• Annals of Coloproctology
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• v.34 no.6
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• pp.286-291
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• 2018

Purpose: Stage-IIIC colon cancer is an advanced disease; however, its oncologic outcomes and prognostic factors remain unclear. In this study, we aimed to determine the predictors of disease-free survival (DFS) in patients with stage-IIIC colon cancer. Methods: From a multicenter database, we retrospectively enrolled 611 patients (355 men and 256 women) who had undergone a potentially curative resection for a stage-IIIC colon adenocarcinoma between 2003 and 2011. The primary endpoint was the 5-year DFS. Results: The median age was 62 years; 213 and 398 patients had right-sided colon cancer (RCC) and left-sided colon cancer (LCC), respectively. The 5-year DFS in all patients was 52.0%; median follow-up time was 35 months (range, 1-134 months). A multivariate Cox regression revealed that female sex (hazard ratio [HR], 1.50; 95% confidence interval [CI], 1.19-1.90; P < 0.01), right-sided tumor location (HR, 1.65; 95% CI, 1.29-2.11; P < 0.01), lymphatic invasion (HR, 1.52; 95% CI, 1.08-2.15; P < 0.01) and a high (${\geq}0.4$) metastatic lymph node ratio (HR, 3.72; 95% CI, 2.63-5.24; P < 0.01) were independent predictors of worse 5-year DFS. Female patients with RCC were 1.79 fold more likely to experience recurrence than male patients with LCC. Conclusion: Female sex and right-sided tumor location are associated with higher tumor recurrence rates in patients with stage-IIIC colon cancers. Aggressive treatment and close surveillance should be planned for patients in these groups.

• Annals of Surgical Treatment and Research
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• v.95 no.5
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• pp.286-296
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• 2018

Purpose: Sentinel lymph node (SLN) biopsy (SLNB) is widely accepted for staging of melanoma patients. It has been shown that clinico-pathological features such as Breslow thickness, ulceration, age, and sex are better predictors of relapse and survival than SLN status alone. The aims of this study were to evaluate the long-term (10-year) prognostic impact of SLNB and to determine predictive factors associated with SLN metastasis, relapse, and melanoma specific mortality (MSM). Methods: This was a prospective observational study on 289 consecutive patients with primary cutaneous melanoma who underwent SLNB from January 2000 to December 2007, and followed until January 2014, at an Italian academic hospital. Results: SLN was positive in 64 patients (22.1%). The median follow-up was 116 months (79-147 months). Tenyear disease-free survival and melanoma specific survival were poor in patients with positive SLN (58.7% and 66.4%, respectively). Only the increasing Breslow thickness resulted independently associated to an increased risk of SLN metastasis. Cox regression analysis showed that a Breslow thickness >2 mm was an independent predictor of relapse, and male sex and Breslow thickness >2 mm was a predictor of MSM. At 10 years, SLN metastasis was not significantly associated to either relapse or MSM. Conclusion: After the fifth year of follow-up, SLN metastasis is not an independent predictive factor of relapse or mortality which are mainly influenced by the characteristics of the primary tumor and of the patient. Patients with a Breslow thickness >2 mm regardless of the SLN status should be considered at high risk for 10-year relapse and mortality.

• Journal of the Korean Dietetic Association
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• v.25 no.3
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• pp.217-228
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• 2019

There have been no published studies concerning the anti-inflammatory effects of corn silk on colon cancer cells. Thus, this study was conducted to investigate the effect of corn silk extract containing high levels of maysin on inflammation and its mechanism of action in colon cancer cells. SW 480 human colon cancer cells were treated with $1{\mu}g/mL$ of lipopolysaccharide (LPS) to induce inflammation, and next they were treated with different concentrations of corn silk extract (0, 5, 10 and $15{\mu}g/mL$). The concentrations of nitric oxide (NO) were determined. The mRNA expressions of inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), tumor necrosis factor ${\alpha}$ ($TNF-{\alpha}$), interleukin-1beta ($IL-1{\beta}$) and interleukin-6 (IL-6), were determined. Western blot analysis was performed to determine the protein expressions of nuclear factor-kappa B ($NF-{\kappa}B$) and mitogen-activated protein kinases, and the latter consists of extracellular signal-related kinase (ERK), c-jun NH2-terminal kinase (JNK) and p38 MAP kinase (p38). The concentration of NO and the mRNA expression of iNOS were significantly and dose-dependently decreased in the corn silk-treated groups (P<0.05). The mRNA expression of $TNF-{\alpha}$, $IL-1{\beta}$ and IL-6 were significantly increased in the LPS-treated group (P<0.05), but these expressions were significantly and dose-dependently decreased in the corn silk treated groups (P<0.05). The protein expressions of $NF-{\kappa}B$ (in a dose-dependent fashion), ERK (at 10 and $15{\mu}g/mL$), JNK (at $15{\mu}g/mL$) and p38 (at 10 and $15{\mu}g/mL$) were significantly decreased with corn silk treatments (P<0.05). In conclusion, corn silk extract containing high levels of maysin seems to inhibit the LPS-induced inflammatory responses in SW480 colon cancer cells via the $NF-{\kappa}B$ pathway.

• Tuberculosis and Respiratory Diseases
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• v.82 no.2
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• pp.118-125
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• 2019

Background: Lung cancer is a leading cause of morbidity and mortality worldwide, and the incidence continues to rise. Although many prognostic factors have been identified, the clinical characteristics and outcomes in Korean lung cancer patients are not well defined. Methods: Of the 23,254 new lung cancer cases registered at the Korea Central Cancer Registry in 2013, total 489 patients from 19 hospitals were abstracted by the Korean Central Cancer Registry. The clinical data retrospectively analyzed, patients were followed up until December 2015. Results: The median age was 69 years (interquartile range, 60-74 years); 65.4% were male and 62.1% were ever-smokers. Cough was the most common initial symptom (33.5%); 13.1% of patients were asymptomatic. While squamous cell carcinoma was the most common subtype in male patients (37.2%), adenocarcinoma was the most frequent histological type in all patients (48.7%) and females (76.3%). The majority of patients received treatment (76.5%), which included surgery, radiation therapy, and chemotherapy. Older age (hazard ratio [HR], 1.037), lower body mass index (HR, 0.904), ever-smoker (HR, 2.003), small cell lung cancer (HR, 1.627), and distant metastasis (HR, 3.990) were independent predictors of mortality. Patients without symptoms (HR, 0.387) and without treatment (HR, 0.364) were associated with a favorable outcome in multivariate Cox analysis. Conclusion: Lung cancer in Korea occurs predominantly in elderly patients, with adenocarcinoma being the most frequent subtype. The prognosis was poorer in ever-smokers and older, malnourished, and untreated patients with advanced lung cancer.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.16 no.2
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• pp.55-67
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• 2021

Objectives This review aimed to investigate studies of Chuna manual therapy (CMT) for low back pain and the evidence of their effects in order to suggest a better research method in the future. Methods We investigated studies on CMT for low back pain by searching Korean web databases from 2020 to 2021. As a result, 72 research papers were analyzed according to their published year, the titles of journals, the types of studies, the techniques of Chuna, and the instruments used for assessment. Results The results were as follows: 1. There were three papers published initially in 2000. this number showed a steady increase, and a total of 72 papers were published that year. 2. Studies on CMT were mainly published in the Journal of Korea Chuna Manual Medicine for Spine and Nerves. 3. When categorized according to the methods of studies, a simple case report was used more often than the sum of randomized controlled trials (RCTs) and non-RCTs. 4. The most frequently adopted technique of Chuna in the examined studies was the COX flexion and distraction technique. 5. The Visual Analog Scale and Oswestry Disability Index were used as primary means of assessment. Conclusions Based on the analysis, it was observed that this review provided limited evidence of CMT use in patients with LBP. Therefore, further investigation using well-designed RCTs is required to obtain higher evidence.

• Journal of Nutrition and Health
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• v.55 no.2
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• pp.263-277
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• 2022

Purpose: The present study examined the associations of Korean Food-based Index of Dietary Inflammatory Potential (FBDI) scores with the prevalence of diabetes and hemoglobin A1c (HbA1c) level of diabetes patients in Korean adults. Methods: The Korean Genome and Epidemiology Study (KoGES) Health Examinee baseline data, collected between 2004 and 2013 and followed up between 2012 and 2016, were used in our study. A total 56,391 participants including diabetes (n = 5,733) and non-diabetes (n = 50,658) were analyzed. The subjects were classified into quartiles of FBDI scores using the semi-quantitative food-frequency questionnaire developed for KoGES. The prevalence rate of diabetes under FBDI scores was assessed by Cox proportional risk models and the severity of the diabetes was analyzed by multiple regression analysis. Results: There were 775 incident cases of diabetes after a mean follow-up of 3.97 years. There was no statistically significant association between FBDI scores and incidence of diabetes. Among diabetes patients at baseline, FBDI scores were related to the risk of progression of diabetes which was represented by greater than 9% HbA1c (Q1 vs. Q4; odds ratio, 1.562 [95% confidence intervals, 1.13-2.15]; p for trend = 0.007). The stratified analysis showed a stronger association in females, irregular exercise group, and higher body mass index group. Conclusion: These results suggest that a pro-inflammatory diet is not associated with the incidence of diabetes but is related to the HbA1c level of diabetes patients. Thus, further longitudinal studies with longer periods are required to determine a relationship between dietary inflammatory index and diabetes in Korea.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.37 no.1
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• pp.1-16
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• 2024

Objectives : We aimed to study the effect of Smilax China L.(SCL), which has anti-inflammatory, antioxidant, and anticancer effects, on the growth of skin cancer cells. Methods : HaCaT cells, a normal human cell line, and skin cancer cells including A431, SK-MEL-5 and SK-MEL-28 cells were treated with Smilax China L. ethanol extract(SCL-EtOH) at concentrations of 5, 10, 20 and 40㎍/㎖. Meanwhile, JB6 Cl41, a normal mouse epithelial cell line, was treated with epidermal growth factor(EGF) and phorbol 12-myristate 13-acetate(TPA), an inflammatory factor, to induce cell transformation and treated with SCL-EtOH. In addition, we treated SK-MEL-5 and SK-MEL-28 cells with SCL-EtOH at various concentrations and checked the effect on the cell cycle. Results : As a result, it showed no toxicity to HaCaT cells up to the highest concentration of 40㎍/㎖, and significant cell growth inhibition to A431, SK-MEL-5 and SK-MEL-28 cells in a time- and concentration-dependent manner. In addition, as a result of checking the shape of skin cancer cells according to SCL-EtOH treatment, it was observed that as the concentration increased, the number of normally attached and growing cells decreased and the shape of the cells changed. Colony formation was significantly reduced in a concentration-dependent manner in JB6 Cl41 cells treated with EGF or TPA. Flow cytometry analysis with propidium iodide(PI) staining showed that SCL-EtOH induced the G2/M phase arrest. We further confirmed the decrease in Cyclin B1 expression and increase in p27 expression associated with the G2/M phase of the cell cycle through western blot analysis. Flow cytometry analysis confirmed that SCL-EtOH induced cell apoptosis. Furthermore, through Western blot analysis, it was observed that the expression of cleaved-caspase-7, which is related to apoptosis, increased. Finally, it was confirmed that the expression of COX-2, an inflammatory marker protein, decreased in a concentration-dependent manner with SCL-EtOH. Conclusions : Through the above results, we have established a basis for applying SCL to the treatment of skin cancer.

• Korean Journal of Radiology
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• v.22 no.9
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• pp.1514-1524
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• 2021

Objective: To develop a radiomics risk score based on dynamic contrast-enhanced (DCE) MRI for prognosis prediction in patients with glioblastoma. Materials and Methods: One hundred and fifty patients (92 male [61.3%]; mean age ± standard deviation, 60.5 ± 13.5 years) with glioblastoma who underwent preoperative MRI were enrolled in the study. Six hundred and forty-two radiomic features were extracted from volume transfer constant (K^trans), fractional volume of vascular plasma space (V_p), and fractional volume of extravascular extracellular space (V_e) maps of DCE MRI, wherein the regions of interest were based on both T1-weighted contrast-enhancing areas and non-enhancing T2 hyperintense areas. Using feature selection algorithms, salient radiomic features were selected from the 642 features. Next, a radiomics risk score was developed using a weighted combination of the selected features in the discovery set (n = 105); the risk score was validated in the validation set (n = 45) by investigating the difference in prognosis between the "radiomics risk score" groups. Finally, multivariable Cox regression analysis for progression-free survival was performed using the radiomics risk score and clinical variables as covariates. Results: 16 radiomic features obtained from non-enhancing T2 hyperintense areas were selected among the 642 features identified. The radiomics risk score was used to stratify high- and low-risk groups in both the discovery and validation sets (both p < 0.001 by the log-rank test). The radiomics risk score and presence of isocitrate dehydrogenase (IDH) mutation showed independent associations with progression-free survival in opposite directions (hazard ratio, 3.56; p = 0.004 and hazard ratio, 0.34; p = 0.022, respectively). Conclusion: We developed and validated the "radiomics risk score" from the features of DCE MRI based on non-enhancing T2 hyperintense areas for risk stratification of patients with glioblastoma. It was associated with progression-free survival independently of IDH mutation status.

• Korean Journal of Radiology
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• v.25 no.5
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• pp.438-448
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• 2024

Objective: To evaluate the therapeutic outcomes of no-touch radiofrequency ablation (NT-RFA) using twin cooled wet (TCW) electrodes in patients experiencing recurrent hepatocellular carcinoma (HCC) after undergoing locoregional treatments. Materials and Methods: We conducted a prospective, single-arm study of NT-RFA involving 102 patients, with a total of 112 recurrent HCCs (each ≤ 3 cm). NT-RFA with TCW electrodes was implemented under the guidance of ultrasonography (US)-MR/CT fusion imaging. If NT-RFA application proved technically challenging, conversion to conventional tumor puncture RFA was permitted. The primary metric for evaluation was the mid-term cumulative incidence of local tumor progression (LTP) observed post-RFA. Cumulative LTP rates were estimated using the Kaplan-Meier method. Multivariable Cox proportional hazard regression was used to explore factors associated with LTP. Considering conversion cases from NT-RFA to conventional RFA, intention-to-treat (ITT; including all patients) and per-protocol (PP; including patients not requiring conversion to conventional RFA alone) analyses were performed. Results: Conversion from NT-RFA to conventional RFA was necessary for 24 (21.4%) out of 112 tumors. Successful treatment was noted in 111 (99.1%) out of them. No major complications were reported among the patients. According to ITT analysis, the estimated cumulative incidences of LTP were 1.9%, 6.0%, and 6.0% at 1, 2, and 3 years post-RFA, respectively. In PP analysis, the cumulative incidence of LTP was 0.0%, 1.3%, and 1.3% at 1, 2, and 3 years, respectively. The number of previous locoregional HCC treatments (adjusted hazard ratio [aHR], 1.265 per 1 treatment increase; P = 0.004), total bilirubin (aHR, 7.477 per 1 mg/dL increase; P = 0.012), and safety margin ≤ 5 mm (aHR, 9.029; P = 0.016) were independently associated with LTP in ITT analysis. Conclusion: NT-RFA using TCW electrodes is a safe and effective treatment for recurrent HCC, with 6.0% (ITT analysis) and 1.3% (PP analysis) cumulative incidence of LTP at 2 and 3-year follow-ups.

• Korean Journal of Radiology
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• v.23 no.10
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• pp.939-948
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• 2022

Objective: Evidence supports the efficacy of coronary computed tomography angiography (CCTA)-based risk scores in cardiovascular risk stratification of patients with suspected coronary artery disease (CAD). We aimed to compare two CCTA-based risk score algorithms, Leiden and Confirm scores, in patients with diabetes mellitus (DM) and suspected CAD. Materials and Methods: This single-center prospective cohort study consecutively included 1241 DM patients (54.1% male, 60.2 ± 10.4 years) referred for CCTA for suspected CAD in 2015-2017. Leiden and Confirm scores were calculated and stratified as < 5 (reference), 5-20, and > 20 for Leiden and < 14.3 (reference), 14.3-19.5, and > 19.5 for Confirm. Major adverse cardiovascular events (MACE) were defined as the composite outcomes of cardiovascular death, nonfatal myocardial infarction (MI), stroke, and unstable angina requiring hospitalization. The Cox model and Kaplan-Meier method were used to evaluate the effect size of the risk scores on MACE. The area under the curve (AUC) at the median follow-up time was also compared between score algorithms. Results: During a median follow-up of 31 months (interquartile range, 27.6-37.3 months), 131 of MACE were recorded, including 17 cardiovascular deaths, 28 nonfatal MIs, 64 unstable anginas requiring hospitalization, and 22 strokes. An incremental incidence of MACE was observed in both Leiden and Confirm scores, with an increase in the scores (log-rank p < 0.001). In the multivariable analysis, compared with Leiden score < 5, the hazard ratios for Leiden scores of 5-20 and > 20 were 2.37 (95% confidence interval [CI]: 1.53-3.69; p < 0.001) and 4.39 (95% CI: 2.40-8.01; p < 0.001), respectively, while the Confirm score did not demonstrate a statistically significant association with the risk of MACE. The Leiden score showed a greater AUC of 0.840 compared to 0.777 for the Confirm score (p < 0.001). Conclusion: CCTA-based risk score algorithms could be used as reliable cardiovascular risk predictors in patients with DM and suspected CAD, among which the Leiden score outperformed the Confirm score in predicting MACE.