• Journal of Gastric Cancer
• /
• v.19 no.2
• /
• pp.173-182
• /
• 2019

Purpose: Intraoperative peritoneal washing cytology (PWC) is used to determine treatment strategies for gastric cancer with suspected serosal invasion. However, a standard staining method for intraoperative PWC remains to be established. We evaluated the feasibility of a rapid and simple staining method using Shorr's stain for intraoperative PWC in advanced gastric cancer. Materials and Methods: Between November 2012 and December 2014, 77 patients with clinical T3 or higher gastric cancer were enrolled. The sensitivity, specificity, and concordance between the Shorr staining method and conventional Papanicolaou (Pap) staining with carcinoembryonic antigen (CEA) immunohistochemistry (IHC) were analyzed. Results: Intraoperative PWC was performed laparoscopically in 69 patients (89.6%). The average time of the procedure was 8.3 minutes, and the average amount of aspirated fluids was 83.3 mL. The average time for Shorr staining and pathologic review was 21.0 minutes. Of the 77 patients, 16 (20.7%) had positive cytology and 7 (9.1%) showed atypical findings; sensitivity and specificity were 73.6% and 98.2% for the Shorr method, and 78.9% and 98.2% for the Pap method with CEA IHC, respectively. Concordance of diagnosis between the 2 methods was observed in 90.9% of cases (weighted ${\kappa}$ statistic=0.875) and most disagreements in diagnoses occurred in atypical findings (6/7). In overall survival, there was no significant difference in C-index between the 2 methods (0.459 in Shorr method vs. 0.458 in Pap with CEA IHC method, P=0.987). Conclusions: Shorr staining could be a rapid and reliable method for intraoperative PWC in advanced gastric cancer.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.34 no.6
• /
• pp.279-284
• /
• 2020

The theory of "eccentric diseases are generally due to phlegm (怪病多屬痰)" means that phlegm is a major cause for intractable diseases including cerebrovascular accident, depression, insanity, and shock from strange things or evil sprint. It has been a key foundation for the diagnosis and treatment of phlegm in traditional Korean medicine. However, the origin of the theory is not clear and controversial. In this study, we critically reviewed the origin and developing process of the theory in the viewpoints of philology and pathology in Korean medicine. Wang Yin-Jun (王隱 君) did not claim that eccentric diseases are generally due to phlegm in Taidingyangshengzhu-lun (泰定養生主論). The miscitation by following medical literature caused the misunderstanding in the meaning of Taidingyangshengzhu-lun, that phlegm can cause variable symptoms and signs. In the Ming dynasty, some poor medical doctors had tended to diagnose any difficult case as phlegm syndrome and to use Kuntan-huan (滾痰丸) as a standard herbal formula for treating phlegm syndrome. However, the tendency to categorize delicate cases easily to phlegm syndrome is not desirable. Besides, the tendency to use Kuntan-huan as a basic formula for the phlegm syndrome might cause diverse and severe adverse effects. Thus, we cannot accept the theory of eccentric diseases is generally due to phlegm without a doubt. In conclusion, this theory might be a valuable aphorism in terms of considering the possibility of the secondary pathologic factors including phlegm and blood stasis which should be considered first in case of intractable diseases.

• Journal of Genetic Medicine
• /
• v.18 no.2
• /
• pp.142-146
• /
• 2021

Alagille syndrome (AGS) is a rare autosomal dominant inherited disorder, with major clinical manifestations of bile duct paucity, cholestasis, cardiovascular anomaly, ophthalmic abnormalities, butterfly vertebrae, and dysmorphic facial appearance. It is caused by heterozygous mutations in JAG1 or NOTCH of the Notch signaling pathway presenting with variable phenotypic penetrance and involving multiple organ systems. The following case report describes a unique case of a 16-year-old female with AGS who presented with the primary complaint of renovascular hypertension. She had a medical history of ventricular septal defect and polycystic ovary syndrome. The patient had a dysmorphic facial appearance including frontal bossing, bulbous tip of the nose, a pointed chin with prognathism, and deeply set eyes with mild hypertelorism. Stenoocclusive changes of both renal arteries, celiac artery, lower part of the abdominal aorta, and left intracranial artery, along with absence of the left internal carotid artery were found on examination. Whole exome sequencing was performed and revealed a pathologic mutation of JAG1, leading to the diagnosis of AGS. Reverse phenotyping detected butterfly vertebrae and normal structure and function of the liver and gallbladder. While the representative symptom of AGS in most scenarios is a hepatic problem, in this case, the presenting clinical features were the vascular anomalies. Clinical manifestations of AGS are diverse, and this case demonstrates that renovascular hypertension might be in some cases a presenting symptom of AGS.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.38 no.3
• /
• pp.162-170
• /
• 2022

In the case of patients with pathological tooth wear, it is necessary to evaluate the loss of the vertical dimension. Setting the appropriate vertical dimension is important to rehabilitate the patient's stable intermaxillary relationship. A 77-year-old female patient's chief complaint was the pain of the mandibular incisors and the lack of molars. At the first visit, pathologic tooth wear of the mandibular incisors were observed. After diagnosis and evaluation, loss of vertical dimension was not observed, but insufficient intermaxillary space for prosthetic restoration was confirmed. Mandibular rehabilitation was performed with vertical dimension increase and this showed satisfactory results both functionally and aesthetically.

• Journal of Chest Surgery
• /
• v.55 no.6
• /
• pp.470-477
• /
• 2022

Background: Upfront surgery followed by systemic treatment is recommended to treat clinical stage I-IIA small cell lung cancer (SCLC), but data on the clinical outcomes are sparse. Thus, this study evaluated the stage migration and long-term prognosis of surgically treated clinical stage I-IIA SCLC. Methods: We retrospectively reviewed 49 patients with clinical stage I-IIA SCLC who underwent upfront surgery between 2000 and 2020. Additionally, we re-evaluated the TNM (tumor-node-metastasis) staging according to the eighth edition of the American Joint Committee on Cancer staging system for lung cancer. Results: The clinical stages of SCLC were cIA in 75.5%, cIB in 18.4%, and cIIA in 6.1% of patients. A preoperative histologic diagnosis was made in 65.3% of patients. Lobectomy and systematic lymph node dissection were performed in 77.6% and 83.7% of patients, respectively. The pathological stages were pI in 67.3%, pII in 24.5%, pIII in 4.1%, and pIV in 4.1% of patients. The concordance rate between clinical and pathological stages was 44.9%, and the upstaging rate was 49.0%. The 5-year overall survival (OS) rate was 67.8%. No significant difference in OS was found between stages pI and pII. However, the OS for stages pIII/IV was significantly worse than for stages pI/II (p<0.001). Conclusion: In clinical stage I-IIA SCLC, approximately half of the patients were pathologically upstaged, and OS was favorable after upfront surgery, particularly in pI/II patients. The poor prognosis of pIII/IV patients indicates the necessity of intensive preoperative pathologic mediastinal staging.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.49 no.2
• /
• pp.61-67
• /
• 2023

This systematic review aimed to analyze the clinicopathological profile and relevant prognostic factors of head and neck rhabdomyosarcoma in pediatric patients. The search was carried out in the electronic search portals PubMed, Lilacs, Embase, Scopus, and Web of Science. The search yielded studies that were then analyzed regarding study topic, data extraction, and risk of bias using the STROBE (Strengthening the Reporting of Observational Studies) guidelines. Finally, three studies were included for qualitative analysis. Most of the cases involved embryonic and alveolar rhabdomyosarcoma. Expression of MYOD1 was highly correlated with diagnosis of spindle cell/sclerosing rhabdomyosarcoma, which appears to have a poor prognosis in children. Furthermore, tumor size <5 cm and absence of metastasis accompanied by complete resection and administration of adjuvant therapies such as chemotherapy and radiotherapy favored a better prognosis.

• Journal of the Korean Society of Radiology
• /
• v.82 no.5
• /
• pp.1140-1162
• /
• 2021

Tearing of the acetabular labrum is a common cause of chronic hip pain. MR arthrography (MRA) of the hip is the imaging procedure of choice for the evaluation of acetabular labrum. Familiarity with the various imaging findings of MRA of the hip allows recognition of normal variants and differentiation from true pathologic conditions. This article comprehensively reviews the technical aspects and interpretation of MRA of the hip. The appearances of normal and abnormal labra in MRA are discussed. Potential pitfalls in labral tear interpretation, such as sulci around the hip, normal variants of the labrum and plicae, and osseocartilaginous and soft tissue lesions identified on MRA of the hip are also described.

• Journal of the Korean Society of Radiology
• /
• v.82 no.5
• /
• pp.1066-1082
• /
• 2021

Incidental adnexal masses considered indeterminate for malignancy are commonly observed on ultrasonography. Multiparametric MRI is the imaging modality of choice for the evaluation of sonographically indeterminate adnexal masses. Conventional MRI enables a confident pathologic diagnosis of various benign lesions due to accurate tissue characterization of fat, blood, fibrous tissue, and solid components. Additionally, functional imaging sequences, including perfusion- and diffusion-weighted imaging, improve the diagnostic efficacy of conventional MRI in differentiating benign from malignant adnexal masses. The ovarian-adnexal reporting and data system (O-RADS) MRI was recently designed to provide consistent interpretations in assigning risk of malignancy to ovarian and other adnexal masses, and to provide a management recommendation for each risk category. In this review, we describe the clinical application of multiparametric MRI for the evaluation of adnexal masses and introduce the O-RADS MRI risk stratification system.

• Korean Journal of Radiology
• /
• v.20 no.8
• /
• pp.1266-1274
• /
• 2019

Objective: To determine whether radiologic extranodal extension (ENE) appearing on pretreatment CT and MRI could predict the prognosis in patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC). Materials and Methods: The study population was obtained from a historical cohort diagnosed with HPV-related OPSCC. A total of 134 OPSCC patients who had a metastatic lymph node on pretreatment CT or MRI were included, and radiologic ENE was evaluated by two experienced head and neck radiologists. Kaplan-Meier and multivariate Cox regression analyses were performed to evaluate the impact of radiologic ENE on progression-free survival (PFS). The diagnostic performance of CT and MRI for the diagnosis of ENE was also evaluated in patients who underwent neck dissection. Results: Seventy patients (52.2%) showed radiologic ENE-positive findings. Although patients showing radiologic ENE had a worse 3-year PFS (83.7% vs. 95.3%, p = 0.023), the association between radiologic ENE and PFS was not statistically significant on multivariate analysis (p = 0.141; hazard ratio, 2.68; 95% confidence interval, 0.72-9.97). CT or MRI had a sensitivity of 62%, specificity of 77.8%, and accuracy of 71.9% for predicting pathologic ENE. Conclusion: Radiologic ENE on CT or MRI did not predict poor PFS in patients with HPV-related OPSCC, although there was a trend towards worse PFS. Further studies are warranted to determine whether radiologic ENE is a useful imaging biomarker to risk-stratify patients with HPV-related OPSCC.

• Journal of Veterinary Clinics
• /
• v.41 no.5
• /
• pp.323-329
• /
• 2024

The Oriental stork (Ciconia boyciana), an endangered species, faces significant threats despite extensive conservation efforts aimed at their reintroduction and long-term survival in South Korea. Understanding the primary causes of mortality and identifying predominant pathological lesions are crucial for enhancing these efforts. This study aimed to investigate the causes of unexplained mortality in Oriental storks between 2019 and 2023 through comprehensive postmortem examinations. Twelve storks, including both wild and captive birds, classified as "unknown" deaths, were examined. The results revealed that parasitic infections, particularly in wild storks, were frequently observed (41.7%). Additionally, gastrointestinal obstruction due to the ingestion of foreign materials was identified in a wild stork, highlighting the impact of environmental pollution. Despite the prevalence of inflammatory lesions in liver (58.3%), no cases of hepatitis were confirmed, except for one case of liver rupture in a wild stork. Notably, three nestling death cases from a single litter of captive storks suggested potential parental infanticide or lack of parental care. The overall results highlight the importance of addressing parasitic infections and environmental risks to improve the survival of wild Oriental storks, and emphasize the need for effective management in breeding facilities. Continuous monitoring and pathological evaluations for mortality cases are essential for understanding disease trends and developing adaptive conservation strategies to ensure the long-term preservation of this endangered species.