Hepatocellular Carcinoma in the Elderly: Clinical Characteristics, Outcomes and Treatment Efficacy, Safety in Older than 75 Years

( Ji Ho Seo ),( Sunmin Kim ),( Eunae Cho ),( Chung Hwan Jun ),( Sun Young Park ),( Sung Bum Cho ),( Chang Hwan Park ),( Hyun Soo Kim ),( Sung Kyu Choi ),( Jong Sun Rew ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: The number of elderly patients diagnosed with hepatocellular carcinoma (HCC) has been increasing because the increase in the longevity of the general population. But there is no proper management based on age stratification in elderly patients. We compared clinical characteristics, outcomes and treatment efficacy, safety between oldest-old (aged more than 85 years), middle-old (aged between 80 and 85 years) and young-old (aged between 75 and 80 years) patients with HCC. Methods: We conducted a retrospective cohort study, from January 2010 to December 2016, at Chonnam National University Hospital. A total of 550 elderly patients whose data included demographics, co-morbidity, etiology of liver disease, presence of cirrhosis, staging of HCC, treatment modality and treatment related adverse event were evaluated retrospectively. Also overall survival was assessed in enrolled patient. Results: Fifty one patients (oldest-old; median 87 years old), 153 patients (middle-old; median 82 years old) and 346 patients (young-old; median 77 years old) were diagnosed with HCC. Both oldest- and middle-old patients, compared to young-old patients had significantly lower rate of alcohol-related disease (13.7% vs 20.9% vs 34.1%, P = 0.001). There were no significant difference in underlying sex, body mass index, presence of co-morbidity, hepatitis C-related disease and stage of HCC. The Child-Pugh class (CPT class A 88.9% vs 84.1% vs 83.6%, CPT class B 11.1% vs 15.9% vs 15.0% and CPT class C 0.0% vs 0.0% vs 1.3%, respectively, P = 0.912) and Model for End Stage Liver Disease score (mean MELD score 7.22±3.34 vs 5.88±3.01 vs 5.77±3.14, P = 0.166) were no significant difference between the patients with active treatment. The modified UICC staging (stage I 5.6% vs 17.1% vs 18.6%, stage II 55.6% vs 46.3% vs 47.3%, Stage III 22.2% vs 24.4% vs 24.8%, Stage IV-A 11.1% vs 6.1% vs 4.9% and Stage IV-B 5.6% vs 6.1% vs 4.4%, respectively, P = 0.826) and Barcelona Clinic Liver Cancer staging (stage 0 5.6% vs 9.8% vs 9.3%, stage A 16.7% vs 17.1% vs 22.1%, stage B 27.8% vs 29.3% vs 24.8%, stage C 50.0% vs 43.9% vs 41.2% and stage D 0.0% vs 0.0% vs 2.7%, respectively, P = 0.878) were no significant difference between the patients with active treatment. Furthermore, there were no difference between the age groups in treatment modality (Surgical resection 0.0% vs 3.3% vs 5.2%, P = 0.166; Radiofrequency ablation 2.0% vs 8.5% vs 11.0%, P=0.113; Transcatheter arterial chemoembolization 21.6% vs 34.6% vs 41.6%, P=0.014; Best supportive care 62.7% vs 40.5% vs 29.2%, P < 0.001), adverse event related treatment (P = 0.731) and disease-free survival days (329 .3±309.1 days vs 271.7 ± 414.2 days vs 357.2 ± 511.6 days, P = 0.336). Multivariate analysis showed that age, performance status, CTP class, MELD score, modified UICC staging, presence of portal vein thrombosis and ruptured HCC are risk factors for mortality. Conclusions: Clinician should make an active treatment in elderly patients with HCC not a age but performance status, liver function and disease status of cancer.

남성화를 보이는 여성에서 발견된 난소의 Steroid Cell Tumor 1예

조인호,정대훈,박영미,서영진,손영실,정철회,강영미,정수전,김영남,이경복,성문수,김기태 인제대학교 2006 仁濟醫學 Vol.27 No.-

Steroid cell tumor is a rare ovarian sex cord-stromal tumor which accounts for 0.1% of all ovarian tumors. Until now, only 4 cases have been reported in domestic literatures. Steroid cell tumor often secrets testosterone and presents virilization in adult women or precocious puberty in children. Treatment is often performed by surgical removal, adjuvant chemotherapy and radiation, but completely accepted treatment was not existed. We experienced a case of steroid cell tumor, which was manifested by typical virilization in a 43-year old patient, who was previously performed hysterectomy and unilateral oophorectomy. So, we present with a brief review of the literatures.

Hepatoprotective and Antioxidative Activities of <i>Cornus officinalis</i> against Acetaminophen-Induced Hepatotoxicity in Mice

Lee, Nam-Hun,Seo, Chang-Seob,Lee, Ho-young,Jung, Da-Young,Lee, Jun-Kyung,Lee, Jin-Ah,Song, Kye Yong,Shin, Hyeun-kyoo,Lee, Mee-Young,Seo, Young Bae,Kim, Hokyoung,Ha, Hyekyung Hindawi Publishing Corporation 2012 Evidence-based Complementary and Alternative Medic Vol.2012 No.-

<P>The fruit of <I>Cornus officinalis </I>Sieb. et Zucc. is commonly prescribed in Asian countries as a tonic formula. In this study, the hepatoprotective effect of ethanolic extracts of the fruit of <I>C. officinalis</I> (ECO) was investigated in a mouse model of acetaminophen- (APAP-) induced liver injury. Pretreatment of mice with ECO (100, 250, and 500 mg/kg for 7 days) significantly prevented the APAP (200 mg/kg) induced hepatic damage as indicated by the serum marker enzymes (AST, ALT, and LDH). Parallel to these changes, ECO treatment also prevented APAP-induced oxidative stress in the mice liver by inhibiting lipid peroxidation (MDA) and restoring the levels of antioxidant enzymes (SOD, CAT, and HO-1) and glutathione. Liver injury and collagen accumulation were assessed using histological studies by hematoxylin and eosin staining. Our results indicate that ECO can prevent hepatic injuries associated with APAP-induced hepatotoxicity by preventing or alleviating oxidative stress.</P>

Ameliorative effect of <i>Alnus japonica</i> ethanol extract on colitis through the inhibition of inflammatory responses and attenuation of intestinal barrier disruption <i>in vivo</i> and <i>in vitro</i>

Chi, Jin Hua,Kim, Young Ho,Sohn, Dong Hwan,Seo, Geom Seog,Lee, Sung Hee Elsevier 2018 BIOMEDICINE AND PHARMACOTHERAPY Vol.108 No.-

<P><B>Abstract</B></P> <P>Inflammatory bowel disease (IBD) is chronic inflammation of the gastrointestinal tract caused by high levels of pro-inflammatory cytokines and epithelial barrier dysfunction. <I>Alnus japonica</I> Steud. (Betulaceae) has been used in traditional Asian medicine. However, the potential of <I>A. japonica</I> for the treatment of intestinal inflammation has not been investigated. This study investigated the effects of ethanol extract from <I>A. japonica</I> bark (AJE) on colonic mucosa injury in mice with dextran sodium sulfate (DSS)-induced colitis. Treatment with AJE ameliorated pathological damage and the histopathologic features of DSS-induced colitis. The administration of AJE also inhibits DSS-induced pro-inflammatory cytokines expression, including interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, and cyclooxygenase (COX)-2. Notably, AJE administration attenuated the reduction of tight junction proteins, zonula occludens (ZO)-1 and occludin, in DSS-induced colitis. In addition, AJE increased heme oxygenase (HO)-1 expression and prevented DSS-induced apoptosis in colonic epithelial cells. Furthermore, <I>in vitro</I> studies demonstrated that AJE inhibits TNF-α-induced IL-8, IL-1β, and COX-2 expression in human intestinal epithelial HT-29 cells and <I>tert</I>-butyl hydroperoxide-induced reduction of ZO-1 and occludin expression in human intestinal epithelial Caco-2 cells. AJE-induced HO-1 protein expression was also found in both HT-29 and Caco-2 cells. Taken together, our findings demonstrated that AJE inhibits intestinal inflammation and protects against intestinal barrier disruption in mice with DSS-induced colitis <I>in vivo</I> and human intestinal epithelial cells <I>in vitro</I>. These results suggest that AJE might have beneficial effects for the treatment of IBD.</P> <P><B>Highlights</B></P> <P> <UL> <LI> AJE attenuates the severity of DSS-induced colitis mice. </LI> <LI> AJE suppresses expression of pro-inflammatory mediators in DSS-induced colitis mice. </LI> <LI> AJE protects intestinal barrier integrity in DSS-induced colitis mice. </LI> <LI> AJE increases HO-1 expression in mouse colonic epithelial cells. </LI> <LI> AJE inhibits inflammation and protects loss of TJ proteins of human IEC cells. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>

Effects of Modified MMT on Mechanical Properties of EVA/MMT Nanocomposites and Their Foams

Xu, Zheng Run,Park, Hae Youn,Kim, Ho Young,Seo, Kwan Ho WILEY-VCH Verlag 2008 Macromolecular symposia Vol.264 No.1

<P>In this study, nanocomposites of poly(ethylene-co-vinyl acetate) with two kinds of organically modified montmorillonite (OMMT) were prepared by melt intercalation. Their structures and mechanical properties were characterized by X-ray diffraction (XRD) and tensile test respectively. Especially, foaming of these nanocomposites mixed with chemical blowing agent was carried out through compression molding. Influences of OMMT on foaming ratio and mechanical properties were investigated by density test, tensile test and tear test. Results revealed that both kinds of OMMT with proper content increased tensile strength and Young's modulus of nanocomposites without a compromise of elongation at break. For foaming, OMMTs apparently improved foaming ratio and in particular, one of them can improve tear strength, tensile strength, Young's modulus and elongation although the density was decreased.</P>

Antioxidant activity in vitro and mucosal protective effect of Rhei Rhizoma on reflux esophagitis induced in rats

Ah Reum Lee,Yu Ock Shin,Joo Young Lee,Min Yeong Kim,Sung Ho Shin,Bu-Il Seo,Young-Bae Seo,Man Hee Rhee,TakakoYokozawa,Chan Hum Park,Seong-SooRoh 한국약용작물학회 2015 한국약용작물학술대회 발표집 Vol.2015 No.05

Purpose Rhei Rhizoma (RR) is one of the herbal medicines traditionally used to treat diverse inflammatory diseases. The present study was undertaken to elucidate the antioxidant and anti-inflammatory activities of Rhei Rhizoma on experimental reflux esophagitis (RE) in rats. Methods The antioxidant activity of RR in vitro was measured in terms of radical scavenging capacity such as DPPH and ABTS. RE was produced by ligating both the pylorus and the transitional junction between the forestomach and the corpus. Rhei Rhizoma (125 and 250 mg/kg) were administered every day for 7 days, and its effect was estimated on comparison with RE control and normal rats. Results RR scavenged DPPH and ABTS effectively and IC50ofDPPH and ABTS radical scavenging activity of RR were 4.8 μg/ml and 15.75 μg/ml. The administration of RR decreased the elevated serum ROS in RE control rats. The RE control rats exhibited the down-regulation of antioxidant-related proteins such as Nrf2 and HO-1expression levels in the esophagitis; however, the level in the RR-treated RE rats was significantly higher than that in the RE control rats. Moreover, RE control rats exhibited the up-regulation of the protein expression related to oxidative stress at the esophagitis, but RR administration significantly reduced the expression of inflammatory proteins through the MAPK-independent signaling pathways. The expression of inflammatory mediators and cytokines by NF-κB activation was modulated through blocking the degradation of IκBα. In addition, the oral administration of RR regulated the gastric mucosal damage in RE rats. Conclusion The administration of Rhei Rhizoma effectively ameliorates the inflammatory damage of esophageal mucosa through radical scavenging activity and the activation of the Nrf2/HO-1 pathway.

The Antioxidant Effect of the Rhaponticum uniflorum Extracts on the Oxidative Stress in H₂O₂ induced Human Keratinocytes

So Hee Ahn,Won Yeoung Choi,Ji Won Jeong,Geon Woo Park,Su Yeon Kang,Eun Jeong Kim,Su Rim Sin,Eun Seo Jang,Gye Won Lee,Young Ho Cho 한국식품영양과학회 2021 한국식품영양과학회 학술대회발표집 Vol.2021 No.10

In this study, To investigate the antioxidant activities of Rhaponticum uniflorum extracts (RUE), we assessed scavenging activities on DPPH, ABTS radicals, and reducing power. The DPPH and ABTS radical scavenging activities (SC50) of RUE were 96.97±1.19 μg/mL and 31.26±0.13 μ g/mL, respectively, and the reducing power significantly increased dose-dependent manner. To study the antioxidant effecters of RUE in H₂O₂ induced human keratinocytes, expression of Nuclear factor erythroid-2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) were determined by Western blot and qRT-PCR. RUE induced the expression of HO-1, a critical target enzyme of Nrf2, in a concentration-dependent manner. The expression of HO- 1 mRNA was also induced in H₂O₂-treated HaCaT cells but no significant difference in the level of HO-1 mRNA was observed. Taken together, these results suggest that RUE may be useful as a potential ingredient for anti-aging products.

IGBT素子의 모델링에 의한 回路解析 시뮬레이션

서영수,조문택,서수호 明知大學校 産業技術硏究所 1994 産業技術硏究所論文集 Vol.13 No.-

IGBT devices have the best features of both power MOSFETs and power bipolar transsistors,i.e., efficient voltage gate drive requirements and high current density capability. When designing circuits and systems that utilized IGBTs or other power semicondutor devices, circuit simulation are needed to examine how the devices ffect the behavior of the circuit. The interaction of the IGBT with the load circuit can be described using the device model and the state equation of the load circuit. The voltage rise of rate at turn-off for inductive loads varies significantly for IGBT with different base life times, and this rate of rise is important in determining the voltage overshoot for a given series resister-inductor load circuit. Expressive voltage overshoot is potentially destructive, so a snubber protection circuit may be required. The protection circuit requirements are unique for the IGBT and can be examined using the model. Simulation of the device-circuit interactions have been experimentally verified for devices with different life times.

두부 못총상의 치험례

서면,김영태,하호균 건국대학교 의과학연구소 1996 건국의과학학술지 Vol.5 No.-

The authors report a rare case of gunshot injury to the head by a nail-gun which was treated by stereotactic surgery. The patient was arrived at our emergency room by 119 rescue. He was 23 years old with semicomatose mentality and decerebrated rigidity. On simple skull series and Brain CT scan, the large nail was located in the 3rd ventricular area in the mid-line with vertical stature. The entry point was identified 1 cm anterior to the coronal suture line and just lateral to the sagittal suture line. We planned stereotactic removal and the stereotactic frame was introduced to the patient. The foreign body was removed stereotactically with the guidance of C-arm fluoroscope. The # 8 L EVD drain was placed into the 3rd ventricle. Intensive care was performed to the young patient, but he died due to initial severe brain damage at # POD 6.

특이한 악관절 강직증 : 진성 악관절 강직증과 상악골과 하악골 사이의 골성 유합

서재훈,조세인,여환호,이기혁,김영균 大韓顎顔面成形再建外科學會 1995 Maxillofacial Plastic Reconstructive Surgery Vol.17 No.2

TMJ ankylosis is classified with true and false type. A true ankylosis is defined as any condition that produces fibrous or bony adhesions between the articular surfaces of the temporomandibular joint. The main causes of true ankylosis are trauma or infection. A false ankylosis results from pathologic conditions outside the joint that limit mobility of the mandible such as myogenic disorders, coronoid impingement or rare direct bony fusion between maxilla and mandible. The treatment of choice of TMJ ankylosis is surgical intervention. We experienced the male patient with complete mouth opening limitation since 45 years before. This patient has true TMJ ankylosis and rare bony synostosis between maxilla and mandible in the right posterior region. We performed surgical intervention and had a favorable result.