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( Seoung Yoon Rho ),( Dae Hoon Han ),( Gi Hong Choi ),( Jin Sub Choi ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: It is known that Gadolinium Ethoxybenzyl Diethylenetriamine Pentaacetic Acid (Gd-EOB-ETPA, EOB) enhanced magnetic resonance imaging (EOB-MRI) improved the detection and diagnosis rate of hepatocellular carcinoma (HCC). In preoperative MRI, additional hypointense nodule (AHIN) is found sometimes, however there are only few studies about prognosis of curative treatments of AHIN and primary HCC lesion together. We aimed to confirm prognosis after surgical treatment in patients with these additional hypointense nodule in EOB-MRI. Methods: We retrospectively reviewed medical records and preoperative images of 522 HCC patients who underwent surgical curative treatment at Hepatoma Clinic, Yonsei Cancer Center, Seoul, South Korea from January 2008 to December 2012. We analyzed general characteristics and conducted propensity score matching analysis of patients. Results: Among 522 patients, we excluded MRI only or CT only and multiple HCC patients. Eventually, 403 patients included and 340 patients with single overt HCC and 63 patients with additional lesion in EOB-MRI were analysed. Of this 63 patients, 19 patients were confirmed HCC pathologically and 44 patients were not confirmed because of treated RFA or non- HCC lesion pathologically. Among 19 patients, non-hypervascular hypointense nodule were 7 (36.8%). Overall survival and disease-free survival analysis showed significant difference between single overt HCC patients and single overt HCC with additional hypointense nodule patients (P=0.027, P<0.001, respectively). After propensity score match analysis, there were no statistically significant differences between single overt HCC patients and and single overt HCC with additional hypointense nodule patients in overall survival analysis (mean 82 months, 95% CI [71.603-92.942] vs. mean 87 months, 95% CI [76.553-97.650], P=0.678) and disease-free survival analysis (median 62 months, 95% CI [29.164-94.836] vs. 32 months, 95% CI [21.240-42.760], P=0.070). Conclusions: In general, survival probabilities of single overt HCC with AHIN patients are inferior to single overt HCC group. After propensity score matching, there were no significant difference between single overt HCC and single overt HCC with AHIN in overall survival and disease-free survival. Therefore, single overt HCC with AHIN should be considered a surgical candidate and combined active treatment is recommended if their liver function is allowed.
Seoung Yoon Rho,Sung Uk Bae,Se Jin Baek,Hyuk Hur,Byung Soh Min,Seung Hyuk Baik,Kang Young Lee,Nam Kyu Kim 대한외과학회 2013 Annals of Surgical Treatment and Research(ASRT) Vol.85 No.6
Purpose: The aim of this study was to assess the feasibility and safety of laparoscopic resection following the insertion of self-expanding metallic stents (SEMS) for the treatment of obstructing left-sided colon cancer. Methods: Between October 2006 and December 2012, laparoscopic resection following SEMS insertion was performed in 54 patients with obstructing left-sided colon cancer. Results: All 54 procedures were technically successful without the need for conversion to open surgery. The median interval from SEMS insertion to laparoscopic surgery was 9 days (range, 3-41 days). The median surgery time was 200 minutes (range, 57-444 minutes), and estimated blood loss was 50 mL (range, 10-3,500 mL). The median time to soft diet was 4 days (range, 2-8 days) and possible length of stay (hypothetical length of stay according to the discharge criteria) was 7 days (range, 4-22 days). The median total number of lymph nodes harvested was 23 (range, 8-71) and loop ileostomy was performed in 2 patients (4%). Six patients (11%) developed postoperative complications: 2 patients with anastomotic leakages, 1 with bladder leakage, and 3 with ileus. There was no mortality within 30 days. Conclusion: The present study shows that the presence of a SEMS does not compromise the laparoscopic approach. Laparoscopic resection following stent insertion for obstructing left-sided colon cancer could be performed with a favorable safety profile and short-term outcome. Large-scale comparative studies with longterm follow-up are needed to demonstrate a significant benefit of this approach.
Rho, Seoung Yoon,Yun, Mijin,Kang, Chang Moo,Lee, Sung Hwan,Hwang, Ho Kyoung,Lee, Woo Jung Elsevier 2018 PANCREATOLOGY Vol.18 No.8
<P><B>Abstract</B></P> <P><B>Background/objectives</B></P> <P>Our institutional experience has demonstrated that bloodless and margin-negative resection is the most potent prognostic factor in treating left-sided pancreatic cancer and we developed selection guideline. The Yonsei criteria (YC) is selection criteria for oncologically safe and effective resection of left-sided pancreatic cancer by a minimally invasive approach. In this study, we investigated whether left-sided pancreatic cancer with YC can be more individualized to predict long-term survival by using clinically and pathologically detectable parameters.</P> <P><B>Methods</B></P> <P>From January 2000 to December 2015, 105 patients underwent distal pancreatectomy for left-sided pancreatic cancer. The medical records of the patients were retrospectively reviewed.</P> <P><B>Results</B></P> <P>Among clinically and pathologically detectable parameters to predict tumor conditions, radiologically determined tumor size (p = 0.080) and SUV<SUB>max</SUB> (p = 0.086) were identified as predictors of early tumor recurrence with marginal significance. Among them, 20% of the patients with YC were identified as having the most favoring tumor condition, with an modified YC score of 3. The patient group with the lowest mYC score was found to have a very long disease-free survival time, with a mean of 108 months, which was statistically different from those with other mYC scores (mYC score = 4, mean 47.1 months [95% CI: 27.8–69.5] vs. mYC score = 5, mean 36.7 months [95% CI: 12.7–60.7], vs. mYC score = 6, mean 10.7 months [95% CI: 3.9–17.4]).</P> <P><B>Conclusions</B></P> <P>Modified Yonsei criteria score can predict long-term survival in resected left-sided pancreatic cancer. And patients within YC with a mYC score = 3 could have a favorable survival outcome.</P>
( Seoung Yoon Rho ),( Dai Hoon Han ),( Jae Geun Lee ),( Dong Jin Joo ),( Myung Soo Kim ),( Soon Il Kim ),( Jin Sub Choi ),( Gi Hong Choi ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: To investigate the feasibility and safety of an alternative robotic living-donor right hepatectomy (RLDRH) technique.Data for minimally invasive living-donor right hepatectomy, especially RLDRH, in a relatively large donor cohort have not been reported yet. Methods: From March 2016 to March 2019, 52 liver donors underwent RLDRH. The clinical and perioperative outcomes of RLDRH were compared with those of conventional open donor right hepatectomy (CODRH; n=62) and laparoscopy-assisted donor right hepatectomy (LADRH; n=118). Donor satisfaction with cosmetic results was compared between RLDRH and LADRH using a body image questionnaire. Results: Although RLDRH had a longer operative time (RLDRH, 493.6 min; CODRH, 404.4 min; LADRH, 355.9 min, P<0.001), its mean estimated blood loss was significantly lower (RLDRH, 109.8 mL; CODRH, 287.1 mL; LADRH, 265.5 mL; P<0.001). The postoperative complication rates were similar among the three groups (RLDRH, 23.1%; CODRH, 35.5%; LADRH, 28.0%; P=0.420). Regarding donor satisfaction, the body image and cosmetic appearance scores were significantly higher in RLDRH than in LADRH. There was no significant difference in hospital stay among the three groups (P=0.105). After propensity score matching, RLDRH showed a shorter hospital stay and similar complication rate than CODRH. Conclusions: RLDRH resulted in a similar postoperative complication rate and shorter length of hospital stay compared with those of CODRH and provided better body image and cosmetic results compared with those of LADRH. RLDRH is feasible and can be safely performed by expert surgeons in both robotic systems and open hepatectomy.
노승윤 ( Seoung Yoon Rho ),이현웅 ( Hyun Woong Lee ),김경식 ( Kyung Sik Kim ) 대한간암학회 2018 대한간암학회지 Vol.18 No.2
Hepatocellular carcinoma (HCC) is the third most common cancer in the digestive system based on survey of domestic cancer incidence, and the ratio of elderly aged 65 or older is expected to rise steadily, leading to a higher incidence of total hepatocellular carcinoma. The most important thing in treating these older patients with HCC is to assess the benefits and risks of the treatment in advance. In other words, the benefit of treatment should be greater than the reduction of survival period or maladjustment due to treatment. Based on these perspectives, we examined how the detailed treatment of hepatocellular carcinoma differs from that of general treatment in elderly patients. In conclusion, older age was not a definite prognostic factor of survival risk-benefit comparison in the most treatment modalities. However it should be carefully considered and approached about possible complications in treating HCC in elderly patients. (J Liver Cancer 2018;18:103-114)
Lee, Seoung-Hoon,Rho, Jaerang,Jeong, Daewon,Sul, Jai-Yoon,Kim, Taesoo,Kim, Nacksung,Kang, Ju-Seob,Miyamoto, Takeshi,Suda, Toshio,Lee, Sun-Kyeong,Pignolo, Robert J,Koczon-Jaremko, Boguslawa,Lorenzo, Jo Nature Publishing Group 2006 Nature medicine Vol.12 No.12
Matrix-producing osteoblasts and bone-resorbing osteoclasts maintain bone homeostasis. Osteoclasts are multinucleated, giant cells of hematopoietic origin formed by the fusion of mononuclear pre-osteoclasts derived from myeloid cells. Fusion-mediated giant cell formation is critical for osteoclast maturation; without it, bone resorption is inefficient. To understand how osteoclasts differ from other myeloid lineage cells, we previously compared global mRNA expression patterns in these cells and identified genes of unknown function predominantly expressed in osteoclasts, one of which is the d2 isoform of vacuolar (H<SUP>+</SUP>) ATPase (v-ATPase) V<SUB>0</SUB> domain (Atp6v0d2). Here we show that inactivation of Atp6v0d2 in mice results in markedly increased bone mass due to defective osteoclasts and enhanced bone formation. Atp6v0d2 deficiency did not affect differentiation or the v-ATPase activity of osteoclasts. Rather, Atp6v0d2 was required for efficient pre-osteoclast fusion. Increased bone formation was probably due to osteoblast-extrinsic factors, as Atp6v02 was not expressed in osteoblasts and their differentiation ex vivo was not altered in the absence of Atp6v02. Our results identify Atp6v0d2 as a regulator of osteoclast fusion and bone formation, and provide genetic data showing that it is possible to simultaneously inhibit osteoclast maturation and stimulate bone formation by therapeutically targeting the function of a single gene.