Purpose: Notable effectiveness of trastuzumab deruxtecan in patients with human epidermal growth factor receptor 2 (HER2)–low advanced breast cancer (BC) has focused pathologists’ attention. We studied the incidence and clinicopathologic characteristics of HER2-low BC, and the effects of immunohistochemistry (IHC) associated factors on HER2 IHC results. Materials and Methods: The Breast Pathology Study Group of the Korean Society of Pathologists conducted a nationwide study using real-world data on HER2 status generated between January 2022 and December 2022. Information on HER2 IHC protocols at each participating institution was also collected. Results: Total 11,416 patients from 25 institutions included in this study. Of these patients, 40.7% (range, 6.0% to 76.3%) were classified as HER2-zero, 41.7% (range, 10.5% to 69.1%) as HER2-low, and 17.5% (range, 6.7% to 34.0%) as HER2-positive. HER2-low tumors were associated with positive estrogen receptor and progesterone receptor statuses (p < 0.001 and p < 0.001, respectively). Antigen retrieval times (≥ 36 minutes vs. < 36 minutes) and antibody incubation times (≥ 12 minutes vs. < 12 minutes) affected on the frequency of HER2 IHC 1+ BC at institutions using the PATHWAY HER2 (4B5) IHC assay and BenchMark XT or Ultra staining instruments. Furthermore, discordant results between core needle biopsy and subsequent resection specimen HER2 statuses were observed in 24.1% (787/3,259) of the patients. Conclusion The overall incidence of HER2-low BC in South Korea concurs with those reported in previously published studies. Significant inter-institutional differences in HER2 IHC protocols were observed, and it may have impact on HER2-low status. Thus, we recommend standardizing HER2 IHC conditions to ensure precise patient selection for targeted therapy.

PURPOSE: Total thyroidectomy with central lymph node dissection (CLND) is a treatment modality of choice for thyroid cancer. Hypocalcemia is the most common complication after total thyroidectomy. The aim of the current study was to determine the association between surgery-related clinical factors and postoperative hypocalcemia. METHODS: A prospective analysis was performed for 101 patients who underwent total thyroidectomy with CLND for papillary cancer from June 2013 to June 2014. Correlation between clinicopathologic factors and postoperative hypocalcemia was analyzed. RESULTS: Based on the postoperative day-2 calcium, 56 patients (55%) developed hypocalcemia and 45 patients (45%) were normal. No significant differences in histopathologic (tumor size, tumor focality, histologic type, number of retrieved lymph nodes, metastatic lymph node, thyroiditis, retrieved parathyroid gland) findings were observed between the hypocalcemia group and normal calcium group. Mean value of the postoperative day-0 parathyroid hormone (PTH) was significantly lower in the hypocalcemia group (hypoca1cemia group: 14.3+/-9.4 pg/mL; normal group: 25.0+/-16.4 pg/mL; P<0.001). In logistic regression analysis, postoperative PTH was a factor significantly affecting postoperative hypocalcemia (OR 0.93; CI: 0.90-0.97; P<0.001). In ROC analysis, the cut-off value of PTH was 19.965 (sensitivity 79%, specificity 58%), and area under the curve (AUC) was 0.709 (95% CI: 0.607-0.811). CONCLUSION: Postoperative PTH was a factor predicting hypocalcemia after total thyroidectomy with CLND. Use of postoperative PTH as a screening tool for prediction of postoperative hypocalcemia would be useful in management of patients with hypocalcemia.
Calcium ; Humans ; Hypocalcemia* ; Logistic Models ; Lymph Node Excision* ; Lymph Nodes* ; Mass Screening ; Parathyroid Hormone ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy* ; Thyroiditis

Gastrointestinal invasive aspergillosis is often reported as part of a disseminated infection, and rarely as an isolated organ infection. Isolated invasive Aspergillus colitis is very rare, being observed only in patients with hematological malignancy and neutropenia. We encountered an unusual case of isolated invasive Aspergillus colitis presenting with hematochezia in a nonneutropenic patient with colon cancer. Fungal hyphae with surrounding inflammatory cells and mucosal necrosis were observed during the histological examination of a biopsy sample obtained at endoscopy. This case indicates that isolated invasive Aspergillus colitis may develop in a variable context of immunosuppression.
Aspergillosis ; Aspergillus ; Biopsy ; Colitis ; Colon ; Colonic Neoplasms ; Endoscopy ; Gastrointestinal Hemorrhage ; Hematologic Neoplasms ; Humans ; Hyphae ; Immunosuppression ; Necrosis ; Neutropenia

BACKGROUND AND OBJECTIVES: Bacterial biofilm is thought to contribute to the progression and persistence of chronic rhinosinusitis. There are many studies which demonstrate these structures on chronic rhinosinusitis (CRS), but the majority of the studies just focus on the documentation of their presence and the method for identification. There are also a few researches that show the impact of biofilm on postoperative surgical outcomes. In this study, we demonstrated bacterial biofilm in CRS patients and determined whether they affect clinical courses and outcomes after surgery. SUBJECTS AND METHOD: The mucosa of ethmoid bulla was obtained during endoscopic sinus surgery from 21 CRS patients. Fluorescent microscope and scanning electron microscopy (SEM) were used for the determination of biofilm. The outcomes of the surgery were evaluated by endoscope every two weeks for 6 months. Preoperative symptom scores, CT scores, and the post operative results were compared between patients with biofilm and patients without biofilm. RESULTS: Bacterial biofilm were seen in 13 (62%) of the 21 CRS patients. A statistical association existed between the presence of biofilm and the worsened preoperative symptom scores, but the preoperative CT scores were not related to the presence of biofilm. Patients with biofilm had long-lasting postoperative mucosal inflammation and a prolonged healing time, and these differences have statistical significance. CONCLUSION: This study showed that the presence of bacterial biofilm were significantly correlated with worsening preoperative symptom scores and the prolonged postoperative recovery time. Therefore, bacterial biofilm may play an important role in the recalcitrant and resistant nature of CRS.
Biofilms ; Blister ; Endoscopes ; Humans ; Inflammation ; Microscopy, Electron, Scanning ; Mucous Membrane

Solitary necrotic nodule (SNN) of the liver is a very uncommon benign lesion, and it is detected incidentally as a rule. It is important to differentiate SNN radiologically from various single hepatic nodules because SNN mimics hepatic metastasis, especially in staging work up of known primary malignancy. The reported imaging findings of SNN are well-defined nodule without enhancement or with subtle peripheral enhancement. There has been no report about the target-like SNN of the liver and about the imaging finding of 3T magnetic resonance imaging and positron emission tomography. We report a case of targetlike SNN of the liver, mimicking hepatic metastasis, with findings of various imaging modalities and try to find a cause of this nodule according to the pathologic and literature review.
Humans ; Liver ; Liver Neoplasms ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Positron-Emission Tomography

Piroplasms are tick-transmitted, intracellular, hemoprotozoan parasites that cause anorexia, fever, anemia, and icterus. Theileriosis is caused by Theileria sergenti and causes major economic losses in grazing cattle in Japan and Korea. In May 2003, we examined the antigenic diversity of the major piroplasm surface protein (MPSP) gene in 35 healthy Jeju black cattle that were born and raised at the National Institute of Subtropical Agriculture. On microscopic examination of Giemsa-stained blood smears, 9 of 35 cattle had intra-erythrocytic piroplasms. Hematological data were within normal range for all 35 cattle. Amplification of DNA from all blood samples using universal MPSP gene primers showed mixed infections with C, I, and B type Theileria spp. Type C was identified in 20 of 35 blood samples, and type B was identified in 17 samples. Allelic variation was seen in type B.
Animals ; Antigens, Protozoan/*genetics ; Base Sequence ; Cattle ; DNA Primers/genetics ; *Genetic Variation ; Korea ; Molecular Sequence Data ; *Phylogeny ; Protozoan Proteins/*genetics ; Sequence Analysis, DNA ; Theileria/*genetics ; Theileriasis/*parasitology

PURPOSE: To compare satisfaction after laser in situ keratomileusis (LASIK) with satisfaction after wavefront guided customized LASIK. METHODS: One hundred fifty-nine patients were included in this randomized, comparative, clinical trial. A myopia-specific Quality of Life Questionnaire was used to evaluate postoperative satisfaction. RESULTS: Overall questionnaire scores improved after both procedures. Wavefront LASIK showed higher satisfaction scores with respect to "Difficulty in visiting others", "Need a lot of help from others", and "Improvement of quality of life". But, most of the questionnaires did not show differences in actual visual satisfaction of daily living. CONCLUSIONS: Conventional and wavefront LASIK improved the visual satisfaction of patients. However, for the most part there was no difference in improvement of daily living between the two procedures.
Humans ; Keratomileusis, Laser In Situ* ; Patient Satisfaction* ; Quality of Life ; Surveys and Questionnaires

PURPOSE: The purpose of this study is to compare the clinical characteristics and predisposing factors of necrotizing enterocolitis (NEC), primarily a disease of the premature, in between term and preterm groups. METHODS: We retrospectively reviewed the medical records of 36 neonates with NEC (> or =modified Bell's staging criteria IIa) who were admitted to the NICU of Seoul National University Children's Hospital from January 1, 2000 through December 31, 2004. 20 full and 16 preterm neonates were compared in regard to demographics, clinical characteristics and predisposing factors. RESULTS: 29/36 neonates(80.6%) were outborn. Mean gestational age and birth weight were 38.5+/-0.9 weeks and 3, 010+/-490 g, term and 31.4+/-3.4 weeks and 1, 460+/-750 g, in preterm respectively group. Mean age at diagnosis was 17.3+/-13.5 days in term versus 20.8+/-19.6 days in preterm group. Abdominal distension was the most common finding in both groups and diarrhea was significantly more common in term group. Congenital heart disease, intrauterine growth retardation, bacterial infection were found in 75.0% of term group. The rates of surgical intervention and complication were higher in preterms, however, mortality rate was higher in term group. Congenital heart disease, especially the presence of complex heart disease with poor systemic perfusion or heart failure, was associated with higher mortality. CONCLUSION: Diarrhea was more common in term group. Neonates with predisposing factors for NEC, especially in term neonates with congenital heart disease, should be followed closely for early diagnosis and proper treatment.
Bacterial Infections ; Birth Weight ; Causality* ; Demography ; Diagnosis ; Diarrhea ; Early Diagnosis ; Enterocolitis, Necrotizing* ; Fetal Growth Retardation ; Gestational Age ; Heart Defects, Congenital ; Heart Diseases ; Heart Failure ; Humans ; Infant, Newborn* ; Medical Records ; Mortality ; Perfusion ; Retrospective Studies ; Seoul

Heterotopic pregnancy, the potentially fatal condition in which simultaneous gestations occurs at two or more implantation sites, was first reported in 1708 as an autopsy finding. In natural conception cycles it is a rare event, occuring less than 1:30,000 pregnancies. However, with assisted reproduction techniques, this incidence increase. Also the frequency of heterotopic pregnancy has steadily increased because of rising incidence of pelvic inflammatory disease, former tubal surgery. We report a case of discovery of heterotopic pregnancy after missed abortion with brief review of literature.
Abortion, Missed* ; Autopsy ; Female ; Fertilization ; Incidence ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Heterotopic* ; Reproductive Techniques

BACKGROUND: LB20304(gemifloxacin) is a new fluoroquinolone antibacterial agent with excellent activity against both Gram-negative and Gram-positive organisms. In vitro studies using clinical isolates have shown gemifloxacin to be highly active against penicillin-resistant strains of S. pneumoniae and in contrast to other reference quinolones, gemifloxacin retained good activity against clinical isolates of S. pneumoniae that were resistant to other members of the quinolone class. Therefore, gemifloxacin is thought to be effective in treating acute bacterial exacerbation of chronic bronchitis(AECB). The objective of this study was to evaluate the efficacy and safety of oral gemifloxacin at doses of 160mg or 320mg once daily for 7 days for the treatment of AECB in Korean adult population. METHODS: This was a randomized, multicenter, double-blind, parallel group Phase II study to assess the clinical and antibacterial efficacy and safety of oral gemifloxacin for the treatment of AECB. Treatment Group A (67 patients) took oral gemifloxacin 160mg once daily for seven days and treatment Group B (70 patients) took oral gemifloxacin 320mg once daily for seven days. RESULTS: The demographic profiles of the two treatment groups were similar. The clinical response at follow-up was 84.2% in the gemifloxacin 160-mg group, and 88.7% in the gemifloxacin-320 mg group, showing no statistically significant difference between two treatment groups(p=0.49). The clinical response at the end of therapy was 96.5% in the 160-mg group, and 96.4% in the 320-mg group. The bacteriological response at the end of therapy and follow-up were 81.8% and 78.9%, respectively, in the 160-mg group, and 86.4% and 84.2%, respectively, in the 320-mg group, showing no statistically significant difference between two treatment groups(p=0.68 and 0.68, respectively). S. pneumoniae(12 isolates) and H. influenzae(10 isolates) were the most prevalent pathogens. The MICs were lower for gemifloxacin than other quinolones against these key pathogens, and for S. pneumoniae, the MICs for gemifloxacin were considerably lower(< or = 0.03 ug/mL) than those for other quinolones, beta-lactams and acrolides. In the period on-therapy plus 30 days post-therapy, a total of 18 patients(26.9%) in the gemifloxacin 160mg group and 22 patients(31.4%) in the 320mg group reported at least one adverse event(AE). The most frequently reported AE was abdominal pain(3/67 patients, 4.5%) in the gemifloxacin 160mg group and increased level of hepatic enzyme(5/70 patients, 7.1%) in the 320mg group. The overall AE profiles for the two treatment groups were similar. Two out of 67 patients(3.0%) in the gemifloxacin 160mg group and 1/70 patients(1.4%) in the 320mg group reported at least one serious AE, however, none of which was considered by the investigator to be of suspected or probable relationship to study medication. CONCLUSION: The results of this study showed that gemifloxacin at doses of 160mg or 320mg once daily for 7 days in the treatment of acute exacerbations of chronic bronchitis(AECB) in adult Koreans was a very effective and safe treatment both clinically and bacteriologically.
Adult* ; beta-Lactams ; Bronchitis, Chronic* ; Double-Blind Method* ; Follow-Up Studies ; Humans ; Mesylates* ; Pneumonia ; Quinolones ; Research Personnel