Prognostic significance of lymphovascular invasion in sporadic colorectal cancer.

Lim, Seok-Byung,Yu, Chang Sik,Jang, Se Jin,Kim, Tae Won,Kim, Jong Hoon,Kim, Jin Cheon Lippincott [etc.] ; Lippincott WilliamsWilkins 2010 Diseases of the colon and rectum Vol.53 No.4

<P>PURPOSE: It remains unclear whether lymphovascular invasion marks a poor prognosis for patients with sporadic colorectal cancers. Here, we analyzed the association between lymphovascular invasion and the clinicopathological features and prognosis of sporadic colorectal cancer patients. METHODS: The clinicopathological features and prognosis of 2417 patients with sporadic primary colorectal cancer who underwent an operation at the Asan Medical Center between January 1998 and December 2002 were examined. The patients' clinicopathological parameters and follow-up and survival data were obtained from a prospectively collected database. RESULTS: Of the 2417 patients, a lymphovascular invasion-positive tumor was detected in 610 (25.2%). Compared with patients with lymphovascular invasion-negative tumors those with lymphovascular invasion-positive tumors were older (P < .001) and had higher preoperative serum carcinoembryonic antigen levels (P = .011). Their tumors were also more likely to be poorly differentiated (P < .001) and more advanced in terms of T and N categories (P < .001 and P < .001, respectively). The lymphovascular invasion-positive tumors were also more likely to have metastasized systemically (P < .001). Although lymphovascular invasion-positive and lymphovascular invasion-negative tumors metastasized equally frequently to the liver, lung, peritoneum, and bone, lymphovascular invasion-positive tumors metastasized to systemic lymph nodes more often (P < .001). These tumors also recurred at systemic lymph nodes after curative intent surgery more often (P = .007). Lymphovascular invasion-positive status was an independent unfavorable prognostic factor for the 5-year overall and 5-year disease-free survival of patients with sporadic colorectal cancer (P < .001 and P < .001, respectively). CONCLUSION: Lymphovascular invasion-positive status could be used to identify patients with sporadic primary colorectal cancer with aggressive tumors and as a factor that independently indicates an unfavorable prognosis.</P>

Magnetic resonance imaging of amyloid plaques using hollow manganese oxide nanoparticles conjugated with antibody a&bgr;1–40 in a transgenic mouse model

Kim, Jae-Hun,Ha, Tae Lin,Im, Geun Ho,Yang, Jehoon,Seo, Sang Won,Lee, In Su,Lee, Jung Hee Lippincott Williams Wilkins, Inc. 2013 NEUROREPORT - Vol.24 No.1

<P>In this study, we have shown the feasibility of hollow manganese oxide nanoparticles (HMON) conjugated with an antibody of A beta 1-40 peptide (abA beta 40) (HMON-abA beta 40) for MRI of amyloid plaques in APP/PS1 transgenic mice. MR brain images in APP/PS1 transgenic mice and their nontransgenic littermates were acquired using a 7.0 T MRI system before, and 24 and 72 h after an injection of HMON-abA beta 40. After the injection of HMON-abA beta 40, we found hyperenhanced spots in the frontal cortex area on T1-weighted MR images for transgenic mice, which corresponded qualitatively to amyloid plaques detected by thioflavin-S staining. For quantitative analysis, percent MR signal changes in six brain regions (olfactory cortex, frontal cortex, cerebral cortex, thalamus, hippocampus, and cerebellar cortex) were compared between transgenic and wild-type mice. We found significant increases in the percent MR signal changes in the olfactory cortex, frontal cortex, cerebral cortex, and hippocampus, but there were no significant differences in the thalamus and cerebellar cortex for transgenic mice compared with wild-type mice. This unique strategy allowed us to detect brain regions subjected to amyloid plaque deposition in Alzheimer's disease transgenic mouse models and has a potential to be developed for human applications, which has a current utility in preclinical research, particularly in monitoring therapeutic response for drug development in Alzheimer's disease. NeuroReport 24:16-21 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. NeuroReport 2013, 24:16-21</P>

Autonomic Dysfunction in Normal Tension Glaucoma: The Short-term Heart Rate Variability Analysis

Na, Kyung-Sun,Lee, Na Young,Park, Sung-Hwan,Park, Chan Kee Lippincott Williams Wilkins, Inc. 2010 Journal of glaucoma Vol.19 No.6

INTRODUCTION: The purpose of this study was to investigate the dysfunction of autonomic control that may be a contributing factor in normal tension glaucoma (NTG) by showing the short-term heart rate variability in NTG patients. MATERIALS AND METHODS: Newly diagnosed NTG patients and an age-matched normal control group were enrolled in this prospective study. Blood pressure was obtained and the electrocardiogram was monitored for 5 minutes after 30-minute rest in a supine position. Electrocardiographic signals were transferred to a heart rate analyzer. The time and frequency domain parameters of heart rate variability were analyzed between two groups. RESULT: In all, 77 NTG patients and 30 healthy controls were included in the study. There were no significant differences between NTG and controls with respect to age, sex, and a hypertensive history, heart rate, systolic pressure, and diastolic pressure. NTG patients showed a significant reduction in the standard deviation of the mean of qualified normal-to-normal intervals in comparison with controls (27.64±10.90 vs. 36.22±10.21, P=0.041). Low-frequency values in NTG patients were statistically lower than in healthy controls (P=0.001) and the low-frequency/high-frequency ratio was significantly higher in the NTG group (P=0.000). DISCUSSION: Our study results showed that the dysfunction of an autonomic control is associated with NTG patients.

Cocaine inhibits leptin-induced increase of the cocaine- and amphetamine-regulated transcript peptide in the nucleus accumbens in rats

Cho, Bo Ram,Yoon, Hyung Shin,Kim, Wha Young,Vezina, Paul,Kim, Jeong-Hoon Lippincott Williams & Wilkins 2017 NeuroReport Vol.28 No.11

<P>Two well-known appetite-regulatory peptides, leptin and cocaine-and amphetamine-regulated transcript (CART), are known to be involved in the brain rewarding pathway. However, it is not yet known how they interact in the nucleus accumbens, an important region mediating the rewarding effects of drugs of abuse. Using the immunoassay method, we found that a microinjection of leptin into the nucleus accumbens core induces an immediate and transient increase of the CART peptide in this site, whereas these effects were inhibited by cocaine. These results expand the role of accumbal leptin to the regulation of the CART peptide and further suggest that possible interaction of these appetite-regulating peptides may be involved in cocainemediated rewarding effects. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.</P>

The Clinical Implication and Prediction of Diffuse Splenic FDG Uptake During Cancer Surveillance

Nam, Hyun-Yeol,Kim, Seong-Jang,Kim, In-Joo,Kim, Bum-Soo,Pak, Kyoungjune,Kim, Keunyoung Lippincott Williams Wilkins, Inc. 2010 Clinical nuclear medicine Vol.35 No.10

OBJECTIVE:: The purpose of this study was to investigate correlations between diffuse splenic FDG uptake and hematological and inflammatory parameters to clarify the significance of splenic FDG uptake on PET/CT images. METHODS:: We retrospectively analyzed the consecutive records of F-18 FDG PET/CT scans and selected 31 patients with diffuse splenic FDG uptake as patient group. A total of 25 patients who underwent F-18 FDG PET/CT scans for simple health checkup were enrolled as control group. ROIs were placed on the liver and spleen to measure maximal standardized uptake value (SUVmax). The spleen SUVmax was divided by the liver SUVmax to calculate the spleen/liver ratio. The correlations between the S/L ratio and various hematological parameters were evaluated. RESULTS:: The S/L ratio was positively correlated with serum C-reactive protein level, white blood cell count, and neutrophil count and negatively correlated with hemoglobin, hematocrit, and red blood cell count. Under multiple regression analysis, the Hb level and the C-reactive protein level were the significant predictors for diffuse splenic FDG uptake. CONCLUSION:: In conclusion, our study suggests that concurrent inflammation or anemia at the time of PET/CT study could be one of various causes of diffuse splenic FDG uptake.

Response Rates to Medical Treatments and Long-term Clinical Outcomes of Nonsurgical Patients With Intestinal Behçet Disease

Chung, Moon Jae,Cheon, Jae Hee,Kim, Seung Up,Park, Jae Jun,Kim, Tae Il,Kim, Nam Kyu,Kim, Won Ho Lippincott WilliamsWilkins, Inc. 2010 JOURNAL OF CLINICAL GASTROENTEROLOGY Vol.44 No.6

BACKGROUND: The aims of this study were to evaluate the efficacy of medical treatments and to identify factors to predict clinical outcome of intestinal Behçet disease (BD) during medical treatment. METHODS: We performed a retrospective review of the medical records of 93 patients who were diagnosed and medically treated with intestinal BD at Severance Hospital, Seoul, Korea from 1992 to 2007. A therapeutic response was evaluated 8 weeks after the initiation of medical treatment, and cumulative recurrence and surgery rates were also assessed during long-term follow-up. RESULTS: The initial remission rate at 8 weeks after treatment was 66.7%. During the follow-up period, cumulative recurrence rates for intestinal BD were 24.9% at 2 years and 43.0% at 5 years. The recurrence rate was significantly higher in patients with apparent gastrointestinal symptoms at their initial presentation, volcano-type and deep intestinal ulcers, and those who failed to achieve complete remission during the initial treatment. Cumulative rates for surgery were 6.7% at 2 years and 15.1% at 5 years. The typical type of ulcers was the only predictive factor for the likelihood of surgery. CONCLUSIONS: Our study demonstrates that a considerable number of patients experience disease relapse during follow-up despite a high-remission rate after medical treatment for intestinal BD. Careful observation and intensive treatment should be carried out, especially in patients without complete remission after initial treatment, with deep and volcano-shaped ulcers, or with apparent gastrointestinal symptoms at the time of diagnosis.

Impact of the attainment of current recommended low-density lipoprotein cholesterol goal of less than 70 mg/dl on clinical outcomes in very high-risk patients treated with drug-eluting stents

Kim, Byeong-Keuk,Kim, Dong Whan,Oh, Seungjin,Yoon, Se-Jung,Park, Sungha,Jeon, Dong Woon,Yang, Joo Young Lippincott Williams Wilkins, Inc. 2010 Coronary artery disease Vol.21 No.3

OBJECTIVE: We sought to evaluate whether the attainment of low-density lipoprotein cholesterol (LDL-C) goal of less than 70 mg/dl would affect clinical outcomes in Korean patients treated with drug-eluting stents (DES). BACKGROUND: The current cholesterol guideline has strongly recommended reducing LDL-C to less than 70 mg/dl as the goal of therapy for very high-risk patients. METHODS: From 2003 to 2006, a total of 1347 very high-risk patients were treated with DES. Among them, we identified 578 eligible patients with follow-up LDL-C within 6–8 months after DES and divided these patients into two groups based on the level of follow-up LDL-C: group A, follow-up LDL less than 70 mg/dl (n=234) and group B, LDL of at least 70 mg/dl (n=344). Then we analyzed the incidence of major adverse cardiac and cerebrovascular events [MACCE: death, myocardial infarction, target-vessel revascularization (TVR), non-TVR, cerebrovascular accidents] of both the groups. RESULTS: During the follow-up (mean duration=30±10 months), group A showed a significantly lower TVR (6%) and MACCE rate (14%), compared with group B (TVR: 12%, P=0.032; MACCE: 24%, P=0.002). However, there was no difference in the rate of death, myocardial infarction, or cerebrovascular accidents between the two groups. By multivariate analysis, follow-up LDL-C level of less than 70 mg/dl was one of the significant predictors for the occurrence of MACCE (odds ratio=0.39, 95% confidence interval: 0.21–0.72, P=0.003) or TVR (odds ratio=0.39, 95% confidence interval: 0.20–0.76, P=0.005). CONCLUSION: This study showed that the attainment of LDL-C goal of less than 70 mg/dl was significantly associated with a lower MACCE or TVR rate in very high-risk Korean patients treated with DES.

Clinical Characteristics of Depressed Patients With a History of Suicide Attempts: Results From the CRESCEND Study in South Korea

Park, Min-Hyeon,Kim, Tae-Suk,Yim, Hyeon-Woo,Jeong, Seung Hee,Lee, Chul,Lee, Chang-Uk,Kim, Jae-Min,Jung, Sung-Won,Lee, Min-Soo,Jun, Tae-Youn Lippincott Williams Wilkins, Inc. 2010 The Journal of nervous and mental disease Vol.198 No.10

South Korea is a country with one of the highest suicide rates in the world, and the suicide rate is still on the rise. The purpose of this study was to determine the sociodemographic and clinical characteristics of suicide attempts and risk factors related to suicide attempts among depressed patients in South Korea. Among the 1183 participants, 21.4% had a history of a suicide attempt. When the severity of depression was controlled, the risk factors for patients who attempted suicide included younger age, experienced significant life events before 12 years of age, psychotic symptoms, and previous depressive episodes. The characteristics of attempted suicide in depressed patients in South Korea can be summarized as a high suicide attempt rate with no difference in the number of suicide attempts and lethality between males and females. This unique tendency is probably related to the sociodemographic and cultural characteristics of South Korea.

How Can We Enhance the Performance of Liver Stiffness Measurement Using FibroScan in Diagnosing Liver Cirrhosis in Patients With Chronic Hepatitis B?

Kim, Seung Up,Kim, Do Young,Park, Jun Yong,Lee, Jin Ha,Ahn, Sang Hoon,Kim, Ja Kyung,Paik, Yong Han,Lee, Kwan Sik,Chon, Chae Yoon,Choi, Eun Hee,Song, Ki Jun,Park, Young Nyun,Han, Kwang-Hyub Lippincott WilliamsWilkins, Inc. 2010 JOURNAL OF CLINICAL GASTROENTEROLOGY Vol.44 No.1

GOAL: This study aimed to enhance the diagnostic accuracy by defining different cutoff liver stiffness measurement (LSM) values according to alanine aminotransferase (ALT) level and combining LSM with noninvasive models in patients with chronic hepatitis B (CHB). BACKGROUND: Several studies have indicated that ALT influences LSM using FibroScan. STUDY: The study prospectively enrolled 200 patients (143 men, mean age 45.4 y) between June 2007 and November 2008 who had been diagnosed with CHB and underwent both liver biopsy and LSM on the same day. RESULTS: The area under the receiver operating characteristic curves (AUROC) of LSM for predicting cirrhosis in patients with ALT ≤upper limit of normal (ULN) was higher than that of all patients or those with ALT >ULN and ≤2× ULN (AUROC=0.884 vs. 0.849 and 0.867). The cutoff LSM values for ≥F2, ≥F3, and F4 were 6.0, 7.5, and 10.1 kPa, respectively, in patients with ALT ≤ULN, whereas they were 8.9, 11.0, and 15.5 kPa, respectively, in those with ALT >ULN and ≤2× ULN. The combination of LSM and the age-spleen-platelet ratio index performed the best at predicting cirrhosis, regardless of ALT level (AUROC=0.917 in patients with ALT ≤ULN, 0.909 in those with ALT ≤2× ULN, and 0.894 in all patients). CONCLUSIONS: Different cutoff LSM values according to ALT level and combination with age-spleen-platelet ratio index can enhance the performance of LSM in CHB, regardless of ALT level.

Deficits in Eye Gaze During Negative Social Interactions in Patients With Schizophrenia

Choi, Soo-Hee,Ku, Jeonghun,Han, Kiwan,Kim, Eosu,Kim, Sun I.,Park, Junyoung,Kim, Jae-Jin Lippincott Williams Wilkins, Inc. 2010 The Journal of nervous and mental disease Vol.198 No.11

Impaired social functioning has been reported in patients with schizophrenia. This study aimed to examine characteristics of interpersonal behaviors in patients with schizophrenia during various social interactions using the virtual reality system. Twenty-six patients and 26 controls engaged in the virtual conversation tasks, including 3 positive and 3 negative emotion-laden conversations. Eye gaze and other behavioral parameters were recorded during the listening and answering phases. The amount of eye gaze was assessed as smaller in the patients than in the controls. A significant interaction effect of group status and emotional type was found for the listening phase. The amount of eye gaze in the patients inversely correlated with self-rated scores of assertiveness for the listening phase. These results suggest that the patients displayed inadequate levels of augmentations in eye gaze during negative emotional situations. These deficits should be considered in the treatment and social skills training for patients with schizophrenia.