1.Experience with a dual-lumen subclavian catheter for hemodialysis.
Sang Up BAEK ; Chul MOON ; Kyung Bal HUR
Journal of the Korean Surgical Society 1992;43(1):102-110
No abstract available.
Catheters*
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Renal Dialysis*
2.Serum Dickkopf-1 as a Biomarker for the Diagnosis of Hepatocellular Carcinoma.
Seung Up KIM ; Jeon Han PARK ; Hyon Suk KIM ; Jae Myun LEE ; Hyun Gyu LEE ; Hyemi KIM ; Sung Hoon CHOI ; Shinhwa BAEK ; Beom Kyung KIM ; Jun Yong PARK ; Do Young KIM ; Sang Hoon AHN ; Jong Doo LEE ; Kwang Hyub HAN
Yonsei Medical Journal 2015;56(5):1296-1306
PURPOSE: Dickkopf-1 (DKK-1) is a Wnt/beta-catenin signaling pathway inhibitor. We investigated whether DKK-1 is related to progression in hepatocellular carcinoma (HCC) cells and HCC patients. MATERIALS AND METHODS: In vitro reverse-transcription polymerase chain reaction (RT-PCR), wound healing assays, invasion assays, and ELISAs of patient serum samples were employed. The diagnostic accuracy of the serum DKK-1 ELISA was assessed using receiver operating characteristic (ROC) curves and area under ROC (AUC) analyses. RESULTS: RT-PCR showed high DKK-1 expression in Hep3B and low in 293 cells. Similarly, the secreted DKK-1 concentration in the culture media was high in Hep3B and low in 293 cells. Wound healing and invasion assays using 293, Huh7, and Hep3B cells showed that DKK-1 overexpression promoted cell migration and invasion, whereas DKK-1 knock-down inhibited them. When serum DKK-1 levels were assessed in 370 participants (217 with HCC and 153 without), it was significantly higher in HCC patients than in control groups (median 1.48 ng/mL vs. 0.90 ng/mL, p<0.001). The optimum DKK-1 cutoff level was 1.01 ng/mL (AUC=0.829; sensitivity 90.7%; specificity 62.0%). Although DKK-1 had a higher AUC than alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) (AUC=0.829 vs. 0.794 and 0.815, respectively), they were statistically similar (all p>0.05). When three biomarkers were combined (DKK-1 plus AFP plus DCP), they showed significantly higher AUC (AUC=0.952) than single marker, DKK-1 plus AFP, or DKK-1 plus DCP (all p<0.001). CONCLUSION: DKK-1 might be a key regulator in HCC progression and a potential therapeutic target in HCC. Serum DKK-1 could complement the diagnostic accuracy of AFP and DCP.
Area Under Curve
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Biomarkers/blood/metabolism
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Biomarkers, Tumor/blood
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Carcinoma, Hepatocellular/blood/*diagnosis
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Enzyme-Linked Immunosorbent Assay
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Female
;
Humans
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Intercellular Signaling Peptides and Proteins/*blood/*metabolism
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Liver Neoplasms/blood/*diagnosis
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Male
;
Middle Aged
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Protein Precursors/blood/metabolism
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Prothrombin/metabolism
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ROC Curve
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Reverse Transcriptase Polymerase Chain Reaction/*methods
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Sensitivity and Specificity
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alpha-Fetoproteins/analysis/metabolism
3.The Modified Response Evaluation Criteria in Solid Tumors (RECIST) Yield a More Accurate Prognoses Than the RECIST 1.1 in Hepatocellular Carcinoma Treated with Transarterial Radioembolization
Jae Seung LEE ; Hong Jun CHOI ; Beom Kyung KIM ; Jun Yong PARK ; Do Young KIM ; Sang Hoon AHN ; Kwang-Hyub HAN ; Song-Ee BAEK ; Yong Eun CHUNG ; Mi-Suk PARK ; Myeong-Jin KIM ; Hyung jin RHEE ; Seung Up KIM
Gut and Liver 2020;14(6):765-774
Background/Aims:
The Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and modified RECIST (mRECIST) criteria have been used to assess treatment responses for hepatocellular carcinoma (HCC) patients. We investigated which criteria provides better survival predictions in HCC patients treated with transarterial radioembolization (TARE).
Methods:
In total, 102 patients with unresectable intrahe-patic HCC, who were treated with TARE between 2012 and 2017, were reviewed retrospectively. The treatment response after TARE was evaluated at 1, 3, and 6 months by the mRE-CIST and RECIST 1.1. Responders were defined as patients with complete or partial responses by each criterion.
Results:
The median age of 83 men and 19 women was 64.3 years.The median alpha-fetoprotein and des-gamma-carboxy pro-thrombin levels were 37.1 ng/mL and 1,780.0 mAU/mL, re-spectively. The median maximal tumor size was 8.3 cm, and multiple tumors were observed in 36 patients (35.3%). Dur-ing the follow-up period (median, 20.7 months), 21 patients (20.6%) died, with a mean survival time of 55.5 months. The cumulative survival rate was 96.1% at 6 months and 89.3% at 12 months. Responders, defined by the mRECIST at 1, 3, and 6 months after TARE, showed better survival outcomes than nonresponders (hazard ratio [HR]=5.736, p=0.008 at 1 month; HR=3.145, p=0.022 at 3 months, and HR=2.887, p=0.061 at 6 months). The survival rates of responders and nonresponders defined by the RECIST 1.1 were similar (all p>0.05).
Conclusions
Response evaluations that use the mRECIST provide more accurate prognoses than those that use the RECIST 1.1 in HCC patients treated with TARE.