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Biomedical subjects

Won Jae Lee

Publications and source records attributed to Won Jae Lee.

At least 37 records · Page 2Linked to original sources

Needle tract implantation after sonographically guided percutaneous biopsy of hepatocellular carcinoma: evaluation of doubling time, frequency, and features on CT.

OBJECTIVE: The purpose of this study was to evaluate the doubling time, frequency, and features on dynamic CT of extrahepatic needle tract implantation of malignant neoplasms after sonographically guided percutaneous biopsy for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Between January 1997 and June 2003, 1,055 patients underwent sonographically guided percutaneous biopsy for HCC. The serial changes of implanted tumor volume were estimated on retrospective review of CT, and their doubling times were calculated from the two CT scans showing the first and last visible implanted tumors. The frequency of extrahepatic needle tract implantation of malignant neoplasms was evaluated overall and according to the type of needle used. The CT features of the implanted tumors were examined with regard to size, number, location, morphology, and enhancement pattern. RESULTS: The mean doubling time of extrahepatic needle tract implantation of malignant neoplasms after sonographically guided percutaneous biopsy was 112 days (range, 22-415 days). The mean time interval between biopsy and the emergence of the implanted tumor on CT was 267 days (range, 116-619 days). The overall frequency was 0.76% (8/1,055). The frequencies according to the type of needle were 1.3% (8/622) for the group treated with the end-cutting needle and 0% (0/433) for the group treated with the tru-cut needle; these frequencies differ from each other with statistical significance (p < 0.05, Fisher's exact test). Fifteen of the 17 implanted tumors were round or oval enhancing nodules along the needle tract, and 13 showed persistent enhancement on equilibrium phase images. CONCLUSION: The doubling times of extrahepatic needle tract implantation of malignant neoplasms after sonographically guided percutaneous biopsy for HCC were similar to those of typical HCCs in the liver on CT-based analysis. The frequency was relatively low, and their CT features were similar to those reported previously.

Abdominal Neoplasms↗

[Imaging diagnosis of hepatocellular carcinoma].

In patients with chronic liver disease, hepatocellular carcinomas are developed from regenerative nodule via dysplastic nodule and early hepatocellular carcinoma to advanced hepatocellular carcinoma during multistep hepatocarcinogenesis. In this article, imaging findings of various imaging modalities are described pertaining to the above mentioned hepatocellular nodules occurring in the cirrhotic liver, correlating with pathologic findings.

Carcinoma, Hepatocellular↗

Cyclooxygenase inhibitors induce apoptosis in oral cavity cancer cells by increased expression of nonsteroidal anti-inflammatory drug-activated gene.

We have investigated whether NAG-1 is induced in oral cavity cancer cells by various NSAIDs and if apoptosis induced by NSAIDs can be linked directly with the induction of NAG-1. NAG-1 expression was increased by diclofenac, aceclofenac, indomethacin, ibuprofen, and sulindac sulfide, in the order of NAG-1 induction, but not by acetaminophen, piroxicam or NS-398. Diclofenac was the most effective NAG-1 inducer. Incubation with diclofenac inhibited cell proliferation and induced apoptosis. The expression of NAG-1 was observed in advance of the induction of apoptosis. Conditioned medium from NAG-1-overexpressing Drosophila cells inhibited SCC 1483 cells proliferation and induced apoptosis. In summary, some NSAIDs induce NAG-1 expression in oral cavity cancer cells and the induced NAG-1 protein appears to mediate apoptosis. Therefore, NSAIDs may be considered as a possible chemopreventive agent against oral cavity cancer.

Anti-Inflammatory Agents, Non-Steroidal↗

Cutting edge: direct interaction of TLR4 with NAD(P)H oxidase 4 isozyme is essential for lipopolysaccharide-induced production of reactive oxygen species and activation of NF-kappa B.

LPS, the primary constituent of the outer membrane of Gram-negative bacteria, is recognized by TLR4. Binding of TLR4 to LPS triggers various cell signaling pathways including NF-kappaB activation and reactive oxygen species (ROS) production. In this study, we present the data that LPS-induced ROS generation and NF-kappaB activation are mediated by a direct interaction of TLR4 with (NAD(P)H oxidase 4 (Nox) 4), a protein related to gp91phox (Nox2) of phagocytic cells, in HEK293T cells. Yeast two hybrid and GST pull-down assays indicated that the COOH-terminal region of Nox4 interacted with the cytoplasmic tail of TLR4. Knockdown of Nox4 by transfection of small interference RNA specific to the Nox4 isozyme in HEK293T cells expressing TLR4 along with MD2 and CD14 resulted in inhibition of LPS-induced ROS generation and NF-kappaB activation. Taken together, these results indicate that direct interaction of TLR4 with Nox4 is involved in LPS-mediated ROS generation and NF-kappaB activation.

Cell Line↗

Depiction and local staging of rectal tumors: comparison of transrectal US before and after water instillation.

PURPOSE: To determine whether transrectal ultrasonography (US) with intrarectal water instillation can improve the depiction and accuracy of US in local staging of rectal tumors. MATERIALS AND METHODS: Between October 1999 and February 2002, 63 patients (mean age, 56 years; age range, 23-91 years) with 63 rectal tumors were evaluated with transrectal US before and after intrarectal water instillation. Transrectal US examinations were performed with a 7-10-MHz radial transducer. Immediately after the first transrectal US examination, the rectal lumen was filled with 50-150 mL of degassed water, and a second US examination was performed. All patients underwent surgery within 1 month after transrectal US. Depiction of the tumor was compared between the two methods. The McNemar test was used to compare the accuracy between the two techniques in local staging of the tumor by using pathologic findings in the resected specimen as the standard. RESULTS: The tumors ranged from 0.5 to 8.0 cm (mean, 2.8 cm) as measured at pathologic evaluation. All 63 tumors were clearly depicted at transrectal US after water instillation, while only 42 (67%) of the tumors were depicted at transrectal US before water instillation. In the 42 tumors clearly depicted at transrectal US examinations both before and after water instillation, the accuracy of transrectal US in local tumor staging was significantly higher after water instillation (85.7% [36 of 42]) than before water instillation (57.1% [24 of 42]; P <.001). CONCLUSION: Water instillation during transrectal US examination of rectal tumors improves the depiction and local staging of the tumors.

Adult↗

Aesthetic reconstruction of the nasal tip using a folded composite graft from the ear.

Defects of the nasal tip, the alar, and the columella were treated with composite grafts from the postauricular area. The graft was folded into a three-dimensional shape, which provided a three-layered reconstruction of skin, cartilage and nasal lining. This procedure preserved the shape of the reconstruction for a longer time and yielded a good aesthetic result. Moreover, although this method was simple and was carried out in one stage, it left minimal morbidity of the donor site, and produced satisfying results.

Female↗

Paracoccus haeundaensis sp. nov., a Gram-negative, halophilic, astaxanthin-producing bacterium.

An aerobic, non-motile, Gram-negative, orange-pigmented, rod-shaped, astaxanthin-producing marine bacterium was isolated from the Haeundae Coast, Korea. This strain, BC74171T, produced carotenoids, mainly astaxanthin. All the type strains of the genus Paracoccus were compared with strain BC74171T using 16S rRNA gene sequence analysis, fatty acid patterns and physiological reaction profiles. Based on the results of these analyses, it is proposed that strain BC74171T represents a novel species, Paracoccus haeundaensis sp. nov. The type strain is BC74171T (= KCCM 10460T = LMG P-21903T).

DNA, Bacterial↗

Sequential activation of phosphatidylinositol 3-kinase, beta Pix, Rac1, and Nox1 in growth factor-induced production of H2O2.

The generation of reactive oxygen species (ROS) in cells stimulated with growth factors requires the activation of phosphatidylinositol 3-kinase (PI3K) and the Rac protein. We report here that the COOH-terminal region of Nox1, a protein related to gp91(phox) (Nox2) of phagocytic cells, is constitutively associated with beta Pix, a guanine nucleotide exchange factor for Rac. Both growth factor-induced ROS production and Rac1 activation were completely blocked in cells depleted of beta Pix by RNA interference. Rac1 was also shown to bind to the COOH-terminal region of Nox1 in a growth factor-dependent manner. Moreover, the depletion of Nox1 by RNA interference inhibited growth factor-induced ROS generation. These results suggest that ROS production in growth factor-stimulated cells is mediated by the sequential activation of PI3K, beta Pix, and Rac1, which then binds to Nox1 to stimulate its NADPH oxidase activity.

Animals↗

Therapeutic efficacy and safety of percutaneous radiofrequency ablation of hepatocellular carcinoma abutting the gastrointestinal tract.

OBJECTIVE: The purpose of this study was to evaluate the therapeutic efficacy and safety of percutaneous radiofrequency ablation in the treatment of hepatocellular carcinomas abutting the gastrointestinal tract. MATERIALS AND METHODS: Forty-one patients with hepatocellular carcinomas abutting the gastrointestinal tract underwent sonographically guided percutaneous radiofrequency ablation. Forty-one tumors (1.2-4.3 cm in maximum diameter) had parts 5 mm or greater (or at least one quarter of their circumferences) abutting the stomach in 23 patients and the colon in 18 patients. Thirty tumors were ablated with internally cooled electrodes and 11 with multitined expandable electrodes. All patients were followed up for at least 1 year after ablation. Therapeutic efficacy and safety were evaluated with follow-up sonography and multiphase helical CT. RESULTS: At 1-month follow-up CT, three (7%) of the 41 tumors showed residual unablated tumor in the ablation zone. Of the remaining 38 hepatocellular carcinomas (93%) with no evidence of residual unablated tumor, four (11%) showed local tumor progression in the ablation zones on subsequent follow-up CT. We observed one major complication-a small perihepatic abscess-that needed specific treatment. CONCLUSION: Percutaneous radiofrequency ablation is an effective and safe technique for treating hepatocellular carcinomas abutting the gastrointestinal tract.

Adult↗

Changes in bile ducts after radiofrequency ablation of hepatocellular carcinoma: frequency and clinical significance.

OBJECTIVE: The purpose of our study was to determine the frequency of bile duct changes after radiofrequency ablation for hepatocellular carcinoma and to evaluate their clinical significance. MATERIALS AND METHODS: Between April 1999 and August 2003, 389 patients with 521 hepatocellular carcinomas underwent a total of 571 sessions of radiofrequency ablation. The maximum dimension of the tumors measured on sonography was 2.4 +/- 0.9 cm (mean +/- SD) (range, 0.5-5.0 cm). The frequency and type of bile duct changes resulting from radiofrequency ablation, the time interval between radiofrequency ablation and the first appearance of bile duct changes, and the serial changes at follow-up CT were analyzed. Complications related to bile duct changes were also evaluated by reviewing medical records and CT scans. RESULTS: Bile duct changes occurred in 69 (12%) of 571 sessions and 66 (17%) of 389 patients. Bile duct changes seen on CT included mild dilatation of upstream bile ducts surrounding the ablation zone in 57 patients (82.6%), biloma in the ablation zone in four patients (5.8%), and both in eight patients (11.6%). The mean time interval between radiofrequency ablation and the initial appearance of bile duct change was 1.6 months (range, immediate-9 months). Most (87%) of the 69 patients with bile duct changes showed no progression on follow-up CT, and only nine (13%) had slight progression. All patients but one, in whom cholangitis developed, had no major complications requiring specific treatment during the follow-up period. CONCLUSION: Although bile duct changes were frequent after the radiofrequency ablation of hepatocellular carcinoma, most were of no clinical significance, and major complications requiring additional treatment were rare.

Adult↗

Evaluation of hepatic focal nodular hyperplasia with contrast-enhanced gray scale harmonic sonography: initial experience.

OBJECTIVE: To assess the potential of contrast-enhanced gray scale harmonic sonography in the evaluation of the typical vascular and enhancement patterns of hepatic focal nodular hyperplasia. METHODS: Thirteen patients with 13 lesions of hepatic focal nodular hyperplasia underwent contrast-enhanced gray scale harmonic sonography. After the injection of a microbubble contrast agent (SH U 508A), gray scale harmonic sonographic studies using a Coded Harmonic Angio technique were performed with a combination of a period of continuous scanning to assess the vascular pattern (vascular imaging) and interval delay scanning to determine the sequential enhancement pattern (acoustic emission imaging). Each imaging pattern was categorized and analyzed by consensus of 2 experienced radiologists. RESULTS: In 12 (92%) of 13 lesions, vascular imaging during the arterial phase showed central arteries of a spoked wheel pattern, whereas the remaining lesion had stippled vascularity. On acoustic emission imaging, 11 (85%) of 13 lesions were hyperechoic during the early phase, and the remaining 2 (15%) were isoechoic compared with surrounding parenchyma. Ten (77%) of 13 lesions remained either hyperechoic (5 of 13) or isoechoic (5 of 13) during the delay phase, whereas the remaining 3 lesions (23%) were hypoechoic. CONCLUSIONS: Contrast-enhanced gray scale harmonic sonography showed the typical vascularity of a spoked wheel pattern during the vascular phase and persistent enhancement on serial acoustic emission imaging in most cases of hepatic focal nodular hyperplasia, and thereby it can be a promising technique in noninvasive diagnosis of this entity.

Adolescent↗

Recurrent hepatocellular carcinoma: percutaneous radiofrequency ablation after hepatectomy.

PURPOSE: To evaluate the therapeutic efficacy and safety of percutaneous radiofrequency (RF) ablation for recurrent hepatocellular carcinoma (HCC) in the liver after hepatectomy. MATERIALS AND METHODS: Forty-five patients with 53 recurrent HCC tumors in the liver underwent percutaneous RF ablation with ultrasonographic guidance. All patients had a history of hepatic resection for HCC. The mean diameter of recurrent tumors was 2.1 cm (range, 0.8-4.0 cm). All patients were followed up for at least 10 months after ablation (range, 10-40 months; mean, 23 months). Therapeutic efficacy and complications were evaluated with multiphase helical computed tomography (CT) at regular follow-up visits. Overall and disease-free survival rates were calculated. RESULTS: At follow-up CT after initial RF ablation, 11 (21%) of 53 ablated HCC tumor sites showed residual tumor or local tumor progression. After additional RF ablation, complete ablation of 46 (87%) of 53 tumors was attained. Also at initial follow-up CT, before either additional RF ablation or other treatment was performed, 21 (47%) of 45 patients were found to have 41 new HCC tumors at other liver sites. Of these, nine tumors in eight patients were treatable with a second application of RF ablation. Overall survival rates at 1, 2, and 3 years were 82%, 72%, and 54%, respectively. No deaths or complications requiring further treatment occurred as a result of RF ablation. CONCLUSION: Percutaneous RF ablation is an effective and safe method for treating recurrent HCC in the liver after hepatectomy, with a good overall patient survival rate.

Adult↗

Cloning and characterization of an eukaryotic initiation factor-2alpha kinase from the silkworm, Bombyx mori.

Eukaryotic initiation factor 2alpha (eIF-2alpha) kinases are involved in the translational regulations that occur in response to various types of environmental stress, and play an important role in the cellular defense system operating under unfavorable conditions. The identification of additional eIF-2alpha kinases and the elucidation of their functions are necessary to understand how different eIF-2alpha kinases can specifically respond to distinct stimuli. Here, we report a novel eIF-2alpha kinase, termed BeK, from the silkworm, Bombyx mori. This gene encodes 579 amino acids and contains all 11 catalytic domains of protein-serine/threonine kinases. Most notably, it contains an "Ile-Gln-Met-Xaa-Xaa-Cys" motif, which is highly conserved from yeast to mammalian eIF-2alpha kinases. BeK does not show any significant homology in the NH(2) terminal regulatory domain, suggesting a distinct regulatory mechanism of this novel eIF-2alpha kinase. BeK is ubiquitously expressed in the various tissues throughout the final larval stage. Importantly, BeK is activated in Drosophila Schneider cells following heat shock and osmotic stress, and activated-BeK has been shown to phosphorylate an eIF-2alpha subunit at the Ser(50) site. However, other forms of stress, such as immune stress, endoplasmic reticulum stress and oxidative stress, cannot significantly elicit BeK activity. Interestingly, the baculovirus gene product, PK2, can inhibit BeK enzymatic activity, suggesting that BeK may be an endogenous target for a viral gene product. Taken together, these data indicate that BeK is a novel eIF-2alpha kinase involved in the stress response in B. mori.

Amino Acid Sequence↗

Poor sensitivity of sonography in detection of hepatocellular carcinoma in advanced liver cirrhosis: accuracy of pretransplantation sonography in 118 patients.

The objective of this study was to assess the detectability of hepatocellular carcinoma by sonography in advanced cirrhotic patients undergoing liver transplantation. We retrospectively reviewed pretransplantation sonography in 118 consecutive patients with advanced liver cirrhosis. We assessed the detectability of hepatocellular carcinoma in relation to tumor size, location, total liver volume, and degree of sonographic heterogeneity of the liver parenchyma. On pathologic examination, 51 hepatocellular carcinomas were identified in 31 patients. Pretransplantation sonography depicted 14 of 51 (27%) hepatocellular carcinomas. Detectability was significantly affected according to tumor size ( p=0.0099), but there was no significant difference according to tumor location, liver volume, or degree of sonographic heterogeneity of the liver parenchyma. Our study suggests that sonography is not sufficiently sensitive to detect hepatocellular carcinoma in patients with advanced liver cirrhosis. Tumor size is the only factor influencing the detectability of hepatocellular carcinoma.

Carcinoma, Hepatocellular↗

Bowel wall thickening in patients with Crohn's disease: CT patterns and correlation with inflammatory activity.

AIM: To assess CT patterns of bowel wall thickening in patients with Crohn's disease and to correlate these patterns with inflammatory activity. MATERIALS AND METHODS: We conducted a retrospective review of 58 helical abdominal CT scans of 53 patients with pathologically proven Crohn's disease. CT patterns of thickened bowel wall were divided into four types based on patterns of mural stratification and enhancement: type A, multilayered mural stratification; type B, two layers with strong mucosal enhancement and prominent low-density submucosa; type C, two layers without strong mucosal enhancement; and type D, homogeneous enhancement. We evaluated CT findings of the bowel and adjacent structures. We also reviewed pathologic features and clinical data to determine inflammatory activity. RESULTS: Fifty-five (95%) of 58 CT examinations showed bowel wall thickening. Of these 55 CT scans, type A pattern was found in 33 (60%), type B in 10 (18%), type C in five (9%), and type D in seven (13%). CT scans with type A showed significantly more wall thickening than those with either type C or type D. Histology revealed 43 cases with active disease and 12 with quiescent appearance. Thirty of 33 CT scans with type A and all 10 with type B were classified as acute disease, and three of five with type C and six of seven with type D as quiescent. CONCLUSION: In patients with Crohn's disease, CT patterns of bowel wall thickening correlated with inflammatory activity. Thickened bowel wall with layering enhancement is predictive of acute disease, and that of homogeneous enhancement suggests quiescence.

Adolescent↗

Preoperative depiction of hepatocellular carcinoma: ferumoxides-enhanced MR imaging versus triple-phase helical CT.

PURPOSE: To compare ferumoxides-enhanced magnetic resonance (MR) imaging with triple-phase helical computed tomography (CT) for the preoperative depiction of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Seventy consecutive patients with a total of 79 HCC nodules underwent ferumoxides-enhanced MR imaging and triple-phase helical CT before surgery. The diagnosis of HCC was established by means of pathologic examination after surgical resection in all patients. MR images obtained with all sequences and triple-phase helical CT images were reviewed independently by three radiologists on a segment-by-segment basis. Accuracy for diagnosis of HCC was assessed by applying receiver operating characteristic (ROC) analysis to observations of 78 hepatic segments with at least one HCC nodule and 70 segments without HCC. RESULTS: The diagnostic accuracy of findings at ferumoxides-enhanced MR imaging (with mean area-under-the-ROC-curve [A(z)] values for the three observers of 0.986, 0.979, and 0.980) was significantly higher (P <.001) than that of findings at triple-phase helical CT (with mean A(z) values for the three observers of 0.945, 0.948, and 0.964). The mean sensitivity of MR imaging (95%, 222 of 234 segments) was also significantly higher than that of triple-phase helical CT (88%, 205 of 234 segments) (P =.001, McNemar test). The mean specificity was 97% (261 of 270 segments) for MR imaging and 98% (264 of 270 segments) for CT, but this difference was not significant (P =.754, McNemar test). CONCLUSION: Ferumoxides-enhanced MR imaging is superior to triple-phase helical CT for the preoperative depiction of HCC.

Adult↗

Early assessment of the therapeutic response to radio frequency ablation for hepatocellular carcinoma: utility of gray scale harmonic ultrasonography with a microbubble contrast agent.

OBJECTIVE: To evaluate the utility of gray scale harmonic ultrasonography with a microbubble contrast agent in the early assessment of the therapeutic response to radio frequency ablation for hepatocellular carcinoma. METHODS: Seventy-five patients with 81 nodular hepatocellular carcinomas (1.3-4.8 cm) treated with percutaneous radio frequency ablation were evaluated with contrast-enhanced gray scale harmonic ultrasonography after intravenous bolus injection of a galactose-based microbubble contrast agent. The vascularity within the ablation zones was evaluated with a continuous scan for 3 to 5 seconds between 15 and 30 seconds after initiation of contrast agent injection. To evaluate the perfusion of the ablation zones, intermittent stimulated acoustic emission imaging was performed with a rapid sweeping technique from the end of the continuous scan. All patients underwent follow-up 3-phase helical computed tomography at 1 month after radio frequency ablation and were followed for at least 1 year. The results of contrast-enhanced ultrasonography were compared with those of follow-up computed tomography in terms of the presence or absence of residual unablated tumors. RESULTS: In 10 (12%) of the 81 treated hepatocellular carcinomas, contrast-enhanced ultrasonography showed either nodular or crescentic enhancing foci at the margins of ablation zones, suggesting residual unablated tumors. Contrast-enhanced computed tomography obtained 1 month after radio frequency ablation confirmed the residual unablated tumors in the same 10 lesions. Diagnostic agreement between 1-month follow-up computed tomography and contrast-enhanced ultrasonography was achieved in all 81 cases (100%). CONCLUSIONS: Contrast-enhanced gray scale harmonic ultrasonography can be a reliable alternative to contrast-enhanced computed tomography in the early assessment of the therapeutic response to radio frequency ablation for hepatocellular carcinoma.

Adult↗

Correlation between the echogenicity of dysplastic nodules and their histopathologically determined fat content.

OBJECTIVE: To correlate the echogenicity of dysplastic nodules in cirrhotic liver with the difference in fat content between lesions and surrounding liver. METHODS: This retrospective study involved 65 histopathologically proved dysplastic nodules (39 high grade and 26 low grade). Their echogenicity compared with that of surrounding parenchyma was determined sonographically, and differences in the proportions of fat globules contained in the nodules and in surrounding liver tissue were evaluated histopathologically. The sonographic and histopathologic findings were correlated. RESULTS: Among the 65 dysplastic nodules, echogenicity was high in 30 (46%), equal in 5 (8%), and low in 30 (46%). In all cases, there was significant correlation between echogenicity on sonographic imaging and the difference in fat content between nodules and surrounding liver tissue (P < .01). There was, however, no significant correlation between the degree of dysplasia and sonographic echogenicity (P > .05). CONCLUSIONS: The echogenicity of dysplastic nodules correlated with their fat content. Echogenicity did not, however, predict whether the grade of a nodule was high or low.

Adult↗