Objective:Lynch syndrome(LS)increases the risk of various cancers,including colorectal cancer,endometrial cancer and gastric cancer(GC).The incidence of LS among microsatellite instability-high(MSI-H)GC and their asso...Objective:Lynch syndrome(LS)increases the risk of various cancers,including colorectal cancer,endometrial cancer and gastric cancer(GC).The incidence of LS among microsatellite instability-high(MSI-H)GC and their association in South Korea remains underexplored.This study investigates LS-associated pathogenic germline variants in MSI-H GC patients using whole-exome sequencing(WES)on normal tissues.Methods:This retrospective study included patients who underwent gastrectomy for GC at Soonchunhyang University Bucheon and Cheonan Hospitals from January 2011 to October 2023.Among 1,537 patients screened for MSI status,127(8.3%)were identified as MSI-H.WES was performed on normal tissues from 123 patients.Pathogenic/likely pathogenic(P/LP)variants in mismatch repair(MMR)genes were identified using in silico models and protein loss assessments in corresponding tumor tissues.Results:Of the 127 MSI-H GC cases,characteristics aligned with typical MSI-H GC.The average age was70.02 years,with 98(77.2%)located in the lower body and 81(63.8%)of the intestinal type.All five MSI markers were positive in 46.5%of cases,whereas four markers were positive in 27.6%.Of the MSI-H GCs,10 LS candidates were identified.Three patients had known P/LP variants[MLH1(c.1758dup),MSH6(c.3261dup),MSH2(c.1241T>C)].Seven patients had variants of unknown significance(VUS)in MMR genes.Six(4.9%)patients were identified as having LS or possible LS,including one patient with the MLH1(c.1153C>T)variant previously classified as VUS but now considered LS-associated.Conclusions:This large-scale screening for LS in MSI-H GC patients using retrospective samples confirmed the lower incidence of LS than those of colorectal or endometrial cancer and GC patients in Western countries,emphasizing the need for clinical consideration in managing MSI-H GC patients.展开更多
AIM: To evaluate the factors associated with liver function alterations after laparoscopy-assisted gastrectomy (LAG) for gastric cancer. METHODS: We collected the data of gastrectomy patients with gastric cancer and d...AIM: To evaluate the factors associated with liver function alterations after laparoscopy-assisted gastrectomy (LAG) for gastric cancer. METHODS: We collected the data of gastrectomy patients with gastric cancer and divided them into 2 groups: open gastrectomy (OG) and LAG. We also collected the data of patients with colon cancer to evaluate the effect of liver manipulations during surgery on liver function alterations. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, and alkaline phosphatase were measured on the preoperative day and postoperative day 1 (POD1), POD3, POD5, and POD7. RESULTS: No changes in liver function were observed after the operation in patients with colon cancer (n = 121). However, in gastric cancer patients (n = 215), AST and ALT levels increased until POD5 compared to those in colon cancer patients and these findings were observed both in the LAG and OG without a significant difference except at POD1. The mean hepatic enzyme levels at POD1 in the LAG group were significantly higher than those in the OG group (P = 0.047 for AST and P = 0.039 for ALT). The factors associated with elevated ALT on POD1 in patients with gastric cancer were body mass index (P < 0.001), operation time (P < 0.001), intraoperative hepatic injury (P = 0.048), and ligation of an aberrant left hepatic artery (P = 0.052) but not type of operation (OG vs LAG, P = 0.094). CONCLUSION: We conclude that the liver function alteration after LAG may have been caused by direct liver manipulation or aberrant hepatic artery ligation rather than the CO2 pneumoperitoneum.展开更多
AIM To determine the relationship between F-18 fluorodeoxyglucose(FDG) uptake of bone marrow(BM) on positron emission tomography/computed tomography(PET/CT) and clinical factors and to assess the prognostic value of F...AIM To determine the relationship between F-18 fluorodeoxyglucose(FDG) uptake of bone marrow(BM) on positron emission tomography/computed tomography(PET/CT) and clinical factors and to assess the prognostic value of FDG uptake of BM in gastric carcinoma.METHODS We retrospectively enrolled 309 gastric cancer patients who underwent staging FDG PET/CT and curative surgical resection. FDG uptake of primary tumor was visually classified as positive or negative FDG uptake. Mean FDG uptake of BM(BM SUV) and BM-to-liver uptake ratio(BLR) were measured. The relationships of BM SUV or BLR with clinical factors were evaluated. The prognostic values of BM SUV, BLR, and other clinical factors for predicting recurrence-free survival(RFS) and overall survival(OS) were assessed.RESULTS Of 309 patients, 38 patients(12.3%) experienced cancer recurrence and 18 patients(5.8%) died. Patients with advanced gastric cancer, positive FDG uptake, and recurrence had higher values of BM SUV and BLR than those with early gastric cancer, negative FDG uptake, and no recurrence(P < 0.05). BM SUV and BLR were significantly correlated with hemoglobin level, neutrophil-to-lymphocyte ratio, and platelet-tolymphocyte ratio(P < 0.05). On multivariate analysis, multiple tumors, T stage, lymph node metastasis, tumor involvement of resection margin, and BLR were significantly associated with RFS(P < 0.05). T stage, lymph node metastasis, hemoglobin level, and BLR were significantly associated with OS(P < 0.05). CONCLUSION BLR on PET/CT was an independent prognostic factor for RFS and OS in gastric cancer patients with curative surgical resection.展开更多
Fish bones are the most common foreign objects leading to bowel perforation.Most cases are confined to the extraluminal space without penetration of an adjacent organ.However,abscess formation due to the perforation o...Fish bones are the most common foreign objects leading to bowel perforation.Most cases are confined to the extraluminal space without penetration of an adjacent organ.However,abscess formation due to the perforation of the rectosigmoid colon by a fish bone can lead to the penetration of the urinary bladder and may subsequently cause the fish bone to migrate into the urinary bladder.In the presented case,a 42-yearold female was admitted for lower abdominal pain.The computed tomography(CT)demonstrated a 5cm pelvic abscess containing a thin and curvilinear foreign body.After conservative management,the patient was discharged.After 1 mo,the subject developed a mechanical ileus.Surgery had to be delayed due to her hyperthyroidism.Migration of the foreign body to the urinary bladder was shown on additional CT.A Yellowish fish bone 3.5 cm in size was removed through intraoperative cystoscopy.The patient was discharged 8 d after the operation without any unexpected event.展开更多
Objective: It has been suggested that some internet users spend so much time on the internet that their personal and/or professional lives suffer. This study compared the temperament and character of problematic inter...Objective: It has been suggested that some internet users spend so much time on the internet that their personal and/or professional lives suffer. This study compared the temperament and character of problematic internet users (PIU) with that of problematic drug users (PDU) among Korean adolescents and aimed to examine the personality characteristics of adolescents with internet use problems. Method: We enrolled participants from high schools (n = 487), internet cafés (n = 89), and an adolescent-substance abuse consultation office (n = 45). All subjects were assessed using the Korean Internet Addiction Scale (KIAS), the Korean Adolescent Drug Addiction Screening Test-2 (KOADAST-2), and the Korean version of the Temperament and Character Inventory (K-TCI). Subjects were classified into the following four groups based on the KIAS and KOADAST-2 results: normal controls, pure PIUs, pure PDUs, and dual problematic users. Differences in the subscale scores on the K-TCI were analyzed by group. Results: Scores for Reward dependence (RD) were significantly lower in pure PIUs than in pure PDUs (13.85 ± 4.07 versus 15.44 ± 3.56, p < 0.05). Scores for Self-Directedness (SD) were lower in pure PIUs (18.21 ± 6.90) and pure PDUs (18.22 ± 6.03) than in normal controls (20.88 ± 6.60), although the scores did not differ significantly between pure PIUs and pure PDUs. Scores for Cooperativeness (C) were lower in pure PIUs than in normal controls (23.97 ± 7.02 versus 26.57 ± 6.67, p < 0.05). Conclusions: The results of this study suggest that PIUs are more socially insensitive and that they may experience more inter-personal problems than PDUs.展开更多
基金supported by a National Research Foundation of Korea(NRF)grant funded by the Korean government(MSIT)(No.2022R1A2C2092005)the Soonchunhyang University Research Fund。
文摘Objective:Lynch syndrome(LS)increases the risk of various cancers,including colorectal cancer,endometrial cancer and gastric cancer(GC).The incidence of LS among microsatellite instability-high(MSI-H)GC and their association in South Korea remains underexplored.This study investigates LS-associated pathogenic germline variants in MSI-H GC patients using whole-exome sequencing(WES)on normal tissues.Methods:This retrospective study included patients who underwent gastrectomy for GC at Soonchunhyang University Bucheon and Cheonan Hospitals from January 2011 to October 2023.Among 1,537 patients screened for MSI status,127(8.3%)were identified as MSI-H.WES was performed on normal tissues from 123 patients.Pathogenic/likely pathogenic(P/LP)variants in mismatch repair(MMR)genes were identified using in silico models and protein loss assessments in corresponding tumor tissues.Results:Of the 127 MSI-H GC cases,characteristics aligned with typical MSI-H GC.The average age was70.02 years,with 98(77.2%)located in the lower body and 81(63.8%)of the intestinal type.All five MSI markers were positive in 46.5%of cases,whereas four markers were positive in 27.6%.Of the MSI-H GCs,10 LS candidates were identified.Three patients had known P/LP variants[MLH1(c.1758dup),MSH6(c.3261dup),MSH2(c.1241T>C)].Seven patients had variants of unknown significance(VUS)in MMR genes.Six(4.9%)patients were identified as having LS or possible LS,including one patient with the MLH1(c.1153C>T)variant previously classified as VUS but now considered LS-associated.Conclusions:This large-scale screening for LS in MSI-H GC patients using retrospective samples confirmed the lower incidence of LS than those of colorectal or endometrial cancer and GC patients in Western countries,emphasizing the need for clinical consideration in managing MSI-H GC patients.
文摘AIM: To evaluate the factors associated with liver function alterations after laparoscopy-assisted gastrectomy (LAG) for gastric cancer. METHODS: We collected the data of gastrectomy patients with gastric cancer and divided them into 2 groups: open gastrectomy (OG) and LAG. We also collected the data of patients with colon cancer to evaluate the effect of liver manipulations during surgery on liver function alterations. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, and alkaline phosphatase were measured on the preoperative day and postoperative day 1 (POD1), POD3, POD5, and POD7. RESULTS: No changes in liver function were observed after the operation in patients with colon cancer (n = 121). However, in gastric cancer patients (n = 215), AST and ALT levels increased until POD5 compared to those in colon cancer patients and these findings were observed both in the LAG and OG without a significant difference except at POD1. The mean hepatic enzyme levels at POD1 in the LAG group were significantly higher than those in the OG group (P = 0.047 for AST and P = 0.039 for ALT). The factors associated with elevated ALT on POD1 in patients with gastric cancer were body mass index (P < 0.001), operation time (P < 0.001), intraoperative hepatic injury (P = 0.048), and ligation of an aberrant left hepatic artery (P = 0.052) but not type of operation (OG vs LAG, P = 0.094). CONCLUSION: We conclude that the liver function alteration after LAG may have been caused by direct liver manipulation or aberrant hepatic artery ligation rather than the CO2 pneumoperitoneum.
基金Supported by Soonchunhyang University Research Fund and Research Fund of Catholic Kwandong University International St.Mary's Hospital
文摘AIM To determine the relationship between F-18 fluorodeoxyglucose(FDG) uptake of bone marrow(BM) on positron emission tomography/computed tomography(PET/CT) and clinical factors and to assess the prognostic value of FDG uptake of BM in gastric carcinoma.METHODS We retrospectively enrolled 309 gastric cancer patients who underwent staging FDG PET/CT and curative surgical resection. FDG uptake of primary tumor was visually classified as positive or negative FDG uptake. Mean FDG uptake of BM(BM SUV) and BM-to-liver uptake ratio(BLR) were measured. The relationships of BM SUV or BLR with clinical factors were evaluated. The prognostic values of BM SUV, BLR, and other clinical factors for predicting recurrence-free survival(RFS) and overall survival(OS) were assessed.RESULTS Of 309 patients, 38 patients(12.3%) experienced cancer recurrence and 18 patients(5.8%) died. Patients with advanced gastric cancer, positive FDG uptake, and recurrence had higher values of BM SUV and BLR than those with early gastric cancer, negative FDG uptake, and no recurrence(P < 0.05). BM SUV and BLR were significantly correlated with hemoglobin level, neutrophil-to-lymphocyte ratio, and platelet-tolymphocyte ratio(P < 0.05). On multivariate analysis, multiple tumors, T stage, lymph node metastasis, tumor involvement of resection margin, and BLR were significantly associated with RFS(P < 0.05). T stage, lymph node metastasis, hemoglobin level, and BLR were significantly associated with OS(P < 0.05). CONCLUSION BLR on PET/CT was an independent prognostic factor for RFS and OS in gastric cancer patients with curative surgical resection.
文摘Fish bones are the most common foreign objects leading to bowel perforation.Most cases are confined to the extraluminal space without penetration of an adjacent organ.However,abscess formation due to the perforation of the rectosigmoid colon by a fish bone can lead to the penetration of the urinary bladder and may subsequently cause the fish bone to migrate into the urinary bladder.In the presented case,a 42-yearold female was admitted for lower abdominal pain.The computed tomography(CT)demonstrated a 5cm pelvic abscess containing a thin and curvilinear foreign body.After conservative management,the patient was discharged.After 1 mo,the subject developed a mechanical ileus.Surgery had to be delayed due to her hyperthyroidism.Migration of the foreign body to the urinary bladder was shown on additional CT.A Yellowish fish bone 3.5 cm in size was removed through intraoperative cystoscopy.The patient was discharged 8 d after the operation without any unexpected event.
文摘Objective: It has been suggested that some internet users spend so much time on the internet that their personal and/or professional lives suffer. This study compared the temperament and character of problematic internet users (PIU) with that of problematic drug users (PDU) among Korean adolescents and aimed to examine the personality characteristics of adolescents with internet use problems. Method: We enrolled participants from high schools (n = 487), internet cafés (n = 89), and an adolescent-substance abuse consultation office (n = 45). All subjects were assessed using the Korean Internet Addiction Scale (KIAS), the Korean Adolescent Drug Addiction Screening Test-2 (KOADAST-2), and the Korean version of the Temperament and Character Inventory (K-TCI). Subjects were classified into the following four groups based on the KIAS and KOADAST-2 results: normal controls, pure PIUs, pure PDUs, and dual problematic users. Differences in the subscale scores on the K-TCI were analyzed by group. Results: Scores for Reward dependence (RD) were significantly lower in pure PIUs than in pure PDUs (13.85 ± 4.07 versus 15.44 ± 3.56, p < 0.05). Scores for Self-Directedness (SD) were lower in pure PIUs (18.21 ± 6.90) and pure PDUs (18.22 ± 6.03) than in normal controls (20.88 ± 6.60), although the scores did not differ significantly between pure PIUs and pure PDUs. Scores for Cooperativeness (C) were lower in pure PIUs than in normal controls (23.97 ± 7.02 versus 26.57 ± 6.67, p < 0.05). Conclusions: The results of this study suggest that PIUs are more socially insensitive and that they may experience more inter-personal problems than PDUs.
