1
|
Kim H, Choi SY, Heo TY, Kim KR, Lee J, Yoo MY, Lee TG, Han JH. Value of glucose transport protein 1 expression in detecting lymph node metastasis in patients with colorectal cancer. World J Clin Cases 2024; 12:931-941. [PMID: 38414613 PMCID: PMC10895641 DOI: 10.12998/wjcc.v12.i5.931] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/04/2024] [Accepted: 01/22/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND There are limited data on the use of glucose transport protein 1 (GLUT-1) expression as a biomarker for predicting lymph node metastasis in patients with colorectal cancer. GLUT-1 and GLUT-3, hexokinase (HK)-II, and hypoxia-induced factor (HIF)-1 expressions may be useful biomarkers for detecting primary tumors and lymph node metastasis when combined with fluorodeoxyglucose (FDG) uptake on positron emission tomography/computed tomography (PET/CT). AIM To evaluate GLUT-1, GLUT-3, HK-II, and HIF-1 expressions as biomarkers for detecting primary tumors and lymph node metastasis with 18F-FDG-PET/CT. METHODS This retrospective study included 169 patients with colorectal cancer who underwent colectomy and preoperative 18F-FDG-PET/CT at Chungbuk National University Hospital between January 2009 and May 2012. Two tissue cores from the central and peripheral areas of the tumors were obtained and were examined by a dedicated pathologist, and the expressions of GLUT-1, GLUT-3, HK-II, and HIF-1 were determined using immunohistochemical staining. We analyzed the correlations among their expressions, various clinicopathological factors, and the maximum standardized uptake value (SUVmax) of PET/CT. RESULTS GLUT-1 was found at the center or periphery of the tumors in 109 (64.5%) of the 169 patients. GLUT-1 positivity was significantly correlated with the SUVmax of the primary tumor and lymph nodes, regardless of the biopsy site (tumor center, P < 0.001 and P = 0.012; tumor periphery, P = 0.030 and P = 0.010, respectively). GLUT-1 positivity and negativity were associated with higher and lower sensitivities of PET/CT, respectively, for the detection of lymph node metastasis, regardless of the biopsy site. GLUT3, HK-II, and HIF-1 expressions were not significantly correlated with the SUVmax of the primary tumor and lymph nodes. CONCLUSION GLUT-1 expression was significantly correlated with the SUVmax of 18F-FDG-PET/CT for primary tumors and lymph nodes. Clinicians should consider GLUT-1 expression in preoperative endoscopic biopsy in interpreting PET/CT findings.
Collapse
Affiliation(s)
- Hongsik Kim
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju 28644, South Korea
| | - Song-Yi Choi
- Department of Pathology, Chungnam National University College of Medicine, Daejeon 35015, South Korea
| | - Tae-Young Heo
- Information and Statistics, Chungbuk National University, Cheongju 28644, South Korea
| | - Kyeong-Rok Kim
- Information and Statistics, Chungbuk National University, Cheongju 28644, South Korea
| | - Jisun Lee
- Department of Radiology, College of Medicine, Chungbuk National University, Chungbuk National University Hospital, Cheongju-si 28644, South Korea
| | - Min Young Yoo
- Department of Nuclear Medicine, School of Medicine, Inha University, Incheon 22332, South Korea
| | - Taek-Gu Lee
- Department of Surgery, Chungbuk National University, College of Medicine, Cheongju-si 28644, South Korea
| | - Joung-Ho Han
- Department of Internal Medicen, Chungbuk National University, College of medicine, Cheongju-si 28644, South Korea
| |
Collapse
|
2
|
Lee TG, Hwang HJ. Fatal progression of the leptomeningeal carcinomatosis from primary rectal adenocarcinoma: A case report. Asian J Surg 2024:S1015-9584(24)00228-8. [PMID: 38336490 DOI: 10.1016/j.asjsur.2024.01.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Affiliation(s)
- Taek-Gu Lee
- Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Hui-Jeong Hwang
- Department of Cardiology, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
| |
Collapse
|
3
|
Hwang HJ, Lee TG. Impact on clinical outcomes of renin-angiotensin system inhibitors against doxorubicin-related toxicity in patients with breast cancer and hypertension: A nationwide cohort study in South Korea. PLoS One 2023; 18:e0294649. [PMID: 37983233 PMCID: PMC10659172 DOI: 10.1371/journal.pone.0294649] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/05/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Although doxorubicin (DOX) is a commonly used potent chemotherapeutic agent in patients with breast cancer, its cardiotoxic effect is a concern, particularly in patients with hypertension. Antihypertensive renin-angiotensin system (RAS) inhibitors may potentially play a role in preventing overt heart failure (HF) due to DOX toxicity. This study aimed to evaluate whether the use of RAS inhibitors improves clinical outcomes in patients with hypertension and breast cancer undergoing DOX-containing chemotherapy. METHODS A total of 54,344 female patients who were first diagnosed with breast cancer and initiated into DOX therapy between 2008 and 2015 were recruited from a nationwide Korean cohort. Patients were divided into two groups: with and without hypertension (HT, n = 10,789; non-HT, n = 43,555), and the RAS inhibitor group (n = 1,728) was sub-classified from the HT group. Two propensity score-matched cohorts were constructed to compare the clinical outcomes between non-HT and HT groups and between non-HT and RAS inhibitor groups. The primary outcome was the composite of HF and death. RESULTS After propensity score matching, the HT group had a higher risk for HF (adjusted hazard ratio [HR] = 1.30, 95% confidence intervals [95% CI] = 1.09-1.55) compared to the non-HT group, but there was no significant difference in primary outcome between the two groups. The RAS inhibitor group had a lower risk for primary outcome (adjusted HR = 0.78, 95% CI = 0.65-0.94) and death (adjusted HR = 0.81, 95% CI = 0.66-0.99) compared to the non-HT group. CONCLUSIONS Hypertension is a risk factor for HF in patients with breast cancer undergoing DOX chemotherapy. However, the RAS inhibitors used to treat hypertension may contribute to decreased mortality and improved clinical outcomes.
Collapse
Affiliation(s)
- Hui-Jeong Hwang
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - Taek-Gu Lee
- Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| |
Collapse
|
4
|
Kim DH, Yun HY, Ryu DH, Han HS, Han JH, Kim KB, Choi H, Lee TG. Clinical significance of the number of retrieved lymph nodes in early gastric cancer with submucosal invasion. Medicine (Baltimore) 2022; 101:e31721. [PMID: 36401371 PMCID: PMC9678558 DOI: 10.1097/md.0000000000031721] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The prognosis of early gastric cancer (EGC) with submucosal invasion is favorable; however, several cases of recurrence have been reported even after curative gastrectomy. This study aimed to investigate risk factors and evaluate the clinical significance of the number of retrieved lymph nodes (LNs) in EGC with submucosal invasion. We retrospectively analyzed the data of 443 patients with gastric cancer with submucosal invasion after curative gastrectomy for recurrent risk factors. Recurrence was observed in 22 of the 443 gastric cancer patients with submucosal invasion. In the univariate analysis, the risk factors for recurrence were the number of retrieved LNs ≤ 25 and node metastasis. In the multivariate analysis, retrieved LNs ≤ 25 (hazard ratio [HR] = 5.754, P-value = .001) and node metastasis (HR = 3.031, P-value = .029) were independent risk factors for recurrence after curative gastrectomy. Body mass index was related to retrieved LNs ≤ 25 in univariate and multivariate analyses (HR = .510, P = .002). The number of retrieved LNs and node metastases were independent risk factors for EGC with submucosal invasion. For EGC with submucosal invasion, retrieved LNs > 25 are necessary for appropriate diagnosis and treatment.
Collapse
Affiliation(s)
- Dae Hoon Kim
- Department of Surgery, Chungbuk National University Hospital, Korea
- Department of Surgery, Chungbuk National University College of Medicine, Korea
| | - Hyo Yung Yun
- Department of Surgery, Chungbuk National University Hospital, Korea
- Department of Surgery, Chungbuk National University College of Medicine, Korea
- *Correspondence: Hyo Yung Yun, Department of Surgery, Chungbuk National University College of Medicine, 410, Sungbong-ro, Heungduk-gu, Cheongju 361-763, Korea (e-mail: )
| | - Dong Hee Ryu
- Department of Surgery, Chungbuk National University Hospital, Korea
- Department of Surgery, Chungbuk National University College of Medicine, Korea
| | - Hye Sook Han
- Internal Medicine, Chungbuk National University Hospital, Korea
- Internal Medicine, Chungbuk National University College of Medicine, Korea
| | - Joung-Ho Han
- Department of Surgery, Chungbuk National University Hospital, Korea
- Internal Medicine, Chungbuk National University Hospital, Korea
| | - Ki Bae Kim
- Department of Surgery, Chungbuk National University Hospital, Korea
- Internal Medicine, Chungbuk National University Hospital, Korea
| | - Hanlim Choi
- Department of Surgery, Chungbuk National University Hospital, Korea
- Department of Surgery, Chungbuk National University College of Medicine, Korea
| | - Taek-Gu Lee
- Department of Surgery, Chungbuk National University Hospital, Korea
- Department of Surgery, Chungbuk National University College of Medicine, Korea
| |
Collapse
|
5
|
Xu K, Ryu DH, Choi JW, Choi H, Kim DH, Lee TG, Kim MJ, Park S, Yoo KC. Clinical impact of surgical treatment for the spontaneously ruptured resectable hepatocellular carcinoma: A single institution experience. Medicine (Baltimore) 2022; 101:e30307. [PMID: 36107587 PMCID: PMC9439726 DOI: 10.1097/md.0000000000030307] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Spontaneously ruptured hepatocellular carcinoma (srHCC) is a fatal complication of hepatocellular carcinoma (HCC). In addition, emergency treatment is frequently fraught with difficulties. This study aimed to investigate the prognosis and recurrence pattern in patients undergoing hepatectomy for the srHCC. This retrospective study included 11 patients with srHCC treated using either emergency hepatectomy or emergency transarterial embolization (TAE) followed by staged hepatectomy between January 2015 and December 2019. The patients visited the emergency room because of a sudden rupture of HCC without being diagnosed with HCC. We analyzed the prognosis, recurrence rate, and survival in these patients after hepatectomy. Four of the 11 patients in this study were classified as Child-Pugh class A and 7 as Child-Pugh class B. Nine patients visited for sudden onset of abdominal pain, and 2 for sudden onset of shock. The median hemoglobin level at the time of the visit was 11.5 g/dL (interquartile range: 9.8-12.7). Five patients underwent one-stage hepatectomy and 6 underwent emergency TAE hemostasis followed by staged hepatectomy. Median overall survival and recurrence-free survivals were 23 and 15 months, respectively. Recurrence occurred in 7 patients (4 in the one-stage group and 3 in the staged group). Among patients with recurrence, 6 had intrahepatic recurrence and 3 peritoneal metastases. Patients with srHCC who undergo staged hepatectomy can achieve a relatively good prognosis. The most common sites of recurrence after hepatectomy are intrahepatic and peritoneal. Peritoneal metastases are more likely to occur after one-stage hepatectomy.
Collapse
Affiliation(s)
- KangHe Xu
- Department of Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Dong Hee Ryu
- Department of Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea
- Department of Surgery, Chungbuk National University Hospital, Cheongju, Korea
- * Correspondence: Dong Hee Ryu, Department of Surgery, College of Medicine, Chungbuk National University, Chungbuk National University Hospital, 776, 1sunhwan-ro Seowon-gu, Cheongju-si Chungcheongbuk-do, 28644, Korea (e-mail: )
| | - Jae-Woon Choi
- Department of Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea
- Department of Surgery, Chungbuk National University Hospital, Cheongju, Korea
| | - Hanlim Choi
- Department of Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea
- Department of Surgery, Chungbuk National University Hospital, Cheongju, Korea
| | - Dae Hoon Kim
- Department of Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea
- Department of Surgery, Chungbuk National University Hospital, Cheongju, Korea
| | - Taek-Gu Lee
- Department of Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea
- Department of Surgery, Chungbuk National University Hospital, Cheongju, Korea
| | - Myung Jo Kim
- Department of Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea
- Department of Surgery, Chungbuk National University Hospital, Cheongju, Korea
| | - Sungmin Park
- Department of Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea
- Department of Surgery, Chungbuk National University Hospital, Cheongju, Korea
| | - Kwon Cheol Yoo
- Department of Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea
- Department of Surgery, Chungbuk National University Hospital, Cheongju, Korea
| |
Collapse
|
6
|
Lee TG, Kim DH, Yun H, Ryu DH. Successful endoscopic vacuum therapy for the lateral duodenal fistula. Asian J Surg 2022; 45:1807-1808. [PMID: 35599128 DOI: 10.1016/j.asjsur.2022.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/06/2022] [Indexed: 12/01/2022] Open
Affiliation(s)
- Taek-Gu Lee
- Department of Surgery, Chungbuk National University Hospital, South Korea; Department of Surgery, Chungbuk National University College of Medicine, South Korea
| | - Dae Hoon Kim
- Department of Surgery, Chungbuk National University Hospital, South Korea; Department of Surgery, Chungbuk National University College of Medicine, South Korea.
| | - HyoYung Yun
- Department of Surgery, Chungbuk National University Hospital, South Korea; Department of Surgery, Chungbuk National University College of Medicine, South Korea
| | - Dong Hee Ryu
- Department of Surgery, Chungbuk National University Hospital, South Korea; Department of Surgery, Chungbuk National University College of Medicine, South Korea
| |
Collapse
|
7
|
Lee TG, Kim DH, Yun HY, Ryu DH. Acute gastric and Non-Mesenteric colonic infarction following mRNA COVID-19 vaccination. Asian J Surg 2022; 45:1469-1470. [PMID: 35618584 PMCID: PMC9091259 DOI: 10.1016/j.asjsur.2022.04.142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 04/07/2022] [Indexed: 01/06/2023] Open
Affiliation(s)
- Taek-Gu Lee
- Department of Surgery, Chungbuk National University Hospital, South Korea; Department of Surgery, Chungbuk National University College of Medicine, South Korea
| | - Dae Hoon Kim
- Department of Surgery, Chungbuk National University Hospital, South Korea; Department of Surgery, Chungbuk National University College of Medicine, South Korea.
| | - Hyo Yung Yun
- Department of Surgery, Chungbuk National University Hospital, South Korea; Department of Surgery, Chungbuk National University College of Medicine, South Korea
| | - Dong Hee Ryu
- Department of Surgery, Chungbuk National University Hospital, South Korea; Department of Surgery, Chungbuk National University College of Medicine, South Korea
| |
Collapse
|
8
|
Kim MJ, Lee TG. Transanal minimally invasive surgery using laparoscopic instruments of the rectum: A review. World J Gastrointest Surg 2021; 13:1149-1165. [PMID: 34754384 PMCID: PMC8554714 DOI: 10.4240/wjgs.v13.i10.1149] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 07/18/2021] [Accepted: 09/16/2021] [Indexed: 02/06/2023] Open
Abstract
Transanal minimally invasive surgery (TAMIS) was first described in 2010 as an alternative to transanal endoscopic microsurgery (TEM). The TAMIS technique can be access to the proximal and mid-rectum for resection of benign and early-stage malignant rectal lesions and also used for noncurative intent surgery of more advanced lesions in patients who are not candidates for radical surgery. TAMIS has a shorter learning curve, reduced device setup time, flexibility in instrument use, and versatility in application than TEM. Also, TAMIS shows similar results in a view of the operation time, conversion rate, reoperation rate, and complication to TEM. For these reasons, TAMIS is an easily accessible, technically feasible, and cost-effective alternative to TEM. Overall, TAMIS has enabled the performance of high-quality local excision of rectal lesions by many colorectal surgeons. As TAMIS becomes more broadly utilized such as pelvic abscess drainage, rectal stenosis, and treatment of anastomotic dehiscence, the acquisition of appropriate training must be ensured, and the continued assessment and assurance of outcome must be maintained.
Collapse
Affiliation(s)
- Myung Jo Kim
- Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, South Korea
| | - Taek-Gu Lee
- Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, South Korea
| |
Collapse
|
9
|
Juhn JW, Lee KC, Lee TG, Wi HM, Kim YS, Hahn SH, Nam YU. Multi-chord IR-visible two-color interferometer on KSTAR. Rev Sci Instrum 2021; 92:043559. [PMID: 34243393 DOI: 10.1063/5.0043811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/29/2021] [Indexed: 06/13/2023]
Abstract
Major parts of an IR-visible two-color interferometer (TCI) on KSTAR have been upgraded for the multi-chord operation: (1) a diode-pumped-solid-state (DPSS) laser (660 nm) replacing the former HeNe laser (633 nm), (2) vacuum-compatible vibration isolator with titanium retro-reflectors, and (3) full digital phase comparator for multi-chord real-time density signals. The commercial compact DPSS laser suits the multiple chord configuration with its strong beam power (500 mW) and long coherent length (>100 m). Ti retro-reflectors are mounted on vacuum-compatible vibration isolators. The isolators are essential for the visible beams to avoid any fringe skips due to their short wavelength, considering the speed of the mechanical vibration (up to hundreds of μm). Field-programmable-gate-array (FPGA) modules count the entire fringes fast enough with a signal output rate up to 1.25 MHz, solving the fringe skip issues. The FPGA module enables the full digital processing of the phase comparator with a CORDIC algorithm after the sampling rate of 160 MS/s for the 40 MHz intermediate frequency of each beam. The full digital signals are transferred to the main plasma control system in real-time. Stable single-input-single-output operation of the KSTAR density control was demonstrated with the TCI. The real-time density profile control is also promising in the near future, with multiple actuators such as pellets and gas puffings.
Collapse
Affiliation(s)
- June-Woo Juhn
- Korea Institute of Fusion Energy, Daejeon 34133, Republic of Korea
| | - K C Lee
- Korea Institute of Fusion Energy, Daejeon 34133, Republic of Korea
| | - T G Lee
- Korea Institute of Fusion Energy, Daejeon 34133, Republic of Korea
| | - H M Wi
- Korea Institute of Fusion Energy, Daejeon 34133, Republic of Korea
| | - Y S Kim
- Korea Institute of Fusion Energy, Daejeon 34133, Republic of Korea
| | - S H Hahn
- Korea Institute of Fusion Energy, Daejeon 34133, Republic of Korea
| | - Y U Nam
- Korea Institute of Fusion Energy, Daejeon 34133, Republic of Korea
| |
Collapse
|
10
|
Lee TG, Yoon SM, Lee SJ. Endoscopic radial incision and cutting technique for treatment-naive stricture of colorectal anastomosis: Two case reports. World J Gastrointest Surg 2020; 12:460-467. [PMID: 33304448 PMCID: PMC7701878 DOI: 10.4240/wjgs.v12.i11.460] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/30/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Anastomotic stenosis (AS) after colorectal surgery was treated with balloon dilation, endoscopic procedure or surgery. The endoscopic procedures including dilation, electrocautery incision, or radial incision and cutting (RIC) were preferred because of lower complication rates than surgery and are less invasive. Endoscopic RIC has a greater success rate than dilation methods. Most reports showed that repeated RICs were needed to maintain patency of the anastomosis. We report that single session RIC was applied only to treatment-naive patients with AS.
CASE SUMMARY Two female patients presented with AS. One patient had advanced rectal cancer and the other had a refractory stenosis following surgery for endometriosis at sigmoid colon. The endoscopic RIC procedure was performed as follows. A single small incision was carefully made to increase the view of the proximal colon and the incision was expanded until the surgical stapling line. Finally, we made a further circumferential excision with endoscopic knife along the inner border of the surgical staple line. At the end of the procedure, the standard colonoscope was able to pass freely through the widened opening. All patients showed improved AS after a single session of RIC without immediate or delayed procedure-related complications. Follow-up colonoscopy at 7 and 8 mo after endoscopic RIC revealed intact anastomotic sites in both patients. No treatment-related adverse events or recurrence of the stenosis was demonstrated during follow-up periods of 20 and 23 mo.
CONCLUSION The endoscopic RIC may play a role as one of treatment options for treatment-naive AS with short stenotic lengths.
Collapse
Affiliation(s)
- Taek-Gu Lee
- Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju-si 28644, Chungcheongbuk-do, South Korea
| | - Soon Man Yoon
- Department of Internal medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju-si 28644, Chungcheongbuk-do, South Korea
| | - Sang-Jeon Lee
- Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju-si 28644, Chungcheongbuk-do, South Korea
| |
Collapse
|
11
|
Lee TG, Yoon SM, Kim MJ. Successful treatment of basaloid squamous cell carcinoma in the rectosigmoid colon: A case report and review of literature. World J Clin Cases 2020; 8:3057-3063. [PMID: 32775387 PMCID: PMC7385607 DOI: 10.12998/wjcc.v8.i14.3057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/30/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Compared with colorectal adenocarcinoma, basaloid squamous cell carcinomas (BSCCs) arising in the colorectum are rare and have very poor prognosis. To date, only nine cases have been reported. Most BSCCs are extensively involved in metastasis to the lymph node, liver, and lung at diagnosis. Despite many clinicians attempting to effectively treat BSCCs, therapeutic consensus has not been established due to lack of information.
CASE SUMMARY A 58-year-old woman presented with abdominal pain, diarrhea, fever, and hematochezia. She was referred from a department of gynecology and was diagnosed with a suspicious leiomyosarcoma of the rectum or a pedunculated myoma of the uterus. An exophytic growing mass at the right lateral wall of the rectum with an internal cystic portion and hemorrhage was observed on magnetic resonance imaging. The patient underwent low anterior resection and total hysterectomy with bilateral salphingo-oophorectomy. Histopathological findings revealed a cellular mass with a solid growth pattern and few glandular structures, many foci of intratumoral necrosis, and a palisading pattern. The pathologist diagnosed tumor as a BSCC, and the patient received chemotherapy with fluorouracil/leucovorin without radiotherapy. The patient is currently alive 8 years after the surgery with no manifestations of metastatic colon cancer.
CONCLUSION Our case suggest that curative resection and chemotherapy play important roles in improving survival, and radiotherapy may be an option to avoid radiation-associated enteritis.
Collapse
Affiliation(s)
- Taek-Gu Lee
- Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, South Korea
| | - Soon Man Yoon
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, South Korea
| | - Myung Jo Kim
- Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, South Korea
| |
Collapse
|
12
|
Lee TG, Son SM, Kim MJ, Lee SJ. Penile metastasis in rectal cancer with pathologic complete response after neoadjuvant chemoradiotherapy: The first case report and literature review. Medicine (Baltimore) 2020; 99:e21215. [PMID: 32702890 PMCID: PMC7373531 DOI: 10.1097/md.0000000000021215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
RATIONALE Penile metastasis in rectal cancer is very rare and often originates from prostatic or bladder cancer. The prognosis of penile metastasis is poor and its treatments are more often palliative than curative due to association with disseminated metastases. Pathologic complete response (pCR) in rectal cancer with neoadjuvant chemoradiotherapy (CRT) has been shown to be surrogate marker of favorable long-term outcomes and currently has no report of penile metastasis. Here, we first report isolated penile metastasis in rectal cancer with pCR after neoadjuvant CRT. PATIENT CONCERN The patient was a 74-year-old male with metastasis to the glans penis from rectal cancer diagnosed 9 months after abdominoperineal resection. Physical examination revealed palpable multiple nodules on the glans penis. DIAGNOSIS Penile biopsy revealed metastatic carcinoma from the rectal cancer. INTERVENTION Chemotherapy was started as soon as possible, because patient suffered urinary discomfort by rapid growing metastatic lesions. He is currently receiving palliative chemotherapy with modified FOLFOX-6 (mFOLFOX-6; oxaliplatin with 5-fluorouracil and folinic acid) plus bevacizumab. OUTCOME The patient is still alive 4 months after diagnosis with markedly decreased metastatic lesions. LESSON We propose that although penile metastasis in rectal cancer with pCR after preoperative neoadjuvant CRT is extremely rare, it might help to start early palliative chemotherapy and clinicians should be aware of this possibility.
Collapse
Affiliation(s)
| | - Seung-Myoung Son
- Department of Pathology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | | | | |
Collapse
|
13
|
Hwang HJ, Lee TG. Primary mesh repair of traumatic Spigelian hernia resulting from a fall: A case report. Asian J Surg 2020; 43:924-925. [PMID: 32532682 DOI: 10.1016/j.asjsur.2020.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/07/2020] [Indexed: 10/24/2022] Open
Affiliation(s)
- Hui-Jeong Hwang
- Department of Internal Medicine, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - Taek-Gu Lee
- Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, South Korea.
| |
Collapse
|
14
|
Abstract
INTRODUCTION Appendectomy is one of the most common emergency surgical operations. Stump appendicitis is a rare complication after appendectomy and is caused by acute inflammation of the remnant part of the appendix. Because of the low index of suspicion owing to a previous history of appendectomy, the diagnosis of stump appendicitis is often delayed. METHODS Between January 2008 and December 2017, 6 patients were diagnosed with stump appendicitis with or without perforation at a single institution. They had undergone operative management with laparoscopic approach. The clinical data of these patients were retrospectively analyzed by reviewing the medical records and pathologic reports. RESULTS Five patients were male, with a mean age of 42.4 years (range 11-77 years). The time interval after initial appendectomy ranged from 2 weeks to 30 years. Three patients underwent laparoscopic completion appendectomy, and the others underwent laparoscopic ileocecectomy. The mean hospital stay was 9 days (range 5-13 days). There were no cases of open conversion. CONCLUSIONS Stump appendicitis is a rare complication after appendectomy. A laparoscopic procedure can be performed for management of stump appendicitis with or without perforation.
Collapse
Affiliation(s)
- Hanlim Choi
- Department of Surgery, Chungbuk National University Hospital
- Department of Surgery, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Young Jin Choi
- Department of Surgery, Chungbuk National University Hospital
- Department of Surgery, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Taek-Gu Lee
- Department of Surgery, Chungbuk National University Hospital
- Department of Surgery, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Dae Hoon Kim
- Department of Surgery, Chungbuk National University Hospital
- Department of Surgery, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jae-Woon Choi
- Department of Surgery, Chungbuk National University Hospital
- Department of Surgery, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Dong Hee Ryu
- Department of Surgery, Chungbuk National University Hospital
- Department of Surgery, Chungbuk National University College of Medicine, Cheongju, Korea
| |
Collapse
|
15
|
Abstract
Objective The aim of this study was to identify clinicopathological factors that affect the number of lymph nodes (LNs) (12 or more) retrieved from patients with colorectal cancer (CRC), particularly those with pathologic T1 (pT1) disease. Methods From 429 CRC patients, 75 pT1 cancers were identified and digitally scanned. Binary logistic regression analysis was performed to identify the clinicopathological factors affecting the number of LNs retrieved from all 429 patients and from the subset of patients with pT1 CRC. Results For the 429 patients, the mean number of harvested LNs per specimen was 20 (median, 19). The number of retrieved LNs was independently associated with maximum tumor diameter > 2.3 cm and right-sided tumor location. The mean number of LNs retrieved from the 75 patients with pT1 CRC was 14 (median, 15); retrieval of 12 or more LNs from this group was independently associated with maximum tumor diameter > 14.1 mm. Conclusion The number of LNs retrieved from patients with CRC was associated with maximum tumor diameter and right-sided tumor location. For patients with pT1 CRC, maximum tumor diameter was independently associated with the harvesting of 12 or more LNs.
Collapse
Affiliation(s)
- Seung-Myoung Son
- Department of Pathology, Chungbuk National University Hospital, Cheongju, Republic of Korea.,Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Chang Gok Woo
- Department of Pathology, Chungbuk National University Hospital, Cheongju, Republic of Korea.,Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Ok-Jun Lee
- Department of Pathology, Chungbuk National University Hospital, Cheongju, Republic of Korea.,Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Sang-Jeon Lee
- Department of Surgery, Chungbuk National University Hospital, Cheongju, Republic of Korea.,Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Taek-Gu Lee
- Department of Surgery, Chungbuk National University Hospital, Cheongju, Republic of Korea.,Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Ho-Chang Lee
- Department of Pathology, Chungbuk National University Hospital, Cheongju, Republic of Korea.,Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| |
Collapse
|
16
|
Kim JJ, Park SS, Lee TG, Lee HC, Lee SJ. Large Cell Neuroendocrine Carcinoma of the Colon With Carcinomatosis Peritonei. Ann Coloproctol 2018; 34:222-225. [PMID: 30048995 PMCID: PMC6140363 DOI: 10.3393/ac.2018.02.27] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 02/27/2018] [Indexed: 02/07/2023] Open
Abstract
Colorectal large-cell neuroendocrine carcinomas (NECs) are extremely rare and have very poor prognosis compared to adenocarcinomas. A 74-year-old man presented with abdominal pain, diarrhea and hematochezia. The histopathologic report of colonoscopic biopsy performed at a local clinic was a poorly differentiated carcinoma. An abdominopelvic computed scan revealed irregularly enhanced wall thickening at the sigmoid colon with regional fat stranding and lymphnode enlargement. He underwent a laparoscopic high anterior resection with selective peritonectomy for peritoneal carcinomatosis, intraoperative peritoneal irrigation chemotherapy, and early postoperative intraperitoneal chemotherapy for 5 days. The tumor had a high proliferation rate (mitotic count > 50/10 HPFs and 90% of the Ki-67 index) and lymph-node metastases had occurred. On immunohistochemistry, the tumor cells expressed CD56 and synaptophysin. Large-cell NEC was confirmed. Systemic chemotherapy with cisplatin/etoposide was done. The patient is still alive after 3 years with no evidence of recurrence.
Collapse
Affiliation(s)
- Jang Jin Kim
- Department of Surgery, Chungbuk National University Hospital, Cheongju, Korea
| | - Sung Su Park
- Department of Surgery, Chungbuk National University Hospital, Cheongju, Korea
| | - Taek-Gu Lee
- Department of Surgery, Chungbuk National University Hospital, Cheongju, Korea
| | - Ho-Chang Lee
- Department of Pathology, College of Medicine, Chungbuk National University, Cheongju, Korea.,Department of Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Sang-Jeon Lee
- Department of Surgery, Chungbuk National University Hospital, Cheongju, Korea.,Department of Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea
| |
Collapse
|
17
|
Lee JY, Yoon SM, Kim JT, Kim KB, Kim MJ, Park JG, Lee TG, Lee SJ, Koong SS, Han JH, Chae HB, Park SM, Youn SJ. Diagnostic and prognostic value of preoperative 18F-fluorodeoxyglucose positron emission tomography/computed tomography for colorectal cancer: comparison with conventional computed tomography. Intest Res 2017; 15:208-214. [PMID: 28522951 PMCID: PMC5430013 DOI: 10.5217/ir.2017.15.2.208] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 08/14/2016] [Accepted: 09/21/2016] [Indexed: 01/27/2023] Open
Abstract
Background/Aims 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) has been used for preoperative staging of colorectal cancer (CRC). However, the diagnostic accuracy of FDG-PET/CT for detection of lymph node or distant metastasis and its prognostic role have not been well established. We therefore evaluated the diagnostic and prognostic value of FDG-PET/CT in comparison with conventional CT for CRC. Methods We investigated 220 patients who underwent preoperative FDG-PET/CT and CT, followed by curative surgery for CRC. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG-PET/CT and CT for detection of lymph node metastasis and distant metastasis were evaluated. In addition, we assessed the findings of FDG-PET/CT and CT according to outcomes, including cancer recurrence and cancer-related death, for evaluation of prognostic value. Results For detection of lymph node metastasis, FDG-PET/CT had a sensitivity of 44%, a specificity of 84%, and an accuracy of 67%, compared with 59%, 65%, and 62%, respectively, for CT (P=0.029, P=0.000, and P=0.022). For distant metastasis, FDG-PET/CT had a sensitivity of 79%, a specificity of 94%, and an accuracy of 93%, compared with 79%, 87%, and 86%, respectively, for CT (P=1.000, P=0.004, and P=0.037). In addition, positive findings of lymph node metastasis and distant metastasis on FDG-PET/CT were associated significantly with cancer recurrence or cancer-related death (P=0.009, P=0.001, respectively). Conclusions Preoperative FDG-PET/CT had a higher specificity and accuracy compared to CT for detection of lymph node metastasis and distant metastasis of CRC. In addition, FDG-PET/CT could be a valuable prognostic tool for CRC.
Collapse
Affiliation(s)
- Joo Young Lee
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Soon Man Yoon
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jeong Tae Kim
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Ki Bae Kim
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Mi Jin Kim
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jae Geun Park
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Taek-Gu Lee
- Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Sang-Jeon Lee
- Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Sung Soo Koong
- Department of Nuclear Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Joung-Ho Han
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hee Bok Chae
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Seon Mee Park
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Sei Jin Youn
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| |
Collapse
|
18
|
Yoon T, Shin DM, Kim S, Lee S, Lee TG, Kim K. Precise observation of C. elegans dynamic behaviours under controlled thermal stimulus using a mobile phone-based microscope. J Microsc 2017; 266:28-34. [PMID: 28066886 DOI: 10.1111/jmi.12513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 07/11/2016] [Revised: 10/05/2016] [Accepted: 11/17/2016] [Indexed: 11/30/2022]
Abstract
We investigated the temperature-dependent locomotion of Caenorhabditis elegans by using the mobile phone-based microscope. We developed the customized imaging system with mini incubator and smartphone to effectively control the thermal stimulation for precisely observing the temperature-dependent locomotory behaviours of C. elegans. Using the mobile phone-based microscope, we successfully followed the long-term progress of specimens of C. elegans in real time as they hatched and explored their temperature-dependent locomotory behaviour. We are convinced that the mobile phone-based microscope is a useful device for real time and long-term observations of biological samples during incubation, and can make it possible to carry out live observations via wireless communications regardless of location. In addition, this microscope has the potential for widespread use owing to its low cost and compact design.
Collapse
Affiliation(s)
- T Yoon
- Department of Cogno-Mechatronics Engineering, Pusan National University, Busan, Republic of Korea
| | - D-M Shin
- Research Center for Energy Convergence Technology, Pusan National University (PNU), Busan, Republic of Korea
| | - S Kim
- Department of Optics and Mechatronics Engineering, Pusan National University, Busan, Republic of Korea
| | - S Lee
- Department of Cogno-Mechatronics Engineering, Pusan National University, Busan, Republic of Korea
| | - T G Lee
- Department of Design, Pusan National University, Busan, Republic of Korea
| | - K Kim
- Department of Cogno-Mechatronics Engineering, Pusan National University, Busan, Republic of Korea.,Department of Optics and Mechatronics Engineering, Pusan National University, Busan, Republic of Korea
| |
Collapse
|
19
|
Kim HS, Cho HJ, Yoo SG, Kim JH, Han JI, Lee TG, Kim JW. Intravitreal anti-vascular endothelial growth factor monotherapy for large submacular hemorrhage secondary to neovascular age-related macular degeneration. Eye (Lond) 2015; 29:1141-51. [PMID: 26272443 DOI: 10.1038/eye.2015.131] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 04/17/2015] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To evaluate the efficacy of anti-vascular endothelial growth factor (VEGF) monotherapy for large submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD). METHODS A total of 49 treatment-naive patients (49 eyes) with large SMH (more than five disc areas (DAs)) secondary to nAMD were retrospectively included. All patients were treated with an initial series of 3 monthly intravitreal anti-VEGF injections, followed by as-needed injections. At the 12-month follow-up, changes in best-corrected visual acuity (BCVA), hemorrhage area, central foveal thickness, and development of vitreous hemorrhage after treatment were evaluated. RESULTS The mean SMH area was 13.9 ± 8.8 disk areas (DAs) and mean symptom duration was 7.25 ± 5.9 days at baseline. The mean number of injections was 4.49 ± 1.61. Twelve months after treatment, the mean BCVA significantly improved from 1.14 ± 0.61 logarithm of the minimum angle of resolution (logMAR; 20/276, Snellen equivalent) to 0.82 ± 0.53 logMAR (20/132; P = 0.002). Twenty-four eyes (49%) showed improvement of more than three lines of BCVA at 12 months after treatment. Baseline BCVA (odds ratio (OR), 5.119; 95% confidence interval (CI), 1.993-9.545; P = 0.004), duration of symptoms (OR, 0.727; 95% CI, 0.332-0.952; P = 0.024), hemorrhage area (OR, 0.892; 95% CI, 0.721-0.965; P = 0.011), and baseline central foveal thickness (OR, 0.881; 95% CI, 0.722-0.945; P = 0.032) were significantly associated with good visual acuity 12 months after treatment. CONCLUSIONS Intravitreal anti-VEGF monotherapy is a valuable treatment option for large SMH secondary to nAMD.
Collapse
Affiliation(s)
- H S Kim
- Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine, Seoul, South Korea
| | - H J Cho
- Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine, Seoul, South Korea
| | - S G Yoo
- Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine, Seoul, South Korea
| | - J H Kim
- Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine, Seoul, South Korea
| | - J I Han
- Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine, Seoul, South Korea
| | - T G Lee
- Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine, Seoul, South Korea
| | - J W Kim
- Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine, Seoul, South Korea
| |
Collapse
|
20
|
Yoon SM, Lee TG, Han JH, Chae HB, Park SM, Youn SJ, Lee SJ. Endoscopic treatment using a knife to correct complete anastomotic obstruction following rectal cancer surgery. Endoscopy 2014; 46 Suppl 1 UCTN:E145-6. [PMID: 24756266 DOI: 10.1055/s-0034-1364949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Soon Man Yoon
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Taek-Gu Lee
- Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Joung Ho Han
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hee Bok Chae
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Seon Mee Park
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Sei Jin Youn
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Sang-Jeon Lee
- Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| |
Collapse
|
21
|
Abstract
A perineal hernia (PH) is formed by a protrusion of intra-abdominal viscera through a defect in the pelvic floor. This is a rare complication after a conventional abdominoperineal resection (APR). However, the risk of a PH may be increased after a laparoscopic resection because this technique can cause fewer postoperative adhesions, predisposing the small bowel to sliding down toward the pelvis. However, only a few case reports describe the transperineal approach for the repair of a PH after a laparoscopic APR. We present a case of a PH after a laparoscopic APR; the PH was repaired with synthetic mesh by using a transperineal approach. A transperineal approach using a mesh to reconstruct the pelvic floor is less invasive and more effective. We suggest that this technique should probably be the first choice for treating an uncomplicated PH that occurs after a laparoscopic APR.
Collapse
Affiliation(s)
- Taek-Gu Lee
- Department of Surgery, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Sang-Jeon Lee
- Department of Surgery, Chungbuk National University College of Medicine, Cheongju, Korea
| |
Collapse
|
22
|
Choi SY, Sung R, Lee SJ, Lee TG, Kim N, Yoon SM, Lee EJ, Chae HB, Youn SJ, Park SM. Podoplanin, α-smooth muscle actin or S100A4 expressing cancer-associated fibroblasts are associated with different prognosis in colorectal cancers. J Korean Med Sci 2013; 28:1293-301. [PMID: 24015033 PMCID: PMC3763102 DOI: 10.3346/jkms.2013.28.9.1293] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 06/18/2013] [Indexed: 01/09/2023] Open
Abstract
The interactions between the tumor microenvironment and tumor cells determine the behavior of the primary tumors. Whether cancer-associated fibroblasts (CAF) have a tumor progressive or a protective role likely depends on the type of tumor cells and the CAF subpopulation. In the present study, we analyzed the prognostic significance of CAF subpopulations in colorectal cancer (CRC). CAF phenotypes were analyzed in 302 CRC patients by using antibodies against podoplanin (PDPN), α-smooth muscle actin (α-SMA), and S100A4. The relationship between the CAF phenotypes and 11 clinicopathological parameters were evaluated and their prognostic significance was analyzed from the disease-free and overall survival times. We observed that at the tumor invasive front, PDPN CAFs were present in 40% of the cases, and S100A4 or α-SMA CAFs were detected in all the cases. PDPN/S100A4 and α-SMA/S100A4 dual-stained CAFs were observed in 10% and 40% of the cases, respectively. The PDPN(+) CAFs were associated with 6 favorable clinicopathological parameters and prolonged disease-free survival time. The PDPN(-)/α-SMA(high) CAFs were associated with 6 aggressive clinicopathological parameters and tended to exhibit shorter disease-free survival time. On the other hand, the PDPN(-)/S100A4(high) CAFs were associated with 2 tumor progression parameters, but not with disease prognosis. The PDPN(+) CAF phenotype is distinct from the α-SMA or S100A4 CAFs in that it is associated with less aggressive tumors and a favorable prognosis, whereas the PDPN(-)/α-SMA(high) or PDPN(-)/S100A4(high) CAFs are associated with tumor progression in CRC. These findings suggest that CAFs can be a useful prognostic biomarker or potential targets of anti-cancer therapy in CRC.
Collapse
Affiliation(s)
- Song-Yi Choi
- Department of Pathology, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Rohyun Sung
- Department of Pathology, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Sang-Jeon Lee
- Department of Surgery, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Taek-Gu Lee
- Department of Surgery, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Nayoung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Soon Man Yoon
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Eun Jeoung Lee
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hee Bok Chae
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Sei Jin Youn
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Seon Mee Park
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| |
Collapse
|
23
|
Seo SH, Park J, Wi HM, Lee WR, Kim HS, Lee TG, Kim YS, Kang JS, Bog MG, Yokota Y, Mase A. Development of frequency modulation reflectometer for Korea Superconducting Tokamak Advanced Research tokamak. Rev Sci Instrum 2013; 84:084702. [PMID: 24007083 DOI: 10.1063/1.4817305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Frequency modulation reflectometer has been developed to measure the plasma density profile of the Korea Superconducting Tokamak Advanced Research tokamak. Three reflectometers are operating in extraordinary polarization mode in the frequency range of Q band (33.6-54 GHz), V band (48-72 GHz), and W band (72-108 GHz) to measure the density up to 7 × 10(19) m(-3) when the toroidal magnetic field is 2 T on axis. The antenna is installed inside of the vacuum vessel. A new vacuum window is developed by using 50 μm thick mica film and 0.1 mm thick gold gasket. The filter bank of low pass filter, notch filter, and Faraday isolator is used to reject the electron cyclotron heating high power at attenuation of 60 dB. The full frequency band is swept in 20 μs. The mixer output is directly digitized with sampling rate of 100 MSamples/s. The phase is obtained by using wavelet transform. The whole hardware and software system is described in detail and the measured density profile is presented as a result.
Collapse
Affiliation(s)
- Seong-Heon Seo
- National Fusion Research Institute, Daejeon 305-333, South Korea
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Lee SJ, Choi SY, Kim WJ, Ji M, Lee TG, Son BR, Yoon SM, Sung R, Lee EJ, Youn SJ, Park SM. Combined aberrant expression of E-cadherin and S100A4, but not β-catenin is associated with disease-free survival and overall survival in colorectal cancer patients. Diagn Pathol 2013; 8:99. [PMID: 23783026 PMCID: PMC3728147 DOI: 10.1186/1746-1596-8-99] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 05/21/2013] [Indexed: 12/22/2022] Open
Abstract
Background/Aims Epithelial-to-mesenchymal transition (EMT) in cancers is related to metastasis, recurrence, and poor prognosis. We evaluated whether EMT-related proteins can act as prognostic biomarkers in colorectal cancer (CRC) patients. Methods We evaluated the expression of E-cadherin, β-catenin, and S100A4 by immunohistochemistry (IHC) in 333 CRC tissues from the tumor center and invasive margin. Tumor budding, cell grade, tumor stage, type of tumor growth, peritumoral lymphocyte infiltration (TLI), and perineural- or lymphovascular invasion were evaluated as pathological parameters. mRNA levels of E-cadherin, N-cadherin, β-catenin, and S100A4 from 68 specimens from the same set were analyzed by real time quantitative RT-PCR. Results Loss of E-cadherin, nuclear β-catenin, and gain of S100A4 were higher in the invasive margin than in the tumor center. Loss of E-cadherin was associated with cell grade, macroscopic type, perineural invasion, and tumor budding, β-catenin with microsatellite instability and tumor site, and S100A4 with growth type, macroscopic type, AJCC stage, lymphovascular invasion, and perineural invasion. The aberrant expression of E-cadherin and S100A4 not β-catenin in the invasive margin was a significant and independent risk factor for disease-free and overall-survival by multivariate analysis, along with AJCC stage and perineural invasion. mRNA levels of β-catenin and S100A4 were correlated with the IHC findings at the tumor invasive margin. E-cadherin and N-cadherin showed a weak inverse correlation. Conclusions The combination of loss of E-cadherin and gain of S100A4 in the tumor invasive margin can be used to stratify patients with the same AJCC stage into different survival groups. Virtual slides The virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9398289629244673
Collapse
Affiliation(s)
- Sang-Jeon Lee
- Department of Surgery, Chungbuk National University College of Medicine and Medical Research Institute, Cheongju, Chungbuk 361-763, Republic of Korea
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Lee SM, Kang SB, Jang JH, Park JS, Hong S, Lee TG, Ahn S. Early rehabilitation versus conventional care after laparoscopic rectal surgery: a prospective, randomized, controlled trial. Surg Endosc 2013; 27:3902-9. [PMID: 23708720 DOI: 10.1007/s00464-013-3006-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2012] [Accepted: 04/29/2013] [Indexed: 12/31/2022]
Abstract
BACKGROUND Although early rehabilitation programs have been reported to be effective after laparoscopic colectomy, there is no report of the efficacy of rehabilitation programs after rectal cancer surgery. This study was designed to evaluate the efficacy of an early rehabilitation program after laparoscopic low anterior resection for mid or low rectal cancer in a randomized, controlled trial. METHODS Ninety-eight patients who had undergone a laparoscopic low anterior resection with defunctioning ileostomy were randomized on a 1:1 basis to an early rehabilitation program (n = 52) or conventional care (n = 46). The primary endpoint was recovery rate at 4 days postoperatively. The secondary endpoints were recovery time, postoperative hospital stay, complications, readmission rates, pain on a visual analogue scale, and quality of life (QOL) according to Short Form 36. RESULTS The recovery rates were not different in both groups (rehabilitation, 25 % vs. conventional, 13 %, p = 0.135). Recovery time and postoperative hospital stay was similar between the groups (rehabilitation, 137 h [107-188] vs. conventional, 146.5 h [115-183], p = 0.47; 7.5 days [7-11] vs. 8.0 days [7-10], p = 0.882). The complication rates did not differ between the two groups, but more complications were noted in the rehabilitation program group (42.3 vs. 24.0 %, p = 0.054), which was related to postoperative ileus (28.8 vs. 13.0 %, p = 0.057) and acute voiding difficulty (19.6 vs. 4.7 %, p = 0.032). There was no readmission within 1 month of surgery. Pain and QOL were similar in both groups. CONCLUSIONS This randomized trial did not show that an early rehabilitation program is beneficial after laparoscopic low anterior resection. Our results confirm that postoperative ileus and acute voiding difficulty are major obstacles to fast-track surgery for mid or low rectal cancer. This study was registered (registration number NCT00606944).
Collapse
Affiliation(s)
- Sung-Min Lee
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang, Seongnam, 463-707, South Korea
| | | | | | | | | | | | | |
Collapse
|
26
|
Abstract
Subcutaneous metastasis from colorectal cancer is an unusual presentation. Most perineal subcutaneous metastases are found in extensive involvements of multiorgan metastases or local recurrences of rectal cancer. Subcutaneous metastasis from colon cancer is considered as a distant metastasis with poor prognosis. We report an unusual case of solitary subcutaneous metastasis beneath the perineum without solid organ involvement after a curative anterior resection for sigmoid colon cancer. The patient underwent a perineal resection, and chemotherapy with the FOLFOX (fluorouracil, leucovorin, and oxaliplatin) regimen was instituted. Eight months later, multiple lung metastases were found, and chemotherapy was restarted with the FOLFIRI (fluorouracil, leucovorin, and irinotecan) regimen. However, lung metastases progressed, and new metastases appeared at the adrenal glands, the kidneys and the cerebellum. The patient died 30 months after the diagnosis of perineal subcutaneous metastasis. He lived relatively long in comparison with patients in previous reports.
Collapse
Affiliation(s)
- Taek-Gu Lee
- Department of Surgery, Chungbuk National University College of Medicine, Cheongju, Korea
| | | |
Collapse
|
27
|
Lee TG, Park SS, Lee SJ. Treatment of a recurrent rectourethral fistula by using transanal rectal flap advancement and fibrin glue: a case report. J Korean Soc Coloproctol 2012; 28:165-9. [PMID: 22816061 PMCID: PMC3398113 DOI: 10.3393/jksc.2012.28.3.165] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Accepted: 01/30/2012] [Indexed: 12/02/2022]
Abstract
Rectourethral fistulas (RUFs) in adults are rare and could result from complicated trauma, and prostatic or rectal surgery. RUFs have been treated initially by using primary repair and omental interposition with or without a colostomy during surgery. Recurrent RUFs require complex surgery, such as a low rectal resection and coloanal anastomosis, an interposition flap of the datos muscle or gracilis muscle, and others. Recently, transanal rectal flap advancement and fibrin glue injection have provided an effective occlusion of RUFs. However, no reports about this technique exist for cases of recurrent RUFs. We report a case of a recurrent RUF successfully repaired by using transanal rectal flap advancement combined with fibrin glue injection into the fistula tract. The postoperative course was uneventful without complications. At the 1-year follow-up, no complications such as urethral stricture or recurrence existed, and voiding was normal without anal incontinence.
Collapse
Affiliation(s)
- Taek-Gu Lee
- Department of Surgery, Chungbuk National University College of Medicine, Cheongju, Korea
| | | | | |
Collapse
|
28
|
Yi JW, Lee TG, Lee HS, Heo SC, Jeong SY, Park KJ, Kang SB. Apical-node metastasis in sigmoid colon or rectal cancer: is it a factor that indicates a poor prognosis after high ligation? Int J Colorectal Dis 2012; 27:81-7. [PMID: 21739197 DOI: 10.1007/s00384-011-1271-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/28/2011] [Indexed: 02/04/2023]
Abstract
PURPOSE The prognostic significance of apical-node metastasis around the inferior mesenteric artery (IMA) remains unclear. We investigated the oncological relevance of apical-node metastasis detected after high ligation of the IMA in stage III sigmoid colon or rectal cancer. METHODS Between May 2003 and December 2007, 229 consecutive patients with stage III sigmoid colon or rectal cancer, who had undergone curative resection with high ligation, were analyzed. Cox proportional regression model was used to identify the prognostic factors for disease-free survival. RESULTS Thirty-one patients (13.5%) had apical-node metastases: 0% with T0-1, 3.8% with T2, 11.5% with T3, and 29.3% with T4 disease (p = 0.017). Additionally, the factors related to apical-node metastasis were tumor size, number of metastatic lymph nodes, lymph-node ratio, and N-stage. Multivariate analysis showed that the lymph-node ratio (odds ratio (OR) = 40.53, 95% confidence interval (CI) = 8.41-195.22, p < 0.001) was an independent prognostic factor for disease-free survival but that apical-node metastasis was not a factor that predicted a poor outcome (OR = 1.53, 95% CI = 0.81-2.91, p = 0.192). Apical-node metastasis was not a prognostic factor for disease-free survival on multivariate analysis of the subgroups based on tumor location (sigmoid colon cancer: OR = 1.42, 95% CI = 0.42-1.82, p = 0.577; rectal cancer: OR = 1.82, 95% CI = 0.82-4.06, p = 0.141). CONCLUSIONS This study suggests that apical-node metastasis is not a poor prognostic factor for stage III sigmoid colon or rectal cancer after high ligation.
Collapse
Affiliation(s)
- Jin-Wook Yi
- Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, 463-707, Republic of Korea
| | | | | | | | | | | | | |
Collapse
|
29
|
Eun LY, Song H, Choi E, Lee TG, Moon DW, Hwang D, Byun KH, Sul JH, Hwang KC. Implanted bone marrow-derived mesenchymal stem cells fail to metabolically stabilize or recover electromechanical function in infarcted hearts. Tissue Cell 2011; 43:238-45. [PMID: 21700305 DOI: 10.1016/j.tice.2011.04.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Revised: 04/26/2011] [Accepted: 04/27/2011] [Indexed: 11/27/2022]
Abstract
Mesenchymal stem cells (MSCs) have been used with success in several clinical applications for clinical treatment of ischemic hearts. However, the reported effects of MSC-based therapy on myocardial infarction (MI) are inconsistent. In particular, the preventive effects of MSC-based therapy on arrhythmic sudden death and metabolic disorders after infarction remain controversial. Here, we investigated the effects of MSCs on reverse remodeling in an infarcted myocardium, and found that MSC-therapy failed to achieve the complete regeneration of infarcted myocardium. Histological analyses showed that although infarct size and interstitial fibrosis induced by MI recovered significantly after MSC treatment, these improvements were marginal, indicating that a significant amount of damaged tissue was still present. Furthermore, transplanted MSCs had slight anti-apoptotic and anti-inflammatory effects in MSC-implanted regions and no significant improvements in cardiac function were observed, suggesting that naïve MSCs might not be the right cell type to treat myocardial infarction. Furthermore, small ion profiling using ToF-SIMS revealed that the metabolic stabilization provided by the MSCs implantation was not significant compared to the sham group. Together, these results indicate that pretreatment of MSCs is needed to enhance the benefits of MSCs, particularly when MSCs are used to treat arrhythmogenicity and metabolically stabilize infarcted myocardium.
Collapse
Affiliation(s)
- L Y Eun
- Yonsei University Graduate School of Medicine, Seoul 120-752, Republic of Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Yang HY, Sun WY, Lee TG, Lee SJ. A case of colovesical fistula induced by sigmoid diverticulitis. J Korean Soc Coloproctol 2011; 27:94-8. [PMID: 21602969 PMCID: PMC3092082 DOI: 10.3393/jksc.2011.27.2.94] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Accepted: 03/10/2011] [Indexed: 12/05/2022]
Abstract
Colonic diverticulosis has continuously increased, noticeably left-sided diseases, in Korea. A colovesical fistula is an uncommon complication of diverticulitis, and its most common cause is diverticular disease. Confirmation of its presence generally depends on clinical findings, such as pneumaturia and fecaluria. The primary aim of a diagnostic workup is not to observe the fistular tract itself but to find the etiology of the disease so that an appropriate therapy can be initiated. We present here the case of a 79-year-old man complaining of pneumaturia and fecaluria. On abdomen and pelvis CT, the patient was diagnosed as having a colovesical fistula due to sigmoid diverticulitis. After division of the adhesion between the sigmoid colon and the bladder, the defect of the bladder wall was repaired by simple closure. The colonic defect was treated with a segmental resection, including the rectosigmoid junction. The patient is doing well at 6 months after the operation and shows no evidence of recurrence of the fistula.
Collapse
Affiliation(s)
- Hwa-Yeon Yang
- Department of Surgery, Chungbuk National University College of Medicine, Cheongju, Korea
| | | | | | | |
Collapse
|
31
|
Lee TG, Kang SB, Heo SC, Jeong SY, Park KJ. Risk Factors for Persistent Anal Incontinence After Restorative Proctectomy in Rectal Cancer Patients with Anal Incontinence: Prospective Cohort Study. World J Surg 2011; 35:1918-24. [PMID: 21519972 DOI: 10.1007/s00268-011-1116-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Taek-Gu Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, Gyeonggi-do 463-707, Republic of Korea
| | | | | | | | | |
Collapse
|
32
|
Lee TG, Kang SB, Kim DW, Hong S, Heo SC, Park KJ. Comparison of early mobilization and diet rehabilitation program with conventional care after laparoscopic colon surgery: a prospective randomized controlled trial. Dis Colon Rectum 2011; 54:21-8. [PMID: 21160309 DOI: 10.1007/dcr.0b013e3181fcdb3e] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE Although laparoscopic surgery may permit earlier recovery compared with open surgery, no published randomized controlled trial has investigated the benefit of a multimodal rehabilitation program after laparoscopic colonic resection. This study aimed to evaluate the efficacy of a rehabilitation program after laparoscopic colon surgery in the context of a randomized controlled trial. METHODS Between September 2007 and October 2009, 100 patients who had received laparoscopic colon surgery were selected for the study and randomly assigned on a 1:1 basis to a rehabilitation program group with early mobilization and diet (n = 46) or conventional care group (n = 54). The rehabilitation program group received early oral feeding, early ambulation, and regular laxative. The primary outcome was recovery time, measured with criteria of tolerable diet for 24 hours, safe ambulation, analgesic-free, and afebrile status without major complications. Secondary outcomes were postoperative hospital stay, complications, quality of life by Short Form 36, pain by visual analog scale, and readmission. This study was registered (ID number NCT00606944, http://register.clinicaltrials.gov). RESULTS Recovery time was shorter in the rehabilitation program group than in the conventional care group (median (interquartile range), 4 (3-5) d vs 6 (5-7) d, respectively; P < .0001). There was no difference in postoperative hospital stay between the 2 groups (rehabilitation program group, 7 (6-8) d vs conventional care group, 8 (7-9) d; P = .065). There was no difference in complication rates between the rehabilitation program group and conventional care group (10.9% vs 20.4%, respectively; P = .136). Quality of life and pain were similar in both groups. There were no readmissions or mortality. CONCLUSIONS A rehabilitation program with early mobilization and diet after laparoscopic colon surgery results in reduced recovery time without increased complications. These results suggest that a multimodal rehabilitation program may increase the short-term benefits after laparoscopic colon surgery.
Collapse
Affiliation(s)
- Taek-Gu Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | | | | | | | | | | |
Collapse
|
33
|
Kang SB, Park JW, Jeong SY, Nam BH, Choi HS, Kim DW, Lim SB, Lee TG, Kim DY, Kim JS, Chang HJ, Lee HS, Kim SY, Jung KH, Hong YS, Kim JH, Sohn DK, Kim DH, Oh JH. Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): short-term outcomes of an open-label randomised controlled trial. Lancet Oncol 2010; 11:637-45. [PMID: 20610322 DOI: 10.1016/s1470-2045(10)70131-5] [Citation(s) in RCA: 682] [Impact Index Per Article: 48.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The safety and short-term efficacy of laparoscopic surgery for rectal cancer after preoperative chemoradiotherapy has not been demonstrated. The aim of the randomised Comparison of Open versus laparoscopic surgery for mid and low REctal cancer After Neoadjuvant chemoradiotherapy (COREAN) trial was to compare open surgery with laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy. METHODS Between April 4, 2006, and Aug 26, 2009, patients with cT3N0-2 mid or low rectal cancer without distant metastasis after preoperative chemoradiotherapy were enrolled at three tertiary-referral hospitals. Patients were randomised 1:1 to receive either open surgery (n=170) or laparoscopic surgery (n=170), stratified according to sex and preoperative chemotherapy regimen. Short-term outcomes assessed were involvement of the circumferential resection margin, macroscopic quality of the total mesorectal excision specimen, number of harvested lymph nodes, recovery of bowel function, perioperative morbidity, postoperative pain, and quality of life. Analyses were based on the intention-to-treat population. Patients continue to be followed up for the primary outcome (3-year disease-free survival). This study is registered with ClinicalTrials.gov, number NCT00470951. FINDINGS Two patients (1.2%) in the laparoscopic group were converted to open surgery, but were included in the laparoscopic group for analyses. Estimated blood loss was less in the laparoscopic group than in the open group (median 217.5 mL [150.0-400.0] in the open group vs 200.0 mL [100.0-300.0] in the laparoscopic group, p=0.006), although surgery time was longer in the laparoscopic group (mean 244.9 min [SD 75.4] vs 197.0 min [62.9], p<0.0001). Involvement of the circumferential resection margin, macroscopic quality of the total mesorectal excision specimen, number of harvested lymph nodes, and perioperative morbidity did not differ between the two groups. The laparoscopic surgery group showed earlier recovery of bowel function than the open surgery group (time to pass first flatus, median 38.5 h [23.0-53.0] vs 60.0 h [43.0-73.0], p<0.0001; time to resume a normal diet, 85.0 h [66.0-95.0] vs 93.0 h [86.0-121.0], p<0.0001; time to first defecation, 96.5 h [70.0-125.0] vs 123 h [94.0-156.0], p<0.0001). The total amount of morphine used was less in the laparoscopic group than in the open group (median 107.2 mg [80.0-150.0] vs 156.9 mg [117.0-185.2], p<0.0001). 3 months after proctectomy or ileostomy takedown, the laparoscopic group showed better physical functioning score than the open group (0.501 [n=122] vs -4.970 [n=128], p=0.0073), less fatigue (-5.659 [n=122] vs 0.098 [n=129], p=0.0206), and fewer micturition (-2.583 [n=122] vs 4.725 [n=129], p=0.0002), gastrointestinal (-0.400 [n=122] vs 4.331 [n=129], p=0.0102), and defecation problems (0.535 [n=103] vs 5.327 [n=99], p=0.0184) in repeated measures analysis of covariance, adjusted for baseline values. INTERPRETATION Laparoscopic surgery after preoperative chemoradiotherapy for mid or low rectal cancer is safe and has short-term benefits compared with open surgery; the quality of oncological resection was equivalent.
Collapse
Affiliation(s)
- Sung-Bum Kang
- Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Kang SB, Lee TG. Muscle Regeneration: Research for the Treatment of Fecal Incontinence. J Korean Soc Coloproctol 2010. [DOI: 10.3393/jksc.2010.26.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sung-Bum Kang
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Taek-Gu Lee
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| |
Collapse
|
35
|
Heo SC, Kang SB, Chung JK, Hwang KT, Seungbum R, Lee TG, Park KJ. Experiences on Obturator Hernia and Review of Korean Cases. J Korean Surg Soc 2010. [DOI: 10.4174/jkss.2010.78.1.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Seung Chul Heo
- Department of Surgery, Seoul National University College of Medicine, Korea
- Department of Surgery, Boramae Hospital, Seoul, Korea
| | - Sung-Bum Kang
- Department of Surgery, Seoul National University College of Medicine, Korea
- Department of Surgery, Bundang Seoul National University Hospital, Seongnam, Korea
| | - Jung Kee Chung
- Department of Surgery, Seoul National University College of Medicine, Korea
- Department of Surgery, Boramae Hospital, Seoul, Korea
| | - Ki-Tae Hwang
- Department of Surgery, Boramae Hospital, Seoul, Korea
| | - Ryoo Seungbum
- Department of Surgery, Seoul National University College of Medicine, Korea
- Department of Surgery, Seoul National University Hospital, Korea
| | - Taek-Gu Lee
- Department of Surgery, Bundang Seoul National University Hospital, Seongnam, Korea
| | - Kyu-Joo Park
- Department of Surgery, Seoul National University College of Medicine, Korea
- Department of Surgery, Seoul National University Hospital, Korea
| |
Collapse
|
36
|
Park SY, Kim KS, Lee TG, Park SS, Kim SM, Han W, Noh DY, Kim SW. The accuracy of preoperative core biopsy in determining histologic grade, hormone receptors, and human epidermal growth factor receptor 2 status in invasive breast cancer. Am J Surg 2009; 197:266-9. [PMID: 18614146 DOI: 10.1016/j.amjsurg.2007.11.024] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2007] [Revised: 11/02/2007] [Accepted: 11/02/2007] [Indexed: 11/19/2022]
Affiliation(s)
- So Yeon Park
- Department of Pathology, Seoul National University Bundang Hospital, Sungnamsi, Gyeonggido, Korea
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Choi YS, Lee SI, Lee TG, Kim SW, Cheon G, Kang SB. Economic outcomes of laparoscopic versus open surgery for colorectal cancer in Korea. Surg Today 2007; 37:127-32. [PMID: 17243031 DOI: 10.1007/s00595-006-3356-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2006] [Accepted: 07/17/2006] [Indexed: 01/02/2023]
Abstract
PURPOSE To compare the economic outcomes of laparoscopic surgery (LAP) with those of open surgery (OS) for colorectal cancer. METHODS We compared operating room (OR) costs, OR hospital-profits, total hospital charges, and payments made for 67 consecutive patients who underwent either OS (n = 41) or LAP (n = 26) for colorectal cancer. RESULTS The operating time was longer in the LAP group (P < 0.001), but the hospital stay was shorter (P < 0.001). OR costs were higher in the LAP group, which was primarily attributed to the higher costs of consumables (LAP 1441, OS 575 dollars; P < 0.001) and the longer operating time (LAP 215 min, OS 155 min; P < 0.001). Total hospital charges were also higher after LAP (LAP 5017 dollars, OS 4093 dollars; P < 0.001). Patients paid more after LAP (P < 0.001), but there was no significant difference between the two groups in National Health Insurance Corporation payments. CONCLUSION Laparoscopic surgery is less cost-effective than OS for colorectal cancer. The higher costs of consumables and the longer operating time associated with LAP must be addressed to make LAP more cost-effective.
Collapse
Affiliation(s)
- Yoo Shin Choi
- Department of Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Seongnam-si, Gyeonggi-do, 463-707, South Korea
| | | | | | | | | | | |
Collapse
|
38
|
Selvaraj M, Lee TG. Direct Synthesis of Well-Ordered and Unusually Reactive MnSBA-15 Mesoporous Molecular Sieves with High Manganese Content. J Phys Chem B 2006; 110:21793-802. [PMID: 17064142 DOI: 10.1021/jp063957i] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The mesoporous MnSBA-15 materials with different n(Si)/n(Mn) ratios of 4, 8, 20, and 50 have been synthesized, for the first time, using manganese nitrate tetrahydrate and Pluronic 123 triblock polymer [(EO)20(PO)70(EO)20] by simply adjusting the molar ratio of water to hydrochloric acid (n(H2O)/n(HCl)) under direct hydrothermal conditions. For the effect of structural and textural properties with incorporation of manganese, the MnSBA-15 has been synthesized with different synthesis temperatures at the fixed molar ratios of n(Si)/n(Mn) = 4 and n(H2O)/n(HCl) = 295 in the synthesis gel. The hydrothermal and thermal stabilities of MnSBA-15 have also been investigated. The calcined MnSBA-15 materials prepared have been characterized by ICP-AES, XRD, N2 adsorption, ESR, FE-SEM, and TEM. The ICP-AES studies show a higher amount of manganese incorporation on the silica pore walls, as MnSBA-15 with a n(Si)/n(Mn) ratio up to 2.2 can be successfully prepared at a fixed n(H2O)/n(HCl) molar ratio of 295 by adjusting the ratios of n(Si)/n(Mn) in the synthesis gel. The structural and textural properties of calcined MnSBA-15 prepared can be found by the results of XRD and N2 adsorption. The investigation of ESR results clearly describe the effect of structure and Mn species coordination on the SBA-15 silica pore walls while the uniform pore diameter and rope-like hexagonal mesoporous structure of MnSBA-15 can be identified by TEM and FE-SEM images. With increasing synthesis temperature, an increase the unit cell parameter, pore size, and pore volume and a decrease the specific surface area and pore wall thickness of MnSBA-15 can be obviously noted by the results of XRD and N2 adsorption. The hexagonal MnSBA-15 materials prepared could be tested as catalysts in epoxidation of trans-stilbene to produce trans-stilbene oxide under various optimal conditions while their catalytic properties could also be compared to the results of MnMCM-41 and ZrMnMCM-41.
Collapse
Affiliation(s)
- M Selvaraj
- Department of Chemical and Biomolecular Engineering, National University of Singapore, Singapore - 119260.
| | | |
Collapse
|
39
|
Choi YS, Han HS, Yoon YS, Lee TG, Jang JY, Kim SW, Park YH. Laparoscopic End-to-End Choledochocholedochostomy for Bile Duct Injury During Laparoscopic Cholecystectomy. J Laparoendosc Adv Surg Tech A 2006; 16:264-6. [PMID: 16796437 DOI: 10.1089/lap.2006.16.264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 12/13/2022] Open
Abstract
Bile duct injury is one of the serious complications associated with laparoscopic cholecystectomy. If the bile duct injury is circumferential or the bile duct is transected, conversion to open surgery is usually done. With the continuing development of laparoscopic techniques, procedures that previously seemed implausible can now be performed laparoscopically. We describe a case of successful laparoscopic end-to-end choledochocholedochostomy after the common bile duct was mistaken for the cystic duct intraoperatively and transected.
Collapse
Affiliation(s)
- Yoo-Shin Choi
- Department of Surgery, College of Medicine, Seoul National University, Seoul, Korea
| | | | | | | | | | | | | |
Collapse
|
40
|
Jeon YH, Heo YS, Kim CM, Hyun YL, Lee TG, Ro S, Cho JM. Phosphodiesterase: overview of protein structures, potential therapeutic applications and recent progress in drug development. Cell Mol Life Sci 2005; 62:1198-220. [PMID: 15798894 DOI: 10.1007/s00018-005-4533-5] [Citation(s) in RCA: 171] [Impact Index Per Article: 9.0] [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: 11/26/2022]
Abstract
Phosphodiesterases (PDEs) are essential regulators of cyclic nucleotide signaling with diverse physiological functions. Because of their great market potential and therapeutic importance, PDE inhibitors became recognized as important therapeutic agents in the treatment of various diseases. Currently, there are seven PDE inhibitors on the market, and the pharmacological and safety evaluations of many drug candidates are in progress. Three-dimensional (3D) structures of catalytic domains of PDE 1, -3, -4, -5 and -9 in the presence of their inhibitors are now available, and can be utilized for rational drug design. Recent advances in molecular pharmacology of PDE isoenzymes resulted in identification of new potential applications of PDE inhibitors in various therapeutic areas, including dementia, depression and schizophrenia. This review will describe the latest advances in PDE research on 3D structural studies, the potential of therapeutic applications and the development of drug candidates.
Collapse
Affiliation(s)
- Y H Jeon
- R and D Center, CrystalGenomics, 2nd Building of Asan Institute for Life Sciences, 388-1 Pungnap-2-dong, Songpa-Gu, Seoul 138-736, Korea
| | | | | | | | | | | | | |
Collapse
|
41
|
Yoon WH, Song IS, Lee BH, Jung YJ, Kim TD, Li G, Lee TG, Park HD, Lim K, Hwang BD. Differential regulation of vimentin mRNA by 12-O-tetradecanoylphorbol 13-acetate and all-trans-retinoic acid correlates with motility of Hep 3B human hepatocellular carcinoma cells. Cancer Lett 2004; 203:99-105. [PMID: 14670623 DOI: 10.1016/j.canlet.2003.08.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [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: 12/13/2022]
Abstract
Vimentin is a growth-related gene and often expressed when epithelial cells are stimulated to proliferate by growth factors. In cancer, vimentin expression is associated with a dedifferentiated malignant phenotype, increased motility, invasive ability and poor prognosis. We studied the regulation of vimentin mRNA and multistep invasion processes following treatment of 12-O-tetradecanoylphorbol 13-acetate (TPA) and all-trans-retinoic acid (RA) in Hep 3B hepatocellular carcinoma cells. TPA showed marked induction of vimentin mRNA, while RA decreased the mRNA level. TPA or RA did not affect cell proliferation, cell-matrix protein adhesion, and matrix metalloproteinases and urokinase plasminogen activator activities. In vitro invasion ability was significantly increased or decreased with TPA or RA treatment, paralleled to the in vitro motile activity, respectively. These findings suggest that TPA and RA could modulate the invasive potential of Hep 3B cells by altering cellular motility related to differential regulation of vimentin mRNA.
Collapse
Affiliation(s)
- Wan-Hee Yoon
- Department of Surgery, College of Medicine, Cancer Research Institute, Chungnam National University and Hospital, 640 Daesa-Dong, Joong-Ku, 301-721 Daejon, South Korea.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Hedrick E, Lee TG, Biswas P, Zhuang Y. The development of iodine based impinger solutions for the efficient capture of Hg0 using direct injection nebulization-inductively coupled plasma mass spectrometry analysis. Environ Sci Technol 2001; 35:3764-3773. [PMID: 11783657 DOI: 10.1021/es010648r] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Inductively coupled plasma mass spectrometry (ICP/MS) with direct injection nebulization (DIN) was used to evaluate novel impinger solution compositions capable of capturing elemental mercury (Hg0) in EPA Method 5 type sampling. An iodine based impinger solution proved to be very efficient for Hg0 capture and was amenable to direct analysis by DIN-ICP/MS. Hg0 capture efficiency using aqueous iodine (I3-) was comparable to Hg0 capture using acidified potassium permanganate impinger solutions which were analyzed by cold vapor atomic absorption spectrometry (CVAAS), with greater than 98% capture of Hg0 in the first oxidizing impinger. Using DIN-ICP/MS, it was demonstrated for the first time that iodine can be generated just prior to impinger sampling for efficiently oxidizing Hg0 and retaining it in solution as HgI4(2-). Due to the increased interest in Hg speciation from combustion sources and the potential for using DIN-ICP/MS for multiple metals analyses, an impinger sampling train for gaseous Hg speciation and multiple metals analyses using DIN-ICP/MS analyses is presented. The unique feature of such a sampling train is that each impinger solution in the series is amenable to direct analysis by DIN-ICP/MS. A bituminous coal was combusted in a bench scale coal system, and gaseous Hg species (oxidized and elemental) were determined using the proposed impinger train. The DIN-ICP/MS instrumental detection limit was 0.003 ppb, and MDLs ranged from 0.007 to 0.116 microg/L (ppb) in a variety of impinger solutions used for Hg capture.
Collapse
Affiliation(s)
- E Hedrick
- National Exposure Research Laboratory, U.S. Environmental Protection Agency, Cincinnati, Ohio 45268, USA.
| | | | | | | |
Collapse
|
43
|
Abstract
Superoxide is the most important armory on the primary defense line of monocytes against invading pathogens, and the identification of new stimuli and the characterization of the regulatory mechanism of superoxide generation are of paramount importance. In this study, we identified 3 novel peptides by screening a synthetic hexapeptide combinatorial library and modification of 1 of the peptides. The isolated peptides that can induce superoxide generation in human monocytes are His-Phe-Tyr-Leu-Pro-Met-CONH(2) (HFYLPM), Met-Phe-Tyr-Leu-Pro-Met-CONH(2) (MFYLPM), and His-Phe-Tyr-Leu-Pro-D-Met-CONH(2) (HFYLPm). All 3 peptides also caused intracellular calcium ([Ca(++)](i)) rise. We tested the specificities of the peptides on cells of different origin by looking at [Ca(++)](i) rise. All 3 peptides acted specifically on leukocytes and not on nonimmune cells. Among leukocytes, HL60 and Jurkat T cells were stimulated specifically by MFYLPM or HFYLPM, respectively. As a physiologic characteristic of the peptides, we observed that all 3 peptides induced chemotactic migration of monocytes. Studying receptor specificity, we concluded that the 3 peptides might act on some shared and some distinct receptor(s) on leukocytes. Studying intracellular signaling set in motion by the peptides revealed that HFYLPM, but not MFYLPM or HFYLPm, induced chemotaxis via phosphatidylinositol-3 kinase and protein kinase C. Because HFYLPM, MFYLPM, and HFYLPm not only exhibit different specificities depending on cell type and status of differentiation but also stimulate cells via distinct receptors and signaling, the 3 novel peptides might be useful tools to study leukocyte activation.
Collapse
Affiliation(s)
- Y S Bae
- Division of Molecular and Life Sciences, Pohang University of Science and Technology, Korea
| | | | | | | | | | | |
Collapse
|
44
|
Giorgi JB, Lee TG, Naumkin FY, Polanyi JC, Raspopov SA, Wang J. Photoinduced charge-transfer reaction at surfaces. Part I. (HCl)m..Nan/LiF(001) + hv (640 nm)-->(HCl)m - 1 Cl-Nan+/LiF(001) + H(g). Faraday Discuss 2001:85-97; discussion 161-89. [PMID: 11272005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
A sub-monolayer of atomic sodium, Nan, was deposited on LiF(001) at 50 K and characterized by temperature-programmed desorption, X-ray photoelectron spectroscopy, and titration with HCl. The Nan was dosed with HCl to form (HCl)m..Nan/LiF(001), which was then irradiated by 640 nm laser-radiation to induce a charge-transfer (CT) reaction. Reaction-product atomic H(g) was observed leaving the surface, by two-color Rydberg-atom time-of-flight (TOF) spectroscopy. These H-atoms gave evidence of arising from the photoinduced harpooning reaction between the sodium clusters, Nan, on the substrate, and (HCl)m adsorbed on the Nan. The translational energy distribution, its vibrational structure, and the angular distribution of H(g) gave information regarding the harpooning event. Translationally and vibrationally excited HCl(g) was shown, by resonance-enhanced multiphoton ionization (REMPI), to be formed as an alternate product; by way of (HCl)m..Nan/LiF(001) + 602 nm-->(HCl)m - 1 Nan/LiF(001) + HCl(g)(v > or = 0).
Collapse
Affiliation(s)
- J B Giorgi
- Department of Chemistry, University of Toronto, Toronto, Ontario, Canada M5S 3H6
| | | | | | | | | | | |
Collapse
|
45
|
Jeon SM, Kim HS, Lee TG, Ryu SH, Suh PG, Byun SJ, Park YB, Choi MS. Lower absorption of cholesteryl oleate in rats supplemented with Areca catechu L. extract. Ann Nutr Metab 2001; 44:170-6. [PMID: 11111132 DOI: 10.1159/000012841] [Citation(s) in RCA: 12] [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: 11/19/2022]
Abstract
Areca catechu L. extracts I and II, prepared using two different solvent systems, exhibited strong inhibitory activities against pancreatic cholesterol esterase (pCEase) in vitro. To determine their cholesterol-lowering effects, these two extracts were investigated by analyzing plasma lipid levels, intestinal enzyme activities, and the absorption of cholesteryl oleate. For 6 days, male rats were fed a diet containing cholesteryl oleate (0.5 g/100 g of body weight) either with or without the Areca nut extract supplements. The supplementation of the two Areca nut extracts significantly lowered the concentrations of plasma cholesterol by 13. 4 and 11.7% and plasma triglycerides by 35.0 and 36.9%, respectively, compared with the pre-experimental values. However, when the cholesteryl oleate diet was fed without any Areca nut extract in high-cholesterol control, the plasma cholesterol and triglyceride concentrations significantly increased by 13.6 and 15.9%, respectively, compared with the pre-experimental values. After 6 days of treatment, the intestinal pCEase activities were significantly lower in the groups supplemented with the Areca nut extracts (37.8 and 26.5%) than in the group with no extract supplement (83.2%). The supplements also significantly elevated the excretion of [1,2(n)-(3)H]cholesteryl oleate administered orally, when determined by the large intestinal contents, 930.5 Bq/day (Areca I) and 1,766.3 Bq/day (Areca II) vs. 98.1 Bq/day (high-cholesteryl oleate (CO) control). The inhibition of pCEase activity with the supplementation of the Areca nut extracts could account for the decrease in [1,2(n)-(3)H]cholesteryl oleate absorption that resulted in decreased radioactivity in blood.
Collapse
Affiliation(s)
- S M Jeon
- Department of Food Science and Nutrition, Kyungpook National University, Taegu, Korea
| | | | | | | | | | | | | | | |
Collapse
|
46
|
Back SH, Kim JE, Rho J, Hahm B, Lee TG, Kim EE, Cho JM, Jang SK. Expression and purification of an active, full-length hepatitis C viral NS4A. Protein Expr Purif 2000; 20:196-206. [PMID: 11049744 DOI: 10.1006/prep.2000.1301] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 11/22/2022]
Abstract
The nonstructural protein 3 (NS3) of the hepatitis C virus (HCV) is a bifunctional protein with protease and helicase activities. Nonstructural protein 4A (NS4A) is preceded by NS3 and augments the proteolytic activity of NS3 through protein-protein interaction. The central domain of NS4A has been shown to be sufficient for the enhancement of the NS3 protease activity. However, investigations on the roles of the N-terminal and the C-terminal regions of NS4A have been hampered by the difficulty of purification of full-length NS4A, a polypeptide that contains highly hydrophobic amino acid residues. Here we report a procedure by which one can produce and purify an active, full-length NS4A using maltose-binding protein fusion method. The full-length NS4A fused to the maltose binding protein is soluble and maintains its NS3 protease-enhancing activity.
Collapse
Affiliation(s)
- S H Back
- Department of Life Science, Division of Molecular and Life Sciences, Pohang University of Science and Technology, San 31, Hyoja-Dong, Pohang, Kyungbuk, 790-784, Korea
| | | | | | | | | | | | | | | |
Collapse
|
47
|
Lee KH, Cho SJ, Byun HS, Na DG, Choi NC, Lee SJ, Jin IS, Lee TG, Chung CS. Triphasic perfusion computed tomography in acute middle cerebral artery stroke: a correlation with angiographic findings. Arch Neurol 2000; 57:990-9. [PMID: 10891981 DOI: 10.1001/archneur.57.7.990] [Citation(s) in RCA: 55] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To evaluate the usefulness of triphasic perfusion computed tomography (TPCT) in diagnosing middle cerebral artery (MCA) occlusion and in assessing the perfusion deficit and collateral circulation in patients with acute ischemic stroke. BACKGROUND Conventional angiography is the criterion standard for the diagnosis of MCA occlusion and for the assessment of perfusion deficit and collateral blood supply. The risk of hemorrhagic transformation after recanalization of occluded arteries by thrombolytic therapy is considered high when pretherapeutic residual flow is markedly reduced. PATIENTS AND METHODS In 8 patients within 3 hours of onset of acute MCA stroke, precontrast computed tomographic scans were taken, and then TPCT was performed after power-injector controlled intravenous administration of contrast media. Sequential images of early, middle, and late phases were obtained. The whole procedure took 5 minutes. Perfusion deficit on TPCT was graded as "severe" or "moderate," depending on the state of collateral flow. Digital subtraction angiography (DSA) was performed in all patients within 6 hours of acute stroke. Direct intra-arterial urokinase infusion was begun immediately after the angiographic superselection of the MCA occlusion site in 6 of the 8 patients within 7 hours of onset (range, 4.3-6.2 hours). RESULTS The DSA findings showed occlusion of the MCA stem (n = 1) and at the bifurcation (n = 4). The sites of proximal MCA occlusion could be identified on the early and middle images of TPCT in all 5 patients. On DSA findings, all 8 patients had a zone of perfusion deficit with markedly slow leptomeningeal collaterals and a zone of perfusion deficit with no collaterals. The zone of severe perfusion deficit on TPCT corresponded to the zone of perfusion deficit with no or few collaterals on angiography, and the zone of moderate perfusion deficit on TPCT corresponded to that of perfusion deficit with markedly slow leptomeningeal collaterals. Early parenchymal hypoattenuation on precontrast computed tomography was confined to the zone of severe perfusion deficit on TPCT. The initial National Institutes of Health Stroke Scale score correlated better with the total extent of severe perfusion deficit and moderate perfusion deficit on TPCT than that of severe perfusion deficit alone. After direct intra-arterial thrombolysis within 7 hours of onset, symptomatic hemorrhagic transformation did not develop in 4 patients with small severe perfusion deficit (33% or less of the presumed MCA territory). However, the remaining 2 patients with large severe perfusion deficit (more than 50% of the presumed MCA territory) deteriorated to death with hemorrhagic transformation. CONCLUSIONS Triphasic perfusion computed tomography is useful for diagnosing proximal MCA occlusion and assessing perfusion deficit and collateral circulation as reliably as DSA. The zone of severe perfusion deficit on TPCT may be presumed to be the ischemic core, and that of moderate perfusion deficit, the penumbra zone. Triphasic perfusion computed tomography may be used as a rapid and noninvasive tool to make thrombolysis safer.
Collapse
Affiliation(s)
- K H Lee
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul, 135-710, Korea.
| | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Hayashi T, Lee TG, Hazelwood M, Hedrick E, Biswas P. Characterization of activated carbon fiber filters for pressure drop, submicrometer particulate collection, and mercury capture. J Air Waste Manag Assoc 2000; 50:922-929. [PMID: 10902384 DOI: 10.1080/10473289.2000.10464136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The use of activated carbon fiber (ACF) filters for the capture of particulate matter and elemental Hg is demonstrated. The pressure drop and particle collection efficiency characteristics of the ACF filters were established at two different face velocities and for two different aerosols: spherical NaCl and combustion-generated silica particles. The clean ACF filter specific resistance was 153 kg m-2 sec-1. The experimental specific resistance for cake filtration was 1.6 x 10(6) sec-1 and 2.4 x 10(5) sec-1 for 0.5- and 1.5-micron mass median diameter particles, respectively. The resistance factor R was approximately 2, similar to that for the high-efficiency particulate air filters. There was a discrepancy in the measured particle collection efficiencies and those predicted by theory. The use of the ACF filter for elemental Hg capture was illustrated, and the breakthrough characteristic was established. The capacity of the ACF filter for Hg capture was similar to other powdered activated carbons.
Collapse
Affiliation(s)
- T Hayashi
- Aerosol & Air Quality Research Laboratory, University of Cincinnati, OH, USA
| | | | | | | | | |
Collapse
|
49
|
Bae YS, Kim Y, Kim JH, Lee TG, Suh PG, Ryu SH. Independent functioning of cytosolic phospholipase A2 and phospholipase D1 in Trp-Lys-Tyr-Met-Val-D-Met-induced superoxide generation in human monocytes. J Immunol 2000; 164:4089-96. [PMID: 10754302 DOI: 10.4049/jimmunol.164.8.4089] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Recently, a novel peptide (Trp-Lys-Tyr-Met-Val-D-Met, WKYMVm) has been shown to induce superoxide generation in human monocytes. The peptide stimulated phospholipase A2 (PLA2) activity in a concentration- and time-dependent manner. Superoxide generation as well as arachidonic acid (AA) release evoked by treatment with WKYMVm could be almost completely blocked by pretreatment of the cells with cytosolic PLA2 (cPLA2)-specific inhibitors. The involvement of cPLA2 in the peptide-induced AA release was further supported by translocation of cPLA2 to the nuclear membrane of monocytes incubated with WKYMVm. WKYMVm-induced phosphatidylbutanol formation was completely abolished by pretreatment with PKC inhibitors. Immunoblot showed that monocytes express phospholipase D1 (PLD1), but not PLD2. GF109203X as well as butan-1-ol inhibited peptide-induced superoxide generation in monocytes. Furthermore, the interrelationship between the two phospholipases, cPLA2 and PLD1, and upstream signaling molecules involved in WKYMVm-dependent activation was investigated. The inhibition of cPLA2 did not blunt peptide-stimulated PLD1 activation or vice versa. Intracellular Ca2+ mobilization was indispensable for the activation of PLD1 as well as cPLA2. The WKYMVm-dependent stimulation of cPLA2 activity was partially dependent on the activation of PKC and mitogen-activated protein kinase, while PKC activation, but not mitogen-activated protein kinase activation, was an essential prerequisite for stimulation of PLD1. Taken together, activation of the two phospholipases, which are absolutely required for superoxide generation, takes place through independent signaling pathways that diverge from a common pathway at a point downstream of Ca2+.
Collapse
Affiliation(s)
- Y S Bae
- Department of Life Science, Pohang University of Science and Technology, Pohang, Korea
| | | | | | | | | | | |
Collapse
|
50
|
Jun K, Piedras-Rentería ES, Smith SM, Wheeler DB, Lee SB, Lee TG, Chin H, Adams ME, Scheller RH, Tsien RW, Shin HS. Ablation of P/Q-type Ca(2+) channel currents, altered synaptic transmission, and progressive ataxia in mice lacking the alpha(1A)-subunit. Proc Natl Acad Sci U S A 1999; 96:15245-50. [PMID: 10611370 PMCID: PMC24805 DOI: 10.1073/pnas.96.26.15245] [Citation(s) in RCA: 359] [Impact Index Per Article: 14.4] [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: 11/18/2022] Open
Abstract
The Ca(2+) channel alpha(1A)-subunit is a voltage-gated, pore-forming membrane protein positioned at the intersection of two important lines of research: one exploring the diversity of Ca(2+) channels and their physiological roles, and the other pursuing mechanisms of ataxia, dystonia, epilepsy, and migraine. alpha(1A)-Subunits are thought to support both P- and Q-type Ca(2+) channel currents, but the most direct test, a null mutant, has not been described, nor is it known which changes in neurotransmission might arise from elimination of the predominant Ca(2+) delivery system at excitatory nerve terminals. We generated alpha(1A)-deficient mice (alpha(1A)(-/-)) and found that they developed a rapidly progressive neurological deficit with specific characteristics of ataxia and dystonia before dying approximately 3-4 weeks after birth. P-type currents in Purkinje neurons and P- and Q-type currents in cerebellar granule cells were eliminated completely whereas other Ca(2+) channel types, including those involved in triggering transmitter release, also underwent concomitant changes in density. Synaptic transmission in alpha(1A)(-/-) hippocampal slices persisted despite the lack of P/Q-type channels but showed enhanced reliance on N-type and R-type Ca(2+) entry. The alpha(1A)(-/-) mice provide a starting point for unraveling neuropathological mechanisms of human diseases generated by mutations in alpha(1A).
Collapse
Affiliation(s)
- K Jun
- National Creative Research Initiatives Center for Calcium and Learning, Pohang University of Science and Technology, Pohang, Korea
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|