PURPOSE: We aimed to investigate the correlations between expressions of angiogenic cytokines VEGF-A, C, D of primary colorectal cancer and liver metastasis. METHODS: We examined paraffin-embedded primary colorectal cancer tissue from 45 patients who had liver resection due to colorectal liver metastasis (metastasis group) and 37 patients who had surgical resection due to colorectal cancer only (control group). In the control group, local recurrence and distant metastasis had not occurred. Immunohistochemical staining for VEGF-A, C and D was performed. We analysed the correlations between expression of VEGF-A, C and D in primary colorectal cancer tissues and clinicopathologic parameters. RESULTS: VEGF-A expressions of primary colorectal carcinoma were not different between the two groups. VEGF-C was more frequently expressed in the metastasis group (P=0.008) but VEGF-D was more expressed in the control group (P=0.003). Patients with VEGF-C negative and VEGF-D positive expression were predominant in the control group (P=0.020). Tumor location, T stage, lymph node metastasis and tumor differentiation were not related with the expressions of VEGF-A, C, D but only preoperative CEA was positively correlated with VEGF-A and C expression. CONCLUSION: Expressions of VEGF-C in primary tumor were more frequent in metastatic colorectal cancer and expressions of VEGF-D were more frequent in nonmetastatic colorectal cancer. More large-scale prospective studies for VEGF-C and D expression in colorectal cancer are necessary.
Colorectal Neoplasms ; Cytokines ; Humans ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factor C ; Vascular Endothelial Growth Factor D

PURPOSE: To assess the feasibility of the da Vinci(R) surgical system in performing gastrectomies for gastric cancer. METHODS: Between 31 December 2007 and 30 June 2008, twenty patients underwent robotic gastrectomies using the da Vinci(R) surgical system for gastric cancer. Retrospectively, clinicopathologic and postoperative surgical outcomes were retrieved from the Stomach Cancer Database at Dong-A University Medical Center. RESULTS: Two patients with serosa invasion required conversion to laparotomy. Seventeen robotic distal gastrectomies and one robotic total gastrectomy were performed. Most patients underwent D1+beta or D2 lymph node dissection. The average number of retrieved lymph nodes was 41. Mean operative time was 271 minutes. Estimated blood loss was 30 ml and mean postoperative hospital stay was 5.1 days. No postoperative complications were reported. CONCLUSION: While application of robotic technology for gastric cancer is technically feasible, problems of long operative times and extremely high costs remain. More randomized studies comparing long-term surgical outcomes between robotic, conventional open, and laparoscopic surgery are needed.
Academic Medical Centers ; Gastrectomy ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Operative Time ; Postoperative Complications ; Retrospective Studies ; Serous Membrane ; Stomach Neoplasms

PURPOSE: Isolated local recurrence (ILR) after mastectomy is associated with increased risk of cancer-specific survival. This study evaluated the long-term survival and prognostic factors after ILR. METHODS: Between January 1988 and December 2004, 1,169 patients with early breast cancer (stage I or II) were treated with modified radical mastectomy at Kyungpook hospital. Retrospectively, 40 patients with isolated local recurrence (ILR) were found by medical records and we investigated their clinicopathologic factors and conducted analyses of prognostic factors, calculated overall survival, and relapse-free survival. RESULTS: The median follow-up times after initial operation and ILR were each 91 (range, 18~219) months and 40 (range, 1~205) months. There were 18 patients of 2nd recurrence and 15 expired by distant metastasis. The overall survivals at 5 years and 10 years after ILR were 65% and 49%. The relapse-free survivals at 5 years and 10 years after ILR were 54% and 29%. After 2nd recurrence, the mean survival time was 21 months and the 3-year overall survival rate was 21%. By univariate and multivariate analyses, the time interval between initial operation and ILR was only statistically significant independent prognostic factor of overall survival after ILR. The 10 year-overall survival rates of < or =24 months and >24 months to ILR were each 26% and 70%. There was no independent prognostic factor of relapse-free survival after ILR. CONCLUSION: For patients who developed isolated local recurrence after modified radical mastectomy for early breast cancer, shorter time interval to ILR is a poor prognostic factor of overall survival after ILR.
Breast ; Breast Neoplasms ; Follow-Up Studies ; Humans ; Mastectomy ; Mastectomy, Modified Radical ; Medical Records ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies ; Survival Rate

PURPOSE: Apocrine carcinoma of the breast is rare and there is confusion about the criteria of its histopathologic diagnosis. The purpose of this study is to investigate the clinical and pathologic characteristics of the disease. METHODS: 9 patients diagnosed with apocrine carcinoma or apocrine carcinoma in situ and 1,009 patients diagnosed with non-apocrine carcinoma of the breast from April 1999 to March 2008 were retrospectively analyzed. RESULTS: The mean age of the patients with apocrine carcinoma was 52.3 year. 5 patients (55.6%) among 9 patients with apocrine carcinoma were postmenopausal. There were 2,1 and 6 patients with stage 0, I and II disease, respectively according the TNM stage. These demographic and clinical differences between the patients with apocrine carcinoma and non-apocrine carcinoma were not significant. Only four patients (44.4%) were preoperatively diagnosed with apocrine carcinoma or apocrine carcinoma in situ. By surgical biopsy, additional 5 patients were diagnosed as apocrine carcinoma. In the immunohistochemical study, Bcl-2 was positive in one (12.5%) of 8 patients. p53 was positive in 4 (44.4%) of 9 patients. Expressions of estrogen and progesterone receptor were positive only in two patients (22.2%) with weakly positive staining. Androgen receptor was positively expressed in all cases (100%) of apocrine carcinoma. Overexpression of c-erb-B2 was detected in four patients. CONCLUSION: Treatment modality and prognosis of apocrine carcinoma are similar as non-apocrine carcinoma. But its preoperative diagnosis is more difficult than that of non-apocrine carcinoma and it shows different expression of hormone receptor. Further study is needed for the development of new hormonal therapy using androgen.
Biopsy ; Breast ; Breast Neoplasms ; Carcinoma in Situ ; Estrogens ; Humans ; Prognosis ; Receptors, Androgen ; Receptors, Progesterone ; Retrospective Studies

The study of the epidemiology of toxic liver injury has been limited in Korea. The number of hospitalizations for toxic liver injury has been estimated to be 2,400 persons per year. About 30~40% of fulminant hepatitis was attributed to toxic hepatitis. The frequent causative agents of toxic hepatitis in Korea are herbal medicines (34~40%), folk remedies (23~34%), and prescribed medicines (24~55%). However, the most common agents causing severe liver injury including fulminant hepatitis are herbal medicine and folk remedies. Antituberculosis drugs and acetaminophen are two common causes of fulminant hepatitis among prescribed drugs. Alcohol is one of the leading causes of chronic liver disease in Korea. No nationwide study on the epidemiology of alcoholic liver disease (ALD) has been carried out, but 7~31% of cirrhosis has been reported to be alcoholic in a few single-center studies. Alcohol could be a risk factor for the development of hepatocellular carcinoma (HCC) in chronic viral hepatitis. Several studies have shown that alcohol increased the risk of HCC in liver cirrhosis with HBsAg or anti-HCV. Furthermore, alcoholic cirrhosis with occult hepatitis B virus infection increased the risk of HCC.
Drug-Induced Liver Injury/diagnosis/*epidemiology/etiology ; Humans ; Korea/epidemiology ; Liver Cirrhosis, Alcoholic/complications/epidemiology ; Liver Diseases, Alcoholic/complications/*epidemiology ; Liver Neoplasms/etiology ; Risk Factors

Chronic hepatitis C (CHC) is the third most common cause of chronic liver disease and hepatocellular carcinoma (HCC) in Korea, following hepatitis B virus (HBV) infection and alcohol. HCV prevalence among Koreans older than 40 years of age has been estimated to be 1.29%. The prevalence of CHC increases with age, with the peak prevalence at the age of 60 or older. Blood transfusions have generated no risk of HCV infection since April 1991, when routine screening for anti-HCV in blood donors was adopted in Korea. Although injection drug use seems to be one of the most important risk factors of HCV infection among young adults in urban areas, the majority of CHC patients are not associated with injection drug use. Exposure to acupuncture was identified as a significant risk factor among older adults in rural areas. The mean age of patients with HCV-related cirrhosis and HCC was consistently about 10 years above that of patients associated with HBV. Genotypes 1b and 2a are the two most common types with almost equal proportions, and other genotypes are extremely rare. Korean patients with CHC have a high likelihood of responding to combination therapy with pegylated interferon and ribavirin, with a sustained virological response rate of 60-70% in patients with genotype 1 and 85-90% in those with genotype 2.
Antiviral Agents/therapeutic use ; Genotype ; Hepacivirus/genetics ; Hepatitis C, Chronic/drug therapy/*epidemiology/transmission/virology ; Humans ; Korea/epidemiology ; Prevalence ; Risk Factors

Hepatitis B virus (HBV) infection is the one of the most common causes of the liver diseases in Korea. Since the discovery of Australia antigen (hepatitis associated antigen, or HBsAg later), hepatitis associated antigen was tested widely. HBsAg was detected in 6.6~8.6% in 1980's. Later, it decreased to 5.7% in 1990's. Remarkably, seropositivity of the children deceased to 0.2% after the nationwide vaccination program. Although hepatitis B vaccines are highly effective, the failure rate of perinatal prophylaxis in babies born to HBsAg positive mother was reported to be 4.25%. Treatment of chronic hepatitis B was initiated after the introduction of interferon alpha. Lamivudine opened a new era of oral antiviral agent, and it has been widely used in Korea since 1999. Adefovir was proven to have a good efficacy for lamivudine-resistant chronic hepatitis B. Newer potent antiviral agents such as entecavir, clevudine, and telbivudine are available currently. Further studies are warranted for understanding factors influencing natural history, improving treatment outcomes, and overcoming vaccine non-response.
Acute Disease ; Antiviral Agents/therapeutic use ; Hepatitis B/diagnosis/drug therapy/*epidemiology/prevention & control ; Hepatitis B Surface Antigens/analysis ; Hepatitis B Vaccines/administration & dosage ; Hepatitis B, Chronic/epidemiology ; Humans ; Immunization Programs ; Korea/epidemiology ; Seroepidemiologic Studies

The seroprevalence of anti-HAV (hepatitis A virus) has been decreasing in Korea. The decrease in HAV infection in young adults has resulted in the reduction of individuals with protective antibody and an increase in hepatitis A in the adult population. The increase in HAV infection in adults will have an impact on the magnitude and severity of the disease. In Korea, symptomatic hepatitis A has been gradually increasing since the mid-1990s, with a tendency toward an increase in mean age and disease severity. The endemic genotype of HAV in Korea has been changing from genotype IA alone to a mixture of genotype IA and IIIA. Therefore, preventive measures including universal vaccination in infants and active immunization of the adult population should be considered.
Adult ; Child ; Hepatitis A/*epidemiology/immunology/prevention & control ; Hepatitis A Vaccines/administration & dosage ; Humans ; Incidence ; Korea/epidemiology ; Seroepidemiologic Studies

No abstract available.

No abstract available.
Adult ; Aged ; Humans ; Liver Neoplasms/*radiography ; Male ; Middle Aged ; Neuroendocrine Tumors/*radiography ; Tomography, X-Ray Computed