Postlaparoscopic shoulder pain (PLSP) frequently follows laparoscopic surgery. In this placebo-controlled study, we evaluated the efficacy of two perioperative doses of pregabalin 300 mg 12 h apart for preventing and attenuating PLSP after laparoscopic cholecystectomy. The frequency and severity of PLSP, need for postoperative rescue analgesia, and side effect profiles were assessed for 48 h postoperatively. In both groups, the overall incidence of PLSP did not differ significantly, and the pain score for PLSP, time to first rescue analgesia, and cumulative ketorolac consumption were similar at each timepoint. However, the 2-h postoperative incidence of oversedation was higher with pregabalin.

Frequent somatic TERT promoter mutations and CTNNB1 mutations in hepatocellular carcinoma

Tetraarsenic hexoxide (As₄O₆₎ has been used in Korean folk medicines for the treatment of cancer, however its anti-cancer mechanisms remain obscured. Here, this study investigated the anti-cancer effect of As₄O₆ on SW620 human colon cancer cells. As₄O₆ has showed a dose-dependent inhibition of SW620 cells proliferation. As₄O₆ significantly increased the sub-G1 and G2/M phase population, and Annexin V-positive cells in a dose-dependent manner. G2/M arrest was concomitant with augment of p21 and reduction in cyclin B1, cell division cycle 2 (cdc 2) expressions. Nuclear condensation, cleaved nuclei and poly (adenosine diphosphate‑ribose) polymerase (PARP) activation were also observed in As₄O₆-treated SW620 cells. As₄O₆ induced depolarization of mitochondrial membrane potential (MMP, ΔΨm) but not reactive oxygen species (ROS) generation. Further, As₄O₆ increased death receptor 5 (DR5), not DR4 and suppressed the B‑cell lymphoma‑2 (Bcl-2) and X-linked inhibitor of apoptosis protein (XIAP) family proteins. As₄O₆ increased the formation of AVOs (lysosomes and autophagolysosomes) and promoted the conversion of microtubule-associated protein 1A/1B-light chain 3 (LC3)-I to LC3-II in a dose- and time- dependent manner. Interestingly, a specific phosphoinositide 3-kinase (PI3K)/Akt inhibitor (LY294002) augmented the As₄O₆ induced cell death; whereas p38 mitogen-activated protein kinases (p38 MAPK) inhibitor (SB203580) abrogated the cell death. Thus, the present study provides the first evidence that As₄O₆ induced G2/M arrest, apoptosis and autophagic cell death through PI3K/Akt and p38 MAPK pathways alteration in SW620 cells.

The shortage of donor organs occasionally mandates the use of hepatic allografts from anti–HBc (+) donors. HBIG and/or lamivudine are recommended for the prevention of de novo HBV infection in naive patients, but there are attendant problems, such as mutant strain emergence and high cost. Active immunization presents a better alternative than the use of HBIG or lamivudine, if it can be proven to be effective. Accordingly, we investigated the outcome of HBV vaccination in pediatric hepatic transplant recipients. Between July 1999 and October 2001, 19 pediatric recipients were administered HBV vaccinations after liver transplantation at Seoul National University Hospital. Nine patients received a graft from anti–HBc (+) donors and 10 from anti–HBc (-) donors. When steroid was withdrawn, recombinant HBV vaccine was administered. The median follow–up period after vaccination was 10.0 ± 5.2 months. Seventeen of the 19 patients showed a positive response to vaccination. In 9 patients who received grafts from anti–HBc (+) donors, 2 patients showed no response, 4 patients low response (peak HBsAb titer <1,000 IU/L), and 3 patients high response (peak HBsAb titer ≥1,000 IU/L). De novo HBV infection developed in 1 of 2 patients who showed no response to vaccination. In 10 patients who received grafts from anti–HBc (-) donors, 5 showed a low response and 5 a high response. In conclusion, HBV vaccination in pediatric patients after liver transplantation appeared to exhibit some effectiveness at protecting young children that received a graft from anti–HBc (+) donors from de novo HBV infection.

Chang IS, et al. Korean J Radiol. 2011 Mar-Apr;12(2):203-209. http://dx.doi.org/10.3348/kjr.2011.12.2.203