Metastatic hepatocellular carcinoma presenting as facial nerve palsy and facial pain

Facial nerve palsy due to temporal bone metastasis of hepatocellular carcinoma (HCC) has rarely been reported. We experienced a rare case of temporal bone metastasis of HCC that initially presented as facial nerve palsy and was diagnosed by surgical biopsy. This patient also discovered for the first time that he had chronic hepatitis B and C infections due to this facial nerve palsy. Radiation therapy greatly relieved the facial pain and facial nerve palsy. This report suggests that hepatologists should consider metastatic HCC as a rare but possible cause of new-onset cranial neuropathy in patients with chronic viral hepatitis

Synergistic Effects of Simvastatin and Irinotecan against Colon Cancer Cells with or without Irinotecan Resistance

Aims. We here investigated whether the combination of simvastatin and irinotecan could induce the synergistic effect on colon cancer cells with or without resistance to irinotecan. Methods. We investigated cell proliferation assay and assessed cell death detection ELISA and caspase-3 activity assay of various concentrations of simvastatin and irinotecan to evaluate the efficacy of drug combination on colon cancer cells with or without irinotecan resistance. Results. The IC50 values of simvastatin alone and irinotecan alone were 115.4±0.14 μM (r=0.98) and 62.5±0.18 μM (r=0.98) in HT-29 cells without resistance to irinotecan. The IC50 values of these two drugs were 221.9±0.22 μM (r=0.98) and 195.9±0.16 μM (r=0.99), respectively, in HT-29 cell with resistance to irinotecan. The results of combinations of the various concentrations of two drugs showed that combined treatment with irinotecan and simvastatin more efficiently suppressed cell proliferation of HT-29 cells even with resistance to irinotecan as well as without resistance. Furthermore, the combination of simvastatin and irinotecan at 2:1 molar ratio showed the best synergistic interaction. Conclusion. Simvastatin could act synergistically with irinotecan to overcome irinotecan resistance of colon cancer

Risk Factors for Recurrence of Clostridium difficile Infection: Effect of Vancomycin-resistant Enterococci Colonization

Recurrent Clostridium difficile infection (CDI) is one of the most difficult problems in healthcare infection control. We evaluated the risk factors associated with recurrence in patients with CDI. A retrospective cohort study of 84 patients with CDI from December 2008 through October 2010 was performed at Pusan National University Yangsan Hospital. Recurrence occurred in 13.1% (11/84) of the cases and in-hospital mortality rate was 7.1% (6/84). Stool colonization with vancomycin-resistant enterococci (VRE) (P = 0.006), exposure to more than 3 antibiotics (P = 0.009), low hemoglobin levels (P = 0.025) and continued use of previous antibiotics (P = 0.05) were found to be more frequent in the recurrent group. Multivariate analysis indicated that, stool VRE colonization was independently associated with CDI recurrence (odds ratio, 14.519; 95% confidence interval, 1.157-182.229; P = 0.038). This result suggests that stool VRE colonization is a significant risk factor for CDI recurrence

Effects of dietary supplementation of a lipid-coated zinc oxide product on the fecal consistency, growth, and morphology of the intestinal mucosa of weanling pigs

Background Dietary supplementation of zinc oxide (ZnO) to 2000 to 4000 mg/kg is known to be effective for the prevention and treatment of post-weaning diarrhea in the pig. Such a pharmacological supplementation, however, can potentially result in environmental pollution of the heavy metal, because dietary ZnO is mostly excreted unabsorbed. Two experiments (Exp.) were performed in the present study to determine the effects of a lipid-coated ZnO supplement Shield Zn (SZ) compared with those of ZnO. Methods In Exp. 1, a total of 240 21-day-old weanling pigs were fed a diet supplemented with 100 mg Zn/kg as ZnO (ZnO-100), ZnO-2500, SZ-100, or SZ-200 in 24 pens for 14 days on a farm with its post-weaning pigs exhibiting a low incidence of diarrhea. Exp. 2 was performed using 192 24-day-old piglets as in Exp. 1 on a different farm, which exhibited a high incidence of diarrhea. Results In Exp. 1, fecal consistency (diarrhea) score (FCS) was less for the ZnO-2500 and SZ-200 groups than for the SZ-100 group (P < 0.05), with no difference between the SZ-100 and ZnO-100 groups. Both average daily gain (ADG) and gain:feed ratio were less for the SZ-200 group than for the ZnO-2500 group, with no difference between the ZnO-100 group and SZ-100 or SZ-200 group. The villus height (VH), crypt depth (CD), and VH:CD ratio of the intestinal mucosa were not influenced by the treatment. In Exp. 2, FCS was lowest for the ZnO-2500 group, with no difference among the other groups. However, neither the ADG nor gain:feed ratio was influenced by the treatment. Conclusion Results suggest that physiological SZ supplementation has less beneficial effects than pharmacological ZnO for the alleviation of diarrhea irrespective of its severity and for promoting growth without influencing their integrity of the intestinal mucosal structures with little advantage over physiological ZnO in weanling pigs with a small pen size.This work was supported by the Gyeongnam National University of Science and Technology Grant in 2016