PURPOSE: Lgr5 is a well-known stem cell marker in colorectal cancer (CRC). This retrospective study evaluated the expressions of Lgr5 in CRC specimens, and examined whether these expressions were associated with survival outcomes.METHODS: We used immunohistochemistry to retrospectively examine expressions of Lgr5 in paraffin-embedded specimens from 337 patients with CRC between January 2009 and December 2013. All clinicopathologic data were collected by retrospective review based on medical records. The correlation between its expression and clinicopathological data as well as clinical outcomes of patients was analyzed.RESULTS: Low expression and high expression of Lgr5 in 337 patients were 175 (51.9%) and 162 (48.1%), respectively. There was no statistically significant difference in the association of Lgr5 expression with clinicopathologic factors (age, tumor location, lymphatic invasion, vascular invasion, perineural invasion, TNM stage, and differentiation). In the survival analysis, the high expression group of Lgr5 showed a better prognosis than the low expression group in disease-free survival (P=0.044). However, overall survival was not significantly different between the two groups (P=0.087). In multivariate analysis, we found that high expression of Lgr5 was independent prognostic factor for tumor relapse (hazard ratio, 0.601; 95% confidence interval, 0.388–0.929; P=0.022).CONCLUSION: In present study, high expression of Lgr5 is an independent predictor of favorable prognosis in patients with CRC. So, further well designed, prospective, large scale studies are needed to examine the value of Lgr5 as a prognostic biomarker for CRC.
Colorectal Neoplasms ; Disease-Free Survival ; Humans ; Immunohistochemistry ; Medical Records ; Multivariate Analysis ; Neoplastic Stem Cells ; Prognosis ; Prospective Studies ; Recurrence ; Retrospective Studies ; Stem Cells

BACKGROUND: Hepatitis B virus (HBV) infection leads to hepatic and extrahepatic manifestations including chronic kidney disease (CKD). However, the association between HBV and CKD is not clear. This study investigated the association between chronic HBV infection and CKD in a nationwide multicenter study. METHODS: A total of 265,086 subjects who underwent health-check examinations in 33 hospitals from January 2015 to December 2015 were enrolled. HBV surface antigen (HBsAg) positive cases (n = 10,048), and age- and gender-matched HBsAg negative controls (n = 40,192) were identified. CKD was defined as a glomerular filtration rate (GFR) < 60 mL/min/1.73 m² or proteinuria as at least grade 2+ of urine protein. RESULTS: HBsAg positive cases showed a significantly higher prevalence of GFR < 60 mL/min/1.73 m² (3.3%), and proteinuria (18.9%) than that of the controls (2.6%, P < 0.001, and 14.1%, P < 0.001, respectively). In the multivariate analysis, HBsAg positivity was an independent factor associated with GFR < 60 mL/min/1.73 m² along with age, blood levels of albumin, bilirubin, anemia, and hemoglobin A1c (HbA1c). Likewise, HBsAg positivity was an independent factor for proteinuria along with age, male, blood levels of bilirubin, protein, albumin, and HbA1c. A subgroup analysis showed that HBsAg positive men but not women had a significantly increased risk for GFR < 60 mL/min/1.73 m². CONCLUSION: Chronic HBV infection was significantly associated with a GFR < 60 mL/min/1.73 m² and proteinuria (≥ 2+). Therefore, clinical concern about CKD in chronic HBV infected patients, especially in male, is warranted.
Anemia ; Antigens, Surface ; Bilirubin ; Case-Control Studies* ; Female ; Glomerular Filtration Rate ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Male ; Multivariate Analysis ; Prevalence ; Proteinuria ; Renal Insufficiency, Chronic*

OBJECTIVE: Owing to advances in laparoscopic technique and equipment, a single-port laparoscopic surgery has been applied in various fields of surgery. However, the application of a single-port laparoscopic surgery for pregnant women has been rarely reported. The aim of this study was to emphasize the feasibility of single-port laparoscopic appendectomy in pregnant women. METHODS: In seven pregnant women who underwent abdominal ultrasonography and physical examination, surgery was performed under the diagnosis of acute appendicitis. In all the patients, single-port laparoscopic appendectomy was performed in the same way. The laparoscopic surgical devices used during surgery were same as those in conventional laparoscopic appendectomy. RESULTS: Age ranged from 25 to 33 years (mean, 29.7 years), gestational age ranged from 7 weeks 3 days to 17 weeks 6 days (mean gestational age, 14 weeks 3 days). The mean operation time was 19 minutes (range, 16–22 minutes). No surgical related complications and any issues occurred. CONCLUSION: Single-port laparoscopic appendectomy for pregnant women is considered one of the treatment methods.
Appendectomy* ; Appendicitis ; Diagnosis ; Female ; Gestational Age ; Humans ; Laparoscopy ; Physical Examination ; Pregnancy ; Pregnant Women* ; Ultrasonography

PURPOSE: The aim of our study is to investigate the current status of metabolic and bariatric surgery in Daejeon and Chungcheong province and examine the role and necessity of the community research society. MATERIALS AND METHODS: In this retrospective study, 58 patients who underwent bariatric and metabolic surgery from January 2010 to June 2018 were included. Patients' demographics and comorbidities, operation type and early complications were analyzed. RESULTS: Mean age was 36.9±11.4 (range, 18–64) years, and mean preoperative body mass index was 39.2±6.9 (range, 24.6–56.1) kg/m². The most frequently performed operation was sleeve gastrectomy (48 cases, 82.8%), followed by adjustable gastric banding (8 cases, 13.8%) and Roux-en-Y gastric bypass (2 cases, 3.4%). Postoperative complications were reported in two patients; however, no mortality was reported. CONCLUSION: We investigated the patients who underwent metabolic and bariatric surgery in Daejeon Chungcheong province. Our research society will continue to ensure safe operation and proper management of morbidly obese patients in our community.
Bariatric Surgery ; Body Mass Index ; Comorbidity ; Demography ; Gastrectomy ; Gastric Bypass ; Humans ; Mortality ; Obesity ; Postoperative Complications ; Retrospective Studies

PURPOSE: The aims of this study were to evaluate the expression of the large tumor suppressor (LATS) genes LATS1 and LATS2 by immunohistochemical staining of gastric cancer, and to evaluate the clinicopathological significance of LATS expression and its correlation with overall survival (OS). MATERIALS AND METHODS: LATS1 and LATS2 expression in a tissue microarray was detected by immunohistochemistry, using 264 gastric cancer specimens surgically resected between July 2006 and December 2009. RESULTS: Low expression of LATS1 was significantly associated with more advanced American Joint Committee on Cancer (AJCC) stage (P=0.001) and T stage (P=0.032), lymph node (LN) metastasis (P=0.040), perineural invasion (P=0.042), poor histologic grade (P=0.007), and diffuse-type histology by the Lauren classification (P=0.033). Low expression of LATS2 was significantly correlated with older age (≥65, P=0.027), more advanced AJCC stage (P=0.001) and T stage (P=0.001), LN metastasis (P=0.004), perineural invasion (P=0.004), poor histologic grade (P<0.001), and diffuse-type histology by the Lauren classification (P<0.001). Kaplan-Meier survival analysis revealed significantly poor OS rates in the groups with low LATS1 (P=0.037) and LATS2 (P=0.037) expression. CONCLUSIONS: Expression of LATS1 or LATS2 is a significant marker for a good prognosis in patients with gastric cancer.
Classification ; Genes, Tumor Suppressor ; Humans ; Immunohistochemistry ; Joints ; Long-Acting Thyroid Stimulator ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Stomach Neoplasms*

PURPOSE: Programmed death-1 and its ligands (PD-L1 and PD-L2) can induce T-cell apoptosis in many solid tumors, although there is limited information regarding their roles in colorectal cancer.METHODS: We used immunohistochemistry to retrospectively examine expressions of PD-L1 and PD-L2 in paraffin-embedded specimens from 104 patients with colorectal cancer.RESULTS: Among the 104 included patients, 31 patients (29.8%) had positive PD-L1 expression and 73 patients (70.2%) had negative PD-L1 expression. Positive PD-L2 expression was observed in 83 patients (79.8%) and negative PD-L2 expression was observed in 21 patients (20.2%). Positive PD-L1 expression group showed higher overall survival rate (OS) and disease-free survival (DFS) than negative PD-L1 expression group. However, the overall survival and DFS were not significantly different between positive and negative PD-L2 expressions group. The multivariate analyses revealed that short OS was independently associated with positive PD-L1 expression (hazard ratio [HR], 2.781; 95% confidence interval [CI], 1.284–6.026; P=0.01), regional lymph node status (HR, 2.611; 95% CI, 1.258–5.418; P=0.01), and distant metastasis (HR, 4.279; 95% CI, 1.449–12.638; P=0.009). In addition, short DFS was independently associated with positive PD-L1 expression (HR, 2.846; 95% CI, 1.393–5.815; P=0.004) and regional lymph node status (HR, 2.310; 95% CI, 1.122–4.758; P=0.023).CONCLUSION: Although prospective multi-center studies are needed to validate our findings, we found that PD-L1 expression predicted OS and DFS among patients with colorectal cancer.
Apoptosis ; Colorectal Neoplasms ; Disease-Free Survival ; Humans ; Immunohistochemistry ; Ligands ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Prospective Studies ; Retrospective Studies ; Survival Rate ; T-Lymphocytes

PURPOSE: Recent research has shown that there is a relationship between the level of preoperative serum TSH and a papillary thyroid carcinoma. Therefore, this study examined the correlation between the serum TSH and papillary thyroid carcinoma. METHODS: The preoperative serum TSH level of papillary thyroid carcinoma and nodular hyperplasia of 418 patients from 2009 Jan. to 2011 Dec. was examined. The patients were divided into 3 groups, nodular hyperplasia, less than 1 cm micropapillary carcinoma and more than 1 cm papillary carcinoma, and their TSH levels were compared. RESULTS: Nodular hyperplasia and total papillary carcinoma was found in 98 (23.0%) and 322 (77.0%) patients, respectively. After dividing the patients according to the size of the mass, there were 224 (53.6%) patients with a mass less than 1 cm in size and 98 (23.4%) patients with a mass more than 1 cm in size. The preoperative serum TSH level of the 3 groups showed a significant difference, which was 1.180±1.168 μIU/ml in the nodular hyperplasia group, 1.670±1.224 μIU/ml in the micropapillary carcinoma group and 2.279±2.837 μIU/ml in the papillary carcinoma group (P<0.001). On the other hand, there were no significant correlations between the preoperative serum TSH level and gender, age, metastasis to lymph node, number of masses and extrathyroidal extensions. CONCLUSION: The larger size of the papillary thyroid carcinoma, the higher the preoperative high serum TSH level. Therefore, the stimulation of TSH can affect the progression of papillary thyroid carcinoma but more study will be needed.
Carcinoma, Papillary ; Hand ; Humans ; Hyperplasia ; Lymph Nodes ; Neoplasm Metastasis ; Thyroid Gland* ; Thyroid Neoplasms*

BACKGROUND/AIMS: Immediate postpolypectomy bleeding (IPPB) increases the procedure time and it may disturb performing a safe polypectomy. The purpose of this study is to investigate whether clipping before snare polypectomy of large pedunculated polyps is useful for the prevention of IPPB. METHODS: This is a single arm, pilot study. We enrolled patients with pedunculated colorectal polyps that were 1 cm in size or more from 4 university hospitals between June 2009 and June 2010. Clips were applied at the stalk and snare polypectomy was then performed. The complications, including IPPB, were investigated. RESULTS: Fifty six pedunculated polyps in 47 patients (Male:Female=36:11; age, 56+/-11 years) were included. The size of the polyp heads was 17+/-8 mm. Tubular adenoma was most common (57%). The number of clips used before snare polypectomy was 2+/-0.5. The procedure was successful in all cases. IPPB occurred in 2 cases (3.6%), and both of these were managed by additional clipping. Delayed bleeding occurred in another one case (1.8%), which improved with conservative treatment. No perforation occurred. CONCLUSIONS: We suggest that clipping before snare polypectomy of pedunculated polyps may be an easy and effective technique for the prevention of IPPB, and this should be confirmed in large scale, prospective, controlled studies.
Adenoma ; Arm ; Head ; Hemorrhage ; Hospitals, University ; Humans ; Intermittent Positive-Pressure Breathing ; Pilot Projects ; Polyps ; SNARE Proteins