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1.
Article in English | WPRIM | ID: wpr-919476

ABSTRACT

Background@#Neutrophilic asthma (NeuA) is usually resistant to corticosteroids. Tiotropium bromide (TIO) is a bronchodilator that is used as an add-on therapy to inhaled corticosteroid and long-acting β2 agonist in asthma treatment. However, the role of TIO in NeuA is not fully known. Thus, the aim of this study was to evaluate the effect of TIO on NeuA compared to that of corticosteroids. @*Methods@#C57BL/6 female mice were sensitized with ovalbumin and lipopolysaccharide to induce neutrophilic inflammation. Dexamethasone (DEX) was administered on days 14, 17, 20, and 23. TIO was inhaled on days 21, 21, and 23. On day 24, mice were sacrificed. Airway hyper-responsiveness, levels of cytokines in bronchoalveolar lavage (BAL) and lung homogenates, and lung tissue histopathology were compared between the two groups. @*Results@#Neutrophil counts, T helper 2 cells (TH2)/TH17 cytokines, and pro-inflammatory cytokine in BAL fluids were elevated in the NeuA group. TIO group showed lower total cells, neutrophil counts, and eosinophil counts in BAL fluids than the DEX group (p<0.001, p<0.05, and p<0.001, respectively). Airway resistance was attenuated in the TIO group but elevated in the NeuA group (p<0.001). Total protein, interleukin (IL)-5, and IL-17A levels in BAL fluids were lower in the TIO group than in the NeuA group (all p<0.05). @*Conclusion@#TIO showed more potent effects than DEX in improving airway inflammation and attenuating airway resistance in NeuA.

2.
Article in English | WPRIM | ID: wpr-918220

ABSTRACT

Objective@#To compare the clinical and radiologic findings between perforated and non-perforated choledochal cysts in children. @*Materials and Methods@#Fourteen patients (mean age ± standard deviation, 1.7 ± 1.2 years) with perforated choledochal cysts (perforated group) and 204 patients (3.6 ± 3.8 years) with non-perforated choledochal cysts (non-perforated group) were included between 2000 and 2019. All patients underwent choledochal cyst excision after ultrasound, CT, or MR cholangiopancreatography. Relevant data including demographics, clinical symptoms, laboratory findings, imaging findings, and outcomes were analyzed. Statistical differences were compared using the Mann-Whitney U test and Fisher’s exact test. @*Results@#Choledochal cyst perforation occurred only in children under the age of 4 years. Acute symptoms, including fever (p < 0.001), were more common in the perforated group than in the non-perforated group. High levels of white blood cells (p = 0.004), C-reactive protein (p < 0.001), and serum amylase (p = 0.002), and low levels of albumin (p < 0.001) were significantly associated with the perforated group. All 14 patients with perforated choledochal cysts had ascites, whereas only 16% (33/204) of patients in the non-perforated group had ascites (p < 0.001). In the subgroup of patients who had ascites, a large amount of ascites (p = 0.001), increase in the amount of ascites in a short time (p < 0.001), complex ascites (p < 0.001), and perihepatic pseudocysts (p < 0.001) were more common in the perforated group than in the non-perforated group. @*Conclusion@#Children with perforated choledochal cysts have characteristic clinical and radiologic findings compared to those with non-perforated choledochal cysts. In young children with choledochal cysts, perforation should be differentiated in cases with acute symptoms, laboratory abnormalities, and characteristic ascites findings.

3.
Article in English | WPRIM | ID: wpr-913323

ABSTRACT

Purpose@#Sleep-disordered breathing is one of the complicating characteristics in patients with Prader-Willi syndrome (PWS). No detailed description and risk factors are suggested on breathing problems during sleep in Korean children with PWS. @*Methods@#We reviewed clinical and sleep-study data in patients with PWS who underwent polysomnography before they took the growth hormone therapy. @*Results@#Of the 27 patients with PWS, 25 (92.6%) had sleep-disordered breathing, of whom 14 showed moderate to severe sleep apnea. Obstructive dominance was prevalent (64%), followed by central dominance (24%). The apnea-hypopnea index (AHI) increased with increasing weight-for-height z-score (WHZ) (r = 0.50, P = 0.009), but did not differ by age. Apnea duration of over 12 months was longer in the patient group than in the infant group (15.1 ± 4.3 seconds vs. 9.4 ± 1.7 seconds, P = 0.001) and in the obese than nonobese groups (16.8 ± 4.3 seconds vs. 10.0 ± 2.0 seconds, P = 0.003). Desaturation below 70% was more common in the obese than nonobese subjects (3/9 vs. 0/18, P = 0.029). Age was not different between the central and obstructive apnea groups, but patients with central apnea tended to be younger than patients with obstructive apnea (median [range]: 8.0 months [6.0–12.0 months] vs.16.5 months [8.5–79.5 months], P = 0.092). In addition, patients with obstructive apnea showed higher AHI (12.8 [5.9–19.2] vs. 3.9 [3.4–4.5], P = 0.045). @*Conclusion@#Sleep-disordered breathing is common in PWS children with different intensity and patterns according to age and BMI. Close monitoring of breathing problems during sleep is required in PWS patients.

4.
Article in Korean | WPRIM | ID: wpr-916404

ABSTRACT

Purpose@#To evaluate the repeatability of retinal nerve fiber layer (RNFL) thickness and Bruch’s membrane opening-minimum rim width (BMO-MRW) measurements by spectral-domain optical coherence tomography (SD-OCT) in wet age-related macular degeneration (wAMD) and diabetic macular edema (DME). @*Methods@#This was a prospective study. The RNFL thickness and BMO-MRW parameters for each sector and global average were measured twice by SD-OCT. Repeatability was evaluated using the intraclass correlation coefficient (ICC) and coefficient of variation (CV). If the optic disc membrane was confirmed, it was analyzed by dividing it into three groups based on severity. @*Results@#A total of 99 eyes (48 with wAMD, 51 with DME) were included in the analysis. The ICCs of the global RNFL thickness and global BMO-MRW measurements were 0.996 and 0.997, respectively, in wAMD and 0.994 and 0.996, respectively, in DME eyes. The CV values of global RNFL thickness and BMO-MRW were 0.60% and 0.73%, respectively, in wAMD eyes and 1.10% and 1.21%, respectively, in DME eyes. The disc membrane on the optic nerve head significantly affected global BMO-MRW repeatability (B = 0.814, p < 0.001). @*Conclusions@#Both RNFL thickness and BMO-MRW measurements showed good repeatability in eyes with wAMD and DME. The severity of the optic disc membrane significantly affected the repeatability of BMO-MRW measurements in eyes with wAMD and DME. Therefore, physicians should examine the BMO-MRW in eyes with severe optic disc membrane.

5.
Article in English | WPRIM | ID: wpr-899633

ABSTRACT

Purpose@#The aim of this study was to identify the individual, job, and organizational factors affecting the individual innovative behaviors among tertiary care hospitals’ nurses. @*Methods@#The participants in this study were 230 nurses who have worked more than one year in tertiary care hospitals. Data were collected using self-administered questionnaires that included individual factors (self efficacy, and empowerment), job factors (knowledge and skills for evidence-based practice, and beliefs for evidence-based practice), organizational factors (perceived organizational support), and individual innovation behavior. The SPSS/WIN 25.0 program was used for data analysis which included descriptive analysis, t-test, ANOVA, Scheffé test, Pearson’s correlation coefficient, and hierarchical regression analysis. Results: Individual innovative behavior had significant positive correlations with all of individual, job, and organizational factors. The results of hierarchical regression analysis showed that knowledge and skills for evidence-based practice (β=.28, p<.001), self efficacy (β=.25, p=.002), gender (female, β=.23, p<.001), and beliefs for evidence-based practice (β=.17, p=.016) were significant factors influencing on individual innovative behavior. Conclusion: These findings suggest that knowledge, skills and beliefs for evidence-based practice, and self efficacy were linked to individual innovative behaviors.Therefore, education and human resource management improving self efficacy, knowledge, skills and beliefs for evidence-based practice are needed to increase nurses’ individual innovative behaviors in tertiary care hospitals.

6.
Article in English | WPRIM | ID: wpr-899547

ABSTRACT

Objectives@#The purpose of this study was to determine the difference in the genotype distribution of Porphyromonas gingivalis (P. gingivalis), the main cause of periodontal disease, according to smoking status. @*Methods@#Two hundred thirty adults with periodontal disease were selected as subjects and were classified into either a smoking or non-smoking group. Smoking behavior was assessed with a self-administered questionnaire, and subgingival plaque was collected and analyzed using polymerase chain reaction to confirm the P. gingivalis genotype. For statistical analysis, SPSS Ver 25.0 was used. @*Results@#P. gingivalis was expressed in 224 subjects (97.4%), and there was no difference in its expression rate according to smoking. However, there was a significant difference in smoking in type III genotype and smoking period in type II genotype with P. gingivalis (P=0.003). @*Conclusions@#Although smoking was not related to the overall distribution of P. gingivalis, increased volume and duration may inhibit the expression of type II and type III genotypes.

7.
Article in English | WPRIM | ID: wpr-898715

ABSTRACT

We previously showed that γ-glutamyltranspeptidase (GGT), an enzyme involved in glutathione metabolism, in Bacillus subtilis acts as a virulence factor for osteoclastogenesis via the RANKL-dependent pathway. Hence, it can be hypothesized that GGT of periodontopathic bacteria acts as a virulence factor in bone destruction. Because Fusobacterium nucleatum, which is a periodontopathic pathogen, has GGT with a primary structure similar to that of B. subtilis GGT (37.7% identify), the bone-resorbing activity of F. nucleatum GGT was examined here. Recombinant GGT (rGGT) of F. nucleatum was expressed in Escherichia coli and purified using the His tag of rGGT. F. nucleatum rGGT (Fn rGGT) was expressed as a precursor of GGT, and then processed to a heavy subunit and a light subunit, which is characteristic of general GGTs, including the human and B. subtilis enzymes. Osteoclastogenesis was achieved in a co-culture system of mouse calvaria-derived osteoblasts and bone marrow cells. Fn rGGT induced osteoclastogenesis to a level similar to that of B. subtilis rGGT; furthermore, osteoclastogenesis was induced in a dose-dependent manner. These results suggest that F. nucleatum GGT possesses a virulent bone-resorbing activity, which could play an important role in the pathogenesis of periodontitis.

8.
Article in English | WPRIM | ID: wpr-898190

ABSTRACT

Background@#Nonalcoholic fatty liver disease (NAFLD) is the most prevalent cause of chronic liver disease worldwide. Type 2 diabetes mellitus (T2DM) is a risk factor that accelerates NAFLD progression, leading to fibrosis and cirrhosis. Thus, here we aimed to develop a simple model to predict the presence of NAFLD based on clinical parameters of patients with T2DM. @*Methods@#A total of 698 patients with T2DM who visited five medical centers were included. NAFLD was evaluated using transient elastography. Univariate logistic regression analyses were performed to identify potential contributors to NAFLD, followed by multivariable logistic regression analyses to create the final prediction model for NAFLD. @*Results@#Two NAFLD prediction models were developed, with and without serum biomarker use. The non-laboratory model comprised six variables: age, sex, waist circumference, body mass index (BMI), dyslipidemia, and smoking status. For a cutoff value of ≥60, the prediction accuracy was 0.780 (95% confidence interval [CI], 0.743 to 0.817). The second comprehensive model showed an improved discrimination ability of up to 0.815 (95% CI, 0.782 to 0.847) and comprised seven variables: age, sex, waist circumference, BMI, glycated hemoglobin, triglyceride, and alanine aminotransferase to aspartate aminotransferase ratio. Our non-laboratory model showed non-inferiority in the prediction of NAFLD versus previously established models, including serum parameters. @*Conclusion@#The new models are simple and user-friendly screening methods that can identify individuals with T2DM who are at high-risk for NAFLD. Additional studies are warranted to validate these new models as useful predictive tools for NAFLD in clinicalpractice.

9.
Article in English | WPRIM | ID: wpr-891929

ABSTRACT

Purpose@#The aim of this study was to identify the individual, job, and organizational factors affecting the individual innovative behaviors among tertiary care hospitals’ nurses. @*Methods@#The participants in this study were 230 nurses who have worked more than one year in tertiary care hospitals. Data were collected using self-administered questionnaires that included individual factors (self efficacy, and empowerment), job factors (knowledge and skills for evidence-based practice, and beliefs for evidence-based practice), organizational factors (perceived organizational support), and individual innovation behavior. The SPSS/WIN 25.0 program was used for data analysis which included descriptive analysis, t-test, ANOVA, Scheffé test, Pearson’s correlation coefficient, and hierarchical regression analysis. Results: Individual innovative behavior had significant positive correlations with all of individual, job, and organizational factors. The results of hierarchical regression analysis showed that knowledge and skills for evidence-based practice (β=.28, p<.001), self efficacy (β=.25, p=.002), gender (female, β=.23, p<.001), and beliefs for evidence-based practice (β=.17, p=.016) were significant factors influencing on individual innovative behavior. Conclusion: These findings suggest that knowledge, skills and beliefs for evidence-based practice, and self efficacy were linked to individual innovative behaviors.Therefore, education and human resource management improving self efficacy, knowledge, skills and beliefs for evidence-based practice are needed to increase nurses’ individual innovative behaviors in tertiary care hospitals.

10.
Article in English | WPRIM | ID: wpr-891843

ABSTRACT

Objectives@#The purpose of this study was to determine the difference in the genotype distribution of Porphyromonas gingivalis (P. gingivalis), the main cause of periodontal disease, according to smoking status. @*Methods@#Two hundred thirty adults with periodontal disease were selected as subjects and were classified into either a smoking or non-smoking group. Smoking behavior was assessed with a self-administered questionnaire, and subgingival plaque was collected and analyzed using polymerase chain reaction to confirm the P. gingivalis genotype. For statistical analysis, SPSS Ver 25.0 was used. @*Results@#P. gingivalis was expressed in 224 subjects (97.4%), and there was no difference in its expression rate according to smoking. However, there was a significant difference in smoking in type III genotype and smoking period in type II genotype with P. gingivalis (P=0.003). @*Conclusions@#Although smoking was not related to the overall distribution of P. gingivalis, increased volume and duration may inhibit the expression of type II and type III genotypes.

11.
Article in English | WPRIM | ID: wpr-891011

ABSTRACT

We previously showed that γ-glutamyltranspeptidase (GGT), an enzyme involved in glutathione metabolism, in Bacillus subtilis acts as a virulence factor for osteoclastogenesis via the RANKL-dependent pathway. Hence, it can be hypothesized that GGT of periodontopathic bacteria acts as a virulence factor in bone destruction. Because Fusobacterium nucleatum, which is a periodontopathic pathogen, has GGT with a primary structure similar to that of B. subtilis GGT (37.7% identify), the bone-resorbing activity of F. nucleatum GGT was examined here. Recombinant GGT (rGGT) of F. nucleatum was expressed in Escherichia coli and purified using the His tag of rGGT. F. nucleatum rGGT (Fn rGGT) was expressed as a precursor of GGT, and then processed to a heavy subunit and a light subunit, which is characteristic of general GGTs, including the human and B. subtilis enzymes. Osteoclastogenesis was achieved in a co-culture system of mouse calvaria-derived osteoblasts and bone marrow cells. Fn rGGT induced osteoclastogenesis to a level similar to that of B. subtilis rGGT; furthermore, osteoclastogenesis was induced in a dose-dependent manner. These results suggest that F. nucleatum GGT possesses a virulent bone-resorbing activity, which could play an important role in the pathogenesis of periodontitis.

12.
Article in English | WPRIM | ID: wpr-890486

ABSTRACT

Background@#Nonalcoholic fatty liver disease (NAFLD) is the most prevalent cause of chronic liver disease worldwide. Type 2 diabetes mellitus (T2DM) is a risk factor that accelerates NAFLD progression, leading to fibrosis and cirrhosis. Thus, here we aimed to develop a simple model to predict the presence of NAFLD based on clinical parameters of patients with T2DM. @*Methods@#A total of 698 patients with T2DM who visited five medical centers were included. NAFLD was evaluated using transient elastography. Univariate logistic regression analyses were performed to identify potential contributors to NAFLD, followed by multivariable logistic regression analyses to create the final prediction model for NAFLD. @*Results@#Two NAFLD prediction models were developed, with and without serum biomarker use. The non-laboratory model comprised six variables: age, sex, waist circumference, body mass index (BMI), dyslipidemia, and smoking status. For a cutoff value of ≥60, the prediction accuracy was 0.780 (95% confidence interval [CI], 0.743 to 0.817). The second comprehensive model showed an improved discrimination ability of up to 0.815 (95% CI, 0.782 to 0.847) and comprised seven variables: age, sex, waist circumference, BMI, glycated hemoglobin, triglyceride, and alanine aminotransferase to aspartate aminotransferase ratio. Our non-laboratory model showed non-inferiority in the prediction of NAFLD versus previously established models, including serum parameters. @*Conclusion@#The new models are simple and user-friendly screening methods that can identify individuals with T2DM who are at high-risk for NAFLD. Additional studies are warranted to validate these new models as useful predictive tools for NAFLD in clinicalpractice.

13.
Article in Korean | WPRIM | ID: wpr-920338

ABSTRACT

Purpose@#The purpose of this study was to investigate the relationship among perceived importance to rehabilitation nursing, role conflict, working environments, and the performance of rehabilitation nursing in rehabilitation hospitals nurses. @*Methods@#The participants in this study were 254 nurses from 8 rehabilitation hospitals. Data was collected using a self administered questionnaire. Collected data was analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients and multiple regression analysis with the SPSS 24.0 program. @*Results@#Each average score of performance of rehabilitation nursing, perceived importance to rehabilitation nursing, role conflict, working environment were 3.27±0.46, 4.16±0.46, 3.62±0.63, 2.54±0.46. The factors influencing the performance of rehabilitation nursing were the perceived importance to rehabilitation nursing (β=.39, p<.001) and the working environment (β=.19, p=.002). @*Conclusion@#Findings of this study indicate the necessity of strengthening perceived importance of rehabilitation nursing and improving working environment to improve the performance of rehabilitation nursing in rehabilitation hospitals.

14.
Journal of Korean Diabetes ; : 153-159, 2021.
Article in Korean | WPRIM | ID: wpr-918907

ABSTRACT

The present article demonstrates an unusual case of type 1 autoimmune pancreatitis (AIP), focusing on the cause of deterioration in glycemic control and weight loss in a patient with pre-existing type 2 diabetes mellitus (DM). A 67-year-old man was diagnosed with type 2 DM 23 years prior and presented with weight loss of approximately 6 kg over a period of 3 months and hemoglobin A1c (HbA1c) of 9.1%. His carbohydrate antigen 19-9 (CA 19-9) level was elevated to 158.54 U/mL (normal, 0~37 U/mL). Considering these findings, we needed to rule out hidden malignancy. Computed tomography of the abdomen showed diffuse swelling of the pancreas uncinated process. The serum immunoglobulin G (IgG) level was elevated to 2,418 mg/dL (normal, 700~1,600 mg/dL), and IgG4 level was elevated to 1,115.0 mg/dL (normal range, 3.9~86.4 mg/dL). This case highlights that AIP should be considered as a cause of significant weight loss and a deterioration in glycemic control in patients with DM. Furthermore, a pancreatic imaging study should be considered in clinical practice to differentiate pancreatic cancer and AIP.

15.
Journal of Korean Diabetes ; : 225-237, 2021.
Article in Korean | WPRIM | ID: wpr-918905

ABSTRACT

The accuracy and convenience of continuous glucose monitoring (CGM), which efficiently evaluates glycemic variability and hypoglycemia, are improving. There are two types of CGM: professional CGM and personal CGM. Personal CGM is subdivided into real-time CGM (rt-CGM) and intermittently scanned CGM (isCGM). CGM is being emphasized in both domestic and foreign diabetes management guidelines. Regardless of age or type of diabetes, CGM is useful for diabetic patients undergoing multiple insulin injection therapy or using an insulin pump. rt-CGM is recommended for all adults with type 1 diabetes (T1D), and can also be used in type 2 diabetes (T2D) treatments using multiple insulin injections. In some cases, short-term or intermittent use of CGM may be helpful for patients with T2D who use insulin therapy other than multiple insulin injections and/or oral hypoglycemic agents. CGM can help to achieve A1C targets in diabetes patients during pregnancy. CGM is a safe and cost-effective alternative to self-monitoring blood glucose in T1D and some T2D patients. CGM used in diabetes management works optimally with proper education, training, and follow up. To achieve the activation of CGM and its associated benefits, it is necessary to secure sufficient repetitive training and time for data analysis, management, and education. Various supports such as compensation, insurance coverage expansion, and reimbursement are required to increase the effectiveness of CGM while considering the scale of benefit recipients, policy priorities, and financial requirements.

16.
Article in English | WPRIM | ID: wpr-875114

ABSTRACT

Lymphomatoid granulomatosis (LG) is a rare B-cell type angiocentric lymphoproliferative disease that can progress to extranodal lymphoma with high mortality. It most commonly affects the lungs, although extrapulmonary systems, including the brain and skin, can also be involved. LG in pediatric patients has been very rarely reported in the literature with limited imaging features. Herein, we report a pediatric case of LG involving the lung and brain with characteristic imaging findings.

17.
Article in English | WPRIM | ID: wpr-874065

ABSTRACT

Purpose@#Respiratory virus infection is a common cause of hospitalization in children. Rapid testing for respiratory viruses, such as the FilmArray method, can be clinically useful. However, insufficient evidence exists to support its use in standard clinical care. @*Methods@#We retrospectively analyzed data from children under 18 years old who received the multiplex real-time polymerase chain reaction array (multiplex RT-PCR) method in 2017 and by FilmArray respiratory panel (FilmArray RP) in 2018. @*Results@#Between January, 2017 and December, 2018, we reviewed data from 1,480 hospitalized children. The number of children with virus detection in respiratory viral PCR was 523 in the multiplex RT-PCR method and 419 in the FilmArray method. Seasonal virus outbreak patterns were similar to those of Korea Centers for Disease Control and Prevention in both groups. There was no difference between the 2 groups in the mean length of hospital stay. The time from admission to isolation by influenza infection was significantly shorter in the FilmArray group than in the multiplex RT-PCR group among patients who were not diagnosed with influenza infection by rapid antigen test at the time of admission. @*Conclusion@#The use of FilmArray method for respiratory viruses did not diminish length of hospital stay. However, the FilmArray method may quickly detect the prevalence of respiratory infection and aid in clinical treatment. In addition, it was related with a reduced time from admission to isolation by influenza infection in hospitalized children who were not identified with influenza infection by rapid antigen test at the time of admission.

18.
Article in Korean | WPRIM | ID: wpr-913277

ABSTRACT

Honey is a food ingested worldwide. Allergic reaction to honey is rare and only a few cases have been reported in the literature. A 20-month-old boy developed angioedema 30 minutes after eating rice cake containing honey. After 2 weeks, we performed food challenge tests with honey which resulted in anaphylaxis. This is the first case report on anaphylaxis to honey in Korea.

19.
Article | WPRIM | ID: wpr-835494

ABSTRACT

Periodontitis is a bacteria-induced inflammatory disease associated with alveolar bone loss. Osteoclast is a macrophage-lineage cell that exhibits phagocytic activity; however, osteoclast phagocytic activity has not been demonstrated under pathological conditions. Diabetes is a pathological condition that exacerbates alveolar bone loss via periodontitis; therefore, we examined phagocytic osteoclasts in diabetic rats that had periodontitis. The rats were divided into the control (C), periodontitis (P), and diabetes with periodontitis (DP) groups. Diabetes and periodontitis were induced by streptozotocin injection and ligature of the mandibular first molars, respectively. On days 3 and 20 after the ligature, the rats were sacrificed, and osteoclasts containing inclusions were quantified by tartrate-resistant acid phosphatase staining. On day 3, there were more osteoclasts containing inclusions in the DP group than in the C group. Among inclusions, osteocyte-like cells and dense bodies were more frequently observed in the DP group than in the C group. Cytoplasm-like structures were elevated more in the DP group than in the C and P groups. However, no differences were observed on day 20. Interestingly, some osteoclasts were in contact with the osteocytes within the exposed lacunae and contained several inclusions within a large vacuole. Thus, the elevation of phagocytic osteoclasts in rats with diabetes and periodontitis provides insight into the role of osteoclast phagocytic activity under pathological conditions.

20.
Article | WPRIM | ID: wpr-834548

ABSTRACT

Background@#Immunomodulatory therapies targeting the interaction between programmed cell death protein 1 and programmed death-ligand 1 (PD-L1) have become increasingly important in anticancer treatment. Previous research on the subject of this immune response has established an association with tumor aggressiveness and a poor prognosis in certain cancers. Currently, scant information is available on the relationship between PD-L1 expression and gallbladder cancer (GBC). @*Methods@#We investigated the expression of PD-L1 in 101 primary GBC cases to determine the potential association with prognostic impact. PD-L1 expression was immunohistochemically assessed using a single PD-L1 antibody (clone SP263). Correlations with clinicopathological parameters, overall survival (OS), or progression- free survival (PFS) were analyzed. @*Results@#PD-L1 expression in tumor cells at cutoff levels of 1%, 10%, and 50% was present in 18.8%, 13.8%, and 7.9% of cases. Our study showed that positive PD-L1 expression at any cutoff was significantly correlated with poorly differentiated histologic grade and the presence of lymphovascular invasion (p < .05). PD-L1 expression at cutoff levels of 10% and 50% was significantly positive in patients with perineural invasion, higher T categories, and higher pathologic stages (p < .05). Additionally, there was a significant association noted between PD-L1 expression at a cutoff level of 50% and worse OS or PFS (p = .049 for OS, p = .028 for PFS). Other poor prognostic factors included histologic grade, T category, N category, pathologic stage, lymphovascular invasion, perineural invasion, growth pattern, and margin of resection (p < .05). @*Conclusions@#The expression of PD-L1 in GBC varies according to cutoff level but is valuably associated with poor prognostic parameters and survival. Our study indicates that the overexpression of PD-L1 in GBC had a negative prognostic impact.

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