83 results on '"Ha WS"'
Search Results
2. Epidemiological linkage between migraine and diabetes mellitus: a systematic review and meta-analysis.
- Author
-
Ha WS, Nguyen VK, and Chu MK
- Subjects
- Humans, Diabetes Mellitus epidemiology, Diabetes Mellitus, Type 1 epidemiology, Diabetes Mellitus, Type 1 complications, Migraine Disorders epidemiology
- Abstract
Background: This study aimed to elucidate the nature and extent of the associations between diabetes mellitus (DM) and migraine through a systematic review and meta-analysis., Methods: We searched the PubMed, Web of Science, and Scopus databases without a specified start date until June 2, 2024. Cross-sectional and cohort studies analyzing the risk of migraine in individuals with DM and vice versa were included. Studies without at least age and sex adjustments were excluded. Data were extracted to calculate odds ratios (ORs) and hazard ratios (HRs). Risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale., Results: Eight cross-sectional studies (131,361 patients with DM and 1,005,604 patients with migraine) and four cohort studies (103,205 patients with DM patients and 32,197 patients with migraine) were included. Meta-analyses of the cross-sectional studies showed no significant overall association between DM and migraine. Subgroup analyses revealed that type 1 diabetes reduced the odds of having migraine (OR 0.48, 95% confidence interval [CI] 0.30-0.77), while migraine without aura (MO) increased the odds of having DM (OR 1.19, 95% CI 1.02-1.39). The cohort studies indicated that DM decreased the risk of developing migraine (HR 0.83, 95% CI 0.76-0.90), and a history of migraine increased the risk of developing DM (HR 1.09, 95% CI 1.01-1.17)., Conclusions: DM, particularly type 1 diabetes, is negatively associated with migraine occurrence, whereas migraine, especially MO, is positively associated with DM occurrence. However, most of the results remained at a low or very low level of evidence, indicating the need for further research., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF
3. Development and Validation of Machine Learning Models to Predict Postoperative Delirium Using Clinical Features and Polysomnography Variables.
- Author
-
Ha WS, Choi BK, Yeom J, Song S, Cho S, Chu MK, Kim WJ, Heo K, and Kim KM
- Abstract
Background: Delirium affects up to 50% of patients following high-risk surgeries and is associated with poor long-term prognosis. This study employed machine learning to predict delirium using polysomnography (PSG) and sleep-disorder questionnaire data, and aimed to identify key sleep-related factors for improved interventions and patient outcomes. Methods: We studied 912 adults who underwent surgery under general anesthesia at a tertiary hospital (2013-2024) and had PSG within 5 years of surgery. Delirium was assessed via clinical diagnoses, antipsychotic prescriptions, and psychiatric consultations within 14 days postoperatively. Sleep-related data were collected using PSG and questionnaires. Machine learning predictions were performed to identify postoperative delirium, focusing on model accuracy and feature importance. Results: This study divided the 912 patients into an internal training set (700) and an external test set (212). Univariate analysis identified significant delirium risk factors: midazolam use, prolonged surgery duration, and hypoalbuminemia. Sleep-related variables such as fewer rapid eye movement (REM) episodes and higher daytime sleepiness were also linked to delirium. An extreme gradient-boosting-based classification task achieved an AUC of 0.81 with clinical variables, 0.60 with PSG data alone, and 0.84 with both, demonstrating the added value of PSG data. Analysis of Shapley additive explanations values highlighted important predictors: surgery duration, age, midazolam use, PSG-derived oxygen saturation nadir, periodic limb movement index, and REM episodes, demonstrating the relationship between sleep patterns and the risk of delirium. Conclusions: The artificial intelligence model integrates clinical and sleep variables and reliably identifies postoperative delirium, demonstrating that sleep-related factors contribute to its identification. Predicting patients at high risk of developing postoperative delirium and closely monitoring them could reduce the costs and complications associated with delirium.
- Published
- 2024
- Full Text
- View/download PDF
4. Influence of next-generation artificial intelligence on headache research, diagnosis and treatment: the junior editorial board members' vision - part 1.
- Author
-
Petrušić I, Ha WS, Labastida-Ramirez A, Messina R, Onan D, Tana C, and Wang W
- Subjects
- Humans, Headache diagnosis, Headache therapy, Biomedical Research methods, Biomedical Research standards, Artificial Intelligence trends
- Abstract
Artificial intelligence (AI) is revolutionizing the field of biomedical research and treatment, leveraging machine learning (ML) and advanced algorithms to analyze extensive health and medical data more efficiently. In headache disorders, particularly migraine, AI has shown promising potential in various applications, such as understanding disease mechanisms and predicting patient responses to therapies. Implementing next-generation AI in headache research and treatment could transform the field by providing precision treatments and augmenting clinical practice, thereby improving patient and public health outcomes and reducing clinician workload. AI-powered tools, such as large language models, could facilitate automated clinical notes and faster identification of effective drug combinations in headache patients, reducing cognitive burdens and physician burnout. AI diagnostic models also could enhance diagnostic accuracy for non-headache specialists, making headache management more accessible in general medical practice. Furthermore, virtual health assistants, digital applications, and wearable devices are pivotal in migraine management, enabling symptom tracking, trigger identification, and preventive measures. AI tools also could offer stress management and pain relief solutions to headache patients through digital applications. However, considerations such as technology literacy, compatibility, privacy, and regulatory standards must be adequately addressed. Overall, AI-driven advancements in headache management hold significant potential for enhancing patient care, clinical practice and research, which should encourage the headache community to adopt AI innovations., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF
5. Development and Validation of Artificial Intelligence Models for Prognosis Prediction of Juvenile Myoclonic Epilepsy with Clinical and Radiological Features.
- Author
-
Kim KM, Choi BK, Ha WS, Cho S, Chu MK, Heo K, and Kim WJ
- Abstract
Background: Juvenile myoclonic epilepsy (JME) is a common adolescent epilepsy characterized by myoclonic, generalized tonic-clonic, and sometimes absence seizures. Prognosis varies, with many patients experiencing relapse despite pharmacological treatment. Recent advances in imaging and artificial intelligence suggest that combining microstructural brain changes with traditional clinical variables can enhance potential prognostic biomarkers identification. Methods : A retrospective study was conducted on patients with JME at the Severance Hospital, analyzing clinical variables and magnetic resonance imaging (MRI) data. Machine learning models were developed to predict prognosis using clinical and radiological features. Results : The study utilized six machine learning models, with the XGBoost model demonstrating the highest predictive accuracy (AUROC 0.700). Combining clinical and MRI data outperformed models using either type of data alone. The key features identified through a Shapley additive explanation analysis included the volumes of the left cerebellum white matter, right thalamus, and left globus pallidus. Conclusions: This study demonstrated that integrating clinical and radiological data enhances the predictive accuracy of JME prognosis. Combining these neuroanatomical features with clinical variables provided a robust prediction of JME prognosis, highlighting the importance of integrating multimodal data for accurate prognosis.
- Published
- 2024
- Full Text
- View/download PDF
6. Trends in Triptan Usage in Korea: A Population-Based Cohort Study.
- Author
-
Ha WS, Jeong J, Song S, Yum J, and Chu MK
- Subjects
- Humans, Republic of Korea, Female, Male, Retrospective Studies, Middle Aged, Adult, Aged, Young Adult, Practice Patterns, Physicians' trends, Logistic Models, Databases, Factual, Drug Prescriptions statistics & numerical data, Sumatriptan therapeutic use, Cohort Studies, Odds Ratio, Adolescent, Migraine Disorders drug therapy, Tryptamines therapeutic use
- Abstract
Background: Migraine presents a significant global health problem that emphasizes the need for efficient acute treatment options. Triptans, introduced in the early 1990s, have substantially advanced migraine management owing to their effectiveness compared to that of traditional medications. However, data on triptan use in migraine management from Asian countries, where migraines tend to have milder symptoms than those in European and North American countries, are limited. This study aimed to identify the trends in triptan usage in Korea., Methods: This retrospective cohort study used data from the Korean National Health Insurance Service-National Sample Cohort spanning from 2002 to 2019. Patients with migraine were identified using the International Classification of Diseases 10th revision codes, and triptan prescriptions were evaluated annually in terms of quantity, pills per patient, and associated costs. The distribution of triptan prescriptions across different medical specialties was also examined. Factors contributing to the odds of triptan use were analyzed using multivariable logistic regression., Results: From 2002 to 2019, the total number of triptan tablets, prescriptions, and patients using triptans increased by 24.0, 17.1, and 13.6 times, respectively, with sumatriptan being the most frequently prescribed type of triptan. Additionally, the number of prescriptions and related costs have consistently increased despite stable pricing because of government regulation. By 2019, only approximately one-tenth of all patients with migraines had been prescribed triptans, although there was a notable increase in prescriptions over the study period. These prescription patterns varied according to the physician's specialty. After adjusting for patient-specific factors including age and sex, the odds of prescribing triptans were higher for neurologists than for internal medicine physicians (odds ratio 2.875, P < 0.001), while they were lower for general practitioners (odds ratio 0.220, P < 0.001)., Conclusion: The findings revealed an increasing trend in triptan use among individuals with migraines in Korea, aligning with global usage patterns. Despite these increases, the overall prescription rate of triptans remains low, indicating potential underutilization and highlighting the need for improved migraine management strategies across all medical fields. Further efforts are necessary to optimize the use of triptans in treating migraines effectively., Competing Interests: Chu MK was the site investigator for a multicenter trial sponsored by Biohaven Pharmaceuticals, Allergan Korea, and the Ildong Pharmaceutical Company. Additionally, Chu MK has received lecture honoraria from Eli Lilly and Company, Handok-Teva, and the Ildong Pharmaceutical Company over the past 24 months; grants from the Yonsei University College of Medicine (6-2021-0229) and the Korea Health Industry Development Institute (KHIDI) (HV22C0106); and an NRF grant from the Korean government (MSIT) (2022R1A2C1091767). The other authors have no conflicts of interest to declare., (© 2024 The Korean Academy of Medical Sciences.)
- Published
- 2024
- Full Text
- View/download PDF
7. Advances in Exercise in the Clinical Trials of Migraine: A Scoping Review.
- Author
-
Ha WS and Chu MK
- Subjects
- Humans, Clinical Trials as Topic, Yoga, Exercise physiology, Migraine Disorders therapy, Migraine Disorders prevention & control, Exercise Therapy methods
- Abstract
Purpose of Review: This review aimed to investigate emerging evidence regarding the effectiveness of exercise for migraines, focusing on the results of recent trials. Additionally, it explored the possibility of exercise as a treatment for migraines., Recent Findings: Between 2020 and 2023, five, four, one, and two trials were conducted regarding the effect of aerobic exercise, anaerobic exercise, Tai Chi, and yoga, respectively, on migraine; all studies showed significant effects. Two trials on aerobic exercise showed that high-intensity exercise was similar to or slightly more effective than moderate-intensity exercise as a treatment for migraines. Three trials on anaerobic exercise reported its effectiveness in preventing migraines. Regarding efficacy, side effects, and health benefits, aerobic exercises and yoga are potentially beneficial strategies for the prevention of migraines. Further studies are needed to develop evidence-based exercise programs for the treatment of migraines., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Published
- 2024
- Full Text
- View/download PDF
8. Altered immunity in migraine: a comprehensive scoping review.
- Author
-
Ha WS and Chu MK
- Subjects
- Humans, Cytokines immunology, Immunity, Cellular immunology, Immunity, Humoral immunology, Migraine Disorders immunology
- Abstract
Background: The pathogenesis of migraine remains unclear; however, a large body of evidence supports the hypothesis that immunological mechanisms play a key role. Therefore, we aimed to review current studies on altered immunity in individuals with migraine during and outside attacks., Methods: We searched the PubMed database to investigate immunological changes in patients with migraine. We then added other relevant articles on altered immunity in migraine to our search., Results: Database screening identified 1,102 articles, of which 41 were selected. We added another 104 relevant articles. We found studies reporting elevated interictal levels of some proinflammatory cytokines, including IL-6 and TNF-α. Anti-inflammatory cytokines showed various findings, such as increased TGF-β and decreased IL-10. Other changes in humoral immunity included increased levels of chemokines, adhesion molecules, and matrix metalloproteinases; activation of the complement system; and increased IgM and IgA. Changes in cellular immunity included an increase in T helper cells, decreased cytotoxic T cells, decreased regulatory T cells, and an increase in a subset of natural killer cells. A significant comorbidity of autoimmune and allergic diseases with migraine was observed., Conclusions: Our review summarizes the findings regarding altered humoral and cellular immunological findings in human migraine. We highlight the possible involvement of immunological mechanisms in the pathogenesis of migraine. However, further studies are needed to expand our knowledge of the exact role of immunological mechanisms in migraine pathogenesis., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF
9. Association between migraine and the risk of vascular dementia: A nationwide longitudinal study in South Korea.
- Author
-
Shin H, Ha WS, Kim J, Park SH, Han K, and Baek MS
- Subjects
- Humans, Female, Longitudinal Studies, Retrospective Studies, Cohort Studies, Republic of Korea epidemiology, Risk Factors, Incidence, Dementia, Vascular epidemiology, Migraine Disorders epidemiology
- Abstract
Objective: We aimed to examine the potential association between migraine and vascular dementia (VaD) using a nationwide population database., Background: Migraine and VaD showed similar structural and functional changes in pathophysiology process and shared common risk factors, However, whether migraine prevalence increases VaD incidence remains controversial., Methods: This retrospective population-based cohort study used the medical records from the Korean National Health Insurance System database. Migraine (G43) was defined by using the Tenth Revision of the International Classification of Diseases code. More than two migraine diagnoses at least 3 months apart were defined as "chronic migraine". Cox proportional hazards model estimated hazard ratios (HRs) of VaD for group comparisons., Results: We included 212,836 patients with migraine and 5,863,348 individuals without migraine. During 10 years of follow-up, 3,914 (1.8%) and 60,258 (1.0%) patients with and without migraine, respectively, were newly diagnosed with VaD. After adjustment, patients with migraine showed a 1.21-fold higher risk of VaD than those without migraine (HR = 1.21; 95% confidence interval (CI): 1.17-1.25). Patients with chronic migraine showed a higher cumulative incidence of VaD than those with episodic migraine. The adjusted HR for the VaD incidence with migraine was higher in: (1) patients aged <65 years; (2) women; (3) patients without hypertension, diabetes, or atrial fibrillation; and (4) non-smokers., Conclusion: Migraine is associated with an increased risk of VaD, particularly in chronic migraine patients. Incidence of VaD in the setting of migraine may have distinct pathophysiology from that of VaD with traditional cardiovascular risks., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Shin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
- Published
- 2024
- Full Text
- View/download PDF
10. Risk Factors and Temporal Patterns of Poststroke Epilepsy across Stroke Subtypes: Insights from a Nationwide Cohort Study in Korea.
- Author
-
Ha WS, Jang K, Cho S, Kim WJ, Chu MK, Heo K, and Kim KM
- Subjects
- Humans, Male, Female, Republic of Korea epidemiology, Middle Aged, Risk Factors, Aged, Retrospective Studies, Adult, Ischemic Stroke epidemiology, Ischemic Stroke complications, Aged, 80 and over, Cohort Studies, Subarachnoid Hemorrhage epidemiology, Subarachnoid Hemorrhage complications, Cerebral Hemorrhage epidemiology, Cerebral Hemorrhage complications, Epilepsy epidemiology, Stroke epidemiology, Stroke complications
- Abstract
Introduction: We aimed to investigate the risk factors associated with poststroke epilepsy (PSE) among patients with different subtypes of stroke, focusing on age-related risk and time-varying effects of stroke subtypes on PSE development., Methods: A retrospective, nationwide, population-based cohort study was conducted using Korean National Health Insurance Service-National Sample Cohort data. Patients hospitalized with newly diagnosed stroke from 2005 to 2015 were included and followed up for up to 10 years. The primary outcome was the development of PSE, defined as having a diagnostic code and a prescription for anti-seizure medication. Multivariable Cox proportional hazard models were used to estimate PSE hazard ratios (HRs), and time-varying effects were also assessed., Results: A total of 8,305 patients with ischemic stroke, 1,563 with intracerebral hemorrhage (ICH), and 931 with subarachnoid hemorrhage (SAH) were included. During 10 years of follow-up, 4.6% of patients developed PSE. Among patients with ischemic stroke, significant risk factors for PSE were younger age (HR = 1.47), living in rural areas (HR = 1.35), admission through the emergency room (HR = 1.33), and longer duration of hospital stay (HR = 1.45). Time-varying analysis revealed elevated HRs for ICH and SAH, particularly in the first 2 years following the stroke. The age-specific HRs also showed an increased risk for those under the age of 65, with a noticeable decrease in risk beyond that age., Conclusion: The risk of developing PSE varies according to stroke subtype, age, and other demographic factors. These findings underscore the importance of tailored poststroke monitoring and management strategies to mitigate the risk of PSE., (© 2024 S. Karger AG, Basel.)
- Published
- 2024
- Full Text
- View/download PDF
11. The association between migraine and Parkinson's disease: a nationwide cohort study.
- Author
-
Ha WS, Kim J, Hwang HW, Lee SH, Kim JI, Hong JY, Park SH, Han KD, and Baek MS
- Subjects
- Male, Female, Humans, Cohort Studies, Risk Factors, Comorbidity, Incidence, Parkinson Disease epidemiology, Parkinson Disease etiology, Migraine Disorders epidemiology, Migraine Disorders complications, Migraine Disorders diagnosis
- Abstract
Objectives: Clinical studies have suggested an association between migraine and the occurrence of Parkinson's disease (PD). However, it is unknown whether migraine affects PD risk. We aimed to investigate the incidence of PD in patients with migraine and to determine the risk factors affecting the association between migraine and PD incidence., Methods: Using the Korean National Health Insurance System database (2002-2019), we enrolled all Koreans aged ≥40 years who participated in the national health screening program in 2009. International Classification of Diseases (10th revision) diagnostic codes and Rare Incurable Diseases System diagnostic codes were used to define patients with migraine (within 12 months of enrollment) and newly diagnosed PD., Results: We included 214,193 patients with migraine and 5,879,711 individuals without migraine. During 9.1 years of follow-up (55,435,626 person-years), 1,973 (0.92%) and 30,664 (0.52%) individuals with and without migraine, respectively, were newly diagnosed with PD. Following covariate adjustment, patients with migraine showed a 1.35-fold higher PD risk than individuals without migraine. The incidence of PD was not significantly different between patients with migraine with aura and those without aura. In males with migraine, underlying dyslipidemia increased the risk of PD (p=0.012). In contrast, among females with migraine, younger age (<65 years) increased the risk of PD (p=0.038)., Conclusions: Patients with migraine were more likely to develop PD than individuals without migraine. Preventive management of underlying comorbidities and chronic migraine may affect the incidence of PD in these patients. Future prospective randomized clinical trials are warranted to clarify this association.
- Published
- 2024
- Full Text
- View/download PDF
12. Association between migraine and Alzheimer's disease: a nationwide cohort study.
- Author
-
Kim J, Ha WS, Park SH, Han K, and Baek MS
- Abstract
Background and Objective: Migraine is a common chronic neurological disease characterized by pulsating headaches, photophobia, phonophobia, nausea, and vomiting. The prevalence of dementia in individuals aged over 65 years in Korea is more than 10%, and Alzheimer's disease (AD) dementia accounts for most cases. Although these two neurological diseases account for a large portion of the medical burden in Korea, few studies have examined the relationship between the two diseases. Therefore, this study investigated the incidence and risk of AD in patients with migraines., Methods: We retrospectively collected nationwide data from a national health insurance claims database governed by Korea's National Health Insurance Service. Among Koreans in the 2009 record, patients with migraine were identified according to the International Classification of Diseases, 10th revision (ICD-10) code G43. First, we screened the database for participants aged over 40 years. Individuals diagnosed with migraine at least twice over more than 3 months in a year were considered to have chronic migraine in this study. Further, all participants with an AD diagnosis (ICD-10 code: Alzheimer's disease F00, G30) were investigated for AD dementia development. The primary endpoint was AD development., Results: The overall incidence of AD dementia was higher in individuals with a history of migraine than in those with no migraine history (8.0 per 1,000 person-years vs. 4.1 per 1,000 person-years). The risk of AD dementia was higher in individuals diagnosed with migraine (hazard ratio = 1.37 [95% confidence interval, 1.35-1.39]) than in the control group after adjustments for age and sex. Individuals with chronic migraine had a higher incidence of AD dementia than those with episodic migraine. Younger age (<65 years old) was associated with an increased risk of AD dementia compared to older age (≥65 years old). Higher body mass index (BMI) (≥25 kg/m
2 ) was also associated with an increased risk of AD dementia compared to lower BMI (<25 kg/m2 ) ( p < 0.001)., Conclusion: Our results suggest that individuals with a migraine history are more susceptible to AD than those without a migraine history. Additionally, these associations were more significant in younger and obese individuals with migraine than in individuals without migraine., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Kim, Ha, Park, Han and Baek.)- Published
- 2023
- Full Text
- View/download PDF
13. Cyclin D1 Serves as a Poor Prognostic Biomarker in Stage I Gastric Cancer.
- Author
-
Go SI, Ko GH, Lee WS, Lee JH, Jeong SH, Lee YJ, Hong SC, and Ha WS
- Abstract
TNM stage still serves as the best prognostic marker in gastric cancer (GC). The next step is to find prognostic biomarkers that detect subgroups with different prognoses in the same TNM stage. In this study, the expression levels of epidermal growth factor receptor (EGFR) and cyclin D1 were assessed in 96 tissue samples, including non-tumorous tissue, adenoma, and carcinoma. Then, the prognostic impact of EGFR and cyclin D1 was retrospectively investigated in 316 patients who underwent R0 resection for GC. EGFR positivity increased as gastric tissue became malignant, and cyclin D1 positivity was increased in all the tumorous tissues. However, there was no survival difference caused by the EGFR positivity, while the cyclin D1-postive group had worse overall survival (OS) than the cyclin D1-negative group in stage I GC (10-year survival rate (10-YSR): 62.8% vs. 86.5%, p = 0.010). In subgroup analyses for the propensity score-matched (PSM) cohort, there were also significant differences in the OS according to the cyclin D1 positivity in stage I GC but not in stage II and III GC. Upon multivariate analysis, cyclin D1 positivity was an independent prognostic factor in stage I GC. In conclusion, cyclin D1 may be a useful biomarker for predicting prognosis in stage I GC.
- Published
- 2022
- Full Text
- View/download PDF
14. Deep-learning-based image quality enhancement of compressed sensing magnetic resonance imaging of vessel wall: comparison of self-supervised and unsupervised approaches.
- Author
-
Eun DI, Jang R, Ha WS, Lee H, Jung SC, and Kim N
- Subjects
- Adult, Aged, Algorithms, Deep Learning, Female, Healthy Volunteers, Humans, Imaging, Three-Dimensional methods, Machine Learning, Magnetic Resonance Imaging methods, Male, Middle Aged, Prospective Studies, Reproducibility of Results, Signal-To-Noise Ratio, Cerebral Arteries diagnostic imaging, Image Enhancement methods, Image Processing, Computer-Assisted methods
- Abstract
While high-resolution proton density-weighted magnetic resonance imaging (MRI) of intracranial vessel walls is significant for a precise diagnosis of intracranial artery disease, its long acquisition time is a clinical burden. Compressed sensing MRI is a prospective technology with acceleration factors that could potentially reduce the scan time. However, high acceleration factors result in degraded image quality. Although recent advances in deep-learning-based image restoration algorithms can alleviate this problem, clinical image pairs used in deep learning training typically do not align pixel-wise. Therefore, in this study, two different deep-learning-based denoising algorithms-self-supervised learning and unsupervised learning-are proposed; these algorithms are applicable to clinical datasets that are not aligned pixel-wise. The two approaches are compared quantitatively and qualitatively. Both methods produced promising results in terms of image denoising and visual grading. While the image noise and signal-to-noise ratio of self-supervised learning were superior to those of unsupervised learning, unsupervised learning was preferable over self-supervised learning in terms of radiomic feature reproducibility.
- Published
- 2020
- Full Text
- View/download PDF
15. The Use of CD44 Variant 9 and Ki-67 Combination Can Predicts Prognosis Better Than Their Single Use in Early Gastric Cancer.
- Author
-
Go SI, Ko GH, Lee WS, Lee JH, Jeong SH, Lee YJ, Hong SC, and Ha WS
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Gene Expression Regulation, Neoplastic, Genetic Variation, Humans, Male, Middle Aged, Prognosis, Propensity Score, Stomach Neoplasms metabolism, Survival Analysis, Tissue Array Analysis, Biomarkers, Tumor metabolism, Hyaluronan Receptors metabolism, Ki-67 Antigen metabolism, Stomach Neoplasms mortality, Up-Regulation
- Abstract
Purpose: We previously demonstrated that CD44v9 and Ki-67 played an important role in predicting poor prognosis of early gastric cancer (EGC). However, little is known about combined use of both biomarkers as prognostic biomarker. The present study was performed to investigate the significance of CD44v9 and Ki-67 expression as a combination biomarker for EGC., Materials and Methods: With tissue microarray for 158 EGC tissues, we performed immunohistochemical staining for CD44v9 and Ki-67. The whole patients were divided into three groups (group A, CD44v9- negative/Ki-67-low; group B, neither group A or C; and group C, CD44v9-positive/Ki-67- high). Its clinical significance was re-analyzed with adjustment via propensity score matching (PSM). For validation, we performed bootstrap resampling., Results: The median follow-up duration was 90.4 months (range, 3.7 to 120.4 months). In the comparison according to CD44v9/Ki-67 expression, the combined use of the two biomarker clearly separated the three groups by 5-year survival rates (5-YSR, 96.3%, 89.8%, and 76.8% in group A, B, and C, respectively; p=0.009). After PSM, 5-YSR were 97.7% and 76.8% in group A+B and group C, respectively (p=0.002). Multivariable analysis demonstrated that group C had independently poor prognosis (hazard ratio, 9.137; 95% confidence interval, 1.187 to 70.366; p=0.034) compared with group A. Bootstrap resampling internally validated this result (p=0.016)., Conclusion: This study suggests that both positive CD44v9 and high Ki-67 expression are associated with poor prognosis in EGC, and the combined use of these markers provides better prognostic stratification than the single use of them.
- Published
- 2019
- Full Text
- View/download PDF
16. Postoperative lower limb compensation in patient with adult spinal deformity.
- Author
-
Ha WS and Shin MH
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Postoperative Period, Lower Extremity physiology, Posture physiology, Spinal Diseases surgery
- Abstract
The objective of this study was to determine whether inadequate decompensation of spine and pelvis would lead to persistent compensatory action of lower extremity. Patients who underwent adult spinal deformity from January 2014 to December 2016 were included. Postoperatively, patients who showed persistent lower extremity compensation (femur obliquity angle/FOA ≥ 5°) were classified into compensated lower extremity (CLE) group and decompensated lower extremity (DLE) group with FOA < 5°. Sagittal vertical axis (SVA), T1 spinopelvic inclination, TPA (T1 pelvic angle), thoracic kyphosis, lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt, sacral slope and FOA were measured and compared between two groups. The lack of lumbar lordosis was assessed by PI-LL mismatch and multivariate analysis were used to investigate correlation in changes of parameters. 115 patients were classified into CLE group (23 patients) and DLE group (92 patients). Thoracic compensations were more prevalent in the CLE group while pelvic compensation was more prominent in the DLE group. Both postoperative TPA and PI-LL in the CLE group were greater than those in the DLE group while postoperative SVA was similar. At 1 year postoperatively, SVA was increased in the CB group with persistent lower extremity compensation. Changes in FOA had moderate correlation with changes in SVA and strong correlation with changes in TPA. In conclusion, postoperative persistent lower limb compensation can be interpreted into surgical undercorrection. TPA rather than SVA is a useful parameter to assess global alignment and compensatory action of the lower extremity., (Copyright © 2018 Elsevier Ltd. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
17. Feasibility of a novel laparoscopic technique with unidirectional knotless barbed sutures for the primary closure of duodenal ulcer perforation.
- Author
-
Kim TH, Park JH, Jeong SH, Lee JK, Kwag SJ, Kim JY, Lee W, Woo JW, Jang JY, Song EJ, Park T, Jeong CY, Ju YT, Jung EJ, Hong SC, Choi SK, Ha WS, and Lee YJ
- Subjects
- Duodenal Ulcer complications, Equipment Design, Feasibility Studies, Female, Humans, Male, Middle Aged, Operative Time, Peptic Ulcer Perforation etiology, Postoperative Complications, Retrospective Studies, Duodenal Ulcer surgery, Laparoscopy methods, Peptic Ulcer Perforation surgery, Sutures
- Abstract
Background: Laparoscopic primary repair is one of the main procedures used for perforated gastric ulcers, and this technique requires reproducible and secure suturing. The aim of this study was to investigate the safety and efficacy of a novel continuous suture method with barbed sutures during laparoscopic repair for perforated peptic ulcers., Patients and Methods: Clinical data from 116 consecutive patients undergoing laparoscopic repair for perforated peptic ulcers were collected between November 2009 and October 2015. Continuous suturing with 15-cm-long unidirectional absorbable barbed sutures was used for laparoscopic repair in the study group, termed group V (n = 51). Patients who underwent laparoscopic repair with conventional interrupted sutures were defined as group C (n = 65). The complication and operative data were compared between groups., Results: Although there was no difference between group V and group C in the overall complication rate (15.7% vs. 24.6%; p = 0.259), the complication rate related to suturing was lower (3.9% vs. 15.4%; p = 0.04) in group V. Group V showed rates of 0% for leakage, 2% for intra-abdominal fluid collection, and 2% for stricture; the corresponding rates in group C were 3.1, 7.7, and 4.6%, respectively. Regarding operative data, the total operation time (V vs. C, 87.7 min vs. 131.2 min), total suture time (7.1 min vs. 25.3 min), and suture time per stitch (1.2 min vs. 6.2 min) were significantly shorter in group V than in group C (p < 0.001)., Conclusion: The use of a continuous suture technique with unidirectional barbed sutures is as safe as the conventional suture technique and allows easier and faster suturing in the repair of perforated peptic ulcers.
- Published
- 2018
- Full Text
- View/download PDF
18. Influence of Fixture Thread Exposure on Marginal Bone Level Around Different Implant Systems: A Preliminary Study in Dogs.
- Author
-
Choi B, Yoon HJ, Ha WS, and Park YM
- Subjects
- Animals, Dogs, Male, Mandible surgery, Surface Properties, Alveolar Bone Loss etiology, Dental Implantation, Endosseous methods, Dental Implants, Dental Prosthesis Design
- Abstract
Purpose: To evaluate the influence of implant neck structures on marginal bone loss around intentionally exposed implant fixtures by histomorphometric analysis., Materials and Methods: Twenty-four implants representing 3 implant systems were placed in three dogs; an implant system with SLA surface without microthreads (group A); one with SLA + calcium surface without microthreads (group B); and one with SLA surface with microthreads (group C). The histomorphometric analyses for vertical defect length (VDL), infrabony defect height (IDH), and defect depth (DD) were performed at the buccal and lingual sides of each fixture., Results: The VDL was lower in group A relative to groups B and C on the buccal and lingual sides. The IDH and DD were higher in group A than group C on the buccal and lingual sides; however, no statistically significant differences were noted between the groups in VDL, IDH, and DD on the buccal and lingual sides of the fixtures., Conclusions: In this preliminary study, marginal bone resorption pattern in the canine mandible varied according to the neck design of each implant fixture. Further studies with larger sample size are needed to confirm the effect of microthreads and surface roughness on the marginal bone loss at the exposed implant fixture., (© 2016 by the American College of Prosthodontists.)
- Published
- 2018
- Full Text
- View/download PDF
19. Histopathological Findings of Intracranial Thrombi in Nonbacterial Thrombotic Endocarditis.
- Author
-
Kim K, Kim J, Ahn SH, Ha WS, Koo YJ, Kim DJ, Nam HS, and Heo JH
- Published
- 2017
- Full Text
- View/download PDF
20. Overexpression of Neuron-Specific Enolase as a Prognostic Factor in Patients with Gastric Cancer.
- Author
-
Park T, Lee YJ, Jeong SH, Choi SK, Jung EJ, Ju YT, Jeong CY, Park M, Hah YS, Yoo J, Ha WS, Hong SC, and Ko GH
- Abstract
Purpose: Enolase is a cytoplasmic enzyme that catalyzes the conversion of 2-phosphoglycerate to phosphoenolpyruvate in the glycolytic pathway. The aim of this study was to investigate whether the overexpression of neuron-specific enolase (NSE) can serve as a prognostic factor in patients with gastric cancer (GC)., Materials and Methods: To assess its prognostic value in GC, NSE expression was measured by immunohistochemistry in a clinically annotated tissue microarray comprising of 327 human GC specimens. Cytoplasmic NSE expression was scored from 0 to 4, reflecting the percentage of NSE-positive cells., Results: In terms of histology as per the World Health Organization criteria (P=0.340), there were no differences between the NSE overexpression (NSE-OE) and NSE underexpression (NSE-UE) groups. The NSE-OE group showed a significantly lower rate of advanced GC (P<0.010), lymph node metastasis (P=0.010), advanced stage group (P<0.010), cancer-related death (P<0.010), and cancer recurrence (P<0.010). Additionally, a Kaplan-Meier survival analysis revealed that the NSE-OE group had longer cumulative survival times than the NSE-UE group (log-rank test, P<0.010). However, there were no significant differences in the serum levels of NSE expression in patients with GC and healthy volunteers (P=0.280)., Conclusions: Patients with NSE overexpressing GC tissues showed better prognostic results, implying that NSE could be a candidate biomarker of GC., Competing Interests: Conflict of Interest: No potential conflict of interest relevant to this article was reported.
- Published
- 2017
- Full Text
- View/download PDF
21. Prognostic impact of Ki-67 in patients with gastric cancer-the importance of depth of invasion and histologic differentiation.
- Author
-
Ko GH, Go SI, Lee WS, Lee JH, Jeong SH, Lee YJ, Hong SC, and Ha WS
- Subjects
- Adult, Aged, Aged, 80 and over, Biomarkers, Tumor metabolism, Disease Progression, Female, Follow-Up Studies, Humans, Immunohistochemistry, Kaplan-Meier Estimate, Male, Middle Aged, Multivariate Analysis, Neoplasm Invasiveness diagnosis, Neoplasm Invasiveness pathology, Prognosis, Propensity Score, Tissue Array Analysis, Young Adult, Ki-67 Antigen metabolism, Stomach Neoplasms metabolism, Stomach Neoplasms pathology
- Abstract
Ki-67 protein is a cellular marker for proliferation. The role of Ki-67 as a prognostic biomarker has not been established in gastric cancer. The present study was performed to investigate the significance of Ki-67 expression as a biomarker in early gastric cancer (EGC).With tissue microarray for 320 patients with gastric cancer, we performed immunohistochemical staining for Ki-67. Its clinical significance was analyzed with adjustment via the propensity score-matching. For validation, we performed bootstrap resampling.The median follow-up duration was 72 months (range: 3-120 months). Ki-67-high group showed worse prognosis than Ki-67-low group in EGC (5-YSR, 78.9% vs 92.0%, P = .018), but not in advanced gastric cancer (AGC) (5-YSR, 58.5% vs 59.2%, P = .951). Interestingly, in the patients with well-differentiated histology, prognosis for Ki-67-high group was considerably worse than that for Ki-67-low group (5-YSR, 67.0% vs 94.4%, P = .012), but not in those with moderately differentiated (P = .504) and poorly differentiated histology (P = .905). In this cohort, there was a strong correlation between the proportion of EGC and well-differentiated histology (r = 0.215, P = .002). Multivariate analysis also revealed that the high-Ki-67 expression serves as a poor prognostic factor in EGC (HR 4.346, 95% CI 1.397-13.515, P = .011), especially in the well-differentiated histology, but not in all the patients (P = .171). Bootstrap resampling internally validated this result (P = .011).This study suggests that Ki-67 expression may be a good biomarker for prognosis prediction for EGC with well-differentiated histologic type.
- Published
- 2017
- Full Text
- View/download PDF
22. A Case of Advanced Gastric Cancer with Para-Aortic Lymph Node Metastasis from Co-Occurring Prostate Cancer.
- Author
-
Park M, Jeong SH, Lee YJ, Park JH, Choi SK, Hong SC, Jung EJ, Ju YT, Jeong CY, Lee JH, and Ha WS
- Abstract
An 84-year-old man was diagnosed with two synchronous adenocarcinomas, a Borrmann type IV advanced gastric adenocarcinoma in his antrum and a well-differentiated Borrmann type I carcinoma on the anterior wall of the higher body of his stomach. Pre-operatively, computed tomography of the abdomen revealed the presence of advanced gastric cancer with peri-gastric and para-aortic lymph node (LN) metastasis. He planned for palliative total gastrectomy owing to the risk of obstruction by the antral lesion. We performed a frozen biopsy of a para-aortic LN during surgery and found that the origin of the para-aortic LN metastasis was from undiagnosed prostate cancer. Thus, we performed radical total gastrectomy and D2 LN dissection. Post-operatively, his total prostate-specific antigen levels were high (227 ng/mL) and he was discharged 8 days after surgery without any complications., Competing Interests: Conflict of Interest: No potential conflict of interest relevant to this article was reported.
- Published
- 2017
- Full Text
- View/download PDF
23. Cooccurrence of Metastatic Papillary Thyroid Carcinoma and Salmonella Induced Neck Abscess in a Cervical Lymph Node.
- Author
-
Kim JM, Kim JY, Jung EJ, Song EJ, Kim DC, Jeong CY, Ju YT, Lee YJ, Hong SC, Choi SK, and Ha WS
- Abstract
Cervical lymph node metastasis is common in patients with papillary thyroid carcinoma (PTC). Salmonella species are rarely reported as causative agents in focal infections of the head and neck. The cooccurrence of lymph node metastasis from PTC and a bacterial infection is rare. This report describes a 76-year-old woman with a cervical lymph node metastasis from PTC and Salmonella infection of the same lymph node. The patient presented with painful swelling in her left lateral neck region for 15 days, and neck ultrasonography and computed tomography showed a cystic mass along left levels II-IV. The cystic mass was suspected of being a metastatic lymph node; modified radical neck dissection was performed. Histopathological examination confirmed the presence of PTC in the resected node and laboratory examination of the combined abscess cavity confirmed the presence of Salmonella Typhi . Following antibiotic sensitivity testing of the cultured Salmonella Typhi , she was treated with proper antibiotics. Cystic lesions in lymph nodes with metastatic cancer may indicate the presence of cooccurring bacterial infection. Thus, culturing of specimen can be option to make accurate diagnosis and to provide proper postoperative management., Competing Interests: The authors have declared that there is no conflict of interests regarding the publication of this paper.
- Published
- 2017
- Full Text
- View/download PDF
24. Relationship between low body mass index and morbidity after gastrectomy for gastric cancer.
- Author
-
Kim JM, Park JH, Jeong SH, Lee YJ, Ju YT, Jeong CY, Jung EJ, Hong SC, Choi SK, and Ha WS
- Abstract
Purpose: This study aimed to evaluate the association between low body mass index (BMI) and morbidity after gastric cancer surgery., Methods: A total of 1,805 patients were included in the study. These subjects had undergone gastric cancer surgery at a single institution between January 1997 and December 2013. Clinicopathologic and morbidity data were analyzed by dividing the patients into 2 groups: underweight patients (BMI < 18.5 kg/m(2)) and nonunderweight patients (BMI ≥ 18.5 kg/m(2))., Results: The overall complication rate as determined by our study was 24.4%. Pulmonary complications occurred more frequently in the underweight group (UWG) than in the non-UWG (10.5% vs. 3.8%, respectively; P = 0.012). Multivariate analysis revealed two independent factors responsible for postoperative pulmonary complications-weight of the patients (UWG vs. non-UWG, 10.8% vs. 3.8%; P < 0.007) and stage of gastric cancer (early stage vs. advanced stage, 3.1% vs. 6.8%; P < 0.023). Multivariate analysis revealed that underweight (UWG vs. non-UWG, 10.8% vs. 3.8%, respectively, P < 0.007) and advanced cancer stage (early stage vs. advanced stage, 3.1% vs. 6.8%, respectively, P = 0.023) were significant risk factors for postoperative pulmonary complications., Conclusion: We concluded that underweight patients had a higher pulmonary complication rate. Additionally, underweight and advanced cancer stage were determined to be independent risk factors for the development of postoperative pulmonary complications.
- Published
- 2016
- Full Text
- View/download PDF
25. CD44 Variant 9 Serves as a Poor Prognostic Marker in Early Gastric Cancer, But Not in Advanced Gastric Cancer.
- Author
-
Go SI, Ko GH, Lee WS, Kim RB, Lee JH, Jeong SH, Lee YJ, Hong SC, and Ha WS
- Subjects
- Disease Progression, Humans, Lymphatic Metastasis, Prognosis, Stomach Neoplasms pathology, Biomarkers, Tumor, Hyaluronan Receptors genetics, Stomach Neoplasms genetics
- Abstract
Purpose: The present study is to investigate the significance of CD44 variant 9 (CD44v9) expression as a biomarker in primary gastric cancer., Materials and Methods: With various gastric tissues, we performed immunohistochemical staining for CD44v9., Results: The positive expression rates for CD44v9 in tumor, including adenoma, early gastric cancer (EGC), and advanced gastric cancer (AGC), were higher than those in non-tumor tissues (p=0.003). In addition, the higher expression for CD44v9 was observed as the tissue becomes malignant. In the analysis of 333 gastric cancer tissues, we found that positive expression rates for CD44v9 were higher in the intestinal type or well differentiated gastric cancer than in the diffuse type or poorly differentiated gastric cancer. Interestingly, the positive expression indicated poor prognosis in EGC (5-year survival rate [5-YSR] in stage I, 81.7% vs. 95.2%; p=0.013), but not in AGC (5-YSR in stage II, 66.9% vs. 62.2%; p=0.821; 5-YSR in stage III, 34.5% vs. 32.0%; p=0.929). Moreover, strong positive expression (3+) showed a trend suggesting worse prognosis only in EGC, and it appeared to be associated with lymph node metastasis., Conclusion: This study suggests that CD44v9 may be a good biomarker for prognosis prediction and for chemoprevention or biomarker-driven therapies only for EGC.
- Published
- 2016
- Full Text
- View/download PDF
26. A noble method for intraoperative fine localization during laparoscopic gastric local resection: endoscopic submucosal cutting and light transmission.
- Author
-
Lee YJ, Park JH, Jeong SH, Ha CY, Kwag SJ, Kim JY, Park T, Jeong CY, Ju YT, Jung EJ, Hong SC, Choi SK, and Ha WS
- Subjects
- Animals, Gastroscopes, Models, Animal, Swine, Gastric Mucosa surgery, Gastroscopy methods, Laparoscopy, Light, Stomach Neoplasms surgery
- Abstract
Background: The main requirements when performing laparoscopic local resection for early mucosal tumors of the stomach are a clearly defined cancer-free margin and precise tumor localization. In this study, a novel method for precise intraoperative tumor localization and appropriate resection in a porcine model is introduced: endoscopic submucosal cutting and light transmission (ESCLT)., Methods: A total of 15 cases of laparoscopic local resection were performed in 6 pigs. The size of the target lesions was approximately 20 mm. The imaginary lesions were located in the high body anterior wall, posterior wall, lower body posterior wall, angle, and antrum anterior wall of the stomach. Mucosal marking around the lesions, mucosal precutting surrounding the marking, and submucosal cutting along the precutting line using white light endoscopy were sequentially performed. Next, an endoscopic light source was placed directly in front of the lesion. Exact oval-shaped submucosal cutting margins were identified via laparoscopy. Laparoscopic local resection was performed after the minimal distance from the stapler line to the submucosal cutting line was confirmed. The sizes of the mucosal marking, submucosal cutting line, and the entire resected mucosa and serosa were measured., Results: The procedure was completed successfully in all pigs. Local resection was completed on all of the lesions. The mean endoscopic and laparoscopic procedure times were 26.1 and 12.7 min, respectively. The mean size of the resected specimens was: (i) marking lesion, 22 × 19.5 mm; (ii) submucosal cutting line, 26.7 × 23.2 mm; (iii) entire resected mucosa, 37 × 31 mm; and (iv) entire resected serosa, 41.7 × 33.1 mm. There was no intraoperative morbidity., Conclusion: ESCLT provides a precise and useful method of intraoperative tumor localization during laparoscopic local resection of the stomach in terms of minimizing the resection of normal stomach tissue and guaranteeing adequate mucosal safety margins.
- Published
- 2015
- Full Text
- View/download PDF
27. Tetraarsenic hexoxide demonstrates anticancer activity at least in part through suppression of NF-κB activity in SW620 human colon cancer cells.
- Author
-
Lee WS, Yun JW, Nagappan A, Park HS, Lu JN, Kim HJ, Chang SH, Kim DC, Lee JH, Jung JM, Hong SC, Ha WS, and Kim G
- Subjects
- Animals, Apoptosis drug effects, Arsenic Trioxide, Cell Line, Tumor, Cell Proliferation drug effects, Colonic Neoplasms genetics, Colonic Neoplasms pathology, Gene Expression Regulation, Neoplastic, Humans, I-kappa B Kinase biosynthesis, Mice, NF-kappa B antagonists & inhibitors, NF-kappa B genetics, Phosphorylation, Tumor Necrosis Factor-alpha biosynthesis, Antineoplastic Agents administration & dosage, Arsenicals administration & dosage, Colonic Neoplasms drug therapy, NF-kappa B biosynthesis, Oxides administration & dosage
- Abstract
Tetraarsenic hexoxide (As4O6) has been used in Korean traditional medicine for the treatment of cancer since the late 1980's, and arsenic trioxide (As2O3) is currently used as a chemotherapeutic agent. Previous studies suggest that the As4O6-induced cell death pathway is different from that of As2O3 and its mechanism of anticancer activity remains unclear. Nuclear factor (NF)-κB is a well-known transcription factor involved in cell proliferation, invasion and metastasis. Hence, in the present study, we investigated the effects of As4O6 on NF-κB activity and NF-κB-regulated gene expression in vitro and in vivo. The cytotoxicity assay revealed that As4O6 inhibited the growth of SW620 cells in a dose-dependent manner, and the half maximal inhibitory concentration (IC50) was ~1 µM after a 48 h treatment. As4O6 suppressed NF-κB activation and suppressed inhibitory κBα (IκBα) phosphorylation stimulated by tumor necrosis factor (TNF). As4O6 also suppressed downstream NF-κB-regulated proteins involved in cancer anti-apoptosis, proliferation, invasion and metastasis. In addition, As4O6 marginally suppressed tumor growth and the anti-NF-κB activity was confirmed using an in vivo xenograft mouse model in which animals were injected with SW620 cells. The present study provides evidence that As4O6 has anticancer properties through suppression of NF-κB activity and NF-κB-mediated cellular responses.
- Published
- 2015
- Full Text
- View/download PDF
28. Prognostic importance of ultrasound BI-RADS classification in breast cancer patients.
- Author
-
Kim JY, Jung EJ, Park T, Jeong SH, Jeong CY, Ju YT, Lee YJ, Hong SC, Ha WS, and Choi SK
- Subjects
- Analysis of Variance, Breast Neoplasms chemistry, Carcinoma, Ductal, Breast chemistry, Disease-Free Survival, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Lymphatic Metastasis diagnostic imaging, Neoplasm Staging, Predictive Value of Tests, Prognosis, Proportional Hazards Models, Receptor, ErbB-2 analysis, Receptors, Estrogen analysis, Receptors, Progesterone analysis, Biomarkers, Tumor analysis, Breast Neoplasms diagnostic imaging, Breast Neoplasms pathology, Carcinoma, Ductal, Breast diagnostic imaging, Carcinoma, Ductal, Breast pathology, Ultrasonography, Mammary
- Abstract
Objective: We investigated the prognostic importance of pre-operative Breast Imaging Reporting and Data System classification in ultrasound imaging., Methods: Histopathological differences and disease-free survival were analyzed in Breast Imaging Reporting and Data System classification subgroups. Univariate and multivariate analyses were used to identify the prognostic factors., Results: We identified 531 invasive breast cancer patients eligible for this study. Most patients classified as Breast Imaging Reporting and Data System 5 had large tumors and a higher rate of lymph node metastasis. However, hormonal receptor or HER-2 status did not differ according to Breast Imaging Reporting and Data System classification. During a median post-operative follow-up of 42.0 months, 43 patients were diagnosed with a disease-specific event. Disease-free survival was significantly lower in patients with Breast Imaging Reporting and Data System 5 than in patients with Breast Imaging Reporting and Data System 3-4. Subgroup analysis of patients with invasive breast cancer of Stage I showed that Breast Imaging Reporting and Data System 5 was an independent negative prognostic indicator of disease-free survival (hazard ratio 9.195; 95% confidence interval, 1.175-71.955; P = 0.035)., Conclusions: Breast Imaging Reporting and Data System classification might be considered as prognostic factors especially in Stage I breast cancer. Further confirmatory studies are needed., (© The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
- Published
- 2015
- Full Text
- View/download PDF
29. Impact of tumor size on subclinical central lymph node metastasis in papillary thyroid microcarcinoma depends on age.
- Author
-
Kim JY, Jung EJ, Park T, Jeong SH, Jeong CY, Ju YT, Lee YJ, Hong SC, Choi SK, and Ha WS
- Subjects
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Carcinoma, Papillary surgery, Female, Follow-Up Studies, Humans, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Staging, Prognosis, Thyroid Neoplasms secondary, Thyroid Neoplasms surgery, Tumor Burden, Young Adult, Carcinoma, Papillary secondary, Thyroid Neoplasms pathology, Thyroidectomy
- Abstract
Background: The aim of this study is to evaluate whether the associations between clinicopathologic factors of papillary thyroid microcarcinoma (PTMC), especially tumor size, and subclinical central lymph node metastasis (LNM) are dependent on patient age., Methods: The medical records of 428 patients who underwent thyroid surgery for PTC measuring ≤1 cm were reviewed. All patients were clinically lymph node negative and underwent thyroidectomy with unilateral or bilateral central lymph node dissection. Univariate and multivariate analyses were performed to identify clinicopathologic factors associated with central LNM., Results: Central LNM was identified in 96 of 428 (22.4%) patients. Mean tumor size was significantly greater in patients with than without central LNM (0.74 ± 0.22 cm vs. 0.64 ± 0.23 cm, P = 0.001). Tumor size > 0.5 cm was significantly predictive of central LNM. Subgroup analysis according to age groups showed that tumor size was an independent predictor of subclinical central LNM only in patients aged ≥45 years., Conclusions: Factors predictive of central LNM in patients with PTMC differed by age. PTMC size was an independent predictor of subclinical central LNM only in patients aged ≥45 years.
- Published
- 2015
- Full Text
- View/download PDF
30. Prognostic importance of baseline neutrophil to lymphocyte ratio in patients with advanced papillary thyroid carcinomas.
- Author
-
Kim JY, Park T, Jeong SH, Jeong CY, Ju YT, Lee YJ, Hong SC, Ha WS, Choi SK, and Jung EJ
- Subjects
- Adult, Carcinoma, Papillary immunology, Disease Progression, Disease-Free Survival, Female, Humans, Leukocyte Count, Male, Middle Aged, Prognosis, Retrospective Studies, Carcinoma, Papillary pathology, Lymphocytes pathology, Neutrophils pathology
- Abstract
Inflammation is associated with several tumor development and progression. However, these associations are not clear in well-differentiated thyroid carcinomas. We assessed whether NLR is a useful prognostic marker in patients with papillary thyroid carcinomas (PTC). The medical records of all patients who underwent thyroid surgery at a single institution between March 2005 and September 2012 were retrospectively evaluated; as a control group, patients who underwent routine health examinations in 2012 were also evaluated. Differences in mean NLR among patient groups were assessed, and clinical characteristics according to NLR quartile were evaluated in patients with PTC. The association between NLR and disease-free survival (DFS) in PTC patients was determined. NLR was significantly higher in the groups with than without thyroid nodules, but did not differ significantly in patients with benign and malignant thyroid nodules. Mean NLR was significantly higher in patients with solid or mixed thyroid than in patients with cystic nodules (1.75 ± 0.92 vs. 1.65 ± 0.74, p = 0.004). Patient follow-up ranged from 6 to 99 months. At 5-year follow-up, 11 patients had disease-specific events. We found that 5-year DFS rate was significantly worse in stages III and IV patients with NLR ≥1.5 than NLR <1.5 (94.1 vs. 99.3 %, p = 0.013). The univariate Cox hazard proportional hazard model for DFS revealed that higher NLR was independently correlated with poorer prognosis (hazard ratio 8.76; 95 % confidence interval 1.09-70.27, p = 0.041). Higher NLR may be a negative prognostic marker for DFS in patients with PTC, especially those with stages III and IV.
- Published
- 2014
- Full Text
- View/download PDF
31. OCT-1 overexpression is associated with poor prognosis in patients with well-differentiated gastric cancer.
- Author
-
Jeong SH, Lee YJ, Cho BI, Ha WS, Choi SK, Jung EJ, Ju YT, Jeong CY, Ko GH, Yoo J, and Hong SC
- Subjects
- Aged, CDX2 Transcription Factor, Cell Line, Tumor, Cell Movement, Cell Proliferation, Female, Homeodomain Proteins genetics, Humans, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Invasiveness, Octamer Transcription Factor-1 analysis, Octamer Transcription Factor-1 genetics, Prognosis, Stomach Neoplasms chemistry, Stomach Neoplasms pathology, Octamer Transcription Factor-1 physiology, Stomach Neoplasms mortality
- Abstract
Octamer transcription factor-1 (OCT-1) is a well-known transcription factor that is reportedly overexpressed in intestinal metaplasia and gastric carcinoma in the intestine. In this study, we investigated OCT-1 overexpression as a prognostic factor for gastric cancer. The association between OCT-1 overexpression (detected using immunohistochemistry) and clinicopathological features including survival was evaluated. In vitro gain-of-function approaches were utilized to assess the function of OCT-1 in malignancy. Analysis of OCT-1 expression in patients with gastric cancer with well-differentiated carcinoma as per the World Health Organization classification showed that OCT-1 overexpression was correlated with advanced tumor invasion (58.8 % of patients with advanced tumor invasion vs. 21.2 % of patients with early tumor invasion; p<0.01), lymph node metastasis (63.9 % of patients with metastasis vs. 24.1 % of those without; p=0.015), and cancer recurrence (83.3 % of patients with recurrence vs. 25.4 % of those without; p<0.01), as well as a lower survival rate (62.8 vs. 87.9 Mo; p<0.01). However, there were no significant differences in the levels of OCT-1 expression in gastric cancer patients with other carcinoma types (p>0.05). Furthermore, we found that the proliferation rate of OCT-1-overexpressing MKN-45 cells was higher than that of the control cells. OCT-1 overexpression may be a marker for poor prognosis in patients with well-differentiated gastric adenocarcinoma.
- Published
- 2014
- Full Text
- View/download PDF
32. Arsenic hexoxide enhances TNF-α-induced anticancer effects by inhibiting NF-κB activity at a safe dose in MCF-7 human breast cancer cells.
- Author
-
Kim MJ, Jung JH, Lee WS, Yun JW, Lu JN, Yi SM, Kim HJ, Chang SH, Kim GS, Hong SC, and Ha WS
- Subjects
- Apoptosis drug effects, Arsenic pharmacology, Caspase 8 biosynthesis, Cell Line, Tumor, Cell Proliferation, Drug Resistance, Neoplasm, Enzyme Activation drug effects, Female, Gene Expression Regulation, Neoplastic, Humans, I-kappa B Kinase metabolism, MCF-7 Cells, Neoplasm Invasiveness, Neoplasm Metastasis, Phosphorylation drug effects, Arsenicals pharmacology, Breast Neoplasms drug therapy, Oxides pharmacology, Transcription Factor RelA antagonists & inhibitors, Tumor Necrosis Factor-alpha metabolism
- Abstract
Arsenic hexoxide (As4O6) has been used in Korean folk remedy for the treatment of cancer since the late 1980s. Evidence suggests that the anticancer effects of As4O6 are different from those of As2O3. Tumor necrosis factor-α (TNF-α) is generally increased in advanced cancer and is closely related to cancer progression, although it has cancer-killing effects. The reason is that TNF-α activates nuclear factor-κB (NF-κB) that is involved in cell proliferation, invasion, drug resistance and metastasis. In the present study, we investigated the effects of As4O6 on NF-κB activity, NF-κB-mediated cellular responses, and NF-κB-regulated gene expressions involved in metastasis at the concentrations of As4O6 where no cytotoxicity was observed. As4O6 suppressed NF-κB activation in both TNF-α-treated and control cells, and also suppressed IκB phosphorylation in a time-dependent manner, suggesting the suppression of NF-κB results, in part, from the inhibition of IκB degradation. We also confirmed the anti-NF-κB activity of As4O6 with synergism with TNF-α by augmenting caspase-8 activation. As4O6 also suppressed NF-κB activation induced by TNF-α, and some of the downstream NF-κB-regulated proteins involved in cancer proliferation, anti-apoptosis and metastasis. In conclusion, the present study demonstrated that As4O6 has anticancer properties by inhibiting NF-κB activation and NF-κB-regulated proteins at least in part through the inhibition of IκB phosphorylation, especially in the conditions of advanced cancer where TNF-α is highly secreted.
- Published
- 2014
- Full Text
- View/download PDF
33. Feasibility of the trans-umbilical route compared with the trans-oral route in gastric upper body endoscopic submucosal dissection: a porcine model.
- Author
-
Jeong SH, Park JH, Yoo MW, Choi SK, Hong SC, Jung EJ, Ju YT, Jeong CY, Ha WS, Ha CY, and Lee YJ
- Subjects
- Animals, Feasibility Studies, Female, Mouth, Neoplasms, Experimental, Operative Time, Stomach Neoplasms surgery, Swine, Umbilicus, Dissection methods, Gastric Mucosa surgery, Natural Orifice Endoscopic Surgery methods
- Abstract
Background: Total gastrectomy is performed for early gastric cancer in the upper body of the stomach because of the high complication rate of endoscopic submucosal dissection (ESD). The aims of the present animal study in pigs were to verify: (1) the feasibility of the trans-umbilical route compared with the trans-oral route in gastric upper body ESD; (2) the non-inferiority of single port laparoscopic lymph node dissection (LLND) compared with multiport LLND; and (3) the safety of 2-basin LLND (upper greater and lesser curvature)., Methods: We separated the pigs (~40 kg each) into two groups: conventional and experimental (n = 5 per group). We performed ESD in the fundus and upper body anterior wall (UBAW) via the trans-oral route and multiport LLND in the conventional group, and via the trans-umbilical route and single port LLND in the experimental group., Results: The completion rates, tissue weights, and specimen diameters of both routes showed no statistical differences in either the fundus or the UBAW. The operative time was shorter with the trans-umbilical route than with the trans-oral route in both areas (p < 0.05). In LLND, there were no differences in surgical outcomes between the multiport and single port groups. Intraoperative perforation was seen in the trans-oral route group (n = 1). Delayed perforation was observed in 30 % of the ESD sites., Conclusions: The trans-umbilical route is feasible and has lower complication rates than the trans-oral route in gastric upper body ESD. Additionally, single port LLND is not inferior to multiport LLND, and one-side-basin dissection is safer than two-side.
- Published
- 2014
- Full Text
- View/download PDF
34. Rebamipide abolishes Helicobacter pylori CagA-induced phospholipase D1 expression via inhibition of NFκB and suppresses invasion of gastric cancer cells.
- Author
-
Kang DW, Hwang WC, Park MH, Ko GH, Ha WS, Kim KS, Lee YC, Choi KY, and Min DS
- Subjects
- Alanine pharmacology, Bacterial Proteins antagonists & inhibitors, Gene Expression Regulation, Enzymologic drug effects, Humans, Neoplasm Invasiveness, Phospholipase D metabolism, Stomach Neoplasms genetics, Up-Regulation drug effects, Alanine analogs & derivatives, Anti-Ulcer Agents pharmacology, Antigens, Bacterial physiology, Bacterial Proteins physiology, Helicobacter pylori drug effects, NF-kappa B antagonists & inhibitors, Phospholipase D genetics, Quinolones pharmacology, Stomach Neoplasms pathology
- Abstract
Infection with cagA-positive Helicobacter pylori is a risk factor for the development of severe gastritis and gastric cancer (GC). CagA protein is injected into gastric epithelial cells and deregulates a variety of cellular signaling molecules. Phospholipase D (PLD) is elevated in many different types of human cancers and has been implicated as a critical factor in inflammation and carcinogenesis. In this study, we show that infection with cagA-positive H. pylori in GC cells significantly induces PLD1 expression via CagA-dependent activation of nuclear factor κB (NFκB). Interestingly, the level of PLD1 protein and IκBα phosphorylation is aberrantly upregulated in H. pylori-infected human GC tissues. Infection with cagA-positive H. pylori and expression of CagA enhanced the binding of NFκB to the PLD1 promoter, and two functional NFκB-binding sites were identified within the PLD1 promoter. Rebamipide, a mucosal-protective antiulcer agent, abolished H. pylori cagA-induced PLD1 expression via inhibition of binding of NFκB to the PLD1 promoter, and also inhibited PLD activity. Moreover, rebamipide suppressed H. pylori-induced matrix metalloproteinase-9, interleukin-8 and activation-induced cytidine deaminase expression as well as invasion of GC cells through downregulation of PLD1. Our data suggest that H. pylori cagA targets PLD1 for invasion of GC cells, and rebamipide might contribute to the antitumorigenic effect of GC cells via inhibition of the H. pylori cagA-NFκB-PLD1 signaling pathway.
- Published
- 2013
- Full Text
- View/download PDF
35. Acute gastric volvulus treated with laparoscopic reduction and percutaneous endoscopic gastrostomy.
- Author
-
Jeong SH, Ha CY, Lee YJ, Choi SK, Hong SC, Jung EJ, Ju YT, Jeong CY, and Ha WS
- Abstract
Acute gastric volvulus requires emergency surgery, and a laparoscopic approach for both acute and chronic gastric volvulus was reported recently to give good results. The case of a 50-year-old patient with acute primary gastric volvulus who was treated by laparoscopic reduction and percutaneous endoscopic gastrostomy is described here. This approach seems to be feasible and safe for not only chronic gastric volvulus, but also acute gastric volvulus.
- Published
- 2013
- Full Text
- View/download PDF
36. Prognostic value of CAPZA1 overexpression in gastric cancer.
- Author
-
Lee YJ, Jeong SH, Hong SC, Cho BI, Ha WS, Park ST, Choi SK, Jung EJ, Ju YT, Jeong CY, Kim JW, Lee CW, Yoo J, and Ko GH
- Subjects
- Aged, CapZ Actin Capping Protein metabolism, Cell Movement, Female, Humans, Lymph Node Excision, Lymphatic Metastasis genetics, Lymphatic Metastasis pathology, Male, Middle Aged, Neoplasm Invasiveness, Neoplasm Recurrence, Local metabolism, Neoplasm Recurrence, Local pathology, Prognosis, Stomach Neoplasms classification, Stomach Neoplasms pathology, CapZ Actin Capping Protein genetics, Gene Expression Regulation, Neoplastic, Stomach Neoplasms genetics
- Abstract
F-actin capping protein α1 subunit (CAPZA1) was previously identified in a proteomic analysis of human gastric cancer clinical specimens and selected for further study. The association between CAPZA1 overexpression, detected by immunohistochemistry, and clinicopathological features including survival were evaluated. In vitro gain-of-function and loss-of-function approaches were utilized to assess the function of CPAZA1 in malignancy. Univariate analysis revealed that poorly differentiated disease, according to the World Health Organization (WHO) classification, advanced T stage, positive lymph nodes, high TNM stage, D2 lymph node dissection, adjuvant chemotherapy and CAPZA1 underexpression were significantly associated with cancer-related death (p<0.05); however, only high TNM stage remained significantly associated by multivariate analysis (p<0.01). CAPZA1 overexpression was associated with well differentiated histology, smaller tumor size, lower T stage, absence of lymph node metastasis, lower TNM stage, lower recurrence rate and longer survival time, compared to CAPZA1 underexpression. In vitro, forced expression of CAPZA1 caused a significant decrease in gastric cancer cell migration and invasion, whereas CAPZA1 depletion had the opposite effect. The present study suggests that CAPZA1 could be a marker of good prognosis in gastric cancer and shows that CAPZA1 is associated with decreased cancer cell migration and invasion.
- Published
- 2013
- Full Text
- View/download PDF
37. Totally laparoscopic distal gastrectomy after learning curve completion: comparison with laparoscopy-assisted distal gastrectomy.
- Author
-
Kim HG, Park JH, Jeong SH, Lee YJ, Ha WS, Choi SK, Hong SC, Jung EJ, Ju YT, Jeong CY, and Park T
- Abstract
Purpose: THE AIMS ARE TO: (i) display the multidimensional learning curve of totally laparoscopic distal gastrectomy, and (ii) verify the feasibility of totally laparoscopic distal gastrectomy after learning curve completion by comparing it with laparoscopy-assisted distal gastrectomy., Materials and Methods: From January 2005 to June 2012, 247 patients who underwent laparoscopy-assisted distal gastrectomy (n=136) and totally laparoscopic distal gastrectomy (n=111) for early gastric cancer were enrolled. Their clinicopathological characteristics and early surgical outcomes were analyzed. Analysis of the totally laparoscopic distal gastrectomy learning curve was conducted using the moving average method and the cumulative sum method on 180 patients who underwent totally laparoscopic distal gastrectomy., Results: Our study indicated that experience with 40 and 20 totally laparoscopic distal gastrectomy cases, is required in order to achieve optimum proficiency by two surgeons. There were no remarkable differences in the clinicopathological characteristics between laparoscopy-assisted distal gastrectomy and totally laparoscopic distal gastrectomy groups. The two groups were comparable in terms of open conversion, combined resection, morbidities, reoperation rate, hospital stay and time to first flatus (P>0.05). However, totally laparoscopic distal gastrectomy had a significantly shorter mean operation time than laparoscopy-assisted distal gastrectomy (P<0.01). We also found that intra-abdominal abscess and overall complication rates were significantly higher before the learning curve than after the learning curve (P<0.05)., Conclusions: Experience with 20~40 cases of totally laparoscopic distal gastrectomy is required to complete the learning curve. The use of totally laparoscopic distal gastrectomy after learning curve completion is a feasible and timesaving method compared to laparoscopy-assisted distal gastrectomy.
- Published
- 2013
- Full Text
- View/download PDF
38. Current status of the use of antiadhesive agents for gastric cancer surgery: a questionnaire survey in South Korea.
- Author
-
Park JH, Jeong SH, Lee YJ, Choi SK, Hong SC, Jung EJ, Jeong CY, Ju YT, and Ha WS
- Abstract
Purpose: The aim of this study was to investigate the current status of the use of antiadhesive agents (AAdAs) via a questionnaire and to discuss the availability of AAdAs., Methods: The survey was sent to a list of members that was approved by the Korean Gastric Association. The survey included questions on AAdA use by surgeons, the type of AAdAs used, and the reasons for not using AAdAs. Surgeons were also asked to describe complications related to AAdAs, and the reliability of its use., Results: The response rate was 21%. The rates of frequent use stratified by procedure were 26.9% (14/52) for open gastrectomy, 5.9% (3/51) for laparoscopic gastrectomy, and 31.5% (17/54) for surgery for postoperative bowel obstruction (P < 0.01). After including data from the occasional use group, the corresponding values were 51.9% (27/52), 19.6% (10/51), and 70.4% (38/54), respectively (P < 0.01). Sefrafilm and Guardix were most commonly used for open procedures. Guardix and Interceed were most commonly used for laparoscopic surgery. The primary reasons for nonuse of AAdAs were ineffectiveness and high cost. Ten percent (4/40) of surgeons observed complications associated with AAdAs. A minority (17.3%, 9/52) had positive attitudes toward AAdAs. The majority of respondents expressed neutral (73.1%, 38/52) or negative (9.6%, 5/52) attitudes toward AAdAs., Conclusion: The low use rates of AAdAs in gastric cancer surgery may be attributable to perceptions that AAdAs are ineffective, unreliable, and costly. We anticipate the emergence of promising antiadhesive strategies that reach far beyond the limitations of current products.
- Published
- 2013
- Full Text
- View/download PDF
39. Effectiveness of endoscopic clipping and computed tomography gastroscopy for the preoperative localization of gastric cancer.
- Author
-
Jeong SH, Bae K, Ha CY, Lee YJ, Lee OJ, Jung WT, Choi SK, Hong SC, Jung EJ, Ju YT, Jeong CY, and Ha WS
- Abstract
Purpose: Before laparoscopic gastrectomy for gastric cancer can be planned, it is very important to know the precise location of the tumor. The aim of this study was to evaluate 3 methods of predicting the exact location of the tumor: preoperative gastrofibroscopy (GFS), preoperative computed tomography gastroscopy (CT), and intraoperative gastroscopy-guided laparoscopy (Lap)., Methods: In this study, 15 patients were prospectively identified, and endoscopic clips were preoperatively placed on the proximal 1 cm of the tumor, at the angle on the greater curvature and opposite the angle on the greater curvature. The distances between the pylorus and the proximal tumor clip (PT), the angle clip (PA), the greater curvature clip (PG), and the gastroesophageal junction were measured by preoperative GFS, preoperative CT, intraoperative Lap, and visual inspection (Vis)., Results: PT, PA, and PG values measured by preoperative GFS differed significantly from the Vis values (P < 0.01). However, preoperative CT measurements of PT, PA, and PG did not differ from the Vis values (P = 0.78, P = 0.48, and P = 0.53, respectively). Intraoperative Lap and Vis PT values differed by only 1.1 cm on an average (P = 0.10), but PA and PG values varied by 1.9 and 3.4 cm, respectively (P = 0.01 for both)., Conclusion: Endoscopic clipping combined with preoperative CT gastroscopy is more useful than preoperative GFS for preoperatively predicting the location of early gastric cancers and will be helpful for planning laparoscopic gastrectomy.
- Published
- 2013
- Full Text
- View/download PDF
40. Pyrophosphatase overexpression is associated with cell migration, invasion, and poor prognosis in gastric cancer.
- Author
-
Jeong SH, Ko GH, Cho YH, Lee YJ, Cho BI, Ha WS, Choi SK, Kim JW, Lee CW, Heo YS, Shin SH, Yoo J, and Hong SC
- Subjects
- Adenocarcinoma, Mucinous enzymology, Adenocarcinoma, Mucinous mortality, Blotting, Western, Case-Control Studies, Cell Movement, Cell Proliferation, Disease Progression, Electrophoresis, Gel, Two-Dimensional, Female, Humans, Immunoenzyme Techniques, Inorganic Pyrophosphatase antagonists & inhibitors, Inorganic Pyrophosphatase genetics, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Recurrence, Local enzymology, Neoplasm Recurrence, Local mortality, Neoplasm Staging, Prognosis, RNA, Messenger genetics, RNA, Small Interfering genetics, Real-Time Polymerase Chain Reaction, Reverse Transcriptase Polymerase Chain Reaction, Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization, Stomach enzymology, Stomach Neoplasms enzymology, Stomach Neoplasms mortality, Survival Rate, Tissue Array Analysis, Tumor Cells, Cultured, Adenocarcinoma, Mucinous pathology, Biomarkers, Tumor metabolism, Inorganic Pyrophosphatase metabolism, Neoplasm Recurrence, Local pathology, Stomach pathology, Stomach Neoplasms pathology
- Abstract
Inorganic pyrophosphatase (PPase) catalyzes the hydrolysis of pyrophosphate to form orthophosphate. Pyrophosphate can substitute for ATP under certain circumstances. We previously conducted a proteomic analysis to investigate tumor-specific protein expression in gastric cancer, and PPase was identified as a potential gastric tumor-specific marker; it was therefore selected for further study. Clinicopathological analysis, using proteomic analysis and immunohistochemistry, was used to validate PPase as a prognostic marker in gastric cancers. Proteomic analysis showed that PPase was overexpressed in patients with lymph node (LN) metastases and high tumor node metastasis (TNM) stages (p < 0.05). Based on immunohistochemistry, patients whose tumors overexpressed PPase had higher T stages, LN metastasis, a higher TNM stage, a higher cancer recurrence rate, and shorter survival times than patients whose tumors exhibited PPase underexpression (p < 0.05). Gain-of-function and loss-of-function approaches were employed to examine the malignant phenotypes of PPase-overexpressing or PPase-depleted cells. A decrease in PPase expression caused a significant decrease in gastric cancer cell migration and invasion in vitro, whereas forced overexpression of PPase enhanced migration but not invasion. Our findings indicate that PPase is involved in gastric tumor progression and that PPase may be a useful marker for poor prognosis of human gastric cancers.
- Published
- 2012
- Full Text
- View/download PDF
41. Prognostic value of sonic hedgehog protein expression in gastric cancer.
- Author
-
Kim JY, Ko GH, Lee YJ, Ha WS, Choi SK, Jung EJ, Jeong CY, Ju YT, Jeong SH, and Hong SC
- Subjects
- Humans, Immunohistochemistry, Kaplan-Meier Estimate, Lymphatic Metastasis, Neoplasm Staging, Prognosis, Stomach Neoplasms diagnosis, Tissue Array Analysis, Biomarkers, Tumor biosynthesis, Hedgehog Proteins biosynthesis, Stomach Neoplasms metabolism
- Abstract
Objective: Sonic hedgehog is produced in gastric epithelial cells and plays a crucial role in parietal cell function and the regulation of gastric epithelial cell differentiation. Emerging evidence suggests that the sonic hedgehog pathway is not only involved in the development of cancers but also in their progression and aggressiveness., Methods: To assess its prognostic value in gastric cancer, sonic hedgehog protein expression was measured by immunohistochemistry in a clinically annotated tissue microarray comprising 319 human gastric cancer specimens. Cytoplasmic sonic hedgehog expression was scored from 0 to 4, reflecting the percentage of sonic hedgehog-positive cells., Results: Specimens were classified into two groups according to their sonic hedgehog score: those with a score ranging from 0 to 3 were considered low expressers and those with a score of 4 were considered overexpressers. The sonic hedgehog overexpression group included more patients with early gastric cancer than the low sonic hedgehog expression group (25.9 vs. 74.1%, P=0.000). Sonic hedgehog expression was lower in patients with lymph node metastasis than in patients without lymph node metastasis (31.4 vs. 68.4%, P=0.02). Similarly, patients with a lower TNM stage showed significantly higher sonic hedgehog expression. In addition, the survival time of patients with sonic hedgehog overexpression was significantly prolonged (69.27±1.39 months) compared with that of patients with low sonic hedgehog expression (61.23±2.04 months, log-rank test, P=0.03)., Conclusions: These results indicate that sonic hedgehog overexpression may be a marker of good prognosis in gastric cancer.
- Published
- 2012
- Full Text
- View/download PDF
42. Fatty acid-binding protein 5 promotes cell proliferation and invasion in human intrahepatic cholangiocarcinoma.
- Author
-
Jeong CY, Hah YS, Cho BI, Lee SM, Joo YT, Jung EJ, Jeong SH, Lee YJ, Choi SK, Ha WS, Park ST, and Hong SC
- Subjects
- Aged, Aged, 80 and over, Bile Duct Neoplasms, Bile Ducts, Intrahepatic, Blotting, Western, Cell Line, Tumor, Cell Proliferation, Cholangiocarcinoma genetics, Fatty Acid-Binding Proteins genetics, Female, Gene Expression Regulation, Neoplastic, Gene Knockdown Techniques, Humans, Liver Neoplasms genetics, Lymphatic Metastasis genetics, Male, Middle Aged, Proteomics methods, Reference Values, Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization, Cholangiocarcinoma metabolism, Cholangiocarcinoma pathology, Fatty Acid-Binding Proteins metabolism, Liver Neoplasms metabolism, Liver Neoplasms pathology
- Abstract
Intrahepatic cholangiocarcinoma (ICC) is a rare primary malignant liver tumor with an extremely poor prognosis. Recently its incidence has increased, however, little attention has been directed to factors related to its molecular carcinogenesis, including oncogenes, tumor suppressor genes and cell cycle-related proteins. ICC is generally characterized by strong proliferation, invasion and early metastasis. These biological behaviors of ICC, with respect to the genetic and molecular aspects, remain to be clarified. In this study, we performed a proteomic analysis to identify the proteomic alterations associated with carcinogenesis of ICC. Protein expression profiles of sixteen cases of ICC were compared with those of adjacent non-involved bile duct tissue. Among the 151 protein spots that showed a statistically significant expression difference (P<0.05), there were 50 spots with significantly increased intensity (3-fold increase) and 17 spots with decreased intensity (3-fold decrease) in cancerous tissues. Of these, increased expression of fatty acid-binding protein 5 (FABP5) was further confirmed by western blot analysis and immunohistochemical analysis. Immunohistochemical analysis of FABP5 expression in tumor specimens obtained from 43 patients with mass-forming (MF) type ICC showed a positive correlation of FABP5 immunoreactivity with tumor size (P=0.047), lymph node metastasis (P=0.013), angioinvasion (P=0.032) and staging (P=0.007). In addition, silencing FABP5 with short hairpin RNA (shRNA) suppressed cell proliferation and invasiveness in HuCCT1 cells, and conversely, overexpression of FABP5 in FABP5-negative Hep3B cells increased cell proliferation and invasiveness. Our study shows that FABP5 is significantly overexpressed in ICC combined lymph node metastasis and is involved in cell proliferation and invasion in vitro. Our data suggest that FABP5 may be associated with tumor progression in ICC.
- Published
- 2012
- Full Text
- View/download PDF
43. Laparoscopic left hemihepatectomy for left intrahepatic duct stones.
- Author
-
Jeong CY, Kim KJ, Hong SC, Jeong SH, Ju YT, Lee YJ, Choi SK, Ha WS, Park ST, and Jung EJ
- Abstract
Purpose: The feasibility of laparoscopic left hemihepatectomy for the management of intrahepatic duct (IHD) stones was evaluated., Methods: The clinical data of 26 consecutive patients who underwent total laparoscopic left hemihepatectomy for IHD stones at Gyeongsang National University Hospital between January 2009 and June 2011 were reviewed retrospectively., Results: The mean operation time was 312.1 ± 63.4 minutes and the mean postoperative hospital stay was 11.8 ± 5.0 days. There were 2 cases of postoperative bile leakage and 3 cases of intra-abdominal fluid collection, which were successfully managed conservatively. Remnant stones were detected in 2 patients. The initial success rate of stone clearance was 92.3% (24 of 26). The remnant stones were located in the common bile duct in both cases and were removed by endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy. Therefore, the final success rate of stone clearance was 100% (26 of 26). During a mean follow-up of 22 months (range, 7 to 36 months), there was no patient with recurrent stone., Conclusion: Laparoscopic surgery could be an effective treatment modality for the management of IHD stones in select patients.
- Published
- 2012
- Full Text
- View/download PDF
44. Clinical features and prognostic factors in papillary thyroid microcarcinoma depends on age.
- Author
-
Cho JK, Kim JY, Jeong CY, Jung EJ, Park ST, Jeong SH, Ju YT, Lee YJ, Hong SC, Ha WS, and Choi SK
- Abstract
Purpose: Clinical outcomes of papillary thyroid microcarcinoma (PTMC) vary. In general, age at diagnosis is an independent prognostic factor in conventional papillary thyroid carcinoma. However, it is unclear in patients of PTMC. The purpose of this study was to identify clinicopathologic features and prognostic factors of PTMC according to patients' age., Methods: Five hundred twenty-seven patients who received thyroid surgery and diagnosed as having PTC between January 2001 and December 2009 were included. The clinical data were retrospectively analyzed., Results: We divided the patients into two groups; group I who were younger than 45 years, and group II who were 45 years old or older. The mean tumor size and incidences of neck lymph nodes involvement of group I was larger than group II. In group II, however, there were more patients who had multiple cancer foci and were body mass index ≥ 25 kg/m(2). The overall incidence of recurrent disease was 3.2%. The incidence of recurrence was higher in group II (2.0% vs. 4.0%), without a statistical difference. In multivariate analysis, the significant risk factors of recurrence were male gender and multifocality in group I, and lymph node metastasis and multifocality in group II. In particular, the male gender and multifocality showed the highest odds ratio (OR) on each group (OR, 4.721 and 6.177)., Conclusion: The patients with PTMCs had different clinical features and prognostic factors according to age. Hence, clinicians should consider a different strategy for therapy and plan for follow-up according to age.
- Published
- 2012
- Full Text
- View/download PDF
45. Diagnosis of a trocar site mass as omental herniation after laparoscopic gastrectomy.
- Author
-
Jeong SH, Lee YJ, Kim DC, Bae K, Choi SK, Hong SC, Jung EJ, Ju YT, Jeong CY, and Ha WS
- Abstract
A trocar site hernia is a rare complication. We report a patient who had an abdominal wall mass at a previous trocar site after laparoscopic distal gastrectomy. It was diagnosed as omental herniation and fat necrosis. We conclude that patients with trocar site masses exhibiting fat density on a computed tomography scan could be followed up without surgery, and that fascial defects located at 10-mm or larger trocar sites should be closed whenever possible to prevent hernia formation.
- Published
- 2012
- Full Text
- View/download PDF
46. Analysis of risk factors for postoperative morbidity in perforated peptic ulcer.
- Author
-
Kim JM, Jeong SH, Lee YJ, Park ST, Choi SK, Hong SC, Jung EJ, Ju YT, Jeong CY, and Ha WS
- Abstract
Purpose: Emergency operations for perforated peptic ulcer are associated with a high incidence of postoperative complications. While several studies have investigated the impact of perioperative risk factors and underlying diseases on the postoperative morbidity after abdominal surgery, only a few have analyzed their role in perforated peptic ulcer disease. The purpose of this study was to determine any possible associations between postoperative morbidity and comorbid disease or perioperative risk factors in perforated peptic ulcer., Materials and Methods: In total, 142 consecutive patients, who underwent surgery for perforated peptic ulcer, at a single institution, between January 2005 and October 2010 were included in this study. The clinical data concerning the patient characteristics, operative methods, and complications were collected retrospectively., Results: The postoperative morbidity rate associated with perforated peptic ulcer operations was 36.6% (52/142). Univariate analysis revealed that a long operating time, the open surgical method, age (≥60), sex (female), high American Society of Anesthesiologists (ASA) score and presence of preoperative shock were significant perioperative risk factors for postoperative morbidity. Significant comorbid risk factors included hypertension, diabetes mellitus and pulmonary disease. Multivariate analysis revealed a long operating time, the open surgical method, high ASA score and the presence of preoperative shock were all independent risk factors for the postoperative morbidity in perforated peptic ulcer., Conclusions: A high ASA score, preoperative shock, open surgery and long operating time of more than 150 minutes are high risk factors for morbidity. However, there is no association between postoperative morbidity and comorbid disease in patients with a perforated peptic ulcer.
- Published
- 2012
- Full Text
- View/download PDF
47. Body size and thyroid nodules in healthy Korean population.
- Author
-
Kim JY, Jung EJ, Park ST, Jeong SH, Jeong CY, Ju YT, Lee YJ, Hong SC, Choi SK, and Ha WS
- Abstract
Purpose: Excess weight and obesity have been associated with numerous diseases including thyroid cancer, but the relationship has been weak. The objective of this study was to evaluate the relationship of body sizes on thyroid nodules in healthy Korean population., Methods: A total of 7,763 persons who underwent a health examination in our health examination center were included in this study. The epidemiologic factors, body size and thyroid ultrasound results were reviewed. We investigated the effects of body size on the presence of thyroid nodules and malignancy., Results: The incidence of thyroid nodules was 20.6%. In the group who were found to have thyroid nodules, mean height, weight and body surface area (BSA) were significantly smaller compared to the others. Especially, in the women, smaller height (less than 160 cm) and overweight (≥ 60 kg) were identified as independent risk factors for the presence of thyroid nodules. The patients with body mass index (BMI) subgroups of normal or overweight had a tendency to have thyroid nodules more frequently. The detection rate of thyroid cancer was 0.47%. The patients with thyroid cancer tended to be smaller in height and BSA than the others., Conclusion: A higher frequency of thyroid nodules was associated with women and, older age. In women, there were significant correlations in height, weight and BMI subgroups to the presence of thyroid nodules.
- Published
- 2012
- Full Text
- View/download PDF
48. Laparoscopic resection of a appendiceal mucocele.
- Author
-
Ju YT, Park ST, Ha WS, Hong SC, Lee YJ, Jung EJ, Jung CY, Jeong SH, and Choi SK
- Abstract
Laparoscopic resection of appendiceal mucoceles has recently been described, but the safety and efficacy are controversial. We present two cases of laparoscopic mucocelectomies involving 14 and 15 cm cystic masses originating from the appendix. The laparoscopic mucocelectomies were performed using four ports. From the beginning of the procedure, a laparoscopic bag was used to safely contain the mucocele, prevent rupture of the mucocele, and retract the mucocele. An endoscopic stapling device was used to transect the base of the cecum. Minimal handling was achieved by gravity and with the use of laparoscopic instruments. Laparoscopic appendectomies are widely performed for acute appendicitis, but laparoscopic resection is not routinely performed for an appendiceal mucocele because of the risk of perforation and subsequent pseudomyxoma peritonei. We report two cases of laparoscopic appendiceal mucocelectomies, which were performed safely with laparoscopic instruments and minimal manipulation.
- Published
- 2011
- Full Text
- View/download PDF
49. Pancreatic Diabetes after Distal Pancreatectomy: Incidence Rate and Risk Factors.
- Author
-
Kim KJ, Jeong CY, Jeong SH, Ju YT, Jung EJ, Lee YJ, Choi SK, Ha WS, Park ST, and Hong SC
- Abstract
Purpose: Pancreatectomy can impair production of endocrine and exocrine hormones. In this study, we evaluated: 1) the incidence rate of diabetes in patients undergoing distal pancreatectomy; 2) the correlation between the occurrence of pancreatic diabetes and the extent of the resected pancreas; and 3) factors associated with the development of pancreatic diabetes., Methods: We retrospectively reviewed the cases of 26 patients who could be compared in abdominal computed tomography before and after distal pancreatectomy for benign or malignant lesions between January, 1999 to June, 2010., Results: The incidence of pancreatic diabetes was 19.2%. Obese patients (BMI>25.0 kg/m(2)) had a higher incidence (p=0.029) of pancreatic diabetes after distal pancreatectomy than non-obese patients. The diabetes group had larger volumes of resected pancreas, but the difference was not statistically significant (p=0.105)., Conclusion: Several factors may be associated with the development of pancreatic diabetes after distal pancreatectomy. It is necessary to closely follow-up development of pancreatic diabetes regardless of the extent of resection.
- Published
- 2011
- Full Text
- View/download PDF
50. The indices of body size and aggressiveness of papillary thyroid carcinoma.
- Author
-
Kim JY, Jung EJ, Jeong SH, Jeong CY, Ju YT, Lee YJ, Hong SC, Choi SK, Ha WS, and Park ST
- Abstract
Purpose: The incidence of papillary thyroid carcinoma (PTC) is increasing worldwide. Positive associations between indices of body size and thyroid cancer have been reported. However, the relationships to cancer severities and/or behaviors are uncertain., Methods: We performed a retrospective analysis of the data of patients who underwent total thyroidectomy due to PTC. The epidemiologic factor and pathologic report after operation were determined based on chart review. The relationships between indices of body size and these parameters were assessed., Results: Positive association between body mass index and T stage was found, but it was not statically significant. In neck lymph node metastasis, the group with metastasis had a tendency for larger mean height and weight, but significant difference was found only in height. However, in the multivariate analysis, the age and size of nodules were only identified as independent risk factors of neck lymph node metastasis (P = 0.000 and 0.019)., Conclusion: There was no independent association between indices of body size and stages of PTC in patients who underwent total thyroidectomy.
- Published
- 2011
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.