142 results on '"Hyung Il Seo"'
Search Results
2. Clinical impact of ampulla of Vater cancer subtype classification based on immunohistochemical staining
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Chae Hwa Kwon, Ji Hyun Ahn, Hyung Il Seo, Dong Uk Kim, Sung Yong Han, Suk Kim, Nam Kyung Lee, Seung Baek Hong, Young Mok Park, and Byeong Gwan Noh
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ampullar of Vater cancer ,Histological subtypes ,Immunohistochemical staining ,CK7 ,CDX2 ,Disease-free survival ,Surgery ,RD1-811 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background The histological subtype is an important prognostic factor for ampulla of Vater (AoV) cancer. This study proposes a classification system for the histological subtyping of AoV cancer based on immunohistochemical (IHC) staining and its prognostic significance. Methods Seventy-five AoV cancers were analyzed for cytokeratin 7 (CK7), CK20, and causal-type homeobox transcription factor 2 (CDX2) expression by IHC staining. We differentiated the subtypes (INT, intestinal; PB, pancreatobiliary; MIX, mixed; NOS, not otherwise specified) into classification I: CK7/CK20, classification II: CK7/CK20 or CDX2, classification III: CK7/CDX2 and examined their associations with clinicopathological factors. Results Classifications I, II, and III subtypes were INT (7, 10, and 10 cases), PB (43, 37, and 38 cases), MIX (13, 19, and 18 cases), and NOS (12, 9, and 9 cases). Significant differences in disease-free survival among the subtypes were observed in classifications II and III using CDX2; the PB and NOS subtype exhibited shorter survival time compared with INT subtype. In classification III, an association was revealed between advanced T/N stage, poor differentiation, lymphovascular invasion (LVI), the PB and NOS subtypes, and recurrence risk. In classification III, the subtypes differed significantly in T/N stage and LVI. Patients with the PB subtype had advanced T and N stages and a higher incidence of LVI. Conclusions Classification using CDX2 revealed subtypes with distinct prognostic significance. Combining CK7 and CDX2 or adding CDX2 to CK7/CK20 is useful for distinguishing subtypes, predicting disease outcomes, and impacting the clinical management of patients with AoV cancer.
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- 2024
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3. Ultrashort Cell-Free DNA Fragments and Vimentin-Positive Circulating Tumor Cells for Predicting Early Recurrence in Patients with Biliary Tract Cancer
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Sung Hee Park, Hye Ji Lee, Tae In Kim, Jonghyun Lee, Sung Yong Han, Hyung Il Seo, and Dong Uk Kim
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biliary tract cancer ,circulating tumor cells (CTCs) ,cell-free DNA (cfDNA) ,postoperative recurrence ,recurrence-free survival (RFS) ,Medicine (General) ,R5-920 - Abstract
Background/Objectives: Biliary tract cancer (BTC) is a rare but aggressive malignancy that requires surgical treatment. However, postoperative recurrence rates are high, and reliable predictors of recurrence are limited. This study aimed to investigate the effectiveness of cell-free DNA (cfDNA) and circulating tumor cells (CTCs) in predicting early recurrence after curative surgery and complete adjuvant therapy in patients with BTC. Methods: Twenty-four patients who underwent R0 and R1 resections and completed adjuvant therapy for BTC between September 2019 and March 2022 were followed up until March 2024. Patients were categorized into early recurrence (ER) and non-ER groups, using one year as the cutoff for recurrence. Results: The combination score derived from ultrashort fragments of cfDNA, vimentin-positive CTCs, and carbohydrate antigen (CA) 19-9 levels showed a statistically significant difference between the ER and non-ER groups (p-value < 0.001). The receiver operating characteristic curve from the combination score and CA 19-9 levels yielded areas under the curve of 0.891 and 0.750, respectively. Conclusions: Although further research is required, these findings suggest that cfDNA and CTCs may increase the accuracy of predicting postoperative recurrence in patients with BTC.
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- 2024
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4. Clinical significance of C-reactive protein-to-prealbumin ratio in predicting early recurrence in resectable pancreatic cancer
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Chae Hwa Kwon, Hyung Il Seo, Dong Uk Kim, Sung Yong Han, Suk Kim, Nam Kyung Lee, Seung Baek Hong, Ji Hyun Ahn, Young Mok Park, and Byung Gwan Noh
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pancreatic neoplasms ,c-reactive protein ,prealbumin ,prognosis ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 ,Surgery ,RD1-811 - Abstract
Purpose Resectable pancreatic ductal adenocarcinoma (PDAC) has a high risk of recurrence after curative resection; despite this, the preoperative risk factors for predicting early recurrence remain unclear. This study therefore aimed to identify preoperative inflammation and nutrition factors associated with early recurrence of resectable PDAC. Methods From March 2021 to November 2021, a total of 20 patients who underwent curative resection for PDAC were enrolled in this study. We evaluated the risk factors for early recurrence within 1 year by univariate and multivariate analyses using Cox hazard proportional regression. The cutoff values for predicting recurrence were examined using receiver operating characteristic (ROC) curves. Results In our univariate and multivariate analyses, C-reactive protein (CRP), CRP-albumin ratio, and CRP-prealbumin ratio, as well as sex and age, were significant independent prognostic factors for early recurrence in PDAC. However, known inflammatory factors (neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios), nutritional factors (albumin, prealbumin, ferritin, vitamin D), and inflammatory-nutritional factors (Glasgow Prognostic Score, modified Glasgow Prognostic Score, albumin-bilirubin) showed no association with early recurrence. In addition, using cutoff values by ROC curve analysis, a high preoperative CRP level of >5 mg/L, as well as high CRP-to-albumin (>5.3) and CRP-to-prealbumin (>1.3) ratios showed no prognostic value. Conclusion Our results showed that inflammatory and perioperative nutritional factors, especially CRP-to-prealbumin ratio, have significant associations with early recurrence after curative resection in resectable PDAC. Therefore, for such patients, a cautious approach is needed when inflammation and poor nutritional status are present.
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- 2023
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5. Clinical impact of serum prealbumin in pancreaticobiliary disease
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Young Mok Park, Hyung Il Seo, Byeong Gwan Noh, Suk Kim, Seung Baek Hong, Nam Kyung Lee, Dong Uk Kim, and Sung Yong Han
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prealbumin ,cholecystitis ,pancreaticobiliary malignancy ,malignant disease ,nutrition ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 ,Surgery ,RD1-811 - Abstract
Purpose Although there are many studies on prealbumin in individual diseases such as malignant or inflammatory diseases, there are few comparative studies. This study aimed to compare the clinical differences between prealbumin levels in cholecystitis and pancreaticobiliary malignancies and investigate the clinical impact of low prealbumin levels in pancreaticobiliary malignancies. Methods From June 2021 to September 2021, 61 patients who had undergone surgery for various pancreaticobiliary diseases were enrolled in this study, and their clinicopathological data were retrospectively analyzed. Results Many elderly patients with malignant diseases had poor American Society of Anesthesiologists (ASA) scores, significantly lower albumin and prealbumin levels, and higher systemic immune inflammation indices. The low prealbumin group was older; had poorer ASA scores; and had significantly lower body mass index and hemoglobin and albumin levels and higher systemic immune inflammation indices than the normal prealbumin group. In malignant diseases, the low prealbumin group had significantly lower body mass index and hemoglobin levels and a tendency toward more advanced disease (lymph node and distant metastasis). Conclusion Preoperative low prealbumin levels had an area under the receiver operator characteristic curve of 0.69, suggesting that it may be useful for predicting pancreaticobiliary malignancies. Prealbumin levels were lower in malignant diseases, possibly related to poor nutritional status and systemic immune inflammation. Low prealbumin levels may predict the risk of more advanced disease.
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- 2022
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6. Multilocular cystic hemangioma of the liver mimicking mucinous cystic neoplasm: a case report
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Nam Kyung Lee, Suk Kim, Seung Baek Hong, So Jeong Lee, and Hyung Il Seo
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cavernous hemangioma ,liver neoplasms ,magnetic resonance imaging ,multidetector computed tomography ,Medicine - Abstract
Hepatic hemangiomas infrequently exhibit atypical imaging features, which may cause diagnostic confusion with hepatic malignancies and lead to unnecessary surgery. We report a rare case of multilocular cystic hemangioma of the liver mimicking a mucinous cystic neoplasm of the liver in a 48-year-old female, focusing on computed tomography and magnetic resonance imaging features and their differential diagnosis.
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- 2022
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7. Long-Term Clinical and Radiologic Outcomes after Stent-Graft Placement for the Treatment of Late-Onset Post- Pancreaticoduodenectomy Arterial Hemorrhage
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Woo Jin Kim, Chang Ho Jeon, Hoon Kwon, Jin Hyeok Kim, Ung Bae Jeon, Suk Kim, Hyung Il Seo, and Chang Won Kim
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embolization ,therapeutic ,liver function tests ,pancreaticoduodenectomy ,postoperative hemorrhage ,stent ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Purpose To evaluate the long-term radiologic and clinical outcomes of stent-graft placement for the treatment of post-pancreaticoduodenectomy arterial hemorrhage (PPAH) based on the imaging findings of stent-graft patency and results of liver function tests. Materials and Methods We retrospectively reviewed the medical records of nine consecutive patients who underwent stent-graft placement for PPAH between June 2012 and May 2017. We analyzed the immediate technical and clinical outcomes and liver function test results. Stentgraft patency was evaluated using serial CT angiography images. Results All stent-grafts were deployed in the intended position for the immediate cessation of arterial hemorrhage and preservation of hepatic arterial blood flow. Technical success was achieved in all nine patients. Eight patients survived after discharge, and one patient died on postoperative day 28. The median follow-up duration was 781 days (range: 28–1766 days). Follow- up CT angiography revealed stent-graft occlusion in all patients. However, serum aspartate aminotransferase or alanine aminotransferase levels in all patients were well below those observed in hepatic infarction cases. Conclusion Stent-graft placement is a safe and effective treatment method for acute life-threatening PPAH. Liver function and distal hepatic arterial blood flow were maintained postoperatively despite the high incidence of stent-graft occlusion observed on follow-up CT.
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- 2021
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8. Diffuse large B-cell lymphoma presenting with cholecystitis-like symptoms
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Sung Pil Yun and Hyung Il Seo
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diffuse large b-cell lymphoma ,gallbladder ,cholecystitis ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 ,Surgery ,RD1-811 - Abstract
Diffuse large B-cell lymphoma that arises from the gallbladder is extremely rare, and the associated studies are not well described in the literature. We report our experience that diffuse large B-cell lymphoma of the gallbladder was diagnosed by histological findings after laparoscopic cholecystectomy in a 75-year-old man. The patient was diagnosed with stage IV lymphoma, and chemotherapy was performed following surgery. The abdominal, chest, neck computed tomography (CT) and positron emission tomography (PET)-CT were performed after chemotherapy, and the results showed that there were no multiple lymphadenopathies. The patient was considered to have achieved complete remission. Diffuse large B-cell lymphoma of the gallbladder is extremely rare and never been diagnosis preoperatively. Pathological examination of the cholecystectomy specimen is important. This will be very helpful for identifying patients who need additional treatment.
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- 2018
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9. Hepatic resection for isolated breast cancer liver metastasis: A single-center experience
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Jae Bong Choi, Hyung Il Seo, Sung Pil Yun, Young Lae Jung, Seok Won Lee, Young Tae Bae, and Suk Kim
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breast neoplasms ,liver metastasis ,liver resection ,prognosis ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 ,Surgery ,RD1-811 - Abstract
Purpose The objective of this study was to investigate the outcomes of selected patients with breast cancer liver metastases (BCLM) without extrahepatic metastases after hepatic resection. Methods Patients whose imaging findings did not show extrahepatic disease were selected for hepatic resection. If R0 resection was available and the operative risk was low in preoperative tests, the patients underwent surgery. Results Between 2011 and 2014, six patients underwent hepatic resection for BCLM. All patients received hepatic resection to achieve an R0 resection. The time interval between initial detection of breast cancer and that of liver metastases in the patients, excluding one patient with synchronous metastases, was 55.2 months. Major liver resection was performed in four patients. Differences were observed in the hormone receptor status between the primary breast tumor and liver metastases; however, no difference was observed in the human epidermal growth factor receptor 2 status. The 1-year and 3-year overall survival rates after hepatic resection were 100% and 83.3%, respectively. The 1-year and 3-year disease free survival rates after hepatic resection were 66.7% and 50.0%, respectively. Conclusion Curative resection may be considered as one of the multimodality treatments for BCLM. It shows benefit in selected patients; its selection criteria needs to be investigated.
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- 2017
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10. Clinicopathological features and surgical outcomes of neuroendocrine tumors of ampulla of Vater
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Kwangho Yang, Sung Pil Yun, Suk Kim, Nari Shin, Do Youn Park, and Hyung Il Seo
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Neoplasms ,Neuroendocrine tumors ,Ampulla of Vater ,Pancreaticoduodenectomy ,Treatment outcome ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Abstract Background The study aims to investigate the clinicopathological features and surgical outcomes of neuroendocrine tumors of ampulla of Vater (NETAoVs) patients who underwent pancreaticoduodenectomy. Methods From January 2007 to December 2014, 45 patients underwent pancreaticoduodenectomy for malignant disease of the ampulla of Vater in our institution. Of those, 5 patients were diagnosed as neuroendocrine tumors. The data included age, sex, presenting symptoms, preoperative imaging, preoperative type of biopsy results, type of operation, pathologic findings and survival status. Results The patient’s mean age was 55.2 ± 9.7 years. Endoscopic ultrasound guided biopsy was performed in 4 patients and gastroduodenoscopic biopsy was performed in one patient. All showed neuroendocrine tumor without mitosis. Mean tumor size was 1.9 ± 0.56 cm (range, 1.2–2.0 cm). Lymph node metastases were detected in two patients. All patients were synaptophysin-positive. Median periods of follow-up were 45 months (range, 43–78 months). Recurrence after operation occurred in two patients. 4 patients were alive at the last follow-up. Conclusions Radical resection for NETAoVs can provide the information of status of lymph node metastasis after surgery. However, correlation between lymph node metastasis and overall survival is uncertain to date.
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- 2017
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11. Proposal of nomograms to predict clinical outcomes in patients with ampulla of Vater cancer based on the Korea‐Japan collaborative study
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Hyung Sun Kim, Woojin Kim, Itaru Endo, Jin‐Young Jang, Hongbeom Kim, Ki Byung Song, Dae Wook Hwang, Chang Moo Kang, Ho Kyoung Hwang, Sang‐Jae Park, Sung‐Sik Han, Yoo‐Seok Yoon, Jae Do Yang, Ryosuke Amano, Sadaaki Yamazoe, Hiroaki Yanagimoto, Tetsuo Ajiki, Masayuki Ohtsuka, Daisuke Suzuki, Dong‐Shik Lee, Yuji Kitahata, Koji Amaya, Jun Sakata, Hyung Il Seo, Junichiro Yamauchi, Yasuhiro Yabushita, Takayuki Tanaka, Naoki Sakurai, Teijiro Hirashita, Akihiko Horiguchi, Michiaki Unno, Dong Do You, Yo‐ichi Yamashita, Shogo Kobayashi, Yusuke Kyoden, Takao Ide, Hiroaki Nagano, Masafumi Nakamura, Hiroki Yamaue, Masakazu Yamamoto, and Joon Seong Park
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Hepatology ,Surgery - Abstract
In this study, we aimed to develop and validate a nomogram to predict overall survival (OS) and recurrence-free survival (RFS) in patients who underwent curative resection of ampulla of Vater (AOV) cancer. This is the first study for nomograms in AOV cancer patients using retrospective data based on an international multicenter study.A total of 2007 patients with AOV adenocarcinoma who received operative therapy between 2002 January and 2015 December in Korea and Japan were retrospectively assessed to develop a prediction model. Nomograms for 5-year OS and 3-year RFS were constructed by dividing the patients who received and who did not receive adjuvant therapy after surgery, respectively. Significant risk factors were identified by univariate and multivariate Cox analyses. Performance assessment of the four prediction models was conducted by the Harrell's concordance index (C-index) and calibration curves using bootstrapping.A total of 2007 and 1873 patients were collected for nomogram construction to predict 5-year OS and 3-year RFS. We developed four types of nomograms, including models for 5-year OS and 3-year RFS in patients who did not receive postoperative adjuvant therapy, and 5-year OS and 3-year RFS in patients who received postoperative adjuvant therapy. The C-indices of these nomograms were 0.795 (95% confidence interval [CI]: 0.766-0.823), 0.712 (95% CI: 0.674-0.750), 0.804 (95% CI: 0.7778-0.829), and 0.703 (95% CI: 0.669-0.737), respectively.This predictive model could help clinicians to choose optimal treatment and precisely predict prognosis in AOV cancer patients.
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- 2022
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12. Complete resection of large-cell neuroendocrine and hepatocellular carcinoma of the liver: A case report
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Byeong Gwan Noh, Hyung-Il Seo, Young Mok Park, Suk Kim, Seung Baek Hong, and So Jeong Lee
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General Medicine - Published
- 2022
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13. Diagnostic performance of magnetic resonance image for malignant intraductal papillary mucinous neoplasms: the importance of size of enhancing mural nodule within cyst
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Seung Baek Hong, Nam Kyung Lee, Suk Kim, Hyung-Il Seo, Young Mok Park, Byeong Gwan Noh, Dong Uk Kim, Sung Yong Han, and Tae Un Kim
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Male ,Cysts ,Pancreatic Intraductal Neoplasms ,Adenocarcinoma, Mucinous ,Magnetic Resonance Imaging ,Carcinoma, Papillary ,Pancreatic Neoplasms ,Humans ,Female ,Radiology, Nuclear Medicine and imaging ,Tomography, X-Ray Computed ,Aged ,Carcinoma, Pancreatic Ductal ,Retrospective Studies - Abstract
To investigate the clinical significance of enhancing mural nodules ≥ 5 mm by comparing the diagnostic performance of high-risk stigmata for diagnosing the malignant IPMN between the international consensus guideline (ICG) 2012 and 2017 in pancreatic magnetic resonance image (MRI).In this retrospective study, we reviewed preoperative pancreatic MRI with surgically confirmed IPMNs between May 2009 and April 2021. High-risk stigmata, defined by ICG 2012 and ICG 2017, associated with malignant IPMN were evaluated using logistic regression analysis. We calculated and compared the sensitivity and specificity of ICG 2012 and ICG 2017 for diagnosing malignant IPMNs. Receiver-operating characteristic (ROC) curves were used to compare ICG 2012 to ICG 2017.A total of 73 patients (43 men and 30 women; mean age, 69 years; standard deviation, 8 years) with 34 malignant IPMNs and 39 benign IPMNs were included. Among high-risk stigmata, enhancing mural nodule ≥ 5 mm, and MPD diameter ≥ 10 mm were the significant predictor of malignant IPMN, in multivariate logistic regression (P 0.001 for all). For the diagnosis of malignant IPMN, the specificity of ICG 2017 for enhancing mural nodules ≥ 5 mm as the high-risk stigmata was significantly higher than that of ICG 2012 (87.2% vs. 64.1%, P = 0.008). However, there was no significant difference in sensitivity between the two guidelines (94.1% vs. 97.1%, P = 1.0). The comparison of the ROC curves showed that the diagnostic performance of ICG 2017 for malignant IPMNs (AUC, 0.91) significantly improved when compared to that of ICG 2012 (AUC, 0.81) (P = 0.01).When applying enhancing mural nodule ≥ 5 mm as a high-risk stigmata, ICG 2017 provided a significantly higher specificity than ICG 2012 without a reduction in sensitivity.
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- 2022
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14. Revised Clinical Practice Guideline of Korean Pancreatobiliary Association for Acute Pancreatitis: Treatment of Local Complication and Necrotizing Pancreatitis
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Young Hoon Choi, Tae Hyeon Kim, Hyung-Il Seo, and Sung Yong Han
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In severe acute pancreatitis, accompanied by local complications such as acute peripancreatic fluid collection, pancreatic pseudocyst, acute necrotic collection and walled-off necrosis, the mortality rate is as high as 12-25%. In many cases, interventional procedure or surgical treatment are required at an appropriate time. Conservative treatment is considered for acute peripancreatic fluid collection. Endoscopic drainage could be considered preferentially for the treatment of pancreatic pseudocysts with clinical symptoms or complications. In the case of necrotizing pancreatitis, conservative treatment is preferred, but therapeutic intervention should be considered if infectious pancreatic necrosis with clinical deterioration is suspected. For therapeutic intervention, it is recommended to proceed with a step-up approach in which drainage is first performed and, if necessary, necrosectomy is performed. The optimal timing of intervention is considered 4 weeks after the onset of pancreatitis when necrosis become walled-off, but early drainage within 4 weeks can be considered depending on the patient's condition. This guideline provides an overview of current treatment strategies for local complications of acute pancreatitis.
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- 2022
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15. Multilocular cystic hemangioma of the liver mimicking mucinous cystic neoplasm: a case report
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Hyung Il Seo, Seung Baek Hong, So Jeong Lee, Nam Kyung Lee, and Suk Kim
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Unnecessary Surgery ,Computed tomography ,Magnetic resonance imaging ,030204 cardiovascular system & hematology ,medicine.disease ,Cystic Neoplasm ,Hemangioma ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Rare case ,medicine ,Radiology ,Differential diagnosis ,medicine.symptom ,business ,Confusion - Abstract
Hepatic hemangiomas infrequently exhibit atypical imaging features, which may cause diagnostic confusion with hepatic malignancies and lead to unnecessary surgery. We report a rare case of multilocular cystic hemangioma of the liver mimicking a mucinous cystic neoplasm of the liver in a 48-year-old female, focusing on computed tomography and magnetic resonance imaging features and their differential diagnosis.
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- 2022
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16. Curative resection of bladder cancer with pancreas head metastasis
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Young Mok Park, So Jeong Lee, Hyung-Il Seo, Tae-Nam Kim, Suk Kim, and Seung Baek Hong
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medicine.medical_specialty ,Uurinary bladder neoplasm ,Metastatic Urothelial Carcinoma ,Bladder cancer ,business.industry ,Neoplasm metastasis ,medicine.medical_treatment ,Cancer ,Case Report ,medicine.disease ,Pancreaticoduodenectomy ,Malignancy ,Metastasis ,Renal cell carcinoma ,Pancreatectomy ,medicine ,General Materials Science ,Radiology ,Pancreatic neoplasm ,business - Abstract
Bladder cancer is the 9th most frequent cancer worldwide. Its incidence is increasing. The pancreas is an infrequent site of metastasis in relation to any type of malignancy. In this study, we report our experience with a patient who has undergone a pancreaticoduodenectomy for metastatic bladder cancer. A 61-year-old male was admitted with jaundice and pancreas head mass. He underwent robot assisted-cystectomy and ileal conduit for bladder cancer 7 months ago. Initial diagnosis under the imaging study was a resectable pancreas head cancer. However, we did not rule-out a metastatic bladder cancer. He underwent a classic pancreaticoduodenectomy. Based on histologic findings and immunohistochemistry results, a pancreas tumor with 4.9-cm sized metastatic urothelial carcinoma was diagnosed. He experienced no complication. He was discharged 11 days after the surgery. Four cycles of gemcitabine and cisplatin were administered. He remained recurrence-free of tumors for 16 months. Although the benefit of pancreatectomy for patient survival has been reported for metastases from renal cell carcinoma, it is unknown for bladder cancer because of no report. We believe that curative resection for metastasis to pancreas of urothelial carcinoma might be helpful for its management.
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- 2021
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17. Development, validation, and comparison of a nomogram based on radiologic findings for predicting malignancy in intraductal papillary mucinous neoplasms of the pancreas: An international multicenter study
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Hyung Il Seo, Michael D. Kluger, Ho-Seong Han, Wookyeong Song, Wonho Choo, Alex B. Blair, Wooil Kwon, Woo Jung Lee, Taesung Park, Nadine C.M. van Huijgevoort, Goro Honda, Takashi Hatori, Ching-Yao Yang, Shin E. Wang, Hyeong Seok Kim, Ki Byung Song, Satoshi Hirano, Hongbeom Kim, Tsutomu Fujii, Matthias Löhr, Yoo Seok Yoon, Song Cheol Kim, Yasushi Hashimoto, Hiroki Yamaue, Fuyuhiko Motoi, Marc G. Besselink, Masayuki Sho, Marco Del Chiaro, Jin He, Dong Wook Choi, Seong Ho Choi, Chang Moo Kang, Hiroaki Nagano, Hee Chul Yu, Yinmo Yang, Jin Seok Heo, Ippei Matsumoto, Sungyoung Lee, Wenhui Lou, Yi Ming Shyr, Christopher L. Wolfgang, Seungyeoun Lee, Yasuhiro Shimizu, Yuichi Nagakawa, Roberto Salvia, Jin-Young Jang, Jae Do Yang, Sang Geol Kim, Claudio Bassi, Youngmin Han, Sohei Satoi, Gloria H. Su, Jun Chul Chung, Giovanni Marchegiani, Masakazu Yamamoto, Roberto Valente, Seiko Hirono, Surgery, CCA - Imaging and biomarkers, CCA - Cancer Treatment and Quality of Life, Amsterdam Gastroenterology Endocrinology Metabolism, and Graduate School
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medicine.medical_specialty ,genetic structures ,urologic and male genital diseases ,Malignancy ,nomogram ,03 medical and health sciences ,0302 clinical medicine ,medicine ,cancer ,Cyst ,Pancreatic duct ,Hepatology ,Receiver operating characteristic ,business.industry ,Nomogram ,medicine.disease ,radiology ,medicine.anatomical_structure ,intraductal papillary mucinous neoplasms of the pancreas ,Dysplasia ,030220 oncology & carcinogenesis ,Cohort ,030211 gastroenterology & hepatology ,Surgery ,Radiology ,Pancreas ,business ,malignancy prediction - Abstract
Background Although we previously proposed a nomogram to predict malignancy in intraductal papillary mucinous neoplasms (IPMN) and validated it in an external cohort, its application is challenging without data on tumor markers. Moreover, existing nomograms have not been compared. This study aimed to develop a nomogram based on radiologic findings and to compare its performance with previously proposed American and Korean/Japanese nomograms. Methods We recruited 3708 patients who underwent surgical resection at 31 tertiary institutions in eight countries, and patients with main pancreatic duct > 10 mm were excluded. To construct the nomogram, 2606 patients were randomly allocated 1:1 into training and internal validation sets, and area under the receiver operating characteristics curve (AUC) was calculated using 10-fold cross validation by exhaustive search. This nomogram was then validated and compared to the American and Korean/Japanese nomograms using 1102 patients. Results Among the 2606 patients, 90 had main-duct type, 900 had branch-duct type, and 1616 had mixed-type IPMN. Pathologic results revealed 1628 low-grade dysplasia, 476 high-grade dysplasia, and 502 invasive carcinoma. Location, cyst size, duct dilatation, and mural nodule were selected to construct the nomogram. AUC of this nomogram was higher than the American nomogram (0.691 vs. 0.664, p = 0.014) and comparable with the Korean/Japanese nomogram (0.659 vs 0.653, p = 0.255). Conclusions A novel nomogram based on radiologic findings of IPMN is competitive for predicting risk of malignancy. This nomogram would be clinically helpful in circumstances where tumor markers are not available. The nomogram is freely available at http://statgen.snu.ac.kr/software/nomogramIPMN.
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- 2021
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18. Is left lateral sectionectomy of the liver without operative site drainage safe and effective?
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Byeong Gwan Noh, Young Mok Park, and Hyung-Il Seo
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Transplantation ,Hepatology ,Gastroenterology ,Surgery - Abstract
Despite its limited benefits, operative site drainage after elective hepatectomy is routinely used. This study aimed to investigate the safety and effectiveness of left lateral sectionectomy without operative site drainage.This study retrospectively collected data from 31 patients who underwent elective left lateral sectionectomy between January 2017 and June 2020. Based on whether operative site drainage was used, the patients were divided into two groups: drainage and non-drainage of the operative site and a comparative analysis was conducted.A total of 31 patients underwent left lateral sectionectomy during the study period. Of these, 22 patients were diagnosed with hepatocellular carcinoma; three, with intrahepatic cholangiocarcinoma; three, with liver metastasis; and three, with benign liver disease. Ten patients underwent laparoscopy. No significant differences were observed between the open and laparoscopic surgery groups. In the univariate analysis, there were no significant differences in the pre-, intra-, and postoperative clinicopathological factors between the non-drainage and drainage groups. The hospitalization period in the non-drainage group was significantly shorter than in the drainage group (8.44 days vs. 5.87 days,Routine use of surgical drainage for left lateral sectionectomy of the liver to prevent intraperitoneal fluid collection is unnecessary.
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- 2022
19. Structured reporting of CT or MRI for perihilar cholangiocarcinoma: usefulness for clinical planning and interdisciplinary communication
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Dong Uk Kim, Tae Un Kim, Hyung Il Seo, Seung Baek Hong, Il Wan Son, Suk Kim, Nam Kyung Lee, and Sung Yong Han
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Male ,medicine.medical_specialty ,Patient Care Planning ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Structured reporting ,parasitic diseases ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,In patient ,Interdisciplinary communication ,Perihilar Cholangiocarcinoma ,Radiation treatment planning ,Aged ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,humanities ,Klatskin tumor ,Bile Duct Neoplasms ,030220 oncology & carcinogenesis ,Female ,Interdisciplinary Communication ,Radiology ,Tomography, X-Ray Computed ,business ,human activities ,Klatskin Tumor - Abstract
To compare the content and communication between the radiologist and the clinicians for treatment planning of structured reports (SRs) and narrative reports (NRs) for reporting CT/MRI findings in patients with perihilar cholangiocarcinoma. This retrospective study included 54 patients with perihilar cholangiocarcinoma who underwent CT/MRI before ERCP or surgery. For all patients, we generated both NRs and SRs for perihilar cholangiocarcinoma and compared the number of key features between NRs and SRs. In addition, three clinicians performed a questionnaire evaluation that included three questions regarding assessment of the sufficiency of information for surgical or procedural planning, the effort required for information extraction, and the report quality rated on a Likert scale. SRs included significantly more predefined key features (6.89 ± 0.31) than NRs (5.87 ± 0.70) (p
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- 2020
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20. Comparison of gemcitabine plus nab-paclitaxel and FOLFIRINOX in metastatic pancreatic cancer
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Dong Uk Kim, Sung Yong Han, Nam Kyung Lee, Seung Baek Hong, Hyung-Il Seo, Suk Kim, and Young Mi Seol
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Adverse event ,Oncology ,Nab-paclitaxel plus gemcitabine ,medicine.medical_specialty ,Metastatic Pancreatic Carcinoma ,FOLFIRINOX ,medicine.medical_treatment ,03 medical and health sciences ,Predict marker ,0302 clinical medicine ,Retrospective Study ,Internal medicine ,Metastatic pancreatic cancer ,medicine ,Chemotherapy ,Adverse effect ,Nab-paclitaxel ,business.industry ,Metastatic pancreatic carcinoma ,General Medicine ,Gemcitabine ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,business ,medicine.drug - Abstract
BACKGROUND Gemcitabine plus nab-paclitaxel (GA) and modified FOLFIRINOX (FFX) have been widely used as standard first-line treatment in pancreatic cancer. However, it is unclear which regimen is more efficacious. AIM To evaluate a retrospective analysis comparing the efficacy and safety of FFX and GA as first-line chemotherapeutic regimens in patients with metastatic pancreatic cancer. METHODS We retrospectively analyzed and compared outcomes in 101 patients who presented with pancreatic cancer and were treated with either GA (n = 54) or FFX (n = 47). Moreover, we performed subgroup analysis based on the neutrophil/lymphocyte ratio (NLR) and Eastern Cooperative Oncology Group (ECOG) performance status. RESULTS There were no significant differences between two groups in baseline characteristics, except for the ECOG performance status. The median progression-free survival (PFS) (6.43 mo vs 4.90 mo, P = 0.058) was comparable between two groups; however, median overall survival (OS) (10.17 mo vs 6.93 mo, P = 0.008) was longer in patients who received GA regimen. In patients with ECOG 0 (PFS: 8.93 mo vs 5.43 mo, P = 0.002; OS: 16.10 mo vs 6.97 mo, P = 0.000) and those with NLR < 3 (PFS: 8.10 mo vs 6.57 mo, P = 0.008; OS: 12.87 mo vs 9.93 mo, P = 0.002), GA regimen showed higher efficacy. CONCLUSION GA regimen may be recommended to the patients with NLR < 3 or ECOG 0 status although GA and FFX showed comparable efficacy outcomes in patients with metastatic pancreatic cancer.
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- 2020
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21. First-line chemotherapy in very elderly patients with metastatic pancreatic cancer: Gemcitabine monotherapy vs combination chemotherapy
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Dong Uk Kim, Suk Kim, Hyung-Il Seo, Seung Baek Hong, Sung Yong Han, Nam Kyung Lee, and Young Mi Seol
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Oncology ,medicine.medical_specialty ,medicine.medical_treatment ,Combination chemotherapy ,Elderly ,Internal medicine ,Pancreatic cancer ,Metastatic pancreatic cancer ,medicine ,Retrospective Cohort Study ,Chemotherapy ,business.industry ,social sciences ,General Medicine ,Ductal carcinoma ,medicine.disease ,Gemcitabine ,humanities ,Adverse drug event ,First line chemotherapy ,business ,medicine.drug - Abstract
BACKGROUND Combination chemotherapy (gemcitabine plus nab-paclitaxel and FOLFIRINOX) is widely used as the standard first-line treatment for pancreatic cancer. Considering the severe toxicities of combination chemotherapy, gemcitabine monotherapy (G mono) could be used as a first-line treatment in very elderly patients or those with a low Eastern Cooperative Oncology Group status. However, reports on the efficacy of G mono in patients older than 75 years are limited. AIM To evaluate the efficacy of G mono and combination chemotherapy by comparing their clinical outcomes in very elderly patients with pancreatic cancer. METHODS We retrospectively analyzed 104 older patients with pancreatic cancer who underwent chemotherapy with G mono (n = 45) or combination therapy (n = 59) as a first-line treatment between 2011 and 2019. All patients were histologically diagnosed with ductal adenocarcinoma. Primary outcomes were progression-free survival and overall survival. We also analyzed subgroups according to age [65-74 years (elderly) and ≥ 75 years (very elderly)]. Propensity score matching was performed to compare the outcomes between the two chemotherapy groups. RESULTS The baseline characteristics were significantly different between the two chemotherapy groups, especially regarding age, ratio of multiple metastases, tumor burden, and Eastern Cooperative Oncology Group performance status. After propensity score matching, the baseline characteristics were not significantly different between the chemotherapy groups in elderly and very elderly patients. In the elderly patients, the median progression-free survival (62 d vs 206 d, P = 0.000) and overall survival (102 d vs 302 d, P = 0.000) were longer in the combination chemotherapy group. However, in the very elderly patients, the median progression-free survival (147 d and 174 d, respectively, P = 0.796) and overall survival (227 d and 211 d, respectively, P = 0.739) were comparable between the G mono and combination chemotherapy groups. Adverse events occurred more frequently in the combination chemotherapy group than in the G mono group, especially thromboembolism (G mono vs nab-paclitaxel vs FOLFIRINOX; 8.9% vs 5.9% vs 28%, P = 0.041), neutropenia (40.0% vs 76.5% vs 84.0%, P = 0.000), and neuropathy (0% vs 61.8% vs 28.0%, P = 0.006). CONCLUSION In elderly patients, combination therapy is more effective than G mono. However, G mono is superior for the management of metastatic pancreatic cancer in very elderly patients.
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- 2020
22. Clinicopathologic analysis of intraductal papillary neoplasm of bile duct: Korean multicenter cohort study
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Jin Seok Heo, Hongbeom Kim, Heejeong Lee, Jung Hoon Kim, Yoo Seok Yoon, Ho-Seong Han, Sang Jae Park, Il Young Park, Yang Won Nah, Jung Hee Lee, Haeryoung Kim, Joo Young Kim, Hong Jin Kim, Wan-Joon Kim, Eun Kyung Hong, Seung-Mo Hong, Wooil Kwon, Chang Ho Cho, Jae Ri Kim, Hee Sung Kim, Hyung Il Seo, Kyu Yeoun Won, Hye-Jeong Choi, In Woong Han, Young Hun Roh, Kyung-Hee Kim, Jeong Mo Bae, Hyeon Kook Lee, Joon Hyuk Choi, Yu Na Kang, Wonae Lee, Chong Woo Chu, Woo Sung Moon, Kee Taek Jang, In Sang Song, Kyungbun Lee, Young Dong Yu, Sungho Jo, Shin Hwang, Seung Eun Lee, Ho Gak Kim, Hee Chul Yu, Jin Sook Jeong, Jong Sil Lee, Chang-Sup Lim, Sun Whe Kim, Min Sun Cho, Hyung Woo Park, Koo Jeong Kang, Sun Hyung Joo, Do Youn Park, Dong-Sik Kim, Kang Min Han, Jin-Young Jang, Chi Young Jeong, and Dong Wook Choi
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medicine.medical_specialty ,Gastroenterology ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Republic of Korea ,medicine ,Humans ,Survival analysis ,Intraductal Papillary Neoplasm ,Hepatology ,Bile duct ,business.industry ,Incidence (epidemiology) ,medicine.disease ,Bile Ducts, Intrahepatic ,medicine.anatomical_structure ,Bile Duct Neoplasms ,Dysplasia ,030220 oncology & carcinogenesis ,Cohort ,030211 gastroenterology & hepatology ,Bile Ducts ,business ,Rare disease ,Cohort study - Abstract
Background IPNB is very rare disease and most previous studies on IPNB were case series with a small number due to low incidence. The aim of this study is to validate previously known clinicopathologic features of intraductal papillary neoplasm of bile duct (IPNB) based on the first largest multicenter cohort. Methods Among 587 patients previously diagnosed with IPNB and similar diseases from each center in Korea, 387 were included in this study after central pathologic review. We also reviewed all preoperative image data. Results Of 387 patients, 176 (45.5%) had invasive carcinoma and 21 (6.0%) lymph node metastasis. The 5-year overall survival was 80.9% for all patients, 88.8% for IPNB with mucosal dysplasia, and 70.5% for IPNB with invasive carcinoma. According to the “Jang & Kim's modified anatomical classification,” 265 (68.5%) were intrahepatic, 103 (26.6%) extrahepatic, and 16 (4.1%) diffuse type. Multivariate analysis revealed that tumor invasiveness was a unique predictor for survival analysis. (p = 0.047 [hazard ratio = 2.116, 95% confidence interval 1.010–4.433]). Conclusions This is the first Korean multicenter study on IPNB through central pathologic and radiologic review process. Although IPNB showed good long-term prognosis, relatively aggressive features were also found in invasive carcinoma and extrahepatic/diffuse type.
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- 2020
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23. Clinicopathological characteristics of intraductal papillary neoplasm of the bile duct: a Japan‐Korea collaborative study
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Hyung Il Seo, Keiichi Kubota, Sang-Jae Park, Yasuo Haruyama, Noriyoshi Fukushima, Dong Wook Choi, Yasuni Nakanuma, Dong Sup Yoon, Yoh Zen, Dong-Sik Kim, Jin Seok Heo, Eun Kyung Hong, Jaeri Kim, Yang Won Nah, Michiaki Unno, Haeryoung Kim, Masaru Miyazaki, Atsushi Nanashima, Tetsuo Ohta, Jin-Young Jang, Kazuo Inui, Takatsugu Matsumoto, Masafumi Nakamura, Takumi Fukumoto, Shinji Uemoto, Yuhki Sakuraoka, Seung-Mo Hong, Kyung Bun Lee, Joo Young Kim, Kee Taek Jang, Itaru Endo, Shin Hwang, Koo Jeong Kang, Toru Furukawa, and Ho-Seong Han
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medicine.medical_specialty ,Intrahepatic bile ducts ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Internal medicine ,Republic of Korea ,medicine ,Humans ,In patient ,Intraductal Papillary Neoplasm ,Biliary tract neoplasm ,Invasive carcinoma ,Hepatology ,Intraductal papillary mucinous neoplasm ,Bile duct ,business.industry ,medicine.disease ,Bile Ducts, Intrahepatic ,medicine.anatomical_structure ,Bile Duct Neoplasms ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Surgery ,Bile Ducts ,Pancreas ,business - Abstract
BACKGROUND The prevalent location and incidence of intraductal papillary neoplasm of the bile duct (IPNB) and invasive carcinoma associated with them have varied markedly among studies due to differences in diagnostic criteria and tumor location. METHODS IPNBs were classified into two types: Type 1 IPNB, being histologically similar to intraductal papillary mucinous neoplasm of the pancreas, and Type 2 IPNB, having a more complex histological architecture with irregular papillary branching or foci of solid-tubular components. Medical data were evaluated. RESULTS Among 694 IPNB patients, 520 and 174 had Type 1 and Type 2, respectively. The levels of AST, ALT, ALP, T. Bil, and CEA were significantly higher in patients with Type 2 than in those with Type 1. Type 1 IPNB was more frequently located in the intrahepatic bile duct than Type 2, whereas Type 2 was more frequently located in the distal bile duct than Type 1 IPNB (P
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- 2020
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24. Revised Clinical Practice Guidelines of the Korean Pancreatobiliary Association for Acute Pancreatitis
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Sang Hyub Lee, Jung Wan Choe, Young Koog Cheon, Miyoung Choi, Min Kyu Jung, Dong Kee Jang, Jung Hyun Jo, Jae Min Lee, Eui Joo Kim, Sung Yong Han, Young Hoon Choi, Hyung-Il Seo, Dong Ho Lee, and Hong Sik Lee
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Hepatology ,Gastroenterology - Abstract
Acute pancreatitis can range from a mild, self-limiting disease requiring no more than supportive care, to severe disease with life-threatening complications. With the goal of providing a recommendation framework for clinicians to manage acute pancreatitis, and to contribute to improvements in national health care, the Korean Pancreatobiliary Association (KPBA) established the Korean guidelines for acute pancreatitis management in 2013. However, many challenging issues exist which often lead to differences in clinical practices. In addition, with newly obtained evidence regarding acute pancreatitis, there have been great changes in recent knowledge and information regarding this disorder. Therefore, the KPBA committee underwent an extensive revision of the guidelines. The revised guidelines were developed using the Delphi method, and the main topics of the guidelines include the following: diagnosis, severity assessment, initial treatment, nutritional support, convalescent treatment, and the treatment of local complications and necrotizing pancreatitis. Specific recommendations are presented, along with the evidence levels and recommendation grades.
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- 2022
25. Clinicopathological Characteristics of Extrahepatic Biliary Neuroendocrine Neoplasms in the Gallbladder, Extrahepatic Biliary Tract, and Ampulla of Vater: A Single-Center Cross-Sectional Study
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Young Mok Park, Hyung Il Seo, Byeong Gwan Noh, Suk Kim, Seung Baek Hong, Nam Kyung Lee, Dong Uk Kim, Sung Yong Han, and So Jeong Lee
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BackgroundSignificant changes were made in the grading and staging systems for neuroendocrine neoplasms (NENs) in 2017. Therefore, a clinical report to comprehensively update the clinicopathological characteristics, therapeutic approaches, and prognosis of these patients should be drafted.MethodsWe retrospectively reviewed a database of 16 patients who developed NENs or mixed endocrine non-endocrine neoplasms (MiNENs) after curative resection. Among them, eight had ampulla of Vater (AoV) tumors, and eight had non-AoV tumors. One patient had NEN Grade 1, five had NEN Grade 2, and five had NEN Grade 3 (G3); all had poorly differentiated neuroendocrine carcinoma. Five patients had MiNEN or combined carcinoma.ResultsThe mean age was 57.88 years. The overall survival rates after curative surgery at 1, 3, and 5 years were 87.1, 80.4, and 71.4%, respectively. The 1-, 3-, and 5-year disease-free survival rates were 87.1%, 79.8%, and 71.8%, respectively. In univariate analysis, age >65 years, mitotic count (>20/10 high-power fields), Ki-67 index >20%, and presence of stones were significant prognosticators, whereas only the mitotic count was statistically significant in the multivariate analysis. Age >65 years (p=0.039), a Ki-67 index >20% (p=0.03), presence of stones (p=0.021), G3 stage disease, MiNEN (p=0.002), or perineural invasion (pConclusionHigh mitosis count had a greater effect on extrahepatic biliary NEN than the tumor-node-metastasis staging system. Patients with AoV tumors had better prognostic predictor factors compared to those with non-AoV tumors.
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- 2022
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26. Fabrication and Biological Activities of Plasmid DNA Gene Carrier Nanoparticles Based on Biodegradable l-Tyrosine Polyurethane
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Soo-Yong Park, Yang H. Yun, Bum-Joon Park, Hyung-Il Seo, and Ildoo Chung
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LTU ,Pharmaceutical Science ,Article ,DNA-LPEI complex ,RS1-441 ,Pharmacy and materia medica ,gene carrier ,transfection ,Drug Discovery ,Molecular Medicine ,Medicine ,biodegradable ,double emulsion - Abstract
Gene therapy is a suitable alternative to chemotherapy due to the complications of drug resistance and toxicity of drugs, and is also known to reduce the occurrence of cellular mutation through the use of gene carriers. In this study, gene carrier nanoparticles with minimal toxicity and high transfection efficiency were fabricated from a biocompatible and biodegradable polymer, l-tyrosine polyurethane (LTU), which was polymerized from presynthesized desaminotyrosyl tyrosine hexyl ester (DTH) and polyethylene glycol (PEG), by using double emulsion and solvent evaporation techniques, resulting in the formation of porous nanoparticles, and then used to evaluate their potential biological activities through molecular controlled release and transfection studies. To assess cellular uptake and transfection efficiency, two model drugs, fluorescently labeled bovine serum albumin (FITC-BSA) and plasmid DNA-linear polyethylenimine (LPEI) complex, were successfully encapsulated in nanoparticles, and their transfection properties and cytotoxicities were evaluated in LX2 as a normal cell and in HepG2 and MCF7 as cancer cells. The morphology and average diameter of the LTU nanoparticles were confirmed using light microscopy, transmission electron microscopy, and dynamic light scattering, while confocal microscopy was used to validate the cellular uptake of FITC-BSA-encapsulated LTU nanoparticles. Moreover, the successful cellular uptake of LTU nanoparticles encapsulated with pDNA-LPEI and the high transfection efficiency, confirmed by gel electrophoresis and X-gal assay transfection, indicated that LTU nanoparticles had excellent cell adsorption ability, facilitated gene encapsulation, and showed the sustained release tendency of genes through transfection experiments, with an optimal concentration ratio of pDNA and LPEI of 1:10. All the above characteristics are ideal for gene carriers designed to transport and release drugs into the cytoplasm, thus facilitating effective gene therapy.
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- 2021
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27. Relationship between high bile juice amylase levels and chronic bacterial infections in patients with gallbladder cancer
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Young Mok Park, Hyung Il Seo, Suk Kim, Seung Baek Hong, Nam Kyung Lee, Dong Uk Kim, Sung Yong Han, So Jeong Lee, and Jae Ri Kim
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Surgery - Abstract
Pancreatic enzyme reflux into the biliary tract is associated with chronic inflammation and increased cellular proliferation in the biliary epithelium, leading to biliary carcinoma. We evaluated the relationship between high bile juice amylase levels and biliary microflora in patients with malignant gallbladder lesions.In this retrospective study, 25 gallbladder specimens were obtained from patients with gallbladder cancer to evaluate amylase levels and perform bacterial culture. The samples were divided into high and low amylase groups and culture-positive and negative groups for analysis. Bile juice amylase 3 times higher than the normal serum amylase level (36-128 IU/L) was considered high.The number of positive cultures was higher in the high amylase group than in the low amylase group, but the difference was insignificant. There were no differences in other clinicopathological factors. Sixteen patients showed positive culture results;Bacteria in gallbladder were identified more frequently when the amylase level was high. High amylase levels in the gallbladder can be associated with caused chronic bacterial infections with occult pancreaticobiliary reflux, potentially triggering gallbladder cancer.
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- 2021
28. Revised Clinical Practice Guidelines of the Korean Pancreatobiliary Association for Acute Pancreatitis.
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Sang Hyub Lee, Jung Wan Choe, Young Koog Cheon, Miyoung Choi, Min Kyu Jung, Dong Kee Jang, Jung Hyun Jo, Jae Min Lee, Eui Joo Kim, Sung Yong Han, Young Hoon Choi, Hyung-Il Seo, Dong Ho Lee, and Hong Sik Lee
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PANCREATITIS ,NECROTIZING pancreatitis ,NATIONAL health services ,DELPHI method ,THERAPEUTIC complications ,ENDOSCOPIC retrograde cholangiopancreatography - Abstract
Acute pancreatitis can range from a mild, self-limiting disease requiring no more than supportive care, to severe disease with life-threatening complications. With the goal of providing a recommendation framework for clinicians to manage acute pancreatitis, and to contribute to improvements in national health care, the Korean Pancreatobiliary Association (KPBA) established the Korean guidelines for acute pancreatitis management in 2013. However, many challenging issues exist which often lead to differences in clinical practices. In addition, with newly obtained evidence regarding acute pancreatitis, there have been great changes in recent knowledge and information regarding this disorder. Therefore, the KPBA committee underwent an extensive revision of the guidelines. The revised guidelines were developed using the Delphi method, and the main topics of the guidelines include the following: diagnosis, severity assessment, initial treatment, nutritional support, convalescent treatment, and the treatment of local complications and necrotizing pancreatitis. Specific recommendations are presented, along with the evidence levels and recommendation grades. [ABSTRACT FROM AUTHOR]
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- 2023
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29. Use of a Cutting Balloon Dilation as a Rescue Therapy in Patients with Benign Bilioenteric Anastomotic Strictures Refractory to Conventional Balloon Dilation
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Jong Hyun Lee, Dong Uk Kim, Sung Yong Han, Gwang Ha Kim, Hyung Il Seo, Seung Baek Hong, Suk Kim, and Chang Won Kim
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Microbiology (medical) ,Immunology ,Immunology and Allergy - Abstract
Percutaneous balloon dilation with or without placement of an external biliary drain is a nonoperative alternative method for treating benign bilioenteric anastomotic strictures. Although this procedure has a high technical success rate, outcomes are less optimal when attempting to dilate refractory tight strictures. For the stricture, cutting balloon can be an option. We present four patients with benign bilioenteric anastomotic strictures refractory to conventional balloon dilation. To the patients, a peripheral cutting balloon over-the-wire system was inflated, following subsequent conventional non-compliant balloon dilation. After the balloon dilation treatment, an external drainage catheter was placed through the stricture site and maintained for up to 30 days. Technical and end-treatment success was achieved in all four patients. In conclusion, the use of cutting balloon dilation may appear to be a safe and effective alternative method of treatment in patients with benign bilioenteric anastomotic strictures refractory to conventional balloon dilation.
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- 2022
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30. The Relationship Between Survival in Pancreatic Cancer Patients and Small Area-Level Deprivation.
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Tae In Kim, Seunghye Jang, Dong Uk Kim, Changhoon Kim, Jonghyun Lee, Sungyong Han, Hyung Il Seo, and Seung Min Hong
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BILIARY tract cancer ,PANCREATIC cancer ,AGE groups ,SURVIVAL rate ,CANCER patients - Abstract
Background/Aims Pancreatic cancer has a relatively low incidence in South Korea, however, its 5-year survival rate is among the lowest, following biliary tract cancer. With the increasing interest in health equity, researches are being conducted about the disparities in cancer prognosis caused by various factors. However, there is a dearth of research on the relationship between small-area level deprivation and cancer survival, especially for pancreatic cancer. This study aims to explore the relationship between area-level deprivation, individual-level factors, and pancreatic cancer survival. Methods The dataset used in this study is the Busan Regional Cancer Registry. For this study, we focused on pancreatic cancer data for the entire Busan population (N=34,999) from 2003 to 2020. The follow-up period started on the date of diagnosis and ended on December 31, 2022. At the individual level, explanatory variables included age groups (0-44, 45-64, 65-74, ≥75), gender, stage (local, regional, distant) and year. At the regional level, it was divided into 205 neighborhoods based on individuals' place of residence. The Kaplan-Meier method was used for statistical analysis. Results From 2003-2020, we analyzed 7,367 pancreatic cancer patients from the Busan registry. Most patients were 45-64 years old (37.1%, n=2,733), men (56.8%, n=4,186), and distant stage (48.0%, n=3,539). The least deprived group had 20.3% of all pancreatic cancer patients, and the most deprived had 19.8%. Gender didn't significantly impact survival rates. An analysis of the impact of cancer stage and deprivation index on 1-, 3-, and 5-year survival rates revealed that the decrease in survival rates associated with a higher deprivation index was less pronounced at 3 and 5 years compared to 1 year. Conclusion Conclusively, the influence of deprivation index diminished over time, and patients from more deprived areas exhibited a faster decline in survival rates over time. [ABSTRACT FROM AUTHOR]
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- 2024
31. Vimentin-Positive Circulating Tumor Cells and Circulating Tumor DNA Fragmentation for Predicting Postoperative Early Recurrence in Patients with Biliary Tract Cancer.
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Tae In Kim, Sung Hee Park, Hye Ji Lee, Jonghyun Lee, Sung Yong Han, Hyung Il Seo, and Dong Uk Kim
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BILIARY tract cancer ,CHOLANGIOCARCINOMA ,CIRCULATING tumor DNA ,CELL-free DNA ,RECEIVER operating characteristic curves ,CA 19-9 test - Abstract
Background/Aims Biliary tract cancer (BTC) is a rare but aggressive malignancy that requires surgical treatment for cure. However, post-operative recurrence rates are high, and there are few reliable predictors of recurrence. This study aimed to investigate the utility of circulating tumor cells (CTCs) and cell-free DNA (cfDNA) in predicting early recurrence after surgery in bile duct cancer patients. Methods A total of 24 patients who underwent R0, R1 resection for BTC between September 2019 and March 2022 were followed up until 2024 at a tertiary center in South Korea. Results Patients were categorized into early recurrence (ER) and non-ER groups based on a 1-year as a time to recurrence. A combination score calculated by combining vimentin-positive CTCs and ultrashort fragments of cfDNA showed a statistically significant difference between the ER and non-ER groups (p-value=0.007). The ROC curve from the combination score and CA 19-9 levels yielded an AUC of 0.824, with sensitivity of 75.0% and specificity of 87.5%, indicating high suitability. Conclusion Although further studies are needed, this research suggests that CTCs and cfDNA may be effec-tive markers for predicting post-operative recurrence in biliary tract cancer patients. [ABSTRACT FROM AUTHOR]
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- 2024
32. The Relationship Between Survival in Bile Duct Cancer Patients and Small Area-Level Deprivation.
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Jonghyun Lee, Sung Yong Han, Tae in Kim, Changhoon Kim, Hyung Il Seo, Seunghye Jang, and Dong Uk Kim
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CHOLANGIOCARCINOMA ,MULTILEVEL models ,REGIONAL disparities ,OLDER patients ,SURVIVAL rate - Abstract
Background/Aims Health equity, shaped by socioeconomic factors, influences disparities in cancer risk, survival, and screening. Although studied in Korea, research on the link between small-area deprivation and bile duct cancer survival is limited. This study examines bile duct cancer survival rates and risk factors in Busan (2003-2020), focusing on how age, gender, cancer stage, and the Deprivation Index (DI) affect survival using multilevel analysis. Methods Data from the Busan Regional Cancer Registry included 12,950 bile duct cancer patients diagnosed between 2003 and 2020. The outcome was time from diagnosis to death or end of follow-up (December 31, 2022). Explanatory variables included age, gender, cancer stage, year of diagnosis, and regional DI. Kaplan-Meier survival analysis and multilevel models were applied, with significance set at p<0.05. Results Among the 12,950 patients, most were aged 65-74 (35.3%), male (52.8%), and diagnosed at a distant stage (48.0%). Bile duct cancer diagnoses significantly increased from 2003 to 2020 (p<0.001), with a median survival time of 42 weeks. Younger age and local-stage cancer showed higher survival rates, while gender had no significant effect. The multilevel model indicated that a one-unit increase in the deprivation index reduced survival by 5.7%. Empirical Bayesian estimation revealed lower survival rates in 2004-2006 and 2008, with improvement after 2013. The graph plotting the deprivation index (x-axis) against survival probability (y-axis) demonstrated that the slope of the regional deprivation index was steeper for 3-year and 5-year survival rates compared to the 1-year rate across all cancer stages. Conclusion This study shows that individual (age, cancer stage) and regional factors (deprivation) significantly impact bile duct cancer survival in Busan. Despite improvements, disparities persist, particularly among older patients and those in deprived areas. The findings highlight the need for targeted cancer management and policy interventions to reduce regional survival disparities. [ABSTRACT FROM AUTHOR]
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- 2024
33. Vimentin-Positive Circulating Tumor Cells as Diagnostic and Prognostic Biomarkers in Patients with Biliary Tract Cancer
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Sung Yong Han, Dong Uk Kim, Hyun Suk Ko, Sung Hee Park, Aelee Jang, Hyung Il Seo, So Jeong Lee, and Gwang Ha Kim
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medicine.medical_specialty ,diagnosis ,Vimentin ,Gastroenterology ,circulating tumor cell ,Article ,Biliary disease ,Circulating tumor cell ,vimentin ,Internal medicine ,biliary tract cancer ,Biopsy ,medicine ,In patient ,Biliary tract cancer ,biology ,medicine.diagnostic_test ,business.industry ,General Medicine ,medicine.disease ,Peripheral blood ,Potential biomarkers ,biology.protein ,Medicine ,prognosis ,business - Abstract
Biliary tract cancer (BTC) has poor prognosis, thus, early diagnosis is important to decrease mortality. Although vimentin-positive circulating tumor cells (V-CTCs) are a good candidate for diagnostic and prognostic biomarkers, studies on the topic are limited. We aimed to evaluate the diagnostic efficacy of V-CTCs between BTC and benign biliary disease (BBD) and determine the prognostic value of V-CTCs in BTC patients. We recruited 69 participants who had BTCs and BBDs from a single tertiary referral center. We analyzed CTCs and V-CTCs in peripheral blood using the CD-PRIMETM system. Seven patients were excluded due to a technical failure of CTC detection. CTCs were detected in all 62 patients. CTC count >, 40/mL blood (55.8% vs. 20%, p = 0.039), V-CTC count >, 15/mL blood (57.7% vs. 10%, p = 0.005), and V-CTC/CTC ratio >, 40% (48.1% vs. 10%, p = 0.025) were significantly different between BTCs and BBDs. Two or more of these three parameters (61.5% vs. 10%, p = 0.002) increased the accuracy. A combination of CTC markers with CA19-9 and biopsy increased the accuracy (90.4% vs. 10%, p = 0.000). V-CTC >, 50/mL blood was a significant factor affecting survival (140 (66.6–213.3) vs. 253 (163.9–342.1) days, p = 0.008). V-CTC could be a potential biomarker for early diagnosis and predicting prognosis in patients with BTC.
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- 2021
34. Hepatic resection for isolated stomach cancer liver metastases: A single-center experience
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Hyung-Il Seo and Hyunyou Kim
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medicine.medical_specialty ,Hepatic resection ,business.industry ,Internal medicine ,Medicine ,business ,Single Center ,Stomach cancer ,medicine.disease ,Gastroenterology - Published
- 2019
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35. Validation of the prognostic performance in various nodal staging systems for gallbladder cancer: results of a multicenter study
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Jeong-Ik Park, Bo-Hyun Jung, Kwang Ho Yang, Soon-Chan Hong, Young Hoon Roh, Woohyung Lee, Chi-Young Jeong, Young Il Choi, Je Ho Ryu, Chang Soo Choi, Young Hoon Kim, Dong Hoon Shin, Yohan Park, Yang Won Nah, Hyung Il Seo, and M.H. Yoon
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Male ,Oncology ,medicine.medical_specialty ,Log odds ,Nodal staging ,030230 surgery ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,Humans ,Medicine ,Cholecystectomy ,In patient ,Gallbladder cancer ,Staging system ,Aged ,Neoplasm Staging ,Proportional Hazards Models ,Retrospective Studies ,business.industry ,Reproducibility of Results ,Middle Aged ,Prognosis ,medicine.disease ,Survival Rate ,Multicenter study ,030220 oncology & carcinogenesis ,Lymph Node Excision ,Female ,Gallbladder Neoplasms ,Surgery ,Lymph Nodes ,business - Abstract
Although the current nodal staging system for gallbladder cancer (GBC) was changed based on the number of positive lymph nodes (PLN), it needs to be evaluated in various situations. We reviewed the clinical data for 398 patients with resected GBC and compared nodal staging systems based on the number of PLNs, the positive/retrieved LN ratio (LNR), and the log odds of positive LN (LODDS). Prognostic performance was evaluated using the C-index. Subgroups were formed on the basis of an restricted cubic spline plot as follows: PLN 3 (PLN = 0, 1–2, ≥ 3); PLN 4 (PLN = 0, 1–3, ≥ 4); LNR (LNR = 0, 0–0.269, ≥ 0.27); and LODDS (LODDS
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- 2019
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36. Clinical application of a new hemostatic material using mussel-inspired catecholamine hemostat: A pilot study
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Jae-Hoon Kim, Sung Pil Yoon, Moon Sue Lee, Young Mok Park, Haeshin Lee, and Hyung-Il Seo
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Hemostat ,medicine.medical_specialty ,Hemostatic Agent ,business.industry ,medicine.medical_treatment ,Mussel inspired ,Surgery ,Hemostasis ,medicine ,Catecholamine ,General Materials Science ,Hepatectomy ,Prospective cohort study ,business ,Adverse effect ,medicine.drug - Abstract
Backgrounds/Aims This study aimed to evaluate clinical application of InnoSEAL Plus (a mussel-inspired catecholamine hemostat) as a new hemostatic material for humans. Methods Patients treated with topical hemostatic patches after liver resection were enrolled. They were divided into an experimental group (InnoSEAL Plus group) and two control groups (TachoSil® group and Surgicel Fibrillar® group) for efficacy evaluation. Results A total of 15 patients were enrolled. Each group had five patients. The 3-minute hemostasis success rate was 80.0% (4/5 patients) in the InnoSEAL Plus group, 80.0% (4/5 patients) in the TachoSil® group, and 40.0% (2/5 patients) in the Surgicel Fibrillar® group, showing no significant difference in the success rate among these groups (p > 0.05). All three groups exhibited 100% success rate for 10-minute hemostasis. Both InnoSEAL Plus and TachoSil® groups had one patient developing adverse events, which were treated easily with drug administrations. Conclusions InnoSEAL Plus is expected to be functionally not inferior to other conventional hemostatic agents. However, it is necessary to confirm this through multicenter prospective studies in the future.
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- 2021
37. Should Lymph Nodes Be Retrieved in Patients with Intrahepatic Cholangiocarcinoma? A Collaborative Korea–Japan Study
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Nam-Joon Yi, Hee Chul Yu, Sae Byeol Choi, Dong Wook Choi, Chang Moo Kang, Sang-Jae Park, Shoji Kubo, Tomoo Kitajima, Hyung Il Seo, Kazuki Hashida, Young Hoon Roh, Ryusei Matsuyama, Hongbeom Kim, Hiroaki Nagano, Uyama Naoki, Chi Young Jeong, Sohei Satoi, Takumi Fukumoto, Tae Ho Hong, Kaoru Taira, Kyung-Suk Suh, Shigehiro Shiozaki, Keun Soo Ahn, Takehiro Okabayashi, Takeshi Takahara, and Hiroki Hayashi
- Subjects
Cancer Research ,medicine.medical_specialty ,Surgical strategy ,lcsh:RC254-282 ,Article ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,lymph nodes ,Medicine ,metastasis ,In patient ,Lymph node ,Intrahepatic Cholangiocarcinoma ,nomograms ,business.industry ,Medical record ,Nomogram ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Radiology ,Lymph ,business ,cholangiocarcinoma - Abstract
Background: This study was performed to investigate the oncologic role of lymph node (LN) management and to propose a surgical strategy for treating intrahepatic cholangiocarcinoma (IHCC). Methods: The medical records of patients with resected IHCC were retrospectively reviewed from multiple institutions in Korea and Japan. Short-term and long-term oncologic outcomes were analyzed according to lymph node metastasis (LNM). A nomogram to predict LNM in treating IHCC was established to propose a surgical strategy for managing IHCC. Results: A total of 1138 patients were enrolled. Of these, 413 patients underwent LN management and 725 did not. A total of 293 patients were found to have LNM. The No. 12 lymph node (36%) was the most frequent metastatic node, and the No. 8 lymph node (21%) was the second most common. LNM showed adverse long-term oncologic impact in patients with resected IHCC (14 months, 95% CI (11.4&ndash, 16.6) vs. 74 months, 95% CI (57.2&ndash, 90.8), p <, 0.001), and the number of LNM (0, 1&ndash, 3, 4&le, ) was also significantly related to negative oncologic impacts in patients with resected IHCC (74 months, 95% CI (57.2&ndash, 90.8) vs. 19 months, 95% CI (14.4&ndash, 23.6) vs. 11 months, 95% CI (8.1&ndash, 13.8)), p <, 0.001). Surgical retrieval of more than four (&ge, 4) LNs could improve the survival outcome in resected IHCC with LNM (13 months, 95% CI (10.4&ndash, 15.6)) vs. 30 months, 95% CI (13.1&ndash, 46.9), p = 0.045). Based on preoperatively detectable parameters, a nomogram was established to predict LNM according to the tumor location. The AUC was 0.748 (95% CI: 0.706&ndash, 0.788), and the Hosmer and Lemeshow goodness of fit test showed p = 0.4904. Conclusion: Case-specific surgical retrieval of more than four LNs is required in patients highly suspected to have LNM, based on a preoperative detectable parameter-based nomogram. Further prospective research is needed to validate the present surgical strategy in resected IHCC.
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- 2021
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38. A combined large-cell neuroendocrine carcinoma and hepatocellular carcinoma tumor in the liver: A rare case report
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Byeong Gwan NOH, Youngmok PARK, Hyung Il SEO, Suk KIM, Seung Baek HONG, and So Jeong LEE
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General Materials Science - Published
- 2022
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39. Genetic aberration from normal tissues adjacent to biliary tract cancers
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Dong Uk KIM, Sung Yong HAN, Sung Hee PARK, Semin LEE, and Hyung Il SEO
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General Materials Science - Published
- 2022
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40. Clinical impacts of postoperative delirium after cholecystectomy in elderly patients
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Young Mok Park, Hyung Il Seo, and Byeong Gwan Noh
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Surgery ,General Medicine - Published
- 2022
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41. Pure laparoscopic anatomical liver resection using indocyanine green fluorescent imaging
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Young Mok Park, Byeong Gwan Noh, Hyung Il Seo, and Myung Hee Yoon
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Surgery ,General Medicine - Published
- 2022
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42. Validation of functional liver imaging scores (FLIS) derived from gadoxetic acid-enhanced MRI in patients with chronic liver disease and liver cirrhosis: the relationship between Child-Pugh score and FLIS
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Suk Kim, Sung Yong Han, Ho Jun Lee, Dong Uk Kim, Seung Baek Hong, Hyung Il Seo, Ki Suk Choo, and Nam Kyung Lee
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Gadolinium DTPA ,Liver Cirrhosis ,Male ,medicine.medical_specialty ,Gadoxetic acid ,Cirrhosis ,Contrast Media ,Chronic liver disease ,Gastroenterology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Decompensation ,Retrospective Studies ,medicine.diagnostic_test ,Receiver operating characteristic ,business.industry ,Liver Diseases ,Area under the curve ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Confidence interval ,Liver ,030220 oncology & carcinogenesis ,Female ,Radiology ,business ,medicine.drug - Abstract
To validate the functional liver imaging score (FLIS) for prediction of hepatic function in gadoxetic acid–enhanced MRI. We retrospectively identified 134 patients (88 men, 46 women; mean age, 58.8 years) between January 2015 and December 2018 with the following inclusion criteria: patients diagnosed with liver cirrhosis or chronic liver disease (CLD) who underwent gadoxetic acid–enhanced MRI. Three parameters on hepatobiliary phase images were evaluated for FLIS: liver parenchymal enhancement, biliary excretion, and signal intensity of the portal vein. Patients were classified as CLD (n = 11), Child-Pugh (CP) class A (n = 87), CP B (n = 22), or CP C (n = 14). We assessed the correlation between CP score and both FLIS and its components using Spearman rank correlation. Receiver operating characteristic (ROC) curve analysis was performed to demonstrate the cutoff value of FLIS for differentiating between CP classes. The associations between patient characteristics, serum markers, FLIS, and hepatic decompensation were evaluated with Cox proportional hazard models. FLIS and three FLIS parameters showed strong to very strong correlation with CP score (r = −0.60 to 0.82). ROC curve analysis showed that FLIS ≥ 5 was the optimal cutoff for prediction of CP class A or CLD (sensitivity, 83.7%; specificity, 94.4%; area under the curve [AUC], 0.93). FLIS < 5 was independently associated with the development of first hepatic decompensation in patients with CP A (HR, 50.0; 95% confidence interval, 6.2, 400.4). FLIS showed a strong correlation with hepatic function and can stratify the CP class. In addition, FLIS can help prediction for the development of first decompensation. • Functional liver imaging scores (FLIS) and its three parameters, derived from hepatobiliary phase image, have strong to very strong correlations with Child-Pugh (CP) scores. • FLIS can stratify patients with chronic liver disease or liver cirrhosis according to CP classification. • Low FLIS is an independent predictor for first hepatic decompensation in patients with CP class A.
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- 2020
43. Long-Term Clinical and Radiologic Outcomes after Stent-Graft Placement for the Treatment of Late-Onset Post-Pancreaticoduodenectomy Arterial Hemorrhage
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Woo Jin Kim, Chang Ho Jeon, Hoon Kwon, Jin Hyeok Kim, Ung Bae Jeon, Suk Kim, Hyung Il Seo, and Chang Won Kim
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,R895-920 ,Stent ,embolization ,postoperative hemorrhage ,Pancreaticoduodenectomy ,Gastroenterology ,therapeutic ,Medical physics. Medical radiology. Nuclear medicine ,surgical procedures, operative ,Internal medicine ,medicine ,stent ,Radiology, Nuclear Medicine and imaging ,liver function tests ,pancreaticoduodenectomy ,Liver function tests ,business - Abstract
To evaluate the long-term radiologic and clinical outcomes of stent-graft placement for the treatment of post-pancreaticoduodenectomy arterial hemorrhage (PPAH) based on the imaging findings of stent-graft patency and results of liver function tests.We retrospectively reviewed the medical records of nine consecutive patients who underwent stent-graft placement for PPAH between June 2012 and May 2017. We analyzed the immediate technical and clinical outcomes and liver function test results. Stent-graft patency was evaluated using serial CT angiography images.All stent-grafts were deployed in the intended position for the immediate cessation of arterial hemorrhage and preservation of hepatic arterial blood flow. Technical success was achieved in all nine patients. Eight patients survived after discharge, and one patient died on postoperative day 28. The median follow-up duration was 781 days (range: 28-1766 days). Follow-up CT angiography revealed stent-graft occlusion in all patients. However, serum aspartate aminotransferase or alanine aminotransferase levels in all patients were well below those observed in hepatic infarction cases.Stent-graft placement is a safe and effective treatment method for acute life-threatening PPAH. Liver function and distal hepatic arterial blood flow were maintained postoperatively despite the high incidence of stent-graft occlusion observed on follow-up CT.간 기능 검사와 영상 소견을 기반으로 하여 췌십이지장절제술 후 발생한 후기 출혈에서 스텐트-그라프트를 이용한 치료의 장기적 영상의학적, 임상적 경과를 보고자 한다.2012년 6월부터 2017년 5월까지 췌십이지장절제술 후 발생한 후기 출혈로 스텐트-그라프트 삽입술을 받은 9명의 환자를 후향적으로 분석하였다. 저자들은 시술 직후 술기적, 임상적 결과와 간 기능 검사를 검토하였다. 스텐트-그라프트의 개통성은 CT angiography를 이용하여 평가하였다.모든 스텐트-그라프트는 즉각적인 동맥 출혈을 멈추면서 간동맥 혈류를 유지할 수 있도록 의도했던 위치에 배치되었다. 기술적 성공은 모든 9명의 환자에게서 이루어졌다. 8명의 환자는 시술 후 생존하여 퇴원하였으며 한 명의 환자는 시술 28일 후 사망하였다. 평균 추적 관찰 기간은 781일이었다(범위: 28~1766일). 추적관찰 CT angiography에서 모든 환자의 스텐트-그라프트는 폐쇄되었다. 그러나 모든 환자들에서 간 경색을 시사할 만한 혈중 아스파르테이트아미노전달효소나 알라닌아미노전달효소 수치의 증가를 보이지 않았다.스텐트-그라프트 삽입술은 췌십이지장절제술 후 발생한 생명을 위협하는 후기 출혈의 안전하고 효과적인 치료이다. 간 기능과 간 말단부 동맥혈 공급은 추적관찰 CT상 스텐트-그라프트가 높은 확률로 막힘에도 불구하고 유지된다.
- Published
- 2020
44. Coagulopathy-independent, bioinspired hemostatic materials: A full research story from preclinical models to a human clinical trial
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Keumyeon Kim, Mi-Young Koh, Ji Hyun Ryu, Sung Pil Yun, Hyung Il Seo, Soomi Kim, Haeshin Lee, Jae Hun Kim, Chul Woo Jung, Moon Sue Lee, and Joseph P. Park
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animal structures ,Polymers ,Materials Science ,Adhesion (medicine) ,Hemorrhage ,Bioengineering ,02 engineering and technology ,010402 general chemistry ,Bioinformatics ,01 natural sciences ,Fibrin ,Hemostatics ,Adhesives ,medicine ,Coagulopathy ,otorhinolaryngologic diseases ,Animals ,Humans ,Health and Medicine ,Hardware_REGISTER-TRANSFER-LEVELIMPLEMENTATION ,Research Articles ,Hemostasis ,Multidisciplinary ,biology ,fungi ,technology, industry, and agriculture ,TheoryofComputation_GENERAL ,Proteins ,SciAdv r-articles ,021001 nanoscience & nanotechnology ,medicine.disease ,Blood proteins ,Adhesive proteins ,0104 chemical sciences ,Clinical trial ,surgical procedures, operative ,biology.protein ,0210 nano-technology ,Research Article - Abstract
Mussel-inspired adhesion chemistry provides a useful alternative to the use of fibrin glues., Since the first report of underwater adhesive proteins of marine mussels in 1981, numerous studies have reported mussel-inspired synthetic adhesive polymers. However, none of them have developed up to human-level translational studies. Here, we report a sticky polysaccharide that effectively promotes hemostasis from animal bleeding models to first-in-human hepatectomy. We found that the hemostatic material instantly generates a barrier layer that seals hemorrhaging sites. The barrier is created within a few seconds by in situ interactions with abundant plasma proteins. Therefore, as long as patient blood contains proper levels of plasma proteins, hemostasis should always occur even in coagulopathic conditions. To date, insufficient tools have been developed to arrest coagulopathic bleedings originated from genetic disorders, chronic diseases, or surgical settings such as organ transplantations. Mussel-inspired adhesion chemistry described here provides a useful alternative to the use of fibrin glues up to a human-level biomedical application.
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- 2020
45. Small-cell neuroendocrine carcinoma arising from an extra-hepatic bile duct: a case report
- Author
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Young Mok Park, Jae Ryong Shim, Jae Ri Kim, and Hyung-Il Seo
- Subjects
Pathology ,medicine.medical_specialty ,medicine.anatomical_structure ,Small cell neuroendocrine carcinoma ,business.industry ,Gastroenterology ,medicine ,business ,Bile fluid ,Duct (anatomy) ,Hepatic bile - Published
- 2020
46. Risk prediction for malignant intraductal papillary mucinous neoplasm of the pancreas: logistic regression versus machine learning
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Youngmin Han, Sohei Satoi, Masakazu Yamamoto, Yoo Seok Yoon, C.L. Wolfgang, Hongbeom Kim, Alex B. Blair, Satoshi Hirano, Yuichi Nagakawa, Yi Ming Shyr, Taesung Park, Marc G. Besselink, Hyung Il Seo, Yasuhiro Shimizu, Jin-Young Jang, Michael D. Kluger, Jun Chul Chung, Takashi Hatori, Ippei Matsumoto, Goro Honda, Wooil Kwon, Ki Byung Song, Ho-Seong Han, Sungyoung Lee, Wenhui Lou, Roberto Valente, Yoonhyeong Byun, Ryota Higuchi, Seiko Hirono, Hiroki Yamaue, Fuyuhiko Motoi, Matthias Löhr, Shin E. Wang, Wookyeong Song, Wonho Choo, Jae Seung Kang, Gloria H. Su, Jin Seok Heo, Hiroaki Nagano, Nadine C.M. van Huijgevoort, Giovanni Marchegiani, Chanhee Lee, Ching-Yao Yang, Sang Geol Kim, Claudio Bassi, Seungyeoun Lee, Roberto Salvia, Marco Del Chiaro, Jin He, Dong Wook Choi, Seong Ho Choi, Chang Moo Kang, Hee Chul Yu, Yinmo Yang, Yasushi Hashimoto, Tsutomu Fujii, Song Cheol Kim, Yoo Jin Choi, Jae Do Yang, Woo Jung Lee, Masayuki Sho, Surgery, CCA - Imaging and biomarkers, Amsterdam Gastroenterology Endocrinology Metabolism, and Graduate School
- Subjects
0301 basic medicine ,Male ,Pancreatic Intraductal Neoplasms ,lcsh:Medicine ,computer.software_genre ,Logistic regression ,Main duct ,Machine Learning ,0302 clinical medicine ,malignant ,Risk Factors ,IPMN , malignant, regression ,Diagnosis, Computer-Assisted ,lcsh:Science ,Mathematics ,Interpretability ,Multidisciplinary ,Gastroenterology ,Middle Aged ,Prognosis ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Female ,regression ,Pancreas ,Algorithms ,Machine learning ,Cross-validation ,Article ,03 medical and health sciences ,IPMN ,medicine ,Humans ,Model development ,Aged ,Retrospective Studies ,Intraductal papillary mucinous neoplasm ,business.industry ,lcsh:R ,medicine.disease ,030104 developmental biology ,Logistic Models ,Test set ,lcsh:Q ,Artificial intelligence ,Pancreatic Cyst ,business ,computer - Abstract
Most models for predicting malignant pancreatic intraductal papillary mucinous neoplasms were developed based on logistic regression (LR) analysis. Our study aimed to develop risk prediction models using machine learning (ML) and LR techniques and compare their performances. This was a multinational, multi-institutional, retrospective study. Clinical variables including age, sex, main duct diameter, cyst size, mural nodule, and tumour location were factors considered for model development (MD). After the division into a MD set and a test set (2:1), the best ML and LR models were developed by training with the MD set using a tenfold cross validation. The test area under the receiver operating curves (AUCs) of the two models were calculated using an independent test set. A total of 3,708 patients were included. The stacked ensemble algorithm in the ML model and variable combinations containing all variables in the LR model were the most chosen during 200 repetitions. After 200 repetitions, the mean AUCs of the ML and LR models were comparable (0.725 vs. 0.725). The performances of the ML and LR models were comparable. The LR model was more practical than ML counterpart, because of its convenience in clinical use and simple interpretability.
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- 2020
47. Multimodal treatments of right gastroepiploic arterial leiomyosarcoma with hepatic metastasis: A case report and review of the literature
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Hyung-Il Seo, Suk Kim, Dong-Il Kim, Minjoo Kim, Youngsoo Chung, Do Youn Park, Sung-Pil Yun, and Chang In Choi
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Leiomyosarcoma ,Surgical resection ,medicine.medical_specialty ,business.industry ,Case Report ,General Medicine ,030230 surgery ,medicine.disease ,Hepatic metastasis ,body regions ,03 medical and health sciences ,0302 clinical medicine ,Multimodal treatments ,030220 oncology & carcinogenesis ,Intra-abdominal arterial leiomyosarcoma ,medicine ,Multimodal treatment ,Radiology ,business ,Arterial leiomyosarcoma - Abstract
Leiomyosarcoma of an artery is very rare, and cases with hepatic metastasis are even rarer. We describe a case of a 70-year-old man who after follow up due to rectal cancer, presented with an intra-abdominal hypervascular mass and a hepatic mass. After surgical resection, it was diagnosed as a leiomyosarcoma of the right gastroepiploic artery with hepatic metastasis. Multiple metastases had recurred at the liver. He has survived more than 53 mo through multimodal treatments (three surgical resections, radiofrequency ablation, transarterial chemoembolization, chemotherapies, and targeted therapy). Multimodal treatments, including active surgical resection, may be helpful in the treatment of aggressive diseases such as arterial leiomyosarcoma with metastasis.
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- 2018
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48. Predictive value of metabolic activity detected by pre-operative 18F FDG PET/CT in ampullary adenocarcinoma
- Author
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Hyung Il Seo and Young Mok Park
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Adult ,Male ,Ampulla of Vater ,medicine.medical_specialty ,Multivariate statistics ,Multivariate analysis ,Neutrophils ,ampullary adenocarcinoma ,Common Bile Duct Neoplasms ,Observational Study ,Standardized uptake value ,Adenocarcinoma ,Fluorodeoxyglucose F18 ,Positron Emission Tomography Computed Tomography ,18F-fluorodeoxyglucose positron emission tomography ,Humans ,Medicine ,Lymphocytes ,Aged ,Neoplasm Staging ,Proportional Hazards Models ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Proportional hazards model ,Hazard ratio ,Ampullary Adenocarcinoma ,Retrospective cohort study ,General Medicine ,Middle Aged ,Positron emission tomography ,Lymphatic Metastasis ,standardized uptake value ,Female ,prognosis ,Radiology ,Radiopharmaceuticals ,business ,Research Article - Abstract
In ampullary adenocarcinoma cases, the clinical effects of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) have not yet been well-studied, unlike other prognostic factors that have been reported till date. This study aimed to investigate the clinical impact of maximum standardized uptake value (SUVmax) in predicting the prognosis of ampullary adenocarcinoma. Thirty-eight patients who underwent pre-operative 18F-FDG PET/CT and curative-intent resection of ampullary adenocarcinoma at Pusan National University Hospital (Pusan, South Korea) between 2008 and 2017 were retrospectively analyzed in this study. We evaluated the clinicopathologic outcomes according to the SUVmax using univariate and multivariate Cox proportional hazard regression analyses and receiver operating characteristic analysis to arrive at a cutoff value. Lymph node metastasis was detected in 9 patients, and 15 patients experienced a recurrence during the follow-up period. Among 38 patients, 33 showed an increased FDG uptake by the main tumor. SUVmax of 4.55 was selected as a significant independent predictive factor for patient survival along with poor tumor differentiation and high neutrophil-to-lymphocyte ratio in multivariate analysis (P = .016, hazard ratio = 5.040). Patients with SUVmax under 4.55 exhibited significantly longer overall survival than the rest (
- Published
- 2021
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49. Hepatic resection for isolated breast cancer liver metastasis: A single-center experience
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Sung Pil Yun, Hyung Il Seo, Young Tae Bae, Jae Bong Choi, Suk Kim, Seok Won Lee, and Young Lae Jung
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medicine.medical_specialty ,business.industry ,Hepatic resection ,medicine.disease ,Single Center ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,030220 oncology & carcinogenesis ,Medicine ,030211 gastroenterology & hepatology ,Radiology ,business - Published
- 2017
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50. Three cases of adrenocortical tumors mistaken for hepatocellular carcinomas/diagnostic pitfalls and differential diagnosis
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Chang Hun Lee, Ahrong Kim, So Jeong Lee, Do Youn Park, Won Young Park, Gi Yeong Huh, Kyung Un Choi, Young Keum Kim, and Hyung Il Seo
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Choristoma ,Pathology and Forensic Medicine ,Adrenocortical adenoma ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Adrenal Glands ,Parenchyma ,medicine ,Humans ,Adrenocortical carcinoma ,Oncocytoma ,Diagnostic Errors ,Aged ,Ectopic adrenal gland ,business.industry ,Liver Neoplasms ,General Medicine ,Middle Aged ,medicine.disease ,Adrenal Cortex Neoplasm ,Adrenal Cortex Neoplasms ,Liver ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Female ,030211 gastroenterology & hepatology ,Differential diagnosis ,business - Abstract
Adrenocortical adenomas and carcinomas in other parenchyma are extremely rare, with few cases reported and because of the rarity of these tumors, they occasionally cause problems during diagnosis. Adrenal cortical neoplasms in liver parenchyma can be present in 3 forms, including direct invasion or adhesion to liver parenchyma, tumors arising in adrenohepatic fusion tissue or in ectopic adrenal gland tissue. We report 3 cases of adrenal cortical tumors that were misdiagnosed as hepatocellular carcinoma in the preoperative state. The first case involved an adrenocortical adenoma arising in adrenohepatic fusion tissue. The remaining 2 cases involved an adrenocortical carcinoma and an adrenocortical oncocytoma arising in ectopic adrenal tissue in the liver. We describe the clinical presentations, gross, microscopic findings, immunohistochemical findings with respect to each case, with emphasis on differential diagnosis from hepatocellular carcinoma.
- Published
- 2017
- Full Text
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