• Annals of Surgical Treatment and Research
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• v.95 no.5
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• pp.267-277
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• 2018

Purpose: The aim of this study was to analyze survival outcomes in 1,000 consecutive liver transplantations (LTs) performed at a single institution from 1993 to April 2017. Methods: The study population was divided into 2 groups based on donor type: deceased donor LT (DDLT; n = 181, 18.1%) and living donor LT (LDLT; n = 819; 81.9%), and into 3 periods based on the number of cases (first 300 cases, middle 300 cases, last 400 cases). Results: Infection was the most common cause of death, accounting for 34.8% (95 of 273). Mortality due to hepatocellular carcinoma recurrence occurred most frequently between 1 and 5 years after transplantation. Mortality rate by graft rejection was highest between 5 and 10 years after transplantation. And mortality by de novo malignancy occurred most frequently after 10 years after transplantation. The patient survival rates for the entire population at 5 and 10 years were 74.7%, and 68.6%, respectively. There was no difference in survival rate between the LDLT and DDLT groups (P = 0.188). Cause of disease, disease severity, case period, and retransplantation had a significant association with patient survival (P = 0.002, P = 0.031, P = 0.003, and P = 0.024, respectively). Conclusion: Surgical techniques and perioperative management for transplant patients have improved and undergone standardization. Controlling perioperative infection and managing patients with HCC as LT candidates will result in better outcomes.

• Journal of Chest Surgery
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• v.7 no.1
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• pp.47-60
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• 1974

During the past 10 years 114 patients with empyema have been treated in hospital of Chonnam University. There were 87 males and 27 females ranging from 20 days to 70 years of age. The etiology was pyogenic pneumonia in 36.7%, tuberculosis in 22.7%, paragonimiasis in 8.8%, post-thoracotomy in 5.4%, post-trauma in 4.4%, lung abscess in 3.5%, malignancy in 3.5%, post-esophageal operation in 1.8%, and sterile in 10.5%. The over-all mortality rate was 2% [3 patients]. The majority of deaths occurred in patients with associated systemic illness [liver cirrhosis in I, and renal tuberculosis in I] and resistant tuberculosis for anti-tuberculosis drugs in one patient. Adequate drainage and obliteration of the pleural space continues to be the most important aspect of treatment and can frequently be achieved by closed chest tube thoracostomy in acute empyema especially in children. The more chronic thick-walled or loculated cavities require open drainage [open window therapy], decortication, thoracoplasty, sterilization, and myoplasty for closure of tracheobronchial fistula.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6277-6283
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• 2012

Background: Northern Iran counts as one of the highest prevalence regions for esophageal cancer (EC) worldwide. This study was designed to assess the epidemiologic aspects of EC in north central and northwest Iran over a 10 year period. Materials and Methods: The Guilan cancer registry study (GCRS) is a population-based cancer registry study featuring retrospective (1996-2003) and prospective (2004-2005) phases. A detailed questionnaire based on WHO standards for cancer registratration was applied to gather the required information. Two trained physicians coded information using ICD-O-3 in close coordination with an expert pathologist. Results: A total of 19,936 cases of malignancy (mean age $55.4{\pm}18.0$ years, range: 1-98 years) were registered, including 1,147 cases (670 males, 447 female; mean age: $64.0{\pm}11.5$ years) of EC. In 1996 the male/female ratio among patients with EC was 1.25 which increased to 1.53 in 2005. The lower third of the esophagus still remained the most common site of tumors. The average age-standardized rate (ASR) was 6.9 and 4.1 per $10^5$ men and women, respectively. In 1996, the ASRs were 7.2 and 5.2 per $10^5$ men and women which decreased to 6.9 and 4.1 per $10^5$ in 2004-2005. Squamous cell carcinoma (SCC) was the most prevalent histological subtype of EC accounting over 80% of cases. Conclusions: However the prevalence of adenocarcinoma (ADC) showed an increase to 18.4%. Guilan province may be considered a relatively low incidence region for EC.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.5
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• pp.243-248
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• 2006

Purpose: Liver demonstrates heterogeneous FDG uptake and sometimes it shows abnormally increased uptake even though there is no malignant tissue. However, there was no previous study to correlate these various pattern of hepatic FDG uptake with benign liver disease. Therefore, we evaluated the significance of hepatic FDG uptake associated with various clinical factors including fatty liver, liver function tests and lipid profiles. Materials and Methods: We reviewed a total of 188 patients (male/female: 120/68, mean age: $50{\pm}9$) who underwent PET/CT for screening of malignancy. Patients with DM, impaired glucose tolerance, previous severe hepatic disease or long-term medication history were excluded. The FDG uptake in liver was analyzed semi-quantitatively using ROI on transaxial images (segment 8) and we compared mean standardized uptake value (SUV) between fatty liver and non-fatty liver group. We also evaluated the correlation between hepatic FDG uptake and various clinical factors including serum liver function test (ALT, AST), ${\gamma}-GT$, total cholesterol and triglyceride concentration. The effect of alcoholic history and body mass index on hepatic FDG uptake was analyzed within the fatty liver patients. Results: The hepatic FDG uptake of fatty liver group was significantly higher than that of non-fatty liver group. Serum total cholesterol and triglyceride concentration showed significant correlation with hepatic FDG uptake. However, there was no significant correlation between other factors (ALT, AST, and ${\gamma}-GT$) and FDG uptake. Also there was no difference of mean SUV between normal and abnormal groups on the basis of alcoholic history and body mass Index within fatty liver patients. Fatty liver and high serum triglyceride concentration were the independent factors affecting hepatic FDG uptake according to multivariate analysis. Conclusion: In conclusion, hepatic FDG uptake was strongly correlated with fatty liver and serum triglyceride concentration.

• Tuberculosis and Respiratory Diseases
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• v.51 no.5
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• pp.466-473
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• 2001

Pulmonary epithelioid hemangioendothelioma (PEH), originally termed an intravacular bronchioloalveolar tumor, is a rare pulmonary neoplasm with a vascular origin and slow rate of malignancy. It affects various organs such as the liver, the central nervous system, lung, etc. Clinically, pulmonary epithelioid hemangioendothelioma has been considered to be a borderline malignancy, a generally indolent and nonaggressive tumor that displaces the pulmonary parenchyma over a number of years by slowly enlarging the tumor nodule. The clinical course of PEH is known to be usually benign. Here we report an unusual case of PEH that was highly malignant and was eventually fatal. The PEH was confirmed by microscopic analysis and immunohistochemical staining of CD31+(a membrane receptor and a sensitive and specific marker for vascular lesions) from an open lung biopsy specimen.

• Journal of Gastric Cancer
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• v.9 no.2
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• pp.63-67
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• 2009

Splenic marginal zone lymphoma (SMZL) is a rare type of non-Hodgkin's lymphoma (NHL). We report here on a patient who displayed the synchronous occurrence of SMZL and early gastric cancer (EGC). The patient was a 74 year-old male with liver cirrhosis. An EGC in the gastric antrum was diagnosed and the preoperative abdomen computed tomography scan revealed splenomegaly and intra-abdominal lymphadenopathy. We performed subtotal gastrectomy and the postoperative pathologic examination revealed adenocarcinoma limited to the gastric mucosa and SMZL in the lymph nodes. The patient recovered from the surgery without complications and is now awaiting chemotherapy. SMZL has an indolent clinical course with good long-term survival and so there is the possibility of the occurrence of a second primary malignancy. Rare cases of a second primary malignancy being diagnosed along with SMZL have been described in the literature. Patients with SMZL should be carefully followed after treatment to detect the possible occurance of a second primary malignancy.

• The Korean Journal of Nuclear Medicine
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• v.15 no.2
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• pp.1-9
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• 1981

Bone scans with $^{99m}Tc-MDP$ (methylene diphosphonate) were obtained and analysed in 574 patients with biopsy-proven malignancy, who visited Seoul National University Hospital from April, 1979 to June, 1931. Clinical staging was done in all patients without bone scan information and compared with bone scan to determine the predictive value of bone scanning. 1. Primary site of the maligancies were lung in 152, breast in 97, stomach in 43, colon in 15, esophagus in 9, liver and pancreas in 11, kidney in 14, bladder in 27, prostate in 22, thyroid in 20, skin in 11, bone in 9, head and neck in 36, ovary and uterus in 17, hematopoietic and lymphoretic ular system in 33, nervous system in 10, and others in 9 cases. Primary site was not defined in 39 cases. 2. Bone scans were positive in 186 cases (32.4%), which, included 48 cases (31.6%) of lung cancer, 27 cases (27.8%) of breast cancer, 12 cases(28%) of stomach cancer, 6 cases(40%) of colon cancer, 6 cases(43%) of kidney tumor, 4 cases(15%) of bladder cancer, 14 cases(64%) of prostate cancer, 3 cases(15%) of thyroid cancer and 66 other cases. 3. Bone scans were suspicious in 64 cases (11.2%) which included 29 cases (19.1%) of lung cancer, 10 cases (10.3%) of breast cancer, 4 cases (9.3%) of stomach cancer, one case (7%) of colon cancer, 3 cases(11%) of bladder cancer, 2 cases(10%) of thyroid cancer and 15 other cases. 4. Out of 121 cases with early stage of malignancy (which included 20 cases of lung cancer in stage I, II, 38 cases of breast cancer, 13 cases of stomach cancer, 8 cases of kidney tumor, 14 cases of thyroid cancer in stage $I{\sim}III$, and 6 cases of colon cancer, 14 cases of bladder cancer, 8 cases of prostate cancer in stage $A{\sim}C$, bone scans were positive in 5 cases (4.1%) which included 3 cases of lung cancer one case of breast cancer and one case of prostate cancer, and considered as further advanced stage. Out of 121 cases with early stage of malgnancy, bone scans were suspicious in 21 cases (17.4%) which inlcuded 9 cases of lung cancer, 4 cases of breast cancer, 2 cases of stomach cancer, one case of colon cancer, 3 cases of bladder cancer, and 2 cases of thyroid cancer. From these results, we concluded bone scan was useful in detecting bone metastasis in patients of early stage of malignancy, determining prognosis and establishing therapentic plan.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.316-325
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• 1988

Author made a clinical study of 248 cases of pleural effusion patients who were diagnosed and treated at departments of chest surgery and internal medicine, Pusan National University Hospital, during the period from Jan. 1983 to Dec. 1985. The age distribution ranged from 1 to 76 years old and the ratio of male to female was 1.38:1. The cardinal symptoms were chest pain[69.4%], dyspnea[66.1%], cough[57.7%], fever[37.1%], sputum[26.2%], general malais[13.7%] and cyanosis[1.6%] in this order. The causes of pleural effusion were pulmonary tuberculosis[42.4%], pneumonia[23.0%], malignancy[16.5%], congestive heart failure[9.3%], liver cirrhosis[2.8%] and nephrosis[2.0%] in this order. The protein in the pleural effusions was 1.61*0.90[mean*SD] gm% in transudate and 5.05*1.10[Mean*SD] gm% in exudate. In 34 cases[89.5%]out of 38 transudates, the protein was under 3 gm% and in 201 cases [95.7%] out of 210 exudates, the protein was over 3 gm%. The protein ratio of pleural effusion to serum was 0.2650.11[Mean LSD] in transudates and 0.73*0.12[Mean LSD] in exudate. The ratio under 0.5 was in 36 cases[94.8%] out of 38 transudates and over 0.5 was in 206 cases[98.1%] out of 210 exudates. The LDH in the pleural effusion was 114.7550.3[mean*SD] units / ml in transudate and 627.05325.9[mean*SD] units / ml in exudate. The LDH less than 200 units / ml was in 36 cases[94.6%] out of 38 transudates and more than 200 units / ml was in 199 cases[94.7%] out of 210 exudates. The LDH ratio of pleural effusion to serum was 0.34k 0.11[mean*SD] in transudate and 1.15*1.12[mean*SD] in exudate. The LDH ratio of pleural effusion to serum was less than 0.6 in 36 cases[94.8%]out of 38 transudates and more than 0.6 in 200 cases[95.2%] out of 210 exudates. Etiologic organisms were confirmed in 78 cases[48.1%] among the requested 162 cases. In the 78 cases of etiologic organisms, staphylococcus was 33 cases[20.3%], streptococcus 24 cases[14.8%], Klebsiella pneumonia 7 cases[4.3%], pseudomonas 6 cases[3.7%], E. coli[3.1%], enterobacter 3 cases[1.9%]. 43 patient of pleural effusion from malignancy were undergone three or more thoracenteses. In 13 cases[31.7%], three specimen were negative and in 7 cases[17.1%], three specimens were positive for malignancy. In the remaining of 21 cases[51.2%], malignant cells were found in one or more of the specimens but not in all. Methods of treatment of pleural effusion by closed thoracotomy was 188 cases[75.8%], thoracentesis 27 cases[10.9%], decortication 16 cases[6.5%], thoracoplasty 6 cases[2.4%] and decortication with thoracoplasty 3 cases[1.2%].

• Journal of Microbiology and Biotechnology
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• v.29 no.8
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• pp.1281-1287
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• 2019

Nattokinase (NK, E.C. 3.4.21.62) is a serine protease produced by Bacillus subtilis natto that shows promise for the treatment of thrombotic disease. In this study, we assessed the effects of NK on the development of hepatocellular carcinoma (HCC), a principal malignancy of the liver that causes morbidity and mortality worldwide. Crude extracts of NK (NCE) were isolated from fermentation medium by centrifugation and separated into three fractions (<10 K, 100~30 K and >30K). Orthotopic HCC mouse models were established and NCE was administered by oral gavage. H&E staining was performed to examine the pathology of HCC livers. Immunohistochemistry and immunofluorescence were used to evaluate FOXM1, CD31, CD44 and vimentin expression in the liver. Compared to PBS groups, NCE increased the survival rates of HCC-bearing mice to 31% and decreased ascites. Low-intensity ultrasound imaging showed that the hypoechoic mass area was lower in NCE-treated mice and that tumor growth significantly decreased. IHC staining showed that the expression of FOXM1 was inhibited by NCE treatment. Immunofluorescence results revealed lower levels of CD31, CD44 and vimentin in the NCE groups. Taken together, these data demonstrate that NCE from Bacillus subtilis natto improves survival and inhibits tumor growth in HCC mice.

• Radiation Oncology Journal
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• v.3 no.2
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• pp.163-168
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• 1985

Intraocular melanoma is the most common primary occular malignancy in adult above the age of 20. Before treatment of intraocular melanoma, it is essential to do complete work-ups including LFT (LDH, SGPT), chest X-ray, whole body bone scan. Also, liver-spleen and brain scan will be done if clinically indicated. Though, malignant melanoma is radioresistant, however, show rapid tumor shrinkage after irradiation with total tumor dose of 7,000 to 8,000 rads in 7-8 weeks.