Transfusion support in hematopoietic stem cell transplantation

Transfusion support for hematopoietic stem cell transplantation (HSCT) is an essential part of supportive care, and compatible blood should be transfused into recipients. As leukocyte antigen (HLA) matching is considered first and as the blood group does not impede HSCT, major, minor, bidirectional, and RhD incompatibilities occur that might hinder transfusion and cause adverse events. Leukocyte reduction in blood products is frequently used, and irradiation should be performed for blood products, except for plasma. To mitigate incompatibility and adverse events, local transfusion guidelines, hospital transfusion committees, and patient management should be considered.

An inexpensive, easy, and anatomically similar pericardiocentesis model manufacturing method using gelatin

Objective@#Cardiac tamponade with hemodynamic collapse requires immediate treatment, and ultrasound-guided pericardiocentesis is the treatment of choice. Although an essential skill for emergency physicians, there is a lack of training. We created a phantom that could practice ultrasound-guided pericardiocentesis using readily available materials. The pros and cons of the materials used were then compared. @*Methods@#Cardiac tamponade phantoms were made from gelatin, and included a heart, liver, and rib cage. We conducted a model-specific satisfaction questionnaire targeting 15 emergency physicians. The questionnaire was designed to be answered on a Likert 5-point scale. @*Results@#Creating the gelatin model took 6 hours. At room temperature, the gelatin model was able to retain its shape for 3 days. Fifteen physicians participated in the questionnaire, comprising five subjects having actual pericardiocentesis experience. In the questionnaire, our model achieved high satisfaction with all questions. @*Conclusion@#In our study, the pericardiocentesis phantom made from gelatin could maintain its shape for a long time, there was better recognition of the needle tip, and the model was more similar to the actual cardiac tamponade situation. Considering these positive characteristics, we recommend the phantom as a model for pericardiocentesis training.

Actual sweating as a significant predict factor of acute coronary syndrome

Objective@#This study aims to identify significant factors such as sweat that can be used as important predictors of acute coronary syndrome (ACS) in patients visiting the emergency department (ED) complaining of chest pain. @*Methods@#This observational, retrospective, registry-based study conducted from May 2020 to November 2020 evaluated patients who visited the ED due to chest pain. Parameters associated with ACS were investigated, and the clinical characteristics and symptoms were analyzed. @*Results@#A total of 230 patients visited the ED with chest pain. Of these, 94 (40.9%) were diagnosed with ACS. Univariate regression analysis showed that facial sweating (odds ratio [OR], 2.624; 95% confidence interval [CI], 1.241-5.549; P=0.012) and drench sweating (OR, 3.346; 95% CI, 1.602-6.991; P=0.001) were associated with ACS. Hence, we classified these patients as the actual sweating group. However, the sweaty feeling self-reported by patients with no visible sweat did not correlate with ACS. Multivariate logistic regression analysis showed that age (OR, 1.043; 95% CI, 1.016-1.071; P=0.002), quantum of smoking (OR, 1.023; 95% CI, 1.005-1.041; P=0.010), diastolic blood pressure (OR, 1.028; 95% CI, 1.004-1.049; P=0.009), squeezing chest pain (OR, 2.128; 95% CI, 1.000-4.531; P=0.050), and actual sweating (OR, 2.300; 95% CI, 1.209-4.374; P=0.011) were significantly associated with ACS. @*Conclusion@#Age, the quantum of smoking, diastolic blood pressure, squeezing chest pain, and actual sweating are useful predictors for ACS diagnosis. Unlike actual sweating, patient-reported sweating is not significantly related to the diagnosis of ACS. The results of this study will be beneficial in predicting ACS to ensure early and emergency medical care in the pre-hospital setting.

Primary Tumor Suppression and Systemic Immune Activation of Macrophages through the Sting Pathway in Metastatic Skin Tumor

Purpose@#Agonists of the stimulator of interferon genes (STING) play a key role in activating the STING pathway by promoting the production of cytokines. In this study, we investigated the antitumor effects and activation of the systemic immune response of treatment with DMXAA (5,6-dimethylxanthenone-4-acetic acid), a STING agonist, in EML4-ALK lung cancer and CT26 colon cancer. @*Materials and Methods@#The abscopal effects of DMXAA in the treatment of metastatic skin nodules were assessed. EML4-ALK lung cancer and CT26 colon cancer models were used to evaluate these effects after DMXAA treatment. To evaluate the expression of macrophages and T cells, we sacrificed the tumor-bearing mice after DMXAA treatment and obtained the formalin-fixed paraffin-embedded (FFPE) tissue and tumor cells. Immunohistochemistry and flow cytometry were performed to analyze the expression of each FFPE and tumor cell. @*Results@#We observed that highly infiltrating immune cells downstream of the STING pathway had increased levels of chemokines after DMXAA treatment. In addition, the levels of CD80 and CD86 in antigen-presenting cells were significantly increased after STING activation. Furthermore, innate immune activation altered the systemic T cell-mediated immune responses, induced proliferation of macrophages, inhibited tumor growth, and increased numbers of cytotoxic memory T cells. Tumor-specific lymphocytes also increased in number after treatment with DMXAA. @*Conclusion@#The abscopal effect of DMXAA treatment on the skin strongly reduced the spread of EML4-ALK lung cancer and CT26 colon cancer through the STING pathway and induced the presentation of antigens.

Opinions on the Recovery of Outpatients with Schizophrenia and Their Wills to Recover / 대한정신분열병학회지

Objectives@#To examine the opinions regarding recovery and assess their will to recover in outpatients with schizophrenia. @*Methods@#Total 98 stable outpatients with schizophrenia were enrolled. To investigate the outpatients’ opinions regarding recovery, we asked the subjects to write down the ways they could think they had recovered from their current disease. We classified their answers and chose final 39 statements. Using this questionnaire, they were asked to what extent they agreed with each statement. Moreover, the Recovery Assessment Scale (RAS) was used to measure the subjects’ will to recover. @*Results@#Many of the 39 subjects who were surveyed about their opinions on recovery agreed on 11 statements about taking medicine, social life, daily life, social functioning, positivity about life (happiness, hope, confidence, and tranquility), symptoms, occupation, and self-control. The RAS score showed a significant correlation with age (r=-0.26, p<0.01), age at onset (r=0.26, p<0.01), duration of illness (r=-0.52, p<0.01), and number of hospitalization (r=-0.46, p<0.01). @*Conclusion@#This study shows that positivity about life is an important part of the patients’ subjective recovery criteria in schizophrenia. Therefore, if clinicians pay more attention to this part of subjective recovery, it would strengthen the patients’ will for recovery.

Opinions on the Recovery of Outpatients with Schizophrenia and Their Wills to Recover / 대한정신분열병학회지

Objectives@#To examine the opinions regarding recovery and assess their will to recover in outpatients with schizophrenia. @*Methods@#Total 98 stable outpatients with schizophrenia were enrolled. To investigate the outpatients’ opinions regarding recovery, we asked the subjects to write down the ways they could think they had recovered from their current disease. We classified their answers and chose final 39 statements. Using this questionnaire, they were asked to what extent they agreed with each statement. Moreover, the Recovery Assessment Scale (RAS) was used to measure the subjects’ will to recover. @*Results@#Many of the 39 subjects who were surveyed about their opinions on recovery agreed on 11 statements about taking medicine, social life, daily life, social functioning, positivity about life (happiness, hope, confidence, and tranquility), symptoms, occupation, and self-control. The RAS score showed a significant correlation with age (r=-0.26, p<0.01), age at onset (r=0.26, p<0.01), duration of illness (r=-0.52, p<0.01), and number of hospitalization (r=-0.46, p<0.01). @*Conclusion@#This study shows that positivity about life is an important part of the patients’ subjective recovery criteria in schizophrenia. Therefore, if clinicians pay more attention to this part of subjective recovery, it would strengthen the patients’ will for recovery.

The Comparison of Clinical Variables Among Competitive Employment, Partial Employment, and Unemployment Group in Schizophrenic Outpatients / 신경정신의학

Objectives@#The purpose of this research was to examine differences between clinical variables among outpatients with schizophrenia in competitive and partial employed and unemployed groups. @*Methods@#The study subjects were 168 outpatients with schizophrenia, and these were divided into three groups, that is, competitive (n=20), partial (n=28), and unemployed (n=120) groups, based on employment status. Job and psychopathology data were collected by interview and using self-report questionnaires (self-stigma, will to recover, family attitude, perceived social support, insight into disease, self-esteem, hopelessness, and attitude to drugs). @*Results@#The proportion of male patients in the competitive employment group was greater than in the partial or unemployed groups. Education level was significantly higher, and the number of hospitalizations was significantly lower in the competitive group than in the unemployed group.Levels of self-stigma, will to recover, and perceived social support were significantly higher, and levels of self-esteem and hopelessness were significantly lower in the competitive and partial employment groups than in the unemployed group. Patients in these two groups also reported a more positive family attitude, more insight into the disease, and a more positive attitude toward drugs than patients in the unemployed group. @*Conclusion@#Most clinical variables were similar in the competitive and partial employment groups.The findings of this study suggest environmental and systematic factors are more important for the employment of outpatients with schizophrenia than disease-associated factors.

BaSDAS: a web-based pooled CRISPR-Cas9 knockout screening data analysis system

We developed the BaSDAS (Barcode-Seq Data Analysis System), a GUI-based pooled knockout screening data analysis system, to facilitate the analysis of pooled knockout screen data easily and effectively by researchers with limited bioinformatics skills. The BaSDAS supports the analysis of various pooled screening libraries, including yeast, human, and mouse libraries, and provides many useful statistical and visualization functions with a user-friendly web interface for convenience. We expect that BaSDAS will be a useful tool for the analysis of genome-wide screening data and will support the development of novel drugs based on functional genomics information.

A National Consensus Survey for Current Practicein Brain Tumor Management I: Antiepileptic Drug andSteroid Usage

Background@#: The Guideline Working Group of the Korean Society for Neuro-Oncology (KSNO)conducted a nationwide questionnaire survey for diverse queries faced in the treatment of brain tumors.As part I of the survey, the aim of this study is to evaluate national patterns of clinical practiceabout antiepileptic drug (AED) and steroid usage for management of brain tumors. @*Methods@#: A web-based survey was sent to all members of the KSNO by email. The survey included9 questions of AED usage and 5 questions of steroid usage for brain tumor patients. All questionswere developed by consensus of the Guideline Working Group. @*Results@#: The overall response rate was 12.8% (54/423). Regarding AED usage, the majority ofrespondents (95.2%) routinely prescribed prophylactic AEDs for patients with seizure at the peri/postoperativeperiod. However, as many as 72.8% of respondents prescribed AED routinely for seizure-naïvepatients, and others prescribed AED as the case may be. The duration of AED prophylaxis showedwide variance according to the epilepsy status and the location of tumor. Levetiracetam (82.9%) wasthe most preferred AED for epilepsy prophylaxis. Regarding steroid usage, 90.5% of respondents usesteroids in perioperative period, including 34.2% of them as a routine manner. Presence of peritumoraledema (90.9%) was considered as the most important factor determining steroid usage followed bydegree of clinical symptoms (60.6%). More than half of respondents (51.2%) replied to discontinue thesteroids within a week after surgery if there are no specific medical conditions, while 7.3% preferredslow tapering up to a month after surgery. @*Conclusion@#: The survey demonstrated the prevailing practice patterns on AED and steroid usagein neuro-oncologic field among members of the KSNO. This information provides a point of referencefor establishing a practical guideline in the management of brain tumor patients.

A National Consensus Survey for Current Practicein Brain Tumor Management II:Diffuse Midline Glioma and Meningioma

Background@#: The Guideline Working Group of the Korean Society for Neuro-Oncology (KSNO)conducted a nationwide questionnaire survey for diverse queries faced in the treatment of brain tumors.As part II of the survey, the aim of this study is to evaluate the national patterns of clinical practicefor patients with diffuse midline glioma and meningioma. @*Methods@#: A web-based survey was sent to all members of the KSNO by email. The survey included4 questions of diffuse midline glioma and 6 questions of meningioma (including 2 case scenarios).All questions were developed by consensus of the Guideline Working Group. @*Results@#: In the survey about diffuse midline glioma, 76% respondents performed histologicconfirmation to identify H3K27M mutation on immunohistochemical staining or sequencing methods.For treatment of diffuse midline glioma, respondents preferred concurrent chemoradiotherapy withtemozolomide (TMZ) and adjuvant TMZ (63.8%) than radiotherapy alone (34.0%). In the surveyabout meningioma, respondents prefer wait-and-see policy for the asymptomatic small meningiomawithout peritumoral edema. However, a greater number of respondents had chosen surgical resectionas the first choice for all large size meningiomas without exception, and small size meningiomaswith either peritumoral edema or eloquent location. There was no single opinion with major consensuson long-term follow-up plans for asymptomatic meningioma with observation policy. As many as68.1% of respondents answered that they would not add any adjuvant therapies for World Health Organizationgrade II meningiomas if the tumor was totally resected including dura. @*Conclusion@#: The survey demonstrates the prevailing clinical practice patterns for patients with diffusemidline glioma and meningioma among members of the KSNO. This information provides a pointof reference for establishing a practical guideline in the management of diffuse midline glioma andmeningioma.

A National Consensus Survey for Current Practicein Brain Tumor Management III: Brain Metastasis andPrimary Central Nervous System Lymphoma

Background@#: The Guideline Working Group of the Korean Society for Neuro-Oncology (KSNO)conducted the nationwide questionnaire survey for diverse queries facing to treat patients with braintumor. As part III of the survey, the aim of this study is to evaluate the national patterns of clinical practicefor patients with brain metastasis and primary central nervous system lymphoma (PCNSL). @*Methods@#: A web-based survey was sent to all members of the KSNO by email. The survey included7 questions of brain metastasis and 5 questions of PCNSL, focused on the management strategiesin specific situations. All questions were developed by consensus of the Guideline WorkingGroup. @*Results@#" In the survey about brain metastasis, respondents preferred surgical resection withadjuvant treatment for patients with a surgically accessible single brain metastatic lesion less than 3cm in size without extracranial systemic lesions. However, most respondents considered radiosurgeryfor surgically inaccessible lesions. As the preferred treatment of multiple brain metastases according tothe number of brain lesions, respondents tended to choose radiotherapy with increasing number of lesions.Radiosurgery was mostly chosen for the brain metastases of less than or equal to 4. In the surveyabout PCNSL, a half of respondents choose high-dose methotrexate-based polychemotherapy asthe first-line induction therapy for PCNSL. The consolidation and salvage therapy showed a little variationamong respondents. For PCNSL patients with cerebrospinal fluid dissemination, intrathecal chemotherapywas most preferred. @*Conclusion@#: The survey demonstrates the prevailing clinical practice patterns for patients withbrain metastasis and PCNSL among members of the KSNO. This information provides a point of referencefor establishing a practical guideline in the management of brain metastasis and PCNSL.

Calyxaprenols A-D, New Merohexaprenoid Metabolites from the Marine Sponge Calyx sp

Four new merohexapenoids named calyxaprenols A-D (1 - 4), together with the known compound haliclotriol A (5), have been isolated from the marine sponge Calyx sp. which was collected from the southwest islands of Palau. Based on comprehensive spectroscopic analyses, calyxaprenols A (1) and B (2) were determined to be pentacyclic hexaprenoids that are appended to a glycolic acid-substituted phenol moiety, whereas calyxaprenols C (3) and D (4) possess a tricyclic hexaprenoid skeleton joined to a hydroquinone ring.Identification of new merohexaprenoids from a Calyx sponge expands the known taxonomic distribution of this sparsely distributed class of marine metabolites and increases the chemical diversity described for this genus of marine sponge.

Calyxaprenols A-D, New Merohexaprenoid Metabolites from the Marine Sponge Calyx sp

Four new merohexapenoids named calyxaprenols A-D (1 - 4), together with the known compound haliclotriol A (5), have been isolated from the marine sponge Calyx sp. which was collected from the southwest islands of Palau. Based on comprehensive spectroscopic analyses, calyxaprenols A (1) and B (2) were determined to be pentacyclic hexaprenoids that are appended to a glycolic acid-substituted phenol moiety, whereas calyxaprenols C (3) and D (4) possess a tricyclic hexaprenoid skeleton joined to a hydroquinone ring.Identification of new merohexaprenoids from a Calyx sponge expands the known taxonomic distribution of this sparsely distributed class of marine metabolites and increases the chemical diversity described for this genus of marine sponge.

BaSDAS: a web-based pooled CRISPR-Cas9 knockout screening data analysis system

We developed the BaSDAS (Barcode-Seq Data Analysis System), a GUI-based pooled knockout screening data analysis system, to facilitate the analysis of pooled knockout screen data easily and effectively by researchers with limited bioinformatics skills. The BaSDAS supports the analysis of various pooled screening libraries, including yeast, human, and mouse libraries, and provides many useful statistical and visualization functions with a user-friendly web interface for convenience. We expect that BaSDAS will be a useful tool for the analysis of genome-wide screening data and will support the development of novel drugs based on functional genomics information.

A Case of Unusual Suicide due to Overlapping Inhalation of Nitrous Oxide and Carbon Monoxide / 대한법의학회지

Nitrous oxide (N2O) is a chemical used as a medical anesthetic supplement, industrial semiconductor cleaning agent, and food additive in the manufacture of whipping cream. Nitrous oxide causes hypoxemia and suffocation during repeated inhalation. In severe cases, it causes coma and death. Some of those who are not aware of the dangers still illegally obtain and abuse nitrous oxide even with the law enforcing its use, and some people seem to have abused nitrous oxide after purchasing large amounts in small containers before the law has taken effect. Deaths from misuse of nitrous oxide are extremely rare in South Korea compared to those from other addictions such as carbon monoxide poisoning. No autopsy or follow-up blood tests were performed in this case.However, this is a unique and rare case in which carbon monoxide inhalation due to the combustion of lightning coal at the last moment overlaps with continuous inhalation of large amounts of nitrous oxide for several days beyond simple hallucination use, and is included in this report with a simple literature review.

Comparison of the Clinical and Radiographic Results between 125° and 130° Caput-Collum-Diaphyseal Angle Proximal Femoral Nail Anti-Rotation II in Patients with Intertrochanteric Fracture

Purpose@#This study compared the clinical and radiographic results of two proximal femoral nail antirotation II (PFNA-II) angled by 125° and 130° in patients with intertrochanteric fractures. @*Materials and Methods@#From March in 2015 to September in 2016, 65 patients who underwent a closed reduction and internal fixation with PFNA-II for a femoral intertrochanteric fracture were evaluated retrospectively. The minimum follow-up period was two years. Of those, 30 and 35 patients underwent 125° angled PFNA-II and 130° angled PFNA-II, respectively. The clinical performance was evaluated using the Harris hip score, WOMAC (Western Ontario and McMaster Universities Osteoarthrtis Index), and UCLA (University of California Los Angeles) score. Radiographic analyses were performed using standardized anteroposterior and lateral radiographs to assess the implant position and quality of reduction. The blade length, distance between the blade tip and the tip of the greater trochanter, and distance between the blade tip and the most lateral protrusion point of the greater trochanter in the two groups were measured and compared. @*Results@#The clinical results, including the Harris hip score, WOMAC, and UCLA, were similar in the two groups at the last follow-up postoperatively. In the radiography evaluation, the implant position, quality of reduction, and the blade length were similar in the two groups. The distances between the blade tip and the tip of the greater trochanter were 52.60±3.53 mm and 58.07±5.54 mm in the 125° angled PFNA-II and 130° angled PFNA-II groups, respectively. The distance between the blade tip and the most lateral protrusion point of greater trochanter were 16.48±2.54 mm and 21.19±4.43 mm in the 125° angled PFNA-II and 130° angled PFNA-II groups, respectively. The differences were significant (p=0.031, p=0.012). @*Conclusion@#The operation with the 125° angled PFNA-II showed a more superior and lateral position of the blade than that with the 130° angled PFNA-II. Nevertheless, lateral thigh pain can occur when the blade is positioned superolaterally.

Progress of Coordination and Utilization of Zirconium-89 for Positron Emission Tomography (PET) Studies / 대한핵의학회잡지

Radiometals have been commonly used in medical applications, and utilization of such metals continues to be an attractive research area. In particular, a variety of radiometals have been developed and implemented for molecular imaging. For such applications, ⁸⁹Zr has been one of the most interesting radiometals currently used for tumor targeting. Several chemical ligands were developed as ⁸⁹Zr chelators, and new coordinating methods have also been developed more recently. In addition, immunopositron emission tomography (PET) studies using ⁸⁹Zr-labeled monoclonal antibodies have been performed by several scientists. In this review, recent advances to the coordination of ⁸⁹Zr and the utilization of ⁸⁹Zr in PET studies are described.

Clinical outcomes of patients with a single hepatocellular carcinoma less than 5 cm treated with transarterial chemoembolization

BACKGROUND/AIMS@#Transarterial chemoembolization (TACE) is performed for single hepatocellular carcinoma (HCC) that are not eligible for surgery or ablation therapy. We investigated the clinical outcomes of patients with a single HCC ≤ 5 cm treated with TACE.@*METHODS@#This study analyzed 175 consecutive patients who underwent TACE as an initial treatment for single HCC ≤ 5 cm. Predictive factors for complete response (CR), recurrence after CR, and overall survival (OS) were evaluated.@*RESULTS@#Total 119 patients (68%) achieved CR after TACE. Tumor size 65 years and absence of liver cirrhosis were predictive factors for non-recurrence after CR (p < 0.05). The OS for all patients was 80.7 ± 5.6 months, and the 1-, 3-, and 5-year OS rates were 88.1%, 64.8%, and 49.9%, respectively. In multivariate analysis for OS, CR (hazard ratio [HR], 0.467; 95% confidence interval [CI], 0.292 to 0.747) and Child class A (HR, 0.390; 95% CI, 0.243 to 0.626) were significant factors. The OS for the CR and Child class A group were 92 and 93.6 months, respectively, and that of the non-CR and Child B, C group were 53.3 and 50.7 months, respectively (p < 0.001).@*CONCLUSIONS@#TACE can be a valid treatment in patients with a single HCC ≤ 5 cm not suitable for curative treatment, especially in patients with Child class A and CR after TACE.

Development of a smartphone application for providing disinfectant information on livestock industry

It is important to select the correct disinfectants and to use them appropriately in order to prevent the initial spread of highly infectious livestock disease, such as foot-and-mouth disease or highly pathogenic avian influenza. This study describes a smartphone application developed to enable livestock workers to observe information related to disinfectants for the prevention of livestock disease in the domestic market, regardless of time and location, through a Linux-based Android mobile platform. This application (Konkuk-Disinfectant Information Database) provides information on disinfectant names, components, license and use; it was designed to enable the user to share disinfectant information through social media.

Progress of Coordination and Utilization of Zirconium-89 for Positron Emission Tomography (PET) Studies / 대한핵의학회잡지

Radiometals have been commonly used in medical applications, and utilization of such metals continues to be an attractive research area. In particular, a variety of radiometals have been developed and implemented for molecular imaging. For such applications, ⁸⁹Zr has been one of the most interesting radiometals currently used for tumor targeting. Several chemical ligands were developed as ⁸⁹Zr chelators, and new coordinating methods have also been developed more recently. In addition, immunopositron emission tomography (PET) studies using ⁸⁹Zr-labeled monoclonal antibodies have been performed by several scientists. In this review, recent advances to the coordination of ⁸⁹Zr and the utilization of ⁸⁹Zr in PET studies are described.