1.Imaging findings of intrahepatic cholangiocarcinoma for prognosis prediction and treatment decisionmaking: a narrative review
Jun Gu KANG ; Taek CHUNG ; Dong Kyu KIM ; Hyungjin RHEE
The Ewha Medical Journal 2024;47(4):e66-
Intrahepatic cholangiocarcinoma (iCCA) is a heterogeneous bile duct adenocarcinoma with a rising global incidence and a poor prognosis. This review aims to present a comprehensive overview of the most recent radiological research on iCCA, focusing on its histopathologic subclassification and the use of imaging findings to predict prognosis and inform treatment decisions. Histologically, iCCA is subclassified into small duct (SD-iCCA) and large duct (LD-iCCA) types. SD-iCCA typically arises in the peripheral small bile ducts and is often associated with chronic hepatitis or cirrhosis. It presents as a mass-forming lesion with a relatively favorable prognosis. LD-iCCA originates near the hepatic hilum, is linked to chronic bile duct diseases, and exhibits more aggressive behavior and poorer outcomes.Imaging is essential for differentiating these subtypes and assessing prognostic factors like tumor size, multiplicity, vascular invasion, lymph node metastasis, enhancement patterns, and intratumoral fibrosis. Imaging-based prognostic models have demonstrated predictive accuracy comparable to traditional pathological staging systems. Furthermore, imaging findings are instrumental in guiding treatment decisions, including those regarding surgical planning, lymphadenectomy, neoadjuvant therapy, and the selection of targeted therapies based on molecular profiling. Advancements in radiological research have improved our understanding of iCCA heterogeneity, facilitating prognosis prediction and treatment personalization. Imaging findings assist in subclassifying iCCA, predicting outcomes, and informing treatment decisions, thus optimizing patient management. Incorporating imaging-based approaches into clinical practice is crucial for advancing personalized medicine in the treatment of iCCA. However, further high-level evidence from international multicenter prospective studies is required to validate these findings and increase their clinical applicability.
2.Imaging findings of intrahepatic cholangiocarcinoma for prognosis prediction and treatment decisionmaking: a narrative review
Jun Gu KANG ; Taek CHUNG ; Dong Kyu KIM ; Hyungjin RHEE
The Ewha Medical Journal 2024;47(4):e66-
Intrahepatic cholangiocarcinoma (iCCA) is a heterogeneous bile duct adenocarcinoma with a rising global incidence and a poor prognosis. This review aims to present a comprehensive overview of the most recent radiological research on iCCA, focusing on its histopathologic subclassification and the use of imaging findings to predict prognosis and inform treatment decisions. Histologically, iCCA is subclassified into small duct (SD-iCCA) and large duct (LD-iCCA) types. SD-iCCA typically arises in the peripheral small bile ducts and is often associated with chronic hepatitis or cirrhosis. It presents as a mass-forming lesion with a relatively favorable prognosis. LD-iCCA originates near the hepatic hilum, is linked to chronic bile duct diseases, and exhibits more aggressive behavior and poorer outcomes.Imaging is essential for differentiating these subtypes and assessing prognostic factors like tumor size, multiplicity, vascular invasion, lymph node metastasis, enhancement patterns, and intratumoral fibrosis. Imaging-based prognostic models have demonstrated predictive accuracy comparable to traditional pathological staging systems. Furthermore, imaging findings are instrumental in guiding treatment decisions, including those regarding surgical planning, lymphadenectomy, neoadjuvant therapy, and the selection of targeted therapies based on molecular profiling. Advancements in radiological research have improved our understanding of iCCA heterogeneity, facilitating prognosis prediction and treatment personalization. Imaging findings assist in subclassifying iCCA, predicting outcomes, and informing treatment decisions, thus optimizing patient management. Incorporating imaging-based approaches into clinical practice is crucial for advancing personalized medicine in the treatment of iCCA. However, further high-level evidence from international multicenter prospective studies is required to validate these findings and increase their clinical applicability.
3.Imaging findings of intrahepatic cholangiocarcinoma for prognosis prediction and treatment decisionmaking: a narrative review
Jun Gu KANG ; Taek CHUNG ; Dong Kyu KIM ; Hyungjin RHEE
The Ewha Medical Journal 2024;47(4):e66-
Intrahepatic cholangiocarcinoma (iCCA) is a heterogeneous bile duct adenocarcinoma with a rising global incidence and a poor prognosis. This review aims to present a comprehensive overview of the most recent radiological research on iCCA, focusing on its histopathologic subclassification and the use of imaging findings to predict prognosis and inform treatment decisions. Histologically, iCCA is subclassified into small duct (SD-iCCA) and large duct (LD-iCCA) types. SD-iCCA typically arises in the peripheral small bile ducts and is often associated with chronic hepatitis or cirrhosis. It presents as a mass-forming lesion with a relatively favorable prognosis. LD-iCCA originates near the hepatic hilum, is linked to chronic bile duct diseases, and exhibits more aggressive behavior and poorer outcomes.Imaging is essential for differentiating these subtypes and assessing prognostic factors like tumor size, multiplicity, vascular invasion, lymph node metastasis, enhancement patterns, and intratumoral fibrosis. Imaging-based prognostic models have demonstrated predictive accuracy comparable to traditional pathological staging systems. Furthermore, imaging findings are instrumental in guiding treatment decisions, including those regarding surgical planning, lymphadenectomy, neoadjuvant therapy, and the selection of targeted therapies based on molecular profiling. Advancements in radiological research have improved our understanding of iCCA heterogeneity, facilitating prognosis prediction and treatment personalization. Imaging findings assist in subclassifying iCCA, predicting outcomes, and informing treatment decisions, thus optimizing patient management. Incorporating imaging-based approaches into clinical practice is crucial for advancing personalized medicine in the treatment of iCCA. However, further high-level evidence from international multicenter prospective studies is required to validate these findings and increase their clinical applicability.
4.Imaging findings of intrahepatic cholangiocarcinoma for prognosis prediction and treatment decisionmaking: a narrative review
Jun Gu KANG ; Taek CHUNG ; Dong Kyu KIM ; Hyungjin RHEE
The Ewha Medical Journal 2024;47(4):e66-
Intrahepatic cholangiocarcinoma (iCCA) is a heterogeneous bile duct adenocarcinoma with a rising global incidence and a poor prognosis. This review aims to present a comprehensive overview of the most recent radiological research on iCCA, focusing on its histopathologic subclassification and the use of imaging findings to predict prognosis and inform treatment decisions. Histologically, iCCA is subclassified into small duct (SD-iCCA) and large duct (LD-iCCA) types. SD-iCCA typically arises in the peripheral small bile ducts and is often associated with chronic hepatitis or cirrhosis. It presents as a mass-forming lesion with a relatively favorable prognosis. LD-iCCA originates near the hepatic hilum, is linked to chronic bile duct diseases, and exhibits more aggressive behavior and poorer outcomes.Imaging is essential for differentiating these subtypes and assessing prognostic factors like tumor size, multiplicity, vascular invasion, lymph node metastasis, enhancement patterns, and intratumoral fibrosis. Imaging-based prognostic models have demonstrated predictive accuracy comparable to traditional pathological staging systems. Furthermore, imaging findings are instrumental in guiding treatment decisions, including those regarding surgical planning, lymphadenectomy, neoadjuvant therapy, and the selection of targeted therapies based on molecular profiling. Advancements in radiological research have improved our understanding of iCCA heterogeneity, facilitating prognosis prediction and treatment personalization. Imaging findings assist in subclassifying iCCA, predicting outcomes, and informing treatment decisions, thus optimizing patient management. Incorporating imaging-based approaches into clinical practice is crucial for advancing personalized medicine in the treatment of iCCA. However, further high-level evidence from international multicenter prospective studies is required to validate these findings and increase their clinical applicability.
5.Imaging findings of intrahepatic cholangiocarcinoma for prognosis prediction and treatment decisionmaking: a narrative review
Jun Gu KANG ; Taek CHUNG ; Dong Kyu KIM ; Hyungjin RHEE
The Ewha Medical Journal 2024;47(4):e66-
Intrahepatic cholangiocarcinoma (iCCA) is a heterogeneous bile duct adenocarcinoma with a rising global incidence and a poor prognosis. This review aims to present a comprehensive overview of the most recent radiological research on iCCA, focusing on its histopathologic subclassification and the use of imaging findings to predict prognosis and inform treatment decisions. Histologically, iCCA is subclassified into small duct (SD-iCCA) and large duct (LD-iCCA) types. SD-iCCA typically arises in the peripheral small bile ducts and is often associated with chronic hepatitis or cirrhosis. It presents as a mass-forming lesion with a relatively favorable prognosis. LD-iCCA originates near the hepatic hilum, is linked to chronic bile duct diseases, and exhibits more aggressive behavior and poorer outcomes.Imaging is essential for differentiating these subtypes and assessing prognostic factors like tumor size, multiplicity, vascular invasion, lymph node metastasis, enhancement patterns, and intratumoral fibrosis. Imaging-based prognostic models have demonstrated predictive accuracy comparable to traditional pathological staging systems. Furthermore, imaging findings are instrumental in guiding treatment decisions, including those regarding surgical planning, lymphadenectomy, neoadjuvant therapy, and the selection of targeted therapies based on molecular profiling. Advancements in radiological research have improved our understanding of iCCA heterogeneity, facilitating prognosis prediction and treatment personalization. Imaging findings assist in subclassifying iCCA, predicting outcomes, and informing treatment decisions, thus optimizing patient management. Incorporating imaging-based approaches into clinical practice is crucial for advancing personalized medicine in the treatment of iCCA. However, further high-level evidence from international multicenter prospective studies is required to validate these findings and increase their clinical applicability.
6.Clinical and Cytogenetic Analysis of Midtrimester Amniocentesis.
Jin Gu LEE ; Koo Hyun CHUNG ; Byung Hun KANG ; Heung Tae NOH ; Yun Ee RHEE ; Seon Hoe GU
Korean Journal of Obstetrics and Gynecology 2004;47(10):1872-1879
OBJECTIVE: To analyze the indications, clinical features, cytogenetic results and complications of amniocentesis and to determine the efficacy of antenatal genetic amniocentesis. METHODS: We analyzed retrospectively maternal age, gestational age, indications, transplacental puncture, frequency, discoloration of amniotic fluid, karyotype and complications in 325 cases of prenatal genetic amniocentesis performed at Chungnam National University Hospital from January 2000 to December 2002. RESULTS: The most common age group was from 30 to 34 (31.4%) and mean age was 32.7 years old. 85.3% of cases were performed at 16th-20th gestational weeks. Abnormal maternal serum markers were the most common indication of amniocentesis (56.0%) and the second most common indication was maternal age over 35 (33.2%). Abnormal karyotypes were found in 12 cases (3.6%) and normal variants were 21 cases (6.5%). Numerical aberration were 9 cases (2.7%) and structural aberration were 3 cases (0.3%). Among the autosomal aberrations, Down syndromes were 5 cases and Edward syndrome was 1 case. Among the sex chromosomal aberrations, 47,XXX were 2 cases and Turner syndrome was 1 case. As the increasing maternal age, the incidence of abnormal karyotype was increased. Procedure-related complications occurred in 11.7% of cases and fetal loss rate was 7.4%. No significant associations were found between procedure-related complications and maternal age, gestational age, transplacental puncture, frequency, discoloration of amniotic fluid, and antibiotic treatment. CONCLUSION: Amniocentesis is useful for prenatal genetic diagnosis in pregnancies with increasing risk of chromosome aberrations, such as advanced maternal age, abnormal maternal serum markers or abnormal US findings. Further studies are necessary to identify risk factors of complications after invasive procedure.
Abnormal Karyotype
;
Amniocentesis*
;
Amniotic Fluid
;
Biomarkers
;
Chromosome Aberrations
;
Chungcheongnam-do
;
Cytogenetic Analysis*
;
Cytogenetics*
;
Diagnosis
;
Female
;
Gestational Age
;
Humans
;
Incidence
;
Karyotype
;
Maternal Age
;
Pregnancy
;
Pregnancy Trimester, Second*
;
Punctures
;
Retrospective Studies
;
Risk Factors
;
Turner Syndrome
7.Standard Body Weight in Korean Industrial Workers.
Jung Hak CHUNG ; Pock Soo KANG ; Seok Bhum KIM ; Kong Jun SA ; Jung Kil RHEE ; Gu Wung HAN
Korean Journal of Occupational and Environmental Medicine 1989;1(1):52-60
To contribute to promotion of health and preservation of labor power of Korean laborers, the body height and body weight were measured for 10,407 workers (6,201 male, 4,206 female) in the age group of 20-29, engaged in manufactures in the Gumi industrial complex, Gumi city, Kyungpook province. The above data were extracted from the 1985 periodic examination chart for calculation of the mean body weight, mean body height, correlation coefficient and regression equation between weight and height, standard body weight, body mass index(BMI) and distribution of laborers within Garrow's classification of BMI by age and sex group. Mean body height of 20-29 age group was 168.2+/-5.61 cm for male and 155.9+/-5.26 cm for female. Mean body weight of 20-29 age group was 61.4+/-6.56 kg for male and 52.4+/-6.00 kg for female. Correlation coefficient and regression equation of 20-29 age group were +0.541 and Y(Wt)=0.632X(Ht)-44.975 for male and +0.559 and Y(Wt)=0.637X(Ht)-46.898 for female. Standard body weight of 20-29 age group was 53.0kg at 155cm, 59.3kg at 165cm, 65.6kg at 175cm for male and 51.8kg at 155cm, 58.2kg at 165cm, 64.6kg at 175 cm for female. Range of normal body weight of 20-29 age group was 47.5+/-58.5kg at 155cm, 53.8+/-64.8kg at 165cm, 60.1+/-72.1kg at 175cm for male and 46.9+/-56.8kg at 155cm, 53.2+/-63.2kg at 165cm, 59.6+/-69.6 kg at 175 cm for female. Range of obesity of 20-29 age group was 64.1kg and over at 155cm, 70.3kg and over at 165cm, 76.7kg and over at 175cm for male and 61.8kg and over at 155cm, 68.2kg and over at 165cm, 74.5kg and over at 175 cm for female. Body mass index (kg/m2) of 20-29 age group was 21.7+/-1.95 for male and 21.6+/-2.05 for female, 75.9% of male laborers and 71.3% of famale counterparts fall in the desirable range of BMI by Garrow's classification.
Body Height
;
Body Mass Index
;
Body Weight*
;
Classification
;
Female
;
Gyeongsangbuk-do
;
Health Promotion
;
Humans
;
Ideal Body Weight
;
Male
;
Obesity
8.Bilateral Benign Paroxysmal Positional Vertigo of Horizontal Canal and Posterior Canal.
Myung Whan SUH ; Sung Hyen BAE ; Jae Yun JUNG ; Chung Gu RHEE
Korean Journal of Otolaryngology - Head and Neck Surgery 2008;51(12):1155-1162
Bowing nystagmus, lying down nystagmus, null pointand comparing the slow phase velocity during right and left head roll test may be used to distinguish the side of lesion in lateral canal benign paroxysmal positional vertigo (BPPV). Nonetheless, it is sometimes difficult to distinguish the side of lesion. In particular, when multiple canal BPPV such as lateral and posterior canal BPPV is suspected, the problemis even more complicated. From this reason, usually the side of lesion is first identified for the posterior canal, and the lateral canal BPPV is presumed to be present on the identical side. But is this approachalways correct and justifiable? As there are reports on bilateral posterior canal BPPV and bilateral lateral canal BPPV, there should also be bilateral posterior and lateral canal BPPV cases. We report two cases of bilateral posterior and lateralcanal BPPV, and discuss the grounds for diagnosing these cases as bilateral. The first case is a mixed left posterior canalolithiasis plus right lateral canalolithiasis and the second case is a mixed right posterior canalolithiasis plus left lateral cupulolitiasis. In such cases, mixed nystagmus can make it difficult to directly compare the slow phase velocity during the right and left head roll test. New methods are necessary to distinguish the side of the lesion for the lateral canal. We introduce the concept of AHC (attenuated horizontal component) which seems to be important in deciding the side of lesion in multiple canal BPPV. We also introduce head center nystagmus (HCN) to aid the decision on the side of lesion.
Deception
;
Head
;
Nystagmus, Physiologic
;
Semicircular Canals
;
Vertigo
9.Elevation of heart-femoral pulse wave velocity by short-term low sodium diet followed by high sodium diet in hypertensive patients with sodium sensitivity.
Moo Yong RHEE ; Ji Hyun KIM ; Sang Hoon NA ; Jin Wook CHUNG ; Jun Ho BAE ; Deuk Young NAH ; Namyi GU ; Hae Young KIM
Nutrition Research and Practice 2016;10(3):288-293
BACKGROUND/OBJECTIVES: We compared changes in heart-femoral pulse wave velocity (hfPWV) in response to low sodium and high sodium diet between individuals with sodium sensitivity (SS) and resistance (SR) to evaluate the influence of sodium intake on arterial stiffness. SUBJECTS/METHODS: Thirty-one hypertensive and 70 normotensive individuals were given 7 days of low sodium dietary approach to stop hypertension (DASH) diet (LSD, 100 mmol NaCl/day) followed by 7 days of high sodium DASH diet (HSD, 300 mmol NaCl/day) during 2 weeks of hospitalization. The hfPWV was measured and compared after the LSD and HSD. RESULTS: The hfPWV was significantly elevated from LSD to HSD in individuals with SS (P = 0.001) independently of changes in mean arterial pressure (P = 0.037). Conversely, there was no significant elevation of hfPWV from LSD to HSD in individuals with SR. The percent change in hfPWV from the LSD to the HSD in individuals with SS was higher than that in individuals with SR. Subgroup analysis revealed that individuals with both SS and hypertension showed significant elevation of hfPWV from LSD to HSD upon adjusted analysis using changes of the means arterial pressure (P = 0.040). However, there was no significant elevation of hfPWV in individuals with SS and normotension. CONCLUSION: High sodium intake elevated hfPWV in hypertensive individuals with SS, suggesting that high sodium intake increases aortic stiffness, and may contribute to enhanced cardiovascular risk in hypertensive individuals with SS.
Arterial Pressure
;
Diet*
;
Hospitalization
;
Humans
;
Hypertension
;
Lysergic Acid Diethylamide
;
Pulse Wave Analysis*
;
Sodium*
;
Sodium, Dietary
;
Vascular Stiffness
10.Elevation of heart-femoral pulse wave velocity by short-term low sodium diet followed by high sodium diet in hypertensive patients with sodium sensitivity.
Moo Yong RHEE ; Ji Hyun KIM ; Sang Hoon NA ; Jin Wook CHUNG ; Jun Ho BAE ; Deuk Young NAH ; Namyi GU ; Hae Young KIM
Nutrition Research and Practice 2016;10(3):288-293
BACKGROUND/OBJECTIVES: We compared changes in heart-femoral pulse wave velocity (hfPWV) in response to low sodium and high sodium diet between individuals with sodium sensitivity (SS) and resistance (SR) to evaluate the influence of sodium intake on arterial stiffness. SUBJECTS/METHODS: Thirty-one hypertensive and 70 normotensive individuals were given 7 days of low sodium dietary approach to stop hypertension (DASH) diet (LSD, 100 mmol NaCl/day) followed by 7 days of high sodium DASH diet (HSD, 300 mmol NaCl/day) during 2 weeks of hospitalization. The hfPWV was measured and compared after the LSD and HSD. RESULTS: The hfPWV was significantly elevated from LSD to HSD in individuals with SS (P = 0.001) independently of changes in mean arterial pressure (P = 0.037). Conversely, there was no significant elevation of hfPWV from LSD to HSD in individuals with SR. The percent change in hfPWV from the LSD to the HSD in individuals with SS was higher than that in individuals with SR. Subgroup analysis revealed that individuals with both SS and hypertension showed significant elevation of hfPWV from LSD to HSD upon adjusted analysis using changes of the means arterial pressure (P = 0.040). However, there was no significant elevation of hfPWV in individuals with SS and normotension. CONCLUSION: High sodium intake elevated hfPWV in hypertensive individuals with SS, suggesting that high sodium intake increases aortic stiffness, and may contribute to enhanced cardiovascular risk in hypertensive individuals with SS.
Arterial Pressure
;
Diet*
;
Hospitalization
;
Humans
;
Hypertension
;
Lysergic Acid Diethylamide
;
Pulse Wave Analysis*
;
Sodium*
;
Sodium, Dietary
;
Vascular Stiffness