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Immune checkpoint inhibitors have dramatically revolutionized the therapeutic landscape for patients with advanced malignancies. Recently, convincing evidence has shown meaningful influence of gut microbiome on human immune system. With the complex link between gut microbiome, host immunity and cancer, the variations in the gut microbiota may influence the efficacy of immune checkpoint inhibitors. Indeed, some bacterial species have been reported to be predictive for cancer outcome in patients treated with immune checkpoint inhibitors. Although immune checkpoint inhibitors are currently proven to be an effective anti-tumor treatment, they can induce a distinct form of toxicity, termed immune-related adverse events. Immune-related colitis is one of the common toxicities from immune checkpoint inhibitors, and it might preclude the cancer therapy in severe or refractory cases. The manipulation of gut microbiome by fecal microbiota transplantation or probiotics administration has been suggested as one of the methods to enhance anti-tumor effects and decrease the risk of immune-related colitis. Here we review the role of gut microbiome on immune checkpoint inhibitor therapy and consequent immune-related colitis to provide a new insight for better anti-cancer therapy.
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The sociomedical environment is changing. In the traditional physician-patient relationship, the physician was authoritative and the patient was obedient. The contractual relationship featured patient consent to the physician’s decision. Today, the physician must explain fully the planned medical treatment, and any alternative, to the patient, who has the right to choose her treatment after considering the benefits and side-effects. The Korean Society of Gynecologic Oncology thus decided to standardize the surgical consent forms to meet the legal requirements of modern medicine, improve patient understanding of the surgical details, and protect medical staff from legal disputes. To determine the format and content, subcommittees for each cancer type collected and reviewed all relevant articles and the current consent forms of domestic medical institutions. After several meetings, 16 basic items to be included for each type of gynecologic cancer were selected. Also, to help patients understand the surgical details, figures were included. The revised forms were legally reviewed in terms of the appropriateness of the format and content. We also developed English versions to provide adequate information for foreign patients. We hope that these efforts will promote trust between patients and physicians, and contribute to effective treatment by laying a foundation of mutual respect.
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Endovascular repair of popliteal artery aneurysms (PAA) using a stent graft is suitable for patients with favorable anatomy. In the domestic situation where Gore Medical withdrew, we report two cases of unusual complications of pseudoaneurysm after endovascular repair of PAA. A 44-year-old male with a history of bypass surgery for a PAA presented with recurrent vein graft pseudoaneurysm. Endovascular treatment using a domestic stent graft was performed. However, pseudoaneurysm developed due to the graft fabric tear 1 month later, requiring surgical removal. In another case, an 84-year-old female presented with acute limb ischemia related to PAA. Endovascular aneurysm repair with the same domestic stent graft was performed. However, stent graft failure occurred 2 years later and the patient underwent open surgical repair. There was a graft fabric disintegration. When proper endovascular device is not available, open surgical treatment is the best option for treating PAA.
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Objective@#To compare survival outcomes between bevacizumab (BEV) and olaparib (OLA) maintenance therapy in BRCA-mutated, platinum-sensitive relapsed (PSR) high-grade serous ovarian carcinoma (HGSOC). @*Methods@#From 10 institutions, we identified HGSOC patients with germline and/or somatic BRCA1/2 mutations, who experienced platinum-sensitive recurrence between 2013 and 2019, and received second-line platinum-based chemotherapy. Patients were divided into BEV (n=29), OLA (n=83), and non-BEVon-OLA users (n=36). The OLA and non-BEVon-OLA users were grouped as the OLA intent group. We conducted 1:2 nearest neighbor-matching between the BEV and OLA intent groups, setting the proportion of OLA users in the OLA intent group from 65% to 100% at 5% intervals, and compared survival outcomes among the matched groups. @*Results@#Overall, OLA users showed significantly better progression-free survival (PFS) than BEV users (median, 23.8 vs. 17.4 months; p=0.004). Before matching, PFS improved in the OLA intent group but marginal statistical significance (p=0.057). After matching, multivariate analyses adjusting confounders identified intention-to-treat OLA as an independent favorable prognostic factor for PFS in the OLA 65P (adjusted hazard ratio [aHR]=0.505; 95% confidence interval [CI]=0.280−0.911; p=0.023) to OLA 100P (aHR=0.348; 95% CI=0.184−0.658; p=0.001) datasets. The aHR of intention-to-treat OLA for recurrence decreased with increasing proportions of OLA users. No differences in overall survival were observed between the BEV and OLA intent groups, and between the BEV and OLA users. @*Conclusion@#Compared to BEV, intention-to-treat OLA and actual use of OLA maintenance therapy were significantly associated with decreased disease recurrence risk in patients with BRCA-mutated, PSR HGSOC.
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PURPOSE@#The present study aimed to evaluate the accuracy of a desktop scanner and intraoral scanners based on the volumetric dimensions of a complete arch. @*MATERIALS AND METHODS@#Seven reference models were fabricated based on the volumetric dimensions of complete arch (70%, 80%, 90%, 100%, 110%, 120%, and 130%). The reference models were digitized using an industrial scanner (Solutionix C500; MEDIT) for the fabrication of a computer-aided design (CAD) reference model (CRM). The reference models were digitized using three intraoral scanners (CS3600, Trios3, and i500) and one desktop scanner (E1) to fabricate a CAD test model (CTM). CRM and CTM were then superimposed using inspection software, and 3D analysis was conducted. For statistical analysis, one-way analysis of variance was used to verify the difference in accuracy based on the volumetric dimensions of the complete arch and the accuracy based on the scanners, and the differences among the groups were analyzed using the Tukey HSD test as a post-hoc test (α=.05). @*RESULTS@#The three different scanners showed a significant difference in accuracy based on the volumetric dimensions of the complete arch (P<.05), but the desktop scanner did not show a significant difference in accuracy based on the volumetric dimensions of the complete arch (P=.808). @*CONCLUSION@#The accuracy of the intraoral scanners was dependent on the volumetric dimensions of the complete arch, but the volumetric dimensions of the complete arch had no effect on the accuracy of the desktop scanner. Additionally, depending on the type of intraoral scanners, the accuracy differed according to the volumetric dimensions of the complete arch.
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PURPOSE@#The present study aimed to evaluate the accuracy of a desktop scanner and intraoral scanners based on the volumetric dimensions of a complete arch. @*MATERIALS AND METHODS@#Seven reference models were fabricated based on the volumetric dimensions of complete arch (70%, 80%, 90%, 100%, 110%, 120%, and 130%). The reference models were digitized using an industrial scanner (Solutionix C500; MEDIT) for the fabrication of a computer-aided design (CAD) reference model (CRM). The reference models were digitized using three intraoral scanners (CS3600, Trios3, and i500) and one desktop scanner (E1) to fabricate a CAD test model (CTM). CRM and CTM were then superimposed using inspection software, and 3D analysis was conducted. For statistical analysis, one-way analysis of variance was used to verify the difference in accuracy based on the volumetric dimensions of the complete arch and the accuracy based on the scanners, and the differences among the groups were analyzed using the Tukey HSD test as a post-hoc test (α=.05). @*RESULTS@#The three different scanners showed a significant difference in accuracy based on the volumetric dimensions of the complete arch (P<.05), but the desktop scanner did not show a significant difference in accuracy based on the volumetric dimensions of the complete arch (P=.808). @*CONCLUSION@#The accuracy of the intraoral scanners was dependent on the volumetric dimensions of the complete arch, but the volumetric dimensions of the complete arch had no effect on the accuracy of the desktop scanner. Additionally, depending on the type of intraoral scanners, the accuracy differed according to the volumetric dimensions of the complete arch.
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PURPOSE: This study compared the effectiveness of three methods, fascial distortion model (FDM), myofascial release (MFR), self-myofascial release (SMR), on the neck range of motion and pain. METHODS: In this study, the collected data were processed statistically using SPSS version 22.0 for Windows. Descriptive statistics were used to analyze the general characteristics of the subjects. Repeated measure ANOVA was conducted to analyze the range of motion of the neck of the group and VAS, and Contras was used to see the difference in significance over time. One-way ANOVA was used to compare the differences among the groups and a post-hoc test was used. The significance level (α) was 0.05. RESULTS: In the range of motion, the flexion and extension of the neck, right rotation, and left rotation were significantly different in the SMR, FDM, and MFR groups. The right lateral flexion showed significant differences in the FDM, MFR, and SMR groups. The VAS was similar in the groups at 2 and 4 weeks, but there was a significant difference among the FDM, MFR, and SMR groups at 6 weeks. CONCLUSION: In this study, MFR and MSR as well as FDM were effective in controlling the range of motion and pain control of the neck. Further studies will be needed to determine the effects of long-lasting treatments other than pain control. These studies and the present study will be used as a basis for ongoing research into the duration and method of application for musculoskeletal therapies.
Subject(s)
Humans , Methods , Neck Pain , Neck , Range of Motion, ArticularABSTRACT
PURPOSE: Single incision laparoscopic cholecystectomy (SILC) is increasingly performed worldwide. Accordingly, the Konyang Standard Method (KSM) for SILC has been developed over the past 6 years. We report the outcomes of our procedures. METHODS: Between April 2010 and December 2016, 1,005 patients underwent SILC at Konyang University Hospital. Initially 3-channel SILC with KSM was changed to 4-channel SILC using a modified technique with a snake retractor for exposure of Calot triangle; we called this a modified KSM (mKSM). Recently, we have used a commercial 4-channel (Glove) port for simplicity. RESULTS: SILC was performed in 323 patients with the KSM, in 645 with the mKSM, and in 37 with the commercial 4-channel port. Age was not significantly different between the 3 groups (P = 0.942). The postoperative hospital days (P = 0.051), operative time (P < 0.001) and intraoperative bleeding volume (P < 0.001) were significantly improved in the 3 groups. Drain insertion (P = 0.214), additional port insertion (P = 0.639), and postoperative complications (P = 0.608) were not significantly different in all groups. Postoperative complications were evaluated with the Clavien-Dindo classification. There were 3 cases (0.9%) over grade IIIb (bile duct injury, incisional hernia, duodenal perforation, or small bowel injury) with KSM and 3 (0.5%) with mKSM. CONCLUSION: We evaluated the evolution of the KSM for SILC. The use of the mKSM with a commercial 4-channel port may be the safest and most effective method for SILC.
Subject(s)
Humans , Cholecystectomy, Laparoscopic , Classification , Hemorrhage , Incisional Hernia , Laparoscopy , Methods , Operative Time , Postoperative Complications , SnakesABSTRACT
BACKGROUND AND OBJECTIVES@#Approximately 10–15% of children with Kawasaki disease (KD) do not respond to initial intravenous immunoglobulin (IVIG) and have higher risk for coronary artery lesion (CAL). The aim of this study was to identify predictive factors from laboratory findings in patients who do not respond to IVIG treatment and develop CAL from KD.@*METHODS@#We retrospectively collected nationwide multicenter data from the Korean Society of Kawasaki Disease and included 5,151 patients with KD between 2012 and 2014 from 38 hospitals.@*RESULTS@#Among 5,151 patients with KD, 524 patients belonged to the IVIG-resistant group. The patients in the IVIG-resistant group had a significantly higher serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level (1,573.91±3,166.46 vs. 940.62±2,326.10 pg/mL; p < 0.001) and a higher percentage of polymorphonuclear neutrophils (PMNs) (70.89±15.75% vs. 62.38±32.94%; p < 0.001). Multivariate logistic regression analyses revealed that significantly increased PMN, NT-proBNP, C-reactive protein (CRP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were the predictors of IVIG resistance (p < 0.05). Multivariate logistic regression analyses also showed that only CRP was associated with the risk of CAL (p < 0.01), while PMN, NT-proBNP, AST, and ALT were not.@*CONCLUSIONS@#Elevated PMN, serum NT-proBNP, CRP, AST, and ALT levels are significantly associated with IVIG resistance in patients with KD. Moreover, serum CRP is significantly increased in patients with KD with CAL.
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BACKGROUND AND OBJECTIVES: Approximately 10–15% of children with Kawasaki disease (KD) do not respond to initial intravenous immunoglobulin (IVIG) and have higher risk for coronary artery lesion (CAL). The aim of this study was to identify predictive factors from laboratory findings in patients who do not respond to IVIG treatment and develop CAL from KD. METHODS: We retrospectively collected nationwide multicenter data from the Korean Society of Kawasaki Disease and included 5,151 patients with KD between 2012 and 2014 from 38 hospitals. RESULTS: Among 5,151 patients with KD, 524 patients belonged to the IVIG-resistant group. The patients in the IVIG-resistant group had a significantly higher serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level (1,573.91±3,166.46 vs. 940.62±2,326.10 pg/mL; p < 0.001) and a higher percentage of polymorphonuclear neutrophils (PMNs) (70.89±15.75% vs. 62.38±32.94%; p < 0.001). Multivariate logistic regression analyses revealed that significantly increased PMN, NT-proBNP, C-reactive protein (CRP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were the predictors of IVIG resistance (p < 0.05). Multivariate logistic regression analyses also showed that only CRP was associated with the risk of CAL (p < 0.01), while PMN, NT-proBNP, AST, and ALT were not. CONCLUSIONS: Elevated PMN, serum NT-proBNP, CRP, AST, and ALT levels are significantly associated with IVIG resistance in patients with KD. Moreover, serum CRP is significantly increased in patients with KD with CAL.
Subject(s)
Child , Humans , Alanine Transaminase , Aspartate Aminotransferases , C-Reactive Protein , Coronary Artery Disease , Coronary Vessels , Immunoglobulins , Immunoglobulins, Intravenous , Logistic Models , Mucocutaneous Lymph Node Syndrome , Natriuretic Peptide, Brain , Neutrophils , Retrospective StudiesABSTRACT
PURPOSE: This study aimed to clarify the association between human epidermal growth factor receptor 2 (HER-2) status and the clinicopathologic factors of patients who underwent curative intent gastrectomy.METHODS: From June 2011 to May 2015, curative intent gastrectomy was performed in 441 patients at Konyang University Hospital. Among them, we evaluated the HER-2 status in 113 patients. Data on clinicopathologic parameters such as age, sex, histological subtype, endoscopic Lauren classification, tumor location, size, presence of lymphovascular invasion, invasion depth, pathologic stage, HER-2 overexpression, recurrence and survival were obtained. In this study, pathological HER-2 intensity scores of 0, 1+, and 2+ were assumed to be negative, 3+ only was to be positive for overexpression.RESULTS: In a total of 113 cases who underwent curative intent gastrectomy with HER-2 testing, 16 (14.2%) cases had positivity of HER-2 overexpression. HER-2 overexpression had significant associations with tumor stage (19.0% in I-IIIb vs. 2.9% in IIIc-IV, P=0.036). Survival analysis of HER2 overexpression has no significant difference.CONCLUSION: In this study, HER-2 overexpression rate was 14.2% and patient tumor stage had significant association with HER-2 overexpression.
Subject(s)
Humans , Classification , Epidermal Growth Factor , Gastrectomy , ErbB Receptors , Recurrence , Stomach NeoplasmsABSTRACT
No abstract available.
Subject(s)
Female , Colorectal Neoplasms, Hereditary Nonpolyposis , Endometrial Neoplasms , SurgeonsABSTRACT
Ribosomal protein L21 (RPL21) is a structural component of the 60S subunit of the eukaryotic ribosome. This protein has an important role in protein synthesis and the occurrence of hereditary diseases. Pig is a common laboratory model, however, to the best of our knowledge, its RPL21 gene has not been cloned to date. In this study, we cloned and identified the full-length sequence of the pig RPL21 gene for the first time. In addition, we examined its expression pattern and function by using overexpression or knockdown approaches. As a result, we obtained a 604 bp segment that contains a 483 bp open reading frame encoding 160 amino acids. The pig RPL21 gene is located in the “+” strand of chromosome 11, which spans 2167 bp from 4199792 to 4201958. Pig RPL21 protein has nine strands and two helices in its secondary structure. Pig RPL21 is predominantly expressed in ovary and lung, at lower levels in kidney, small intestine, and skin, and at the lowest levels in heart and liver. Furthermore, RPL21 expression is closely connected with cell proliferation and cell cycle arrest. The results are intended to provide useful information for the further study of pig RPL21.
Subject(s)
Female , Amino Acids , Cell Cycle Checkpoints , Cell Proliferation , Chromosomes, Human, Pair 11 , Clone Cells , Cloning, Molecular , Gene Expression , Genetic Diseases, Inborn , Heart , Intestine, Small , Kidney , Liver , Lung , Open Reading Frames , Ovary , Ribosomal Proteins , Ribosomes , Skin , Sus scrofaABSTRACT
BACKGROUND: The normal cells derived from human embryonic stem cells (hESCs) are regarded as substitutes for damaged or dysfunctional adult cells. However, tumorigenicity of hESCs remains a major challenge in clinical application of hESC-derived cell transplantation. Previously, we generated monoclonal antibody (MAb) 57-C11 specific to the surface molecule on undifferentiated hESCs. The aim of this study is to prove whether 57-C11-positive hESCs are pluripotent and tumorigenic in immunodeficient mice. METHODS: Undifferentiated hESCs were mixed with retinoic acid (RA)-differentiated hESCs at different ratios prior to 57-C11-mediated separation. To isolate 57-C11-positive hESCs from the mixture, biotinylated 57-C11 and streptavidin-coated magnetic beads were added to the mixture. Unbound 57-C11-negative hESCs were first isolated after applying magnet to the cell mixture, and 57-C11-bound hESCs were then released from the magnetic beads. In order to measure the efficiency of separation, 57-C11-positive or -negative hESCs were counted after isolation. To evaluate the efficiency of teratoma formation in vivo, 57-C11-positive or negative cells were further injected into left and right, respectively, testes of nonobese diabetic/severe combined immunodeficiency (NOD/SCID) mice. RESULTS: Approximately 77~100% of undifferentiated hESCs were isolated after applying 57-C11-coated magnetic beads to the mixed cell populations. Importantly, teratomas were not observed in NOD/SCID mice after the injection of isolated 57-C11-negative hESCs, whereas teratomas were observed with 57-C11-positive hESCs. CONCLUSION: 57-C11-positive hESCs are pluripotent and tumorigenic. The combination of 57-C11 and magnetic beads will be useful to eliminate remaining undifferentiated hESCs for the safe cell transplantation.
Subject(s)
Adult , Animals , Humans , Mice , Cell Transplantation , Human Embryonic Stem Cells , Teratoma , Testis , Transplants , TretinoinABSTRACT
Female adnexal tumor of probable Wolffian origin (FATWO) is a rare disease entity that arises from the mesonephric duct system. FATWO is different than other gynecological cancers in terms of embryology. Here, we describe the case of a 52-year-old woman with malignant FATWO. The patient underwent explorative laparotomy and surgical staging after a frozen section revealed malignancy. Detailed examination of the pathologic findings were consistent with FATWO. Counseling and further testing were provided to the patient to assess the risk of germline mutation and epigenetic change. An O-6-methylguanine-DNA methyltransferase gene methylation test was positive, and all other tests were normal. This is the first study to report a case of O-6-methylguanine-DNA methyltransferase methylation with FATWO in Korea.
Subject(s)
Female , Humans , Middle Aged , Counseling , Embryology , Epigenesis, Genetic , Epigenomics , Frozen Sections , Germ-Line Mutation , Korea , Laparotomy , Methylation , Rare Diseases , Wolffian DuctsABSTRACT
Pseudomyxoma peritonei (PMP) is a rare tumor that usually originates in the appendix, but a small number of cases originate in the ovary. Lynch syndrome (LS) is an autosomal dominant hereditary condition that increases the risk of cancer, particularly in the colon and endometrium. Mutations in the mismatch repair genes (MSH2, MLH1, MSH6, and PMS2) increase the risk of LS. Reported PMP cases with hereditary gene mutations of unknown significance are also rare. Here, we investigated a PMP patient and her family members, who have an MSH2 variant of unknown significance. Physicians have an important role in counseling, management, and surveillance based on genetics and pathogenicity.
Subject(s)
Female , Humans , Appendix , Colon , Colorectal Neoplasms, Hereditary Nonpolyposis , Counseling , DNA Mismatch Repair , Endometrium , Genetics , Germ-Line Mutation , Ovary , Pseudomyxoma Peritonei , VirulenceABSTRACT
The objective of the present study was to investigate the effects of three different culture media on the development of canine somatic cell nuclear transfer (SCNT) embryos. Canine cloned embryos were cultured in modified synthetic oviductal fluid (mSOF), porcine zygote medium-3 (PZM-3), or G1/G2 sequential media. Our results showed that the G1/G2 media yielded significantly higher morula and blastocyst development in canine SCNT embryos (26.1% and 7.8%, respectively) compared to PZM-3 (8.5% and 0%) or mSOF (2.3% and 0%) media. In conclusion, this study suggests that blastocysts can be produced more efficiently using G1/G2 media to culture canine SCNT embryos.
Subject(s)
Animals , Blastocyst/cytology , Cloning, Organism/veterinary , Culture Media/metabolism , Dogs/embryology , Embryo Culture Techniques/veterinary , Embryonic Development , Nuclear Transfer Techniques/veterinaryABSTRACT
OBJECTIVE: Women with Lynch syndrome have an increased risk of developing colorectal and gynecologic malignancies such as endometrial cancer. Complex hyperplasia has about a 30% risk of developing into endometrial cancer. The aim of this study was to determine the genetic risk for developing endometrial cancer by immunohistochemical staining of premalignant lesions for mutL homolog 1, mutS homolog 2, mutS homolog 6, and postmeiotic segregation increased 2. METHODS: Twenty cases (n=20) were selected from among patients with available sample blocks for analysis. Clinical information was obtained from medical chart review. Immunohistochemical staining was performed for all of the tumor blocks. Staining was scored based on the intensity (intensity score 0-3) . RESULTS: Among the 20 cases of complex endometrial hyperplasia, 11 (55%) patients showed loss of expression of at least one of the following proteins: mutL homolog 1, mutS homolog 2, mutS homolog 6, or postmeiotic segregation increased 2. Seven (35%) patients were negative for the expression of two or more proteins, and one patient (5%) was negative for the expression of all four proteins. CONCLUSION: More than half of the patients showed loss of expression of at least one mismatch repair protein in our study population. Genetic risk counseling and further tests are recommended for these patients.
Subject(s)
Female , Humans , Colorectal Neoplasms, Hereditary Nonpolyposis , Counseling , DNA Mismatch Repair , Endometrial Hyperplasia , Endometrial Neoplasms , HyperplasiaABSTRACT
We recently experienced a case of endometrial cancer 5 years after the diagnosis of breast cancer in a patient with a mutation in the BRCA2 gene. A 55-year-old Korean woman who had a past history of breast cancer in her 50s underwent an operation for endometrial cancer. Final pathology confirmed stage Ia, and no adjuvant treatment was performed. After surgery, considering her history of sequential cancer occurrence, genetic counseling was offered. The result showed the BRCA2 variation of unknown significance mutation. This is the first case report of sequential cancers (endometrial and breast) in a patient with a BRCA2 mutation among a Korean population.
Subject(s)
Female , Humans , Middle Aged , Breast Neoplasms , Diagnosis , Endometrial Neoplasms , Genes, BRCA2 , Genetic Counseling , PathologyABSTRACT
OBJECTIVES: Borderline ovarian tumors (BOT) are premalignant lesions. Approximately 10% of all epithelial ovarian cancers are known to be hereditary with hereditary breast and ovarian cancer (HBOC) accounting for approximately 90% of cases; the remaining 10% are attributable to Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer (HNPCC). The aim of our study is to estimate this risk based on screening immunohistochemistry (IHC). METHODS: Thirty-four patients diagnosed with BOT were identified. Family history, clinical characteristics, and IHC data (breast cancer 1, early onset [BRCA1], breast cancer 2, early onset [BRCA2], mutS homolog 2 [MSH2], mutL homolog 1 [MLH1]) were collected for all cases from the patients' medical charts. Nuclear staining of the tumor was scored as negative and positive. RESULTS: Among 32 patients, 14 (44%) had serous type and 18 (56%) had mucinous type. The mean patient age was 44 years (range 19-86).The number of patients with weak IHC staining for MSH2 and BRCA2 was 1 (3%) and 6 (19%) respectively. The median follow up was 21.8 months. CONCLUSION: According to the results, we discovered that 3% and 19% of patients with BOT had a risk of hereditary cancer based on IHC analysis respectively. This pilot study may help clinician to counsel effectively for confirmative tests.