Biomedical subjects

Young Il Kim

Publications and source records attributed to Young Il Kim.

At least 19 recordsLinked to original sources

PubMed2006

TTF-1, a homeodomain-containing transcription factor, regulates feeding behavior in the rat hypothalamus.

TTF-1 is a member of the NKx family of homeodomain genes, and is required for morphogenesis and fetal diencephalon development. Our previous studies have shown that TTF-1 expression is maintained in some regions of the postnatal rat brain and transactivates the gene expression of several neuropeptides. In this study, a potential role for TTF-1 in the regulation of feeding behavior was identified. Immunohistochemical analysis showed that TTF-1 is present in several hypothalamic nuclei of the adult rat brain involved in the control of feeding behavior. Food deprivation for two days markedly increased the hypothalamic levels of TTF-1 mRNA and protein. Intracerebroventricular administration of an antisense TTF-1 oligodeoxynucleotide significantly decreased TTF-1 protein abundance in the hypothalamus. This TTF-1 decrease was followed by a significant decrease in neuropeptide Y mRNA content and an increase in proopiomelanocortin mRNA content, and in turn resulted in a decrease of the animal's food intake and body weight. These results suggest a novel role for TTF-1 in the regulation of feeding behavior in the rat hypothalamus.

Animals↗

PubMed2006

Intraarterial gene delivery in rabbit hepatic tumors: transfection with nonviral vector by using iodized oil emulsion.

PURPOSE: To evaluate the feasibility of an iodized oil emulsion that is used for the chemoembolization of hepatocellular carcinoma as a modifier of a nonviral gene transfer system for intraarterial gene delivery in experimentally induced hepatic tumors. MATERIALS AND METHODS: Experiments were performed in accordance with National Institutes of Health guidelines for the care and use of laboratory animals and were approved by the animal research committee at Seoul National University Hospital. VX2 carcinoma was implanted into the liver of 26 rabbits. Four nonviral gene transfer systems were prepared by using pCMV-luc+ as a reporter gene. The first system consisted of a DNA and polyethylenimine (PEI) complex (n = 7); the second, of a DNA and PEI complex mixed with iopamidol and iodized oil (n = 7); the third, of a DNA and PEI complex mixed with iopamidol (n = 7); and the fourth, of a DNA and PEI complex mixed with iodized oil (n = 5). For the DNA and PEI complex that was mixed with iopamidol and iodized oil, iopamidol was used to stabilize the emulsion. Twenty days after tumor implantation, intraarterial gene delivery was performed by selective catheterization of the hepatic artery. Rabbits were euthanized 24 hours after gene delivery. Luciferase activity was assayed in the tumor, left hepatic lobe, right hepatic lobe, and other organs and was statistically analyzed for comparison between complexes by using the Kruskal-Wallis test. RESULTS: Luciferase activity in the tumor was significantly higher for the group that received DNA, PEI, iopamidol, and iodized oil than for any other group (Kruskal-Wallis test, P < .05). Luciferase activity in the left hepatic lobe, right hepatic lobe, and other organs was not significantly different between complexes. Selective gene expression in tumor cells was confirmed by means of immunohistochemical analysis for luciferase. CONCLUSION: It is feasible to use an iodized oil emulsion system for the intratumoral transfection of nonviral vectors in experimentally induced hypervascular hepatic tumors.

Animals↗

PubMed2006

Three-dimensional conformal radiotherapy of unresectable hepatocellular carcinoma patients for whom transcatheter arterial chemoembolization was ineffective or unsuitable.

OBJECTIVES: To evaluate 3-dimensional conformal radiotherapy (3D-CRT) of unresectable hepatocellular carcinoma (HCC) patients for whom transcatheter arterial chemoembolization (TACE) was ineffective or unsuitable, and to determine whether tumor response and portal vein thrombosis (PVT) response to treatment were prognostic factors for overall survival. METHODS: From July 2001 to June 2005, 70 unresectable HCC patients were treated with 3D-CRT; PVT was present in 41 patients. A daily radiation dose ranging from 2 to 3 Gy was administered using 6 or 15 MV x-rays to deliver a total dose between 44 and 54 Gy. RESULTS: Of 70 patients, follow-up computed tomography showed that primary tumor responses were complete response (CR) in 4 (5.7%) patients, partial response (PR) in 34 (48.6%), no response (NR) in 28 (37.1%), and progressive disease (PD) in 4 (8.6%). Of 41 patients with PVT, PVT responses were CR in 4 (9.7%) patients, PR in 12 (29.3%), NR in 20 (48.8%), and PD in 5 (12.2%). The median survival times were 18.0 and 20.1 month in the primary tumor and the PVT responders (CR + PR), respectively, which were longer than the 6.8 and 7.2 months in the primary tumor and the PVT nonresponders (NR + PD), respectively. CONCLUSIONS: 3D-CRT was associated with a 54.3% objective response rate for primary tumors and a 39.0% objective response rate for PVT. Both primary tumor and PVT responses were found to be prognostic factors for overall survival. The present results suggest 3D-CRT is a practical treatment option in HCC patients for whom TACE is ineffective or unsuitable.

Adult↗

PubMed2006

Postbiopsy arterioportal fistula in patients with hepatocellular carcinoma: clinical significance in transarterial chemoembolization.

OBJECTIVE: The purpose of this study was to determine, retrospectively, the frequency of postbiopsy arterioportal fistula in hepatocellular carcinoma and its significance in transarterial chemoembolization (TACE). MATERIALS AND METHODS: Forty-one patients who underwent percutaneous liver biopsy for diagnosis of hepatocellular carcinoma were referred for TACE. The control population comprised 161 patients referred during the same period who underwent TACE without biopsy. We determined that an arterioportal fistula was present by opacification of the portal vein during the arterial phase of angiography or by opacification with iodized oil during TACE. We considered hepatocellular carcinoma to be responsive to TACE when the sum of iodized oil retention in the tumor and a low-attenuation area on CT was greater than 50% of tumor size. We compared the frequency of arterioportal fistula and the rate of tumor response to TACE in both groups and also evaluated possible factors associated with postbiopsy arterioportal fistula, such as age, sex, Child-Pugh score, tumor size, average number of needle passes, average distance that the needle traversed normal liver before reaching the mass, and average interval between biopsy and TACE. RESULTS: Twenty-three (56.1%) of 41 patients in the biopsy group and 19 (11.8%) of 161 patients in the control group had an arterioportal fistula (p < 0.001). The rate of tumor response to TACE was 87.8% (36/41) in the biopsy group and 87.0% (140/161) in the control group (p = 0.5932). Of the possible related factors, only tumor size correlated negatively with the occurrence of arterioportal fistula. CONCLUSION: Percutaneous liver biopsy in hepatocellular carcinoma patients apparently increases the rate of arterioportal fistula but does not seem to affect the rate of tumor response to TACE.

Angiography, Digital Subtraction↗

PubMed2006

Technical feasibility and biocompatibility of a newly designed separating stent-graft in the normal canine aorta.

OBJECTIVE: The objectives of this study were to assess the performance of a newly designed separating stent-graft system with respect to the technical feasibility of transfemoral deployment, the maintenance of vessel patency, and stent deformity due to mechanical defects; and to evaluate its in vivo healing characteristics, including thrombus formation, and endothelial covering of the stent-graft when placed in the normal aorta of a canine model. CONCLUSION: The newly designed separating stent-graft allowed accurate deployment without migration. This animal study also provided an opportunity to examine the healing process associated with an ultrathin polyester fabric nitinol stent and showed predictable healing characteristics in the normal thoracic aorta in this canine model.

Animals↗

PubMed2006

[Survival analysis for patients with hepatocellular carcinoma according to stage, liver function and treatment modalities].

BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) is 3rd leading cause of cancer in Korea and the prognosis for HCC patients is poor. For assessing the present treatment outcome, this study analyzed the three-year survival rate (3-YSR) and the prognostic factors for patients with HCC in Korea. METHODS: Between November 2000 and December 2003, 905 patients with HCC who were diagnosed and treated at the National Cancer Center Korea were enrolled in this study. The clinical variables, tumor characteristics and survival periods were analyzed. RESULTS: The mean age of all patients was 56.2+/-10.3 years and 732 (80.9%) patients were male (M:F=4.2:1). 508 (56.1%) patients died and the median survival period was 15.3 months. The overall 3-YSR of the patients with modified UICC stage I, II, III, IVa and IVb were 67.4%, 65.2%, 30.7%, 9.0% and 5.0%, respectively. The modified UICC stage could not differentiate stage I from II, and stage IVa from IVb, on the 3-YSR. The 3-YSR of the Child-Pugh class A patients with modified UICC stage I or II was 85.4% by surgical resection and it was 69.6% by transcatheter chemoembolization (TACE), respectively (P= .461), and those values for patients with stage III were 49.2% and 36.8%, respectively (P=.081). As compared with systemic chemotherapy or conservative therapy, TACE increased the survival rate more for the Child-Pugh class A patients with stage IV. The independent prognostic factors were serum AFP, portal vein thrombosis, the Child-Pugh classification and the stage of HCC. CONCLUSIONS: This follow-up study will be helpful in assessing the results of treatments for HCC and it will provide data for the establishment of a more effective treatment strategy.

Aged↗

PubMed2005

In vitro CT evaluation of intrahepatic stones: correlation with chemical composition.

OBJECTIVE: To describe in vitro CT features of intrahepatic stones and to correlate CT attenuation with chemical composition. MATERIALS AND METHODS: Of the patients who underwent choledochoscopic intrahepatic stone removal between 1998 and 2001, 54 patients with stones larger than 3 mm were enrolled in this study. In each case, a chemical compositional analysis was performed to determine calcium, cholesterol, total bilirubin, and inorganic phosphorus compositions. The three largest stones obtained from each patient were imaged by CT. CT attenuation numbers were measured in the center images of each stone by drawing free-hand region of interest (ROI). The measured CT attenuation numbers were correlated with their chemical composition. Also, CT attenuation numbers of stones were compared with that of the liver on non-contrast CT (50-70 HU). RESULTS: Stone size ranged from 3.1 to 10.5 mm (mean +/- S.D.: 6.0 +/- 1.4). The CT attenuation numbers (HU) of stones ranged from 36.4 to 410.19 (mean +/- S.D.: 94.6 +/- 49.9). CT numbers of stones were below 70 HU in 11 patients (20.4%), and below 90 HU in 33 patients (59.3%). The chemical analysis data of the stones were as follows: calcium (0.5-6.5 wt.%; mean +/- S.D., 2.6 +/- 1.4), total bilirubin (0.45-24.4 wt.%; 13.1 +/- 6.2), cholesterol (5.4-73.9 wt.%; 29.3 +/- 17.4), phosphorus (0.1-1.2 wt.%; 0.6 +/- 0.3), and non-soluble residue (17.6-85.4 wt.%; 57.0 +/- 22.6). There was a weak but significant correlation between calcium composition and CT attenuation (r = 0.38, P < 0.01) and no significant correlation between other chemical compositions and the CT attenuation (cholesterol, r = 0.01, P > 0.01; total bilirubin, r = 0.05, P > 0.01; phosphorus, r = 0.01, P > 0.01). CONCLUSION: On non-contrast CT, intrahepatic stones would not be hyperattenuating with respect to liver parenchyma in about one fifth of patients. The CT attenuation of stones correlates with calcium and does not correlate with any other chemical composition.

Adult↗

PubMed2005

Comparison of glaucomatous parameters in normal, ocular hypertensive and glaucomatous eyes using optical coherence tomography 3000.

This study was performed to evaluate optic disc appearance, retinal nerve fiber layer (RNFL) thickness, and macular thickness in normal, ocular hypertensive (OHT) and glaucomatous eyes using optical coherence tomography (OCT) 3000. One hundred fifty-eight eyes of 167 consecutive subjects were enrolled: 60 normal, 53 OHT, and 54 glaucomatous. OCT topographic parameters of cup diameter, cup area, rim area, and cup/disc area ratio were significantly less in OHT eyes than in normal eyes and were significantly less in glaucomatous eyes than in normal and OHT eyes. RNFL was significantly thinner in OHT eyes than in normal eyes in the inferior quadrant, and in glaucomatous eyes than in OHT and normal eyes in the mean and for all four quadrants. Macular thickness was significantly thinner in glaucomatous eyes than in OHT and normal eyes throughout all subdivisions. Optic disc parameters, and RNFL and macular thickness measurements made with OCT may be useful in the clinical assessment of glaucoma.

Adult↗

PubMed2005

The escape of temperature-sensitive T antigen immortalized rat hepatocytes from conditional immortalization.

Conditionally immortalized hepatocytes (CIH) established with a gene for the temperature-sensitive mutant of the T antigen (tsT) have characteristics to stop proliferating and to differentiate at nonpermissive temperatures (37-39 degrees C) due to inactivation of the T antigen. Therefore, they may be a good alternative to primary hepatocytes for experimental investigations or clinical applications. Deinduction of the T antigen results in a transient increase of p53 in these cells, leading to reexpression of normal senescence because of the telomere attrition occurring during the early stages of immortalization. To determine this T antigen dependency for the maintenance of immortality, a type of rat CIH was cultured continuously at 39 degrees C. The frequency of occurrence of T-antigen-independent clones ranged from 0.053% to 0.093%. These clones maintained the temperature-sensitive property of the T antigen; nevertheless, they were able to progress to the S phase and proliferate without undergoing apoptosis at 39 degrees C as at 33 degrees C, a permissive temperature. The temperature-sensitive point mutation of tsT was not affected in these clones and the T antigen was functioning properly. The integrity of the p53 pathway was also maintained from the point of Western blot analysis of p21. Although the telomerase continued to be expressed and the telomere length was maintained, marked chromosomal damage could not be avoided in these cells. It is a plausible explanation that this escape phenomenon from conditional immortalization may be related to the change of other genes involved in cell cycles, which have yet to be elucidated. In conclusion, CIH could lose their temperature-sensitive characteristics without the change of tsT, itself, and the T antigen is not always necessary to maintain their immortality. Therefore, the results obtained from experimental investigations using these cells should be interpreted carefully, and unpredictable phenotypic changes should also be taken into consideration when using them in clinical applications.

Animals↗

PubMed2005

Protocol optimization of multidetector computed tomography colonography using pig colonic phantoms.

OBJECTIVE: The introduction of multidetector computed tomography (CT) increases the possibility of enhanced polyp detection using CT colonography. The effects of collimation and tube currents on polyp detection were investigated in pig colonic phantoms to determine the optimal scanning parameters. MATERIALS AND METHODS: Twenty pig colons were prepared, and polyps with diameters ranging from 3 mm to 15 mm were created and randomly distributed. There was a total of 60 polyps; 20 polyps were 3 to 5 mm in size, 21 polyps 6 to 9 mm, and 19 polyps 10 to 15 mm. The pig colons were sealed, distended with air, submerged in water, and were arranged to mimic the in vivo arrangement. CT was performed using a 4-row multidetector CT scanner with collimations of 1, 2.5, and 5 mm, a pitch of 1.75, and mA of 100. A low-dose protocol (mA of 50) was added with a collimation of 1 mm. Two blinded observers independently analyzed the datasets. RESULTS: : The overall sensitivities of CT colonography were 94.2% with 1-mm collimation, 80% with 2.5-mm collimation, and 75% with 5-mm collimation. Considering the sensitivity of each protocol for the size of the polyps, the 1-mm collimation protocol had a sensitivity of 87.5% for 3- to 5-mm polyps, 95.2% sensitivity for 6- to 9-mm polyps, and 100% sensitivity for 10- to 15-mm polyps; the 2.5-mm protocol had 50%, 92.9%, and 97.4% sensitivities, respectively; and the 5-mm protocol had 47.5%, 88.1%, and 89.5% sensitivities, respectively, for the respective polyp size group. A significant difference in sensitivity among the protocols was present in the 3- to 5-mm polyps. No significant difference was seen between the standard- and the low-dose protocols. CONCLUSIONS: The sensitivity of multidetector CT colonography for detecting polyps larger than 5 mm is robust over a range of collimation in pig colonic phantoms. However, reliable detection of polyps 5 mm or smaller requires a 1-mm collimation. Sensitivity is not influenced by lowering the mA from 100 to 50.

Animals↗

PubMed2004

Acute lung injury: effects of prone positioning on cephalocaudal distribution of lung inflation--CT assessment in dogs.

PURPOSE: To quantify cephalocaudal gradient of lung inflation in acute lung injury in a dog model in prone versus supine position. MATERIALS AND METHODS: Experiments were performed in accordance with Guide for the Care and Use of Laboratory Animals, as approved by National Research Council (National Institutes of Health), and were approved by committee on care and use of animals in research at Seoul National University Hospital. After induction of acute lung injury with intravenous injection of oleic acid, dogs were randomized to be ventilated in either prone (n = 6) or supine (n = 6) position. Spiral computed tomography (CT) and hemodynamic measurement were performed sequentially on an hourly basis. Volume and mean attenuation of lung were measured quantitatively by using software to evaluate each CT section. Cephalocaudal gradient of mean lung attenuation, distribution of gas and tissue, and alveolar expansion were assessed. Functional residual capacity and net alveolar expansion of entire lung were measured. Statistical analysis was performed with Friedman, sign, and Mann-Whitney tests. RESULTS: Mean lung attenuation increased gradually from apex to base of lung in supine position. Thus, inflation gradient along cephalocaudal axis was found. Gas was located predominantly in upper lung, whereas tissue was dominant in lower lung in supine position. In supine group, cephalocaudal inflation gradient showed no significant change from baseline up to 4 hours. After prone positioning, cephalocaudal inflation gradient was reduced, and gas and tissue proportions became more uniform along cephalocaudal axis. In prone group, absolute values of cephalocaudal inflation gradient at time points of prone positioning for 1, 2, and 3 hours were significantly lower than baseline values (P < .05) and those in supine group (P < .05). Alveolar expansion occurred in caudal regions, and alveolar contraction occurred in cephalic regions; accordingly, net alveolar volume of entire lung was not altered significantly. Functional residual capacity was unchanged by prone positioning. CONCLUSION: In acute lung injury, prone positioning induced more uniform distribution of gas and tissue along cephalocaudal axis by reducing cephalocaudal inflation gradient.

Animals↗

PubMed2004

Experimentally induced small-bowel tumor in rabbits: US-guided percutaneous 18-gauge core biopsy.

PURPOSE: To evaluate the safety and diagnostic yield of percutaneous 18-gauge core biopsy for an experimentally induced small-bowel tumor in a rabbit model. MATERIALS AND METHODS: Small-bowel tumors were induced by injecting VX2 tumor into 20 rabbits. After 3 weeks, the small bowel was filled with 100 mL of 2% diluted contrast agent containing methylene blue by using a 5-F catheter. Fifty biopsy firings for small-bowel tumor were performed with ultrasonographic (US) guidance by using an 18-gauge automatic gun. Computed tomography (CT) was performed before and immediately after biopsy. Any procedure-related complications, including leakage of air or fluid, hematoma, and perforation as seen at CT and identified at laparotomy, which was performed 48 hours after biopsy, were evaluated. White blood cell (WBC), red blood cell, and platelet counts; hemoglobin and hematocrit levels; and erythrocyte sedimentation rate were also obtained before and 48 hours after biopsy. Comparison was performed with paired t test. The diagnostic yield was calculated, and the specimen was evaluated whether fragments of mucosa were included or not. RESULTS: No contrast agent leakage or pneumoperitoneum suggesting perforation was identified at CT or laparotomy. Fluid leakage was observed with manual squeezing at two biopsy sites (4%). In two rabbits, hemoperitoneum was observed at CT or laparotomy. Hematoma larger than 3 cm was observed in six rabbits. WBC count and erythrocyte sedimentation rate slightly increased, and red blood cells, hemoglobin, hematocrit, and platelets counts had decreased slightly after biopsy but were not significant (P >.05). Definitive histologic diagnosis of tumor was obtained in 44 (88%) of 50 biopsy sites. Fragments of mucosa were observed in 13 (28%) specimens of 10 rabbits. CONCLUSION: Core biopsies of small-bowel tumor can be performed safely with an 18-gauge gun without severe complications and allow histologic diagnosis of small-bowel tumor with a good diagnostic yield.

Animals↗

PubMed2004

Acute iliofemoral deep vein thrombosis: evaluation of underlying anatomic abnormalities by spiral CT venography.

PURPOSE: To evaluate the spectrum of underlying anatomic abnormalities in iliofemoral deep vein thrombosis (DVT) by spiral computed tomographic (CT) venography. MATERIALS AND METHODS: During the past 4 years, 56 patients with acute iliofemoral DVT have been evaluated by CT venography at our institution. Forty-four patients had left-sided DVT, nine had right-sided DVT, and the remaining three had DVT in both extremities. CT venography was performed with use of 2.5-3.2-mm x-ray beam collimation and a 1.25-2.0-mm reconstruction interval. Spiral scans were initiated 5 minutes after intravenous contrast medium injection. The CT venograms were correlated with catheter venograms. In addition, with use of axial sections and their three-dimensional reconstructions, including multiplanar reformation and volume rendering, the presence or absence of central obstructing lesions and their causes were evaluated. RESULTS: Among 44 patients with left-sided DVT, 37 had significant anatomic abnormalities in their iliofemoral veins or inferior vena cava (IVC). The most common lesion was left common iliac vein compression by the right common iliac artery (n = 27; exaggerated by a bony spur in nine and associated with extrinsic compression by the left internal iliac artery in two). Of the nine patients with right-sided DVT, six had significant anatomic abnormalities including encasement or extrinsic compression of their iliac veins by various causes (n = 3) and venous stricture without extrinsic lesions (n = 3). Among three patients with DVT in both extremities, two had anatomic abnormalities in the IVC. Therefore, 45 of 56 patients had anatomic abnormalities central to the thrombosed deep veins. CONCLUSION: The majority of patients with acute iliofemoral DVT had underlying anatomic abnormalities. The presence of central stenosis or obstruction and their causes can be evaluated by spiral CT venography.

Adolescent↗

PubMed2004

Transcatheter arterial embolization with 188Rhenium-HDD-labeled iodized oil in rabbit VX2 liver tumor.

PURPOSE: To evaluate the antitumor effect of transcatheter arterial embolization (TAE) with use of rhenium 188 HDD (4-hexadecyl 2,2,9,9-tetramethyl-4,7-diaza-1,10-decanethiol)-labeled iodized oil and to compare it with that of transcatheter arterial chemoembolization (TACE) with use of an established chemotherapeutic agent and iodized oil in experimentally induced liver tumor. MATERIALS AND METHODS: VX2 carcinoma was grown in the livers of 57 rabbits. TAE was performed with (188)Re-HDD-labeled iodized oil (Re-Lp group; n = 21), doxorubicin/iodized oil emulsion (Dx-Lp group; n = 21), and iodized oil alone (n = 15). Sequential conjugated planar imaging was performed for dosimetry of the radioisotope in the Re-Lp group (n = 15). Growth ratio and percentage of viable tumor were estimated by computed tomography and histopathologic examination. Hepatic and hematologic toxicities were evaluated by biochemical analysis. RESULTS: On conjugated planar imaging, radioactivity was concentrated on the tumor (effective half-life, 16.2 hours), and mean radiation dose to the tumor was 147.7 Gy. The mean growth ratios 1, 2, and 3 weeks after TAE and the percentage of viable tumor in the Re-Lp group (-3.4, -7.6, -11.1, and 0.3%) and the Dx-Lp group (-3.2, -5.3, 29.0, and 2.6%) were significantly lower than the respective values in the iodized oil group (45.5, 145.4, 283.0, and 30.1%; P < .001). However, the differences between the values in the Re-Lp group and those in the Dx-Lp group were not significant (P values of .165-0.497 for growth ratios; P = .134 for percentage of viable tumor). There was similar transient hepatotoxicity in all three groups. CONCLUSIONS: TAE with (188)Re-HDD-labeled iodized oil has potent antitumor effect in VX2 liver tumor that is comparable with that of TACE with an established chemotherapeutic agent.

Animals↗

PubMed2004

Completion thyroidectomy in patients with thyroid cancer who initially underwent unilateral operation.

BACKGROUND: In some instances, thyroid cancer may be diagnosed with histological examination after resection of putative or suspected benign nodule. In these cases, completion thyroidectomy followed by radioiodine ablation is usually recommended to prevent recurrence. If small intrathyroidal cancer is found, completion thyroidectomy may not be performed. Many patients have separate cancers in the contralateral lobe and in these cases completion thyroidectomy is essential even though primary tumour is small and limited within thyroid. OBJECTIVE: We analysed the frequency of malignant lesions in the contralateral lobe after completion thyroidectomy and assessed the predictive factors that may anticipate the presence of malignant lesion that may necessitate completion thyroidectomy. PATIENTS: Between 1995 and 2001, 243 patients were operated under the cytological diagnosis of follicular neoplasm. A total of 214 of them underwent lobectomy and isthmectomy and 81 turned out to have malignant disease in the resected lobe and they underwent completion thyroidectomy within a week to 6 months after the permanent section diagnosis of cancer. Their mean age was 40.7 +/- 12.1 years (range 14-71 years). RESULTS: After initial surgery, 53 patients had follicular carcinoma, 24 papillary carcinoma, one Hürthle cell carcinoma, one medullary, one insular and one anaplastic carcinoma. Mean tumour size was 4.1 +/- 2.6 cm (range 0.9-11 cm). After completion thyroidectomy, factors predicting the presence of cancer in the contralateral lobe were assessed according to clinical parameters and pathologic findings in ipsilateral lobe. First surgery revealed cancer multifocality in 34 cases, perithyroidal tumour extension in six and regional lymph node metastases in three. After completion thyroidectomy, 29 of the 81 patients revealed additional cancer in the contralateral lobe. Age, sex, size or pathologic type of the primary tumour was not associated with the presence of additional tumour in the contralateral lobe. Cancer multifocality in the ipsilateral lobe was the only significant variable to predict the presence of additional cancer in the contralateral lobe (relative risk = 6.03, confidence interval 2.23-16.35). Coexistence of benign nodule in ipsilateral lobe was not associated with increased cancer risk in the contralateral lobe. CONCLUSIONS: When diagnosed as thyroid cancer after unilateral surgery, the only predictive factor for the presence of additional contralateral cancer was multifocality of cancer in the ipsilateral lobe. We suggest that completion thyroidectomy is mandatory if multifocal cancers are found in the resected lobe, even though the cancers are very small and limited within the thyroid.

Adolescent↗

PubMed2004

Volumetric investigation of the frontal-subcortical circuitry in patients with obsessive-compulsive disorder.

The pathophysiology of obsessive-compulsive disorder (OCD) is thought to involve disturbance of the frontal-subcortical circuitry. To investigate the morphological characteristics of this circuitry, we examined the volume of the orbitofrontal cortex, anterior cingulate, thalamus, caudate, and the putamen in 36 age- and sex-matched OCD patients and normal control subjects using three-dimensional magnetic resonance (MR) brain imaging. The left orbitofrontal volumes were found to be significantly smaller in the OCD patients and showed significant negative correlations with obsessive-compulsive symptom severity. These findings suggest that a structural abnormality of this brain region is implicated in the pathophysiology of OCD.

Adult↗

PubMed2004

Differential expression of TGF-beta isoforms during differentiation of HaCaT human keratinocyte cells: implication for the separate role in epidermal differentiation.

The three mammalian isoforms of transforming growth factor-beta(TGF-beta1, beta2, beta3) are potent regulators of cell growth, differentiation, and extracellular matrix deposition. To study their role in skin differentiation, we investigated the expression of TGF-beta isoforms on cell growth and differentiation induction of the human keratinocyte cell line, HaCaT by elevating the Ca(2+) concentration. An ELISA and RT-PCR assay revealed secreted TGF-beta 1 protein and TGF-beta 1 mRNA were increased during calcium-induced differentiation. In contrast, major differences were seen for TGF-beta 2 and TGF-beta 3 mRNA which were decreased during differentiation, but TGF-beta 2 and TGF-beta3 protein were not evident on an ELISA. These results suggest different functions for each TGF-beta isoforms in epidermal differentiation, such that TGF-beta 1 is associated with the more differentiated state, and TGF-beta 2 and TGF-beta 3 may be associated the more proliferated state.

Cell Differentiation↗

PubMed2004

[The clinical report of 1,078 cases of hepatocellular carcinomas: National Cancer Center experience].

BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) is the third leading cause of cancer and the 5 year survival rate is 9.6% in Korea. To develop a strategy for surveillance and treatments, we studied the recent clinical characteristics of HCC diagnosed at single institution in Korea, where is in an endemic area of chronic hepatitis B. METHODS: One thousand and seventy eight patients with HCC who visited the National Cancer Center between June 2001 and December 2003 were retrospectively studied. RESULTS: The male/female ratio was 4.5:1. The mean age of the patients was 56.3 years. 74.2% of patient had hepatitis B virus (HBV) infections, 8.6% had hepatitis C virus (HCV) infections, 6.9% of the patients abused alcohol and 10.3% of the patients had non-B non-C considered as the etiologic factors of their HCC. Only 10.0% of patients had a tumor sized 2 cm or less and 53.3% of patients had a large tumor over 5 cm in diameter. 33.2% of patients had a single tumor. At the time of diagnosis, the modified UICC staging was as follows: 6.5%, 20.1%, 30.9%, 25.2% and 17.3% in stages I, II, III, IVa and IVb, respectively. The initial treatment performed was transcatheter arterial chemoembolization (48.2%), radiofrequency ablation (1.5%), hepatic resection (11.2%), systemic chemotherapy (7.5%), radiotherapy (2.1%), and conservative medical treatments (29.5%). The mean number of treatments was 1.65. The response rates to the initial treatments were 27.9% (complete response), 23.6% (partial response), 7.5% (minimal response), 14.2% (stable disease), and 30.4% (progressive disease). CONCLUSIONS: HBV infection is a major etiologic factor for Korean HCC patients. Most cases are still in advanced stages and these cases responded poorly to any treatments. The national surveillance program and its guideline for HCC are expected to improve the survival of HCC patients.

Adult↗