• Asian Pacific Journal of Cancer Prevention
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• 제15권7호
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• pp.3123-3128
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• 2014

The liver is normally the major site of glucose metabolism in intact organisms and the most important target organ for the action of insulin. It has been widely accepted that insulin resistance (IR) is closely associated with postoperative recurrence of hepatocellular carcinoma (HCC). However, the relationship between IR and drug resistance in liver cancer cells is unclear. In the present study, IR was induced in HepG2 cells via incubation with a high concentration of insulin. Once the insulin-resistant cell line was established, the stability of HepG2/IR cells was further tested via incubation in insulin-free medium for another 72h. Afterwards, the biological effects of insulin resistance on adhesion, migration, invasion and sensitivity to cis-platinum (DDP) of cells were determined. The results indicated that glucose consumption was reduced in insulin-resistant cells. In addition, the expression of the insulin receptor and glucose transportor-2 was downregulated. Furthermore, HepG2/IR cells displayed markedly enhanced adhesion, migration, and invasion. Most importantly, these cells exhibited a lower sensitivity to DDP. By contrast, HepG2/IR cells exhibited decreased adhesion and invasion after treatment with the insulin sensitizer pioglitazone hydrochloride. The results suggest that IR is closely related to drug resistance as well as adhesion, migration, and invasion in HepG2 cells. These findings may help explain the clinical observation of limited efficacy for chemotherapy on a background of IR, which promotes the invasion and migration of cancer cells.

• Tuberculosis and Respiratory Diseases
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• 제55권4호
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• pp.344-352
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• 2003

Background : The prevalence of multidrug resistant tuberculosis (MDR-TB), resistant to isoniazid (INH) and rifampin (RFP), was 5.3% worldwide in 1995 and its increment has raised important public health problems. Resistance to RFP, one of the key drugs in the treatment of tuberculosis, results in grim clinical outcome. Recently rapid detection of RFP-resistant mutations in rpoB gene based on PCR method has become available. This study evaluated the prevalence of RFP resistance in first diagnosed, treatment failure, and recurred patients using INNO-LiPA test, and compared the results of INNO-LiPA with those of conventional mycobacterial drug susceptibility test. Methods : Forty-six patients, who were diagnosed of pulmonary tuberculosis and had revealed positive sputum AFB smear, were enrolled in this study from 1998 to 2002. The cases were classified as one three groups; first diagnosed, treatment failure, or recurred. RFP resistance was studied using an INNO-LiPA Rif. TB kit and compared with that obtained from drug susceptibility based on M. tuberculosis culture study. Results : Twenty-one out of 46 patients were enrolled under first diagnosis of pulmonary tuberculosis, 17 under treatment failure with first line drugs, and 8 under recurrence. The positive and negative predictive values of INNO-LiPA test in diagnosis in RFP resistant tuberculosis compared with conventional mycobacterial drug susceptibility test were 85.7% and 76.0%, respectively. INNO-LiPA result revealed rpoB gene mutation in 20 (80.0%) out of 25 patients who were diagnosed as treatment failure or recurrence, but in only 4 (19.0%) out of 21 patients who were first diagnosed as pulmonary tuberculosis. Conclusion : This study showed that RFP resistance could be diagnosed rapidly and accurately using INNO-LiPA test and that this test might be helpful for choosing second line anti-mycobacterial drugs. It might be of great help in clinical diagnosis and decision when used in complimentarily with drug susceptibility test based on M. tuberculosis culture.

• Clinical and Experimental Pediatrics
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• 제49권7호
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• pp.777-783
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• 2006

Purpose : Urinary tract infection(UTI) is one of the most frequent infections in children. E. coli is the most frequent etiological micropathogen in pediatric community UTI, and E. coli has developed resistance to many antibiotics, highlighting the need for regular surveys of this organism resistant patterns in the community. The aim of this study was to determine the oral antibiotic susceptibility patterns of E. coli, isolated from pediatric patients with uncomplicated community acquired UTI. Methods : E. coli isolates, obtained from pediatric patients with uncomplicated community acquired UTI between October in 2004 to September in 2005. And minimal inhibitory concentrations(MICs) of oral aminopenicillins and beta-lactamase inhibnitors(ampicillin, amoxacillin, ampicillin-sulbactam), oral cephalosporins(cefaclor, cefixime) and sulfa drug(trimethoprime-sulfamethoxazole) were performed according to the National Committee for Clinical Laboratory Standards(NCCLS) guide line. Results : Total 211 organisms were isolated from pediatric out-patients with community UTI. E. coli was the most common organism(89 percent), followed by E. fecalis, Proteus species, S. aureus, M. morganii, and P. aeruginosa. The resistant rates of aminopenicillins and beta-lactamase inhibitors, cefaclor and sulfa drug to E. coli were very high. But, the resistant rate of cefixime was markedly low, and ESBL strains were isolated with small rates. Conclusion : Our study results suggest that aminopenicillins, cefaclor and sulfa drug may not be useful as first line empirical antibiotics to treat pediatric patients with community UTI in Korea. But, 3rd generation cephalosporin such as cefixime can be used as effective second line antibiotics after primary treatment failure, also may be useful as an empirical first line antibiotic. Finally, we conclude that a continuous surveillance study to monitor susceptibility patterns of E. coli in community UTI will be needed for the standard guide lines of empirical oral antibiotic treatment.

• Journal of Trauma and Injury
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• 제29권3호
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• pp.93-97
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• 2016

Hepatic duct confluence injury, which is developed by blunt abdominal trauma, is rare. Conventionally, bile duct injury was treated by surgical intervention. In recent decades, however, there had been an increase in radiologic or endoscopic intervention to treat bile duct injury. In a hemodynamically stable patient, endoscopic intervention is considered as the first-line treatment for bile duct injury. A 40 year-old man was transferred to the emergency department of ${\bigcirc}{\bigcirc}$ trauma center after multiple blunt injuries. Contrast-enhanced abdominal computed tomography performed in another hospital showed a liver laceration with active arterial bleeding, fracture of the sacrum and left inferior pubic ramus, and intraperitoneal bladder rupture. The patient presented with hemorrhagic shock because of intra-peritoneal hemorrhage. After resuscitation, angiographic intervention was performed. After angiographic embolization of the liver laceration, emergency laparotomy was performed to repair the bladder injury. However, there was no evidence of bile duct injury on initial laparotomy. On post-trauma day (PTD) 4, the color of intra-abdominal drainage of the patient changed to a greenish hue; bile leakage was revealed on magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP). Bile leakage was detected near the hepatic duct confluence; therefore, a biliary stent was placed into the left hepatic duct. On PTD 37, contrast leakage was still detected but both hepatic ducts were delineated on the second ERCP. Stents were placed into the right and left hepatic ducts. On PTD 71, a third ERCP revealed no contrast leakage; therefore, all stents were removed after 2 weeks (PTD 85). ERCP and biliary stenting could be effective treatment options for hemodynamically stable patients after blunt trauma.

• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.117-122
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• 2014

Background: Breast cancer is the most common malignancy and the second leading cause of cancer-related death among women in the developed countries. Despite advances in screening, improved local therapies and adjuvant systemic treatments, median survival of metastatic breast cancer patients (MBC) is in the range of 2-3 years at most. We aimed to investigate whether the prognostic factors and therapeutic responses of our Turkish patients are similar to those in the literature. Materials and Methods: We reviewed the medical records of MBC patients who had been treated in our institution between 1999-2009 and analyzed their clinicopathological features and survival outcomes retrospectively Results: A hundred and sixty patients were included. Median age was 47 (23-82), median follow up was 24 (2-186) months. At the time of diagnosis 59% of patients were under the age of 50 and 46% were postmenopausal. The majority (37%) had multiple sites of metastases. Forty percent received endocrine therapy and 40% chemotherapy as first line metastatic treatment. Thirty (20%) patients were treated with molecular targeting agents like trastuzumab, lapatinib and sunitinib, frequently combined with a chemotherapy agent. Five-year overall survival (OS) was 32% and median OS was 38 months for the whole group. Five year progression free survival (PFS) was 10% and median PFS was 10 months. Menopausal status, hormone receptor expression and disease free status had a significant impact on overall survival in the multivariate analysis (p 0.018, p 0.018 and p:0.003, respectively). Conclusions: All our patients were treated with the modern oncologic therapies recommended by the international guidelines. From our data, MBC patients live up to 3-4 years, indicating that further improvement beyond that requires development of new treatment modalities. The survival outcomes of our patients were consistent with the data reported in the literature.

• Clinical and Experimental Pediatrics
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• 제45권3호
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• pp.354-361
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• 2002

Purpose : Selective introduction of genes conferring chemosensitivity into proliferating tumor cells may be used to treat cancer. We first investigated the bystander effect of retrovirus-mediated gene transfer of herpes simplex virus thymidine kinase(HSV-TK) gene to murine neuroblstoma cell line(neuro-2a) in vitro and in vivo. Second, we examined the mechanism and its enhancement of the bystander effect in murine neuroblastoma. Methods : To investigate the bystander effect, we studied tumor growth and survival time after HSV-TK/ganciclovir(GCV) treatment in a syngenic A/J mouse neuroblastoma model by mixing various ratios of HSV-TK-expressing neuro-2a cells with wild type neuro-2a cells followed by GCV treatment. To investigate the mechanism of the bystander effect in murine neuroblastoma, immunohistochemistry using connexin 43, CD4 and CD8-specific monoclonal antibodies was analyzed. We studied whether IL-2-secreting neuro-2a cells(neuro-2a/IL-2) would potentiate the bystander effect. Results : A strong bystander effect was observed in vitro and in vivo. The bystander effect in murine neuroblastoma was dependent on the immune response rather than connexin-mediated gap junction. Neuro-2a/IL-2 treatment enhanced the bystander effect in the HSV-TK/GCV system in murine neuroblastoma model. Conclusion : We conclude that the bystander effect in murine neuroblastoma depends on immune response and is enhanced by neuro-2a/IL-2.

• The korean journal of orthodontics
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• 제24권3호
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• pp.695-707
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• 1994

This study investigates the effects of third molar on the occlusal plane in Angle's class El malocclusion with possibilities of posterior crowding and the interrelationships of occlusal plane inclinations to other skeletal patterns. Above investigations might showed that considerations should be given to third molars with possibilities of posterior crowding in establishing diagnosis and treatment plans for Angle's class III malocclusion patients. The following conclusions were obtained 1. In events of third molars causing possible posterior crowding, maxillary third molars showed more mesial inclinations than second molars, and compared to those with third molar missing cases, first molars were more mesially inclined and displaced more inferiorly from the palatal plane and OP-MP was increase , thus the occlusal plane was less steep. 2. In events of third molars causing possible posterior crowding, the anglulation between AB line and mandibular plane was decreased and ANB showed negative values. Thus chin points were more protruded, ramus were more anteriorly displaced, and increase in lower facial height, genial angle, effective mandibular length and mandibular plane angle were observed. This in all caused more vertical opening and more severe skeletal disturbance. 3. OP-MP was increased as the maxillary first molars were more inferiorly displaced from the palatal plane. As this angle was increased mandibular planes were more inferiorly inclined and LFH, genial angle, effective mandibular length were more increased and mandibular ramus was more anteriorly placed. 4. As the maxillary first molars were more inferiorly placed from the palatal plane, more increased OP-MP/PP-MP ratio made the occlusal plane less steep. As OP-MP/PP-MP was increased, mandibular ramus was more anteriorly placed and made longer, and facial angle and effective mandibular length were increased.

• Asian Pacific Journal of Cancer Prevention
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• 제13권2호
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• pp.517-520
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• 2012

Single original gemcitabine is commonly used as salvage treatment in platinum-resistant ovarian cancer, fallopian tube cancer and primary peritoneal adenocarcinoma (PPA) with a satisfactory outcome. However, efficacy data fro this regimen are limited. We therefore conducted a retrospective study to evaluate the outcome of patients who received single-agent generic gemcitabine (GEMITA) after development of clinical platinum resistance. The study period was between May 2008 and December 2010. Gemcitabine was administered intravenously in two different schedules: 1,000 $mg/m^2$ on day 1,8, and 15 every 28 days; and on days 1 and 8 every 21 days with the same dosage. Administration was until disease progression was noted. The response rate was evaluated using the Gynecologic Cancer Intergroup (GCIG) criteria while toxicity was evaluated according to WHO criteria. Sixty-six patients met the inclusion criteria in the study period. Two-thirds of them received gemcitabine as the second and third line regimen. The overall response rate was 12.1%. The median progression free survival and overall survival was 2 and 10 months, respectively. With the total 550 courses of chemotherapy,the patients developed grades 3 and 4 hematologic toxicity as follows: anemia, 1.5%; leukopenia, 13.7%; neutropenia, 27.3%; and thrombocytopenia, 3.0%. In conclusion, single agent generic gemcitabine revealed a modest efficacy in patients with platinum-resistant ovarian cancer, fallopian tube cancer and PPA without serious toxicity.

• Journal of Distribution Science
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• 제16권12호
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• pp.57-68
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• 2018

Purpose - The development of technologies lead the volume of sale on online market increase but an off-line shopping center is still a core component in the omni-channel strategy. It is generally thought that high-level retailtainment on brick and mortar store affects purchase intentions positively, but some previous studies dispute that and have reported that retailtainment does not affect purchase intentions. So we have studied the additional factors' effect - the nature of purchase and utility - with retailtainment. Research design, data, and methodology - There are 8 treatment groups which were assigned by the method of retailtainment (high vs. low), nature of purchase (essential vs. non-essential), and utility (acquisition vs. transaction). A total of 240 subjects (office workers = 163, 68%; undergraduates = 77, 32%; average age = 30s; female = 39%) were divided into groups and exposed to one of the eight scenarios. Participant's purchase intention was the dependent, and ANOVA and L-matrix were used to analyze for main and interactive effects between factors. Results - First, the main effect and interactive effect between retailtainment and the nature of purchase are significant. We also found that the contrast between essential and non-essential at low-level retailtainment is higher than that of high-level retailtainment. Second, in the case of retailtainment and utility, transaction utility under high-level retailtainment affects purchase intentions positively. Third, between the nature of the purchase and utility, the main effect of the nature of purchase and the interactive effect is significant, but the main effect of utility is not significant. In the case of non-essential goods, the purchase intention was high when transaction utility was provided but in the case of essential goods, acquisition utility increased purchase intentions. Finally, when transaction utility is given, purchase intentions of essential goods increase under low retailtainment, and the purchase intentions of non-essential goods increase under high retailtainment. Conclusions - When customers buy essential goods, discounts decrease purchase intentions. During the season for bargain sales, purchase intentions increase when retailtainment of essential goods is low, and retailtainment of non-essential goods is high.

• Neonatal Medicine
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• 제25권1호
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• pp.37-43
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• 2018

Purpose: Meconium-related ileus is common in preterm infants. Without proper management, it can cause necrotizing enterocolitis and perforation requiring emergent operation. This study was conducted to describe the efficacy and safety of ultrasound-guided Gastrografin enema at bedside for preterm infants with meconium-related ileus. Methods: Between March 2013 and December 2014, this study enrolled preterm infants with birth weight <1,500 g, who were diagnosed with meconium-related ileus requiring ultrasound-guided Gastrografin enema refractory to glycerin or warm saline enemas. Gastrografin was infused until it passed the ileocecal valve with ultrasound guidance at bedside. Results: A total of 13 preterm infants were enrolled. Gestational age and birth weight were 28.6 weeks (range, 23.9-34.3 weeks) and 893 g (range, 610-1,440 g), respectively. Gastrografin enema was performed around postnatal day 8 (range, day 3-11). The success rate was 84.6% (11 of 13 cases). Three of these 11 infants received a second procedure, which was successful. Among 2 unsuccessful cases, one failed to pass meconium while the other required surgery due to perforation. The time required to pass meconium was $2.8{\pm}1.5hours$ (range, 1-6 hours). The time until radiographic improvement was $2.8{\pm}3.4days$ (range, 1-14 days) after the procedure. Conclusion: Ultrasound-guided Gastrografin enema at bedside as a first-line treatment to relieve meconium-related ileus was effective and safe for very low birth weight infants. We could avoid unnecessary emergent operation in preterm infants who have high postoperative morbidity and mortality. This could also avoid transporting small preterm infants to fluoroscopy suite.