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Kim NR, Rho SY, Navarro J, An C, Han DH, Choi JS, Kim MJ, Choi GH. Additional nodules detected using EOB-MRI in patients with resectable single hepatocellular carcinoma: an implication for active treatment strategy. J Liver Cancer 2024; 24:92-101. [PMID: 38351675 PMCID: PMC10990668 DOI: 10.17998/jlc.2024.01.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/16/2024] [Accepted: 01/25/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND/AIM Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOBMRI) further enhances the identification of additional hepatic nodules compared with computed tomography (CT) alone; however, the optimal treatment for such additional nodules remains unclear. We investigated the long-term oncological effect of aggressive treatment strategies for additional lesions identified using EOB-MRI in patients with hepatocellular carcinoma (HCC). METHODS Data from 522 patients diagnosed with solitary HCC using CT between January 2008 and December 2012 were retrospectively reviewed. Propensity score-matched (PSM) analysis was used to compare the oncologic outcomes between patients with solitary HCC and those with additional nodules on EOB-MRI after aggressive treatment (resection or radiofrequency ablation [RFA]). RESULTS Among the 383 patients included, 59 had additional nodules identified using EOB-MRI. Compared with patients with solitary HCC, those with additional nodules on EOB-MRI had elevated total bilirubin, aspartate transaminase, and alanine transaminase; had a lower platelet count, higher MELD score, and highly associated with liver cirrhosis (P<0.05). Regarding long-term outcomes, 59 patients with solitary HCC and those with additional nodules after PSM were compared. Disease-free survival (DFS) and overall survival (OS) were comparable between the two groups (DFS, 60.4 vs. 44.3 months, P=0.071; OS, 82.8 vs. 84.8 months, P=0.986). CONCLUSION The aggressive treatment approach, either resection or RFA, for patients with additional nodules identified on EOBMRI was associated with long-term survival comparable with that for solitary HCC. However, further studies are required to confirm these findings.
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Affiliation(s)
- Na Reum Kim
- Division of Hepatobiliary & Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Seoung Yoon Rho
- Department of Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Jonathan Navarro
- Division of Surgical Oncology, Department of Surgery, Vicente Sotto Memorial Medical Center, Cebu, Philippines
| | - Chansik An
- Department of Radiology, CHA University Bundang Medical Center, Seongnam, Korea
| | - Dai Hoon Han
- Division of Hepatobiliary & Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Sub Choi
- Division of Hepatobiliary & Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Myeong-Jin Kim
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Gi Hong Choi
- Division of Hepatobiliary & Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
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Kim NR, Alhothaifi ED, Han DH, Choi JS, Choi GH. Prognostic impact of R1 resection margin in synchronous and simultaneous colorectal liver metastasis resection: a retrospective cohort study. World J Surg Oncol 2023; 21:169. [PMID: 37280633 DOI: 10.1186/s12957-023-03042-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/19/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND A margin ≥ 1 mm is considered a standard resection margin for colorectal liver metastasis (CRLM). However, microscopic incomplete resection (R1) is not rare since aggressive surgical resection has been attempted in multiple and bilobar CRLM. This study aimed to investigate the prognostic impact of resection margins and perioperative chemotherapy in patients with CRLM. METHODS A total of 368 of 371 patients who underwent simultaneous colorectal and liver resection for synchronous CRLM between 2006 and June 2017, excluding three R2 resections, were included in this study. R1 resection was defined as either abutting tumor on the resection line or involved margin in the pathological report. The patients were divided into R0 (n = 304) and R1 (n = 64) groups. The clinicopathological characteristics, overall survival, and intrahepatic recurrence-free survival were compared between the two groups using propensity score matching. RESULTS The R1 group had more patients with ≥ 4 liver lesions (27.3 vs. 50.0%, P < 0.001), higher mean tumor burden score (4.4 vs. 5.8%, P = 0.003), and more bilobar disease (38.8 vs. 67.2%, P < 0.001) than the R0 group. Both R0 and R1 groups showed similar long-term outcomes in the total cohort (OS, P = 0.149; RFS, P = 0.414) and after matching (OS, P = 0.097, RFS: P = 0.924). However, the marginal recurrence rate was higher in the R1 group than in the R0 group (26.6 vs. 16.1%, P = 0.048). Furthermore, the resection margin did not have a significant impact on OS and RFS, regardless of preoperative chemotherapy. Poorly differentiated, N-positive stage colorectal cancer, liver lesion number ≥ 4, and size ≥ 5 cm were poor prognostic factors, and adjuvant chemotherapy had a positive impact on survival. CONCLUSIONS The R1 group was associated with aggressive tumor characteristics; however, no effect on the OS and intrahepatic RFS with or without preoperative chemotherapy was observed in this study. Tumor biological characteristics, rather than resection margin status, determine long-term prognosis. Therefore, aggressive surgical resection should be considered in patients with CRLM expected to undergo R1 resection in this multidisciplinary approach era.
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Affiliation(s)
- Na Reum Kim
- Department of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Essam Dhafer Alhothaifi
- Department of Surgery, Division of Hepato-Biliary Pancreatic Surgery, King Saud Medical City, Riyadh, Saudi Arabia
| | - Dai Hoon Han
- Department of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin Sub Choi
- Department of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Gi Hong Choi
- Department of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Kim NR, Han DH, Choi GH, Lee JG, Joo DJ, Kim MS, Choi JS. Comparison of surgical outcomes and learning curve for robotic versus laparoscopic living donor hepatectomy: A retrospective cohort study. Int J Surg 2022; 108:107000. [PMID: 36379423 DOI: 10.1016/j.ijsu.2022.107000] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/20/2022] [Accepted: 11/03/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Both laparoscopic living donor right hemihepatectomy (LLDRH) and robotic living donor right hemihepatectomy (RLDRH) have been developed for minimally invasive donor hepatectomy (MIDH), although comparative analysis between the two surgical modalities is lacking. This study aims to compare surgical outcomes of LLDRH and RLDRH at a single institution. MATERIALS AND METHODS From March 2016 to March 2022, 171 patients who underwent MILH of right liver were enrolled and divided into RLDRH and LLDRH. Two surgeons with experience in both techniques performed all procedures. Clinical characteristics, perioperative outcomes of donor and recipient, and donor anatomic variations were compared between both groups, and learning curves were estimated. Subgroup analysis was also performed, including only donors recruited after 2019, when LLDRH was initiated at our institution. RESULTS RLDRH and LLDRH were performed for 102 and 69 patients, respectively. Operative time was significantly longer for RLDRH than LLDRH (464 vs. 407 min, P < 0.001), although estimated blood loss was lower in RLDRH (104 vs. 238 mL, P = 0.002). Incidence of major complications was similar in both groups. After 2019, significantly more RLDRH vs. LLDRH patients had variation in the hepatic artery (14.3% vs. 2.9%, P = 0.020) and portal vein (16.1% vs. 4.3%, P = 0.027). Learning curve for RLDRH was stabilized after approximately the 16th case, whereas that of LLDRH stabilized immediately. CONCLUSION RLDRH resulted in less intraoperative bleeding and comparable postoperative outcomes than LLDRH. Moreover, since 2019, RLDRH has been employed more frequently for donors with hilar structure anatomic variations. Based on our single-center experience, we propose that standardized procedures for RLDRH might help set up pure minimally invasive procedures for donor hepatectomy and facilitate safe implementation of laparoscopic approaches.
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Affiliation(s)
- Na Reum Kim
- Department of Surgery, Division of Hepato-biliary and Pancreatic Surgery, Yonsei University College of Medicine, Seoul, South Korea Department of Transplantation Surgery, Yonsei University College of Medicine, Seoul, South Korea
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Lee NY, Kim NR, Kang JW, Kim G, Han MS, Jang JA, Ahn D, Jeong JH, Han MH, Nam EJ. Increased salivary syndecan-1 level is associated with salivary gland function and inflammation in patients with Sjögren's syndrome. Scand J Rheumatol 2021; 51:220-229. [PMID: 34212822 DOI: 10.1080/03009742.2021.1923162] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objectives: Syndecan-1 (SDC-1), a transmembrane heparin sulphate proteoglycan predominantly expressed on epithelial cells, also exists in a soluble form through ectodomain shedding. SDC-1 expression and shedding may be modulated in the inflammatory milieu of primary Sjögren's syndrome (SS). We investigated SDC-1 expression in minor salivary glands (MSGs) and analysed the association between salivary or plasma levels of SDC-1 and clinical parameters in SS.Method: We measured salivary and plasma SDC-1 levels via an enzyme-linked immunosorbent assay and assessed the salivary flow rates (SFRs) in 70 patients with SS and 35 healthy subjects. Disease activity indices, serological markers, salivary gland scintigraphy, and MSG biopsy were evaluated in patients with SS.Results: SDC-1 expression was upregulated on ductal epithelial cells in inflamed salivary glands. Salivary SDC-1 levels in patients significantly exceeded those in healthy subjects [median (interquartile range) 49.0 (20.7-79.1) vs 3.7 (1.7-6.3) ng/mL, p < 0.001] and inversely correlated with SFRs (r = -0.358, p = 0.032) and ejection fractions of the parotid (r = -0.363, p = 0.027) and submandibular (r = -0.485, p = 0.002) glands in salivary gland scintigraphy. Plasma SDC-1 levels were significantly correlated with the EULAR Sjögren's Syndrome Disease Activity Index (r = 0.507, p < 0.001) and EULAR Sjögren's Syndrome Patient Reported Index (r = 0.267, p = 0.033). Focus scores were correlated with salivary SDC-1 levels (r = 0.551, p = 0.004).Conclusion: Salivary and plasma SDC-1 levels may constitute potential biomarkers for salivary gland function and disease activity, respectively, in SS.
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Affiliation(s)
- N Y Lee
- Department of Laboratory Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Daegu, Republic of Korea
| | - N R Kim
- Division of Rheumatology, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Daegu, Republic of Korea
| | - J W Kang
- Division of Rheumatology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - G Kim
- Division of Rheumatology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea.,Laboratory for Arthritis and Bone Biology, Fatima Research Institute, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - M-S Han
- Laboratory for Arthritis and Bone Biology, Fatima Research Institute, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - J A Jang
- Laboratory for Arthritis and Bone Biology, Fatima Research Institute, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - D Ahn
- Department of Otolaryngology-Head and Neck Surgery, Kyungpook National University Hospital, School of Medicine, Daegu, Republic of Korea
| | - J H Jeong
- Department of Nuclear Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Daegu, Republic of Korea
| | - M-H Han
- Department of Pathology, Kyungpook National University Hospital, School of Medicine, Daegu, Republic of Korea
| | - E J Nam
- Division of Rheumatology, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Daegu, Republic of Korea
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Kim NR, Kim YJ, Hwang IC. A Carcinoid Tumor of the Esophagus Treated with Endoscopic Ablation Therapy. JNMA J Nepal Med Assoc 2016; 55:97-99. [PMID: 28029676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Esophageal carcinoids are exceedingly rare and only a few limited cases have been reported. Because knowledge about esophageal carcinoid is based primarily on case reports, the treatment of choice has not been settled. We report here on a localized carcinoid tumor in the esophagogastric junction. As our initial biopsy was nearly equal for the excision, we only performed coagulation ablation therapy instead of a wide excision which is traditionally recommended. The patient is free of recurrence so far during 50-month follow-up. Our report suggests that esophageal carcinoids may be not particularly associated with a poor prognosis.
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Affiliation(s)
- N R Kim
- Department of Pathology, Gachon University Gil Medical Center, Namdong-gu, Republic of Korea
| | - Y J Kim
- Division of Gastroenterology, Department of Internal Medicine, Gachon University Gil Medical Center, Namdong-gu, Republic of Korea
| | - I C Hwang
- Department of Family Medicine, Gachon University Gil Medical Center, Namdong-gu, Republic of Korea
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Kim JM, Pham LD, Jang YH, Kim NR, Ryoo SY, Jang YR, Jang JM, Jung SC. Isolation and characterization of Mycobacterium avium subspecies paratuberculosis in Korean black goat (Capra hircus aegagrus). ACTA ACUST UNITED AC 2015. [DOI: 10.4067/s0301-732x2015000300017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kim NR, Hong JS, Song YS, Chung BN, Park JW, Ryu KH. The complete genome sequence of a member of a new species of tobamovirus (rattail cactus necrosis-associated virus) isolated from Aporcactus flagelliformis. Arch Virol 2011; 157:185-7. [PMID: 22006045 DOI: 10.1007/s00705-011-1142-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Accepted: 10/06/2011] [Indexed: 11/28/2022]
Abstract
In this study, we identified a new tobamovirus from diseased Aporcactus flagelliformis cactus plants, named it rattail cactus necrosis-associated virus (RCNaV), and determined its complete genome sequence. The full RCNaV genome consisted of 6,506 nucleotides and contained four open reading frames coding for proteins of M(r) 128 kDa (3,441 nt), 185 kDa (4,929 nt), 55 kDa (1452 nt), 36 kDa (1,005 nt) and 19 kDa (513 nt) from the 5' to 3' end, respectively. The overall similarities for the four ORFs of RCNaV were from 32.5% to 64.1% and from 17.0% to 67.3% to those of the other tobamoviruses, at the nucleotide and amino acid level, respectively. Comparison of the coding and non-coding regions of the virus with those of other tobamoviruses showed that RCNaV is the most closely related to cactus mild mottle virus.
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Affiliation(s)
- N R Kim
- Department of Horticulture, Biotechnology and Landscape Architecture, Plant Virus GenBank, Seoul Women's University, Seoul 139-774, Korea
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Lee J, Kim NR, Kim H, Han J, Lee ES, Seong GJ, Kim CY. Negative refraction power causes underestimation of peripapillary retinal nerve fibre layer thickness in spectral-domain optical coherence tomography. Br J Ophthalmol 2010; 95:1284-9. [PMID: 20956274 DOI: 10.1136/bjo.2010.186536] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS Although studies using optical coherence tomography (OCT) reported that the retinal nerve fibre layer (RNFL) thickness of myopic eyes was thinner than those of normal controls, it was unclear if this finding indicated the difference in actual structural thickness or that created by sources affecting accuracy of OCT measurement. This study's aim was to evaluate the effect of refraction power on the measurement of the RNFL thickness using spectral-domain OCT. METHODS OCT scans to measure RNFL thickness were repeated in 15 cycloplegic eyes of 15 participants, while different refraction powers were induced by wearing soft contact lenses of eight different dioptres (-6 to +8). RESULTS Measured RNFL thicknesses decreased significantly with soft contact lenses of higher plus dioptres and increased with those of more minus dioptres. This finding was consistent with or without controlling factors including the signal strength and test-retest variability of the machine. Measurement of peripapillary RNFL thicknesses was not varied between scans performed with and without plano contact lenses. CONCLUSIONS In spectral-domain OCT, RNFL thickness was underestimated in eyes with increasing negative refraction power and overestimated with increasing positive refraction power.
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Affiliation(s)
- J Lee
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
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Kim NR, Kim YJ, Chin HS, Moon YS. Optical coherence tomographic patterns in diabetic macular oedema: prediction of visual outcome after focal laser photocoagulation. Br J Ophthalmol 2009; 93:901-5. [PMID: 19254904 DOI: 10.1136/bjo.2008.152553] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIM To identify optical coherence tomography (OCT) patterns predictive of visual outcome in diabetic macular oedema (DMO) patients who undergo focal laser photocoagulation. METHODS This study involved 70 eyes (45 patients) with clinically significant macular oedema that underwent focal laser photocoagulation using the Early Treatment Diabetic Retinopathy Study protocol. Preoperative macular OCT images were retrospectively examined. OCT features were classified into four patterns: diffuse retinal thickening (DRT); cystoid macular oedema (CMO), serous retinal detachment and vitreomacular interface abnormalities (VMIA). Changes in retinal thickness, retinal volume and visual acuity (VA) after focal laser photocoagulation were evaluated and compared with respect to their OCT features. RESULTS After focal laser photocoagulation, changes in retinal thickness and retinal volume were significantly different for different OCT types (p = 0.002 and p<0.001). The change in VA from baseline was not significantly different between groups (p = 0.613). The DRT pattern was associated with a greater reduction in retinal thickening and better VA improvement than the CMO or VMIA patterns. Proportions of patients with persistent DMO (central macular thickness >250 microm after laser treatment) were greater for the CMO and VMIA patterns than DRT pattern. CONCLUSION DRT patients achieved a greater reduction in retinal thickening and greater VA increases than CMO and VMIA patients. We suggest that classifying DMO structural patterns using OCT might allow visual outcome to be predicted after laser photocoagulation.
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Affiliation(s)
- N R Kim
- Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea
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Bijelic G, Kim NR, O'Donnell MJ. Effects of dietary or injected organic cations on larval Drosophila melanogaster: mortality and elimination of tetraethylammonium from the hemolymph. Arch Insect Biochem Physiol 2005; 60:93-103. [PMID: 16175537 DOI: 10.1002/arch.20085] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This study of larval Drosophila melanogaster examined the effects of injecting the prototypical organic cation tetraethylammonium (TEA) into the hemocoel or adding TEA and/or other organic cations to the diet. Mortality, hemolymph TEA levels, and Malpighian tubule TEA secretion rates were measured. The LD50 for dietary TEA was 158.4 mM and mortality increased if competitive inhibitors of organic cation transporters were also included in the diet. Mortality increased from 24% on TEA (100 mM) alone to 83 and 67% when the diet contained both TEA and quinidine (10 mM) or cimetidine (100 mM), respectively. TEA-selective microelectrode measurements indicated that hemolymph TEA concentration was approximately 3% of that in the diet for larvae maintained on TEA-enriched diet for 24 h. Malpighian tubules isolated from larvae exposed to dietary TEA excreted more TEA than did tubules from controls fed a TEA-free diet. However, the rate of decline of hemolymph TEA concentration following ingestion or injection of TEA into the hemocoel was greater than that explicable by rates of active transport by the gut and Malpighian tubules (MTs). We propose that TEA concentrations in the hemolymph are reduced not only by active transport across the MTs and gut, but also by diffusion into the gut. The latter pathway is particularly important when larvae previously maintained upon TEA-enriched diet are transferred to a TEA-free diet. The ingestion of TEA-free food not only clears the gut lumen, but also creates a TEA-free compartment into which TEA may passively diffuse from the hemolymph.
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Affiliation(s)
- G Bijelic
- Department of Biology, McMaster University, Hamilton, Ontario, Canada
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Abstract
Sclerosing meningioma is a rare morphologic subtype of meningioma and may be mistaken for atypical or malignant meningioma and astrocytoma or schwannoma because of marked collagen deposits and a sparse population of cells with little resemblance to meningothelial cells. Authors describe the histopathologic and immunophenotypic features of five cases of sclerosing meningioma. Histologically, all the cases consisted of paucicellular collagenous tissue containing spindle cells with or without small foci of meningothelial cell proliferation. The morphology and immunohistochemical profile of the spindle cells were different from those of conventional meningothelial cells. The meningothelial cells showed a typical immunoreactivity of conventional meningiomas, while the spindle cells displayed a strong expression of vimentin. The Ki-67 labelling index was uniformly low in all cases, and none of cases expressed p53 protein. In summary, the recognition of meningothelial cells in massively sclerotic lesions is helpful for a correct diagnosis. In the cases with a total absence of meningothelial cells, however, the vague collagenous whorls are more diagnostic rather than immunohistochemistry. Considering association with clear cell meningioma, prospective and retrospective long-term follow-up is necessary for deciding whether reminiscent clear cell meningiomas should be separated from sclerosing meningioma or not.
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Affiliation(s)
- N R Kim
- Department of Pathology, Gachon Medical School Gil Medical Centre, Incheon, Korea
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Cho MY, Joh YG, Kim NR, Jung SI, Bae JW, Kim YC, Koo BH, Whang CW, Suh SO. T-lymphocyte subsets in patients with AJCC stage III gastric cancer during postoperative adjuvant chemotherapy. American Joint Committee on Cancer. Scand J Surg 2003; 91:172-7. [PMID: 12164518 DOI: 10.1177/145749690209100207] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Advanced neoplastic diseases alter the immune response in cancer patients. The aim of this study was to evaluate the changes of T-lymphocyte subsets during postoperative adjuvant chemotherapy, and the relationship between T-lymphocyte subsets and tumor recurrence in AJCC stage III gastric cancers. MATERIAL AND METHODS Analysis of T-lymphocyte subsets was performed in 39 patients with stage III gastric adenocarcinoma who had undergone a curative gastric resection and postoperative chemotherapy. CirculatingT-lymphocyte subsets were measured on venous blood by using flow cytometry and monoclonal antibodies on preoperative day 1, and postoperative months 1, 3, and 6. RESULTS The 5-year disease-free survival rates of patients with stage 3a and 3b gastric cancer were 57.1% and 33.3%, respectively (p = 0.06). Values of CD3+ and CD4+ T-cells, and CD4+/CD8+ ratios were consistently lower in the recurrence group throughout the observation period. CD4+ T-cell counts were significantly lower in the recurrence group on preoperative day 1, and postoperative months 1 and 6. However, most values of the T-lymphocyte subsets showed no statistically significant difference when comparing the stage 3a and 3b disease patient groups. CONCLUSIONS The results of this study suggest that immunosuppression associated with CD3+ and CD4+ T-cell depression is a risk factor for postoperative recurrence in patients with stage III gastric cancer.
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Affiliation(s)
- M Y Cho
- Department of Surgery, College of Medicine, Korea University, Sungbuk-Gu, Seoul.
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15
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Kim NR, Suh YL, Shin HJ, Park IS. Gliofibroma with extensive calcified deposits. Clin Neuropathol 2003; 22:14-22. [PMID: 12617189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
Gliofibroma is a rare astrocytic neoplasm of young people that shows abundant deposition of collagenous matrix around glial cells. It shares some clinical and pathologic features with desmoplastic cerebral astrocytoma of infancy or desmoplastic infantile ganglioglioma. However, histogenesis or clinical behavior of these tumors is not fully known. Here, we report a case of gliofibroma with unusual extensive calcification which complicated radiologic as well as pathologic diagnosis.
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Affiliation(s)
- N R Kim
- Department of Diagnostic Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim NR, Choe G, Shin SH, Wang KC, Cho BK, Choi KS, Chi JG. Childhood meningiomas associated with meningioangiomatosis: report of five cases and literature review. Neuropathol Appl Neurobiol 2002; 28:48-56. [PMID: 11849563 DOI: 10.1046/j.1365-2990.2002.00365.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Meningioangiomatosis is a unique, rare hamartomatous lesion. Meningiomas arising in the background of meningioangiomatosis are rare conditions which pathologically and radiologically mimic invasive meningiomas, but have a benign clinical course in children and young adults. In this study, five such cases are reported. To our knowledge, this is the largest reported collection of meningiomas associated with meningioangiomatosis. Less immunoreactivity for progesterone receptor and high Ki-67 labelling index are generally known to be associated with invasive meningiomas. However, high expression of progesterone receptor and low Ki-67 labelling index in the present cases supports the idea that brain invasion is not an indicator of malignancy but an independent finding associated with meningiomas which have arisen from meningioangiomatosis. We emphasize the good prognosis of such tumours and discuss pathogenesis of meningiomas with meningioangiomatosis.
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Affiliation(s)
- N R Kim
- Department of Pathology, Seoul National University College of Medicine, Chongno-gu, Seoul, Korea
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Abstract
We report a case of the unusual location of a cutaneous bronchogenic cyst on the abdominal wall. The patient was a 9-month-old boy who had presented with a 1.5 cm-sized polypoid mass, present since birth. Pathological examination of the excised mass revealed multiple small cystic structures surrounded by the fibroadipose tissue. The lining epithelium consisted of either pseudostratified ciliated columnar epithelium with goblet cells or a single layer of ciliated or non-ciliated cuboidal to columnar cells. The cystic walls contained a well-developed smooth muscle bundle, mucous glands and hyaline cartilage plate. This lesion was adherent to the peritoneum, but there was no direct communication with the abdominal cavity. Cutaneous bronchogenic cyst located in the abdominal wall has not been described in the English literature. The present case suggests a possible origin from a downward migration, from the sequestered bud of a tracheobronchial tree primordium along the midline of the body surface, during embryonic development.
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Affiliation(s)
- N R Kim
- Department of Pathology, Kangnam General Hospital Public Corporation, Korea
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Yu YS, Shin KC, Kim NR, Lee EJ, Khwarg SI, Chung H, Lee J. Extraocular muscle changes after cryotherapy for retinopathy of prematurity and the development of strabismus in premature infants. Korean J Ophthalmol 2001; 15:87-93. [PMID: 11811588 DOI: 10.3341/kjo.2001.15.2.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
To find out whether the cryotherapy for the treatment of the retinopathy of prematurity (ROP) causes structural changes of the extraocular muscle (EOM), and also whether the changes are related with the occurrence of strabismus. To examine the acute stage change, we conducted a transconjunctival cryotherapy around the superior rectus muscle of a rabbit and resected it 0, 3, 7, 14, and 28 days after the cryotherapy. In observing chronic changes, we first categorized patients who had an esotropia surgery into groups, one of which combined prematurity and cryotherapy and one group affected by prematurity but without having had cryotherapy. Then we compared the change of EOM with that of a fullterm infant group. In a rabbit, edema, acute inflammatory cells and a large amount of degenerated muscle fibers were observed immediately after the cryotherapy and on the 3rd day. On the 7th day, regenerated muscle fibers were observed and on the 14th day, the inflammatory cells decreased and the amount of regenerated muscle fiber increased. On the 28th day, abnormal findings were not observed any more and the muscle was found to be normal. When chronic changes of EOM in human on 1 1/2 to 8 1/2 years after cryotherapy, there were no abnormal findings observed in three groups. From the study, we can infer that cryotherapy can cause acute inflammation and necrosis of muscle fiber but such an acute change will improve and does not result in structural change in the long term. Therefore, the occurrence of strabismus in patients with ROP is considered to be attributable to reasons other than injury of EOM.
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Affiliation(s)
- Y S Yu
- Department of Ophthalmology, Seoul National University College of Medicine, Korea
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Im SH, Wang KC, Kim SK, Oh CW, Kim DG, Hong SK, Kim NR, Chi JG, Cho BK. Childhood meningioma: unusual location, atypical radiological findings, and favorable treatment outcome. Childs Nerv Syst 2001; 17:656-62. [PMID: 11734983 DOI: 10.1007/s003810100507] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2000] [Revised: 07/01/2001] [Indexed: 11/26/2022]
Abstract
OBJECTS To investigate the characteristics of childhood meningioma, especially, locations, radiological findings, pathological features (including proliferative potential) and outcome, 11 children with meningiomas were retrospectively analyzed. RESULTS Unusual location, large size, frequent calcification, and cyst formation were characteristic radiological findings. Gross total resection was achieved in 8 patients, and there was recurrence in 2. Gamma knife radiosurgery was performed on residual and recurrent tumors. MIB-1 indices tended to be high in large tumors. Nine patients had a Karnofsky Performance Scale of more than 70 during the follow-up period of 10 months to 19.5 years. Surgical treatment rendered 4 of 5 epileptic patients seizure free. The childhood meningiomas examined had unusual locations, atypical radiological findings, and various proliferative potentials. CONCLUSIONS Complete resection is the treatment of choice. Gamma knife radiosurgery can be a good alternative for residual tumors and small recurrent tumors. The outcome of childhood meningiomas is good after surgery.
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Affiliation(s)
- S H Im
- Department of Neurosurgery, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea
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Abstract
Erdheim-Chester disease is a rare systemic disorder characterized by a fibrosing xanthogranulomatous infiltration of multiple organs. We report a case of Erdheim-Chester disease with diffuse necrosis leading to difficulty in making a prompt diagnosis. Radiologically, osteosclerotic lesions with osteolytic element involved metadiaphyses of both proximal tibia, and retroperitoneal infiltrations encasing both kidneys, both adrenals, and aorta were found. A biopsy of the tibia showed diffuse infiltration of foamy histiocytes, Touton-type giant cells, and fibroblastic cells associated with extensive coagulative necrosis. Immunohistochemically, foamy histiocytes were positive for CD68 and peanut agglutinin and negative for S-100 protein. A few Langerhans' cells, which were difficult to identify in hematoxylin-eosin stain, were highlighted by immunostain for S-100 protein. The patient received supportive therapy and was alive 1 1/2 years after diagnosis, with newly developed bilateral retrobulbar lesions and worsened heart failure.
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Affiliation(s)
- N R Kim
- Department of Diagnostic Pathology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
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