Isolated Double-Chambered Right Ventricle in a Young Adult

Double-chambered right ventricle (DCRV) is a rare congenital heart disorder in which the right ventricle is divided by an anomalous muscle bundle into a high pressure inlet portion and a low pressure outlet portion. We report a case of isolated DCRV without symptoms in adulthood, diagnosed through echocardiography, cardiac catheterization and cardiac magnetic resonance imaging

Corticospinal Tract Compression by Hematoma in a Patient with Intracerebral Hemorrhage: A Diffusion Tensor Tractography and Functional MRI Study

The purpose of this study was to demonstrate corticospinal tract compression that was due to a hematoma by using diffusion tensor tractography (DTT) and functional MRI (fMRI) in a patient with an intracerebral hemorrhage (ICH). A 23-year-old right-handed woman presented with severe paralysis of her right extremities at the onset of a spontaneous ICH. Over the first three days from onset, the motor function of the affected upper and lower extremities rapidly recovered to the extent that she was able to overcome applied resistance to the affected limbs, and her limbs regained normal function 3 weeks after onset. The tract of the right hemisphere originated from the primary sensori-motor cortex (SM1) and it passed through the known corticospinal tract pathway. However, the tract of the left hemisphere was similar to that of the right hemisphere except that it was displaced to the antero-medial side by the hematoma at the cerebral peduncle. Only the contralateral SM1 area centered on the precentral knob was activated during affected (right) or unaffected (left) hand movements, respectively. In conclusion, fMRI and DTT demonstrated a corticospinal tract compression due to hematoma in this patient. We conclude that the combined use of these two modalities appears to improve the accuracy of investigating the state of the corticospinal tract

Impact of immunosuppressant therapy on early recurrence of hepatocellular carcinoma after liver transplantation

Background/AimsThe most commonly used immunosuppressant therapy after liver transplantation (LT) is a combination of tacrolimus and steroid. Basiliximab induction has recently been introduced; however, the most appropriate immunosuppression for hepatocellular carcinoma (HCC) patients after LT is still debated.MethodsNinety-three LT recipients with HCC who took tacrolimus and steroids as major immunosuppressants were included. Induction with basiliximab was implemented in 43 patients (46.2%). Mycophenolate mofetil (MMF) was added to reduce the tacrolimus dosage (n=28, 30.1%). The 1-year tacrolimus exposure level was 7.2 ± 1.3 ng/mL (mean ± SD).ResultsThe 1- and 3-year recurrence rates of HCC were 12.9% and 19.4%, respectively. Tacrolimus exposure, cumulative steroid dosages, and MMF dosages had no impact on HCC recurrence. Induction therapy with basiliximab, high alpha fetoprotein (AFP; >400 ng/mL) and protein induced by vitamin K absence/antagonist-II (PIVKA-II; >100 mAU/mL) levels, and microvascular invasion were significant risk factors for 1-year recurrence (P<0.05). High AFP and PIVKA-II levels, and positive 18fluoro-2-deoxy-d-glucose positron-emission tomography findings were significantly associated with 3-year recurrence (P<0.05).ConclusionsInduction therapy with basiliximab, a strong immunosuppressant, may have a negative impact with respect to early HCC recurrence (i.e., within 1 year) in high-risk patients

2023 Korean Endocrine Society Consensus Guidelines for the Diagnosis and Management of Primary Aldosteronism

Primary aldosteronism (PA) is a common, yet underdiagnosed cause of secondary hypertension. It is characterized by an overproduction of aldosterone, leading to hypertension and/or hypokalemia. Despite affecting between 5.9% and 34% of patients with hypertension, PA is frequently missed due to a lack of clinical awareness and systematic screening, which can result in significant cardiovascular complications. To address this, medical societies have developed clinical practice guidelines to improve the management of hypertension and PA. The Korean Endocrine Society, drawing on a wealth of research, has formulated new guidelines for PA. A task force has been established to prepare PA guidelines, which encompass epidemiology, pathophysiology, clinical presentation, diagnosis, treatment, and follow-up care. The Korean clinical guidelines for PA aim to deliver an evidence-based protocol for PA diagnosis, treatment, and patient monitoring. These guidelines are anticipated to ease the burden of this potentially curable condition

Biological Reaction Engineering for the Preparation of C9 Chemicals from Oleic Acid: 9‑Aminononanoic Acid, 1,9-Nonanediol, 9‑Amino-1-nonanol, and 1,9-Diaminononane

Engineering of native and recombinant enzyme reactions in whole-cell biocatalysis may allow the production of a variety of chemicals. In particular, fine-tuning of the reaction selectivity may enable the preparation of a desired product to a high conversion. Here, we demonstrated that various C9 chemicals such as 9-aminononanoic acid, 1,9-nonanediol, 9-amino-1-nonanol, and 1,9-diaminononane could be produced from renewable C18 oleic acid. As a representative example, activation of six recombinant enzyme reactions (e.g., fatty acid double bond hydratase, long-chain secondary alcohol dehydrogenase, Baeyer–Villiger monooxygenase, lipase, primary alcohol dehydrogenase, and ω-aminotransferases) with repression of one native enzyme reaction (i.e., aldehyde dehydrogenase) in Escherichia coli-based biocatalysis led to the formation of 9-aminononanoic acid with an isolation yield of 54% from oleic acid via 10-hydroxyoctadecanoic acid, 10-keto-octadecanoic acid, 9-(nonanoyloxy)nonanoic acid, 9-hydroxynonanoic acid, and 9-oxo-nonanoic acid. This study will contribute to biosynthesis of not only ω-aminoalkanoic acids but also ω-amino-1-alkanols and α,ω-diaminoalkanes from renewable fatty acids (e.g., oleic acid and ricinoleic acid)

Efficacy of modified regimen with attenuated doses of paclitaxel plus carboplatin combination chemotherapy in elderly and/or weak patients with advanced non-small cell lung cancer

Purpose: We conducted this studs to evaluate the activity and toxicity of a combination regimen of paclitaxel plus carboplatin in patients with advanced NSCLC aged 65 years or older and/or in those with an ECOG performance status (PS) 2. Materials and methods: Chemotherapy-naive patients with unresectable pathologically-proven NSCLC and of either age greater than or equal to 65 or ECOG PS 2 were eligible. Patients received modified regimen with attenuated doses of paclitaxel (135 mg/m(2) i.v. for 3 h D1) and carboplatin (AUC = 5, D1) every 3 weeks. Results: Thirty-five patients were enrolled. Nineteen patients were aged 65 or older (54%) and 26 patients (74%) were ECOG PS 2. The objective response rate was 40% with 14 partial responses. The median time to progression was 22 weeks. Grade 3 leucopenia occurred in 1 cycle and one case of neutropenic fever. Conclusions: The modified regimen with attenuated doses of paclitaxel plus carboplatin combination chemotherapy was effective and well tolerated in patients with advanced NSCLC aged 65 years or older and for in those with ECOG PS 2. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved