BACKGROUND: The Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system and the Sequential Organ Failure Assessment (SOFA) scoring system are widely used for critically ill patients. We evaluated whether APACHE II score and SOFA score predict the outcome for trauma patients in the intensive care unit (ICU). METHODS: We retrospectively analyzed trauma patients admitted to the ICU in a single trauma center between January 2014 and December 2015. The APACHE II score was figured out based on the data acquired from the first 24 hours of admission; the SOFA score was evaluated based on the first 3 days in the ICU. A total of 241 patients were available for analysis. Injury Severity score, APACHE II score, and SOFA score were evaluated. RESULTS: The overall survival rate was 83.4%. The non-survival group had a significantly high APACHE II score (24.1 ± 8.1 vs. 12.3 ± 7.2, P < 0.001) and SOFA score (7.7 ± 1.7 vs. 4.3 ± 1.9, P < 0.001) at admission. SOFA score had the highest areas under the curve (0.904). During the first 3 days, SOFA score remained high in the non-survival group. In the non-survival group, cardiovascular system, neurological system, renal system, and coagulation system scores were significantly higher. CONCLUSIONS: In ICU trauma patients, both SOFA and APACHE II scores were good predictors of outcome, with the SOFA score being the most effective. In trauma ICU patients, the trauma scoring system should be complemented, recognizing that multi-organ failure is an important factor for mortality.
APACHE* ; Cardiovascular System ; Complement System Proteins ; Critical Care* ; Critical Illness ; Humans ; Injury Severity Score ; Intensive Care Units* ; Mortality ; Multiple Trauma ; Retrospective Studies ; Survival Rate ; Trauma Centers

No abstract available.
Adult ; Diagnosis, Differential ; Female ; Humans ; Liver/pathology/radiography/ultrasonography ; Peliosis Hepatis/pathology/*radiography ; Tomography, X-Ray Computed

BACKGROUND: Idiopathic duct centric pancreatitis (IDCP) is a subtype of autoimmune pancreatitis (AIP) that is histologically characterized by granulocytic epithelial lesion and scarce IgG4-positive cells. This subtype of AIP has not been documented in Asian countries. METHODS: We reviewed 38 histologically confirmed AIP cases and classified them into lymphoplasmacytic sclerosing pancreatitis (LPSP) and IDCP. Then, clinicopathological characteristics were compared between LPSP and IDCP. RESULTS: Fourteen cases (36.8%) were IDCP. IDCP affected younger patients more than LPSP. IDCP was associated with ulcerative colitis in 35.7% of cases, whereas LPSP was associated with IgG4-related sclerosing diseases such as cholangitis, retroperitoneal fibrosis or sialadenitis in 41.7% of cases. IDCP was microscopically characterized by neutrophilic ductoacinitis with occasional granulocytic epithelial lesions, whereas LPSP was characterized by storiform inflammatory cell-rich fibrosis and obliterative phlebitis. IgG4-positive cells were not detected in any IDCP case but more than 20 IgG4-positive cells per high-power-field were invariably detected in LPSP cases. All patients with IDCP responded dramatically to steroids without recurrence, whereas 33.3% of patients with LPSP developed recurrences. CONCLUSIONS: IDCP is clinicopathologically distinct from LPSP and can be diagnosed when neutrophilic ductoacinitis or granulocytic epithelial lesions are observed in a pancreatic biopsy under the appropriate clinical setting.
Asian Continental Ancestry Group ; Biopsy ; Biopsy, Needle ; Cholangitis ; Colitis, Ulcerative ; Fibrosis ; Humans ; Neutrophils ; Pancreatitis ; Phlebitis ; Recurrence ; Retroperitoneal Fibrosis ; Sialadenitis ; Steroids

BACKGROUND: Surgical resection is the treatment of choice of intraductal papillary mucinous neoplasm (IPMN) of the pancreas. However, the benefit of clearing resection margin is still controversial. METHODS: We reviewed 281 surgically resected cases of IPMN. The recurrences were compared according to the histologic grade (benign or borderline IPMN, malignant noninvasive IPMN, invasive carcinoma) and size (pancreatic intraepithelial neoplasia, PanIN, less than 0.5 cm in the long axis; and IPMN, greater than or equal to 0.5 cm) of the residual lesions at the resection margin. RESULTS: Sixty cases (21.4%) were invasive carcinoma, and 221 (78.6%) noninvasive cases included 87 (31.0%) benign, 107 (38.1%) borderline and 11 (3.9%) malignant noninvasive IPMN cases. In noninvasive IPMN, increased recurrence in patients with five or more years of follow-up was only related to the involvement of resection margin by severe dysplasia. The recurrence of invasive carcinoma was high (27.3%) even when the resection margin was clear, and was not related to the grade or size of residual tumors at the resection margin. CONCLUSIONS: Invasiveness is a strong risk factor for recurrence in IPMN regardless of the status of the resection margin. However, in noninvasive IPMN, histologic grading of residual lesions at the resection margin predicts local recurrence.
Carcinoma, Intraductal, Noninfiltrating ; Follow-Up Studies ; Humans ; Mucins ; Neoplasm, Residual ; Pancreas ; Recurrence ; Risk Factors

Understanding the important alterations during hepatocarcinogenesis as well as the characteristic magnetic resonance imaging (MRI) and histopathological features will be helpful for managing patients with chronic liver disease and hepatocellular carcinoma. Recent advances in MRI techniques, such as fat/iron quantification, diffusion-weighted images, and gadoxetic acid-enhanced MRI, have greatly enhanced our understanding of hepatocarcinogenesis.
Carcinoma, Hepatocellular ; Humans ; Liver Diseases ; Magnetic Resonance Imaging ; Pathology

BACKGROUND: BRAF mutation has been recognized as an important biomarker of colorectal cancer (CRC) for targeted therapy and prognosis prediction. However, sequencing for every CRC case is not cost-effective. An antibody specific for BRAF V600E mutant protein has been introduced, and we thus examined the utility of BRAF VE1 immunohistochemistry for evaluating BRAF mutations in CRC. METHODS: Fifty-one BRAF-mutated CRCs and 100 age and sexmatched BRAF wild-type CRCs between 2005 and 2015 were selected from the archives of Asan Medical Center. Tissue microarrays were constructed and stained with BRAF VE1 antibody. RESULTS: Forty-nine of the 51 BRAF-mutant CRCs (96.1%) showed more than moderate cytoplasmic staining, except for two weakly stained cases. Six of 100 BRAF wild-type cases also stained positive with BRAF VE1 antibody; four stained weakly and two stained moderately. Normal colonic crypts showed nonspecific weak staining, and a few CRC cases exhibited moderate nuclear reactivity (3 BRAF-mutant and 10 BRAF wild-type cases). BRAF-mutated CRC patients had higher pathologic stages and worse survival than BRAF wild-type patients. CONCLUSIONS: BRAF VE1 immunohistochemistry showed high sensitivity and specificity, but occasional nonspecific staining in tumor cell nuclei and normal colonic crypts may limit their routine clinical use. Thus, BRAF VE1 immunohistochemistry may be a useful screening tool for BRAF V600E mutation in CRCs, provided that additional sequencing studies can be done to confirm the mutation in BRAF VE1 antibody-positive cases.
Cell Nucleus ; Chungcheongnam-do ; Colon ; Colorectal Neoplasms ; Cytoplasm ; Humans ; Immunohistochemistry ; Mass Screening ; Mutant Proteins ; Prognosis ; Sensitivity and Specificity ; Sequence Analysis, DNA

Traditional hyperthermia involves increasing the temperature at the tumor site to above 39 ℃, inducing death in cancer cells. Although hyperthermia is an effective cancer treatment, its clinical application has decreased due to potential complications, including damage to surrounding normal tissue. In recent years, modulated electro-hyperthermia (mEHT) has emerged as an effective and safe treatment modality. mEHT selectively heats tumor cells to 42–43 °C, while reducing the average temperature in the treatment area, including the surrounding normal tissue, compared to conventional methods. Additionally, mEHT may be used in combination with systemic chemotherapy and radiation therapy in tumor treatment, providing a synergistic effect to increase efficacy. As chemotherapy and radiation therapy technologies advance, the application of combined mEHT may improve clinical outcomes. In this study, we review and discuss reports on the clinical outcomes of mEHT combined with chemotherapy and/or radiation therapy, which are established anticancer treatments.

Traditional hyperthermia involves increasing the temperature at the tumor site to above 39 ℃, inducing death in cancer cells. Although hyperthermia is an effective cancer treatment, its clinical application has decreased due to potential complications, including damage to surrounding normal tissue. In recent years, modulated electro-hyperthermia (mEHT) has emerged as an effective and safe treatment modality. mEHT selectively heats tumor cells to 42–43 °C, while reducing the average temperature in the treatment area, including the surrounding normal tissue, compared to conventional methods. Additionally, mEHT may be used in combination with systemic chemotherapy and radiation therapy in tumor treatment, providing a synergistic effect to increase efficacy. As chemotherapy and radiation therapy technologies advance, the application of combined mEHT may improve clinical outcomes. In this study, we review and discuss reports on the clinical outcomes of mEHT combined with chemotherapy and/or radiation therapy, which are established anticancer treatments.

Traditional hyperthermia involves increasing the temperature at the tumor site to above 39 ℃, inducing death in cancer cells. Although hyperthermia is an effective cancer treatment, its clinical application has decreased due to potential complications, including damage to surrounding normal tissue. In recent years, modulated electro-hyperthermia (mEHT) has emerged as an effective and safe treatment modality. mEHT selectively heats tumor cells to 42–43 °C, while reducing the average temperature in the treatment area, including the surrounding normal tissue, compared to conventional methods. Additionally, mEHT may be used in combination with systemic chemotherapy and radiation therapy in tumor treatment, providing a synergistic effect to increase efficacy. As chemotherapy and radiation therapy technologies advance, the application of combined mEHT may improve clinical outcomes. In this study, we review and discuss reports on the clinical outcomes of mEHT combined with chemotherapy and/or radiation therapy, which are established anticancer treatments.

Traditional hyperthermia involves increasing the temperature at the tumor site to above 39 ℃, inducing death in cancer cells. Although hyperthermia is an effective cancer treatment, its clinical application has decreased due to potential complications, including damage to surrounding normal tissue. In recent years, modulated electro-hyperthermia (mEHT) has emerged as an effective and safe treatment modality. mEHT selectively heats tumor cells to 42–43 °C, while reducing the average temperature in the treatment area, including the surrounding normal tissue, compared to conventional methods. Additionally, mEHT may be used in combination with systemic chemotherapy and radiation therapy in tumor treatment, providing a synergistic effect to increase efficacy. As chemotherapy and radiation therapy technologies advance, the application of combined mEHT may improve clinical outcomes. In this study, we review and discuss reports on the clinical outcomes of mEHT combined with chemotherapy and/or radiation therapy, which are established anticancer treatments.