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Biomedical subjects

Mee Sook Roh

Publications and source records attributed to Mee Sook Roh.

13 recordsLinked to original sources

Endoscopic mucosal resection with precutting vs. anchoring technique using snare tip for 10-25 mm nonpedunculated colorectal polyps: a randomized controlled trial.

BACKGROUND AND AIMS: Modified endoscopic mucosal resection (EMR) techniques using a snare tip, precutting EMR (P-EMR) and anchoring EMR (A-EMR), have been developed for the effective resection of nonpedunculated colorectal polyps measuring 10-25&#x2005;mm. Although previous studies have compared either P-EMR or A-EMR with conventional EMR, no study has directly compared these two snare tip-assisted techniques within modified EMR. This study aimed to evaluate P-EMR and A-EMR in terms of the R0 resection rate and procedure duration. METHODS: This prospective randomized controlled trial enrolled patients with nonpedunculated colorectal polyps measuring 10-25&#x2005;mm. The patients were randomly assigned to the P-EMR or A-EMR groups. The primary outcome was R0 resection rate, defined as en bloc resection with histologically tumor-free margins. Secondary outcomes included the injection-to-snaring time, total procedure time, and adverse events. RESULTS: Each group included 63 polyps, of which 126 were analyzed in the final evaluation. Both groups achieved high R0 resection rates (93.7% for P-EMR and 88.9% for A-EMR), with no significant difference ( P &#x2005;=&#x2005;0.344). However, the A-EMR group demonstrated significantly shorter injection-to-snaring time (181.8&#x2005;&#xb1;&#x2005;81.9 vs. 320.9&#x2005;&#xb1;&#x2005;143.5&#x2005;s, P &#x2005;<&#x2005;0.001) and total procedure time (259.7&#x2005;&#xb1;&#x2005;139.7 vs. 479.8&#x2005;&#xb1;&#x2005;249.0&#x2005;s, P &#x2005;<&#x2005;0.001). Adverse events, including intraprocedural and delayed bleeding, were comparable between the groups. CONCLUSION: Both P-EMR and A-EMR demonstrated high R0 resection rates for nonpedunculated polyps measuring 10-25&#x2005;mm. However, A-EMR achieved these outcomes with a shorter procedure time than P-EMR.

Humans↗

Fascin immunoreactivity for preoperatively predicting lymph node metastases in peripheral adenocarcinoma of the lung 3 cm or less in diameter.

OBJECTIVE: Fascin is an actin-bundling protein that induces cell membrane protrusions and increases the motility of normal and transformed epithelial cells. We evaluated the expression of fascin by performing immunohistochemistry to determine its role in the progression of small-size peripheral lung adenocarcinomas and to elucidate its utility as a preoperative novel therapeutic option. METHODS: Immunohistochemistry for fascin was performed in 49 peripheral adenocarcinomas of 25% (high grade). RESULTS: Overall, fascin immunoreactivity was detected in 30 (61.2%) out of the total 49 cases. The tumors with high-grade fascin immunoreacivity tended to more frequently show lymph node metastasis (P = 0.0007), lymphovascular invasion (P = 0.0084) and a higher stage (P = 0.05). There was no significant association with age, gender, tumor size and the histological subtype. The 2mm-sized TMA cores, which were considered as a substitute for percutaneous needle biopsy sample in this study, showed concordant results with the CWT section (kappa = 0.836). CONCLUSIONS: We suggest that fascin immunoreactivity may identify the subsets of peripheral adenocarcinomas of the lung 3 cm or less in diameter that have a different potential to metastasize to the regional lymph nodes. The evaluation of fascin immunoreactivity on the preoperative biopsy sample could be a novel therapeutic strategy for selecting the most appropriate therapy for small-size pulmonary adenocarcinomas.

Adenocarcinoma↗

[The relationship between ACE I/D polymorphism and HDL cholesterol].

OBJECTIVES: The purpose of this study is to evaluate the association of the angiotensin converting enzyme (ACE) insertion/deletion (I/D) polymorphism with cardiovascular disease risk factors. METHODS: Out of a total of 608 middle-aged adults who visited local health centers, 424 subjects (104 male, 320 female) who had not been diagnosed with hypertension, diabetes mellitus, or hyperlipidemia were included in this study. ACE genotypes were determined in all subjects by polymerase chain reaction methods. RESULTS: Statistical differences in high-density lipoprotein (HDL) cholesterol levels according to ACE genotype were observed using ANOVA (p<0.05), but no differences were found in other cardiovascular risk factors. Specifically, men with the DD and DI genotypes had significantly lower HDL cholesterol levels than those with the II genotype based on the LSD multi-comparison test (p<0.05). CONCLUSIONS: In men, the D-allele of the ACE I/D polymorphism was significantly associated with reduced HDL cholesterol levels. In the future, larger studies are needed to confirm this relationship between ACE I/D polymorphism and HDL cholesterol.

Cardiovascular Diseases↗

Expression of double-stranded RNA-activated protein kinase (PKR) and its prognostic significance in lymph node negative rectal cancer.

OBJECTIVE: The interferon-induced, double-stranded RNA-activated, protein kinase (PKR) is a key regulator of translational initiation, and plays an important role in the regulation of cell proliferation, apoptosis and transformation. The aim of this study was to evaluate the prognostic significance of PKR in lymph node negative rectal cancer. METHODS: Forty-three patients with stage II rectal carcinoma who underwent potentially curative resection followed by post-operative adjuvant chemoradiation and 5-fluorouracil-based chemotherapy were investigated immunohistochemically using the monoclonal antibody TJ4C4. Overall scores for PKR expression were calculated based on staining intensity and immunoreactive tumor cell fraction. Clinical information, including tumor grade, carcinoembryonic antigen (CEA), disease-free survival (DFS) and overall survival (OS) was evaluated and compared with the degree of PKR expression. RESULTS: The median follow-up duration was 53.2 months, and median patient age was 55 years (range 33-73). No relationships were found between PKR score and age, sex, tumor grade or CEA level; however, smaller tumors (< or =5 cm) were associated with high PKR score (P = 0.025). When patients were subdivided into two groups based on the PKR score, the relapse rate was lower for those with a high PKR score (7.4 versus 43.8%, P = 0.008), and a significant difference was found between these two groups in terms of 5 year DFS (92.6 versus 55.6%, P = 0.0072) and 5 year OS (92.6 versus 57.7%, P = 0.0459). Other clinicopathologic variables were not related to clinical outcome. CONCLUSION: PKR expression levels were associated with disease recurrence, DFS and OS in lymph node negative rectal cancer patients.

Adenocarcinoma↗

Expression of double-stranded RNA-activated protein kinase in small-size peripheral adenocarcinoma of the lung.

The authors investigated the protein expression of double-stranded RNA-activated protein kinase (PKR), which was identified by using a previous cDNA microarray study, to discover PKR's correlations with several pathological parameters and to elucidate its role in neoplastic transformation and progression of lung adenocarcinomas. Immunohistochemistry for PKR was performed and a semiquantitative scoring method was calculated based on staining intensity and percentage of immunoreactive tumor cells (high vs low) for one bronchioloalveolar carcinoma (BAC), 16 adenocarcinomas consisting of BAC and invasive carcinoma (mixed) and 21 invasive adenocarcinomas without BAC (invasive). The BAC had high-grade expression and the mixed type tended to more frequently show high-grade expression than the invasive type (P = 0.028). There were no significant associations with age, tumor size, lymph node metastasis, lymphovascular invasion or the pathological stage. The Kaplan-Meier survival curves demonstrated that the patients with high-grade PKR expression had significantly shorter survival periods than those patients with low-grade PKR expression (P = 0.018). These results do not support the concept of PKR as a tumor suppressor in small-size peripheral adenocarcinomas of the lung.

Adenocarcinoma↗

Establishment and characterization of an STI571-resistant human myelogenous leukemia cell line, SR-1.

The tyrosine kinase inhibitor STI571 is an effective agent for the treatment of chronic myelogenous leukemia (CML). However, a lack of response to STI571 or the recurrence of the disease after a transient initial response is usually seen in patients with advanced stage CML. We have established a novel STI571 (Gleevec/Glivec, imatinib mesylate)-resistant acute myelocytic leukemia cell line (SR-1) from an STI571-resistant blast crisis patient. By flow cytometry, the immunophenotype of SR-1 was found to be compatible with a myeloid lineage (CD13+, CD33+, HLA-DR+, anti-MPO+). Conventional cytogenetics showed a three-way reciprocal translocation involving 7p22, 9q34, and 22q11.2, i.e., a variant Philadelphia chromosome translocation. The BCR/ABL rearrangement was detected by fluorescence in situ hybridization and reverse transcriptase polymerase chain reaction. To determine the tumorigenicity of the SR-1 cell line in vivo, cells were injected subcutaneously into severe combined immunodeficiency mice. Four weeks later, tumors had grown and showed the same laboratory findings as in SR-1. Although STI571 resistance is a known treatment complication, in vivo STI571-resistant cell lines have not been fully established. We hope that our SR-1 cell line may be useful in molecular pathogenetic investigations of STI571-resistant CML.

Adult↗

Gene expression profiling of breast cancers with emphasis of beta-catenin regulation.

To gain molecular understanding of carcinogenesis of breast cancer, gene expression profiles were analyzed using cDNA microarray representing 4,600 cDNAs in 10 breast cancer samples and the adjacent noncancerous breast tissues from the same patients. The alterations in gene expression levels were confirmed by reversetranscription PCR in four randomly selected genes. Genes that were differently expressed in cancer and noncancerous tissues were identified. 106 (of which 55 were known) and 49 (of which 28 were known) genes were up- or down-regulated, respectively, in greater than 60% of the breast cancer samples. In cancer tissues, genes related to cell cycle, transcription, metabolism, cell structure/motility and signal transduction were mostly up-regulated. Furthermore, three cancer tissues showing immunohistochemically aberrant accumulation of beta-catenin in the nucleus and/or cytoplasm revealed down-regulation of Siah and Axin genes and up-regulation of Wnt and c-myc genes. These findings were highly consistent with Wnt signaling pathway associated with beta-catenin regulation previously suggested by others. Our studies, therefore, provide not only a molecular basis to understand biological processes of breast cancer but also useful resources to define the mechanism of beta-catenin expression in tumorigenesis of breast cancer.

Adult↗

Autoimmune hemolytic anemia in a patient with primary ovarian non-Hodgkin's lymphoma.

The primary ovarian lymphoma is a rare disease with poor prognosis. The incidence of autoimmune hemolytic anemia in patients with non-Hodgkin's lymphoma is estimated at 3%. However, a substantial portion of the previously reported cases of ovarian lymphoma actually represented ovarian involvement by more diffuse lymphomatous process. If stringent criteria are used for case selection, true primary ovarian lymphoma usually carries a favorable prognosis. We present a primary malignant lymphoma of ovary accompanied by autoimmune hemolytic anemia in a 29-yr-old patient. After ablative surgery, the hemoglobin level and the reticulocyte count were normalized. One year following surgery and chemotherapy, the patient is alive and disease free.

Adult↗

A gene expression in study human gastric adenocarcinoma using a cDNA microarray.

BACKGROUND/AIMS: cDNA microarray provides a powerful alternative with an unprecedented view scope in monitoring gene expression levels and leads to discoveries of regulatory pathways involved in complicated biological processes. Our aim was to explore the different gene expression patterns in early and advanced gastric cancer. METHODS: By using a cDNA microarray representing 4,608 cDNA clusters, we studied the expression profiling in 10 paired gastric adenocarcinoma samples and the adjacent noncancerous gastric tissues. The alterations in gene expression levels were confirmed by Northern blot and reverse-transcription (RT) PCR. RESULTS: Genes that were differently expressed in cancer and noncancerous tissues were identified. Forty-four and 92 (26 and 43 of them were known, respectively) genes or cDNA were up- and down-regulated, respectively, in more than 80% of gastric adenocarcinoma samples. The semi-quantitative RT-PCR results were consistent with the microarray findings. To distinguish between early and advanced gastric cancers, we used a supervised learning classification approach. When we used 16 and 20 genes as predictors, the prediction was all yielded statistically significant. Moreover, when we used 9 genes, we could predict with the highest accuracy. CONCLUSIONS: These results may provide not only a new molecular basis for understanding biological properties of gastric adenocarcinoma, but also useful resources for future development of therapeutic targets and diagnostic markers for gastric adenocarcinoma.

Adenocarcinoma↗

Sentinel lymph node biopsy with 99mTC tin-colloid in patients with gastric carcinoma.

BACKGROUND/AIMS: The sentinel lymph node (SLN) is defined as the first draining node from the primary lesion. The objective of this study was to determine the feasibility of SLN biopsy in patients with gastric cancer for assessment of lymph node status. METHODOLOGY: From November 2001 through to July 2002, SLN biopsy was performed in twenty-two consecutive patients whose preoperative imaging studies showed T2 or T1 and no lymph node metastasis. Three hours prior to each operation, 99mTc tin-colloid (2.0ml, 1.0mCi) was injected into the submucosa of gastric tumor via endoscope. After SLN biopsy had been performed using gamma probe (NEO2000 Gamma Detection System, Neoprobe CO, 1999, USA), all the patients underwent radical gastrectomy. The SLN was cut and immediately manipulated for frozen section, and processed to make paraffin block for H&E and immunohistochemistry (IHC) staining. RESULTS: On average, 1.8 (range 1-5) SLNs were identified per patient. The location of all SLNs was in the perigastric area. No skip metastases were found. SLNs were identified in 20 of the 22 patients (success rate, 90.9%). The sensitivity of the SLN status in the diagnosis of the lymph node status was 82.2% (5/6) and the specificity was 100.0% (14/14). The diagnostic accuracy according to SLN status was 95.0% (19 of 20). CONCLUSIONS: SLN biopsy using radioisotope in patients with gastric cancer was a technically feasible procedure and a minimally invasive approach in the assessment of the nodal status in each patient.

Adenocarcinoma↗

Utility of thyroid transcription factor-1 and cytokeratin 20 in identifying the origin of metastatic carcinomas of cervical lymph nodes.

The identification of primary location of a metastatic tumor is a difficult diagnostic problem and sometimes can be facilitated by the use of immunohistochemical markers. Thyroid transcription factor-1 (TTF-1) is a 38-kDa nuclear homeodomain transcription factor that is expressed specifically in lung or thyroid neoplasms. Cytokeratin 20 (CK20) is a 46-kDa low-molecular-weight cytokeratin that shows restricted expression in adenocarcinomas of the gastrointestinal tract (GIT) and transitional cell carcinomas of the urinary tract. We studied the immunohistochemical expression of TTF-1 and CK20 in 68 metastatic carcinomas in cervical lymph nodes. The primary sites were the lung in 29 cases, stomach in 13, colorectum in 3, and other sites in 23. TTF-1 expression was detected in 69.0% of metastatic lung carcinomas and none in metastatic GIT carcinomas, whereas CK20 expression was detected in 68.8% of metastatic GIT carcinomas and none of metastatic lung carcinomas. TTF-1 had a specificity of 0.95 and a sensitivity of 0.69 for metastatic lung carcinoma, whereas CK20 had a specificity of 1.00 and a sensitivity of 0.69 for metastatic GIT carcinoma. These results indicate that TTF-1 and CK20 should be the first choice as a component of antibody panel to prove or to exclude the lung and GIT origin, respectively, especially in patients presenting with metastatic carcinomas of unknown primary site.

Adenocarcinoma↗

Hyaline vascular-type Castleman disease presenting as an esophageal submucosal tumor: case report.

Castleman disease is a relatively rare disorder of lymphoid tissue that involves the gastrointestinal tract in a variety of clinical and pathologic manifestations. A submucosal location has never been described in the medical literature. We report a case of esophageal Castleman disease involving the submucosal layer in a 62-year-old man, which was confirmed on pathology. Esophagography and CT demonstrated an intramural tumor, and a leiomyoma or leiomyosarcoma was suspected based on the known incidence of such tumors.

Castleman Disease↗

Diagnostic utility of GLUT1 in the differential diagnosis of liver carcinomas.

BACKGROUND/AIMS: Malignant cells require high energy via glycolytic generation of ATP for cell proliferation and survival. This process is thought to be mediated by glucose transporters (GLUTs). GLUT1 appears to be expressed aberrantly in many cancers. The liver is the main organ closely related to glycogen metabolism and it is thought that GLUT expression might be altered in the tumors arising in the liver. METHODOLOGY: We studied GLUT1 expression in 22 hepatocellular carcinomas (HCC) and 16 cholangiocarcinomas (CC) and compared it to the expression of hepatocyte specific antigen (HSA) and cytokeratin 19 (CK19) by immunohistochemical studies. RESULTS: In HCC, GLUT1 was expressed in 4.5% (1/22), HSA in 77.3% (17/22) and CK19 in none (0/22). In CC, GLUT1 was expressed in 81.3% (13/16), HSA in none (0/16) and CK19 in 100% (16/16). Interestingly, GLUT1 was not expressed in normal hepatocytes and bile duct epithelium around the tumor, whereas CK19 was expressed in normal bile ducts and tumor cells. CONCLUSIONS: These results indicate that GLUT1 might be related to development of bile duct carcinoma and its expression was a more reliable marker for detection of bile duct carcinoma than CK19. Additionally, GLUT1 might potentially be useful as a means of distinguishing CC from HCC.

Bile Duct Neoplasms↗