Purpose: The aim of this study was to evaluate the significance of pH monitoring at two levels, hypopharynx and esophagus in gastroesophageal reflux. Methods: 29 patients with pathological gastroesophageal reflux were classified into two groups: Group I had recurrent respiratory symptoms and Group II had not recurrent respiratory symptoms. The ambulatory pH monitoring was performed at the hypopharynx and the esophagus simultaneously with two channel catheter for 18~24 hr. The pathological reflux was defined when the percent of time that pH was below 4.0 exceeding the 95th percentile of normal value. Hypopharyngeal reflux was defined as the pharyngeal pH drops below 4. Results: 39 patients were performed pH monitoring at the level of hypopharynx and esophagus for 24 hours. Among 7 patients with chronic respiratory symptom, 6 patients (85.7%) have pathological esophageal reflux. Among 32 patients without chronic respiratory symptom, 23 patients (71.8%) have pathological esophageal reflux. Thus 29 out of 39 patients (74%) have pathological esophageal reflux. In the Group I, all parameters except the longest episode showed significant differences between hypopharyngeal and esophageal pH monitoring. None of parameters showed significant differences between group I and II in the pharyngeal pH monitoring. Conclusion: Regardless of presence of respiratory symptoms, the pH monitoring at the pharyngeal level in patients with gastroesophageal reflux did not showed any differences compared with the esophageal pH monitoring. Therefore we may reconsider the usefulness of hypopharyngeal pH monitoring in patients with chronic respiratory symptoms.
Hyun Soo Ahn;Yeong Yi An;Ye Won Jeon;Young Jin Suh;Hyun-Joo Choi
Journal of the Korean Society of Radiology
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v.82
no.3
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pp.654-669
/
2021
Purpose To evaluate the accuracy of MRI in predicting the pathological complete response (pCR) and the residual tumor size of breast cancer after neoadjucant chemotherapy (NAC), and to determine the factors affecting the accuarcy. Materials and Methods Eighty-eight breast cancer patients who underwent surgery after NAC at our center between 2010 and 2017 were included in this study. pCR was defined as the absence of invasive cancer on pathological evaluation. The maximum diameter of the residual tumor on post-NAC MRI was compared with the tumor size of the surgical specimen measured pathologically. Statistical analysis was performed to elucidate the factors affecting pCR and the residual tumor size-discrepancy between the MRI and the pathological measurements. Results The pCR rate was 10%. The diagnostic accuracy of MRI and the area under the curve for predicting pCR were 90.91% and 0.8017, respectively. The residual tumor sizes obtained using MRI and pathological measurements showed a strong correlation (r = 0.9, p < 0.001), especially in patients with a single mass lesion (p = 0.047). The size discrepancy between MRI and the pathological measurements was significantly greater in patients with the luminal type (p = 0.023) and multifocal tumors/non-mass enhancement on pre-NAC MRI (p = 0.047). Conclusion MRI is an accurate tool for evaluating pCR and residual tumor size in breast cancer patients who receive NAC. Tumor subtype and initial MRI features affect the accuracy of MRI.
Metosonimus yokosawai was found deeply invaded into the submucosa of the small intestine of mice (ICR) when they were immunosuppressed by prednisolone injection. Experimental groups consisted of control, fluke infection (1,800 metacercariae per mouse) and fluke infection plus immunosuppression. In fluke infection group, many worms were found sectioned in the intervillous space of the jejunum and ileum at 6 hrs, 12 hrs, and 1 day after infection, and pathological changes characterized by villous atrophy and crypt hyperplasia were observed. After 3 days, only a few worms were found in intestinal sections, and after 7 days, the pathological changes became minimal. No worm was found penetrated beyond the mucosal layer. On the other hand, in immunosuppressed mice, numerous worms were found sectioned in the duodenum and jejunum, irrespective of the infection period up to 14 days. Pathological changes of the mucosa were minimal until 3 days after infection, but at 5 days marked destruction of the mucosal layer was observed. At this time many flukes were found invaded deeply into the submucosa facing the muscular layer. Despite continuous immunosuppression, the mucosal damage was gradually recovered at 7-21 days post-infection. The results showed that immunosuppression of ICR mice can induce, for a short perid of time, severe mucosal damage, and allow deep invasion of M. yokogcuwai into the submucosa of the small intestine.
Introduction and Purpose: The frequency of bilateral breast cancer is 1.4-11.0% among all breast cancers. It can present as synchronous (SC) or metachronous (MC). Data regarding clinical course of bilateral breast cancer are scarce. In this study, we therefore evaluated demographic, pathological and clinical characteristics, treatments and responses in bilateral breast cancer cases; making distinctions between metachronous-synchronous and comparing with historic one-sided data for the same parameters. Materials and Methods: One hundred fifty bilateral breast cancer cases from ten different centers between 2000 and 2011 were retrospectively scanned. Age of the cases, family history, menopausal status, pathological features, pathological stages, neoadjuvant, surgery, adjuvant and palliative chemotherapy/radiotherapy were examined in the context of the first and second occurrence and discussed with reference to the literature. Results: Metachronous and synchronous groups showed similar age, menopausal status, tumor type, HER2/neu expression; the family history tumor grade, tumor stage, ER-negativity rate, local and distant metastases rates, surgery, adjuvant chemotherapy application rates were identified as significantly different. Palliative chemotherapy response rate was greater in the metachronous group but median PFS rates did not differ between the groups. Conclusion: Although bilateral breast cancer is not frequent, MC breast cancer is different from SC breast cancer by having more advanced grade, stage, less ER expression, more frequent rates of local relapse and distant metastasis and better response to chemotherapy in case of relapse/metastasis.
Lee, Wei Ching;Yusof, Mastura Md.;Lau, Fen Nee;Ee Phua, Vincent Chee
Asian Pacific Journal of Cancer Prevention
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v.14
no.6
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pp.3941-3944
/
2013
Background: The use of preoperative chemoirradiation is the commonest treatment strategy employed in Malaysia for locally advanced rectal cancer. We need to determine the local control and survival rates for comparison with established rates in the literature. Materials and Methods: This retrospective study analyzed all newly diagnosed patients with rectal adenocarcinoma who underwent long course preoperative radiotherapy (RT) at the Department of Radiotherapy and Oncology, Kuala Lumpur Hospital (HKL) between $1^{st}$ January 2004 and $31^{st}$ December 2010. The aim of the study was to determine the radiological response post radiotherapy, pathological response including circumferential resection margin (CRM) status, 3 years local control, 3 years overall survival (OS) and 3 years disease free survival (DFS). Statistical analysis was performed using the SPSS software. Kaplan-Meier and log rank analysis were used to determine survival outcomes. Results: A total of 507 patients with rectal cancer underwent RT at HKL. Sixty seven who underwent long course preoperative RT were eligible for this study. The median age at diagnosis was 60 years old with a range of 26-78 years. The median tumour location was 6 cm from the anal verge. Most patients had suspicion of mesorectum involvement (95.5%) while 28.4% of patients had enlarged pelvic nodes on staging CT scan. All patients underwent preoperative chemo-irradiation except for five who had preoperative RT alone. Only 38 patients underwent definitive surgery (56.7%). Five patients were deemed to be inoperable radiologically and 3 patients were found to have unresectable disease intraoperatively. The remaining 21 patients defaulted surgery (31.3%). The median time from completion of RT to surgery was 8 weeks (range 5.6 to 29.4 weeks). Fifteen patients (39.5%) had surgery more than 8 weeks after completion of RT. Complete pathological response was noted in 4 patients (10.5%). The pathological CRM positive rate after RT was 18.4%. With a median follow-up of 38.8 months, the 3 year local control rate was 67%. The 3 years rate for CRM positive (<2 mm), CRM clear (>2 mm) and pCR groups were 0%, 88.1% and 100% respectively (p-value of 0.007). The 3 year OS and DFS were 57.3% and 44.8% respectively. Conclusions: In conclusion, the approach of long course preoperative chemoirradiation for rectal cancer needs to be re-examined in our local setting. The high rate of local recurrence is worrying and is mainly due to patient defaulting post-preoperative chemoirradiation or delayed definitive surgery.
Lee Hak-Cheol;Ham Tai-Soo;Chung Yoo-Yeol;Cho Seong-Lyong;Lee Jag-Hyeon
Journal of Veterinary Clinics
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v.6
no.2
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pp.307-318
/
1989
In recent years much attention has been paid to swine respiratory infection caused by Pasteurella(P) multocida with rapid expansion of pork Industry in Korea. The present study was performed to observe the etiologic situation of P. multocida infection by bacteriological, serological(serotyping) and pathological examinations with the lungs respectively. In addition antibiotic susceptibility test was carried out against the isolated strains of P. multocida. The results obtained are as follows : 1. Eighteen strains(12.8%) wert isolated from the 140 cases of swine lungs examined, and biological and biochemical characteristics of the isolates were the sam as those in the references of other workers, whereas some differences were observed in sugar fermentation and enzyme activity according to the strain of isolates. 2. Capsular serotyping performed on 18 P. multocida revealed that 13 strains(72.2%) were A type and 5 strains(27.8%) were D type, respectively. 3. When serotyping was performed against somatic antigen on 18 strains capsular types of which were identified as described above 9(50%), 3(16.7%) and 4(22.2%) strains belong to 1:A, 3:A and 2:D, respectively, but untypable 2 strains(11.1%) were observed. 4. Antibiotic susceptibility test by employing disc method for 24 kinds of drugs revealed that 15 kinds of antibiotics were sensitive to 18 strains of P. multocida isolated such as ampicillin(l00%), penicillin(100%), cloxacillin(56%), piperacillin(70%), cefotaxime(30%), minocycline(60%), chloramphenicol(95%), erythromycin(39%), kanamycin(17%), gentamicin(70%), amikasin(30%), colistin(78%) and nalidixic acid(5%), respectively, but resistant to 9 kinds of antibiotics such as sulpenicillin, cefazolin, cephalothin, cefametazol, cefoperazone, kitasamycin, oleandomycin. lincomycin and bacitracin. 5. Pathological features of 60 cases of swine lungs indicated that pneumonic .lesions were observed in 38 cases(63.3%) examined by macroscopic finding, in which lesions of 8 cases(13.4%) would correspond to those of mycoplasmal infection, and 30 cases(50%) were similar to viral infection by histopathological finding, whereas 22 cases(36.7%) were considered to be normal by ecropsy or histopathological finding.
A bone marrow biopsy that has undergone decalcification with 10% nitric acid could not be used for various pathological tests and had extremely limited reproducibility. The fixing solution of each experimental group was differentiated in usage, one solution including acid and the other not. The use of the decalcification solution was separated into either acidic or alkaline (EDTA), and further experiments were conducted with differing time phases. When using a fixing solution and decalcification solution which included acid, the specimens were faulty to the extent that all pathological tests were impossible. However specimens that were processed with an EDTA type decalcification solution did not display a non-specific reaction in EBV ISH and were even able to produce results that were at a level suited to various studies or a pathological diagnosis in the FISH, DNA, RNA tests. By improving the fixing and decalcification of bone marrow biopsy, the study was able to make possible ISH, FISH, DNA tests as well as RNA study, and secured the sensitivity, specificity, and reproducibility of various test methods. The stabilization of various test methods that use bone marrow biopsy contributes to the diagnosis, prognosis, prediction, treatment of the patient and provide guidelines for decision-making.
Ko, Sang Yoon;Lee, Hyung Eun;Park, Se Jin;Jeon, Se Jin;Kim, Boseong;Gao, Qingtao;Jang, Dae Sik;Ryu, Jong Hoon
Biomolecules & Therapeutics
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v.23
no.2
/
pp.156-164
/
2015
Alzheimer's disease (AD) is a neurodegenerative disorder associated with progressive memory loss and neuronal cell death. Although numerous previous studies have been focused on disease progression or reverse pathological symptoms, therapeutic strategies for AD are limited. Alternatively, the identification of traditional herbal medicines or their active compounds has received much attention. The aims of the present study were to characterize the ameliorating effects of spinosin, a C-glucosylflavone isolated from Zizyphus jujuba var. spinosa, on memory impairment or the pathological changes induced through amyloid-${\beta}_{1-42}$ oligomer ($A{\beta}O$) in mice. Memory impairment was induced by intracerebroventricular injection of $A{\beta}O$ ($50{\mu}M$) and spinosin (5, 10, and 20 mg/kg) was administered for 7 days. In the behavioral tasks, the subchronic administration of spinosin (20 mg/kg, p.o.) significantly ameliorated $A{\beta}O$-induced cognitive impairment in the passive avoidance task or the Y-maze task. To identify the effects of spinosin on the pathological changes induced through $A{\beta}O$, immunohistochemistry and Western blot analyses were performed. Spinosin treatment also reduced the number of activated microglia and astrocytes observed after $A{\beta}O$ injection. In addition, spinosin rescued the $A{\beta}O$-induced decrease in choline acetyltransferase expression levels. These results suggest that spinosin ameliorated memory impairment induced through $A{\beta}O$, and these effects were regulated, in part, through neuroprotective activity via the anti-inflammatory effects of spinosin. Therefore, spinosin might be a useful agent against the amyloid ${\beta}$ protein-induced cognitive dysfunction observed in AD patients.
Jeong, Seok Hun;An, Yoonsuk;Choi, Ji-Yeob;Park, Boyoung;Kang, Daehee;Lee, Min Hyuk;Han, Wonshik;Noh, Dong-Young;Yoo, Keun-Young;Park, Sue K.
Journal of Preventive Medicine and Public Health
/
v.50
no.6
/
pp.401-410
/
2017
Objectives: The purpose of this study was to examine the associations of childbirth, breastfeeding, and their interaction with breast cancer (BC) risk reduction, and to evaluate the heterogeneity in the BC risk reduction effects of these factors by menopause, hormone receptor (HR) status, and pathological subtype. Methods: BC patients aged 40+ from the Korean Breast Cancer Registry in 2004-2012 and controls from the Health Examinee cohort participants were included in this study after 1:1 matching (12 889 pairs) by age and enrollment year. BC risk according to childbirth, breast-feeding, and their interaction was calculated in logistic regression models using odds ratios (ORs) and 95% confidence intervals (CIs). Results: BC risk decreased with childbirth (3+ childbirths relative to 1 childbirth: OR, 0.66; 95% CI, 0.56 to 0.78 and OR, 0.80; 95% CI, 0.68 to 0.95 in postmenopausal and premenopausal women, respectively); and the degree of risk reduction by the number of children was heterogeneous according to menopausal status (p-heterogeneity=0.04), HR status (p-heterogeneity<0.001), and pathological subtype (p-heterogeneity<0.001); whereas breastfeeding for 1-12 months showed a heterogeneous association with BC risk according to menopausal status, with risk reduction only in premenopausal women (p-heterogeneity<0.05). The combination of 2 more childbirths and breastfeeding for ${\geq}13$ months had a much stronger BC risk reduction of 49% (OR, 0.51; 95% CI, 0.45 to 0.58). Conclusions: This study suggests that the combination of longer breastfeeding and more childbirths reduces BC risk more strongly, and that women who experience both 2 or more childbirths and breastfeed for ${\geq}13$ months can reduce their BC risk by about 50%.
Objective: To study the relationship between clinical pathologic characteristics, treatment modalities and prognostic factors in HER-2 (Human Epidermal growth factor Receptor-2) overexpressed breast carcinoma. Materials and Methods: Major clinico-pathological factors including therapeutic modalities and survival status of 371 breast cancer patients with HER2 over-expression, teated at Yantai Yuhuangding Hospital from March of 2002 to December of 2010 were retrospectively studied, with special attention focused on survival-related factors. Results: The median age of the total 371 patients in this study was 48 years at time of diagnosis, among which, the leading pathological type was infiltrating ductal carcinoma (92.5%); 62.8% presented with a primary tomor larger than 2 cm in diameter at diagnosis, 51.0% had axillary lymph node (ALN) metastases; ER (Estrogen receptor)/PR (Progesterone receptor) double negative occured in 52.8% of cases, and PCNA (proliferation cell nuclear antigen) (+++) was found in 55.1%. HER-2 overexpressed patients were usually in advanced stage when the diagnosis was made (72.8% at stages IIA~IIIC). The prognosis and survival were assessed in 259 patients with complete follow-up data. 5-year DFS (disease-free survival) and OS (overall survival) rate was 68.0% and 78.0% respectively. Univariate analysis revealed that age, tumor size, ALN metastases, LVSI (lymph-vascular space involvement), PCNA status, hormonal therapy, chemotherapy cycles, and HER-2 overexpression, correlated closely with the prognosis. ALN metastases, LVSI, PCNA status and chemotherapy cycles were independent predictors of survival. Conclusions: HER-2 overexpressed breast cancer has special clinical and pathological characteristics, with advanced clinical stages and high rate of ER/PR double negative. Lymph node metastases, LVSI, PCNA and chemotherapy cycles are independent predictors of prognosis.
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