Cellular toxicity profile of a new ophthalmic sponge.

Introduction: Ophthalmic sponges are used for cleaning the eye surface and absorbing fluids during ophthalmic procedures. This study compared the biological safety and stability of a new ophthalmic sponge, Occucell® (OccuTech Inc, Seongnam, Korea), on the human conjunctival epithelial cells with those of preexisting products to evaluate its clinical application.Materials and Methods: The cytotoxicity of four products, Occucell, a new product, Ultracell®, Eyetec-1, and Eyetec-2, on conjunctival epithelial cells, was evaluated using the MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) analysis. Additionally, human conjunctival epithelial cells were stained with a Live & Dead marker and observed using a fluorescence microscope. To evaluate the effect of the ophthalmic sponges on the secretion of IL-1ß and TNF-α, cultured conjunctival epithelial cells were treated with 0.5% DMSO eluates of the ophthalmic sponges, and IL-1ß and TNF-α mRNA levels were estimated using real-time polymerase chain reaction assays.Results: Cells treated with Occucell showed comparable viability to those treated with other preexisting products. Conjunctival epithelial cells showed more than 90% viability when treated with the ophthalmic sponge extracts, as determined by the MTT assay. No significant differences in the number of live & dead cells were observed between the control and treatment groups. Cells treated with all four ophthalmic sponge eluates showed similar IL-1ß and TNF-α mRNA levels.Discussion: Occucell, an eye sponge used during ophthalmic surgery in clinical practice, did not affect the viability of conjunctival epithelial cells, and more than 90% of the cells were viable after the treatment. Further, Occucell showed similar effects on IL-1ß and TNF-α secretion as that of other ophthalmic sponges used in the clinic. This suggested that Occucell is a safe product comparable to the preexisting products.

Radioimmunotherapy with 131 I-rituximab for patients with relapsed or refractory follicular or mantle cell lymphoma.

AIM: This study aimed to evaluate the safety and efficacy of 131 I-rituximab in patients with relapsed or refractory follicular or mantle cell lymphoma. METHODS: Twenty-four patients with relapsed or refractory follicular or mantle cell lymphoma were administered unlabeled rituximab (70 mg) immediately before receiving a therapeutic dose of 131 I-rituximab. Contrast-enhanced 18F-fluorodeoxyglucose positron emission tomography/computed tomography was used a month later to assess tumor response. RESULTS: This study enrolled 24 patients between June 2012 and 2022. Depending on how they responded to radioimmunotherapy (RIT), 131 I-rituximab was administered one to five times. Of the 24 patients, 9 achieved complete response after RIT and 8 achieved partial response. The median progression-free and overall survival was 5.9 and 37.9 months, respectively. During the follow-up period of 64.2 months, three patients were diagnosed with a secondary malignancy. Among treatment-related adverse events, hematologic toxicities were common, and grade 3-4 thrombocytopenia and neutropenia were reported in 66.6% of cases. CONCLUSION: 131 I-rituximab has an effective and favorable safety profile in patients with relapsed or refractory follicular lymphoma and mantle cell lymphoma. This suggests that RIT may also be considered a treatment option for patients with relapsed or refractory follicular lymphoma and mantle cell lymphoma.

Comparison of brain-derived neurotrophic factor among subtypes of exudative age-related macular degeneration.

PURPOSE: To compare the levels of brain-derived neurotrophic factor (BDNF) in serum and aqueous humor (AH) in eyes with typical neovascular age-related macular degeneration (tAMD), polypoidal choroidal vasculopathy (PCV), and retinal angiomatous proliferation (RAP). METHODS: This prospective study included 20 patients with tAMD, 20 patients with PCV, 20 patients with RAP, and 20 healthy controls. BDNF levels in the serum and AH were assessed using enzyme-linked immunosorbent assay. RESULTS: Serum and AH BDNF levels were significantly lower in the age-related macular degeneration groups (tAMD, PCV, and RAP) than in the control group (p < 0.05). There was no significant difference in the mean BDNF levels in the serum and AH among the different nAMD subtypes (p = 0.538). CONCLUSIONS: We confirmed that serum and AH BDNF levels were independent of the nAMD subtype.

Antrochoanal Polyp and Migrated Dental Implant in the Ipsilateral Maxillary Sinus.

Antrochoanal polyp is usually a benign solitary mass lesion originated from maxillary sinus mucosa and emerging through maxillary ostium. We report a rare case of antrochoanal polyp and migrated dental implant in the ipsilateral maxillary sinus. Clinicians should be aware that ACP may have other concomitant conditions such as migrated dental implants.

Thyroglossal Duct Cyst in the Suprasternal Region.

A thyroglossal duct cyst (TGDC) is the most common congenital anterior neck mass. It can develop from residual tissue not degenerated during development and is mainly diagnosed in pediatric patients. However, a TGDC is sometimes diagnosed for the first time in adult patients. A TGDC is mainly caused by repeated infections of the duct and there might be no specific symptoms. A TGDC can occur anywhere from the floor of the mouth to the thyroid but is most often found at the infrahyoid level. Over the past 10 years, there has been no report of a TGDC in the suprasternal region among TGDCs in unusual locations. This paper describes one case of a suprasternal TGDC with a review of the literature on this topic.

A clinical study of submandibular schwannoma.

OBJECTIVE: Schwannoma is a slowly growing benign neurogenic tumor that develops from the cells of the nerve sheath. The occurrence of schwannoma in the submandibular space is very rare. MATERIALS AND METHODS: From January 2010 to March 2021, we reviewed all patients who had been operated on in the otolaryngology department over 11 years and found 61 patients diagnosed with schwannomas at the final biopsy after surgery. In these patients, only 3 submandibular schwannomas were identified, and their clinical characteristics were analyzed. RESULTS: Three schwannomas (4.9%) developed in the submandibular space. The main symptoms were neck swelling followed by neck discomfort. All submandibular schwannomas were removed surgically with a transcervical approach under general anesthesia. Two patients, who were diagnosed preoperative submandibular tumors, were considered to have developed schwannomas from the lingual nerve, and 1 patient was considered to have developed a schwannoma from the hypoglossal nerve. There were no major surgical complications, including postoperative nerve damage. CONCLUSIONS: Submandibular schwannomas are extremely rare, but they should be included in the differential diagnosis of submandibular tumors.

Region-Based Static Video Stitching for Reduction of Parallax Distortion.

In this paper, we propose a semantic segmentation-based static video stitching method to reduce parallax and misalignment distortion for sports stadium scenes with dynamic foreground objects. First, video frame pairs for stitching are divided into segments of different classes through semantic segmentation. Region-based stitching is performed on matched segment pairs, assuming that segments of the same semantic class are on the same plane. Second, to prevent degradation of the stitching quality of plain or noisy videos, the homography for each matched segment pair is estimated using the temporally consistent feature points. Finally, the stitched video frame is synthesized by stacking the stitched matched segment pairs and the foreground segments to the reference frame plane by descending order of the area. The performance of the proposed method is evaluated by comparing the subjective quality, geometric distortion, and pixel distortion of video sequences stitched using the proposed and conventional methods. The proposed method is shown to reduce parallax and misalignment distortion in segments with plain texture or large parallax, and significantly improve geometric distortion and pixel distortion compared to conventional methods.

Multi-Frame Based Homography Estimation for Video Stitching in Static Camera Environments.

In this paper, a multi-frame based homography estimation method is proposed for video stitching in static camera environments. A homography that is robust against spatio-temporally induced noise can be estimated by intervals, using feature points extracted during a predetermined time interval. The feature point with the largest blob response in each quantized location bin, a representative feature point, is used for matching a pair of video sequences. After matching representative feature points from each camera, the homography for the interval is estimated by random sample consensus (RANSAC) on the matched representative feature points, with their chances of being sampled proportional to their numbers of occurrences in the interval. The performance of the proposed method is compared with that of the per-frame method by investigating alignment distortion and stitching scores for daytime and noisy video sequence pairs. It is shown that alignment distortion in overlapping regions is reduced and the stitching score is improved by the proposed method. The proposed method can be used for panoramic video stitching with static video cameras and for panoramic image stitching with less alignment distortion.

The Derived Neutrophil-to-Lymphocyte Ratio Is an Independent Prognostic Factor in Transplantation Ineligible Patients with Multiple Myeloma.

BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR) is an independent prognostic marker in solid and hematological cancers. While the derived NLR (dNLR) was shown to be non-inferior to the NLR in large cohorts of patients with different cancer types, it has not been validated as a prognostic marker for multiple myeloma (MM) to date. METHODS: Between May 22, 2011 and May 29, 2014, 176 patients with MM from 38 centers who were ineligible for autologous stem cell transplantation were analyzed. The dNLR was calculated using complete blood count differential data. The optimal dNLR cut-off value according to receiver operating characteristic analysis of overall survival (OS) was 1.51. All patients were treated with melphalan and prednisone combined with bortezomib. RESULTS: The complete response rate was lower in the high dNLR group compared to the low dNLR group (7 vs. 26.1%, respectively; p = 0.0148); the corresponding 2-year OS rates were 72.2 and 84.7%, respectively (p = 0.0354). A high dNLR was an independent poor prognostic factor for OS (hazard ratio 2.217, 95% CI 1.015-4.842; p = 0.0458). CONCLUSION: The dNLR is a readily available and cheaply obtained parameter in clinical studies, and shows considerable potential as a new prognostic marker for transplantation-ineligible patients with MM.

A prospective, open-label, multicenter, observational study to evaluate the efficacy and safety of bortezomib-melphalan-prednisone as initial treatment for autologous stem cell transplantation-ineligible patients with multiple myeloma.

Bortezomib-melphalan-prednisone (VMP) showed superior efficacy versus MP as first-line treatment for transplantation-ineligible multiple myeloma (MM). This study investigated the efficacy of VMP for Korean patients with MM.Overall, 177 MM patients received 9 cycles of VMP in this prospective, multicenter, observational study. The primary endpoint was 2-year progression-free survival (PFS).Thirty-nine (22%) patients were aged ≥ 75 years and 83 (47.4%) patients had International Staging System stage III. A median of 5 cycles were delivered. Overall response rate (ORR) was 72.9%, and complete response (CR) rate was 20.3%. With a median follow-up of 11.9 months, median PFS was 17 months. The 2-year PFS and overall survival (OS) rates were 29.2% and 80.0%, respectively. Median OS was not reached. PFS was significantly different depending on performance status (Eastern Cooperative Oncology Group < 2 vs. ≥ 2; p = 0.0002), ß2-microglobulin level (< 5.5 vs. ≥ 5.5 mg/L; p = 0.0481), and cumulative dose of bortezomib (< 35.1 vs. ≥ 35.1 mg/m2; p < 0001). The common adverse events (AEs) were in line with the well-known toxicity profiles associated with VMP.In conclusion, VMP is a feasible and effective front-line treatment for transplant-ineligible older patients with MM in Korea. Continuing therapy with prompt adjustment of treatment according to AEs may be important to improve outcomes of elderly patients.

Stage IV advanced diffuse large B-cell lymphoma in human immunodeficiency virus infection with achieving cure by using highly active antiretroviral therapy alone: a case report.

After the introduction of highly active antiretroviral therapy (HAART), there has been a decrease in the incidence of lymphoma among the HIV-infected population and also significantly improved survival rates. We describe a remarkable case of an HIV-infected patient with advanced stage IV diffuse large B-cell lymphoma (DLBCL), completely regressed with the use of HAART alone. He remained disease-free for 6 years and he achieved cure without chemotherapy. Although several cases of low-grade lymphoma with complete regression were reported, we could not find any case of stage IV high-grade malignant lymphoma with HAART alone in complete remission for over 5 years from our review of the literature. This unique case shows the importance of HAART in improving survival and achieving cure in HIV-high-grade malignant lymphoma.

Prediction of survival by applying current prognostic models in diffuse large B-cell lymphoma treated with R-CHOP followed by autologous transplantation.

BACKGROUND: Among the currently available prognostic models for diffuse large B-cell lymphoma (DLBCL), we investigated to determine which is most adoptable for DLBCL patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) followed by upfront autologous stem cell transplantation (auto-SCT). METHODS: We retrospectively evaluated survival differences among risk groups based on the International Prognostic Index (IPI), the age-adjusted IPI (aaIPI), the revised IPI (R-IPI), and the National Comprehensive Cancer Network IPI (NCCN-IPI) at diagnosis in 63 CD20-positive DLBCL patients treated with R-CHOP followed by upfront auto-SCT. RESULTS: At the time of auto-SCT, 74.6% and 25.4% of patients had achieved complete remission and partial remission after R-CHOP, respectively. As a whole, the 5-year overall (OS) and progression-free survival (PFS) rates were 78.8% and 74.2%, respectively. The 5-year OS and PFS rates according to the IPI, aaIPI, R-IPI, and NCCN-IPI did not significantly differ among the risk groups for each prognostic model (P-values for OS: 0.255, 0.337, 0.881, and 0.803, respectively; P-values for PFS: 0.177, 0.904, 0.295, and 0.609, respectively). CONCLUSION: There was no ideal prognostic model among those currently available for CD20-positive DLBCL patients treated with R-CHOP followed by upfront auto-SCT.

Weekly docetaxel and gemcitabine in previously treated metastatic esophageal squamous cell carcinoma.

AIM: To assess the efficacy and safety of weekly docetaxel plus a fixed-dose rate (FDR) of gemcitabine in metastatic esophageal squamous cell carcinoma (SCC). METHODS: A multi-center, open-label, prospective phase II study was designed. Thirty-three esophageal SCC patients with documented progression after fluoropyrimidine/platinum-based first-line chemotherapy were enrolled and treated with docetaxel 35 mg/m(2) and gemcitabine 1000 mg/m(2) iv at a FDR (10 mg/m(2) per minute) on days 1 and 8. Treatment was repeated every twenty-one days until disease progression, unacceptable toxicity, or consent withdrawal. The primary endpoint was response rate (RR), and secondary endpoints were safety, progression-free survival (PFS) and overall survival (OS). RESULTS: Combination of weekly docetaxel and FDR gemcitabine was well tolerated: the most common treatment-related adverse events were anemia (97%), fatigue (64%) and neutropenia (55%). One patient with multiple lung and lymph node metastases died of respiratory failure after receiving four cycles of chemotherapy, and the possibility of drug-induced pneumonitis could not be completely excluded. Disease control (objective response plus stable disease) in the ITT population was achieved in 88% of patients, and the overall RR was 30% (95%CI: 15%-46%). The median PFS and OS were 4.0 (95%CI: 3.4-4.6) and 8.8 mo (95%CI: 7.8-9.8 mo), respectively. CONCLUSION: A combination of weekly docetaxel and FDR gemcitabine showed promising antitumor activity and tolerability in previously treated, metastatic esophageal SCC.

Retrospective analysis of extra-gastrointestinal stromal tumors.

AIM: To investigate the clinicopathologic features of patients with extra-gastrointestinal stromal tumors (EGISTs) in South Korea. METHODS: A total of 51 patients with an EGIST were identified. The clinicopathologic features, including sex, age, location, tumor size, histology, mitotic rate, immunohistochemical features, genetic status and survival data, were analyzed. RESULTS: The median age was 55 years (range: 29-80 years), and male:female ratio was 1:1.04. The most common site was in the mesentery (n = 15) followed by the retroperitoneum (n = 13) and omentum (n = 8). The median tumor size was 9.0 cm (range: 2.6-30.0 cm) and the median mitotic rate was 5.0/50HPF. (1/50 - 185/50). KIT was analyzed in 16, which revealed 10 cases with wild-type KIT and 6 cases with an exon 11 mutation. Among 51 patients, 31 patients had undergone surgery, and 10 had unresectable disease and had taken palliative imatinib, which resulted in 22.7 mo of progression-free survival. Of the patients who had undergone surgery, 18 did not take adjuvant imatinib, and 8 of these were categorized as "high risk" according to the risk criteria. However, the relapse-free survival was not different (P = 0.157) between two groups. CONCLUSION: Because the biologic behaviors of GISTs differ according to the location of the tumor, a more stratified strategy is required for managing EGISTs including incorporation of molecular features.

Bone marrow metastasis of colon cancer as the first site of recurrence: A case report.

Bone marrow metastasis from solid tumors is usually accepted as not only incurable, but as fatal. Colon cancer is a relatively rare malignancy that involves the bone marrow, and to the best of our knowledge, there have been no studies in the literature reporting only bone marrow metastasis of colon cancer as the first presentation of relapse. The present study reports the case of a 74-year-old female patient treated by resection and adjuvant chemotherapy for stage IIIc colon cancer who presented with severe thrombocytopenia with intracranial hemorrhage, and the bone marrow was first and only site of metastasis. There was no evidence of skeletal metastasis. The clinical course was extremely aggressive and the patient succumbed ten days after admission, finally being diagnosed in the postmortem examination. The present study also discusses bone marrow metastasis of solid tumors, with particular respect to the diagnostic difficulties of such rare cases.

Simvastatin plus capecitabine-cisplatin versus placebo plus capecitabine-cisplatin in patients with previously untreated advanced gastric cancer: a double-blind randomised phase 3 study.

PURPOSE: We aimed to the addition of synthetic 3-hydroxy-3-methyglutaryl coenzyme A (HMG-CoA) reductase inhibitor, simvastatin to capecitabine-cisplatin (XP) in patients with previously untreated advanced gastric cancer (AGC). METHODS: In this double-blind, placebo-controlled, phase III study, we enrolled patients aged 18 years or older with histological or cytological confirmed metastatic adenocarcinoma of the stomach or gastroesophageal junction (GEJ) at nine centres in Korea. Patients, stratified by disease measurability and participating site, were randomly assigned (1:1) to receive capecitabine 1000mg/m(2) twice daily for 14 days and cisplatin 80 mg/m(2) on day 1 every 3 weeks plus either simvastatin 40 mg or placebo, once daily. Cisplatin was given for 8 cycles; capecitabine and simvastatin were administered until disease progression or unacceptable toxicities. This study is registered with ClinicalTrials.gov, number NCT01099085. RESULTS: Between February 2009 and November 2012, 244 patients were enrolled and assigned to treatment groups (120 simvastatin, 124 placebo). Median progression free survival (PFS) for 120 patients allocated XP plus simvastatin was 5.2 months (95% confidence interval (CI) 4.3-6.1) compared with 4.63 months (95% CI 3.5-5.7) for 124 patients who were allocated to XP plus placebo (hazard ratio 0.930, 95% CI 0.684-1.264; p=0.642). 63 (52.5%) of 120 patients in simvastatin group and 70 (56.4%) of 124 had grade 3 or higher adverse events. CONCLUSIONS: Addition of 40 mg simvastatin to XP does not increase PFS in our trial, although it does not increase toxicity. Low dose of simvastatin (40 mg) to chemotherapy is not recommended in untargeted population with AGC.

R-CHOP chemoimmunotherapy followed by autologous transplantation for the treatment of diffuse large B-cell lymphoma.

BACKGROUND: We investigated factors that influence outcomes in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab combined with the CHOP regimen (R-CHOP) followed by upfront autologous stem cell transplantation (Auto-SCT). METHODS: We retrospectively evaluated survival differences between subgroups based on the age-adjusted International Prognostic Index (aaIPI) and revised-IPI (R-IPI) at diagnosis, disease status, and positron emission tomographic/computerized tomographic (PET/CT) status at transplantation in 51 CD20-positive DLBCL patients treated with R-CHOP followed by upfront Auto-SCT. RESULTS: Patients had either stage I/II bulky disease (5.9%) or stage III/IV disease (94.1%). The median patient age at diagnosis was 47 years (range, 22-66 years); 53.3% and 26.7% had high-intermediate and high risks according to aaIPI, respectively. At the time of Auto-SCT, 72.5% and 27.5% experienced complete (CR) and partial remission (PR) after R-CHOP, respectively. The median time from diagnosis to Auto-SCT was 7.27 months (range, 3.4-13.4 months). The 5-year overall (OS) and progression-free survival (PFS) were 77.3% and 72.4%, respectively. The 5-year OS and PFS rates according to aaIPI, R-IPI, and PET/CT status did not differ between the subgroups. More importantly, the 5-year OS and PFS rates of the patients who achieved PR at the time of Auto-SCT were not inferior to those of the patients who achieved CR (P=0.223 and 0.292, respectively). CONCLUSION: Survival was not influenced by the aaIPI and R-IPI at diagnosis, disease status, or PET/CT status at transplantation, suggesting that upfront Auto-SCT might overcome unfavorable outcomes attributed to PR after induction chemoimmunotherapy.

Spontaneous complete regression of multiple metastases of hepatocellular carcinoma: A case report.

Spontaneous regression of cancer is a partial or complete disappearance of malignant tumor without specific treatment. Spontaneous regression of hepatocellular carcinoma (HCC) is a rare condition, and the mechanism underlying it is unclear. This report presents a rare case of spontaneous complete regression of HCC, as revealed by tumor markers and imaging studies. A 64-year-old Korean male patient with hepatitis B virus-associated chronic hepatitis presented with HCC. The patient had undergone right lobectomy of the liver but the cancer recurred with multiple lung and adrenal metastases after 14 months. The patient received palliative cytotoxic chemotherapy. However, there was no clinical benefit and the disease progressed. It was decided to discontinue anticancer therapy and administer only supportive care. After approximately six months, the symptoms disappeared and the HCC had completely regressed. The patient remains alive over five years after recurrence.