• Clinical Endoscopy
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• v.56 no.4
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• pp.479-489
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• 2023

Background/Aims: Accurate neoplastic prediction can significantly decrease costs associated with pathology and unnecessary colorectal polypectomies. Narrow-band imaging (NBI) and dual-focus (DF) mode are promising emerging optical technologies for recognizing neoplastic features of colorectal polyps digitally. This study aimed to clarify the clinical usefulness of NBI with and without DF assistance in the neoplastic prediction of small colorectal polyps (<10 mm). Methods: This cross-sectional study included 530 small colorectal polyps from 343 consecutive patients who underwent colonoscopy at the University Medical Center from September 2020 to May 2021. Each polyp was endoscopically diagnosed in three successive steps using white-light endoscopy (WLE), NBI, and NBI-DF and retrieved for histopathological assessment. The diagnostic accuracy of each modality was evaluated with reference to histopathology. Results: There were 295 neoplastic polyps and 235 non-neoplastic polyps. The overall accuracies of WLE, WLE+NBI, and WLE+NBI+NBI-DF in the neoplastic prediction of colorectal polyps were 70.8%, 87.4%, and 90.8%, respectively (p<0.001). The accuracy of WLE+NBI+NBI-DF was significantly higher than that of WLE+NBI in the polyp size ≤5 mm subgroup (87.3% vs. 90.1%, p<0.001). Conclusions: NBI improved the real-time neoplastic prediction of small colorectal polyps. The DF mode was especially useful in polyps ≤5 mm in size.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.1
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• pp.55-63
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• 2012

The odontogenic keratocyst (OKC) was originally classified as a developmental cyst, and OKCs were histologically divided into orthokeratotic (O-OKCs) and parakeratotic (P-OKCs) types. Clinical features differ between O-OKCs and P-OKCs with P-OKCs having a tendency to recur after surgical treatment. According to the revised histopathological classification of odontogenic tumors by the World Health Organization (2005), the term keratocystic odontogenic tumor (KCOT) has been adopted to describe P-OKCs. In this retrospective study, we examined 186 KCOTs treated at the Maxillofacial Surgery Department of the Tokyo Medical and Dental University Hospital from 1981 through 2005. The patients ranged in age from 7 to 85 years (mean, 32.7) and consisted of 93 males and 93 females. The most frequently treated areas were the mandibular molar region and ramus. The majority of KCOTs in the maxillary region were treated by enucleation and primary closure. The majority of KCOTs in the mandibular region were enucleated, and the wound was left open. Marginal resection was performed in the 4 patients with large lesions arising in the mandible. In patients who were followed for more than a year, recurrences were observed in 19 of 120 lesions (15.8%). The recurrences were found at the margins of the primary lesion in contact with the roots of the teeth or at the upper margins of the mandibular ramus. Clinicians should consider aggressive treatment for KCOTs because the recurrence rate of P-OKCs is higher than that of other cyst types such as O-OKCs, dentigerous cysts, primordial cysts that were non-keratinized, and slightly keratinized stratified squamous epithelium. Although more aggressive treatment is needed for KCOTs as compared to other cystic lesions, it is difficult to make a precise diagnosis preoperatively on the basis of clinical features and X-ray imaging. Therefore, preoperative biopsy is necessary for selecting the appropriate treatment for patients with cystic lesions.

• Tuberculosis and Respiratory Diseases
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• v.75 no.2
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• pp.52-58
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• 2013

Background: More than half of cases for advanced non-small-cell lung cancer (NSCLC) occur in elderly patients with a median age at diagnosis of 70 years. The aim of our study was to examine the clinical features and prognostic factors contributing to mortality in elderly patients with advanced NSCLC. Methods: Following a retrospective review of clinical data, 122 patients aged 70 years and over with a histopathological diagnosis of locally advanced (stage IIIB, n=32) and metastatic (stage IV, n=90) NSCLC between 2005 and 2011 were enrolled. Results: The median age was 76 years (interquartile range, [IQR], 72-80 years), and 85 (70%) patients were male. Fifty-seven (46%) patients had never smoked, and 17 (19%) were in a malnourished state with a body mass index (BMI) of <$18.5kg/m^2$. The initial treatments included chemotherapy (40%) and radiotherapy (7%), but 57% of the patients received supportive care only. The 1-year survival rate was 32%, and the 3-year survival rate was 4%, with a median survival duration of 6.2 months (IQR, 2.5-15.3 months). Male gender (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.3-3.9; p=0.005), low BMI (HR, 2.3; 95% CI, 1.3-3.9; p=0.004), and supportive care only (HR, 1.9; 95% CI, 1.2-2.9; p=0.007) were independent predictors of shorter survival based on a Cox proportional hazards model. Conclusion: Elderly patients with advanced NSCLC had a poor prognosis, particularly male patients, those with a low BMI, and those who received supportive care only.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.4
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• pp.758-770
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• 1996

Discectomy is the oldest and most commonly performed operation for the painful temporomandibular joint with internal derangement. It is the one operation for which there are longest follow-up study, with Eriksson, Silver, and Tolvanen et al reporting good results in patients about 30 years after discectomy. About 80% to 90% of patients clinically experience relief from pain and dysfunction after discectomy, and interestingly, the results may improve with time. However such as Myrhaug found headache and Poswillo supposed pain and limitation of movement as postoperative complications, even though this operation had the longest follow-up term, several aspects of discectomy remain unclear. The controversies to discectomy for TMJ with pain and dysfunction have laid emphasis only upon clinical results, and then the histomorphological study was planned to evaluate the morphologic change of TMJ after discectomy. To clarify the nature of the change through an observation on the morphologic changes of articular cartilage and subchondral bone of the condyle resulting from experimental unilateral discectomy in rabbit, the author excised the left articular discs of 12 male rabbits(control 4 rabbits), weighing about 3kg, and at 1, 3, 6, 9 weeks following surgery, harvested both(left surgical site and right nonsurgical sits) TMJ. The specimens were examined with light microscope after H-E and MT stain and the obtained results were as follows. 1. Histopathological features showed thickening of articular zone and active proliferation of fibrocartilaginous zone associated with slight proliferative zone in surgical site than control group. Also replacement of chondrocytes in calcified cartilaginous zone into bone cells was observed. 2. There were thinning of thickness of each zone of articular cartilage except calcified cartilagnous zone was observed in nonsurgical site. 3. In MT stain of condylar trabeculae, there was increased calcification in nonsurgical site than control and surgical site and the degree of calcification was similar in surgical site and control group. 4. In both site of experimental group no features of degenerative changes were observed. From the above results, it is presumed that the morphologic changes of surgical site discectomy are compensatory remodeling process characterized by an hyperplastic reaction of the articular zone and fibrocartilaginous zone filling the void created by removing the disc, and the bone changes are secondary to changes in the cartilage. Increased degree of calcification seen in condylar trabeculae of nonsurgical site results from the excessive use of condyle of that site.

• Childhood Kidney Diseases
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• v.8 no.2
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• pp.149-158
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• 2004

Purpose : In order to evaluate the value of the renal expression of ICAM-1 as a marker of renal injury, we analyzed the relationship between abnormal tubular expression of ICAM-1 and histopathological features and clinical manifestations in children with IgA nephropathy (IgAN). Methods: The clinical data from 43 patients with IgAN were analyzed retrospectively and compared to the histopathologic subclassification proposed by Haas. ICAM-1 in tubular epithelium was assessed using the LSAB(Labeled streptavidine biotin) kit on the renal biopsy specimens. Results: In 43 patients with primary IgAN, 28 males and 15 females aged $12.2{\pm}2.2$ years were studied. There were no differences of renal tubular expression of ICAM-1 between patients with gross hematuria and without gross hematuria. But renal tubular expression of ICAM-1 in patients with proteinuria was significantly higher than that of in patients without proteinuria($78.2{\pm}14.19%\;vs\;55.8{\pm}32.20%,\;P<0.05$). Renal tubular expression of ICAM-1 was also associated with the severity of histopathological degree using Haas classification method. In subclass I, renal tubular expression of ICAM-1 was significantly lower than those of other subclasses. A significant correlation was found between the tubular expression of ICAM-1 and the total amount of protein in 24 hour collected urine$(r_s=0.47236,\;p<0.05)$. But there were no significant correlations between the renal tubular expression of ICAM-1 and interstitial cellular infiltration, tubular atrophy, and interstitial fibrosis respectively(F=0.89, P>0.05; F=0.31, p>0.05; F=0.21, p>0.05). Conclusion: Renal tubular expression of ICAM-1 can be a useful marker of renal injury in children with IgAN. (J Korean Soc Pediatr Nephrol 2004;8:149-158)

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2231-2235
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• 2013

Background: Categorizing breast tumors based on the ER, PR and HER/Neu 2 receptor status is necessary in order to predict outcome and assist in management of breast cancer. Herfe we assessed this question in South Indian patients. Materials and Methods: A total of 619 formalin fixed paraffin embedded breast tumor tissues were collected from pathology archives after receipt of ethical clearance. With the help of primary and secondary conjugated antibodies, expression status of ER, PR and HER2/neu was determined. All the experimental data were assessed for correlations with histopathological features of tumors and clinical presentation of the subjects. Results: In the present study, the ages ranged from 20-87 years with a mean of $50.0{\pm}12.q$ years, and majority of the tumors (84%) were of infiltrating duct cell carcinoma type. Assessment of ER, PR and Her-2/neu expression showed that 46% were triple negative. Interestingly, an inverse relation between ER, PR and HER-2/neu was apparent in 41.2% (p<0.0001) of the tumors, of which 24.5% (p<0.0001) were ER and PR co-negative but HER-2 positive. Conclusions: ER and PR positive tumors are less common (i.e<30%) compared to HER-2/neu positive tumors (i.e>50%) in Indian breast cancer patients, underlining the need for effective diagnostic screening and specific therapeutic managements in order to improve the survival rate of patients in low resource countries such as India.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.6813-6823
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• 2015

Glioblastoma, also known as glioblastoma multiforme (GBM), is the most aggressive of human brain tumors and has a stunning progression with a mean survival of one year from the date of diagnosis. High cell proliferation, angiogenesis and/or necrosis are histopathological features of this cancer, which has no efficient curative therapy. This aggressiveness is associated with particular heterogeneity of the tumor featuring multiple genetic and epigenetic alterations, but also with implications of aberrant signaling driven by growth factors. The transforming growth factor ${\beta}$ ($TGF{\beta}$) superfamily is a large group of structurally related proteins including $TGF{\beta}$ subfamily members Nodal, Activin, Lefty, bone morphogenetic proteins (BMPs) and growth and differentiation factor (GDF). It is involved in important biological functions including morphogenesis, embryonic development, adult stem cell differentiation, immune regulation, wound healing and inflammation. This superfamily is also considered to impact on cancer biology including that of GBM, with various effects depending on the member. The $TGF{\beta}$ subfamily, in particular, is overexpressed in some GBM types which exhibit aggressive phenotypes. This subfamily impairs anti-cancer immune responses in several ways, including immune cells inhibition and major histocompatibility (MHC) class I and II abolishment. It promotes GBM angiogenesis by inducing angiogenic factors such as vascular endothelial growth factor (VEGF), plasminogen activator inhibitor (PAI-I) and insulinlike growth factor-binding protein 7 (IGFBP7), contributes to GBM progression by inducing metalloproteinases (MMPs), "pro-neoplastic" integrins (${\alpha}v{\beta}3$, ${\alpha}5{\beta}1$) and GBM initiating cells (GICs) as well as inducing a GBM mesenchymal phenotype. Equally, Nodal promotes GICs, induces cancer metabolic switch and supports GBM cell proliferation, but is negatively regulated by Lefty. Activin promotes GBM cell proliferation while GDF yields immune-escape function. On the other hand, BMPs target GICS and induce differentiation and sensitivity to chemotherapy. This multifaceted involvement of this superfamily in GBM necessitates different strategies in anti-cancer therapy. While suppressing the $TGF{\beta}$ subfamily yields advantageous results, enhancing BMPs production is also beneficial.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.7077-7084
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• 2015

Background: Oral squamous cell carcinoma (OSCC) is the most prevalent malignancy among males in India. While tobacco and alcohol are main aetiological factors, human papilloma virus (HPV) presence has surprisingly increased in head and neck Squamous Cell Carcinoma (HNSCC) in the past two decade but its frequency in OSCCS is still uncertain. We aim to explore the frequency of HPV and its major genotypes in North Indian patients and their association with clinicopathological and histopathological features and p16 expression pattern. Materials and Methods: The study group comprised 250 histologically proven cases of OSCC. HPV was detected by real time PCR in tumor biopsy specimens and confirmed by conventional PCR with PGMY09/PGMY11 primers. Genotyping for high-risk types 16/18 was conducted by type specific PCR. p16 expression was assessed by immunohistochemsitry. Results: HPV presence was confirmed in 23/250 (9.2%) OSCC cases, of which 30.4% had HPV 16 infection, 17.4%were positive for HPV 18 and 26.1% had co-infections. HPV presence was significantly associated with male gender (p=0.02) and habit of pan masala chewing (p=0.01). HPV positive cases also had a history of tobacco consumption in 91.3% cases. p16 over expression was observed in 39.1% of HPV positive cases but this was not significantly different from negative cases (p=0.54). Conclusions: The frequency of HPV in OSCC is low in North-India and majority of cases are associated with a tobacco habit. It appears that tobacco shows a confounding effect in HPV positive cases and use of p16 protein as a reliable marker to assess the potential etiological role of HPV in OSCC in our population is not suggested.

• Toxicological Research
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• v.29 no.2
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• pp.91-98
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• 2013

Armeniacae semen (AS) has been considered a toxic herb in the Korean medicine as it contains hydrogen cyanide and amygdalin, especially in its endocarp. Therefore, prebrewed AS that is devoid of endocarp has been traditionally used. In the present study, amygdalin content of the prebrewed AS was significantly lower ($2.73{\pm}0.32{\mu}g/ml$; p<0.01) than the content in the extract that contained the endocarps ($28.50{\pm}6.71{\mu}g/ml$); amygdalin content corresponded to 10% of the extract in the present study. Because of single oral dose toxicity of prebrewed AS according to the recommendation of Korea Food and Drug Administration Guidelines (2009-116, 2009), which was based on single oral dose toxicity study of prebrewed AS, mortality due to toxic principles was significantly reduced. In this study, 2,000 mg/kg of prebrewed AS led to death of 1 female rat and 1 male rat at the end of 2 hr of administration. Based on these results, the 50% lethal dose in both male and female rats was determined to be 9279.5 mg/kg. Seizure, loss of locomotion, and increases in respiration and heart rate were observed as prebrewed AS treatment-related toxicological signs; these signs were restrictedly manifested in the prebrewed AS (2,000 mg/kg)-treated rats. In addition, no changes were observed in body weight, organ weight, gross features, and histopathological parameters with 2,000 mg/kg of AS in both male and female rats. These findings serve as direct evidence that amygdalin in AS is the toxic principle, which can be reduced by the traditional prebrewing method involving the exclusion of endocarp.

• Journal of Veterinary Clinics
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• v.28 no.4
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• pp.438-441
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• 2011

A 7-year-old castrated, domestic shorthair cat was presented with a 2-year history of chronic nasal discharge and sneezing. Upon presentation, bilateral mucopurulent nasal discharge and stertorous respiration were marked. Physical examination revealed a tachypnea. Oral examination was unremarkable and chest radiology was normal. Findings of nasal cytology and skull radiology were not specific and further imaging technique, endoscopic examination and histopathology was performed for a definite diagnosis. Fluid, and/or soft tissue opacity was found in bilateral nasal cavity, nasopharyngeal regions and right side tympanic bulla through the CT scan. No evidence of neoplasia was revealed. A rigid rhinoscopy, flexible bronchoscopy and otoscopy was used for the visualization of the lesions and tissue biopsy biopsy was performed for histopathology. On histopathological examination, the nasal mass consisted mainly of large numbers of plasma cells and lymphocytes. And the final diagnosis was lymphoplasmacytic rhinitis based on histopathologic examination. Long term management with oral cyclosporine (5 mg/kg, BID) was safe and successful in this cat. This is the first case report described clinical and diagnostic characteristic features of feline lymphoplasmacytic rhinitis and its clinical outcome using oral cyclosporine in Korea.