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: Several previous studies and case reports have reported ethanol-induced symptoms in patients receiving anticancer drugs containing ethanol. Most docetaxel formulations contain ethanol as a solvent. However, there are insufficient data on ethanol-induced symptoms when docetaxel-containing ethanol is administered. The primary purpose of this study was to investigate the frequency and pattern of ethanol-induced symptoms during and after docetaxel administration. The secondary purpose was to explore the risk factors for ethanol-induced symptoms. Materials and Methods: This was a prospective, multicenter, observational study. The participants filled out ethanol-induced symptom questionnaire on the day of chemotherapy and the following day. Results: Data from 451 patients were analyzed. The overall occurrence rate of ethanol-induced symptoms was 44.3% (200/451 patients). The occurrence rate of facial flushing was highest at 19.7% (89/451 patients), followed by nausea in 18.2% (82/451 patients), and dizziness in 17.5% (79/451 patients). Although infrequent, unsteady walking and impaired balance occurred in 4.2% and 3.3% of patients, respectively. Female sex, presence of underlying disease, younger age, docetaxel dose, and docetaxel-containing ethanol amount were significantly associated with the occurrence of ethanol-induced symptoms. Conclusion The occurrence of ethanol-induced symptoms was not low in patients receiving docetaxel-containing ethanol. Physicians need to pay more attention to the occurrence of ethanol-induced symptoms and prescribe ethanol-free or low-ethanol-containing formulations to high-risk patients.

Background: Neuroinflammation plays an important role in cognitive decline and memory impairment in neurodegenerative disorders. Previously, we demonstrated that Humulus japonicus (HJ) has anti-inflammatory effects in rodent models of Alzheimer’s disease and Parkinson’s disease. The present study aimed to examine the protective potential of HJ extracts against lipopolysaccharide (LPS)-induced cognitive impairment and scopolamine-induced amnesia in mouse models. Cognitive improvement of mice was investigated by novel object recognition test. For analyzing effects on neuroinflammation, immunohistochemistry and quantitative real-time polymerase chain reaction (qRTPCR) assays were performed. Results: We found that the oral administration of HJ significantly improved cognitive dysfunction induced by LPS in a novel object recognition test. The LPS-induced activation of microglia was notably decreased by HJ treatment in the cortex and hippocampus. HJ administration with LPS also significantly increased the mRNA expression of interleukin (IL)-10 and decreased the mRNA expression of IL-12 in the parietal cortex of mice. The increased expression of LPS-induced complement C1q B chain (C1bq) and triggering receptor expressed on myeloid cells 2 (Trem2) genes was significantly suppressed by HJ treatment. In addition, HJ administration significantly improved novel object recognition in a scopolamine-induced amnesia mouse model. Conclusions These findings revealed that HJ has a beneficial effect on cognitive impairment and neuroinflammation induced by systemic inflammation and on amnesia induced by scopolamine in mice.

Background/Aims: Predicting histological ulceration in early gastric cancer (EGC) during endoscopic examination is crucial for endoscopists deciding on the treatment modality. The aim of this study was to investigate the endoscopic factors that can predict histological ulcerations in EGCs. Methods: We retrospectively analyzed patients who underwent endoscopic submucosal dissection (ESD) for EGC. Clinical features and endoscopic characteristics of EGC such as location, histological differentiation, longest diameter, tumor morphology, mucosal break, converging fold, color change, and surface irregularity were reviewed. Histological ulceration was defined based on ESD specimens. Results: A total of 633 EGC lesions from 613 patients were included and histological ulcerations were found in 90 lesions (14.2%). Presence of converging folds, tumor morphology, and color changes on endoscopic examination were related to histological ulceration in the univariate analysis and converging folds along with color changes were statistically significant factors in the multivariate analysis. Kaplan–Meier analysis showed that patients with histological ulcerations in EGCs tended to have higher marginal recurrence rates. Conclusions Mucosal breaks are not equivalent to histological ulcerations. Rather, the existence of converging folds and color changes during endoscopic examination suggest histological ulcerations. Endoscopists should consider these factors when they decide the treatment modality for EGCs.

No abstract available.
Eosinophilia* ; Proton Pumps* ; Protons*

OBJECTIVES: The aim of the study was to develop a North Korean version of the Composite International Diagnostic Interview (NK-CIDI) and to evaluate the reliability and validity of NK-CIDI. METHODS: Subjects were 100 North Korean defectors, aged 18 to 65, who were recruited in a center for defectors in the National Medical Center or who were on an education curriculum in the defector settlement support center. NK-CIDI was developed based on the Korean version of CIDI considering the sociocultural background of North Korea. Inter-rater reliability, test/retest reliability, and validity of NK-CIDI were evaluated and kappa value was calculated. RESULTS: Different vocabularies and awkward expressions were adjusted, and additional explanations were supplemented for difficult phases. The target for development of NK-CIDI was early defectors who entered South Korea less than 3 months ago. Inter-rater reliability (n=30, kappa value 0.35-1.00), test/retest reliability (n=30, kappa value 0-0.86), and diagnostic validity (n=100, kappa value -0.02-0.42) were evaluated. CONCLUSION: Compared to the general population, defectors experience more psychiatric issues, and a standardized tool for diagnosis is needed. In this study, NK-CIDI was developed and the results suggest that reliability is acceptable but validity needs further verification. NK-CIDI could be utilized in future epidemiologic studies.
Curriculum ; Democratic People's Republic of Korea ; Diagnosis ; Education ; Epidemiology ; Korea ; Mental Disorders ; Reproducibility of Results ; Vocabulary

Menetrier's disease in childhood is a rare form of gastropathy characterized by hypoalbuminemia, endoscopic and/or radiologic findings of hypertrophic gastric folds, and histologic findings of foveolar hyperplasia in the stomach. It tends to have a self-limited course compared to the chronic and complicated course in adult Menetrier's disease. A 7-year-old boy was referred to Incheon St. Mary's Hospital for facial edema. Physical examination on admission showed periorbital swelling, pitting edema in both legs, and epigastric tenderness. Laboratory tests on admission indicated hypoproteinemia (3.0 g/dL) with hypoalbuminemia (2.1 g/dL) and hypogammaglobulinemia. Urinalysis showed no abnormalities. The test results for anti-cytomegalovirus immunoglobulin M and cytomegalovirus PCR were negative. Stool Helicobacter pylori antigen was positive and fecal alpha1-antitrypsin clearance was 40.1 mL/day, consistent with protein-losing gastroenteropathy. Gastroduodenoscopy showed hypertrophic edematous gastric folds, erythema, and superficial erosion in the body of the stomach. The duodenum was normal. Histologic findings showed foveolar hyperplasia. His symptoms improved with conservative treatment including proton pump inhibitor from day 9 of hospitalization and resolved completely. Here we reported a case of pediatric protein-losing hypertrophic gastropathy associated with Helicobacter pylori infection.
Adult ; Agammaglobulinemia ; Child ; Cytomegalovirus ; Duodenum ; Edema ; Erythema ; Gastritis, Hypertrophic* ; Helicobacter pylori* ; Hospitalization ; Humans ; Hyperplasia ; Hypoalbuminemia ; Hypoproteinemia ; Immunoglobulin M ; Incheon ; Leg ; Male ; Physical Examination ; Polymerase Chain Reaction ; Proton Pumps ; Stomach ; Urinalysis

There are a variety of different causes of parkinsonism including PD, secondary parkinsonism, and the parkinsonism plus syndromes. Secondary parkinsonism is caused by structural, toxic, metabolic, or infectious mechanisms. Among structural causes, intracranial neoplasms are a rare cause of secondary parkinsonism. Moreover, there are almost never case reports with intracranial space-occupying lesions resulting in parkinsonism associated with rapid cognitive impairment. Therefore, we report herein a 37-year-old woman diagnosed with papillary meningioma who presented with parkinsonism associated with rapidly progressive cognitive impairment mimicking diffuse Lewy body disease.
Adult ; Brain Neoplasms ; Dementia ; Female ; Humans ; Lewy Body Disease ; Meningioma ; Parkinson Disease, Secondary ; Parkinsonian Disorders

The use of mesenchymal stem cells (MSCs) has emerged as a potential new treatment for myocardial infarction. However, the poor viability of MSCs after transplantation critically limits the efficacy of this new strategy. The expression of microRNA-210 (miR-210) is induced by hypoxia and is important for cell survival under hypoxic conditions. Hypoxia increases the levels of hypoxia inducible factor-1 (HIF-1) protein and miR-210 in human MSCs (hMSCs). miR-210 positively regulates HIF-1alpha activity. Furthermore, miR-210 expression is also induced by hypoxia through the regulation of HIF-1alpha. To investigate the effect of miR-210 on hMSC survival under hypoxic conditions, survival rates along with signaling related to cell survival were evaluated in hMSCs over-expressing miR-210 or ones that lacked HIF-1alpha expression. Elevated miR-210 expression increased survival rates along with Akt and ERK activity in hMSCs with hypoxia. These data demonstrated that a positive feedback loop involving miR-210 and HIF-1alpha was important for MSC survival under hypoxic conditions.
Cell Survival ; Cobalt ; Gene Expression Regulation/*physiology ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit/genetics/*metabolism ; Mesenchymal Stromal Cells/drug effects/metabolism/*physiology ; MicroRNAs/*metabolism ; Oxygen/pharmacology ; *Oxygen Consumption ; RNA, Small Interfering/metabolism

BACKGROUND: The incidence of early colorectal epithelial neoplasm (ECEN) is increasing, and its pathologic diagnosis is important for patient care. We investigated the incidence of ECEN and the current status of its pathologic diagnosis. METHODS: We collected datasheets from 25 institutes in Korea for the incidence of colorectal adenoma with high grade dysplasia (HGD) and low grade dysplasia in years 2005, 2007, and 2009; and early colorectal carcinoma in the year 2009. We also surveyed the diagnostic terminology of ECEN currently used by the participating pathologists. RESULTS: The average percentage of diagnoses of adenoma HGD was 7.0%, 5.0%, and 3.4% in years 2005, 2007, and 2009, respectively. The range of incidence rates of adenoma HGD across the participating institutes has gradually narrowed over the years 2005 to 2009. The incidence rate of early colorectal carcinoma in the year 2009 was 21.2%. The participants did not share a single criterion or terminology for the diagnosis of adenoma HGD. The majority accepted the diagnostic terms that distinguished noninvasive, mucosal confined, and submucosal invasive carcinoma. CONCLUSIONS: Further research requirements suggested are a diagnostic consensus for the histopathologic diagnosis of ECEN; and standardization of diagnostic terminology critical for determining the disease code.
Academies and Institutes ; Adenoma ; Colorectal Neoplasms ; Consensus ; Incidence ; Korea ; Neoplasms, Glandular and Epithelial ; Pathology, Surgical ; Patient Care