1.Hyperfunctioning Parathyroid Carcinoma.
Eun Chol CHO ; Woong Yun CHUNG ; Hogeun KIM ; Cheong Soo PARK
Korean Journal of Endocrine Surgery 2001;1(1):113-117
PURPOSE: Most cases of primary hyperparathyroidism are due to either a parathyroid adenoma or parathyroid hyperplasia. Parathyroid carcinoma is a very rare cause of hyperparathyroidism. Although the diagnosis of parathyroid carcinoma is usually established by pathologic criteria especially of vascular or capsular invasion, some clinical and biochemical features differentiate it from benign forms of hyperparathyroidism. We undertook a retrospective study in 4 patients with functioning parathyroid carcinoma, with the aim of conveying experience from management of this rare cause of kyperparathyroidism. METHODS: Clinical simptoms, biochemical laboratory, radiologic, and intraoperative findings, extent of surgical resection. histologic findings, local recurrence and distant metastasis were analysed in 4 patients diagnosed pathologically as a parathyroid carcinoma after operation from 1992 to 1998. RESULTS: Mean age was 46.7 years (33~51 years) and male to female ratio was 1:3. Neck mass was found in 3 patients, multiple bone pain in 3 patients and renal stone in 1 patient. One case has suffered from chronic renal failure for 19 years. Although preoperative laboratory evaluations showed the aspects of hyperparathyroidsm in all the cases, mean serum calcium level was 11.1 mg/dl (10.5~12.0 mg/ dl), slightly elevated. Laboratory values after surgery were within the normal range in 3 cases. However, in one case with chronic renal failure, serum PTH levels, serially checked, were above the normal range. Any of imaging methods failed to suggest a parathyroid carcinoma preoperatively. Parathyroid adenoma was suspected in 2 cases, thyroid cancer in the other cases before surgery. The extent of resection was radical resection of parathyroid lesion with more than node dissection and in 2 cases, the resection of recurrent laryngeal nerve or strap muscles was added. During followup period, any local or systemic recurrence were not evident in all the cases. CONCLUSION: Although functioning parathyroid carcinoma is a rare disease and its preoperative diagnosis, in general, cannot easily be made, the understanding of characteristic clinical and biochemical feature could help diagnosis at first surgery. Radical resection without remaining residual tumor is most important fo the management of the parathyroid cancer.
Calcium
;
Diagnosis
;
Female
;
Follow-Up Studies
;
Humans
;
Hyperparathyroidism
;
Hyperparathyroidism, Primary
;
Hyperplasia
;
Kidney Failure, Chronic
;
Male
;
Muscles
;
Neck
;
Neoplasm Metastasis
;
Neoplasm, Residual
;
Parathyroid Neoplasms*
;
Rare Diseases
;
Recurrence
;
Recurrent Laryngeal Nerve
;
Reference Values
;
Retrospective Studies
;
Thyroid Neoplasms
2.Hyperfunctioning Parathyroid Carcinoma.
Eun Chol CHO ; Woong Yun CHUNG ; Hogeun KIM ; Cheong Soo PARK
Korean Journal of Endocrine Surgery 2001;1(1):113-117
PURPOSE: Most cases of primary hyperparathyroidism are due to either a parathyroid adenoma or parathyroid hyperplasia. Parathyroid carcinoma is a very rare cause of hyperparathyroidism. Although the diagnosis of parathyroid carcinoma is usually established by pathologic criteria especially of vascular or capsular invasion, some clinical and biochemical features differentiate it from benign forms of hyperparathyroidism. We undertook a retrospective study in 4 patients with functioning parathyroid carcinoma, with the aim of conveying experience from management of this rare cause of kyperparathyroidism. METHODS: Clinical simptoms, biochemical laboratory, radiologic, and intraoperative findings, extent of surgical resection. histologic findings, local recurrence and distant metastasis were analysed in 4 patients diagnosed pathologically as a parathyroid carcinoma after operation from 1992 to 1998. RESULTS: Mean age was 46.7 years (33~51 years) and male to female ratio was 1:3. Neck mass was found in 3 patients, multiple bone pain in 3 patients and renal stone in 1 patient. One case has suffered from chronic renal failure for 19 years. Although preoperative laboratory evaluations showed the aspects of hyperparathyroidsm in all the cases, mean serum calcium level was 11.1 mg/dl (10.5~12.0 mg/ dl), slightly elevated. Laboratory values after surgery were within the normal range in 3 cases. However, in one case with chronic renal failure, serum PTH levels, serially checked, were above the normal range. Any of imaging methods failed to suggest a parathyroid carcinoma preoperatively. Parathyroid adenoma was suspected in 2 cases, thyroid cancer in the other cases before surgery. The extent of resection was radical resection of parathyroid lesion with more than node dissection and in 2 cases, the resection of recurrent laryngeal nerve or strap muscles was added. During followup period, any local or systemic recurrence were not evident in all the cases. CONCLUSION: Although functioning parathyroid carcinoma is a rare disease and its preoperative diagnosis, in general, cannot easily be made, the understanding of characteristic clinical and biochemical feature could help diagnosis at first surgery. Radical resection without remaining residual tumor is most important fo the management of the parathyroid cancer.
Calcium
;
Diagnosis
;
Female
;
Follow-Up Studies
;
Humans
;
Hyperparathyroidism
;
Hyperparathyroidism, Primary
;
Hyperplasia
;
Kidney Failure, Chronic
;
Male
;
Muscles
;
Neck
;
Neoplasm Metastasis
;
Neoplasm, Residual
;
Parathyroid Neoplasms*
;
Rare Diseases
;
Recurrence
;
Recurrent Laryngeal Nerve
;
Reference Values
;
Retrospective Studies
;
Thyroid Neoplasms
3.Outcomes of Laparoscopic Left Lateral Sectionectomy vs. Open Left Lateral Sectionectomy: Single Center Experience.
Kyung Hwan KIM ; Yang Seok KOH ; Chol Kyoon CHO ; Young Hoe HUR ; Hee Joon KIM ; Eun Kyu PARK
Journal of Minimally Invasive Surgery 2017;20(1):29-33
PURPOSE: Laparoscopic surgery has become the mainstream surgical operation due to its stability and feasibility. Even for liver surgery, the laparoscopic approach has become an integral procedure. According to the recent international consensus meeting on laparoscopic liver surgery, laparoscopic left lateral sectionectomy (LLS) might be a new standard of care for left lateral surgical lesions. This study was designed to compare open LLS to laparoscopic LLS. METHODS: In total, 82 patients who had undergone LLS at Chonnam National University Hwasun Hospital between 2008 and 2015 were enrolled in this study. Among them, 59 patients underwent open LLS and 23 underwent laparoscopic LLS. These two groups were compared according to general characteristics and operative outcomes. RESULTS: The data analysis results showed that laparoscopic liver resection is superior to open liver resection in terms of the amount of bleeding during the operation and the duration of hospital stay. There was no statistical difference between the two groups in terms of operation time (p value=0.747). The amount of bleeding during the operation was 145.5±149.4 ml on average for the laparoscopic group and 320±243.8 ml on average for the open group (p value=0.005). The mean duration of hospital stay was 10.7±5.8 days for the laparoscopic surgery group and 12.2±5.1 days for the open surgery group (p value=0.003). CONCLUSION: This study showed that laparoscopic LLS is safe and feasible, because it involves less blood loss and a shorter hospital stay. For left lateral lesions, laparoscopic LLS might be the first option to be considered.
Consensus
;
Hemorrhage
;
Humans
;
Jeollanam-do
;
Laparoscopy
;
Length of Stay
;
Liver
;
Standard of Care
;
Statistics as Topic
4.Cystic lymphangioma of the pancreas mimicking pancreatic pseudocyst.
Ho Hyun KIM ; Eun Kyu PARK ; Jin Shick SEOUNG ; Young Hoe HUR ; Yang Seok KOH ; Jung Chul KIM ; Chol Kyoon CHO ; Hyun Jong KIM
Journal of the Korean Surgical Society 2011;80(Suppl 1):S55-S58
Lymphangiomas are rare congenital benign tumors arising from the lymphatic system, and are mostly encountered in the neck and axillary regions of pediatric patients (95%). Lymphangioma of the pancreas is extremely rare accounting for less than 1% of these tumors. We report here on a case of pancreatic cystic lymphangioma. A 54-year-old woman presented with intermittent postprandial abdominal discomfort and radiating back pain. Abdominal computed tomography scan revealed 8 x 6.5 cm hypodense cystic mass arising from the tail of the pancreas without septa or solid component. The initial impression was a pancreatic pseudocyst. The patient underwent distal pancreatectomy with splenectomy. The histopathologic and immunohistochemical study helped make the diagnosis of a pancreatic cystic lymphangioma. Herein, we report a case of pancreatic cystic lymphangioma mimicking pancreatic pseudocyst and review the relevant medical literature.
Accounting
;
Back Pain
;
Female
;
Humans
;
Lymphangioma
;
Lymphangioma, Cystic
;
Lymphatic System
;
Middle Aged
;
Neck
;
Pancreas
;
Pancreatectomy
;
Pancreatic Cyst
;
Pancreatic Pseudocyst
;
Splenectomy
5.Synchronous Gastrointestinal Stromal Tumor and Ampullary Neuroendocrine Tumor in Association with Neurofibromatosis Type 1: A Report of Three Cases
Eun Kyu PARK ; Hee Joon KIM ; Yun Ho LEE ; Yang Seok KOH ; Young Hoe HUR ; Chol Kyoon CHO
The Korean Journal of Gastroenterology 2019;74(4):227-231
Neurofibromatosis type 1 (NF1) is an autosomal dominant hereditary disorder. The pathogenesis of NF1 is suggested to be an alteration of the NF-1 gene, which normally functions as a tumor suppressor. A mutation of NF-1 causes the development of viable tumors in various sites. On the other hand, the synchronous manifestation of a gastrointestinal stromal tumor (GIST) and neuroendocrine tumor (NET) in the background of NF1 is extremely rare. This paper reports three cases treated with surgical intervention along with the long-term follow-up results. Three patients showed synchronous ampullary NET and GIST in association with NF1 supported by postoperative histopathologic analysis. Surgical treatments, such as pancreatoduodenectomy and local excision were applied. No recurrence occurred during the postoperative follow-up period of 10, 9, and 2.7 years. Synchronous GIST and NET in the background of NF1 is extremely rare, but the possible coexistence of other tumors in NF1 patients is relatively higher than that in the general population. Furthermore, both NETs and GISTs occurring in NF1 patients tend to be smaller in size compared to that in the general population. Therefore, when NF1 patients present with vague abdominal discomfort, close attention must be paid to identifying the coexistence of other neoplasms.
Follow-Up Studies
;
Gastrointestinal Stromal Tumors
;
Hand
;
Humans
;
Neuroendocrine Tumors
;
Neurofibromatoses
;
Neurofibromatosis 1
;
Pancreaticoduodenectomy
;
Recurrence
6.Synchronous Gastrointestinal Stromal Tumor and Ampullary Neuroendocrine Tumor in Association with Neurofibromatosis Type 1: A Report of Three Cases
Eun Kyu PARK ; Hee Joon KIM ; Yun Ho LEE ; Yang Seok KOH ; Young Hoe HUR ; Chol Kyoon CHO
The Korean Journal of Gastroenterology 2019;74(4):227-231
Neurofibromatosis type 1 (NF1) is an autosomal dominant hereditary disorder. The pathogenesis of NF1 is suggested to be an alteration of the NF-1 gene, which normally functions as a tumor suppressor. A mutation of NF-1 causes the development of viable tumors in various sites. On the other hand, the synchronous manifestation of a gastrointestinal stromal tumor (GIST) and neuroendocrine tumor (NET) in the background of NF1 is extremely rare. This paper reports three cases treated with surgical intervention along with the long-term follow-up results. Three patients showed synchronous ampullary NET and GIST in association with NF1 supported by postoperative histopathologic analysis. Surgical treatments, such as pancreatoduodenectomy and local excision were applied. No recurrence occurred during the postoperative follow-up period of 10, 9, and 2.7 years. Synchronous GIST and NET in the background of NF1 is extremely rare, but the possible coexistence of other tumors in NF1 patients is relatively higher than that in the general population. Furthermore, both NETs and GISTs occurring in NF1 patients tend to be smaller in size compared to that in the general population. Therefore, when NF1 patients present with vague abdominal discomfort, close attention must be paid to identifying the coexistence of other neoplasms.
Follow-Up Studies
;
Gastrointestinal Stromal Tumors
;
Hand
;
Humans
;
Neuroendocrine Tumors
;
Neurofibromatoses
;
Neurofibromatosis 1
;
Pancreaticoduodenectomy
;
Recurrence
7.Feasibility of Laparoscopic Right Posterior Sectionectomy for Malignant Lesion Compared to Open Right Posterior Sectionectomy: Retrospective, Single Center Study
Eui Sung JEONG ; Yang Seok KOH ; Chol Kyoon CHO ; Hee Joon KIM ; Eun Kyu PARK
Journal of Minimally Invasive Surgery 2020;23(2):74-79
Purpose:
We aimed to compare the operative outcomes of laparoscopic right posterior sectionectomy (RPS) and open RPS and evaluate the feasibility of laparoscopic RPS.
Methods:
From January 2009 to December 2017, laparoscopic liver resections were performed in 235 patients at Chonnam National University Hwasun Hospital, South Korea. We retrospectively analyzed the clinical data of 16 patients who underwent laparoscopic RPS and compared the outcomes with those who underwent open RPS (n=17).
Results:
The laparoscopic group had a mean tumor size of 3.82±1.73 cm (open group [OG]; 4.18±2.07 cm, p=0.596), mean tumor-free margin of 10.44±9.69 mm (OG; 10.06±10.62 mm, p=0.657), mean operation time of 412.2±102.2 min (OG; 275.0±60.5, p<0.001), mean estimated blood loss of 339.4±248.3 ml (OG; 236.4±102.7 ml, p=0.631), mean postoperative hospital stay of 11.63±2.58 days (OG; 14.71±4.69 days, p=0.027), and mean postoperative peaks of aspartate aminotransferase, alanine aminotransferase, total bilirubin, and prothrombin time of 545 mg/dl, 538 mg/dl, 1.39 mg/dl, 1.41 international normalized ratio (OG; 237 (p<0.001), 216 (p<0.001), 1.52 (p=0.817), and 1.45 (p=0.468)), respectively. There were no deaths or major complications in ether group. There were no cases of open conversion. Laparoscopic RPS was associated with a shorter hospital stay, prolonged operation time and lower complication rate. With long-term prognosis, no difference was found in overall survival rate and disease-free survival rate between the two groups.
Conclusion
Laparoscopic RPS can be performed, but the problems of long operative time and decrease in liver function should be resolved.
8.Prehypertension and Left Ventricular Diastolic Dysfunction in Middle-Aged Koreans.
Shin Yi JANG ; Sujin KIM ; Chang Kwan LEE ; Eun Jeong CHO ; Soo Jin CHO ; Sang Chol LEE
Korean Circulation Journal 2016;46(4):536-541
BACKGROUND AND OBJECTIVES: Left ventricular diastolic dysfunction is known to be a marker of myocardial damage, in particular myocardial fibrosis resulting from hypertension (HT). However, few studies have shown an association between the grade of diastolic dysfunction and blood pressure classification. We investigated the association between diastolic dysfunction and prehypertension (preHT) in apparently healthy adults who underwent routine health examinations. SUBJECTS AND METHODS: The study sample included 4261 Koreans, 45 to 64 years of age with no previous history of HT, diabetes mellitus, malignancy, proven coronary artery disease, or valvular heart disease based on echocardiography, who underwent routine health examinations including echocardiography. The subjects were classified into three groups based on resting blood pressure: prehypertensive, hypertensive, and normotensive. RESULTS: The prevalence of preHT in our study was 42.1%. After adjusting for age, gender, smoking status, alcohol consumption, fasting blood sugar, serum lipid profile, and body mass index, left ventricular diastolic dysfunction grades 1 and 2 were significantly more frequent in subjects with preHT (odds ratio [OR] 1.66 [95% confidence interval {CI} 1.40-1.96] and 1.37 [95% CI 0.95-1.97], respectively). When analyzed according to gender, the increased OR was especially notable in males. CONCLUSION: Left ventricular diastolic dysfunction appears to be significantly associated with preHT in Korean middle-aged males.
Adult
;
Alcohol Drinking
;
Blood Glucose
;
Blood Pressure
;
Body Mass Index
;
Classification
;
Coronary Artery Disease
;
Diabetes Mellitus
;
Echocardiography
;
Fasting
;
Fibrosis
;
Heart Valve Diseases
;
Humans
;
Hypertension
;
Male
;
Prehypertension*
;
Prevalence
;
Smoke
;
Smoking
;
Ventricular Dysfunction, Left
9.Liver resection for hepatocellular carcinoma: case-matched analysis of laparoscopic versus open resection.
Ho Hyun KIM ; Eun Kyu PARK ; Jin Shick SEOUNG ; Young Hoe HUR ; Yang Seok KOH ; Jung Chul KIM ; Chol Kyoon CHO ; Hyun Jong KIM
Journal of the Korean Surgical Society 2011;80(6):412-419
PURPOSE: To analyze the outcomes of laparoscopic liver resection compared with open liver resection in patients with hepatocellular carcinoma (HCC). METHODS: Between July 2005 and December 2009, 26 consecutive patients with HCC underwent a pure laparoscopic liver resection, and data from this group (laparoscopic liver resection group, L-group) were compared with a retrospective control group of 29 patients who underwent open liver resection for HCC (open liver resection group, O-group) during the same period. The two groups were matched in terms of demographic data, tumor size, degree of liver cirrhosis, American Society of Anesthesiology score, type of resection, and tumor location. RESULTS: Median operation time and the amount of intraoperative packed red blood cell transfusion in the L-group were 147.5 minutes and 0.35 units, respectively. The L-group revealed a shorter operation time (147.5 vs. 220.0 minutes, P = 0.031) than the O-group. No difference in perioperative morbidity or mortality rates was observed (3.8, 0 vs. 24.1%, 0%; P = 0.054, non-specific, respectively); the L-group was associated with a shorter hospital stay than the O-group (11.08 vs. 16.07 days, P = 0.034). After a mean follow-up of 23.9 months (range, 0.7 to 59.4 months), the 1-year disease-free survival rate was 84.6% in the L-group and 82.8% in the O-group (P = 0.673). CONCLUSION: Laparoscopic liver resection for HCC is feasible and safe in selected patients and can produce good surgical results with a shorter postoperative hospital stay and similar outcomes in terms of perioperative morbidity, mortality, and disease-free survival than open resection.
Anesthesiology
;
Carcinoma, Hepatocellular
;
Disease-Free Survival
;
Erythrocyte Transfusion
;
Follow-Up Studies
;
Humans
;
Laparoscopy
;
Length of Stay
;
Liver
;
Liver Cirrhosis
;
Retrospective Studies
10.KARE Genomewide Association Study of Blood Pressure Using Imputed SNPs.
Kyung Won HONG ; Ji Eun LIM ; Young Jin KIM ; Nam H CHO ; Chol SHIN ; Bermseok OH
Genomics & Informatics 2010;8(3):103-107
The imputation of untyped SNPs enables researchers to validate association findings across SNP arrays and also enables them to test a large number of SNPs to reveal the fine structure of the association peak, facilitating interpretation of the results and the location of causal polymorphisms. In this study, we applied the imputation method to a genomewide association study and recapitulated the previously associated gene loci of blood pressure traits in Korean cohorts. A total of 1,827,004 SNPs were imputed by the IMPUTE program, and we conducted a genomewide association study for systolic and diastolic blood pressure. While no SNPs passed the Bonferroni correction p-value (p=2.74x10-8 for 1,827,004 SNPs), 12 novel loci for systolic blood pressure and 16 novel loci for diastolic blood pressure were detected by imputed SNPs, with 10-5