EBV infection has been causally associated with incidence of many carcinomas. EBV-associated gastric carcinoma (EBVaGC) has been classified as a unique gastric carcinoma subset, suggesting EBV infection is related to the development of gastric cancer. In this study, general trends of EBVaGC studies for last half-decades were reviewed in several perspectives of clinical significance, virological importance and etiological interests. Throughout this comprehensive reviewing, new study trends of EBV and EBVaGC for next half-decades were suggested.
Epstein-Barr Virus Infections ; Herpesvirus 4, Human* ; Incidence ; Methylation ; Prognosis ; Stomach Neoplasms

PURPOSE: To evaluate the feasibility of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) for preoperative concurrent chemoradiotherapy (PCRT) in locally advanced rectal cancer (LARC), by comparing with 3-dimensional conformal radiotherapy (3D-CRT). MATERIALS AND METHODS: Patients who were treated with PCRT for LARC from 2015 January to 2016 December were retrospectively enrolled. Total doses of 45 Gy to 50.4 Gy with 3D-CRT or SIB-IMRT were administered concomitantly with 5-fluorouracil plus leucovorin or capecitabine. Surgery was performed 8 weeks after PCRT. Between PCRT and surgery, one cycle of additional chemotherapy was administered. Pathologic tumor responses were compared between SIB-IMRT and 3D-CRT groups. Acute gastrointestinal, genitourinary, hematologic, and skin toxicities were compared between the two groups based on the RTOG toxicity criteria. RESULTS: SIB-IMRT was used in 53 patients, and 3D-CRT in 41 patients. After PCRT, no significant differences were noted in tumor responses, pathologic complete response (9% vs. 7%; p = 1.000), pathologic tumor regression Grade 3 or higher (85% vs. 71%; p = 0.096), and R0 resection (87% vs. 85%; p = 0.843). Grade 2 genitourinary toxicities were significantly lesser in the SIB-IMRT group (8% vs. 24%; p = 0.023), but gastrointestinal toxicities were not different across the two groups. CONCLUSION: SIB-IMRT showed lower GU toxicity and similar tumor responses when compared with 3D-CRT in PCRT for LARC.
Capecitabine ; Chemoradiotherapy* ; Drug Therapy ; Fluorouracil ; Humans ; Leucovorin ; Neoadjuvant Therapy ; Radiotherapy, Conformal* ; Radiotherapy, Intensity-Modulated* ; Rectal Neoplasms* ; Retrospective Studies ; Skin

PURPOSE: To evaluate the feasibility of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) for preoperative concurrent chemoradiotherapy (PCRT) in locally advanced rectal cancer (LARC), by comparing with 3-dimensional conformal radiotherapy (3D-CRT). MATERIALS AND METHODS: Patients who were treated with PCRT for LARC from 2015 January to 2016 December were retrospectively enrolled. Total doses of 45 Gy to 50.4 Gy with 3D-CRT or SIB-IMRT were administered concomitantly with 5-fluorouracil plus leucovorin or capecitabine. Surgery was performed 8 weeks after PCRT. Between PCRT and surgery, one cycle of additional chemotherapy was administered. Pathologic tumor responses were compared between SIB-IMRT and 3D-CRT groups. Acute gastrointestinal, genitourinary, hematologic, and skin toxicities were compared between the two groups based on the RTOG toxicity criteria. RESULTS: SIB-IMRT was used in 53 patients, and 3D-CRT in 41 patients. After PCRT, no significant differences were noted in tumor responses, pathologic complete response (9% vs. 7%; p = 1.000), pathologic tumor regression Grade 3 or higher (85% vs. 71%; p = 0.096), and R0 resection (87% vs. 85%; p = 0.843). Grade 2 genitourinary toxicities were significantly lesser in the SIB-IMRT group (8% vs. 24%; p = 0.023), but gastrointestinal toxicities were not different across the two groups. CONCLUSION: SIB-IMRT showed lower GU toxicity and similar tumor responses when compared with 3D-CRT in PCRT for LARC.
Capecitabine ; Chemoradiotherapy* ; Drug Therapy ; Fluorouracil ; Humans ; Leucovorin ; Neoadjuvant Therapy ; Radiotherapy, Conformal* ; Radiotherapy, Intensity-Modulated* ; Rectal Neoplasms* ; Retrospective Studies ; Skin

Sparganosis is a rare parasitic infection caused by plerocercoid tapeworm larvae of the genus Spirometra. While initially asymptomatic, the migrating larvae initially appear as subcutaneous nodules, which can be mistaken for cancer because all parts of the body can be affected, including the abdominal cavity, genitourinary tract, gastrointestinal tract, musculoskeletal system, central nervous system, and even the breasts. Therefore, we report here a case of sparganosis that was differentially diagnosed from recurrence of breast cancer.
Abdominal Cavity ; Breast Neoplasms* ; Breast* ; Central Nervous System ; Cestoda ; Gastrointestinal Tract ; Larva ; Musculoskeletal System ; Recurrence* ; Sparganosis* ; Spirometra

PURPOSE: Insulin-like growth factors (IGFs) regulate a wide range of biological functions including cell proliferation, differentiation, and apoptosis through paracrine and autocrine mechanisms. Accordingly, the present study analyzed polymorphisms of IGF genes and their impact on the prognosis for patients with gastrointestinal stromal tumors (GISTs). METHODS: Two hundred-thirteen consecutive patients with GISTs who underwent curative surgery from 5 medical centers were enrolled in the present study. The genomic DNA was extracted from paraffin-embedded tumor tissue, and four IGF-1 (+2995C/A, +533C/T, IVS2-16540A/G, Ex4-177G/C) and one IGF-2 (IVS1+1280A/G) gene polymorphisms were determined using a Sequenom MassARRAY system. RESULTS: With a median follow-up of 18.4 months, the estimated 5-year relapse-free survival and overall survival rates were 69.9% and 86.7%, respectively. In a multivariate analysis including age, gender, primary site of disease, pathology, and risk stratification, no significant association was observed between the polymorphism of the IGF-1 and IGF-2 genes and survival. CONCLUSION: None of the five IGF-1 and IGF-2 gene polymorphisms investigated in this study was found to be an independent prognostic marker for Korean patients with surgically resected GIST. However, further studies on a larger scale are warranted to clarify the role of IGF-1 and IGF-2 gene polymorphisms as a prognostic biomarker for GIST patients.
Apoptosis ; Cell Proliferation ; DNA ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; Humans ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Multivariate Analysis ; Polymorphism, Single Nucleotide ; Prognosis ; Somatomedins ; Survival Rate

PURPOSE: Insulin-like growth factors (IGF) regulate a wide range of biological functions including cell proliferation, differentiation, and apoptosis through paracrine and autocrine mechanisms. Accordingly, the present study analyzed polymorphisms of IGF genes and their impact on the prognosis for patients with colorectal cancer. MATERIALS AND METHODS: Four hundred and two consecutive patients with curatively resected colorectal adenocarcinoma were enrolled in the present study. The genomic DNA was extracted from fresh colorectal tissue and 8 polymorphisms of IGF genes determined using a real-time polymerase chain reaction genotyping assay. RESULTS: Pathologic stages after surgery were as follows: stage 0/I (n=85, 21.1%), stage II (n=147, 36.6%), stage III (n=145, 36.1%), and stage IV (n=25, 6.2%). Multivariate survival analysis including stage, age, site of disease, and carcinoembryonic antigen level showed that the progression-free survival for patients with the IGF2 +1280 GG genotype was slightly better than for the patients with the combined IGF2 +1280 AA and AG genotype (p=0.056), although there was no significant difference in the overall survival. However, the other polymorphisms were not associated with survival. CONCLUSION: None of the 8 IGF1 or IGF2 gene polymorphisms investigated in this study were found to be independent prognostic markers for Korean patients with surgically resected colorectal cancer.
Adenocarcinoma ; Apoptosis ; Carcinoembryonic Antigen ; Cell Proliferation ; Colorectal Neoplasms ; Disease-Free Survival ; DNA ; Genotype ; Humans ; Polymorphism, Genetic ; Prognosis ; Real-Time Polymerase Chain Reaction ; Somatomedins

PURPOSE: Insulin-like growth factors (IGF) regulate a wide range of biological functions including cell proliferation, differentiation, and apoptosis through paracrine and autocrine mechanisms. Accordingly, the present study analyzed polymorphisms of IGF genes and their impact on the prognosis for patients with colorectal cancer. MATERIALS AND METHODS: Four hundred and two consecutive patients with curatively resected colorectal adenocarcinoma were enrolled in the present study. The genomic DNA was extracted from fresh colorectal tissue and 8 polymorphisms of IGF genes determined using a real-time polymerase chain reaction genotyping assay. RESULTS: Pathologic stages after surgery were as follows: stage 0/I (n=85, 21.1%), stage II (n=147, 36.6%), stage III (n=145, 36.1%), and stage IV (n=25, 6.2%). Multivariate survival analysis including stage, age, site of disease, and carcinoembryonic antigen level showed that the progression-free survival for patients with the IGF2 +1280 GG genotype was slightly better than for the patients with the combined IGF2 +1280 AA and AG genotype (p=0.056), although there was no significant difference in the overall survival. However, the other polymorphisms were not associated with survival. CONCLUSION: None of the 8 IGF1 or IGF2 gene polymorphisms investigated in this study were found to be independent prognostic markers for Korean patients with surgically resected colorectal cancer.
Adenocarcinoma ; Apoptosis ; Carcinoembryonic Antigen ; Cell Proliferation ; Colorectal Neoplasms ; Disease-Free Survival ; DNA ; Genotype ; Humans ; Polymorphism, Genetic ; Prognosis ; Real-Time Polymerase Chain Reaction ; Somatomedins

BACKGROUND: Effective chest compression may improve the return of spontaneous circulation and neurologic outcome in arrest victims. For fear of rescuer's fatigue, guidelines for cardiopulmonary resuscitation (CPR) recommended that chest compression (CC) should be switched every 2 minutes, but there is little evidence. We investigated whether health personnel could provide consistent quality of CC for 2 minutes. METHODS: We recruited prospectively health personnel working on one university hospital. On the day assigned randomly, CPR performance data was collected with use of CPR recording technology. Quality of CPR was calculated every 30 seconds interval. To identify the quality decay, we used repeated measure analysis of variance with SPSS 17.0 for analysis. RESULTS: We analyzed 8,485 CCs performed by 41 subjects. Total number of CC decayed between 90 to 120 seconds (51.6 +/- 3.3 to 50.8 +/- 3.5, p = 0.020) within recommended range. The ratio of correct depth CC decayed between 90 to 120 seconds, falling from 83.4 +/- 24.9% to 68.3 +/- 38.4% (p = 0.002). The ratio of low depth CC increased significantly over time (10.2 +/- 20.7% to 31.3 +/- 38.5%, p < 0.001). CONCLUSIONS: Health personnel may provide adequate number of CC for 2 minutes. But, the number of correct depth CC may decay between 90 to 120 seconds. Also the number of low depth CC may increase over time.
Cardiopulmonary Resuscitation ; Fatigue ; Health Personnel ; Humans ; Manikins ; Prospective Studies ; Quality of Health Care ; Thorax

The present study evaluated the survival impact of standard adjuvant chemotherapy and prognostic differences between Epstein-Barr virus (EBV)-associated gastric cancer (EBVaGC) and EBV-negative gastric cancer (EBVnGC). A total of 276 patients were enrolled according to the following criteria: 1) pathologically diagnosed with primary gastric adenocarcinoma, 2) test results from EBV-encoded RNA in situ hybridization, 3) stage II/III according to the 7th edition of UICC/AJCC staging system for gastric cancer, and 4) postoperative adjuvant chemotherapy. Fifty-nine (21.4%) and 217 (78.6%) patients exhibited EBVaGC and EBVnGC, respectively, while 129 (46.7%) patients were classified as stage II and 147 (53.3%) as stage III. As for adjuvant chemotherapy, 87 (31.5%) patients received capecitabine and oxaliplatin, while 189 (68.5%) received S-1 monotherapy. With a median follow-up duration of 21.3 (6.4-89.0) months, the estimated 3-year disease-free survival (DFS) and overall survival (OS) rates were 74.8% and 83.0%, respectively. In univariate analysis and multivariate analysis using a Cox proportional hazard model including age, gender, stage, Lauren classification, and the type of chemotherapy, EBV-positivity was not significantly associated with DFS (p-value= 0.630) regardless of the type of chemotherapy. Therefore, no association was found between EBV positivity and the survival outcomes in patients with curatively resected gastric cancer who received standard adjuvant chemotherapy.
Adenocarcinoma ; Capecitabine ; Chemotherapy, Adjuvant* ; Classification ; Disease-Free Survival ; Drug Therapy ; Epstein-Barr Virus Infections ; Follow-Up Studies ; Gastrectomy* ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Multivariate Analysis ; Proportional Hazards Models ; RNA ; Stomach Neoplasms ; Survival Rate

Although nivolumab shows survival benefits for patients with advanced gastric cancer (AGC), predictive biomarkers for nivolumab treatment in AGC remain unclear, especially in the case of peritoneal metastases. This study investigated the clinical significance of the prognostic nutrition index (PNI), reflecting the host nutritional status and immunity, in AGC patients undergoing nivolumab monotherapy. This study retrospectively analyzed 53 AGC patients who received nivolumab between October 2017 and February 2021. Among them, 35 patients with peritoneal metastases were reviewed to investigate the relationship between the PNI and oncological outcomes. The PNI was calculated as 10×serum albumin level (g/dl)+0.005×total lymphocyte count (per mm3 ) at the first administration of nivolumab. With a median follow-up duration of 2.0 (0.3-13.5) months, the median overall survival (OS) was 2.0 months. The overall response and disease-control rates were 0.0% and 20.0%, respectively. Among the 35 patients, 13 patients were identified as a high-PNI group. In the univariate analysis, the high-PNI group showed a significantly longer PFS and OS than the low-PNI group. In the multivariate analysis, the high-PNI was independently associated with a longer PFS (p=0.021) and OS (p=0.022). The PNI can be useful for predicting PFS and OS in AGC patients with peritoneal metastases. However, further studies are required to validate these results in AGC and new strategies are needed to improve the outcome for AGC patients with peritoneal metastases.