1.Comparison of the prevalence and histology between primary benign bladder tumors and recurrent benign lesions after transurethral resection of malignant bladder tumors
Jae Jin BAEK ; Yong Deuk SEO ; Dong Ha KIM ; Won Tae SEO ; Su Hwan KANG ; Taek Sang KIM ; Bong Kwon CHUN
Kosin Medical Journal 2023;38(1):43-49
Background:
Benign bladder tumors are rare disease entities, and insufficient studies have assessed their epidemiological characteristics. The authors investigated the prevalence of benign bladder tumors by retrospectively investigating pathology reports of transurethral resection of bladder tumor (TURBT) procedures over the past 20 years.
Methods:
We analyzed 1,674 pathology reports of TURBT conducted in 1,160 patients from January 1, 2000, to April 30, 2022. The prevalence of benign tumors and histological classification according to the presence of primary (group 1) and recurrent (group 2) bladder lesions were retrospectively investigated.
Results:
The mean age of patients was 65.2±11.5 years, and 1,284 cases (79.1%) were in men. Benign bladder tumors comprised 278 cases (248 patients) accounting for about 17.1% of the total TURBT cases (278/1,624). Furthermore, 184 patients (16.0%, 184/1,147) belonged to group 1 and 78 patients (27.4%, 78/285) belonged to group 2. Among all benign lesions that underwent TURBT, cystitis was the most common (41.0%, 114/278), and this rate was higher in group 2 (64/184 [34.8%] vs. 50/94 [53.2%], p<0.001). The prevalence of non-neoplastic lesions was higher in group 1 (44/184 [23.9] vs. 11/94 [11.7%], p<0.001). There was no difference in the prevalence of noninvasive urothelial neoplasms between the two groups (22/184 [12.0%] vs. 8/94 [8.5%], p=0.86).
Conclusions
The probability of benign lesions in TURBT was 17.1%, among which cystitis was the most common. When TURBT was performed for recurrent lesions, the frequency of benign tumors was higher than that of primary benign bladder tumors.
2.Primary Tumor Suppression and Systemic Immune Activation of Macrophages through the Sting Pathway in Metastatic Skin Tumor
Chun-Bong SYNN ; Dong Kwon KIM ; Jae Hwan KIM ; Youngseon BYEON ; Young Seob KIM ; Mi Ran YUN ; Ji Min LEE ; Wongeun LEE ; Eun Ji LEE ; Seul LEE ; You-Won LEE ; Doo Jae LEE ; Hyun-Woo KIM ; Chang Gon KIM ; Min Hee HONG ; June Dong PARK ; Sun Min LIM ; Kyoung-Ho PYO
Yonsei Medical Journal 2022;63(1):42-55
Purpose:
Agonists of the stimulator of interferon genes (STING) play a key role in activating the STING pathway by promoting the production of cytokines. In this study, we investigated the antitumor effects and activation of the systemic immune response of treatment with DMXAA (5,6-dimethylxanthenone-4-acetic acid), a STING agonist, in EML4-ALK lung cancer and CT26 colon cancer.
Materials and Methods:
The abscopal effects of DMXAA in the treatment of metastatic skin nodules were assessed. EML4-ALK lung cancer and CT26 colon cancer models were used to evaluate these effects after DMXAA treatment. To evaluate the expression of macrophages and T cells, we sacrificed the tumor-bearing mice after DMXAA treatment and obtained the formalin-fixed paraffin-embedded (FFPE) tissue and tumor cells. Immunohistochemistry and flow cytometry were performed to analyze the expression of each FFPE and tumor cell.
Results:
We observed that highly infiltrating immune cells downstream of the STING pathway had increased levels of chemokines after DMXAA treatment. In addition, the levels of CD80 and CD86 in antigen-presenting cells were significantly increased after STING activation. Furthermore, innate immune activation altered the systemic T cell-mediated immune responses, induced proliferation of macrophages, inhibited tumor growth, and increased numbers of cytotoxic memory T cells. Tumor-specific lymphocytes also increased in number after treatment with DMXAA.
Conclusion
The abscopal effect of DMXAA treatment on the skin strongly reduced the spread of EML4-ALK lung cancer and CT26 colon cancer through the STING pathway and induced the presentation of antigens.
3.γ-Linolenic Acid versus α-Lipoic Acid for Treating PainfulDiabetic Neuropathy in Adults: A 12-Week, Double-Placebo, Randomized, NoninferiorityTrial
Jong Chul WON ; Hyuk-Sang KWON ; Seong-Su MOON ; Sung Wan CHUN ; Chong Hwa KIM ; Ie Byung PARK ; In Joo KIM ; Jihyun LEE ; Bong Yun CHA ; Tae Sun PARK
Diabetes & Metabolism Journal 2020;44(4):542-554
This study was a multicenter, parallel-group, double-blind, double-dummy, randomized,noninferiority trial to evaluate the efficacy and safety of γ-linolenic acid(GLA) relative to α-lipoic acid (ALA) over a 12-week treatment period in type 2diabetes mellitus (T2DM) patients with painful diabetic peripheral neuropathy (DPN). This study included 100 T2DM patients between 20 and 75 years of age who had painfulDPN and received either GLA (320 mg/day) and placebo or ALA (600 mg/day) and placebo for12 weeks. The primary outcome measures were mean changes in pain intensities as measuredby the visual analogue scale (VAS) and the total symptom scores (TSS). Of the 100 subjects who initially participated in the study, 73 completed the 12-weektreatment period. Per-protocol analyses revealed significant decreases in the mean VASand TSS scores compared to baseline in both groups, but there were no significantdifferences between the groups. The treatment difference for the VAS (95% confidenceinterval [CI]) between the two groups was −0.65 (−1.526 to 0.213) and theupper bound of the 95% CI did not exceed the predefined noninferiority margin(δ1=0.51). For the TSS, the treatment difference was −0.05(−1.211 to 1.101) but the upper bound of the 95% CI crossed the noninferioritymargin (δ2=0.054). There were no serious adverse events associatedwith the treatments. GLA treatment in patients with painful DPN was noninferior to ALA in terms of reducingpain intensity measured by the VAS over 12 weeks.
4.Neuron-specific enolase as a novel biomarker reflecting tuberculosis activity and treatment response.
Sung Jin NAM ; Jee Yeong JEONG ; Tae Won JANG ; Mann Hong JUNG ; Bong Kwon CHUN ; Hee Jae CHA ; Chul Ho OAK
The Korean Journal of Internal Medicine 2016;31(4):694-702
BACKGROUND/AIMS: It is not clear which tests are indicative of the activity and severity of tuberculosis (TB). This study aimed to investigate the predictive value of neuron-specific enolase (NSE) and to determine the origin of NSE in TB patients. METHODS: A single-center retrospective analysis was conducted on newly diagnosed TB patients between January and December 2010. Patients were categorized into one of two disease groups (focal segmental or extensive) based on chest X-ray. Pre- and post-treatment NSE concentrations were evaluated. To determine the origin of serum NSE concentration, NSE staining was compared with macrophage-specific CD68 staining in lung tissues and with a tissue microarray using immunohistochemistry and immunofluorescence. RESULTS: A total of 60 newly diagnosed TB patients were analyzed. In TB patients, NSE serum concentration was significantly increased and NSE level decreased after treatment (p < 0.001). In proportion to serum high-sensitivity C-reactive protein concentration, the mean serum concentration of NSE in the extensive group (25.12 ng/mL) was significantly higher than that in the focal segmental group (20.23 ng/mL, p = 0.04). Immunohistochemical staining revealed a large number of macrophages that stained positively for both NSE and CD68 in TB tissues. In addition, NSE signals mostly co-localized with CD68 signals in the tissue microarray of TB patients. CONCLUSIONS: Our results suggest that NSE may be a practical parameter that can be used to monitor TB activity and treatment response. Elevated serum NSE level originates, at least in part, from macrophages in granulomatous lesions.
C-Reactive Protein
;
Diagnosis
;
Fluorescent Antibody Technique
;
Humans
;
Immunohistochemistry
;
Lung
;
Macrophages
;
Phosphopyruvate Hydratase*
;
Retrospective Studies
;
Thorax
;
Tuberculosis*
;
Tuberculosis, Pulmonary
5.Metachronous anterior urethral metastasis of prostatic ductal adenocarcinoma.
Jeong Hyun OH ; Taek Sang KIM ; Hyun Yul RHEW ; Bong Kwon CHUN
Kosin Medical Journal 2016;31(1):66-70
Prostate cancer is increasing in frequency in Korea. Among them, ductal adenocarcinoma (DCP) has a more aggressive and poor prognosis than acinar adenocarcinoma (ACP), despite its low incidence. Patients usually present with symptoms of lower urinary tract symptoms and hematuria due to increasing tumor mass within the lumen of the prostatic urethra, making diagnosis of DCP by the transrectal prostate biopsy difficult. DCP is often metastasized at the time of diagnosis. DCP is transferable to most other organs but the metastasis to the anterior urethra is rare. There is no doubt that localized DCP requires radical prostatectomy (RP) but the guidelines for adjuvant therapy after RP have not yet been established. Methods of the treatment are confounded by individual differences, and arriving at a consensus is challenging due to insufficient data. We report a case of DCP and urethral metastasis after RP, thus aiding in the determination of treatment guidelines.
Adenocarcinoma*
;
Biopsy
;
Consensus
;
Diagnosis
;
Hematuria
;
Humans
;
Incidence
;
Individuality
;
Korea
;
Lower Urinary Tract Symptoms
;
Neoplasm Metastasis*
;
Prognosis
;
Prostate
;
Prostatectomy
;
Prostatic Neoplasms
;
Urethra
6.Factors Associated with Metastatic Lymph Node Ratio, Extranodal Extension in the Central Compartment Node-Positive Papillary Thyroid Carcinoma.
Chan Woo PARK ; Jun Woong SONG ; Bong Kwon CHUN ; Sung Won KIM ; Hyoung Shin LEE ; Jong Chul HONG ; Kang Dae LEE
Korean Journal of Otolaryngology - Head and Neck Surgery 2015;58(7):475-480
BACKGROUND AND OBJECTIVES: Lymph node (LN) metastasis occurs in 30-80% of patients presenting for initial treatment of papillary thyroid carcinoma (PTC). The presence of LN metastasis is an independent risk factor for recurrence, which can add significant treatment morbidity. The LN ratio (LNR) and extranodal extension (ENE) have been shown to be important prognostic factors in PTC. The purpose of this study was to assess the characteristic features of LNR and ENE. SUBJECTS AND METHOD: We undertook a retrospective study of 411 patients treated between January, 2011 and December, 2013 for central compartment node-positive PTC by thyroidectomy and central compartment neck dissection (CCND) at our institution. We compared various clinicopathologic parameters such as age, gender, tumor size, multifocality, bilaterality, local invasion, extrathyroidal extension and aggressive variants between LNR and ENE. RESULTS: The significant associated factors for high LNR (defined as higher than 0.5) in multivariate analysis were gender (p=0.001, odds ratio=2.285) and multifocality (p=0.027, odds ratio=2.092). On the other hand, the significant associated factors for ENE in multivariate analysis were primary tumor size (p=0.023, odds ratio=1.965) and local invasion (p=0.043, odds ratio=1.870). CONCLUSION: Being male, multifocality, large primary tumor size (defined as larger than 1 cm) and local invasion were revealed as associated factors for LNR and ENE. Therefore, elective CCND should be considered for patients with PTC, for whom a thorough investigation of associative factors should be made before surgery.
Carcinoma, Papillary
;
Hand
;
Humans
;
Lymph Nodes*
;
Lymphatic Metastasis
;
Male
;
Multivariate Analysis
;
Neck Dissection
;
Neoplasm Metastasis
;
Recurrence
;
Retrospective Studies
;
Risk Factors
;
Thyroid Neoplasms*
;
Thyroidectomy
7.Saccular Aneurysm of the External Jugular Vein: A Case Report.
Hae Young LEE ; Sung Ho CHO ; Taek Yong KO ; Hyun Su KIM ; Jong In KIM ; Sung Dal PARK ; Sung Rae CHO ; Bong Kwon CHUN
The Korean Journal of Thoracic and Cardiovascular Surgery 2014;47(2):171-173
Saccular aneurysm of the external jugular vein presenting as a neck mass is very rare. We report the surgical treatment of an external jugular venous aneurysm in a 48-year-old female patient due to the cosmetic problem of neck engorgement, concomitant with thyroidectomy for cancer.
Aneurysm*
;
Female
;
Humans
;
Jugular Veins*
;
Middle Aged
;
Neck
;
Thyroidectomy
;
Vascular Diseases
8.Efficacy and safety of antiplatelet-combination therapy after drug-eluting stent implantation.
Yun Kyeong CHO ; Chang Wook NAM ; Hyoung Seob PARK ; Hyuck Jun YOON ; Hyungseop KIM ; Seung Ho HUR ; Yoon Nyun KIM ; Jang Hoon LEE ; Dong Heon YANG ; Bong Ryeol LEE ; Byung Chun JUNG ; Woong KIM ; Jong Seon PARK ; Jin Bae LEE ; Kee Sik KIM ; Kwon Bae KIM
The Korean Journal of Internal Medicine 2014;29(2):210-216
BACKGROUND/AIMS: Combination single-pill therapy can improve cost-effectiveness in a typical medical therapy. However, there is a little evidence about the efficacy and tolerability of combination single-pill antiplatelet therapy after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). METHODS: From June to November 2012, in total, 142 patients who met the following criteria were enrolled: at least 18 years old; successful PCI with DES at least 3 months earlier; and regular medication of aspirin and clopidogrel with no side effects. After VerifyNow P2Y12 and aspirin assays, the combination single pill of aspirin and clopidogrel was given and laboratory tests were repeated 6 weeks later. RESULTS: At baseline, the incidence of aspirin resistance, defined as aspirin reaction unit (ARU) > or = 550, was 9.2%, that of clopidogrel resistance, defined as P2Y12 reaction unit (PRU) > or = 230, was 46.5%, and that of percent inhibition of PRU < 20% was 32.4%. At follow-up, the incidence of resistance by ARU value was 7.0%, 50.0% by PRU value, and 35.9% by percentage inhibition of PRU, respectively. The mean values of ARU (431.5 +/- 63.6 vs. 439.8 +/- 55.2; p = 0.216) and PRU (227.5 +/- 71.4 vs. 223.3 +/- 76.0; p = 0.350) were not significantly different before versus after antiplatelet-combination single-pill therapy. Five adverse events (3.5%) were observed during the study period. CONCLUSIONS: Combination single-pill antiplatelet therapy, which may reduce daily pill burden for patients after PCI with DES, demonstrated similar efficacy to separate dual-pill antiplatelet therapy.
Aged
;
Antiplatyhelmintic Agents/*administration & dosage/adverse effects
;
Aspirin/*administration & dosage/adverse effects
;
Drug Combinations
;
Drug Resistance
;
*Drug-Eluting Stents
;
Female
;
Humans
;
Intention to Treat Analysis
;
Male
;
Middle Aged
;
Myocardial Ischemia/blood/diagnosis/*therapy
;
Percutaneous Coronary Intervention/adverse effects/*instrumentation
;
Platelet Function Tests
;
Prospective Studies
;
Tablets
;
Ticlopidine/administration & dosage/adverse effects/*analogs & derivatives
;
Time Factors
;
Treatment Outcome
9.A Case of Mediastinal Ectopic Thyroid Tissue Diagnosed by Endobronchial Ultrasound Guided Transbronchial Needle Aspiration.
Sae Jin PARK ; Shin Jun LEE ; In Kyoung SHIM ; Tae Won JANG ; Bong Kwon CHUN
Kosin Medical Journal 2011;26(1):89-92
A 77-year old woman was referred to hospital with dyspnea and chest dull pain for 5 months. The chest radiograph showed a mass located in the mediastinum. Trachea was deviated to right side. Chest computed tomography showed an enhancing large mass at the middle mediastinum. Endobronchial ultrasonography showed hyperechoic mediastinal mass. We performed endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA). Histologic finding was thyroid tissue with a benign looking papilla. Ectopic thyroid is an uncommon embryological aberration characterized by the presence of thyroid tissue in a site other than in its usual pretracheal region. It occurs along the path of descent of the developing thyroid primodium from the foramen cecum. It is extremely rare for mediastinal ectopic thyroid tissue diagnosised by EBUS-TBNA, so we report here on a case of mediastinal ectopic thyroid and we review the relevant medical literature.
Biopsy, Needle
;
Bronchoscopy
;
Cecum
;
Dyspnea
;
Female
;
Humans
;
Mediastinal Neoplasms
;
Mediastinum
;
Needles
;
Thorax
;
Thyroid Dysgenesis
;
Thyroid Gland
;
Trachea
10.Successful Treatment of Stereotactic Body Radiation Therapy Combined with Transarterial Chemolipiodolization for Hepatocellular Carcinoma with Biliary Obstruction.
Chan Kwon PARK ; Si Hyun BAE ; Hong Jun YANG ; Ho Jong CHUN ; Il Bong CHOI ; Jong Young CHOI ; Seung Kew YOON
The Korean Journal of Internal Medicine 2011;26(1):94-98
Conventional radiation therapy (RT) is a widely recognized treatment for hepatocellular carcinoma (HCC). However, conventional RT plays only a limited role in HCC treatment because of its low efficacy and the low tolerance of the liver for this modality. Stereotactic body radiation therapy (SBRT) was recently developed and represents the most advanced radiation therapy technique currently available. It can deliver a high dose in a short time to well-defined hepatic tumors, with rapid dose fall-off gradients. We believe that SBRT with transarterial chemolipiodolization (TACL) may prove promising as a combined treatment modality for HCC due to its precision and relative safety. Here we present a case of successful treatment of advanced HCC with obstructive jaundice using this combined modality.
Carcinoma, Hepatocellular/complications/*therapy
;
*Chemoembolization, Therapeutic
;
Combined Modality Therapy
;
Humans
;
Jaundice, Obstructive/etiology/therapy
;
Liver Neoplasms/complications/*therapy
;
Male
;
Middle Aged
;
*Radiosurgery

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