• Genomics & Informatics
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• v.17 no.3
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• pp.30.1-30.4
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• 2019

Neuroblastoma is a major cause of cancer death in early childhood, and its timely and correct diagnosis is critical. Gene expression datasets have recently been considered as a powerful tool for cancer diagnosis and subtype classification. However, no attempts have yet been made to apply deep learning using gene expression to neuroblastoma classification, although deep learning has been applied to cancer diagnosis using image data. Taking the International Neuroblastoma Staging System stages as multiple classes, we designed a deep neural network using the gene expression patterns and stages of neuroblastoma patients. Despite a small patient population (n = 280), stage 1 and 4 patients were well distinguished. If it is possible to replicate this approach in a larger population, deep learning could play an important role in neuroblastoma staging.

• Journal of Chest Surgery
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• v.33 no.3
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• pp.240-244
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• 2000

Background: Neuroblastoma is the third most common malignancy of chidhood, and is the most common mediastinal mass in children under the age of 2 years. However, the results of surgical treatment have been seldomly reported in Korea. Therefore, we analyzed the results of surgical treatment in children with neuroblastoma and its influencing factors. Material and Method: We studied the clinical characteristics and prognosis of 12 children, 11 makes and 1 female, whose primary thoracic neurobalstomas or ganglioneuroblastomas were diagnosed and operated between 1977 and 1997. Men age at presentation was 29.9 months. Result: Respiratory symptoms were the modes of performed in 9 patients. Complete excision, partial excision, and biopsy only were performed in 9, 2, and 1 patients respectively. Ten patients of thoractic neuroblastomas survived (83.3%) during follow-up period. Conclusion: The postoperatve 5-year survival of thoracic neuroblastoma was 76.4% and the prognosis was related to the stage of neuroblastoma. We suggest that complete resection should be considered as preferential method in the treatment of thoracic neuroblastoma in children, especially with early stage.

• Advances in pediatric surgery
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• v.6 no.2
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• pp.156-159
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• 2000

Neuroblastoma arises from the embryonic tissue of the adrenergic rest. It is commonly found in children and mostly in nonrenal tissue. We present a case of intrarenal neuroblastoma which was initially thought to be a Wilms' tumor. The patient was a 18 months-old girl treated with radical nephrectomy and adjuvant chemotherapy after operation. The neoplasm within the kidney in children cannot always indicate Wilms' tumor. Neuroblastoma of the adrenal gland or retroperitoneal tissue may often compress or invade the kidney directly or arise from the kidney. Clinical aspects that differentiate between neuroblastoma and Wilms' tumor are discussed with a review of the literatures.

• Nutrition Research and Practice
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• v.4 no.4
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• pp.276-282
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• 2010

The principal objective of this study was to evaluate the chemopreventive and therapeutic effects of a combination of all-trans-retinoic acid (RA) and knockdown of delta-like 1 homologue (Drosophila) (DLK1) on neuroblastoma, the most common malignant disease in children. As unfavorable neuroblastoma is poorly differentiated, neuroblastoma cell was induced differentiation by RA or DLK1 knockdown. Neuroblastoma cells showed elongated neurite growth, a hallmark of neuronal differentiation at various doses of RA, as well as by DLK1 knockdown. In order to determine whether or not a combination of RA and DLK1 knockdown exerts a greater chemotherapeutic effect on neuroblastoma, cells were incubated at 10 nM RA after being transfected with SiRNA-DLK1. Neuronal differentiation was increased more by a combination of RA and DLK1 knockdown than by single treatment. Additionally, in order to assess the signal pathway of neuroblastoma differentiation induced by RA and DLK1 knockdown, treatment with the specific MEK/ERK inhibitors, U0126 and PD 98059, was applied to differentiated neuroblastoma cells. Differentiation induced by RA and DLK1 knockdown increased ERK phosphorylation. The MEK/ERK inhibitor U0126 completely inhibited neuronal differentiation induced by both RA and DLK1 knockdown, whereas PD98059 partially blocked neuronal differentiation. After the withdrawal of inhibitors, cellular differentiation was fully recovered. This study is, to the best of our knowledge, the first to demonstrate that the specific inhibitors of the MEK/ERK pathway, U0126 and PD98059, exert differential effects on the ERK phosphorylation induced by RA or DLK1 knockdown. Based on the observations of this study, it can be concluded that a combination of RA and DLK1 knockdown increases neuronal differentiation for the control of the malignant growth of human neuroblastomas, and also that both MEK1 and MEK2 are required for the differentiation induced by RA and DLK1 knockdown.

• Advances in pediatric surgery
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• v.1 no.1
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• pp.95-99
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• 1995

Neuroblastoma is the most common solid malignancy in childhood. However, a neuroblastoma presenting as bilateral and multifocal is very rare. A male newborn weighing 2.7 kg was born by normal vaginal delivery at 39 weeks' gestation to a 27-year-old mother who had a normal pregnancy. He was in good condition at birth but presented palpable masses in the both upper abdomen and both side of the neck. Ultrasound examination showed the lesions to be $3{\times}3cm$ sized calcified mass in right suprarenal area and $5{\times}3cm$ sized homogenous mass in left suprarenal area. The abdominal mass was also examined by computed tomography with similar findings. With the impression of bilateral neuroblastoma or metastatic spread, the laparotomy was performed on the 13th day of life. Frozen section of biopsy of the left neck mass was obtained, which showed neuroblastoma. Intraoperative findings revealed bilateral adrenal masses which were distinct and anatomically separate. Bilateral adrenalectomy was accomplished and the initial postoperative course was uneventful. The patient was discharged for hopeless and expired at age 45 days. We present bilateral adrenal neuroblastoma considered to be simultaneous occurrence rather than metastases from one site to another.

• Journal of Korean Neurosurgical Society
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• v.57 no.3
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• pp.147-151
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• 2015

Objective : Neuroblastoma is one of common childhood tumors. Although its mortality is very high, there is no effective treatment yet. The aim of this project is to evaluate cytotoxic effects of melatonin (MLT) an endogen hormone and 13-cis retinoic acid (13-cis-RA) also named as isotretinoin an analogue of vitamin A on neuroblastoma SH-SY5Y cell line. Methods : In this study, SH-SY5Y cell line was used. After cell culture, the cells were exposed to different doses of MLT and 13-cis-RA. 24 and 48 hours later. While the viabilities was estimated with MTT cell viability assay test, apoptotic indexes were calculated after staining with TUNEL based apoptosis kit. Results : It was observed that MLT has very effective cytotoxic potential than 13-cis-RA on neuroblastoma cell line. At the same time, when MLT and 13-cis-RA were combined, this effect was potentiated. On the other hand, it was found that the effect of 13-cis-RA individually on neuroblastoma cells was very slight. Conclusion : We suggest that in the treatment of patient with neuroblastoma, MLT is very effective and also this effect can be augmented by combination with 13-cis-RA.

• Advances in pediatric surgery
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• v.11 no.2
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• pp.99-106
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• 2005

Neuroblastoma treatment remains challenging, but treatment has become more effective due to the establishment of clinical and biological variables that determine prognostic risks. Initially, stage and age were the prime determinants of survival used in clinical practice. Risk-based therapy currently is the hallmark of neuroblastoma treatment. This study reviews one center's experience with the management of neuroblastoma. Sixty-three patients with neuroblastoma were treated from 1989 to 2003. All patients were graded according to the International Neuroblastoma Staging System (INSS) at diagnosis. There were 37 boys and 26 girls. The median age was 2.14 years (range, 33 days-10.2years). The primary site was the adrenal gland in 47, dumbbell shape extending into spinal canal in 6, retroperitoneum in 5, mediastinum in 3, and other sites in 2. The probability of 5-year overall survival (OS) and event free survival (EFS) were 46.7 % and 44.2 % by Kaplan-Meier method. According to INSS, there were stage 1 in 2 cases, stage 2 in 5, stage 3 in 12, stage 4 in 42, and stage 4s in 2. There were statistically significant differences in the survival rates between patients with stage1, 2 and stage 3, 4(P<0.05). For the stage 3 and 4, the extents of surgical resection, determined from the operative records and pathologies, were complete resection in 17 cases, minimal residual in 15, and partial resection 11, and the 5-year OS rate was 57.8, 51.4, and 13.6 %, respectively. There is a trend toward higher OS with more complete resection (P<0.05). We conclude that age and stage at diagnosis are prognostic factors, and complete excision of the primary tumor can provide better prognosis for patients with stage 3 and 4 neuroblastoma.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.sup1
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• pp.134-136
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• 2008

Neuroblastoma is the most common extracranial solid tumor in children. In diagnostic assessment of neuroblastoma, $^{18}F-FDG$ PET has been reported to have high diagnostic performance, especially, very high sensitivity in staging, restaging, and assessment of therapeutic efficacy. In comparison with conventional diagnostic imaging modalities including a, bone scan, and MIBG scan, $^{18}F-FDG$ PET showed better diagnostic performance. According to clinical research data hitherto, $^{18}F-FDG$ PET is expected to be an effective diagnostic tool in the management of neuroblastoma.

• Advances in pediatric surgery
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• v.14 no.1
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• pp.75-82
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• 2008

Neuroblastoma arises from the primitive neural crest cells, and is a common malignancy in childhood. The clinical features are characterized by biological heterogeneity. Neuronal degeneration and differentiation occur in some patients. However treatment in the high risk group accounting for approximately half, has not been satisfactory despite a multimodal approach. Therefore, effective treatment is determined by the risk group of prognostic factors, such as age at diagnosis, stage of disease, pathological finding and N-myc amplification. Neuroblastoma can be diagnosed prenatally, which suggests its origin during the normal embryogenesis. Recent knowledge of molecular biology, such as Trk genes, and the concept of cancer stem cells have given us some improved understanding on this disease. Currently, targeted therapies based on the molecular biology of neuroblastoma are under investigation and increasing survival rate and decreasing late complications could be appreciated.

• Clinical and Experimental Pediatrics
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• v.51 no.2
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• pp.214-218
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• 2008

Neuroblastoma is one of the most common extracranial solid tumor of childhood, and treatment of refractory neuroblastoma remains a significant clinical problem. Iodine-131-metaiodobenzylguanidine ($^{131}I-MIBG$) therapy is an alternative approach to treat stage IV neuroblastoma. We report the palliative effect of $^{131}I-MIBG$ in three cases of relapsed neuroblastoma after autologous peripheral blood stem cell transplantation. $^{131}I-MIBG$ is an effective and relatively nontoxic palliative therapy resulting in reduction of pain and prolongation of survival.