Comparison of Long-Term Oncologic Outcomes Between Surgical T4 and T3 in Patients Diagnosed With Pathologic Stage IIA Right Colon Cancer.

Purpose: T stage plays an important role in the classification of subgroups in stage II colon cancer. Patients with pathologic T4 are at high risk of recurrence and it is recommended to include adjuvant chemotherapy in the treatment plan, while this is not necessary in pathologic T3. There is a discrepancy between the surgical T stage (sT), as determined by the surgeon in the operative field, and pathologic T stage (pT). The pathologic stage is considered a standard prognostic factor, but it has not been established whether the surgical stage has an oncologic impact. The aim of this study was to compare oncologic outcomes between sT4 and sT3 in pathologic stage IIA right colon cancer. Methods: Between January 2005 and December 2018, there were 354 patients who underwent right hemicolectomy performed by a single surgeon (JHB) at a tertiary hospital. The data from these patients were retrospectively collected and analyzed. Only those patients with pathologic stage IIA (pT3N0M0) right colon adenocarcinomas were included in this study. Patients with mucinous carcinoma, signet ring cell carcinoma, squamous cell carcinoma, or hereditary colon cancer, and who had emergent surgery were excluded. Finally, 86 patients were included in this study. The patients were categorized, according to their surgical records, into either the sT4 group (n=28) or the sT3 group (n=58). Results: There were no statistical differences between the two groups in terms of age, sex, body mass index, comorbidities, cancer location, histologic grade, lymphovascular invasion, perineural invasion, number of harvested lymph nodes, and adjuvant chemotherapy. The 5-year overall survival rate was significantly different between the sT4 and sT3 groups (92.6% vs. 97.7%, p=0.024). In addition, the 5-year disease-free survival rate was significantly different between the sT4 and sT3 groups (88.6% vs. 97.7%, p=0.017). In the multivariate Cox regression analysis, a classification of sT4 was a significant independent predictive factor for recurrence (p = 0.023). Conclusions: Long-term oncologic outcomes have shown significant differences between surgical T4 and T3 in pathologic stage IIA right colon cancer patients. Further large-scale, multicenter studies are required to verify the clinical impact of the surgical staging.

The impact of Model for End-Stage Liver Disease score on deceased donor liver transplant outcomes in low volume liver transplantation center: a retrospective and single-center study.

PURPOSE: In June 2016, the Model for End-Stage Liver Disease (MELD) score was employed in South Korea instead of the Child-Turcotte-Pugh (CTP) score. This study compared the outcomes of deceased donor liver transplantation (DDLT) before and after the MELD system application. METHODS: This retrospective study reviewed 48 patients who underwent DDLT for end-stage liver disease at a single tertiary referral center between January 2014 and December 2018. The patients were categorized into the pre-MELD (22 patients) and post-MELD (26 patients) groups. The demographics, postoperative outcomes, and overall survival time were evaluated between the 2 groups. RESULTS: The 2 groups had no differences in age, sex, ABO type, etiology for liver transplantation, CTP-score, operation time, cold ischemic time, and amount of red blood cell transfusion, although their MELD score differed significantly (post-MELD group, 36.2 ± 4.9; pre-MELD group, 27.7 ± 11.8; P < 0.001). The post-MELD group has longer intensive care unit stay (11.2 ± 9.5 days vs. 5.7 ± 4.5 days, P = 0.018) and hospital stay than the pre-MELD group (36.8 ± 26 days vs. 22.8 ± 9.3 days, P = 0.016). The 1-year survival rate was lower in the post-MELD group (61.5% vs. 86.4%, P = 0.029). CONCLUSION: After MELD allocation, patients with high MELD scores had increased DDLT and consequently required a longer recovery time, which could negatively affect survival. According to the experience of a small-volume center, these problems were related to both severe organ shortages in South Korea and MELD allocation.

A large buoy-based radioactivity monitoring system for gamma-ray emitters in surface seawater.

A buoy (shallow water light type) -based in situ gamma-ray spectrometry system with a 7.6 cmØ × 7.6 cm NaI(Tl) detector for remote real-time monitoring of gamma-ray emitting radionuclides in surface seawater is presented. To convert measured count rates to radioactivity, the full energy peak efficiency of the detector for radionuclides in seawater was estimated using Monte Carlo simulation with the MCNP code. The efficiency calibration was validated by comparing the results with a sampling analysis of 40K in seawater at the sites where the monitoring systems were deployed. The minimum detectable activity of the system for 137Cs, 134Cs and 131I with gamma-ray measurement time is discussed.

Poorly differentiated thyroid carcinoma: An institutional experience.

Purpose: The incidence of poorly differentiated thyroid carcinoma (PDTC) is extremely low among thyroid cancers and there is no standardized treatment guideline for it. In this study, we have analyzed PDTC patients and reviewed their clinicopathological features. Methods: Data of PDTC patients from our institution are collected through the electronic medical database. We analyzed them by several parameters such as basic demographics, presenting symptom, preoperative cytology results, associated pathology, surgical results, surgery type, and distant metastasis. Results: We collected 23 cases in our institution. Apart from two patients who were transferred to another hospital upon diagnosis, all 21 operated cases are analyzed. The parameters we studied were age, sex, presenting symptoms, distant metastasis and pathological features such as tumor size, associated pathology, predominant pattern and so on. We also provided descriptive analyses according to the type of presentation and treatment; patients with distant metastasis, juvenile cancer, and concurrent hyperthyroidism. Furthermore, we provided different cases in which the initial surgical plans differed. Conclusion: We present 21 cases of PDTC patients and clarify their clinicopathological features. Despite some limitations, this study may shed light for future research regarding treatment of PDTC patients.

Fluctuations of exposure rate at regional radiation monitoring stations in Korea.

Based on hourly means of exposure rate between August 2000 and July 2001 at nine Regional Radiation Monitoring Stations (RRMS) in Korea, we analyzed spatio-temporal characteristics of exposure rate. The mean and fluctuations of exposure rates were 99 and 3.8 nGy h(-1), respectively. The hourly exposure rate over 9 RRMS indicated a diurnal pattern with the exposure rates reaching a maximum between 5:00 and 8:00 a.m. in the early morning and a broad minimum between 4:00 and 10:00 p.m. in the afternoon. The fluctuations of exposure rate in the inland areas were less than 3.2 nGy h(-1), and those of exposure rate in coastal areas were larger than 3.9 nGy h(-1). The frequency distribution of exposure rates had one peak around the mean and was to be skewed to the right or positively skewed and its tails were fatter than those of a normal distribution. The interrelations of exposure rates at each station generally decreased with the distance between the stations. Empirical orthogonal function (EOF) analysis showed that almost all (99.9%) of exposure rate fluctuations were described by simultaneous variations. The spatial distribution of the first EOF modes of actual, low-pass (periods longer than one month) and high-pass (periods shorter than one month) exposure rate series were similar to each other.

Radiological impact in Korea following the Fukushima nuclear accident.

The pathway and radiological impact of the radioactive plume released at the Fukushima nuclear accident site on the Korean Peninsula has been studied. On March 28, 2011, only (131)I was first observed at all 12 regional monitoring stations in Korea, and the highest activity concentrations in aerosol were 3.12 mBq/m(3) for (131)I at Gunsan, 1.19 mBq/m(3) for (134)Cs and 1.25 mBq/m(3) for (137)Cs at Busan on April 7, 2011. These radionuclides were also detected in dry and wet deposition samples, while the significant increase of (131)I, (134)Cs and (137)Cs activity concentrations were not observed in seawater and marine biota samples.

Medically used radionuclides (131I, 99mTc) in the urban sewage system: the case of the Daejeon metropolitan city, Korea.

In order to assess the behaviour of radioactivity (specifically (131)I concentrations in wastewater and sludge at sewage treatment plant) discharged into municipal sewage by therapy patients receiving treatment, the use of radiopharmaceuticals in four hospitals was quantitatively evaluated and the patients were classified by their residence. (131)I concentrations were estimated using a simple assumption model for radioiodine treatments of 94 patients, and measured by HPGe in inflow points, respectively. A good agreement was found between (131)I concentrations estimated with the model and those measured in the inflow points at the sewage treatment plant.