The Association between Kidney Function, Coronary Artery Disease, and Clinical Outcome in Patients Undergoing Coronary Angiography

To characterize the association between chronic kidney disease (CKD), mortality, severity of coronary artery disease (CAD), treatment modality of CAD, and type of coronary stents among patients undergoing coronary angiography (CAG), we retrospectively reviewed the electronic medical records of the patients who underwent CAG at Seoul National University Bundang Hospital in Korea between May 2003 and January 2006. CKD was staged using an estimated glomerular filtration rate (eGFR) from the creatinine value prior to CAG. There were 3,637 patients included. The presence of CAD was 48% in CKD stage 1, 61% in stage 2, 73% in stage 3, 87% in stage 4, and 81% in stage 5. Survival rate gradually diminished for patients with decreasing renal function. No significant differences in all-cause and cardiac mortality were observed by medical treatment, PCI or CABG, in CKD patients with an eGFR less than 60 mL/min/1.73 m2. CKD patients with drug-eluting stents showed significantly lower all-cause mortality (5.4% vs. 13.3%) and incidence of myocardial infarction (1.7% vs. 10%) than those with bare metal stents. In conclusion, an eGFR is a strong independent prognostic marker among patients undergoing CAG and the severity of CAD increases progressively with worsening renal function

Gene expression profiling of mucinous ovarian tumors and comparison with upper and lower gastrointestinal tumors identifies markers associated with adverse outcomes.

PURPOSE: Advanced-stage mucinous ovarian carcinoma (MOC) has poor chemotherapy response and prognosis and lacks biomarkers to aid stage I adjuvant treatment. Differentiating primary MOC from gastrointestinal (GI) metastases to the ovary is also challenging due to phenotypic similarities. Clinicopathologic and gene-expression data were analyzed to identify prognostic and diagnostic features. EXPERIMENTAL DESIGN: Discovery analyses selected 19 genes with prognostic/diagnostic potential. Validation was performed through the Ovarian Tumor Tissue Analysis consortium and GI cancer biobanks comprising 604 patients with MOC (n = 333), mucinous borderline ovarian tumors (MBOT, n = 151), and upper GI (n = 65) and lower GI tumors (n = 55). RESULTS: Infiltrative pattern of invasion was associated with decreased overall survival (OS) within 2 years from diagnosis, compared with expansile pattern in stage I MOC [hazard ratio (HR), 2.77; 95% confidence interval (CI), 1.04–7.41, P = 0.042]. Increased expression of THBS2 and TAGLN was associated with shorter OS in MOC patients (HR, 1.25; 95% CI, 1.04–1.51, P = 0.016) and (HR, 1.21; 95% CI, 1.01–1.45, P = 0.043), respectively. ERBB2 (HER2) amplification or high mRNA expression was evident in 64 of 243 (26%) of MOCs, but only 8 of 243 (3%) were also infiltrative (4/39, 10%) or stage III/IV (4/31, 13%). CONCLUSIONS: An infiltrative growth pattern infers poor prognosis within 2 years from diagnosis and may help select stage I patients for adjuvant therapy. High expression of THBS2 and TAGLN in MOC confers an adverse prognosis and is upregulated in the infiltrative subtype, which warrants further investigation. Anti-HER2 therapy should be investigated in a subset of patients. MOC samples clustered with upper GI, yet markers to differentiate these entities remain elusive, suggesting similar underlying biology and shared treatment strategies

Evaluation of serum CA-125 levels for preoperative counseling in endometrioid endometrial cancer: A multi-center study

Objective. To evaluate the role of serum CA-125 levels for preoperative counseling in endometrioid endometrial cancer (EEC). Methods. We reviewed 413 patients with EEC from 6 tertiary medical centers between July 1996 and June 2008. All patients were divided into (1) 4 categories of preoperative serum CA-125 levels: 70 U/mL (n = 43) or (2) 3 categories: low-risk (n = 240); intermediate-risk (n = 99); high-risk diseases (n = 74). Results. Receiver operative curves showed the best cut-off values of 16.2-40.8 U/mL for predicting prognostic factors with 53.4-84.2% of sensitivity, 43.9-81.7% of specificity, 48.8-82.1% of positive predictive value (PPV), 48.5-83.8% of negative predictive value (NPV) and 48.6-83.0% of accuracy. Especially, adnexal involvement was predicted with the highest accuracy (83.0%) at >= 40.8 U/mL. The best cut-off values for preoperative selection of intermediate- to high-risk, and high-risk diseases were 17.3 U/mL and 21.9 U/mL (62.4% and 68.9% of sensitivity; 54.6% and 64.3% of specificity; 57.9% and 64.2% of PPV; 59.2% and 67.4% of NPV, 58.5% and 65.8% of accuracy). Furthermore, >70 U/mL of preoperative serum CA-125 levels was a prognostic factor for poor progression-free and overall survivals. Conclusions. Serum CA-125 levels may not be useful for predicting most of prognostic factors, and may not contribute to preoperative selection of patients with intermediate- or high-risk disease who need adjuvant radiotherapy in EEC. However, serum CA-125 levels may be helpful in preoperative counseling for young patients who want ovarian preservation, and >70 U/mL could be considered as a risk factor for poor survival. (C) 2010 Elsevier Inc. All rights reserved.Kim K, 2009, J GYNECOL ONCOL, V20, P203, DOI 10.3802/jgo.2009.20.4.203SHUSTER LT, 2008, MENOPAUSE INT, V14, P111Kim HS, 2008, ONKOLOGIE, V31, P315, DOI 10.1159/000131270Kong A, 2007, ANN ONCOL, V18, P1595, DOI 10.1093/annonc/mdm066DENSCHLAG D, 2007, AM J OBSTET GYNECOL, V196, pE1Heintz APM, 2006, INT J GYNECOL OBSTET, V95, pS161Creasman WT, 2006, INT J GYNECOL OBSTET, V95, pS105Riedinger JM, 2006, ANN ONCOL, V17, P1234, DOI 10.1093/annonc/mdl120Takac I, 2006, WIEN KLIN WOCHENSCHR, V118, P62, DOI 10.1007/s00508-006-0554-9Chung HH, 2006, ACTA OBSTET GYN SCAN, V85, P1501, DOI 10.1080/00016340601022777Santillan A, 2005, J CLIN ONCOL, V23, P9338, DOI 10.1200/JCO.2005.02.2582Walsh C, 2005, OBSTET GYNECOL, V106, P693Powell JL, 2005, J REPROD MED, V50, P585Gadducci A, 2004, BIOMED PHARMACOTHER, V58, P24, DOI 10.1016/j.biopha.2003.11.003Santala M, 2003, ANTICANCER RES, V23, P3097Hsieh CH, 2002, GYNECOL ONCOL, V86, P28, DOI 10.1006/gyno.2002.6664Ginath S, 2002, INT J GYNECOL CANCER, V12, P372Dotters DJ, 2000, AM J OBSTET GYNECOL, V182, P1328, DOI 10.1067/mob.2000.106251Koper NP, 1998, ANTICANCER RES, V18, P1897Sood AK, 1997, OBSTET GYNECOL, V90, P441Lo SST, 1997, TUMOR BIOL, V18, P241SCAMBIA G, 1994, GYNECOL ONCOL, V54, P292ROSE PG, 1994, OBSTET GYNECOL, V84, P12LEHTOVIRTA P, 1994, BRIT J OBSTET GYNAEC, V101, P532FAYERS PM, 1993, INT J GYNECOL CANCER, V3, P285BLOSS JD, 1991, GYNECOL ONCOL, V40, P74SOPER JT, 1990, AM J OBSTET GYNECOL, V163, P1204DUK JM, 1989, OBSTET GYNECOL, V73, P661DUK JM, 1986, AM J OBSTET GYNECOL, V155, P1097BAST RC, 1983, NEW ENGL J MED, V309, P883

Molecular Genetic Characterization of the Merozoite Surface Protein 1 Gene of Plasmodium vivax from Reemerging Korean Isolates▿

Plasmodium vivax merozoite surface protein 1 (PvMSP-1) has been considered a major candidate for the development of an antimalaria vaccine, but the molecule exhibits antigenic diversity among isolates. The extent of genetic polymorphism in the region between interspecies conserved blocks 4 and 5 (ICB4 and ICB5) of the PvMSP-1 gene was analyzed for 30 Korean isolates. Two genotypes, SK-A and SK-B, were identified on the basis of amino acid substitution. Almost all the amino acid sequences of the Korean isolates were nearly identical to those of the Solomon Island isolate Solo-83 (97.8 to 99.9% similarity) and Philippine isolates Ph-79, Ph-52-2, and Ph-49 (97.3 to 99.8% similarity). Also, we report two sequences in the isolates that were characterized on the basis of restriction fragment length polymorphism (RFLP). The RFLP profiles following digestion with the DraI restriction enzyme produced two distinguishable patterns. This study might be the first report of the region between ICB4 and ICB5 of the MSP-1 gene of P. vivax in South Korea

Clinical Efficacy and Safety of Silicone Elastomer Sheet during Decompressive Craniectomy: Anti-Adhesive Role in Cranioplasty

(1) Background: Cranioplasty is a surgery to repair a skull bone defect after decompressive craniectomy (DC). If the process of dissection of the epidural adhesion tissue is not performed properly, it can cause many complications. We reviewed the effect of a silicone elastomer sheet designed to prevent adhesion. (2) Methods: We retrospectively reviewed 81 consecutive patients who underwent DC and subsequent cranioplasty at our institution between January 2015 and December 2019. We then divided the patients into two groups, one not using the silicone elastomer sheet (n = 50) and the other using the silicone elastomer sheet (n = 31), and compared the surgical outcomes. (3) Results: We found that the use of the sheet shortened the operation time by 24% and reduced the estimated blood loss (EBL) by 43% compared to the control group. Moreover, the complication rate of epidural fluid collection (EFC) in the group using the sheet was 16.7%, which was lower than that in the control group (41.7%, p < 0.023). Multivariate logistic regression analysis showed the sheet (OR 0.294, 95% CI 0.093–0.934, p = 0.039) to be significantly related to EFC. (4) Conclusions: The technique using the silicone elastomer sheet allows surgeons to easily dissect the surgical plane during cranioplasty, which shortens the operation time, reduces EBL, and minimizes complications of EFC

Clinical Efficacy and Safety of Silicone Elastomer Sheet during Decompressive Craniectomy: Anti-Adhesive Role in Cranioplasty

(1) Background: Cranioplasty is a surgery to repair a skull bone defect after decompressive craniectomy (DC). If the process of dissection of the epidural adhesion tissue is not performed properly, it can cause many complications. We reviewed the effect of a silicone elastomer sheet designed to prevent adhesion. (2) Methods: We retrospectively reviewed 81 consecutive patients who underwent DC and subsequent cranioplasty at our institution between January 2015 and December 2019. We then divided the patients into two groups, one not using the silicone elastomer sheet (n = 50) and the other using the silicone elastomer sheet (n = 31), and compared the surgical outcomes. (3) Results: We found that the use of the sheet shortened the operation time by 24% and reduced the estimated blood loss (EBL) by 43% compared to the control group. Moreover, the complication rate of epidural fluid collection (EFC) in the group using the sheet was 16.7%, which was lower than that in the control group (41.7%, p p = 0.039) to be significantly related to EFC. (4) Conclusions: The technique using the silicone elastomer sheet allows surgeons to easily dissect the surgical plane during cranioplasty, which shortens the operation time, reduces EBL, and minimizes complications of EFC

Targeted combinational therapy inducing mitochondrial dysfunction

We report on a mitochondria-specific combinational theranostic agent, 1. This system contains a chlorambucil prodrug and an aggregation induced emission dye. In addition, compound 1 bears both an intracellular thiol-triggered moiety and a mitochondria targeting unit (triphenylphosphonium). Glutathione (GSH) is the most abundant thiol and its concentrations are significantly higher in a great number of cancer cell lines, compared to normal cells. The GSH-induced prodrug 1 upon activation releases chlorambucil and exhibits mitochondria targeted aggregation induced emission (AIE) fluorescence, resulting in cell apoptosis via the caspase pathway due to mitochondrial dysfunction.status: publishe