Journal of Yeungnam Medical Science

Focused Review article

Gastroenterology and Hepatology
Overview of hepatocarcinogenesis focusing on cellular origins of liver cancer stem cells: a narrative review: Jong Ryeol Eun; J Yeungnam Med Sci. 2025;42:3. Published online November 11, 2024; DOI: https://doi.org/10.12701/jyms.2024.01088

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Abstract PDF: Hepatocellular carcinoma (HCC) accounts for 85% to 90% of primary liver cancers and generally has a poor prognosis. The hierarchical model, which posits that HCC originates from liver cancer stem cells (CSCs), is now widely accepted, as it is for other cancer types. As CSCs typically reside in the G0 phase of the cell cycle, they are resistant to conventional chemotherapy. Therefore, to effectively treat HCC, developing therapeutic strategies that target liver CSCs is essential. Clinically, HCCs exhibit a broad spectrum of pathological and clinical characteristics, ranging from well-differentiated to poorly differentiated forms, and from slow-growing tumors to aggressive ones with significant metastatic potential. Some patients with HCC also show features of cholangiocarcinoma. This HCC heterogeneity may arise from the diverse cellular origins of liver CSCs. This review explores the normal physiology of liver regeneration and provides a comprehensive overview of hepatocarcinogenesis, including cancer initiation, isolation of liver CSCs, molecular signaling pathways, and microRNAs. Additionally, the cellular origins of liver CSCs are reviewed, emphasizing hematopoietic and mesenchymal stem cells, along with the well-known hepatocytes and hepatic progenitor cells.

Original article

Surgery
Diagnostic performance of F-18 FDG PET or PET/CT for detection of recurrent gastric cancer: a systematic review and meta-analysis: Chang In Choi, Jae Kyun Park, Tae Yong Jeon, Dae-Hwan Kim; J Yeungnam Med Sci. 2023;40(Suppl):S37-S46. Published online August 17, 2023; DOI: https://doi.org/10.12701/jyms.2023.00220

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Background
This systematic review and meta-analysis investigated the diagnostic performance of F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) or PET/computed tomography (PET/CT) for the detection of disease recurrence after curative resection of gastric cancer.
Methods
The PubMed and Embase databases, from the earliest available date of indexing through November 30, 2019, were searched for studies evaluating the diagnostic performance of F-18 FDG PET or PET/CT to detect recurrent disease after gastric cancer surgery.
Results
Across 17 studies (1,732 patients), the pooled sensitivity for F-18 FDG PET or PET/CT was 0.82 (95% confidence interval [CI], 0.74–0.88) with heterogeneity of I2=76.5 (p<0.001), and the specificity was 0.86 (95% CI, 0.78–0.91) with heterogeneity of I2=94.2 (p<0.001). Likelihood ratio (LR) tests gave an overall positive LR of 6.0 (95% CI, 3.6–9.7) and negative LR of 0.2 (95% CI, 0.14–0.31). The pooled diagnostic odds ratio was 29 (95% CI, 13–63). The summary receiver operating characteristic curve indicates that the area under the curve was 0.91 (95% CI, 0.88–0.93).
Conclusion
The current meta-analysis showed good sensitivity and specificity of F-18 FDG PET or PET/CT for detecting recurrent disease after curative resection of gastric cancer despite heterogeneity in ethnicity, recurrence rate, histology, and interpretation method.

Citations

Citations to this article as recorded by

Follow-Up and Strategies After Curative Surgical Resection for Gastric Cancer
Seokin Kang
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2025; 25(4): 336. CrossRef

Review articles

Anesthesiology and Pain Medicine
Breakthrough pain and rapid-onset opioids in patients with cancer pain: a narrative review: Jinseok Yeo; J Yeungnam Med Sci. 2024;41(1):22-29. Published online June 30, 2023; DOI: https://doi.org/10.12701/jyms.2023.00367

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Abstract PDF

Breakthrough pain is transitory pain that occurs despite the use of opioids for background pain control. Breakthrough pain occurs in 40% to 80% of patients with cancer pain. Despite effective analgesic therapy, patients and their caregivers often feel that their pain is not sufficiently controlled. Therefore, an improved understanding of breakthrough pain and its management is essential for all physicians caring for patients with cancer. This article reviews the definition, clinical manifestations, accurate diagnostic strategies, and optimal treatment options for breakthrough pain in patients with cancer. This review focuses on the efficacy and safety of rapid-onset opioids, which are the primary rescue drugs for breakthrough pain.

Citations

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A scoping review of breakthrough cancer pain: Multidimensional patient needs and influencing factors
Qingyi Li, Yanlei Sheng, Xinyu Liu, Jie Li, Lisi Zhu, Yang Yang, Luhong Hu
Asia-Pacific Journal of Oncology Nursing.2025; 12: 100780. CrossRef
Validation of the Chinese Version Breakthrough Pain Assessment Tool in Cancer Patients
Lin-Jiu Chen, Kun-Ming Rau, Pei-Chao Lin, Yi Liu, Pi-Ling Chou
Pain Management Nursing.2025;[Epub] CrossRef
Evaluating the Efficacy of Fentanyl Versus Diclofenac Sodium as Transdermal Patches in Controlling Post-operative Pain in Mandibular Third Molar Surgeries: A Prospective Comparative Study
Swastik Hazra, Sapna Tandon, Hemant Mehra, Himanshu Chauhan, T. Adarsha, Dipanjan Chatterjee
FACE.2025;[Epub] CrossRef

Dentistry
Role of gene therapy in treatment of cancer with craniofacial regeneration—current molecular strategies, future perspectives, and challenges: a narrative review: Himanshu Singh; J Yeungnam Med Sci. 2024;41(1):13-21. Published online May 23, 2023; DOI: https://doi.org/10.12701/jyms.2023.00073

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Abstract PDF

Gene therapy involves the introduction of foreign genetic material into host tissue to alter the expression of genetic products. Gene therapy represents an opportunity to alter the course of various diseases. Hence, genetic products utilizing safe and reliable vectors with improved biotechnology will play a critical role in the treatment of various diseases in the future. This review summarizes various important vectors for gene therapy along with modern techniques for potential craniofacial regeneration using gene therapy. This review also explains current molecular approaches for the management and treatment of cancer using gene therapy. The existing literature was searched to find studies related to gene therapy and its role in craniofacial regeneration and cancer treatment. Various databases such as PubMed, Science Direct, Scopus, Web of Science, and Google Scholar were searched for English language articles using the keywords “gene therapy,” “gene therapy in present scenario,” “gene therapy in cancer,” “gene therapy and vector,” “gene therapy in diseases,” and “gene therapy and molecular strategies.”

Citations

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Integrated cell membrane encapsulated PQDs-TK quantum dot nanoclusters with ROS-responsive triggering for efficient and visualized DNA delivery
Tiange Wang, Yanlin Sun, Dong Zeng, Mengying Wang, Yajing Zhang, Gang Liu, Xin Chen, Liang Liu
Journal of Colloid and Interface Science.2025; 683: 393. CrossRef

Case report

Oncology and Cancer Research
Intraabdominal abscess mimicking gastric cancer recurrence: a case report: Yong-Eun Park; J Yeungnam Med Sci. 2023;40(4):426-429. Published online February 1, 2023; DOI: https://doi.org/10.12701/jyms.2022.00864

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Abstract PDF

Surgical site infection is a common healthcare-associated infection that rarely occurs several months after surgery. Herein, a case is described in which an abdominal mass lesion was found at a 6-month follow-up visit after gastrectomy was performed for early gastric cancer. Positron emission tomography-computed tomography revealed a 2.5 cm-sized mass with a high maximal standard uptake value (8.32), located above a previous anastomosis site. Locoregional recurrence of gastric cancer was diagnosed by multidisciplinary team discussion, and explorative laparotomy was performed. However, surgical and pathologic findings revealed that the mass was an intraabdominal abscess. In conclusion, differential diagnosis of delayed abscess formation should be considered if the possibility of tumor recurrence is low, especially after early gastric cancer surgery.

Citations

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ChatGPT-4o outperforms gemini advanced in assisting multidisciplinary decision-making for advanced gastric cancer
Huizi Li, Jiaobao Huang, Kuntang Liu, Jibiao Liu, Queling Liu, Zhiyong Zhou, Zhen Zong, Shengxun Mao
European Journal of Surgical Oncology.2025; 51(8): 110096. CrossRef

Original articles

Oncology and Cancer Research
Clinical implication of adjuvant chemotherapy according to mismatch repair status in patients with intermediate-risk stage II colon cancer: a retrospective study: Byung Woog Kang, Dong Won Baek, Eunhye Chang, Hye Jin Kim, Su Yeon Park, Jun Seok Park, Gyu Seog Choi, Jin Ho Baek, Jong Gwang Kim; J Yeungnam Med Sci. 2022;39(2):141-149. Published online December 22, 2021; DOI: https://doi.org/10.12701/yujm.2021.01571

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Abstract PDF

Background
The present study evaluated the clinical implications of adjuvant chemotherapy according to the mismatch repair (MMR) status and clinicopathologic features of patients with intermediate- and high-risk stage II colon cancer (CC).
Methods
This study retrospectively reviewed 5,774 patients who were diagnosed with CC and underwent curative surgical resection at Kyungpook National University Chilgok Hospital. The patients were enrolled according to the following criteria: (1) pathologically diagnosed with primary CC; (2) stage II CC classified based on the 7th edition of the American Joint Committee on Cancer staging system; (3) intermediate- and high-risk features; and (4) available test results for MMR status. A total of 286 patients met these criteria and were included in the study.
Results
Among the 286 patients, 54 (18.9%) were identified as microsatellite instability-high (MSI-H) or deficient MMR (dMMR). Although all the patients identified as MSI-H/dMMR showed better survival outcomes, T4 tumors and adjuvant chemotherapy were identified as independent prognostic factors for survival. For the intermediate-risk patients identified as MSI-low (MSI-L)/microsatellite stable (MSS) or proficient MMR (pMMR), adjuvant chemotherapy exhibited a significantly better disease-free survival (DFS) but had no impact on overall survival (OS). Oxaliplatin-containing regimens showed no association with DFS or OS. Adjuvant chemotherapy was not associated with DFS in intermediate-risk patients identified as MSI-H/dMMR.
Conclusion
The current study found that the use of adjuvant chemotherapy was correlated with better DFS in MSI-L/MSS or pMMR intermediate-risk stage II CC patients.

Citations

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Behavioral and Neuroanatomical Consequences of Cell-Type Specific Loss of Dopamine D2 Receptors in the Mouse Cerebral Cortex
Gloria S. Lee, Devon L. Graham, Brenda L. Noble, Taylor S. Trammell, Deirdre M. McCarthy, Lisa R. Anderson, Marcelo Rubinstein, Pradeep G. Bhide, Gregg D. Stanwood
Frontiers in Behavioral Neuroscience.2022;[Epub] CrossRef
A pilot retrospective study of comprehensive nursing care on psychological disorder in colorectal cancer undergoing chemotherapy
Zhou-Yi Zhang, Rui Wang, Li Zhang, Ming-Li Gu, Xiu-E Guan
Medicine.2022; 101(28): e29707. CrossRef

Oncology and Cancer Research
Treatment decision for cancer patients with fever during the coronavirus disease 2019 (COVID-19) pandemic: In Hee Lee, Sung Ae Koh, Soo Jung Lee, Sun Ah Lee, Yoon Young Cho, Ji Yeon Lee, Jin Young Kim; Yeungnam Univ J Med. 2021;38(4):344-349. Published online August 23, 2021; DOI: https://doi.org/10.12701/yujm.2021.01144

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Abstract PDF: Background
Cancer patients have been disproportionally affected by the coronavirus disease 2019 (COVID-19) pandemic, with high rates of severe outcomes and mortality. Fever is the most common symptom in COVID-19 patients. During the COVID-19 pandemic, physicians may have difficulty in determining the cause of fever (COVID-19, another infection, or cancer fever) in cancer patients. Furthermore, there are no specific guidelines for managing cancer patients with fever during the COVID-19 pandemic. Thus, this study evaluated the clinical characteristics and outcomes of cancer patients with fever during the COVID-19 pandemic.
Methods
This study retrospectively reviewed the medical records of 328 cancer patients with COVID-19 symptoms (fever) admitted to five hospitals in Daegu, Korea from January to October 2020. We obtained data on demographics, clinical manifestations, laboratory test results, chest computed tomography images, cancer history, cancer treatment, and outcomes of all enrolled patients from electronic medical records.
Results
The most common COVID-19-like symptoms were fever (n=256, 78%). Among 256 patients with fever, only three (1.2%) were diagnosed with COVID-19. Most patients (253, 98.8%) with fever were not diagnosed with COVID-19. The most common solid malignancies were lung cancer (65, 19.8%) and hepatobiliary cancer (61, 18.6%). Twenty patients with fever experienced a delay in receiving cancer treatment. Eighteen patients discontinued active cancer treatment because of fever. Major events during the treatment delay period included death (2.7%), cancer progression (1.5%), and major organ dysfunction (2.7%).
Conclusion
Considering that only 0.9% of patients tested for COVID-19 were positive, screening for COVID-19 in cancer patients with fever should be based on the physician’s clinical decision, and patients might not be routinely tested.

Case reports

Hematology
Adrenal insufficiency development during chemotherapy plus anti-programmed death receptor-1 monoclonal antibody (tislelizumab) therapy in patients with advanced gastric cancer: two case reports: Jin Ho Baek; J Yeungnam Med Sci. 2022;39(1):62-66. Published online April 19, 2021; DOI: https://doi.org/10.12701/yujm.2021.00934

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Abstract PDF

Immune checkpoint inhibitor (ICI)-associated adrenal insufficiency is rare but may become a serious adverse event in patients treated with ICIs. The present case report documents two cases of adrenal insufficiency developed during chemotherapy plus tislelizumab (百泽安, Baize’an; BeiGene Ltd.) therapy in patients with advanced gastric cancer. Adrenal insufficiency developed after 6 and 13 cycles of treatment and was well controlled with hydrocortisone. The patients also developed hypothyroidism, which was managed with levothyroxine. Two patients showed a partial response, and one patient out of two achieved a near-complete response, sustaining over 11 months. Increased awareness of ICI-related adrenal insufficiency is crucial for early detection and prompt management of patients treated with ICIs.

Citations

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A case report of mesalazine alleviating diarrhea in a patient with nasopharyngeal cancer after tislelizumab treatment
Xiaomei Zhou, Yu Shu, Xi Chen, Bo Luo
Immunotherapy.2025; 17(7): 485. CrossRef
Analysis of adverse drug reactions in 507 cases of Tislelizumab: A real-world retrospective study based on data from Guangxi, China
Shaohuan Lu, Dajian Chen, Yang Li, Qianxi Chen, Guangyi Meng, Keiko Hosohata
PLOS One.2025; 20(8): e0329464. CrossRef
Immune checkpoint inhibitor-related adrenal hypofunction and Psoriasisby induced by tislelizumab: A case report and review of literature
Yisi Deng, Manling Huang, Runpei Deng, Jun Wang
Medicine.2024; 103(12): e37562. CrossRef
Severe thyrotoxicosis induced by tislelizumab: a case report and literature review
Liman Huo, Chao Wang, Haixia Ding, Xuelian Shi, Bin Shan, Ruoying Zhou, Ping Liang, Juan Hou
Frontiers in Oncology.2023;[Epub] CrossRef
Immune-related adverse events with severe pain and ureteral expansion as the main manifestations: a case report of tislelizumab-induced ureteritis/cystitis and review of the literature
Qihao Zhou, Zhiquan Qin, Peiyuan Yan, Qunjiang Wang, Jing Qu, Yun Chen
Frontiers in Immunology.2023;[Epub] CrossRef
Isolated Renal Calyceal Urothelial Carcinoma Effectively Treated With PD-1 Inhibitor Alone: A Case Report And Literature Review
Shihao Li, Yi Zhu, Zhijian Xu, Jianjun Liu, Hongwei Liu
Frontiers in Oncology.2022;[Epub] CrossRef

Gastroenterology and Hepatology
Gastric cancer and adenomatous colorectal polyp concomitant with pyogenic liver abscess and bacteremia: Min Kyu Kang, Hee Jung Kwon, Min Cheol Kim; Yeungnam Univ J Med. 2020;37(3):246-249. Published online April 10, 2020; DOI: https://doi.org/10.12701/yujm.2020.00094

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Abstract PDF: Synchronous gastric cancer and adenomatous colorectal polyp in patients with Klebsiella pneumoniae-induced pyogenic liver abscess (KP-PLA) and bacteremia is a rare presentation. A 58-year-old man with a 6-month history of diabetes mellitus (DM) presented with febrile sensation and dull abdominal pain in the right upper quadrant of the abdomen. Subsequent to laboratory test results and abdominal computed tomography findings, KP-PLA with bacteremia was diagnosed. After intravenous antibiotic administration, his symptoms improved, and upper endoscopy and colonoscopy were performed to evaluate the cause of KP-PLA. Biopsy specimens of the prepyloric anterior wall revealed a moderately differentiated adenocarcinoma. Endoscopic mucosal resection of the colon revealed high-grade dysplasia. Early gastric cancer (EGC) and adenomatous colorectal polyps with high-grade dysplasia concomitant with KP-PLA and bacteremia were diagnosed in our patient who had DM. Intravenous antibiotic treatment for KP-PLA, subtotal gastrectomy for EGC, and colonoscopic mucosal resection for the colon polyp were performed. After 25 days of hospitalization, subtotal gastrectomy with adjacent lymph node dissection was performed. Follow-up ultrasound imaging showed resolution of the abscess 5 weeks post-antibiotic treatment, as well as no tumor metastasis. Upper gastrointestinal endoscopy and colonoscopy should be performed to evaluate gastric cancer in patients with PLA or bacteremia, accompanied with DM or an immunocompromised condition.

Cardiology and Cardiovascular Medicine
Fatal progressive right heart failure in a pancreatic cancer patient: Jeong Tae Byoun, Jae Young Cho; Yeungnam Univ J Med. 2020;37(2):122-127. Published online September 19, 2019; DOI: https://doi.org/10.12701/yujm.2019.00332

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Abstract PDF

Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare but fatal complication of cancer and causes pulmonary hypertension and acute/subacute right heart failure. PTTM is most commonly associated with gastric cancer and more rarely associated with pancreatic cancer. We report a case of progressive right heart failure associated with clinically diagnosed pancreatic cancer, suggesting PTTM.

Citations

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A rare, life-threatening debut of pancreatic adenocarcinoma: Pulmonary tumor thrombotic microangiopathy
Pablo Jiménez-Labaig, Soledad Fernández Solé, Susana Gómez Varela, Jorge García Calvo, Sergio Carrera Revilla, Alberto Muñoz Llarena
Current Problems in Cancer: Case Reports.2023; 10: 100238. CrossRef
Evidence of sex differences in cancer‐related cardiac complications in mouse models of pancreatic and liver cancer
Anna Gams, Alejandro Nevarez, Stephanie Perkail, Aileen Venegas, Sharon A. George, Tatiana Efimova, Igor R. Efimov
Physiological Reports.2023;[Epub] CrossRef
Prospective of Pancreatic Cancer Diagnosis Using Cardiac Sensing
Mansunderbir Singh, Priyanka Anvekar, Bhavana Baraskar, Namratha Pallipamu, Srikanth Gadam, Akhila Sai Sree Cherukuri, Devanshi N. Damani, Kanchan Kulkarni, Shivaram P. Arunachalam
Journal of Imaging.2023; 9(8): 149. CrossRef
Fatal pulmonary tumour thrombotic microangiopathy in patient with ovarian adenocarcinoma: review and a case report
Gintare Neverauskaite-Piliponiene, Kristijonas Cesas, Darius Pranys, Skaidrius Miliauskas, Lina Padervinskiene, Jolanta Laukaitiene, Giedre Baksyte, Gintare Sakalyte, Egle Ereminiene
BMC Cardiovascular Disorders.2022;[Epub] CrossRef

Cardiology and Cardiovascular Medicine
Purulent pericarditis: subdiaphragmatic suppurative focus: Kang-Un Choi, Chan-Hee Lee; Yeungnam Univ J Med. 2020;37(1):63-66. Published online September 4, 2019; DOI: https://doi.org/10.12701/yujm.2019.00311

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Abstract PDF

Purulent pericarditis is defined as a localized pericardial infection with gross pus formation in the pericardial space. Although purulent pericarditis is now rare in the antibiotic era, it may be life-threatening. We describe a rare case of purulent pericarditis that originated from a subdiaphragmatic suppurative focus in an immunocompromised host.

Citations

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Beyond the norm: a case of purulent myopericarditis unveiling diagnostic dilemma
Rukshar Thapa, Pragyat Singh, Anurag Jha, Nirmal Paudel, John T. Godfrey
Annals of Medicine & Surgery.2025; 87(11): 7745. CrossRef
A Study on the Process of Posttraumatic Growth among Helping Professionals in Suicide Prevention: Focused on Grounded Theory
Sungkyu Lee, Hyeyeon Sung, Chonghee Seo
Journal of Social Science.2021; 32(3): 149. CrossRef

Original article

Pathology and Forensic Medicine
What are the most important prognostic factors in patients with residual rectal cancer after preoperative chemoradiotherapy?: Sol-Min Kim, Ghilsuk Yoon, An Na Seo; Yeungnam Univ J Med. 2019;36(2):124-135. Published online April 1, 2019; DOI: https://doi.org/10.12701/yujm.2019.00157

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Abstract PDF

Background
We aimed to establish robust histoprognostic predictors on residual rectal cancer after preoperative chemoradiotherapy (CRT).
Methods
Analyzing known histoprognostic factors in 146 patients with residual disease allows associations with patient outcome to be evaluated.
Results
The median follow-up time was 77.8 months, during which 59 patients (40.4%) experienced recurrence and 41 (28.1%) died of rectal cancer. On univariate analysis, residual tumor size, ypT category, ypN category, ypTNM stage, downstage, tumor regression grade, lymphatic invasion, perineural invasion, venous invasion, and circumferential resection margin (CRM) were significantly associated with recurrence free survival (RFS) or/and cancer-specific survival (CSS) (all p<0.005). On multivariate analysis, higher ypTNM stage and CRM positivity were identified as independent prognostic factors for RFS (ypTNM stage, p=0.024; CRM positivity, p<0.001) and CSS (p=0.022, p=0.017, respectively). Furthermore, CRM positivity was an independent predictor of reduced RFS, irrespective of subgrouping according to downstage (non-downstage, p=0.001; downstage, p=0.010) or lymph node metastasis (non-metastasis, p=0.004; metastasis, p=0.007).
Conclusion
CRM status may be as powerful as ypTNM stage as a prognostic indicator for patient outcome in patients with residual rectal cancer after preoperative CRT.

Citations

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Risk score model for predicting local control and survival in patients with rectal cancer treated with neoadjuvant chemoradiotherapy
Tuba Kurt Catal, Günay Can, İsmai̇l Demi̇rel, Sefi̇ka Ergen, Di̇dem Öksüz
Oncology Letters.2025; 29(5): 1. CrossRef
Potential Prognostic Factors in Low Rectal Cancer Patients Treated With Neoadjuvant Chemoradiation and Abdominoperineal Resection
Mohamed I Fahim, Fady Shafeik, Rasha M Allam, Marina Asaad, Mohammad Taher
Cureus.2025;[Epub] CrossRef
Poor nutrition and sarcopenia are related to systemic inflammatory response in patients with rectal cancer undergoing preoperative chemoradiotherapy
Shinya Abe, Hiroaki Nozawa, Kazushige Kawai, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Junko Kishikawa, Tsuyoshi Ozawa, Yuichiro Yokoyama, Yuzo Nagai, Hiroyuki Anzai, Hirofumi Sonoda, Soichiro Ishihara
International Journal of Colorectal Disease.2022; 37(1): 189. CrossRef
Preoperative sarcopenia is a poor prognostic factor in lower rectal cancer patients undergoing neoadjuvant chemoradiotherapy: a retrospective study
Shinya Abe, Kazushige Kawai, Hiroaki Nozawa, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Junko Kishikawa, Hiroaki Ishii, Yuichiro Yokoyama, Yuzo Nagai, Hiroyuki Anzai, Hirofumi Sonoda, Koji Oba, Soichiro Ishihara
International Journal of Clinical Oncology.2022; 27(1): 141. CrossRef
A Four-Methylated lncRNAs-Based Prognostic Signature for Hepatocellular Carcinoma
Le-En Liao, Dan-Dan Hu, Yun Zheng
Genes.2020; 11(8): 908. CrossRef

Original Article

Urology
Oncological and functional outcomes following robot-assisted laparoscopic radical prostatectomy at a single institution: a minimum 5-year follow-up: Jun-Koo Kang, Jae-Wook Chung, So Young Chun, Yun-Sok Ha, Seock Hwan Choi, Jun Nyung Lee, Bum Soo Kim, Ghil Suk Yoon, Hyun Tae Kim, Tae-Hwan Kim, Tae Gyun Kwon; Yeungnam Univ J Med. 2018;35(2):171-178. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.171

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Abstract PDF

Background
To evaluate mid-term oncological and functional outcomes in patients with prostate cancer treated by robot-assisted laparoscopic radical prostatectomy (RALP) at our institution.
Methods
We retrospectively reviewed the medical records of 128 patients with prostate cancer who underwent RALP at our institution between February 2008 and April 2010. All patients enrolled in this study were followed up for at least 5 years. We analyzed biochemical recurrence (BCR)-free survival using a Kaplan-Meier survival curve analysis and predictive factors for BCR using multivariate Cox regression analysis. Continence recovery rate, defined as no use of urinary pads, was also evaluated.
Results
Based on the D’Amico risk classification, there were 30 low-risk patients (23.4%), 47 intermediaterisk patients (38.8%), and 51 high-risk patients (39.8%), preoperatively. Based on pathological findings, 50.0% of patients (64/128) showed non-organ confined disease (≥T3a) and 26.6% (34/128) had high grade disease (Gleason score ≥8). During a median follow-up period of 71 months (range, 66-78 months), the frequency of BCR was 33.6% (43/128) and the median BCR-free survival was 65.9 (0.4-88.0) months. Multivariate Cox regression analysis revealed that high grade disease (Gleason score ≥8) was an independent predictor for BCR (hazard ratio=4.180, 95% confidence interval=1.02-17.12, p=0.047). In addition, a majority of patients remained continent following the RALP procedure, without the need for additional intervention for post-prostatectomy incontinence.
Conclusion
Our study demonstrated acceptable outcomes following an initial RALP procedure, despite 50% of the patients investigated demonstrating high-risk features associated with non-organ confined disease.

Citations

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Extended pelvic lymphadenectomy does not improve biochemical recurrence in high-risk prostate cancer patients treated with robot-assisted radical prostatectomy: a propensity-matched comparison of two institutions
Sohei Iwagami, Haruka Miyai, Takahito Wakamiya, Shimpei Yamashita, Masaya Nishihata, Isao Hara, Yasuo Kohjimoto
Japanese Journal of Clinical Oncology.2025; 55(9): 1086. CrossRef
Prediction of a positive surgical margin and biochemical recurrence after robot-assisted radical prostatectomy
Ching-Wei Yang, Hsiao-Hsien Wang, Mohamed Fayez Hassouna, Manish Chand, William J. S. Huang, Hsiao-Jen Chung
Scientific Reports.2021;[Epub] CrossRef

Review Article

Urology
Functional recovery after radical prostatectomy for prostate cancer: Young Hwii Ko; Yeungnam Univ J Med. 2018;35(2):141-149. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.141

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Abstract PDF

With the enthusiasm regarding robotic application in radical prostatectomy in accordance with the widespread use of serum prostate-specific antigen as a screening test, the number of surgeries performed for complete removal of the gland is increasing continuously. However, owing to the adjacent anatomical location of the prostate to the nerve and urethral sphincter complex, functional recovery, namely improvement from post-prostatectomy incontinence (PPI) and post-prostatectomy erectile dysfunction, still remains a main problem for patients who are reluctant to undergo surgery and tend to choose alternative ways instead. Since the late 1980s, the introduction of radical prostatectomy by open surgical modalities, the depth of the anatomical understanding of the structure surrounding the prostate is getting tremendous, which leads to the development of new surgical modalities and techniques that are consequently aimed at reducing the incidences of PPI and erectile dysfunction. Briefly, recent data from robotic radical prostatectomy, particularly on PPI, are quite acceptable, but by contrast, the reported potency regain rate still remains <20%, which indicates the need for advanced surgical modification to overcome it. In this review, the authors summarized the recent findings on the anatomy and surgical techniques reported up to now.

Citations

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The assessment of erectile dysfunction after radical prostatectomy using pudendal somatosensory evoked potential
Se Yun Kwon, Jin-Mo Park, Appuwawadu Mestri Nipun Lakshitha de Silva
PLOS ONE.2023; 18(11): e0292847. CrossRef
Fidgetin-like 2 negatively regulates axonal growth and can be targeted to promote functional nerve regeneration
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JCI Insight.2021;[Epub] CrossRef

Case Reports

Pulmonary and Respiratory Medicine
Double primary lung adenocarcinoma diagnosed by epidermal growth factor receptor mutation status: Oh Jung Kwon, Min Hyeok Lee, Sung Ju Kang, Seul Gi Kim, In Beom Jeong, Ji Yun Jeong, Eun Jung Cha, Do Yeun Cho, Young Jin Kim, Ji Woong Son; Yeungnam Univ J Med. 2017;34(2):270-274. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.270

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Abstract PDF: A nodular density was detected on a chest radiograph taken from a 57-year-old Korean woman who was visiting a hospital for a routine check. Chest computed tomography revealed a 4.8 cm lobulated mass in the right lung and another focal nodular lesion in the left lung; biopsies of both lungs revealed adenocarcinoma. We conducted DNA sequencing and peptide nucleic acid clamping to investigate the potential double primary lung cancer. The results verified that the mass in the right lung had a mutation in the epidermal growth factor receptor, whereas the nodule in the left lung had a wild-type sequence, showing that these two were genetically different cancers from one another. Thus, we demonstrate that genetic testing is useful in determining double primary lung cancer, and we herein report on this case.

Gastroenterology and Hepatology
Deep vein thrombosis caused by malignant afferent loop obstruction.: Eun Gyu Kang, Chan Kim, Jeungeun Lee, Min Uk Cha, Joo Hoon Kim, Seo Hwa Park, Man Deuk Kim, Do Yun Lee, Sun Young Rha; Yeungnam Univ J Med. 2016;33(2):166-169. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.166

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Abstract PDF: Afferent loop obstruction following gastrectomy is a rare but fatal complication. Clinical features of afferent loop obstruction are mainly gastrointestinal symptoms. A 56-year-old female underwent radical total gastrectomy with Roux-en-Y esophagojejunostomy for treatment of advanced gastric cancer. After fourteen months postoperatively, she showed gradual development of edema of both legs. Computed tomography (CT) scan showed disease progression at the jejunojejunostomy site and consequent dilated afferent loop, which resulted in inferior vena cava (IVC) compression. A drainage catheter was placed percutaneously into the afferent loop through the intrahepatic duct and an IVC filter was placed at the suprarenal IVC, and selfexpanding metal stents were inserted into bilateral common iliac veins. With these procedures, sympotms related with afferent loop obstruction and deep vein thrombosis were improved dramatically. The follow-up abdominal CT scan was taken 3 weeks later and revealed the completely decompressed afferent loop and improved IVC patency. Surgical treatment should be considered as the first choice for afferent loop obstruction; however, because it is more immediate and less invasive, non-surgical modalities, such as percutaneous catheter drainage or stent placement, can be effective alternatives for inoperable cases or risky patients who have severe medical comorbidities.

Urology
Burnt-out Metastatic Prostate Cancer.: Dong Suk Shin, Dong Hoe Koo, Suhyeon Yoo, Deok Yun Ju, Cheol Min Jang, Kwan Joong Joo, Hyun Chul Shin, Seoung Wan Chae; Yeungnam Univ J Med. 2013;30(2):116-119. Published online December 31, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.2.116

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Abstract PDF: A burnt-out prostate cancer tumor is a very rare clinical entity. The term 'burnt-out' refers to a primary tumor that has spontaneously and nearly completely regressed without treatment. Since metastasis of prostate cancer is usually encountered in the presence of advanced disease, distant metastasis with an undetectable primary tumor is very rare. We report herein a case of a burnt-out prostate cancer tumor that metastasized to the thoracic (T) spine and caused cord compression. A 66-year-old man visited the Emergency Department due to weakness of both legs for the past two days. His blood and urine tests were normal at the time. His spine magnetic resonance imaging (MRI) scans looked like bone metastasis that involved the T-7 vertebral body and a posterior element, and caused spinal cord compression. Other images, including from the brain MRI, neck/chest/abdomino-pelvic computed tomography (CT) scan and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and endoscopy, revealed no lesions that suggested malignancy. After total corpectomy T-7 and screw fixation/fusion at T5 to T10, the pathology report revealed a metastatic carcinoma that was strongly positive for prostate-specific antigen (PSA). The serum PSA value was 1.5 ng/mL. The transrectal 12-core prostate biopsy and ultrasonography showed no definitive hypoechoic lesion, but one specimen had slight (only 1%) adenocarcinoma with a Gleason score of 6 (3+3). The final diagnosis was burned-out prostate cancer with an initial normal PSA value. Although metastatic disease with an unknown primary origin was confirmed, a more aggressive approach in seeking the primary origin could provide a more specific treatment strategy and greater clinical benefit to patients.

Gastroenterology and Hepatology
An Unusual Cause of Gastrointestinal Hemorrhage: Gastrocolic Fistula Caused by Colon Cancer Invasion.: Jeong Hyeon Cho, In Tae Kim, Jin Yi Choi, Song Wook Chun, Beo Deul Kang, Sang Kyun Bae, Hee Man Kim, Ji Sun Song; Yeungnam Univ J Med. 2013;30(1):43-46. Published online June 30, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.1.43

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Abstract PDF: Gastrocolic fistula is a fistulous communication between the stomach and the colon. It is a passage between the gastric epithelium and the colonic epithelium. This uncommon complication is caused by benign and malignant diseases of the stomach or the colon. Its clinical manifestations include weight loss, diarrhea and fecal vomiting; occasionally, anemia, poor oral intake, fatigue and dizziness; and very rarely, gastrointestinal bleeding. In this paper, an unusual case of gastrocolic fistula accompanied by hematochezia, which was revealed to have been caused by colon cancer invasion, is described.

Gastroenterology and Hepatology
Huge Hepatocellular Carcinoma Abruptly Developed within 3 Months.: Sang Hyuk Lee, Byung Ik Kim, Chang Uk Chon, Ki Bae Bang, Eun Haeng Jeong, Jeong Yeon Seo, Eun Hye Park, Ji Soo Seol; Yeungnam Univ J Med. 2012;29(1):48-53. Published online June 30, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.1.48

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Abstract PDF: Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related deaths in South Korea. To decrease its mortality rate, its early detection is very important. Screening for HCC detection has been accepted as the management modality for patients with chronic liver disease. Reported herein is a case involving the marked rapid growth of HCC detected at an advanced stage in a screening test with a 3 months interval. A 49-year-old male patient with chronic hepatitis B was admitted to the hospital due to a liver mass detected on CT scan. The patient underwent a first CT scan 3 months earlier, and no tumor was detected. Follow-up CT scan was performed and showed a 9.1 cm HCC with portal vein thrombosis. Percutaneous liver biopsy was performed, and the diagnosis of hepatocellular carcinoma was confirmed. In the pertinent guidelines, the recommended screening interval for HCC is 6-12 months, but the screening interval and additional diagnostic methods should be considered due to the variation in the HCC growth rate according to the patient's clinical characteristics.

Original Article

Oncology and Cancer Research
Early or Late Gefitinib, Which is Better for Survival?: Retrospective Analysis of 228 Korean Patients with Advanced or Metastatic NSCLC.: Dong Gun Kim, Min Kyoung Kim, Sung Hwa Bae, Sung Ae Koh, Sung Woo Park, Hyun Je Kim, Myung Jin Kim, Hyo Jin Jang, Kyung Hee Lee, Kwan Ho Lee, Jin Hong Chung, Kyung Chul Shin, Hun Mo Ryoo, Myung Soo Hyun; Yeungnam Univ J Med. 2011;28(1):31-44. Published online June 30, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.1.31

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Abstract PDF: BACKGROUND
The optimal timing of treatment with EGFR-tyrosine kinase inhibitors (EGFR-TKI) in NSCLC patients has not yet been determined. METHODS: We separated 228 patients with advanced/metastatic NSCLC treated with gefitinib into an early gefitinib group (patients who received gefitinib as first- or second-line treatment) and a delayed gefitinib group (patients who received gefitinib as third or fourth-line treatment) and attempted to determine whether the timing of gefitinib treatment affected clinical outcomes. RESULTS: Median overall survival (OS), progression free survival (PFS), and median OS from first-line treatment of advanced/metastatic disease (OSt) for 111 patients in the early gefitinib group were 6.2 months, 3.3 months, and 11.6 months. However, median OS, PFS, and OSt for 84 patients in the delayed gefitinib group were 7.8 months, 2.3 months, and 22.7 months. No differences in OS and PFS were observed between the 2 groups. However, OSt was significantly longer in the delayed gefitnib group. Timing of gefitinib therapy was one of the independent predictors of OSt. Hb > or = 10 g/dl, and having never smoked, and ECOG performance status < or =1 were independent predictors of better PFS. CONCLUSION: Deferral of gefitinib therapy in patients with advanced or metastatic NSCLC may be preferable if they are able to tolerate chemotherapy.

Case Reports

Endocrinology, Diabetes, and Metabolism
A Case of Functionary Cystic Parathyroid Adenoma with Papillary Thyroid Carcinoma.: Woo Jin Chang, Hyun Hee Jung, Sang Hyen Park, Se Hoon Sohn, Ji Sung Yoon, Hyoung Woo Lee, Kyu Chang Won, In Ho Cho; Yeungnam Univ J Med. 2010;27(2):139-145. Published online December 31, 2010; DOI: https://doi.org/10.12701/yujm.2010.27.2.139

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Abstract PDF: Cystic parathyroid adenoma is one of rare causes of hyperparathyroidism, and tends to cause increased serum level of parathyroid hormone, alkaline phosphate and serum calcium level similar to when compared to those of solid adenoma.

Pulmonary and Respiratory Medicine
A Case of Paragonimiasis Suspected Lung Cancer.: Yeong Ha Ryu, Dae Hyung Woo, Jung Eun Park, Hyun Jung Kim, Kyeong Cheol Shin, Jin Hong Chung, Kwan Ho Lee; Yeungnam Univ J Med. 2010;27(1):69-73. Published online June 30, 2010; DOI: https://doi.org/10.12701/yujm.2010.27.1.69

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Abstract PDF

A paragonimiasis infestation is caused by the paragonimus species. Paragonimiasis mainly occurs by ingestion of raw or undercooked freshwater crabs or crayfish. In our country, the prevalence of paragonimiasis was high until late 1960s due to eating habits, but after the 1970s the prevalence of the disease has markedly decreased and now the disease is rarely seen. The diagnosis of tuberculosis by Chest X-ray is often confused with pulmonary carcinoma, bacillary and parasitic infections, and chronic mycosis. Pulmonary paragonimiasis must be considered in the differential diagnosis of lung cancer especially in the appropriate clinical setting because effective treatment with praziquantel can be rewarding. We report a case of a 58-year-old woman with pulmonary paragonimiasis that was suspicious for lung cancer, as detected by biopsy.

Citations

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A Case of Delayed Diagnosis of Pulmonary Paragonimiasis due to Improvement after Anti-tuberculosis Therapy
Suhyeon Lee, Yeonsil Yu, Jinyoung An, Jeongmin Lee, Jin-Sung Son, Young Kyung Lee, Sookhee Song, Hyeok Kim, Suhyun Kim
Tuberculosis and Respiratory Diseases.2014; 77(4): 178. CrossRef

Gastroenterology and Hepatology
Colon Cancer with a Nonspecific Inflammatory Colonoscopic Finding.: Jae Hyun Park, Byung Ik Jang, Ho Chan Lee, Sung Joon Kim, Jun Seok Park; Yeungnam Univ J Med. 2009;26(2):114-119. Published online December 31, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.2.114

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Abstract PDF: Colon cancer is the second most common malignancy in Korea. It is classified as superficial type, the mass type, the ulcerative type, the ulceroinfiltrative type, the diffuse infiltrative type and the unclassified type according to the colonoscopic findings. We report here on a case of colon cancer that was initially misdiagnosed as acute infectious colitis at the initial presentation. A 64-year-old man visited to Yeungnam University Hospital for watery diarrhea and lower abdominal pain. Colonoscopy revealed long segmental edematous mucosa and hyperemic mucosa with stenosis in the transverse colon. He was diagnosed as having acute infectious colitis according to the colonoscopic finding. However, two days later after colonoscopy, he visited the emergency room for hematochezia. We performed computerized tomography(CT) and obtained blood samples to find the origin of the bleeding. We found thickening of the transverse colon lumen and ascites on the CT finding and an elevated level of tumor markers; we also obtained the results of the colonoscopic biopsy that was done via colonoscopy. He was finally diagnosed as having colon cancer with carcinomatosis, a poorly differentiated adenocarcinoma.

Obstetrics, Gynecology, and Reproductive Medicine
A Case of Clear Cell Adenocarcinoma of the Uterine Cervix: Sung-Chul Park, Yoon-Ki Park, Doo Jin Lee, Sung-Ho Lee; Yeungnam Univ J Med. 2007;24(2 Suppl):S652-657. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S652

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Abstract PDF: Clear cell adenocarcinoma of cervix is a very rare malignancy of the uterine cervix. The etiology and pathogenesis are unclear. Clear cell adenocarcinomas have been reported most commonly in women with a history of in utero exposure to diethylstilbesterol (DES), these tumors also can develope in the absence of exposure to DES. These tumors account for 4% to 9% of adenocarcinomas of the cervix. We report a case of clear cell adenocarcinoma in the uterine cervix of 40 years-old women who was not related to DES with a brief review of literature.

Original Articles

Radiation Oncology
Comparision of Parotid Gland Dose Distribution between 3DCRT and IMRT in Head and Neck Radiation Therapy: Sang Mo Yun, Sung Kyu Kim; Yeungnam Univ J Med. 2007;24(2 Suppl):S443-448. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S443

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Abstract PDF: Purpose：This study compared 3 dimensional conformal radiation therapy (3DCRT) to intensity modulated radiation therapy (IMRT) in parotid glands sparing in head and neck cancers. Materials and Methods：Planning target volume (PTV) was outlined on each CT slice. The dose of 50.4 Gy was prescribed to the PTV with the conventional fraction, 5 fractions per week. We also outlined spinal cord and both parotid glands. With Eclipse 3 dimensional planning system, 3DCRT and IMRT planning were done.
Results
：After plan optimization, PTV dose distribution was evaluated with dose volume histogram. The 90% isodose curve covered almost all of PTV for both techniques. Maximum and median dose for spinal cord were 36.8 Gy and 34.2 Gy in 3DCRT, 39.9 GY and 37.5 Gy in IMRT. For parotid glands, mean and median dose were 33.6 Gy and 37.6 Gy in 3DCRT, 24.9 Gy and 24.5 Gy in IMRT.
Conclusion
：For the non-pharyngeal head and neck cancers, 3DCRT was cost effective radiation modality in prevention radiation therapy induced xerostomia.

Surgery
The Clinical Relevance of Distinguishing pT2 Gastric Cancer According to the Depth of Invasion and a Difference of Prognosis: Se Won Kim, Sun Kyo Song, Sang Woon Kim; Yeungnam Univ J Med. 2007;24(2 Suppl):S416-423. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S416

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Abstract PDF

Purpose：A difference of a pathologic characteristic in proportion to depth of invasion analyzed in T2 gastric cancer and a difference of depth of invasion examined an influence to lymph node metastasis and prognosis. Materials and Methods：The clinicopathologic outcomes of 432 patients who underwent curative resection for pT2 stage gastric cancers from 1995 to 1999 were reviewed retrospectively. We are compared on lymphatic metastasis, stage distribution, histologic classification, Bormann’s classification, Lauren classification, vessel invasion, lymphatic invasion, neural invasion and 5-year survival rate of pT2 groups(mp vs. ss).
Results
：pT2b(ss) group compare to pT2a(mp) in Lauren classification, ratio of diffused type was higher(p<0.05) and in Bormann classification, infiltration type was higher (p<0.01). Vessel and lymphatic invasion, neural invasion showed significant difference between pT2a(mp) and pT2b(ss) (p<0.01). Difference noted between pT2a(mp) and pT2b(ss) group in a lymph node metastatic rate, degree of a metastasis and stage distribution (p<0.01). On stratifying patients according to depth of invasion, 5-year suvival rate for those with pT2a(mp) group was significantly greater than those with pT2b(ss) group(82.4% vs. 47.4%, respectively: P<0.01). In this study, appeared with the significant prognostic factor in 5-year suvival rate which multivariate analysis, depth of invasion(P<0.05) and lymph node metastasis (P<0.01) that enforced the total gastric cancer patient who had T2 gastric cancer with the object noted, but for patients with accurately staged pN0 group, suvival characteristics were similar for pT2a (mp) and pT2b(ss) gastric cancer (P=0.97).
Conclusion
：The subclassification of pT2 gastric cancer into pT2a(mp) and pT2b(ss) is necessary to demonstrate their different prognosis.

Citations

Citations to this article as recorded by

The Analysis of Clinical Characteristics of pT2a and pT2b Gastric Cancer
Byoung Hyun Choi, Ji Hoon Kim, Jin Ho Kwak, Hyuck Jae Jang, Myung Sik Han
Journal of the Korean Surgical Society.2009; 77(4): 257. CrossRef

Surgery
Efficacy and Side Effect of Docetaxel Based Chemotherapy as Second-Line Treatment in Recurrent Gastric Cancer: Se Won Kim, Sang Woon Kim, Sun Kyo Song; Yeungnam Univ J Med. 2007;24(2 Suppl):S399-406. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S399

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Abstract PDF: Purpose：To investigate the efficacy and safety of docetaxel based chemotherapy as a secondline treatment in patients with metastatic or recurrent gastric cancer. Materials and Methods：Between January 2001 and March 2007, 28 patients with recurrent or metastatic gastric cancer were enrolled. The administered doses of decetaxel was 75 mg/m² on day 1 and 5, cisplatin 60 mg/m² on day 3, 5-FU 600 mg/m² over 24 hrs on day 1 to day 5, every 4 weeks. The response was assessed every 2 cycles. The toxicities were evaluated for every course of chemotherapy according to National Cancer Institute-common toxicity criteria (NCI-CTC).
Results
：For response rates, 3 (10.7%) partial response, 13 (46.4%) stable disease, and 12 (42.9%) progressive disease, respectively. The overall disease control rate was 57.1%. The median time to progression was 3.0 months (2-8 months). Median overall survival was 8 months (5-11 months). NCI-CTC grade 3 leukocytopenia occurred in 1 cases, grade 3 anemia in 1case and grade 3 nausea/vomiting in 2 cases.
Conclusion
：Docetaxel based chemotherapy has a tolerable efficacy with acceptable toxicities in patients with recurrent gastric cancer as a second-line treatment.

Surgery
Efficacy of Unresectable or Recurred Gastric Cancer Treated with TS-1 Chemotherapy or TS-1/CDDP Combination Chemotherapy: Se Won Kim, Sang Woon Kim, Sun Kyo Song; Yeungnam Univ J Med. 2007;24(2 Suppl):S391-398. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S391

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Abstract PDF: Purpose：Although several chemotherapy regimens used against advanced and recurred gastric cancer have been studied extensively in an attempt to further improve the prognosis of patients, no standard chemotherapeutic regimens have been established. The aim of this study was to determine the anti-tumor efficacy and safety of TS-1 or TS-1 plus cisplatin (CDDP). Materials and Methods：From December 2004 to June 2007, we treated 43 patients with unresectable or recurred gastric cancer either with 80 mg/m2 of TS-1 for 28 days, which was followed by a 2-week rest, or with 80 mg/m² of TS-1 for 28 days and 60 mg/m² of CDDP on day 3 every 6 weeks.
Results
：Tumor response rates in the primary chemotherapy group and in the recurrent group were 46.7% and 21.4%, respectively. The median survival rates in the primary and the recurrent group were 14 months and 8 months, and it was not significantly different. But the one-year survival rates according to the kinds of regimens (TS-1 or TS-1/CDDP group) were significantly different (P=0.0014). The incidences of grade 3 or 4 adverse effects were 18%, respectively.
Conclusion
：The anti-tumor efficacy and safety of TS-1 and TS-1 plus CDDP in unresectable or recurred gastric cancer patients seemed to be high with modest adverse effects, thus suggesting the possible use of this regimen for unresectable or recurred gastric cancer patients.

Thoracic and Cardiovascular Surgery
Comparison of Postoperative Results after Pneumonectomy between Lung Cancer and Infectious Lung Disease Groups: Jang Hoon Lee, Jung Cheul Lee; Yeungnam Univ J Med. 2007;24(2 Suppl):S304-309. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S304

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Abstract PDF: Background
：Pneumonectomy has been known with higher rate of morbidity and mortality. Thereby, we evaluated patients who received pneumonectomy for lung cancer and infectious lung disease related to postoperative morbidity and mortality. Materials and methods：The retrospective study was undertaken in 55 patients who had undergone pneumonectomy at Yeungnam University Hospital from January 1996 to December 2004. We devided into two groups, lung cancer group (group A, n=40) and infectious lung disease group (group B, n=15) and then compared and analyzed.
Results
：The mean age was higher in group A and there was statistical significance (60.8 9.4 vs 45.7 12.1, p<0.001). With preoperative pulmonary function test, FEV1, FVC were higher in group A and there were statistical significane (p<0.001, p=0.006). With preoperative lung perfusion scan, the perfusion ratio of affected lung and postoperative predicted FEV1 were higher in group A and there were statistical significance (p<0.001, p=0.007). According to MRC dyspnea scale, change of respiratory difficulty of group A had statistical significance (p<0.001). There were a total 20 postoperative complications (36.4%) of which arrhythmia 7, postoperative bleeding 5, empyema and/or bronchopleural fistula 3, pneumonia 2, adult respiratory distress syndrome 1, vocal cord palsy 1. The postoperative complication rate was no difference between two groups (37.5% vs 33.3%) but arrhythmia developed in group A only. There were 3 postoperative mortalities, all in group A.
Conclusion
：Preoperative pulmonary function test and postoperative predicted FEV1 were lower in group B, however, postoperative complication rate was no difference between two groups and mortality developed in group A only. Because of lesser resected lung volume and well adopted in long term diseased period, there was lesser hemodynamic change in infectious lung disease. So postoperative mortality not developed in infectious lung disease group due to arrhythmia and respiratory failure.

Review Articles

Surgery
Treatment of Rectal Cancer: Sang Hun Jung, Jae Hwang Kim, Min Chul Shim; Yeungnam Univ J Med. 2007;24(2 Suppl):S283-295. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S283

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Abstract PDF: Treatment for rectal cancer continues to develop towards the improved local control and overall survival, maintaining quality of life, and preserving sphincter, genitourinary, and sexual function. Preoperative assessment for tumor depth, lymph node, and distant metastasis has an important role on treatment plan. Preoperative staging is used to determine the indication for neoadjuvant therapy as well as the indication for local excision versus radical cancer resection. Local excision is likely to be curative in patients whose tumor are confined to the submucosa without regional lymph and systemic metastasis. Total mesorectal excision (TME) and autonomic nerve preservation are standard procedure for advanced rectal cancer. In patients with advanced tumor stage (T3/T4 and/or N1) with no distant metastasis, preoperative chemoradiation followed by radical resection has become widely accepted recently.

Pathology and Forensic Medicine
Methods of Margin Assessment in Breast Conserving Surgery: Young Kyung Bae; Yeungnam Univ J Med. 2007;24(2 Suppl):S262-269. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S262

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Abstract PDF

Breast conserving surgery has become the preferred method of treatment for breast cancer. Therefore clear surgical margin is critical to minimize the risk of local recurrence. Although paraffin section of inked surgical margin is the gold standard for margin assessment, this process is time consuming, and results are not available until after the operation. Several methods of intraoperative margin assessment are available including gross evaluation of the tumor specimen, specimen slice radiography, pathologic evaluation with touch preparation cytology or frozen section analysis. Here I review three methods of pathologic evaluation -macroscopic evaluation, touch preparation cytology, and frozen section- and deal with problems and pitfalls that can happen in routine diagnostic fields.

Citations

Citations to this article as recorded by

A Study on the Quality of a Frozen Section of Breast Resection Margin during Breast-Conserving Surgery
Byung-Il Choi, Su-Sie Chin
The Korean Journal of Clinical Laboratory Science.2021; 53(3): 233. CrossRef

Radiation Oncology
Role of Radiation Therapy in Treatment of Stomach Cancers: Sang Mo Yun, Myung Se Kim; Yeungnam Univ J Med. 2007;24(2 Suppl):S245-251. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S245

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Abstract PDF: Although occasionally used as a therapeutic modality, radiotherapy was not a routine part of the treatment of stomach cancer. As a single modality, preoperative radiotherapy showed some benefit, but this was not confirmed in radomized trial. In recent neoadjuvant trials, radiotherapy is usually given concurrently with chemotherapy, and pathologic complete response rates was about 30%. There were small studies of radiotherapy as an adjuvant, either alone or with chemotherapy, but the randomized studies using postoperative radiotherapy alone did not show a survival benefit. The results of intergroup gastric adjuvant trial(INT 0116) were presented in May 2000 at American Society of Clinical Oncology. In that report, postoperative concurrent chemoradiotherapy showed survival benefit. INT 0116 has established postoperative chemoradiotherapy as the standard care for high risk patients with resected stomach cancer. But, INT 0116 had several weak points including lack of standardized nodal dissection and delivery rates of treatments. So, Asian and European investigators did not agree. Korean study showed benefit of postoperative chemoradiotherapy after D2 dissection, but this study was not randomized. Recently, Korean investigators started randomized trial of chemoradiotherapy in D2 dissected patients. This trial may give answer to us about the benefit of postoperative chemoradiotherapy in resected stomach cancer.

Neurosurgery
Nondestructive Neuroaugmentative Surgery for Intractable Cancer Pain: Seong-Ho Kim, Byung-Yon Choi, Soo-Ho Cho; Yeungnam Univ J Med. 2007;24(2 Suppl):S192-202. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S192

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Abstract PDF: Pain is probably one of the most common cancer symptoms. In addition to being a major source of suffering and disability, cancer pain is extremely frightening for patients and their families. The authors propose to adjust the World Health Organization (WHO) pain management ladder from its current three-step approach to a more sophisticated five-step algorithm that includes physical and psychological modalities along the entire continuum of care and adds two more steps related to neuromodulative and neurodestructive procedures once the opioids fail. This review discusses the current surgical options for treating cancer pain, focusing on the continuous drug infusion pump currently available and briefly exploring some of the other surgical options for pain management. The introduction of intrathecal opioid administration for intractable cancer pain is considered as one of the most important breakthroughs in pain management. Morphine, the only opioid approved by FDA for intrathecal administration, has been increasingly utilized for this purpose.

Surgery
Treatment of Advanced Gastric Cancer: Sun-Kyo Song; Yeungnam Univ J Med. 2007;24(2 Suppl):S125-131. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S125

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Abstract PDF: Curative surgery is the most common and desirable treatment for advanced gastric cancer(AGC), but macroscopically curative resection of AGC dose not always mean a curative outcome. For the tailored management of AGC, accurate preoperative stage are made by using abdominal CT, FDG PET and laparoscopy is necessary. In case of T₃/T₄ lesion, neoadjuvant chemotherapy(NAC) and neoadjuvant chemoradiotherapy(NACR) are effective therapeutic approaches with acceptable toxicity without increasing surgical morbidity and mortality. I recommend the use of a multidisciplinary therapeutic strategy for treatment of AGC. Future applications of newer cytotoxic drugs such as oxaliplatin, capecitabine, irinotecan, and docetaxel or targeted therapies may help to improve the management of AGC.

Original Article

Otorhinolaryngology
Docetaxel and Cisplatin Combination Chemotherapy in Patients with Advanced Head and Neck Cancer.: Sung Won Choi, Young Ho Choi, Chang Hoon Bai, Yong Dae Kim, Si Youn Song; Yeungnam Univ J Med. 2006;23(2):162-170. Published online December 31, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.2.162

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Abstract PDF: BACKGROUND
Head and neck cancer is curable at early stages with local-regional therapy. However, most patients are diagnosed with advanced stage disease that requires combination therapy. The aim of this study was to determine the efficacy of docetaxel and cisplatin combination chemotherapy, in patients with advanced head and neck cancer by evaluating the response, survival and organ preservation rates. MATERIALS AND METHODS: We reviewed retrospectively the medical records of 39 patients with advanced head and neck cancer who received docetaxel and cisplatin combination chemotherapy from March 2000 to July 2004. RESULTS: The average age of the 39 patients was 53.4 (range 30 to 73 years) years and the most common primary site was the hypopharynx (23.0%). There were 36 patients who had stage IV disease and three patients with stage III disease. The overall response rate was 76.9% (30/39), including 12 complete responses (30.8%) and 18 partial responses (46.1%). The response rate based on the primary cancer and neck metastasis was 74.4% and 69.3%; the differences were not significant. Among 16 patients with laryngeal and hypopharyngeal cancer, 13 (81.2%) had their larynx preserved after chemotherapy followed by radiotherapy and a survival rate of 61.5%; three patients (18.8%) received a total laryngectomy and had a survival rate of 66.7%. The overall survival rate from the start of chemotherapy was 56.4% with a median survival of 30 months. The common toxicities observed were alopecia, vomiting, diarrhea, hepatotoxicity and anemia but they were all generally manageable. CONCLUSION: Docetaxel and cisplatin combination chemotherapy is an effective regimen with a relatively high response rate and acceptable toxicity

Review

Oncology and Cancer Research
Target Therapy for Colorectal Cancer.: Kyung Hee Lee; Yeungnam Univ J Med. 2006;23(2):143-151. Published online December 31, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.2.143

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Abstract PDF: In the past decade, the median duration of survival among patients with advanced colorectal cancer has increased from 12 months to about 18 months, primarily as a results of the introduction of irinotecan and oxaliplatin. Advances in the understanding of the molecular mechanisms underlying the development and progression of cancer have resulted in the discovery of new therapeutic interventions that target specific molecular abnormalities. Their specificity, and therefore their potential to bind preferentially and modify tumor-specific targets, sparing normal tissues and causing fewer side-effects compared to conventional cytotoxic agents, makes them an attractive therapeutic option. The future of this approach for the treatment of solid tumors is promising

Original Article

Surgery
The Comparison of Survival Rates of Postoperative Adjuvant Chemotherapies in The Stage III Gastric Cancer Patients.: Eun Mi Kim, Se Won Kim, Sang Woon Kim, Sun Kyo Song; Yeungnam Univ J Med. 2006;23(2):193-204. Published online December 31, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.2.193

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Abstract PDF: PURPOSE: Various postoperative adjuvant chemotherapy regimens have been proposed for the patients with advanced gastric cancer. The majority of clinical trials have shown no significant difference in the survival benefit. The aim of this study was to compare the survival rates of postoperative adjuvant chemotherapies used in stage III gastric cancer patients who received curative gastrectomy. MATERIALS AND METHODS: Between 1990 and 1999, a survival analysis was performed in 260 patients who received curative gastric resection and postoperative adjuvant chemotherapy. The patients were divided into four groups according to the chemotherapeutic regimens received. The groups were: the F group: furtulon alone, FM group: furtulon and mitomycin, FAM group: 5-FU, adriamycin and mitomycin, FLEP group: 5-FU, leucovorin, etoposide and cisplatin. The survival rates were analyzed using the Kaplan-Meier method and the Cox proportional hazards model. RESULTS: There were no differences among the groups of patients with regard to tumor characteristics except for lymph node metastasis and the ratio of metastasis to lymph nodes. In the FLEP group, the ratio of metastasis to lymph nodes was higher than in the other groups. The five and ten year survival rates of F, FM, FAM and FLEP were 51.9%, 28.9%, 59.5%, 49.8%, 66.1%, 57.4% and 30.0%, 27.5%, respectively. The univariate analysis showed that age, Borrmann type, lymph node metastasis, ratio of metastasis to lymph nodes, postoperative adjuvant chemotherapy and recurrence were significant factors for survival. For the multivariate analysis, recurrence, age, Borrmann type, ratio of lymph node metastasis and lymph node dissection were independent prognostic factors; however, the postoperative adjuvant chemotherapy was not an independent prognostic factor. CONCLUSION: The FAM regimen was the most beneficial postoperative adjuvant chemotherapy for improved survival rates; the FM regimen was the second and the FLEP regimen was the last. In order to determine the effectiveness of postoperative adjuvant chemotherapy in stage III gastric cancer, well designed prospective studies including a surgery only group will be needed.

Case Report

Gastroenterology and Hepatology
Colon Cancer in Behcet's Disease.: Ji Eun Lee, Jang Won Sohn, Kyu Hyung Lee, Youn Sun Park, Kook Hyun Kim, Jae Won Choi, Jong Ryul Eun, Byung Ik Jang, Tae Nyeun Kim; Yeungnam Univ J Med. 2006;23(1):124-130. Published online June 30, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.1.124

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Abstract PDF

Behcet's disease has rarely been reported in association with malignant diseases. In most cases the autoimmune nature of the disease itself or immunosuppressive drug use has been blamed for malignant transformation. Solid tumors in addition to lymphoid and hematological malignancies are also seen during the course of Behcet's disease. We present here a case of colon cancer in a 40-year-old man with Behcet's disease. A near total colectomy was performed and postoperative chemotherapy and radiotherapy was administered to treat visceral peritoneal invasion. Recurrent evidence was not found. We present the clinical details of this rare case of colon cancer with Behcet's disease.

Citations

Citations to this article as recorded by

Cancer colique au cours de la maladie de Behçet
S. Bouomrani, H. Baïli, K. Souid, I. Kilani, M. Beji
Journal Africain d'Hépato-Gastroentérologie.2016; 10(1): 1. CrossRef
Morbidity of Solid Cancer in Behçet's Disease: Analysis of 11 Cases in a Series of 506 Patients
So Young Na, Jaeyoung Shin, Eun-So Lee
Yonsei Medical Journal.2013; 54(4): 895. CrossRef

Original Articles

Urology
Association between Obesity and Prostate Cancer.: Chang Jun Yoon, Ki Hak Moon, Tong Choon Park; Yeungnam Univ J Med. 2005;22(2):199-210. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.199

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Abstract PDF: BACKGROUND
The role of obesity in prostate cancer etiology remains controversial. The aim of this study was to evaluate the relationship between obesity and prostate cancer risk. MATERIALS AND METHODS: Between January 2000 and June 2005, 286 patients suspected of having prostate cancer underwent prostate biopsy. The clinical records of the 286 study patients were retrospectively reviewed with regard to age, Body Mass Index (BMI), serum PSA, TRUS, and prostate biopsy results. They were stratified by BMI into three groups according to the cutoffs recommended for Asian populations: normal, BMI less than 23 kg/m2; overweight, BMI 23 to 25 kg/m2; and obese, BMI greater than 25 kg/m2. RESULTS: As for BMIs, 132 (46.2%) were normal, 95 (33.2%) overweight and 59 (20.6%) were obese. A total of 99 (34.6%) patients were diagnosed as having prostate cancer. In multivariate logistic regression analyses, no significant association was observed between BMI and prostate cancer detection. CONCLUSION: We initially hypothesized that obesity may be biologically associated with increased prostate cancer development. However, our study did not show a significant association between BMI and prostate cancer.

Otorhinolaryngology
Activation and Abnormalities of Cell Cycle Regulating Factor in Head and Neck Squamous Cell Carcinoma Cell Lines: Abnormal Expression of CDKN2 Gene in Laryngeal Squamous Cell Carcinoma.: Si Youn Song, Tae Hee Han, Chang Hoon Bai, Yong Dae Kim, Kei Won Song; Yeungnam Univ J Med. 2005;22(2):166-182. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.166

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Abstract PDF: BACKGROUND
Cyclin-dependent kinase (CDK) inhibitors are family of molecules that regulate the cell cycle. The CDKN2, a CDK4 inhibitor, also called p16, has been implicated in human tumorigenesis. The CDKN2 inhibits the cyclin/CDK complexes which regulate the transition from G1 to S phase of cell cycle. There is a previous report that homozygous deletion of CDKN2 region on chromosome 9p21 was detected frequently in astrocytoma, glioma and osteosarcoma, less frequently in lung cancer, leukemia and ovarian cancer, but not detected in colon cancer and neuroblastoma. However, little is known about the relationship between CDKN2 and laryngeal cancer. Therefore this study was initiated to investigate the role of CDKN2 in human laryngeal squamous cell carcinoma development. MATERIALS AND METHODS: We used 5 human laryngeal carcinoma cell lines whether they have deletions or losses of CDKN2 gene expression by DNA-PCR or RT-PCR, respectively. We examined 8 fresh frozen human laryngeal cancer tissues to detect the loss of heterozygosity (LOH) of CDKN2. PCR was performed by using microsatellite markers of short arm of human chromosome 9 (D9S126, D9S144, D9S156, D9S161, D9S162, D9S166, D9S171, D9S200 and D9SIFNA). For informative cases, allelic loss was scored if the signal of one allele was significantly decreased in tumor DNA when compared to the same allele in normal DNA. RESULTS: The CDKN2 DNA deletion was observed in 3 cell lines. The CDKN2 mRNA expression was observed in only one cell line, which was very weak. LOH was detected in 7 cases (87.5%). CONCLUSION: These results suggest that CDKN2 plays a role in the carcinogenesis of human laryngeal squamous cell carcinoma.

Otorhinolaryngology
Clinical Characteristics and Prognostic Factors of Nasopharyngeal Cancer.: Chang Hoon Bai, Young Jung Seo, Sang Baik Ye, Young Ho Choi, Yong Dae Kim, Si Youn Song; Yeungnam Univ J Med. 2005;22(1):72-80. Published online June 30, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.1.72

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Abstract PDF: BACKGROUND
Nasopharyngeal cancer is a rare disease with a relatively poor prognosis because it tends to be diagnosed at an advanced stage. The aim of this study was to establish the clinical characteristics of nasopharyngeal cancer. MATERIALS AND METHODS: The medical records of 54 patients with nasopharyngeal cancer from January 1993 to December 2002 were reviewed retrospectively. Forty one cases were male (75.9%) and thirteen were female (24.1%). The average age was of 46.9 (range 16 to 78 years) years. The majority of patients (79.6%) were diagnosed in the advanced stage. The most common complaints were a neck mass (55.5%) and the WHO type III (53.7%) was the most frequent histological type. RESULTS: The cumulative survival rate for a 5-year period was 46.5% and the T stage, N stage, pathologic type, and clinical stage were not significantly related to the survival rate. Sixteen of 54 (31.5%) cases presented with a distant metastasis of the bone, lung, brain, spine, and liver, and six cases (11.1%) presented with a locoregional recurrence. CONCLUSION: TNM staging is not appropriate for predicting survival rate of nasopharyngeal carcinoma patients. Therefore, a newer staging system, which includes new factors, is needed to predict the prognosis.

Oncology and Cancer Research
Phase II Study of Paclitaxel and Cisplatin as Second-line Chemotherapy in Advanced Non-small Cell Lung Cancer.: Yeoung Tae Seo, Bong Seog Kim, Ji Young Go, Dong Suk Choi, Seong Ho Choi, Hye Jin Kim, Young Mi Ahn, Yong Ho Roh, Kyung Hee Lee; Yeungnam Univ J Med. 2004;21(2):198-206. Published online December 31, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.2.198

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Abstract PDF: BACKGROUND
To evaluate the efficacy and safety of paclitaxel and cisplatin against advanced non-small cell lung cancer (NSCLC) as a second-line chemotherapy. SUBJECTS AND METHODS: Twenty-five patients were enrolled. The patients received 200 mg/m2 paclitaxel as a 3-hour intravenous infusion and 60 mg/m2 cisplatin as 30-minute intravenous infusion with vigorous hydration on day 1 every 28 days. The response was assessed every 2 cycles. RESULTS: All 25 patients were assessed for their response and toxicity. Partial responses were observed in 5 patients. The overall response rate was 20% (95% confidence interval, 4%~36%) and the median response duration was 4.5 (range, 2-11) months. The median time to progression was 3.3 (range, 0-14) months. The median overall survival of all patients was 7.4 (range, 1.3-39) months. The hematologic toxicities were minor and easily controlled. CONCLUSION: The combination chemotherapy of paclitaxel and cisplatin as a second-line treatment has a moderate efficacy with an acceptable toxicity in patients with advanced NSCLC.

Radiation Oncology
Design of a New Applicator for High-Dose Rate Vaginal Brachytherapy.: Sei One Shin; Yeungnam Univ J Med. 2000;17(2):123-128. Published online December 31, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.2.123

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Abstract PDF: PURPOSE: This study was aimed to develop a new vaginal applicator(Shin's Applicator) for 2-channel high-dose rate vaginal brachytherapy to evaluate uniformity of surface dose, and to present 3-dimensional dose distribution of the applicator. METHODS: Shin's Applicator was inexpensively constructed using human soft tissue equivalent acrylic bar. We evaluated dose uniformity along the applicator surface using film densitometer and performed vaginal intracavitary brachytherapy after insertion of the applicator using HDR brachytherapy planning software and brachytherapy unit(Ralstron-20B). RESULTS: Shin's Applicator allows improved dose distribution than the existing 1-channel cylinder and achieves diminished urinary bladder and rectal dose by 20%. CONCLUSIONS: From the above results, it can be concluded that Shin's Applicator may be an improved form of a vaginal applicator. Furthermore, it can be suggested that this applicator has an advantage, for it prevents vaginal stenosis after radiation therapy and can be used as a disposable vaginal dilator. Further follow up examination with radiological study may be helpful to evaluate the therapeutic efficacy of this applicator.

Oncology and Cancer Research
Screening Examination of Breast Cancer: Review of the Recommended Guidelines.: Myung Ho Shin, Mi Soo Hwang, Bok Hwan Park; Yeungnam Univ J Med. 1999;16(2):342-346. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.342

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Abstract PDF: BACKGROUND
Delays in breast cancer diagnosis may occur in young women due to a low index of suspicion. The purpose of this study was to compare mammography and breast sonography in detection of breast cancer and to suggest a reasonable guideline for breast cancer screening examination. MATERIALS AND MATHODS: Among 820 patients, 102 patients were under 35 years and 122 patients were above 60 years of age. We reviewed medical records, mammograms and/or ultrasonography of 49 patients under 35 years and 48 patients above 60 years of age with pathologically-proven breast cancer. Pathological reports were as follows: Invasive ductal carcinoma(IDC) was present 61.2% of patients in the young age group and ductal carcinoma in situ(DCIS) in 16.3%. IDC was present in 66.6% of the patients in the old age group, and DCIS in 8.33%. We analyzed mammography and ultrasonography to evaluate their usefullness in detecting breast cancer in patients under 35 years and over 60 years of age. RESULTS: The mammographic results are as follows: 1) detection rate of lesion: 83.8%(under 35yrs), 100%(over 60yrs) 2) sensitivity of cancer: 67.6%(under 35yrs), 91.2%(over 60yrs) The ultrasonographic results are as follows: 1) detection rate of lesion: 100% 2) sensitivity of cancer: 87.2%(under 35yrs), 96.7%(over 60yrs) The breas cancer detection rate in women under 35 years old was comparable to that of women above 60 years old in our study. CONCLUSION: A striking histologic finding in the two groups was a higher incidence of nuclear Grade II and III tumors. This finding correlates with the reported increased incidence of high grade tumors inyoung women and may correlae with the poorer prognosis of breast cancer in young patients. We conclude that early screening examination is helpful for early detection of breast cancer in women under age 35.

Oncology and Cancer Research
A Clinical study on the Hypercalcemia in Primary Bronchogenic Carcinoma.: Hye Jung Park, Kyeong Cheol Shin, Young Chul Moon, Jin Hong Chung, Kwan Ho Lee, Cha Kyung Sung, Hyun Woo Lee; Yeungnam Univ J Med. 1999;16(2):208-218. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.208

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Abstract PDF: BACKGROUND
Lung cancer-associated hypercalcemia is one of the most disabling and life-threatening paraneoplastic desorders. Humoral hypercalcemia is responsible for most lung cancer-associated hypercalcemia. Patients with hypercalcemia are usually in the advenced atage with obvious bulky tumor and carry a poor prognosis. MATERIALS AND METHODS: Total 29 patients satisfied the following criteria: histologically proven primary lung cancer, corrected calcium level> or =10.5 mg/dL, and symptons which could possibly be attributed to hypercalcemia. In this retrospective study, we evalluated the various clinical aspects of hypercalcemia, in relation to cancer stage, histologic cell type, mass size, bone metastasis, performance status, and other possible characteristics RESULTS: Total 29 lung cancer patients with hypercalcemia were studied, and most of them had squamous cell carcinoma in their histologic finding. The incidence of hypercalcemia was significantly higher between 50 and 69 years of age, and in the advancement of cancer stage. Although serum calcium level showed positive correlation with mass size, performance statusm and bone ore frequent in the patients with higher serum calcium level. There were no differences in effectiveness among therapeutic regimens. Hypercalcemia was more frequently in the later stage of disease than during the initial diagnosis of lung cancer. Most of the patients died within 1 month after development of hypercalcemia. CONCLUSION: We concluded that hypercalcemia in lung cancer is related to extremely poor prognosis, and may be one of the causes of drath and should be treated aggressively to prevent sudden deterioration or death.

Oncology and Cancer Research
The clinical relevance of nm23 protein expression in resected gastric cancer patient.: Sun Kyo Song, Hong Jin Kim, Sang Woon Kim; Yeungnam Univ J Med. 1999;16(1):43-51. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.43

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Abstract PDF: The aim of present study was to elucidate whether the expression of nm23 protein might be of clinical value as prognostic factor in gastric cancer. The expression of nm23 protein was analyzed using immunohistochemical method in formalin-fixed and paraffin-embedded tissue samples of 76 gastric carcinoma patients. The cytoplasmic immunoreactivity of nm23 protein were detected in 53.9%(41/76). When the immunoreactivity of nm23 protein with TNM status and other histopathologic findings were compared by using Chi-Square test, nm23 was found to have correlations with the lymph node metastasis(p=0.04), the number of metastatic lymph node, and the invasion of lymphatic vessels(p=0.007). But, it has no correlation with TNM status. The conventional prognostic factors such as the depth of invasion, lymph node metastasis, distant metastasis, Borrmann type, size of tumor, and the curability of operation was found to have strong correlation with the survival time(p<0.003). But, the expression of nm23 protein was not significantly correlated with that in survival analysis. These results showed that the expression of nm23 protein is not a useful prognostic indicator in gastric cancer.

Case Report

Endocrinology, Diabetes, and Metabolism
A Case of Parathyroid Carcinoma with Systemic Calcification.: Heui Sik Kim, Chan Woo Lee, Sang Yiup Nam, Jin Chul Park, Ji Sang Yoon, Jae Chun Lee, Kyu Chang Won, Ihn Ho Cho, Tae Nyun Kim, Hyoung Woo Lee, Myung Soo Hyun, Hyun Woo Lee; Yeungnam Univ J Med. 1997;14(2):459-466. Published online December 31, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.2.459

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Abstract PDF

Hyperparathyroidism due to parathyroid cancer is rare. It is difficult to diagnose preoperatively but there should be an increased index of suspicion in those parathyroid Patient with palpable neck masses, profound hypercalcemia(greater than 14mg/dl), made increase of the parathyroid hormone level to greater than twice normal, and significant metabolic complications. In parathyroid cancer, systemic calcinosis is an extremely rare manifestation. The most common metastatic calcification site is lung and the other involved site is stomach, liver, skin and heart. After resection of parathyroid tumor, this systemic calcinosis is self-limiting. We experienced a patient with primary hyperparathyroidsm, presented with metastatic calcification in the lung and stomach disappeared by successful parathyroidectomy.

Citations

Citations to this article as recorded by

A Case of Parathyroid Carcinoma in a Patient with Stage 3 Chronic Kidney Disease
Youn Hee Cho, Moo Yong Park, Soo Jeong Choi, Jin Kuk Kim, Seung Duk Hwang, Jung Mi Park, Jeong Ja Kwak
Korean Journal of Medicine.2012; 83(6): 796. CrossRef

Original Article

Surgery
Association between cancer and selenium concentration in blood and toenails.: Jung Kil Rhee, Jong Hak Chung, Jun Sakong, Pock Soo Kang, Chang Yoon Kim, Kyeong Soo Lee, Koing Bo Kwon; Yeungnam Univ J Med. 1992;9(1):29-43. Published online June 30, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.1.29

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Abstract PDF

A case-control study was conducted to investigate the association between the risk of cancer and selenium concentration in blood and toenails. Seventy three patients and two hundreds eighty three controls were selected at the Yeungnam University Hospital between May and September in 1991. The selected cases were patients who had been hospitalized for stomach or colon cancer at the Department of General Surgery. The controls were people who visited to check physical examination at the Automated Mediscreening Center. The selenium concentration in whole blood and toenails were measured by atomic absorption spectrophotometer equipped with graphite furnace atomizer. The following information was ascertained for all cancer patients and controls: sex, age, body mass index, blood pressure, total serum cholesterol, and history of smoking and drinking. The mean selenium concentration in blood and toenail for all cancer patients were 143.6±10.8 µg/l and 1.04±0.62 µg/g and for the controls. 167.0±14.5 µg/l and 1.15±0.55 µg/g, respectively. The difference in blood and toenail selenium concentrations of the two cancer sites was not statistically significant. Metastasis did not influence the concentration of selenium in blood and toenails. In the multiple logistic regression analysis, the blood selenium concentration (aOR: 0.888, 95% CI: 0.860-0.918), age, BMI and total serum cholesterol were significant variables for risk of cancer, but the selenium concentration in toenail was not shown to be a significant variable in this regression analysis. The coefficient for blood selenium concentration adjusted for age, sex, diastolic blood pressure, total serum cholesterol, body mass index and smoking was -0.1184 (p<0.01). These findings suggest that low selenium concentration is associated with gastrointestinal cancers. Further epidemiologic studies including important variables such as other antioxidant micronutrients will be necessary.

Citations

Citations to this article as recorded by

Clinical Correlation between Gastric Cancer Type and Serum Selenium and Zinc Levels
Jae Hyo Ji, Dong Gue Shin, Yujin Kwon, Dong Hui Cho, Kyung Bok Lee, Sang Soo Park, Jin Yoon
Journal of Gastric Cancer.2012; 12(4): 217. CrossRef

Case Report

Endocrinology, Diabetes, and Metabolism
A case of SIADH in small cell lung cancer.: Kyu Chang Won, Jong Sik Lim, Chan Woo Lee, Hyoung Woo Lee, Choong Ki Lee, Jin Hong Chung, Myoung Soo Hyun, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1991;8(2):227-234. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.227

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Abstract PDF: The syndrome of inappropriate ADH secretion is a disorder characterized by hyponatremia which results from water retention attributable to ADH release. The hallmark of SIADH is hyponatremia due to water retention, in the presence of urinary osmolality above plasma osmolality. The SIADH was initially described by Schwartz et al (1957). This syndrome, first recognized in patients with bronchogenic carcinoma, has now been observed in a variety of other illnesses. Recently, we encountered a 59 year-old female with small cell lung cancer, also she had SIADH. Thus, we present a case and review the literature on the subject.

Original Articles

Radiation Oncology
A study of dose distribution in postoperative radiotherapy in uterine cervical cancer.: Sei One Shin, Sung Kyu Kim, Myung Se Kim; Yeungnam Univ J Med. 1991;8(1):166-177. Published online June 30, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.1.166

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Abstract PDF: Uterine cervical cancer is the most common malignancy in Korean women. In spite of recent development of early diagnostic and therapeutic modalities, about 40% of treated patient will develop relapse. So more aggressive local treatment such as more extensive surgery and higher radiation dose and administration of systemic chemotherapy will promote the curability but treatment related complications cannot be avoidable. We used 22 cases of early cervical cancer, treated with surgery and post-operative radiotherapy, clinical data of these patients were analyzed to determine relationship between clinical parameters and final outcome. Three out of 22 cases revealed relapse and one patient showed rectovaginal fistula and another patient showed small bowel obstruction and the other patient showed rectal obstruction. Two out of three recurrence were stage IIa and the other one case was stage Ib adenocarcinoma with lymphovascular involvement. Nineteen out of 22 cases were followed without remarkable side effect or treatment related complication or sequelae. We concluded that out treatment policy was safe and effective to eradicate high risk postoperative cervical cancer with acceptable side effects or complication.

Pulmonary and Respiratory Medicine
The Clinical Review of Superior Vena Cava Syndrome.: Joung Sun Kang, Sam Beom Lee, Choong Ki Lee, Jin Hong Chung, Hyoung Woo Lee, Kwan Ho Lee, Myung Soo Hyun, Hyun Woo Lee, Sei One Shin, Myung Se Kim; Yeungnam Univ J Med. 1990;7(2):151-158. Published online December 31, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.2.151

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Abstract PDF: We reviewed 30 cases of superior vena cava syndrome in adult patients who were seen at the Yeungnam University Hospital from January 1985 to June 1990. The results were as follows: 1. The male-to-female ratio was 6.5:1, and the most patients were in the age group between the sixth and seventh decades. 2. The most common symptoms were dyspnea (87%) and followed by cough (63%), facial swelling (63%) and chest pain (44%) and the physical signs were dilated neck vein (97%), facial edema (93%) and facial flushing (45%) in order of frequency. 3. The simple chest x-ray findings were superior mediastinal widening (90%), right hilar mass (77%) and pleural effusion (31%). 4. Diagnosis was made by history and physical examination (100%), chest C-T scan (100%), simple chest x-ray (97%), bronchoscopy with biopsy (40%) and so on. 5. 21 cases of patients were confirmed by histology: 14 cases (46%) of bronchogenic ca, 4 cases (14%) of lymphoma, 3 cases (10%) of metastatic lung ca. Of bronchogenic ca, small cell ca was 7 cases (23%), squamous cell ca, 5 cases (17%), and unclassified cawas 2 cases (6%). 6. In response of treatment, the clinical improvement was achieved in 18 cases with radiotherapy alone, 1 case with chemotherapy only, and 6 cases with radio-chemotherapy.

Radiation Oncology
Radiation Therapy of Head and Neck Cancer with CO-6O HDR Transcatheteric Irradiation.: Sei One Shin, Sung Kyu Kim, Myung Se Kim; Yeungnam Univ J Med. 1990;7(2):109-114. Published online December 31, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.2.109

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Abstract PDF: The basic strategy of irradiation is to deliver a dose to the cancer that is high enough to make cancer cells incapable of reproduction, while keeping the doses to the various healthy tissues below tolerable levels. In order to improve local control and survival, as a boost therapy after external radiotherapy, high dose rate transcatheteric irradiation using remote control after loading system (RALSTRON-20B) was used for twelve patients with head and neck cancers. Present results showed complete remission of cancer in 9 out of 112 patients without treatment related complications. Although this procedure is easy to operate, well trained skillful hand in essential for good results. Furthermore out experience suggested that meticulous treatment planning should be developed for better results.

Review

Gastroenterology and Hepatology
The roles of endoscopic ultrasound in the diagnosis of pancreatobiliary cancer.: Kook Hyun Kim; Yeungnam Univ J Med. 2016;33(2):77-84.; DOI: https://doi.org/10.12701/yujm.2016.33.2.77

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Abstract PDF: Pancreatic cancer, the 4th leading cause of cancer-related death in the United States, has a very poor prognosis. Cholangiocarcinoma originates from either intrahepatic or extrahepatic bile duct, and its incidence is gradually increasing worldwide. Endoscopic retrograde cholangiopancreatography with brush cytology has a high false-negative rate for the diagnosis of biliary malignancy. Recently, endoscopic ultrasonography (EUS) has emerged as the potential modality to detect pancreatic cancer. EUS-guided fine needle aspiration for cytologic analysis made it possible to overcome the obstacle in differentiating between benign and malignant lesions in the pancreatobiliary lesion, and it has been well established as a safe and effective procedure. Herein, the clinical application of EUS in the diagnosis of pancreatobiliary cancer was reviewed.

Case Reports

Oncology and Cancer Research
Metastatic eyelid cancer from gastric adenocarcinoma.: Ji Yoon Jung, Eun Joo Goo, Jae Chang Lee, Jay Song, Sung Ae Koh, Kyung Hee Lee, Young Kyung Bae; Yeungnam Univ J Med. 2016;33(2):142-145.; DOI: https://doi.org/10.12701/yujm.2016.33.2.142

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Abstract PDF: Gastric cancer is the most common cancer in Korean males and can easily spread to distant organs such as the liver, lungs, brain, or bones. However, skin metastasis, particularly of the eye, is rare. Metastatic eyelid cancer is extremely rare; metastases from internal organs have not been reported so far. We recently experienced a patient with metastatic eyelid cancer from adenocarcinoma of the stomach. A 62-year-old female was admitted with a right upper eyelid mass and foreign body sensation. She had a history of stomach cancer of 3 years. She was treated by chemotherapy and radiotherapy for pathologic fracture. After receiving supportive care for 2 years, the mass appeared on her right pupil. Punch-biopsy of the mass was performed and histological examination revealed adenocarcinoma, the same as the initial histological result. We report this case with a review of related literature.

Gastroenterology and Hepatology
Liver abscess and septic complications associated with advanced gastric cancer.: Gun Jung Youn, Young Choi, Min Jae Kim, Jae Sin Lee, Ui Won Ko, Yeon Ho Joo; Yeungnam Univ J Med. 2015;32(1):38-41.; DOI: https://doi.org/10.12701/yujm.2015.32.1.38

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Abstract PDF

Pyogenic liver abscess with metastatic septic complications is a rare and serious infectious disease if not treated properly. Pyogenic liver abscesses are caused by bacterial, fungal, or parasitic organisms. Escherichia coli used to be the predominant causative agent, but Klebsiella pneumoniae emerged as a major cause in the 1990s. Liver abscesses are caused by hepatic invasion via many routes, such as, the biliary tree, portal vein, hepatic artery, direct extension, or penetrating trauma. Furthermore, diabetes mellitus and malignant conditions are established important risk factors of K. pneumoniae liver abscesses and of septic metastasis, and several recent studies have asserted that K. pneumoniae liver abscess might be a presentation of occult or silent colon cancer. We report a case of K. pneumoniae liver abscess, metastatic septic pulmonary embolism, and endophthalmitis associated with diabetes and advanced gastric cancer.

Citations

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Gastric cancer and adenomatous colorectal polyp concomitant with pyogenic liver abscess and bacteremia
Min Kyu Kang, Hee Jung Kwon, Min Cheol Kim
Yeungnam University Journal of Medicine.2020; 37(3): 246. CrossRef
A Case of Advanced Gastric Cancer Concomitant with Pyogenic Liver Abscess in the Patient with Subtotal Gastrectomy
Dong-Hee Park, Nae-Yun Heo, Heon Sa-Kong, Na-Ri Jeong, Su-Jin Jeong, Sung Jin Oh, Kyung Han Nam
The Korean Journal of Gastroenterology.2017; 69(2): 143. CrossRef

Review

Gastroenterology and Hepatology
Cellular origin of liver cancer stem cells.: Jong Ryeol Eun; Yeungnam Univ J Med. 2015;32(1):1-7.; DOI: https://doi.org/10.12701/yujm.2015.32.1.1

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Abstract PDF: Over several decades, a hierarchical cancer stem cell (CSC) model has been established in development of solid cancers, including hepatocellular carcinoma(HCC). In terms of this concept, HCCs originate from liver CSCs. Clinically HCCs show a wide range of manifestations from slow growth to very aggressive metastasis. One of the reasons may be that liver CSCs originate from different cells. This review describes the basic concept of CSCs and the cellular origin of liver CSCs.

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