Shear-Wave Elastographic Features of Breast Cancers: Comparison With Mechanical Elasticity and Histopathologic Characteristics

Lee, Su Hyun,Moon, Woo Kyung,Cho, Nariya,Chang, Jung Min,Moon, Hyeong-Gon,Han, Wonshik,Noh, Dong-Young,Lee, Jung Chan,Kim, Hee Chan,Lee, Kyoung-Bun,Park, In-Ae by Lippincott Williams Wilkins 2014 Vol. No.

OBJECTIVE: The objective of this study was to compare the quantitative and qualitative shear-wave elastographic (SWE) features of breast cancers with mechanical elasticity and histopathologic characteristics. MATERIALS AND METHODS: This prospective study was conducted with institutional review board approval, and written informed consent was obtained. Shear-wave elastography was performed for 30 invasive breast cancers in 30 women before surgery. The mechanical elasticity of a fresh breast tissue section, correlated with the ultrasound image, was measured using an indentation system. Quantitative (maximum, mean, minimum, and standard deviation of elasticity in kilopascals) and qualitative (color heterogeneity and presence of signal void areas in the mass) SWE features were compared with mechanical elasticity and histopathologic characteristics using the Pearson correlation coefficient and the Wilcoxon signed rank test. RESULTS: Maximum SWE values showed a moderate correlation with maximum mechanical elasticity (r = 0.530, P = 0.003). There were no significant differences between SWE values and mechanical elasticity in histologic grade I or II cancers (P = 0.268). However, SWE values were significantly higher than mechanical elasticity in histologic grade III cancers (P < 0.001), which have low amounts of fibrosis, high tumor cellularity, and intratumoral necrosis. In addition, color heterogeneity was correlated with intratumoral heterogeneity of mechanical elasticity (r = 0.469, P = 0.009). Signal void areas in the masses were present in 43% of breast cancers (13 of 30) and were correlated with dense collagen depositions (n = 11) or intratumoral necrosis (n = 2). CONCLUSIONS: Quantitative and qualitative SWE features reflect both the mechanical elasticity and histopathologic characteristics of breast cancers.

Blood pressure–targeted stepwise resuscitation for hemorrhagic shock in rats

Lee, Jae Hyuk,Kim, Kyuseok,Jo, You Hwan,Kim, Min A,Lee, Kyoung-Bun,Rhee, Joong Eui,Doo, Ah-Reum,Lee, Min Ji,Park, Chan Jong,Kim, Joonghee,Chung, Heajin Lippincott Williams Wilkins, Inc. 2014 The journal of trauma and acute care surgery Vol.76 No.3

BACKGROUND: Generation of reactive oxygen species (ROS) is an important mechanism of ischemia-reperfusion injury. Abrupt reoxygenation compared with slow reoxygenation has been known to increase ROS generation. Thus, slow and stepwise reperfusion can reduce ROS generation and subsequent ischemia-reperfusion injury. This study investigated the effect of slow reperfusion by blood pressure–targeted stepwise resuscitation (PSR) in hemorrhagic shock. METHODS: Pressure-controlled hemorrhagic shock was induced in male Sprague-Dawley rats for 1 hour. Rats were then allocated to one of three groups (no-resuscitation group, n = 14; PSR group, n = 15; rapid normalization of blood pressure (RR) group, n = 15). Survival time and hemodynamic changes were recorded and compared. Blood samples and liver tissue were harvested after 6 hours of resuscitation in surviving rats. RESULTS: All of the rats in the no-resuscitation group were expired before the end of the 6-hour observation period. Survival times were significantly longer in the PSR group than in the RR group (survival rates, 11 of 15 vs. 5 of 15, log rank p = 0.032). Plasma amino alanine transferase, histologic liver injury, and ROS generation in the liver tissue were significantly lower in the PSR group than in the RR group (all findings significant, p < 0.05). In addition, PSR significantly decreased plasma nitric oxide, liver interleukin 1&bgr;, and liver interleukin 6 compared with rapid resuscitation in addition to augmenting Akt survival pathways (all p < 0.05). CONCLUSION: Slow reperfusion by PSR decreased mortality, ROS generation, and liver injury in rats undergoing hemorrhagic shock. Stepwise resuscitation also decreased inflammatory cytokine production and augmented Akt survival pathways.

Liver Pathology : Sarcomatoid hepatocellular carcinoma with mixed osteoclast-like giant cells and chondroid differentiation

( Kyoung Bun Lee ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.3

Histopathology of a benign bile duct lesion in the liver: Morphologic mimicker or precursor of intrahepatic cholangiocarcinoma

( Kyoung-bun Lee ) 대한간학회 2016 Clinical and Molecular Hepatology(대한간학회지) Vol.22 No.3

A bile duct lesion originating from intrahepatic bile ducts is generally regarded as an incidental pathologic finding in liver specimens. However, a recent study on the molecular classification of intrahepatic cholangiocarcinoma has focused on the heterogeneity of this carcinoma and has suggested that the cells of different origins present in the biliary tree may have a major role in the mechanism of oncogenesis. In this review, benign intrahepatic bile duct lesions―regarded in the past as reactive changes or remnant developmental anomalies and now noted to have potential for developing precursor lesions of intrahepatic cholangiocarcinoma―are discussed by focusing on the histopathologic features and its implications in clinical practice. (Clin Mol Hepatol 2016;22:400-405)

담낭암의 조직 및 분자 병리학적 발병 기전

이경분 ( Kyoung-bun Lee ) 대한췌담도학회 2018 대한췌담도학회지 Vol.23 No.1

담낭암의 대표적인 조직형은 담낭 점막의 상피세포에서 기원하는 선암(adenocarcinoma)이며, 형태적 유사성에 따라 담도성(biliary), 장관성(intestinal), 위의 소와세포성(foveolar), 혹은 편평상피성(adenosquamous) 등으로 분류할 수 있다. 선암의 전암성 병변은 3가지가 있으며 1) 선종(adenoma), 2) 담도상피내종양(BilIN), 3) 담낭내 유두상 종양(intracystic papillary neoplasm)으로 구분할 수 있다. 이런 전암성 병변은 공통적으로 세포학적 이형성을 갖는 점막 상피 세포의 증식이라는 특징을 갖고 있으나, 종양 세포가 점막 아래 간질을 침습하지 않은 상태의 병변이다. 내강 내로 돌출된 폴립 모양의 병변이나 점막이 과립상으로 비후된 경우, 선종 혹은 담낭내유두상 종양의 경우가 많으며, 육안상 확인되지 않으나 현미경적으로 상피 세포의 이형성이 관찰될 경우 담도상피내종양에 해당한다. 이런 전암성 병변은 이형성의 정도에 따라 저등급(low), 중등급(moderate), 고등급 이형성(high grade dysplasia)의 3등급으로 평가하고 있으며, 고등급의 경우 상피내암(carcinoma in situ)과 동일한 병변으로 취급하고 있다. 선종과 담낭내 유두상 종양은 형태학적 특징이 중복되는 부분이 있어, 진단의 재현성을 높이기 위한 형태학적 기준 마련이 필요한 병변이다. 담낭 선암에서 보고된 가장 대표적인 분자유전학적 변이는 KRAS, TP53과 CDKN2A가 알려져 있고 ERBB2의 증폭도 알려져 있으나, 담도암에 특이적이면서 변이율이 높은 유전자는 많지 않다. 전암성 병변에서 선암으로 이어지는 암발생 과정에서 단계적으로 발견되는 분자유전적변이 또한 전암성 병변의 종류나 만성 담낭염, 췌담도 기형 등의 위험인자 유무에 따라 보고율이 서로 달라, 한 가지 기전으로 설명하기는 어렵다. 만성 담낭염을 선행인자로 갖는 경우 점막 상피의 증식 혹은 화생의 초기 단계에서 COX-2 과발현이나 TP53 변이, 마이토콘드리아 DNA 손상이 발생하고, 초기 이형성 단계에서 3p, 8p 염색체의 이형접합성 소실(loss of heterozygosity, LOH) 및 HER2 증폭이 보고되고 있고, 상피내종양에서는 9p, 18q, 22q, 17p 염색체의 LOH 및 CDK2A 변이가 관찰되는 것으로 알려져 있다. Adenocarcinoma is the major histology of gallbladder cancer. There are three subtypes of adenocarcinoma of the gallbladder: biliary, intestinal, and gastric foveolar subtypes. Also, there are three premalignant lesions of gallbladder adenocarcinoma: adenoma, biliary intraepithelial neoplasia (BilIN), and intracystic papillary neoplasm (ICPN). Premalignant lesion is hyperplasia of dysplastic epithelial cells with no evidence of stromal invasion. BilIN is invisible in gross inspection but can be microscopically identified around invasive tumor or chronic cholecystitis. ICPN is grossly identified as exophytic polypoid mass or diffuse friable thickening of mucosa and composed of mucinous epithelial cells with papillary and tubular arrangement. Dysplasia of BilIN and ICPN is classified by using a three-tiered system and high grade dysplasia is the same group with carcinoma in situ. Adenoma and ICPN have some ambiguities in definition and re-establishment of diagnostic criteria is needed for reproducibility of diagnosis. KRAS, TP53, and CDKN2A are the representative altered molecules in gallbladder cancer. Molecular alteration during dysplasia-carcinoma sequence is too heterogenous depending to the risk factors and type of premalignant lesion to explain the whole process by single process. Over-expression of COX2, mutation of TP53, impairment of mitochondrial DNA were reported in early hyperplastic or metaplastic epithelium. Loss of heterozygosity (LOH) of 3p, 8p chromosomes and amplification of HER2 were reported in low grade dysplasia and LOH of 9p, 18q, 22q, 17p chromosomes and mutation of CDK2A were reported in high grade dysplasia/ carcinoma in situ. Korean J Pancreas Biliary Tract 2018;23(1):1-6

Incorporation of Unnatural Amino Acids in response to AGG Sense Codon

Byeong Sung LEE,Yumi LEE,Seunggun SHIN,Jong Yeob JEON,Kyoung-Soon JANG,Bun Yeol LEE,Sangdun CHOI,Tae Hyeon YOO 한국생물공학회 2017 한국생물공학회 학술대회 Vol.2017 No.10

Preoperative MDCT Assessment of Resectability in Borderline Resectable Pancreatic Cancer: Effect of Neoadjuvant Chemoradiation Therapy

Joo, Ijin,Lee, Jeong Min,Lee, Eun Sun,Ahn, Su Joa,Lee, Dong Ho,Kim, Sun-Whe,Ryu, Ji Kon,Oh, Do-Youn,Kim, Kyubo,Lee, Kyoung-Bun,Jang, Jin-Young American Roentgen Ray Society 2018 AJR Vol.210 No.5

Shear wave elastography in the evaluation of rejection or recurrent hepatitis after liver transplantation.

Yoon, Jeong Hee,Lee, Jae Young,Woo, Hyun Sik,Yu, Mi Hye,Lee, Eun Sun,Joo, Ijin,Lee, Kyoung Bun,Yi, Nam-Joon,Lee, Yoon Jin,Han, Joon Koo,Choi, Byung Ihn Springer International 2013 EUROPEAN RADIOLOGY Vol.23 No.6

<P>To determine whether shear wave elastography (SWE) would be useful in evaluating the presence of rejection or recurrent hepatitis for post-liver transplantation (LT) follow-up.</P>

Korean Guidelines for the Pharmacological Treatment of Social Anxiety Disorder: Initial Treatment Strategies

Hyungkun Yoon,Dong Jae Oh,Ho-Suk Suh,Kyoung-Uk Lee,Se-Won Lim,Jun-Yeob Lee,Jong-Chul Yang,이재헌,Juwon Ha,Bun-Hee Lee,강승걸,Ho-Kyoung Yoon,Jihyun Moon,Seung-Min Bae,Youngdo Kwon,Hyun-Chung Kim,Kang Seob Oh 대한신경정신의학회 2018 PSYCHIATRY INVESTIGATION Vol.15 No.2

Objective The aim of the present study was to provide clinical consensus and evidence regarding initial treatment strategies for the pharmacological treatment of social anxiety disorder (SAD) in Korea. Methods We prepared a questionnaire to derive a consensus from clinicians regarding their preference for the pharmacological treatment of SAD in Korea. Data regarding medication regimens and psychotropic drugs used during initial treatment, the doses used, and the pharmacological treatment duration were obtained. Responses were obtained from 66 SAD experts, and their opinions were classified into three categories (first-line, second-line, third-line) using a chi-square analysis. Results Clinicians agreed upon first-line regimens for SAD involving monotherapy with selective serotonin reuptake inhibitors (SSRIs) or the serotonin-norepinephrine reuptake inhibitor (SNRI) venlafaxine, or combined therapy using antidepressants with betablockers or benzodiazepines on a standing or as-needed basis. First-line psychotropic drug choices for initial treatment included the following: escitalopram, paroxetine, sertraline, venlafaxine, and propranolol. The medication dosage used by domestic clinicians was found to be comparable with foreign guidelines. Domestic clinicians tended to make treatment decisions in a shorter amount of time and preferred a similar duration of maintenance treatment for SAD when compared with foreign clinicians. Conclusion This study may provide significant information for developing SAD pharmacotherapy guidelines in Korea, especially in the early stage of treatment.

Alteration of MRP2 expression and the graft outcome after liver transplantation

Nam-Joon Yi,Joohyun Kim,YoungRok Choi,Heyoung Kim,Kyoung Bun Lee,Ja-June Jang,Jae Young Lee,Jeong Min Lee,Joon Koo Han,Kwang-Woong Lee,Kyung-Suk Suh 대한외과학회 2018 Annals of Surgical Treatment and Research(ASRT) Vol.95 No.5

Purpose: Multidrug resistance-associated protein (MRP) 2 is a glutathione conjugate in the canalicular membrane of hepatocytes. Early graft damage after liver transplantation (LT) can result in alteration of MRP2 expression. The purpose of this study was to evaluate the relationship between the pattern of MRP2 alteration and graft outcome. Methods: Forty-one paraffin-embedded liver graft tissues obtained by protocol biopsy within 2 months after LT; these were stained using monoclonal antibodies of MRP2. We selected 15 live donor biopsy samples as a control, that showed homogenous canalicular staining for MRP2. The pattern of canalicular MRP2 staining of graft was classified into 3 types: homogenous (type C0), focal (type C1), and no (type C2,) staining of the canaliculi. Results: In total, 17.1% graft tissues were type C0, 36.6% were type C1, and 46.3% were type C2. The median operation time was longer in patients with type C2 (562.6 minutes) than in patients with type C0 (393.8 minutes) (P = 0.038). The rates of posttransplant complications were higher in patients with type C2 (100%) than in patients with type C0 (42.9%) and C1 (73.3%) (P < 0.001). Conclusion: MRP2 expression pattern was altered in 82.9% after LT. The pattern of MRP2 alteration was associated with longer operation time and higher rates of post-LT complications.