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Articles in E-pub version are posted online ahead of regular printed publication.

Original article
Identification of the transcriptome profile of Miamiensis avidus after mebendazole treatment
Hyunsu Kim, A-Reum Lee, Kyung-Yoon Jeon, Eun-Ji Ko, Hee-Jae Cha, Mee Sun Ock
Received January 12, 2022  Accepted March 11, 2022  Published online May 16, 2022  
DOI: https://doi.org/10.7180/kmj.22.003    [Epub ahead of print]
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Background
The scuticociliate Miamiensis avidus is a major pathogenic agent that causes significant economic losses in the flounder aquaculture industry. Many different types of drugs are being tested to control this disease, including mebendazole, which is a broad-spectrum antiprotozoal agent. The purpose of this study was to determine whether mebendazole worked in vitro against M. avidus and to explore its mechanism of action.
Methods
Transcriptome and gene ontology analyses were conducted to investigate the specifically expressed gene profile. We confirmed the cytotoxic effect of mebendazole against M. avidus when it was applied intermittently for a total of three times. We also identified differentially expressed genes using transcriptome analysis.
Results
Most of the upregulated genes were membrane transport-related genes, including Na+/K+-ATPase. Most of the downregulated genes were categorized into three groups: tubulin-related, metabolism-related, and transport-related genes. The expression levels of glucose uptake-related genes decreased due to the inhibition of tubulin polymerization, but this was not statistically significant.
Conclusion
Our results demonstrate that intermittent treatment with mebendazole has a significant cytotoxic effect on M. avidus. Furthermore, mebendazole induces downregulation of the tubulin-alpha chain and metabolism-related genes. It is presumed that this leads to a glucose shortage and the death of M. avidus. Transcriptome analysis will provide useful clues for further studies on mebendazole applications for scutica control.
Case reports
A rare case of pure-type embryonal carcinoma mimicking epithelial ovarian carcinoma in a 75-year-old woman
Hyun Been Jo, Eun Taeg Kim, Nam Kyung Lee, Kyung Un Choi, Eon Jin Kim, Yun Joo Shin, Ki Hyung Kim, Dong Soo Suh
Received April 21, 2022  Accepted April 29, 2022  Published online May 3, 2022  
DOI: https://doi.org/10.7180/kmj.21.050    [Epub ahead of print]
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Embryonal carcinoma, a very rare ovarian germ cell tumor, has pure and mixed phenotypes. Pure-type embryonal carcinoma has never been reported in postmenopausal women. The current case was, thus, misdiagnosed as an epithelial ovarian carcinoma based on radiological findings. Herein, we describe the case of ovarian embryonal carcinoma in a 75-year-old woman along with a literature review. Magnetic resonance imaging findings were suggestive of an epithelial ovarian malignancy associated with endometrioma, including ureteral invasion. The patient underwent complete surgical staging. A pathological diagnosis of pure-type embryonal carcinoma was made. The patient’s postoperative course was uneventful, and adjuvant chemotherapy was administered. Embryonal carcinoma in postmenopausal women is a clinical challenge owing to the possibility of its misdiagnosis as epithelial ovarian carcinoma. To the best of our knowledge, this is the first report on pure-type ovarian embryonal carcinoma in a postmenopausal woman, with a description of the clinicopathological characteristics and review of the relevant literature.
Tracheostomy with aortic debranching: a case report
Jin Ho Choi, Haeyoung Lee
Received November 30, 2021  Accepted December 8, 2021  Published online April 27, 2022  
DOI: https://doi.org/10.7180/kmj.21.046    [Epub ahead of print]
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Percutaneous dilatational tracheostomy (PDT) is preferred over conventional surgical tracheostomy for prolonged airway protection and mechanical ventilation. However, despite its advantages, severe PDT-related complications have been reported, including catastrophic hemorrhage from common carotid artery laceration and innominate artery pseudo-aneurysm. PDT can typically be applied to the trachea, which is the focal point for the transverse course of great vessels (e.g., the anomalous brachiocephalic trunk, which overlaps with the targeted lesion anteriorly); therefore, to improve patient outcomes, an alternative method using aortic debranching may be considered.
Case Report
Overcoming high pre-transplant isoagglutinin titers using high-dose intravenous immunoglobulin, salvage plasmapheresis, and booster rituximab without splenectomy in ABO-incompatible living donor liver transplantation: a case report
Hyung Hwan Moon
Received March 17, 2022  Accepted March 28, 2022  Published online March 29, 2022  
DOI: https://doi.org/10.7180/kmj.21.036    [Epub ahead of print]
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High pre-transplant isoagglutinin is a risk factor for antibody-mediated rejection in ABO-incompatible living donor liver transplantation. A 55-year-old man with alcoholic liver cirrhosis underwent ABO-incompatible living donor liver transplantation. The initial isoagglutinin immunoglobulin G titer was 1:1,024. Despite five sessions of plasmapheresis, the isoagglutinin titer was not significantly reduced (from 1:1,024 to 1:512). We decided to perform 11 plasmaphereses and proceed with liver transplantation regardless of the isoagglutinin titer (1:128 at transplantation day). Instead, we planned to administer 0.5 g/kg intravenous immunoglobulin and booster rituximab (200 mg) after transplant. On postoperative day 6, the isoagglutinin titer increased from 1:32 to 1:64, and the patient received plasmapheresis twice. The patient maintained stable liver function without evidence of further complications or rejection. The high-dose intravenous immunoglobulin, salvage plasmapheresis, and booster rituximab protocol might be able to overcome a pre-transplant high isoagglutinin titer in ABO-incompatible living donor liver transplantation without splenectomy.

KMJ : Kosin Medical Journal