaining 71 (35.6%) patients, the LSR disappeared before the decompression (Group B). In the post-operative follow-up visits over more than one year, there were significant differences between the clinical outcomes of the two groups (p<0.05).
Conclusion
It was observed that the long-term clinical outcomes of the intra-operative LSR disappearance before and after MVD were correlated. Thus, this factor may be considered a prognostic factor of HFS after MVD.
doi:10.3340/jkns.2012.52.4.372
PMCID: PMC3488647  PMID: 23133727
Clinical outcome; Hemifacial spasm; Lateral spread response; Microvascular decompression
7.  Adipose-Derived Stem Cells Improve Efficacy of Melanocyte Transplantation in Animal Skin 
Biomolecules & Therapeutics  2014;22(4):328-333.
Vitiligo is a pigmentary disorder induced by a loss of melanocytes. In addition to replacement of pure melanocytes, cocultures of melanocytes with keratinocytes have been used to improve the repigmentation outcome in vitiligo treatment. We previously identified by in vitro studies, that adipose-derived stem cells (ADSCs) could be a potential substitute for keratinocytes in cocultures with melanocytes. In this study, the efficacy of pigmentation including durability of grafted melanocytes and short-term safety was examined in the nude mouse and Sprague-Dawley rat after grafting of primary cultured human melanocytes, with or without different ratios of primary cultured human ADSCs. Simultaneous grafting of melanocytes and ADSCs, which were separately cultured and mixed on grafting at the ratios of 1:1, 1:2, or 1:3, showed better efficacy than that of pure melanocytes. Grafting of melanocytes cocultured with ADSCs resulted in a similar outcome as the grafting of cell mixtures. Skin pigmentation by melanocytes : ADSCs at the ratios of 1:1 and 1:2 was better than at 1:3. No significant difference was observed between the 1-week and 2-week durations in coculturing. Time-course microscopic examination showed that the grafted melanocytes remained a little longer than 6-week post-grafting. No inflammatory cell infiltration was observed in the grafted skin and no melanocytes were detectable in other organs. Collectively, grafting of melanocytes and ADSCs was equally safe and more effective than grafting of melanocytes alone. Despite the absence of significant differences in efficacy between the group of 1:1 and that of 1:2 ratio, 1:2 ratio for 1-week coculturing may be better for clinical use from the cost-benefit viewpoint.
doi:10.4062/biomolther.2014.065
PMCID: PMC4131530  PMID: 25143812
Melanocytes; Adipose-derived stem cells; Grafting; Animal; Efficacy; Short-term safety
8.  Analysis of the Development of the Nasal Septum and Measurement of the Harvestable Septal Cartilage in Koreans Using Three-Dimensional Facial Bone Computed Tomography Scanning 
Archives of Plastic Surgery  2014;41(2):163-170.
Background
The septal cartilage is the most useful donor site for autologous cartilage graft material in rhinoplasty. For successful nasal surgery, it is necessary to understand the developmental process of the nasal septum and to predict the amount of harvestable septal cartilage before surgery.
Methods
One hundred twenty-three Korean patients who underwent three-dimensional (3D) facial bone computed tomography (CT) were selected for evaluation of the midsagittal view of the nasal septum. Multiple parameters such as the area of each component of the nasal septum and the amount of harvestable septal cartilage were measured using Digimizer software.
Results
The area of the total nasal septum showed rapid growth until the teenage years, but thereafter no significant change throughout the lifetime. However, the development of the septal cartilage showed a gradual decline due to ossification changes with aging after puberty in spite of a lack of change in the total septal area. The area of harvestable septal cartilage in young adults was 549.84±151.26 mm2 and decreased thereafter with age.
Conclusions
A 3D facial bone CT scan can provide valuable information on the septal cartilage graft before rhinoplasty. Considering the developmental process of the septal cartilage identified in this study, septal surgery should not be performed until puberty due to the risk of nasal growth impairment. Furthermore, in elderly patients who show a decreased cartilage area due to ossification changes, septal cartilage harvesting should be performed carefully due to the risk of saddle nose deformity.
doi:10.5999/aps.2014.41.2.163
PMCID: PMC3961615  PMID: 24665426
Nasal septum; Nasal cartilage; Multidetector computed tomography
9.  The Comparative Morphometric Study of the Posterior Cranial Fossa : What Is Effective Approaches to the Treatment of Chiari Malformation Type 1? 
Objective
The objective of this study was to investigate changes in the posterior cranial fossa in patients with symptomatic Chiari malformation type I (CMI) compared to a control group.
Methods
We retrospectively reviewed clinical and radiological data from 12 symptomatic patients with CMI and 24 healthy control subjects. The structures of the brain and skull base were investigated using magnetic resonance imaging.
Results
The length of the clivus had significantly decreased in the CMI group than in the control group (p=0.000). The angle between the clivus and the McRae line (p<0.024), as the angle between the supraocciput and the McRae line (p<0.021), and the angle between the tentorium and a line connecting the internal occipital protuberance to the opisthion (p<0.009) were significantly larger in the CMI group than in the control group. The mean vertical length of the cerebellar hemisphere (p<0.003) and the mean length of the coronal and sagittal superoinferior aspects of the cerebellum (p<0.05) were longer in the CMI group than in the control group, while the mean length of the axial anteroposterior aspect of the cerebellum (p<0.001) was significantly shorter in the CMI group relative to control subjects.
Conclusion
We elucidate the transformation of the posterior cranial fossa into the narrow funnel shape. The sufficient cephalocaudal extension of the craniectomy of the posterior cranial fossa has more decompression effect than other type extension of the craniectomy in CMI patients.
doi:10.3340/jkns.2013.54.5.405
PMCID: PMC3873353  PMID: 24379947
Type I Arnold-Chiari malformation; Posterior cranial fossa; Decompressive craniectomy; Embryology; Congenital abnormality
10.  Spinal Epidural Hematoma Related to Intracranial Hypotension 
Korean Journal of Spine  2013;10(3):203-205.
A 45-year-old female patient visited the hospital complaining of severe sudden headache and posterior neck pain. The patient did not have any traumatic history or abnormal neurologic finding. The patient had sudden quadriplegia and sensory loss. Cervical spine MRI scan was taken, and the compatible findings to acute epidural hematoma were shown. The emergency operation was performed. After the operation, the patient recovered all motor and senses. As there was CSF leakage in the postoperative wound, this was confirmed by cervical spinal computed tomography (CT). Then lumbar drainage was thus performed. The opening pressure upon lumbar puncture was not measured as it was very low. As a result of continous CSF leakage, dural repair was performed. After the operation, the patient had been discharged without neurologic deficits. In this case, it is sensible to suspect intracranial hypotension as a possible cause of spinal EDH.
doi:10.14245/kjs.2013.10.3.203
PMCID: PMC3941751  PMID: 24757490
Spinal epidural hematoma; Headache; Neck pain; Cerebrospinal fluid leakage
11.  Comparative Study on the Period of Absolute Bed Rest of Vertebral Compression Fracture 
Korean Journal of Spine  2013;10(3):144-148.
Objective
As a conservative treatment of compression fractures, absolute bed rest (ABR) for a certain period has been recommended, but no guideline on the period has yet been established. Considering that a long ABR period may adversely affect patients, the difference in prognosis according to the ABR period was investigated in this study.
Methods
A prospective study was conducted who were diagnosed with compression fracture. Groups A and B were put on ABR (one week for group A and two weeks for group B). X-ray images at baseline, 1, 2, 4, and 8 weeks were obtained from both groups, for assessment purposes.
Results
The compression rates of both groups were no significant difference at baseline, 1, 2, 4, and 8 weeks. The conditions of 25.9% and 21.2% of the subjects deteriorated in groups A and B, showing no significant difference. Between the groups of age and bone mineral densities (BMD), no significant difference was observed in the incidence of deterioration. In terms of complications development including constipation and other Gastrointestinal problems, voiding difficulty, etc., group A reported 57.4%, and group B, 84.8%, showing a significant difference (p-value=0.001).
Conclusion
No significant difference in the conservative period was observed between the groups. Group B, however, reported a higher complications development rate than group A. Therefore, a short ABR period may be helpful in the early stage of conservative treatment.
doi:10.14245/kjs.2013.10.3.144
PMCID: PMC3941768  PMID: 24757476
Compression fracture; Bed rest; Complications
12.  Changes in Microbial Diversity, Methanogenesis and Fermentation Characteristics in the Rumen in Response to Medicinal Plant Extracts 
This study evaluated the in vitro effect of medicinal plant extracts on ruminal methanogenesis, four different groups of methanogens and ruminal fermentation characteristics. A fistulated Holstein cow was used as a donor of rumen fluid. Licorice and mugwort extracts (Glycyrrhiza uralensis and Artemisia capillaris, 0.5% and 1% of total substrate DM, respectively), previously used as folk remedies, were added to an in vitro fermentation incubated with buffered-rumen fluid. Total gas production in Glycyrrhiza uralensis extract treatment was not significantly different between treatments (p<0.05) while total gas production in the Artemisia capillaris extract treatment was lower than that of the control. Artemisia capillaris extract and Glycyrrhiza uralensis extract reduced CH4 emission by 14% (p<0.05) and 8% (p<0.05), respectively. Ciliate-associated methanogens population decreased by 18% in the medicinal plant extracts treatments. Medicinal plant extracts also affected the order Methanobacteriales community. Methanobacteriales diversity decreased by 35% in the Glycyrrhiza uralensis extract treatment and 30% in the Artemisia capillaris extract treatment. The order Methanomicrobiales population decreased by 50% in the 0.5% of Glycyrrhiza uralensis extract treatment. These findings demonstrate that medicinal plant extracts have the potential to inhibit in vitro ruminal methanogenesis.
doi:10.5713/ajas.2013.13072
PMCID: PMC4093396  PMID: 25049911
Methane Emission; Medicinal Plant Extracts; Real-time PCR; Relative Quantification; Ruminal Methanogenesis
13.  Effect of Leaf Type and Pesticide Exposure on Abundance of Bacterial Taxa in Mosquito Larval Habitats 
PLoS ONE  2013;8(8):e71812.
Lentic freshwater systems including those inhabited by aquatic stages of mosquitoes derive most of their carbon inputs from terrestrial organic matter mainly leaf litter. The leaf litter is colonized by microbial communities that provide the resource base for mosquito larvae. While the microbial biomass associated with different leaf species in container aquatic habitats is well documented, the taxonomic composition of these microbes and their response to common environmental stressors is poorly understood. We used indoor aquatic microcosms to determine the abundances of major taxonomic groups of bacteria in leaf litters from seven plant species and their responses to low concentrations of four pesticides with different modes of action on the target organisms; permethrin, malathion, atrazine and glyphosate. We tested the hypotheses that leaf species support different quantities of major taxonomic groups of bacteria and that exposure to pesticides at environmentally relevant concentrations alters bacterial abundance and community structure in mosquito larval habitats. We found support for both hypotheses suggesting that leaf litter identity and chemical contamination may alter the quality and quantity of mosquito food base (microbial communities) in larval habitats. The effect of pesticides on microbial communities varied significantly among leaf types, suggesting that the impact of pesticides on natural microbial communities may be highly complex and difficult to predict. Collectively, these findings demonstrate the potential for detritus composition within mosquito larval habitats and exposure to pesticides to influence the quality of mosquito larval habitats.
doi:10.1371/journal.pone.0071812
PMCID: PMC3733839  PMID: 23940789
14.  Long-Term Outcomes of Chemoradiation for Anal Cancer Patients 
Yonsei Medical Journal  2012;54(1):108-115.
Purpose
The aim of this study was to evaluate long-term oncologic outcomes after concurrent chemoradiation treatment for anal cancer.
Materials and Methods
Between January 1979 and December 2008, the records of 50 consecutive patients with anal cancer and who were treated by chemoradiation or radiation only with a curative intent were retrospectively reviewed. The oncologic outcomes and the risk factors for recurrence were analyzed.
Results
Of the 50 patients, 49 underwent concurrent chemoradiation and one underwent radiation only. After these definitive treatments, 43 (86.0%) achieved a clinical complete response. During the median follow-up of 60 months (range: 2-202 months), the 5-year overall survival, disease-free survival, and locoregional recurrence-free survival were 84.2%, 72.7%, and 69.9%, respectively. Multivariate analysis revealed that the performance status (p=0.031) and a clinical complete response (p=0.039) were the independent predictors for overall survival; lymph node involvement (p=0.031) was the only independent predictor for disease-free survival.
Conclusion
The performance status and a clinical complete response may be reliable predictors of survival after chemoradiation for anal cancer. The addition of irradiation to the inguinal area may not be significantly associated with the outcomes.
doi:10.3349/ymj.2013.54.1.108
PMCID: PMC3521268  PMID: 23225806
Anal cancer; concurrent chemoradiation; prognosis
15.  Human leukocytes regulate ganglioside expression in cultured micro-pig aortic endothelial cells 
Laboratory Animal Research  2012;28(4):255-263.
Gangliosides are ubiquitous components of the membranes of mammalian cells that are thought to play important roles in various cell functions such as cell-cell interaction, cell adhesion, cell differentiation, growth control, and signaling. However, the role that gangliosides play in the immune rejection response after xenotransplantation is not yet clearly understood. In this study, the regulatory effects of human leukocytes on ganglioside expression in primary cultured micro-pig aortic endothelial cells (PAECs) were investigated. To determine the impact of human leukocytes on the expression of gangliosides in PAECs, we performed high-performance thin layer chromatography (HPTLC) in PAECs incubated with FBS, FBS containing human leukocytes, human serum containing human leukocytes, and FBS containing TNF-α. Both HPTLC and immunohistochemistry analyses revealed that PAECs incubated with FBS predominantly express the gangliosides GM3, GM1, and GD3. However, the expression of GM1 significantly decreased in PAECs incubated for 5 h with TNF-α (10 ng/mL), 10% human serum containing human leukocytes, and 10% FBS containing human leukocytes. Taken together, these results suggest that human leukocytes induced changes in the expression profile of ganglioside GM1 similar to those seen upon treatment of PAECs with TNF-α. This finding may be relevant for designing future therapeutic strategies intended to prolong xenograft survival.
doi:10.5625/lar.2012.28.4.255
PMCID: PMC3542384  PMID: 23326286
Micro-pig aortic endothelial cells; human serum; human leukocyte; tumor necrosis factor-α; ganglioside GM1
16.  Clinical Significance of Serial Serum Carcinoembryonic Antigen Values for Treating Rectal Cancer with Preoperative Chemoradiotherapy 
Purpose
Preoperative chemoradiotherapy is now widely accepted to treat rectal cancer; however, the prognosis for rectal cancer patients during and after chemoradiotherapy must be determined. The aim of this study was to evaluate the serial serum carcinoembryonic antigen (s-CEA) samples in patients with rectal cancer who underwent radical surgery after concurrent chemoradiotherapy (CRT).
Methods
This study evaluated 236 patients with rectal cancer who received preoperative CRT followed by curative surgery between June 2005 and June 2010. We measured the patient's s-CEA levels pre-CRT, post-CRT and post-surgery. Patients were classified into four groups according to their s-CEA concentrations (group 1, high, high, high; group 2, high, high, normal; group 3, high, normal, normal; group 4, normal, normal, normal). We analyzed the clinicopathologic factors and the outcomes among these groups.
Results
Of the 236 patients, 12 were in group 1, 31 were in group 2, 67 were in group 3, and 126 were in group 4. The 3-year disease-free survival rate in group 1 was poorer than those in group 3 (P = 0.007) and group 4 (P < 0.001). In a univariate analysis, type of surgery, clinical N stage, pathologic T or N stage, lymphovascular invasion, perineural invasion, and CEA group were prognostic factors. A multivariate analysis revealed that type of surgery, pathologic T stage, and lymphovascular invasion were independent prognostic factors; however, no statistical significance was associated with the CEA group.
Conclusion
High pre-CRT, post-CRT, and post-surgery s-CEA levels in patients with rectal cancer were associated with high rates of systemic recurrence and poor survival. Therefore, patients with sustained high s-CEA levels during CRT require careful monitoring after surgery.
doi:10.3393/jksc.2012.28.4.205
PMCID: PMC3440490  PMID: 22993707
Rectal neoplasms; Carcinoembryonic antigen; Chemoradiotherapy
17.  Rapid Spontaneous Reduction of a Huge Intracerebral Hematoma 
Rapid reduction of a large acute subdural hematoma has been frequently reported. In my knowledge, however, it was rarely reported that rapid spontaneous reduction occurred in large volume of spontaneous intracerebral hematoma (sICH). We describe a patient with a rapid spontaneous decrease in the volume of a large hematoma. A 73-year-old man presented semi-comatose mentality. Initial brain computed tomography (CT) revealed the huge sICH. An emergency operation was planned, but was not performed due to the refusal of patient's family. Therefore, we decided to treat with conservative therapy. However, follow-up brain CT 16 hours after initial scan showed a remarkable reduction of previous sICH. The mechanism involving the spontaneous rapid decrease of the hematoma is presumed to occur through redistribution in brain atrophy, compression effect from the increased intracranial pressure and dilution through a wash out by the cerebrospinal fluid.
doi:10.7461/jcen.2012.14.2.104
PMCID: PMC3471261  PMID: 23210037
Intracerebral hematoma; Spontaneous reduction; Redistribution
18.  Relationship between ganglioside expression and anti-cancer effects of the monoclonal antibody against epithelial cell adhesion molecule in colon cancer 
Experimental & Molecular Medicine  2011;43(12):693-701.
The human colorectal carcinoma-associated GA733 antigen epithelial cell adhesion molecule (EpCAM) was initially described as a cell surface protein selectively expressed in some myeloid cancers. Gangliosides are sialic acid-containing glycosphingolipids involved in inflammation and oncogenesis. We have demonstrated that treatment with anti-EpCAM mAb and RAW264.7 cells significant inhibited the cell growth in SW620 cancer cells, but neither anti-EpCAM mAb nor RAW264.7 cells alone induced cytotoxicity. The relationship between ganglioside expression and the anti-cancer effects of anti-EpCAM mAb and RAW264.7 was investigated by high-performance thin-layer chromatography. The results demonstrated that expression of GM1 and GD1a significantly increased in the ability of anti-EpCAM to inhibit cell growth in SW620 cells. Anti-EpCAM mAb treatment increased the expression of anti-apoptotic proteins such as Bcl-2, but the expression of pro-apoptotic proteins Bax, TNF-α, caspase-3, cleaved caspase-3, and cleaved caspase-8 were unaltered. We observed that anti-EpCAM mAb significantly inhibited the growth of colon tumors, as determined by a decrease in tumor volume and weight. The expression of anti-apoptotic protein was inhibited by treatment with anti-EpCAM mAb, whereas the expression of pro-apoptotic proteins was increased. These results suggest that GD1a and GM1 were closely related to anticancer effects of anti-EpCAM mAb. In light of these results, further clinical investigation should be conducted on anti-EpCAM mAb to determine its possible chemopreventive and/or therapeutic efficacy against human colon cancer.
doi:10.3858/emm.2011.43.12.080
PMCID: PMC3256297  PMID: 22033101
antibodies, monoclonal; apoptosis; colon neoplasms; EPCAM protein, human; gangliosides; macrophages
19.  Predicting Factors Affecting Clinical Outcomes for Saccular Aneurysms of Posterior Inferior Cerebellar Artery with Subarachnoid Hemorrhage 
Objective
The aim of this study is to investigate the clinical outcomes of surgery and coiling and analyze the predicting factors affecting the clinical outcomes of ruptured posterior inferior cerebellar artery (PICA) aneurysms.
Methods
During the last 15 years, 20 consecutive patients with ruptured PICA aneurysms were treated and these patients were included in this study. The Fisher's exact test was used for the statistical significance of Glasgow Outcome Scale (GOS) according to initial Hunt-Hess (H-H) grade, treatment modalities, and the presence of acute hydrocephalus.
Results
Eleven (55%) and nine (45%) patients were treated with surgical clipping and endovascular treatment, respectively. Among 20 patients, thirteen (65.0%) patients had good outcomes (GOS 4 or 5). There was the statistical significance between initial poor H-H grade, the presence of acute hydrocephalus and poor GOS.
Conclusion
In our study, we suggest that initial H-H grade and the presence of acute hydrocephalus may affect the clinical outcome rather than treatment modalities in the ruptured PICA aneurysms.
doi:10.3340/jkns.2011.50.4.327
PMCID: PMC3243836  PMID: 22200015
Aneurysm; Endovascular treatment; Posterior inferior cerebellar artery; Subarachnoid hemorrhage; Surgical clipping
20.  Interspecies Predation Between Anopheles gambiae s.s. and Culex quinquefasciatus Larvae 
Journal of medical entomology  2010;47(2):287-290.
Interaction of aquatic stages of coexisting mosquito species may have significant influence on resulting adult mosquito populations. We used two coexisting species, Anopheles gambiae s.s. and Culex quinquefasciatus to investigate whether third instars of one species consumed first instars of the other. First instars of one species were readily consumed by a third instar of the other species irrespective food quantity. DNA of Cx. quinquefasciatus was detected in the eight An. gambiae s.s. third instars presumed to have consumed at least one Cx. quinquefasciatus first instar. Likewise, DNA of An. gambiae s.s. was detected in five of eight Cx. quinquefasciatus third instars presumed to have consumed at least one An. gambiae s.s. first instar. A small number of dead first instars was found in the controls indicating that some larvae in the treatment group may have been consumed after they had died. These findings suggest that intraguild predation between the two species may be common in nature and that it is a facultative process that is not induced by food shortage. The findings further suggest that polymerase chain reaction could be a useful technique in the study of this phenomenon in natural habitats.
PMCID: PMC2855145  PMID: 20380312
21.  Population Genetic Structure of Anopheles Arabiensis (Diptera: Culicidae) in a Rice Growing Area of Central Kenya 
Journal of medical entomology  2010;47(2):144-151.
Studies were conducted to examine the population genetic structure of Anopheles arabiensis (Patton) in Mwea Rice Irrigation Scheme and surrounding areas in Central Kenya, under different agricultural systems. This study was motivated by observed differences in malaria transmission indices of An. arabiensis within the scheme compared with adjacent nonirrigated areas. Agricultural practices can modify local microclimate and influence the number and diversity of larval habitats and in so doing may occasion subpopulation differentiation. Thirty samples from each of the three study sites were genotyped at eight microsatellite loci. Seven microsatellite loci showed high polymorphism but revealed no genetic differentiation (FST = 0.006, P = 0.312) and high gene flow (Nm = 29–101) among the three populations. Genetic bottleneck analysis showed no indication of excess heterozygosity in any of the populations. There was high frequency of rare alleles, suggesting that An. arabiensis in the study area has a high potential of responding to selective pressures from environmental changes and vector control efforts. These findings imply that An. arabiensis in the study area occurs as a single, continuous panmictic population with great ability to adapt to human-imposed selective pressures.
PMCID: PMC2856451  PMID: 20380294
Microsatellites; An. arabiensis; gene flow; agricultural practices; Kenya
22.  Expression of eotaxin in 3T3-L1 adipocytes and the effects of weight loss in high-fat diet induced obese mice 
Eotaxin is an important inflammatory chemokine in eosinophil chemotaxis and activation and, thus, is implicated in asthma. Recently, obesity was associated with an increased prevalence of asthma, but the relationship between obesity and eotaxin expression has only been partially understood in obese mice and human studies. Therefore, we studied the expression patterns of eotaxin in 3T3-L1 preadipocytes/adipocytes to determine whether eotaxin levels are influenced by body weight gain and/or reduction in diet-induced obese mice. First, we investigated eotaxin expression during differentiation in 3T3-L1 adipocytes. Then, we treated 3T3-L1 preadipocytes/adipocytes with tumor necrosis factor-alpha (TNF-α), eotaxin, interleukin (IL)-4, IL-5, or leptin. To examine the effects of weight loss in high-fat diet induced obese mice, we fed C57BL/6 mice a high-fat diet or a normal diet for 26 weeks. Then, half of the high-fat diet group were fed a normal diet until 30 weeks to reduce weight. Epididymal adipose tissue, visceral adipose tissue, serum, and bronchoalveolar fluid of mice were examined for eotaxin expression. The results showed that eotaxin expression levels increased with adipocyte differentiation and that more eotaxin was expressed when the cells were stimulated with TNF-α, eotaxin, IL-4, IL-5, or leptin. An in vivo study showed that eotaxin levels were reduced in visceral adipose tissues when high-fat diet fed mice underwent weight loss. Taken together, these results indicate a close relationship between eotaxin expression and obesity as well as weight loss, thus, they indirectly show a relation to asthma.
doi:10.4162/nrp.2011.5.1.11
PMCID: PMC3061264  PMID: 21487491
Eotaxin; 3T3-L1 adipocytes; obesity; weight loss; asthma
23.  Anti-Platelet Drug Resistance in the Prediction of Thromboembolic Complications after Neurointervention 
Objective
The aim of this study was to analyze the correlation between thromboembolic complications and antiplatelet drugs before and after neurointervention.
Methods
Blood samples and radiographic data of patients who received a neurointervention (coil embolization, stent placement or both) were collected prospectively. Rapid platelet function assay-aspirin (RPFA-ASA) was used to calculate aspirin resistance in aspirin reaction units (ARU). For clopidogrel resistance, a P2Y12 assay was used to analyze the percentage of platelet inhibition. ARU > 550 and platelet inhibition < 40% were defined as aspirin and clopidogrel resistance, respectively.
Results
Both aspirin and clopidogrel oral pills were administered in fifty-three patients before and after neurointerventional procedures. The mean resistance values of all patients were 484 ARU and < 39%. Ten (17.0%) of 53 patients showed resistance to aspirin with an average of 597 ARU, and 33 (62.3%) of 53 patients showed resistance to clopidogrel with an average of < 26%. Ten patients demonstrated resistance to both drugs, 5 of which suffered a thromboembolic complication after neurointervention (mean values : 640 ARU and platelet inhibition < 23%). Diabetic patients and patients with hypercholesterolemia displayed mean aspirin resistances of 513.7 and 501.8 ARU, and mean clopidogrel resistances of < 33.8% and < 40.7%, respectively.
Conclusion
Identifying individuals with poor platelet inhibition using standard regimens is of great clinical importance and may help prevent cerebral ischemic events in the future. Neurointerventional research should focus on ideal doses, timing, choices, safety, and reliable measurements of antiplatelet drug therapy, as well as confirming the clinical relevance of aggregometry in cerebrovascular patients.
doi:10.3340/jkns.2010.48.4.319
PMCID: PMC2982909  PMID: 21113358
Aspirin; Clopidogrel; Resistance; Neurointervention
24.  Clinicopathological Features of Primary Jejunoileal Tumors 
Purpose
Tumors of the small bowel are rare, accounting for about 3-6% of all gastrointestinal neoplasms, though they cover more than 90% of the intestinal surface. However, diagnosis and treatment are difficult and present an ongoing challenge for both gastrointestinal surgeons and gastroenterologists. The aim of this study was to investigate the clinical features of small bowel tumors.
Methods
Between November 1994 and November 2007, 81 patients underwent treatments for primary tumors in the jejuno-ileal region at the Department of Surgery, Kangnam St. Mary's Hospital, the Catholic University of Korea. A retrospective review of the patients' characteristics and variable tumor factors was performed.
Results
The mean age of the patients was 53.2 years with 48 men and 33 women. The most common symptom was abdominal pain (59.3%), followed by bleeding (22.2%) and an abdominal mass (6.2%). We found that the patients with ileal tumors complained mainly of abdominal pain (72.9%) whereas the patients with jejunal tumors presented with gastrointestinal bleeding (36.4%) (P = 0.048). Seventy-six of the 81 patients (93.8%) had malignant tumors, including 40 (49.4%) gastrointestinal stromal tumors, 26 (32.1%) lymphomas and 5 (6.2%) adenocarcinomas. No postoperative mortalities were observed. The overall 5-year survival rate of the patients with malignant small bowel tumors was 31.8%.
Conclusion
Because the clinical features of a primary tumor of the small bowel are obscure and its diagnosis is difficult, maintaining a high degree of suspicion and recognizing the possibility of a primary small bowel tumor are important.
doi:10.3393/jksc.2010.26.5.334
PMCID: PMC2998016  PMID: 21152136
Small intestine; Gastrointestinal stromal tumors; Lymphoma
25.  Immunological Factors Relating to the Antitumor Effect of Temozolomide Chemoimmunotherapy in a Murine Glioma Model▿  
In this study, we investigated the potential of combined treatment with temozolomide (TMZ) chemotherapy and tumor antigen-pulsed dendritic cells (DCs) and the underlying immunological factors of TMZ chemoimmunotherapy with an intracranial GL26 glioma animal model. The combined treatment enhanced the tumor-specific immune responses and prolonged the survival more effectively than either single therapy in GL26 tumor-bearing animals. Apoptosis was induced in the tumors of the animals by the treatment with TMZ. Calreticulin (CRT) surface exposure was detected by immunofluorescence staining of TMZ-treated GL26 cells. TMZ chemotherapy increased tumor antigen cross-priming from tumor cells, leading to cross-priming of tumor antigen-specific CD4+ T cells and CD8+ T cells. This chemotherapy appeared to suppress the frequency of CD4+ CD25+ regulatory T cells (Treg). Moreover, this combined therapy resulted in an increase in the tumor infiltration of CD4+ and CD8+ T cells. Collectively, the findings of this study provide evidence that the combination of TMZ chemotherapy and treatment with DC-based vaccines leads to the enhancement of antitumor immunity through increased tumor-specific immune responses via the cross-priming of apoptotic tumor cell death mediated by CRT exposure and, in part, the suppression of Treg. Therefore, CRT exposure, regulatory T cells, and cross-priming by TMZ chemotherapy may be immunological factors related to the enhancement of the antitumor effects of chemoimmunotherapy in an experimental brain tumor model.
doi:10.1128/CVI.00292-09
PMCID: PMC2812079  PMID: 19889936

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