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Background Although kidney transplantation outcomes have improved dramatically after using calcineurin inhibitors (CNIs), CNI toxicity continues to be reported and the mechanism remains uncertain. Here, we investigated the neurotoxicity of CNIs by focusing on the viability of glioma cells. Methods Glioma cells were treated with several concentrations of CNIs for 24 hours at 37℃ and their cell viability was evaluated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Results Exposure to 0, 0.25, 0.5, 2.5, 5.0, and 10.0 mM concentrations respectively showed 100%, 64.3%, 61.3%, 68.1%, 62.4%, and 68.6% cell viability for cyclosporine and 100%, 38.6%, 40.8%, 43.7%, 37.8%, and 43.0% for tacrolimus. The direct toxic effect of tacrolimus on glioma cell viability was stronger than that of cyclosporine at the same concentration. Conclusion CNIs can cause neurological side effects by directly exerting cytotoxic effects on brain cells. Therefore, we should carefully monitor the neurologic symptoms and level of CNIs in kidney transplant patients.

Fabry disease (FD) is an X-linked, recessively inherited, rare, progressive, disorder of glycosphingolipid metabolism affecting multiple organs resulting in organ dysfunction. It is rare to find only one FD affected subject with a de novo mutation. Here we report a case of a 41-year-old Asian male diagnosed with de novo FD. Comprehensive ophthalmological evaluation was performed using slit lamp, color fundus photography, optical coherence tomography, fluorescein angiography, and indocyanine green angiography. On slit lamp examination, cornea verticillata and slightly tortuous, and aneurysmal dilatation of inferior bulbar conjunctival vessels were observed. Other imaging modalities showed unremarkable findings. Cornea verticillata and inferior bulbar conjunctival vascular abnormalities may be detected earlier than other ocular abnormalities in de novo FDs like hereditary FDs.

Background : The long-term prognosis of BK virus-associated nephropathy (BKVAN) in kidney transplant recipients (KTRs) is uncertain. We evaluated the long-term prognosis in KTRs with BKVAN and the clinical significance of BKVAN on post-transplant clinical outcome. Methods : We retrospectively analyzed the medical records of 582 patients who underwent kidney transplant (KT) between 2001 and 2014. We divided the patients into a BKVAN group (15 patients) diagnosed by allograft biopsy and a control group (356 patients). Results : The incidence of BKVAN was 4.0%, and the mean follow-up duration was 93.1 ± 52.3 months. Median time from KT to BKVAN diagnosis was 5.9 months (interquartile range [IQR], 4.4-8.7). In the BKVAN group, 9 (60.0%) KTRs with combined acute rejection progressed to graft failure, and the median time from BKVAN diagnosis to graft failure was 36.2 months (IQR, 9.7-65.5). Death-censored graft survival rate and patient survival rate in the BKVAN group were significantly lower than those in the control group. BKVAN and rejection were independent risk factors for graft failure. In the subgroup analysis, death-censored graft survival rate of KTRs with BKVAN with acute rejection was significantly worst in comparison with similar patients without BKVAN regardless of acute rejection (P ＜ 0.001). Conclusion : The long-term prognosis of BKVAN with acute rejection was very poor because of graft failure caused by inadequate treatment for acute rejection considering BKVAN. Therefore, we should carefully monitor the allograft status of KTRs through regular surveillance tests after treatment for BKVAN with acute rejection.

Epithelioid angiomyolipoma (EAML) is an uncommon, variant type of angiomyolipoma with a possibility of metastatic transformation and distant spread. Angiomyolipomas, including epithelioid variant type, are mostly renal in origin. EAML originating from extrarenal location is very rare and imaging findings are not well described. Herein, we reported a very rare case of EAML arising from the perirenal space that mimicked a malignant retroperitoneal tumor, in a 39-year-old female.

Background: Kidney transplantation (KT) is the treatment of choice for end-stage renal disease patients. The spouse is a major donor in living KT. Clinical outcomes of spousal donor KT are not inferior to those of living related donor KT. In this study, we compared clinical outcomes between ABO-compatible (ABOc) and ABO-incompatible (ABOi) spousal donor KTs. Methods: Thirty-two cases of spousal donor KT performed from January 2011 to August 2013 were analyzed retrospectively. Twenty-one ABOc KTs and 11 ABOi KTs were performed. We investigated patient survival, graft survival, acute rejection, graft function, and complications. Results: During follow-up, patient and graft survival rates were 100% in both groups. There were no significant differences in the incidence of delayed graft function, acute rejection, and the change in graft function between the 2 groups. Medical and surgical complications were not significantly different between the groups. Conclusion: The clinical outcomes of ABOc and ABOi spousal donor KTs were equivalent. In ABOi KT, an emotionally motivated spousal donor KT may be a good alternative to the problem of the absolute shortage of kidney donations.

Background: Data collection from medicine and biomedical science is becoming a large task and increasingly complicated with each passing day. Machine learning methods have been applied to elucidate interactions between genes and genes and their environment. Current Concepts: Many machine learning methods have been used to determine the statistical meaning or relationship in the prediction or progression of diseases through the creation of causal networks based on medical big data. Through these analyses, the occurrence and progression of diseases have been shown to be related to several genes and environmental factors. However, these methods cannot identify the key upstream regulators inferred from genomic, clinical, and environmental medical data. Discussion and Conclusion: The causal Bayesian network (CBN) is a machine learning method that can be used to understand a causal network inferred from the gene expression data. The CBN can help identify the key upstream regulators through examining the causal network inferred from medical big data having genomic information. We can easily improve the clinical outcome through regulation of these identified key upstream factors. Therefore, the CBN may be a powerful and flexible tool in the era of precision medicine. [ABSTRACT FROM AUTHOR]

This study investigates the current situation of medical technologists for blood collection, which is considered the most important step for diagnosis. The survey enrolled 650 medical technologists working in hospitals and medical check centers in Busan, Ulsan, and Gyeongnam. We found that each medical technologist performed blood collection for about 100 patients. There was more than one blood collection failure per day, with more than one case of pain and filing of civil complaints per year. Hence, there was a high work burden on the medical technologists. Cases where a medical technologist was stabbed with a used needle occurred more than once a year, and about 15% of them received infection control and treatment because of stab wounds. Additionally, more than half of the participants suffered from musculoskeletal disorders and mental stress due to blood collection work. Unlike administering intravenous and intramuscular injections using the same needle, no fee is charged for blood collection. Based on the results of this study, it will be possible to improve the safety and rights of medical technologists by calculating the actual fee for blood collection work and assigning a relative value score.

Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium that causes infections in different parts of the body and causes skin and soft tissue infections (SSTI). The present study examined the antimicrobial resistance patterns and molecular epidemiological characteristics of MRSA isolated from nasal swabs in clinical patients. SCCmec type of MRSA isolates from clinical patients were analyzed: 24 cases were SCCmec type-II; two cases were type-II/IVa; one case was type-II/V; one case was type-IVa; 11 cases were not-typeable. The mec complex type of MRSA isolates from clinical patients were analyzed: 29 cases were mec complex type A, and 10 cases were not-typeable, but type B was not found in the present study. In conclusion, SCCmec type-II and mec complex type A were the most dominant MRSA subtypes among the MRSA isolates from a nasal swab of patients, and the results were similar to other studies on hospital-acquired MRSA (HA-MRSA). These results can not only provide basic data for hospital infection management but also be a good guideline for MRSA infections in the Republic of Korea.