Clinical and cost-effectiveness of collaborative traditional Korean and Western medicine treatment for low back pain: A protocol for a prospective observational exploratory study.

BACKGROUND: In South Korea, a few patients with low back pain (LBP) are currently being treated with a combination of traditional Korean medicine (KM) and Western medicine (WM). Although a recent research has reported results regarding patient satisfaction and exploratory effectiveness, evidence of comparative effectiveness still needs to be reviewed. The aim of this study is to evaluate the clinical and cost-effectiveness of KM and WM collaborative treatment (CT) compared with that of sole treatment (ST) for patients with LBP in Korea. METHOD/DESIGN: This multisite, prospective observational comparative effectiveness research study is part of a nationwide pilot project for KM and WM collaboration launched by the Korean Ministry of Health and Welfare. The duration of the study is 8 weeks, and the target number of inclusion is 360 patients. Participants receive treatment according to their treatment plan, and a researcher conducts investigations thrice, every 4 weeks. In the final analysis, the merged data from the participants' questionnaire responses, hospital medical records, and administrative data, and Health Insurance Review and Assessment service data will be compared between the CT and ST groups. DISCUSSION: This study will provide clinical and economic information about CT for LBP, which might be a milestone for establishing future polices about this collaboration in Korea. TRIAL REGISTRATION: The study protocol has been registered with the Clinical Research Information Service (KCT0002827).

Role of IL-1α in cisplatin-induced acute renal failure in mice.

BACKGROUND/AIMS: For unknown reasons, caspase-1 -/- mice, protected against cisplatin-induced acute renal failure (ARF), are deficient in interleukin (IL)-1α. We thus asked whether IL-1α deficiency underlies the mechanism of protection against cisplatin-induced ARF in these mice. METHODS: Cisplatin (30 mg/kg) was injected intraperitoneally into wild-type C57BL/6 mice to produce a cisplatin-induced model of ARF. IL-1α was measured in control vehicle- and cisplatin-treated wild-type animals. We also examined whether IL-1α -/- mice were similarly protected against cisplatin-induced ARF. Additionally, infiltration of CD11b- and CD49b-positive cells, as markers of macrophages, natural killer, and natural killer T cells (pan-NK cells), was investigated in wild-type and IL-1α -/- mice. RESULTS: Compared with vehicle-treated mice, renal IL-1α increased in cisplatin-treated wild-type mice beginning on day 1. IL-1α -/- mice were shown to be protected against cisplatin-induced ARF. No significant difference in the infiltration of neutrophils or CD11b- and CD49b-positive cells were observed between wild-type and IL-1α -/- mice. CONCLUSIONS: Mice deficient in IL-1α are protected against cisplatin-induced ARF. The lack of IL-1α may explain, at least in part, the protection against cisplatin-induced ARF observed in caspase-1 -/- mice. Investigation of the protective mechanism (s) in IL-1α -/- mice in cisplatin-induced ARF merits further study.

Disseminated Mycobacterium avium complex infection in a non-HIV-infected patient undergoing continuous ambulatory peritoneal dialysis.

Isolated bone marrow infection by nontuberculous mycobacteria (NTM) is extremely rare. Recently, we encountered a case of bone marrow Mycobacterium avium complex (MAC) infection, which presented as a fever of unknown origin shortly after starting continuous ambulatory peritoneal dialysis (CAPD). The patient was diagnosed with MAC infection on the basis of PCR-restriction fragment length polymorphism analysis and sequencing of DNA obtained from bone marrow specimens. Although this was a case of severe MAC infection, there was no evidence of infection of other organs. End-stage renal disease (ESRD) patients undergoing dialysis can be considered immunodeficient; therefore, when these patients present with fever of unknown origin, opportunistic infections such as NTM infection should be considered in the differential diagnosis.

Investigation of the Expression of Fractalkine and the Infiltration Characteristics of Fractalkine Receptor Positive Cells and Macrophages in Cisplatin-induced Acute Renal Failure in Mice / 대한신장학회지

PURPOSE: The aim of the present study was to investigate the expression and the infiltration characteristics of fractalkine (CX3CL1)/ its receptor (CX3CR1) positive cells and macrophages in cisplatininduced ARF (CisARF). METHODS: Cisplatin (30 mg/kg) was injected intraperitoneally into wild-type C57BL/6 mice. Time course of CX3CL1 expression/CX3CR1 positive cells and macrophage infiltration in CisARF was investigated by using immunofluorescence for CX3CL1, CX3CR1 and CD 11b in the outer medullary region. And we performed a study whether there was a significant difference of macrophages infiltration between wild type and caspase-1- deficient mice, which was protective against CisARF. RESULTS: (1) Renal dysfunction was the most severe on day 3. (2) The intensity of immunofluorecence staining for CX3CL1 showed that there was a significantly increased expression in the tubulointerstitium rather than blood vessels in cisplatin-treated mice. There were no differences in CX3CR1 positive cells between vehicle and cisplatin-treated mice. (3) Macrophages infiltration was augmented from day 2 after cisplatin administration and preceded the development of CisARF. Macrophages infiltration in caspase-1 -/- mice was significantly lower than wild- type mice in CisARF. CONCLUSION: Our data demonstrated that CX3CL1 expression and macrophage infiltration in CisARF precedes the development of ARF, especially in the tubulointerstitium rather than blood vessels. However, recent reports showed that the blockade of CX3CR1 positive cells and depletion of macrophages could not be protective against CisARF. Therefore, further study is required to determine the role of other inflammatory cells such as natural killer cells in CisARF.