Retrospective Analysis of Peripheral Blood Stem Cell Transplantation for the Treatment of High-Risk Neuroblastoma

Disease relapse after autologous peripheral blood stem cell transplantation (APBSCT) is the main cause of treatment failure in high-risk neuroblastoma (NBL). To reduce relapse, various efforts have been made such as CD34+ selection and double APBSCT. Here the authors reviewed the clinical features and outcomes of high-risk NBL patients and analyzed their survival. The medical records of 36 patients with stage III or IV NBL who underwent APBSCT at Seoul National University Children's Hospital between May 1996 and May 2004 were reviewed. Total 46 APBSCTs were performed in 36 patients. Disease free survival (DFS) and overall survival of all patients were 47.7% and 68.8%, respectively. The patients were allocated to three groups according to the APBSCT type. The DFS of CD34+ non-selected single APBSCT patients (N=13), CD34+ selected single APBSCT patients (N=14), and CD34+ selected double APBSCT patients (N=9) were 55.6%, 40.6%, and 50.0%, respectively, which were not significantly different. Thus the survival was not found to be affected by CD34+ selection or transplantation number. To improve long-term survival, various efforts should be made such as chemotherapy dose intensification, more effective tumor purging, and control of minimal residual disease via the use of differentiating and immune-modulating agents

MLN51 and GM-CSF involvement in the proliferation of fibroblast-like synoviocytes in the pathogenesis of rheumatoid arthritis

Rheumatoid arthritis (RA) is an inflammatory autoimmune disease of unclear etiology. This study was conducted to identify critical factors involved in the synovial hyperplasia in RA pathology. We applied cDNA microarray analysis to profile the gene expressions of RA fibroblast-like synoviocytes (FLSs) from patients with RA. We found that the MLN51 (metastatic lymph node 51) gene, identified in breast cancer, is remarkably upregulated in the hyperactive RA FLSs. However, growth-retarded RA FLSs passaged in vitro expressed small quantities of MLN51. MLN51 expression was significantly enhanced in the FLSs when the growth-retarded FLSs were treated with granulocyte – macrophage colony-stimulating factor (GM-CSF) or synovial fluid (SF). Anti-GM-CSF neutralizing antibody blocked the MLN51 expression even though the FLSs were cultured in the presence of SF. In contrast, GM-CSF in SFs existed at a significant level in the patients with RA (n = 6), in comparison with the other inflammatory cytokines, IL-1β and TNF-α. Most RA FLSs at passage 10 or more recovered from their growth retardation when cultured in the presence of SF. The SF-mediated growth recovery was markedly impaired by anti-GM-CSF antibody. Growth-retarded RA FLSs recovered their proliferative capacity after treatment with GM-CSF in a dose-dependent manner. However, MLN51 knock-down by siRNA completely blocked the GM-CSF/SF-mediated proliferation of RA FLSs. Taken together, our results imply that MLN51, induced by GM-CSF, is important in the proliferation of RA FLSs in the pathogenesis of RA

A cost-effectiveness study of universal screening for hepatitis C virus infection in South Korea: A societal perspective

Background/Aims: This study aimed to evaluate the cost-effectiveness of hepatitis C virus (HCV) screening compared to no screening in the Korean population from societal and healthcare system perspectives. Methods: A published decision-tree plus Markov model was used to compare the expected costs and quality-adjusted life years (QALY) between one-time universal HCV screening and no screening in the population aged 40-65 years using the National Health Examination (NHE) program. Input parameters were obtained from analyses of the National Health Insurance claims data, Korean HCV cohort data, or from the literature review. The population aged 40-65 years was simulated in a model spanning a lifetime from both the healthcare system and societal perspectives, which included the cost of productivity loss due to HCV-related deaths. The incremental cost-effectiveness ratio (ICER) between universal screening and no screening was estimated. Results: The HCV screening strategy had an ICER of $2,666/QALY and$431/QALY from the healthcare system and societal perspectives, respectively. Both ICERs were far less than the willingness-to-pay threshold of $25,000/QALY, showing that universal screening was highly cost-effective compared to no screening. In various sensitivity analyses, the most influential parameters on cost-effectiveness were the antibodies to HCV (anti-HCV) prevalence, screening costs, and treatment acceptance; however, all ICERs were consistently less than the threshold. If the anti-HCV prevalence was over 0.18%, screening could be cost-effective. Conclusions: One-time universal HCV screening in the Korean population aged 40-65 years using NHE program would be highly cost-effective from both healthcare system and societal perspectives.Y

Long-Term Survival in a Patient With Ruptured Hepatocellular Carcinoma

A 57-yr-old woman previously diagnosed with chronic hepatitis B was admitted via the emergency room because she suddenly developed epigastric pain with abdominal distension. On computed tomography (CT), a round enhancing mass was found on the left hepatic lobe with ascites in the peritoneal space. Bloody ascites were found upon tapping the ascites, and this led to the diagnosis of ruptured hepatocellular carcinoma (HCC). The patient was immediately treated with transcatheter arterial chemoembolization (TACE) including 50 mg of adriamycin and 10 mL of lipiodol, and then we performed left lateral segmentectomy 20 days later. To prevent recurrence of HCC by any micrometastasis, the patient subsequently received 8 cycles of adjuvant systemic chemotherapy (a regimen of epirubicin (50 mg/m2), cisplatin (60 mg/m2) and 5-fluorouracil (200 mg/m2)) at monthly intervals. After this, the patient has been regularly followed up and she shows no signs of tumor recurrence 7 years later. This case suggests that surgical resection and subsequent adjuvant systemic chemotherapy with using an ECF regimen may provide long-term survival for patients ruptured HCC

Oral intake of Lactobacillus rhamnosus M21 enhances the survival rate of mice lethally infected with influenza virus

BackgroundInfluenza viruses cause acute respiratory disease. Because of the high genetic variability of viruses, effective vaccines and antiviral agents are limited. Considering the fact that the site of influenza virus entry is the mucosa of the upper respiratory tract, probiotics that can enhance mucosal immunity as well as systemic immunity could be an important source of treatment against influenza infection.MethodsMice were fed with Lactobacillus rhamnosus M21 or skim milk and were challenged with influenza virus. The resulting survival rate, lung inflammation, and changes in the cytokine and secretory immunoglobulin A (sIgA) levels were examined.ResultsBecause of infection (influenza virus), all the mice in the control group and 60% of the mice in the L. rhamnosus M21 group died; however, the remaining 40% of the mice fed with L. rhamnosus M21 survived the infection. Pneumonia was severe in the control group but moderate in the group treated with L. rhamnosus M21. Although there were no significant changes in the proinflammatory cytokines in the lung lysates of mice collected from both groups, levels of interferon-γ and interleukin-2, which are representative cytokines of type I helper T cells, were significantly increased in the L. rhamnosus M21-treated group. An increase in sIgA as well as the diminution of inflammatory cells in bronchoalveolar lavage fluid was also observed in the L. rhamnosus M21-treated group.ConclusionThese results demonstrate that orally administered L. rhamnosus M21 activates humoral as well as cellular immune responses, conferring increased resistance to the host against influenza virus infection

First-time comparison between NO2 vertical columns from GEMS and Pandora measurements

The Geostationary Environmental Monitoring Spectrometer (GEMS) is a UV&ndash;visible spectrometer onboard the GEO-KOMPSAT-2B satellite launched into geostationary orbit in February 2020. To evaluate GEMS NO2 column data, comparison was carried out using NO2 vertical column density (VCD) measured using direct-sunlight observations by the Pandora spectrometer system at four sites in Seosan, South Korea, during November 2020 to January 2021. Correlation coefficients between GEMS and Pandora NO2 data at four sites ranged from 0.35 to 0.48, with root mean square errors (RMSEs) from 4.7 &times; 1015 molec. cm-2 to 5.5 &times; 1015 molec. cm-2 for cloud fraction (CF) &lt; 0.7. Higher correlation coefficients of 0.62&ndash;0.78 with lower RMSEs from 3.3 &times; 1015 molec. cm-2 to 4.3 &times; 1015 molec. cm-2 were found with CF &lt; 0.3, indicating the higher sensitivity of GEMS to atmospheric NO2 in less-cloudy conditions. Overall, GEMS NO2 column data tend to be lower than those of Pandora due to differences in representative spatial coverage, with a large negative bias under high-CF conditions. With correction for horizontal representativeness in Pandora measurement coverage, the correlation coefficients range from 0.69 to 0.81 with RMSEs from 3.2 &times; 1015 molec. cm-2 to 4.9 &times; 1015 molec. cm-2 were achieved for CF &lt; 0.3, showing the better correlation with the correction than that without the correction.</p