1
|
Almendros A, Choi YR, Leung TL, Tam WYJ, Hernandez Muguiro D, Woodhouse FM, Gray JJ, Beatty JA, Barrs VR. Low prevalence of Babesia hongkongensis infection in community and privately-owned cats in Hong Kong. Ticks Tick Borne Dis 2024; 15:102278. [PMID: 37979475 DOI: 10.1016/j.ttbdis.2023.102278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/05/2023] [Accepted: 10/26/2023] [Indexed: 11/20/2023]
Abstract
Domestic cats are susceptible to infection with at least 11 species of Babesia. In Hong Kong, where dogs are commonly infected with B. gibsoni, a single infection in a cat by a novel species, B. hongkongensis, was reported previously. The aim of this study was to investigate the frequency of Babesia spp. detection in cats in Hong Kong. Residual blood-derived DNA from healthy free-roaming community cats (n = 239), and privately-owned cats with and without anaemia undergoing diagnostic investigations (n = 125) was tested for Babesia spp. DNA using a pan-Babesia PCR targeting mitochondrial Cytochrome B, and a B. hongkongensis specific PCR targeting 18S rRNA. Positive samples were confirmed by sequencing and comparative sequence analysis against the GenBank nucleotide database. Babesia hongkongensis was detected in 4/239 (1.7 %) community cats, and 0/125 (0.0 %) privately-owned cats. Babesia gibsoni was detected in 0/239 community cats and 1/125 (0.8 %) privately-owned cats. Cats infected with B. hongkongensis were clinically healthy at the time of sampling. The B. gibsoni-infected cat was anaemic and thrombocytopenic. Cats in Hong Kong can be infected with B. hongkongensis and B. gibsoni, albeit at low frequency. The tick vector for B. hongkongensis is yet to be identified.
Collapse
Affiliation(s)
- A Almendros
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong Special Administrative Region of China.
| | - Y R Choi
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong Special Administrative Region of China; Centre for Animal Health and Welfare, City University of Hong Kong, Kowloon Tong, Hong Kong Special Administrative Region of China
| | - T L Leung
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong Special Administrative Region of China
| | - W Y J Tam
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong Special Administrative Region of China
| | - D Hernandez Muguiro
- Veterinary Diagnostic Laboratory, City University of Hong Kong, Kowloon Tong, Hong Kong Special Administrative Region of China
| | - F M Woodhouse
- The Society for the Prevention of Cruelty to Animals, Wan Chai, Hong Kong Special Administrative Region of China
| | - J J Gray
- The Society for the Prevention of Cruelty to Animals, Wan Chai, Hong Kong Special Administrative Region of China
| | - J A Beatty
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong Special Administrative Region of China; Centre for Animal Health and Welfare, City University of Hong Kong, Kowloon Tong, Hong Kong Special Administrative Region of China
| | - V R Barrs
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong Special Administrative Region of China; Centre for Animal Health and Welfare, City University of Hong Kong, Kowloon Tong, Hong Kong Special Administrative Region of China
| |
Collapse
|
2
|
Park S, Choi YR, Joo DJ, You YK, Kim BW, Nah YW, Cho JY, Kim TS, Hong G, Ju MK, Suh SW, Yang JD, Park PJ, Jeong J, Moon JI, Kim DS, Rhu J. The effect of donor against recipient one-way HLA mismatch on liver transplantation outcomes from a multicenter registry analysis. Sci Rep 2023; 13:22296. [PMID: 38102167 PMCID: PMC10724161 DOI: 10.1038/s41598-023-49178-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023] Open
Abstract
Donor against recipient one-way Human leukocyte antigen (HLA) mismatch (D → R one-way HLA MM) seemed strongly associated with graft-versus-host disease (GVHD). The aim of this study is to investigate the relevance of D → R one-way HLA MM in outcome of liver transplantation (LT). We retrospectively analyzed 2670 patients in Korean Organ Transplantation Registry database between April 2014 and December 2020. The patients were categorized into two groups whether D → R one-way HLA MM or not and evaluated the outcomes of LT between the two groups. 18 patients were found to be D → R one-way HLA MM. The incidence of GVHD (0.3% vs. 22.2%, p < 0.001) and mortality rate (11.6% vs. 38.9%, p = 0.003) was much higher in D → R one-way HLA MM group. D → R one-way HLA MM at 3 loci was seemed to be strongly associated with the incidence of GVHD (OR 163.3, p < 0.001), and found to be the strongest risk factor for patient death (HR 12.75, p < 0.001). Patients with D → R one-way HLA MM at 3 loci showed significantly lower overall survival (p < 0.001) but there were no significant differences in rejection-free survival and death-censored graft survival. D → R one-way HLA MM at 3 loci not only affects the overall survival of LT patients but also the incidence of GVHD.
Collapse
Affiliation(s)
- Sunghae Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, 50 Irwon-Dong, Gangnam-gu, Seoul, 135-710, Korea
| | - Young Rok Choi
- Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Dong Jin Joo
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Young Kyoung You
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bong-Wan Kim
- Department of Liver Transplantation and Hepatobiliary Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Yang Won Nah
- Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Jai Young Cho
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Tae-Seok Kim
- Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Geun Hong
- Department of Surgery, Ewha Womans University Medical College, Seoul, Korea
| | - Man Ki Ju
- Department of Surgery, Yonsei University Gangnam Severance Hospital, Seoul, Korea
| | - Suk-Won Suh
- Department of Surgery, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Jae Do Yang
- Department of Surgery, Jeonbuk National University Hospital, Jeonju, Korea
| | - Pyoung Jae Park
- Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jaehong Jeong
- Department of Surgery, School of Medicine, Soonchunhyang University, Bucheon, Korea
| | - Ju Ik Moon
- Department of Surgery, Konyang University Hospital, Daejeon, Korea
| | - Dong-Sik Kim
- Department of Surgery, Korea University College of Medicine, Seoul, Korea.
| | - Jinsoo Rhu
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, 50 Irwon-Dong, Gangnam-gu, Seoul, 135-710, Korea.
| |
Collapse
|
3
|
Almendros A, Choi YR, Bęczkowski PM, Baiker K, Barrs VR, Beatty JA. Babesia gibsoni Infection in a Cat with Immune-Mediated Haemolytic Anaemia and Thrombocytopenia. Animals (Basel) 2023; 13:2128. [PMID: 37443927 DOI: 10.3390/ani13132128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Tick-borne haemoparasite Babesia gibsoni has been detected rarely in cats, in surveys of apparently healthy animals. In stored blood from a 6-year-old male-neutered domestic shorthair cat in Hong Kong, B. gibsoni DNA was detected retrospectively using PCR for Babesia spp. 18S rRNA and mitochondrial cytochrome B genes, followed by sequencing and basic local alignment search tool (BLAST) analysis. The cat presented with severe haemolytic anaemia and thrombocytopenia. The cat responded to supportive care and glucocorticoids and was clinically normal despite persistent subclinical thrombocytopenia until six months after presentation, when it succumbed to a fatal haemorrhagic episode. Necropsy revealed severe intestinal and pulmonary haemorrhage and hypocellular bone marrow with megakaryocytosis but no other causes of immune-mediated thrombocytopenia (IMTP) or immune-mediated haemolytic anaemia (IMHA). Blood stored on days 158 and 180 tested PCR negative for Babesia spp. This report demonstrates that geographic range of B. gibsoni detection in cats includes Hong Kong. The exclusion of other causes suggests that B. gibsoni might have potentially played a role in triggering immune-mediated disease in this case.
Collapse
Affiliation(s)
- Angel Almendros
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine, City University of Hong Kong, Hong Kong SAR, China
| | - Y R Choi
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine, City University of Hong Kong, Hong Kong SAR, China
| | - Paweł M Bęczkowski
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine, City University of Hong Kong, Hong Kong SAR, China
| | - Kerstin Baiker
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine, City University of Hong Kong, Hong Kong SAR, China
| | - Vanessa R Barrs
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine, City University of Hong Kong, Hong Kong SAR, China
| | - Julia A Beatty
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine, City University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
4
|
Lee KH, Kim JS, Hong SH, Seong D, Choi YR, Ahn YT, Kim KS, Kim SE, Lee S, Sim W, Kim D, Jun B, Yang JW, Yon DK, Lee SW, Kim MS, Dragioti E, Li H, Jacob L, Koyanagi A, Abou Ghayda R, Shin JI, Smith L. Risk factors of COVID-19 mortality: a systematic review of current literature and lessons from recent retracted articles. Eur Rev Med Pharmacol Sci 2020; 24:13089-13097. [PMID: 33378062 DOI: 10.26355/eurrev_202012_24216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Recently, two influential articles that reported the association of (hydroxy)chloroquine or angiotensin converting enzyme (ACE) inhibitors and coronavirus disease 2019 (COVID-19) mortality were retracted due to significant methodological issues. Therefore, we aimed to analyze the same clinical issues through an improved research method and to find out the differences from the retracted papers. We systematically reviewed pre-existing literature, and compared the results with those of the retracted papers to gain a novel insight. MATERIALS AND METHODS We extracted common risk factors identified in two retracted papers, and conducted relevant publication search until June 26, 2020 in PubMed. Then, we analyzed the risk factors for COVID-19 mortality and compared them to those of the retracted papers. RESULTS Our systematic review demonstrated that most demographic and clinical risk factors for COVID-19 mortality were similar to those of the retracted papers. However, while the retracted paper indicated that both (hydroxy)chloroquine monotherapy and combination therapy with macrolide were associated with higher risk of mortality, our study showed that only combination therapy of hydroxychloroquine and macrolide was associated with higher risk of mortality (odds ratio 2.33; 95% confidence interval 1.63-3.34). In addition, our study demonstrated that use of ACE inhibitors or angiotensin receptor blockers (ARBs) was associated with reduced risk of mortality (0.77; 0.65-0.91). CONCLUSIONS When analyzing the same clinical issues with the two retracted papers through a systematic review of randomized controlled trials and relevant cohort studies, we found out that (hydroxy)chloroquine monotherapy was not associated with higher risk of mortality, and that the use of ACE inhibitors or ARBs was associated with reduced risk of mortality in COVID-19 patients.
Collapse
Affiliation(s)
- K H Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Abstract
This paper presents a novel framework to extract highly compact and discriminative features for face video retrieval tasks using the deep convolutional neural network (CNN). The face video retrieval task is to find the videos containing the face of a specific person from a database with a face image or a face video of the same person as a query. A key challenge is to extract discriminative features with small storage space from face videos with large intra-class variations caused by different angle, illumination, and facial expression. In recent years, the CNN-based binary hashing and metric learning methods showed notable progress in image/video retrieval tasks. However, the existing CNN-based binary hashing and metric learning have limitations in terms of inevitable information loss and storage inefficiency, respectively. To cope with these problems, the proposed framework consists of two parts: first, a novel loss function using a radial basis function kernel (RBF Loss) is introduced to train a neural network to generate compact and discriminative high-level features, and secondly, an optimized quantization using a logistic function (Logistic Quantization) is suggested to convert a real-valued feature to a 1-byte integer with the minimum information loss. Through the face video retrieval experiments on a challenging TV series data set (ICT-TV), it is demonstrated that the proposed framework outperforms the existing state-of-the-art feature extraction methods. Furthermore, the effectiveness of RBF loss was also demonstrated through the image classification and retrieval experiments on the CIFAR-10 and Fashion-MNIST data sets with LeNet-5.
Collapse
|
6
|
Lee B, Ahn S, Kim H, Han HS, Yoon YS, Cho JY, Choi YR. Donor Specific Antibody Negative Antibody-Mediated Rejection after ABO Incompatible Liver Transplantation. Korean J Transplant 2018. [DOI: 10.4285/jkstn.2018.32.4.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Boram Lee
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Soomin Ahn
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Haeryoung Kim
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ho-Seong Han
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Yoo-Seok Yoon
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jai Young Cho
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Young Rok Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| |
Collapse
|
7
|
Chung JW, Shin E, Kim H, Han HS, Cho JY, Choi YR, Hong S, Jang ES, Kim JW, Jeong SH. Hepatic iron overload in the portal tract predicts poor survival in hepatocellular carcinoma after curative resection. Liver Int 2018; 38:903-914. [PMID: 29105340 DOI: 10.1111/liv.13619] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 10/27/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Hepatic iron overload is associated with liver injury and hepatocarcinogenesis; however, it has not been evaluated in patients with hepatocellular carcinoma (HCC) in Asia. The aim of this study was to clarify the degree and distribution of intrahepatic iron deposition, and their effects on the survival of HCC patients. METHODS Intrahepatic iron deposition was examined using non-tumorous liver tissues from 204 HCC patients after curative resection, and they were scored by 2 semi-quantitative methods: simplified Scheuer's and modified Deugnier's methods. For the Scheuer's method, iron deposition in hepatocytes and Kupffer cells was separately evaluated, while for the modified Deugnier's method, hepatocyte iron score (HIS), sinusoidal iron score (SIS) and portal iron score (PIS) were systematically evaluated, and the corrected total iron score (cTIS) was calculated by multiplying the sum (TIS) of the HIS, SIS, and PIS by the coefficient. RESULTS The overall prevalence of hepatic iron was 40.7% with the simplified Scheuer's method and 45.1% with the modified Deugnier's method with a mean cTIS score of 2.46. During a median follow-up of 67 months, the cTIS was not associated with overall survival. However, a positive PIS was significantly associated with a lower 5-year overall survival rate (50.0%) compared with a negative PIS (73.7%, P = .006). In the multivariate analysis, a positive PIS was an independent factor for overall mortality (hazard ratio, 2.310; 95% confidence interval, 1.181-4.517). CONCLUSIONS Intrahepatic iron deposition was common, and iron overload in the portal tract indicated poor survival in curatively resected HCC patients.
Collapse
Affiliation(s)
- Jung Wha Chung
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Eun Shin
- Department of Pathology, Hallym University Dongtan Sacred Heart Hospital
| | - Haeryoung Kim
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Ho-Seong Han
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jai Young Cho
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Young Rok Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sukho Hong
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Eun Sun Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jin-Wook Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sook-Hyang Jeong
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| |
Collapse
|
8
|
Ho KM, Han HS, Yoon YS, Cho JY, Choi YR, Jang JS, Kwon SU, Kim S, Choi JK. Laparoscopic Anatomical Segment 2 Segmentectomy by the Glissonian Approach. J Laparoendosc Adv Surg Tech A 2017; 27:818-822. [DOI: 10.1089/lap.2016.0377] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Kit-Man Ho
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Korea
| | - Ho-Seong Han
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Korea
| | - Yoo-Seok Yoon
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Korea
| | - Jai Young Cho
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Korea
| | - Young Rok Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Korea
| | - Jae Seong Jang
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Korea
| | - Seong Uk Kwon
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Korea
| | - Sungho Kim
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Korea
| | - Jang Kyu Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Korea
| |
Collapse
|
9
|
Park J, Lee YH, Choi YR, Lee YJ, Kim DJ, Jheon S, Cho YJ. A Case Treated with Extracorporeal Membrane Oxygenation for Disseminated Cytomegalovirus Infection after Liver Transplantation. Korean J Transplant 2017. [DOI: 10.4285/jkstn.2017.31.2.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Jimyung Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Yoon Hyun Lee
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Young Rok Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Yeon Joo Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Dong Jung Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sanghoon Jheon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Young-Jae Cho
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| |
Collapse
|
10
|
Ho KM, Han HS, Yoon YS, Cho JY, Choi YR, Jang JS, Kwon SU, Kim S, Choi JK. Laparoscopic Anatomical Segment 2 Segmentectomy by the Glissonian Approach. ACTA ACUST UNITED AC 2017. [DOI: 10.1089/vor.2016.0377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Kit-Man Ho
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Surgery, Seoul National University College of Medicine, Seongnam, Korea
| | - Ho-Seong Han
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Surgery, Seoul National University College of Medicine, Seongnam, Korea
| | - Yoo-Seok Yoon
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Surgery, Seoul National University College of Medicine, Seongnam, Korea
| | - Jai Young Cho
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Surgery, Seoul National University College of Medicine, Seongnam, Korea
| | - Young Rok Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Surgery, Seoul National University College of Medicine, Seongnam, Korea
| | - Jae Seong Jang
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Surgery, Seoul National University College of Medicine, Seongnam, Korea
| | - Seong Uk Kwon
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Surgery, Seoul National University College of Medicine, Seongnam, Korea
| | - Sungho Kim
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Surgery, Seoul National University College of Medicine, Seongnam, Korea
| | - Jang Kyu Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Surgery, Seoul National University College of Medicine, Seongnam, Korea
| |
Collapse
|
11
|
Park S, Kim JW, Kim H, Kim JW, Kim YJ, Lee KW, Kim JH, Kim JH, Hwang JH, Choi YR, Cho JY, Yoon YS, Han HS. Prognostic value of p21-activated kinase 4 in resected pancreatic cancer. APMIS 2017; 125:699-707. [PMID: 28556956 DOI: 10.1111/apm.12705] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 03/07/2017] [Indexed: 12/28/2022]
Abstract
Resectable pancreatic cancer has a high recurrence rate after curative surgery. Biomarkers are needed for distinguishing patients who may benefit from curative resection. In this study, we sought to analyze the prognostic value of p21-activated kinase 1 (PAK1), p21-activated kinase 4 (PAK4), human equilibrative nucleoside transporter 1 (hENT1), and thymidylate synthase (TS) in surgically resected pancreatic ductal adenocarcinomas. A total of 160 pancreatic cancer patients who underwent surgery with curative intent were retrospectively reviewed. Tissue microarrays were constructed and immunohistochemical stains were performed for PAK1, PAK4, hENT1, and TS. The absence of PAK4 expression in pancreatic adenocarcinomas was associated with poorer histologic differentiation (p < 0.001), shorter overall survival [hazard ratio (HR) = 2.86, 95% confidence interval (CI) 1.43-5.71; p = 0.003], and disease-free survival (HR = 2.29, 95% CI: 1.11-4.74; p = 0.025) on univariate analyses. In addition, more frequent venous invasion and lymph node metastases were seen in PAK4-negative tumors although not statistically significant. PAK1, hENT1, and TS expression status did not have significant influences on patient survival. In conclusion, PAK4 of the markers tested in this study may be a potential prognostic biomarker for pancreatic adenocarcinomas.
Collapse
Affiliation(s)
- Sehhoon Park
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jin Won Kim
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Haeryoung Kim
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Ji-Won Kim
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Yu Jung Kim
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Keun-Wook Lee
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jee Hyun Kim
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jai Hwan Kim
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jin-Hyeok Hwang
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Young Rok Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jai Young Cho
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Yoo-Seok Yoon
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Ho-Seong Han
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| |
Collapse
|
12
|
Zhao J, van Mierlo KMC, Gómez-Ramírez J, Kim H, Pilgrim CHC, Pessaux P, Rensen SS, van der Stok EP, Schaap FG, Soubrane O, Takamoto T, Viganò L, Winkens B, Dejong CHC, Olde Damink SWM, Martín Pérez E, Cho JY, Choi YR, Phillips W, Michael M, Panaro F, Chenard MP, Verhoef C, Grünhagen DJ, Vara J, Scatton O, Hashimoto T, Makuuchi M, De Rosa G, Ravarino N. Systematic review of the influence of chemotherapy-associated liver injury on outcome after partial hepatectomy for colorectal liver metastases. Br J Surg 2017; 104:990-1002. [PMID: 28542731 DOI: 10.1002/bjs.10572] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/07/2017] [Accepted: 03/29/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND The impact of chemotherapy-associated liver injury (CALI) on postoperative outcome in patients undergoing partial hepatectomy for colorectal liver metastases (CRLM) remains controversial. The objective of this study was to clarify the effect of CALI (sinusoidal dilatation (SD), steatosis and steatohepatitis) on postoperative morbidity and mortality by investigating a large data set from multiple international centres. METHODS PubMed and Embase were searched for studies published between 1 January 2004 and 31 December 2013 with keywords 'chemotherapy', 'liver resection', 'outcome' and 'colorectal metastases' to identify potential collaborating centres. Univariable and multivariable analyses were performed using binary logistic regression models, with results presented as odds ratios (ORs) with 95 per cent confidence intervals. RESULTS A consolidated database comprising 788 patients who underwent hepatectomy for CRLM in eight centres was obtained. In multivariable analyses, severe SD was associated with increased major morbidity (Dindo-Clavien grade III-V; OR 1·73, 95 per cent c.i. 1·02 to 2·95; P = 0·043). Severe steatosis was associated with decreased liver surgery-specific complications (OR 0·52, 95 per cent c.i. 0·27 to 1·00; P = 0·049), whereas steatohepatitis was linked to an increase in these complications (OR 2·08, 1·18 to 3·66; P = 0·012). Subgroup analysis showed that lobular inflammation was the sole component associated with increased overall morbidity (OR 2·22, 1·48 to 3·34; P = 0·001) and liver surgery-specific complications (OR 3·35, 2·11 to 5·32; P < 0·001). Finally, oxaliplatin treatment was linked to severe SD (OR 2·74, 1·67 to 4·49; P < 0·001). CONCLUSION An increase in postoperative major morbidity and liver surgery-specific complications was observed after partial hepatectomy in patients with severe SD and steatohepatitis. Postoperative liver failure occurred more often in patients with severe SD.
Collapse
Affiliation(s)
- J Zhao
- Department of Surgery, Maastricht University Medical Centre and NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - K M C van Mierlo
- Department of Surgery, Maastricht University Medical Centre and NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - J Gómez-Ramírez
- Hepatopancreaticobiliary Surgery Unit, Department of Surgery, Hospital Universitario de la Princesa, Madrid, Spain
| | - H Kim
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National College of Medicine, Seongnam, Korea
| | - C H C Pilgrim
- Hepatopancreaticobiliary Service, Upper Gastrointestinal Surgery, The Alfred Hospital, and Division of Cancer Surgery, Peter MacCallum Cancer Centre, Department of Surgery, University of Melbourne, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - P Pessaux
- Digestive Surgery and Transplantation, Hôpital de Hautepierre, University Hospital of Strasbourg, Strasbourg, France
| | - S S Rensen
- Department of Surgery, Maastricht University Medical Centre and NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - E P van der Stok
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - F G Schaap
- Department of Surgery, Maastricht University Medical Centre and NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - O Soubrane
- Department of Hepatobiliary Surgery and Liver Transplant, Beaujon Hospital, Assistance Publique - Hôpitaux de Paris, Université Denis Diderot, Paris, France
| | - T Takamoto
- Department of Hepatopancreaticobiliary Surgery, Japanese Red Cross Medical Centre, Tokyo, Japan
| | - L Viganò
- Division of Hepatobiliary and General Surgery, Humanitas Clinical and Research Centre, Humanitas University, Rozzano, Italy
| | - B Winkens
- Department of Methodology and Statistics, Maastricht University Medical Centre, and CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands
| | - C H C Dejong
- Department of Surgery, Maastricht University Medical Centre and NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands.,GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - S W M Olde Damink
- Department of Surgery, Maastricht University Medical Centre and NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands.,Department of Hepatopancreaticobiliary Surgery and Liver Transplantation, Institute for Liver and Digestive Health, Royal Free Hospital, University College London, London, UK
| | | | - E Martín Pérez
- Hepatopancreaticobiliary Surgery Unit, Department of Surgery, Hospital Universitario de la Princesa, Madrid, Spain
| | - J Y Cho
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National College of Medicine, Seongnam, Korea
| | - Y R Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National College of Medicine, Seongnam, Korea
| | - W Phillips
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Department of Surgery, University of Melbourne, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - M Michael
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Department of Surgery, University of Melbourne, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - F Panaro
- Digestive Surgery and Transplantation, Hôpital de Hautepierre, University Hospital of Strasbourg, University of Strasbourg, Strasbourg, France
| | - M-P Chenard
- Department of Pathology, Hôpital de Hautepierre, University hospital of Strasbourg, University of Strasbourg, Strasbourg, France
| | - C Verhoef
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - D J Grünhagen
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - J Vara
- Digestive Tumours Unit, Institut Bergonié, Bordeaux, France
| | - O Scatton
- Department of Digestive and Hepatobiliary Surgery, La Pitié Hospital, Université Pierre et Maris Curie, Paris, France
| | - T Hashimoto
- Department of Hepatopancreaticobiliary Surgery, Japanese Red Cross Medical Centre, Tokyo, Japan
| | - M Makuuchi
- Department of Hepatopancreaticobiliary Surgery, Japanese Red Cross Medical Centre, Tokyo, Japan
| | - G De Rosa
- Department of Pathology, Mauriziano Umberto I Hospital, Turin, Italy
| | - N Ravarino
- Department of Pathology, Mauriziano Umberto I Hospital, Turin, Italy
| | | |
Collapse
|
13
|
Kim H, Ahn SW, Hong SK, Yoon KC, Kim HS, Choi YR, Lee HW, Yi NJ, Lee KW, Suh KS. Survival benefit of liver resection for Barcelona Clinic Liver Cancer stage B hepatocellular carcinoma. Br J Surg 2017; 104:1045-1052. [DOI: 10.1002/bjs.10541] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 01/23/2017] [Accepted: 02/01/2017] [Indexed: 01/27/2023]
Abstract
Abstract
Background
Although transarterial chemoembolization is recommended as the standard treatment for Barcelona Clinic Liver Cancer stage B hepatocellular carcinoma (BCLC-B HCC), other treatments including liver resection have been used. This study aimed to determine the survival benefit of treatment strategies including resection for BCLC-B HCC compared with non-surgical treatments.
Methods
The nationwide multicentre database of the Korean Liver Cancer Association was reviewed. Patients with BCLC-B HCC who underwent liver resection as a first or second treatment within 2 years of diagnosis and patients who received non-surgical treatment were selected randomly. Survival outcomes of propensity score-matched groups were compared.
Results
Among 887 randomly selected patients with BCLC-B HCC, 83 underwent liver resection as first or second treatment and 597 had non-surgical treatment. After propensity score matching, the two groups were well balanced (80 patients in each group). Overall median survival in the resection group was better than that for patients receiving non-surgical treatment (50·9 versus 22·1 months respectively; P < 0·001). The 1-, 2-, 3- and 5-year overall survival rates in the resection group were 90, 88, 75 and 63 per cent, compared with 79, 48, 35 and 22 per cent in the no-surgery group (P < 0·001). In multivariable analysis, non-surgical treatment only (hazard ratio (HR) 3·35, 95 per cent c.i. 2·16 to 5·19; P < 0·001), albumin level below 3·5 g/dl (HR 1·96, 1·22 to 3·15; P = 0·005) and largest tumour size greater than 5·0 cm (HR 1·81, 1·20 to 2·75; P = 0·005) were independent predictors of worse overall survival.
Conclusion
Treatment strategies that include liver resection offer a survival benefit compared with non-surgical treatments for potentially resectable BCLC-B HCC.
Collapse
Affiliation(s)
- H Kim
- Department of Surgery, Seoul National University College of Medicine 101, Daehak-ro, Jongno-gu, Seoul 03080, Korea
| | - S W Ahn
- Department of Surgery, Seoul National University College of Medicine 101, Daehak-ro, Jongno-gu, Seoul 03080, Korea
| | - S K Hong
- Department of Surgery, Seoul National University College of Medicine 101, Daehak-ro, Jongno-gu, Seoul 03080, Korea
| | - K C Yoon
- Department of Surgery, Seoul National University College of Medicine 101, Daehak-ro, Jongno-gu, Seoul 03080, Korea
| | - H-S Kim
- Department of Surgery, Seoul National University College of Medicine 101, Daehak-ro, Jongno-gu, Seoul 03080, Korea
| | - Y R Choi
- Department of Surgery, Seoul National University College of Medicine 101, Daehak-ro, Jongno-gu, Seoul 03080, Korea
| | - H W Lee
- Department of Surgery, Seoul National University College of Medicine 101, Daehak-ro, Jongno-gu, Seoul 03080, Korea
| | - N-J Yi
- Department of Surgery, Seoul National University College of Medicine 101, Daehak-ro, Jongno-gu, Seoul 03080, Korea
| | - K-W Lee
- Department of Surgery, Seoul National University College of Medicine 101, Daehak-ro, Jongno-gu, Seoul 03080, Korea
| | - K-S Suh
- Department of Surgery, Seoul National University College of Medicine 101, Daehak-ro, Jongno-gu, Seoul 03080, Korea
| | | |
Collapse
|
14
|
Ho KM, Han HS, Yoon YS, Cho JY, Choi YR, Jang JS, Kwon SU, Kim S, Choi JK. Laparoscopic Total Caudate Lobectomy for Hepatocellular Carcinoma. J Laparoendosc Adv Surg Tech A 2016; 27:1074-1078. [PMID: 27855267 DOI: 10.1089/lap.2016.0459] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Caudate lobe is located in the deep dorsal area of the liver between the portal triad and the inferior vena cava (IVC). Torrential bleeding can occur from the IVC and short hepatic veins during dissection. Isolated total caudate lobe resection is still rare and technically demanding. We herein present a video on the technical aspect of laparoscopic total caudate lobectomy. METHOD A 61-year-old woman was admitted for recurrent hepatocellular carcinoma detected on imaging. She had history of multifocal hepatocellular carcinoma in July 2015 and underwent open cholecystectomy, segment 6 and segment 8 tumorectomy. Ten months later, the computed tomography scan and magnetic resonance imaging showed a 1 cm arterial enhancing lesion in segment I (S1) with no other foci of recurrence. Laparoscopic total caudate lobectomy was contemplated. RESULTS The operative time was 270 minutes. The intraoperative blood loss was 200 mL and blood transfusion was not necessary. The patient was discharged on the fourth postoperative day without any complications. CONCLUSION This report showed the safety and feasibility of laparoscopic total caudate lobectomy. Nonetheless, it is a technically demanding procedure. It should be performed in carefully selected patients and by experienced hepatobiliary surgeons proficient in laparoscopic liver resection.
Collapse
Affiliation(s)
- Kit-Man Ho
- 1 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam-si, Korea.,2 Department of Surgery, Kwong Wah Hospital , Hong Kong, China
| | - Ho-Seong Han
- 1 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam-si, Korea
| | - Yoo-Seok Yoon
- 1 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam-si, Korea
| | - Jai Young Cho
- 1 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam-si, Korea
| | - Young Rok Choi
- 1 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam-si, Korea
| | - Jae Seong Jang
- 1 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam-si, Korea
| | - Seong Uk Kwon
- 1 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam-si, Korea
| | - Sungho Kim
- 1 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam-si, Korea
| | - Jang Kyu Choi
- 1 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam-si, Korea
| |
Collapse
|
15
|
Hsiao YC, Chen CJ, Choi YR. The innovation and economic consequences of knowledge spillovers: fit between exploration and exploitation capabilities, knowledge attributes, and transfer mechanisms. Technology Analysis & Strategic Management 2016. [DOI: 10.1080/09537325.2016.1250879] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Yung-Chang Hsiao
- Department of Business and Management, College of Management, National University of Tainan, Tainan, Taiwan, R.O.C
| | - Chung-Jen Chen
- Graduate Institute of Business Administration, College of Management, National Taiwan University, Taipei, Taiwan, R.O.C
| | - Young Rok Choi
- Graduate School of Technology and Innovation Management, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| |
Collapse
|
16
|
Ho MC, Hasegawa K, Chen XP, Nagano H, Lee YJ, Chau GY, Zhou J, Wang CC, Choi YR, Poon RTP, Kokudo N. Surgery for Intermediate and Advanced Hepatocellular Carcinoma: A Consensus Report from the 5th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2014). Liver Cancer 2016; 5:245-256. [PMID: 27781197 PMCID: PMC5075807 DOI: 10.1159/000449336] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The Barcelona Clinic Liver Cancer (BCLC) staging and treatment strategy does not recommended surgery for treating BCLC stage B and C hepatocellular carcinoma (HCC). However, numerous Asia-Pacific institutes still perform surgery for this patient group. This consensus report from the 5th Asia-Pacific Primary Liver Cancer Expert Meeting aimed to share opinions and experiences pertaining to liver resection for intermediate and advanced HCCs and to provide evidence to issue recommendations for surgery in this patient group. SUMMARY Thirteen experts from five Asia-Pacific regions were invited to the meeting; 10 of them (Japan: 2, Taiwan: 3, South Korea: 2, Hong Kong: 1, and China: 2) voted for the final consensus. The discussion focused on evaluating the preoperative liver functional reserve and surgery for large tumors, multiple tumors, HCCs with vascular invasion, and HCCs with distant metastasis. The feasibility of future prospective randomized trials comparing surgery with transarterial chemoembolization for intermediate HCC and with sorafenib for advanced HCC was also discussed. The Child-Pugh score (9/10 experts) and indocyanine green retention rate at 15 min (8/10) were the most widely accepted methods for evaluating the preoperative liver functional reserve. All (10/10) experts agreed that portal hypertension, tumor size >5 cm, portal venous invasion, hepatic venous invasion, and extrahepatic metastasis are not absolute contraindications for the surgical resection of HCC. Furthermore, 9 of the 10 experts agreed that tumor resection may be performed for patients with >3 tumors. The limitations of surgery are associated with a poor liver functional reserve, incomplete tumor resection, and a high probability of recurrence. KEY MESSAGES Surgery provides significant survival benefits for Asian-Pacific patients with intermediate and advanced HCCs, particularly when the liver functional reserve is favorable. However, prospective randomized controlled trials are difficult to conduct because of technical and ethical considerations.
Collapse
Affiliation(s)
- Ming-Chih Ho
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan (ROC),*Ming-Chih Ho, MD, PhD, Department of Surgery, National Taiwan University Hospital and, National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei 100, Taiwan (ROC), Tel. +886 2 23123456, E-Mail
| | - Kiyoshi Hasegawa
- Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Xiao-Ping Chen
- Department of Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hiroaki Nagano
- Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Young-Joo Lee
- Department of Surgery, Asan Medical Center, Seoul, Republic of Korea
| | - Gar-Yang Chau
- Department of Surgery, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taipei, Taiwan (ROC)
| | - Jian Zhou
- Department of Liver Surgery and Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Chih-Chi Wang
- Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan (ROC)
| | - Young Rok Choi
- Department of Surgery, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | | | - Norihiro Kokudo
- Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
17
|
Yoo T, Lee KW, Yi NJ, Choi YR, Kim H, Suh SW, Jeong JH, Lee JM, Suh KS. Peri-Transplant Change in AFP Level: a Useful Predictor of Hepatocellular Carcinoma Recurrence Following Liver Transplantation. J Korean Med Sci 2016; 31:1049-54. [PMID: 27366001 PMCID: PMC4900995 DOI: 10.3346/jkms.2016.31.7.1049] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 03/28/2016] [Indexed: 01/10/2023] Open
Abstract
Pretransplant alpha-fetoprotein (AFP) is a useful tumor marker predicting recurrence of hepatocellular carcinoma (HCC). Little is known, however, about the relationship between changes in AFP concentration and prognosis. This study investigated the clinical significance of change in peri-transplant AFP level as a predictor of HCC recurrence. Data from 125 HCC patients with elevated pretransplant AFP level who underwent liver transplantation (LT) between February 2000 and December 2010 were retrospectively reviewed. Patients with AFP normalization within 1 month after LT were classified into the rapid normalization group (n = 97), with all other patients classified into the non-rapid normalization group (n = 28). Tumor recurrence was observed in 17 of the 97 patients (17.5%) with rapid normalization; of these, 11 patients had high AFP levels and six had normal levels at recurrence. In contrast, tumor recurrence was observed in 24 of the 28 patients (85.7%) without rapid normalization, with all 24 having high AFP levels at recurrence. Multivariate analysis showed that non-rapid normalization (harzard ratio [HR], 4.41, P < 0.001), sex (HR, 3.26, P = 0.03), tumor size (HR, 1.15, P = 0.001), and microvascular invasion (HR, 2.65, P = 0.005) were independent risk factors for recurrence. In conclusion, rapid normalization of post-LT AFP level at 1 month is a useful clinical marker for HCC recurrence. Therefore, an adjuvant strategy and/or intensive screening are needed for patients who do not show rapid normalization.
Collapse
Affiliation(s)
- Tae Yoo
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.; Department of Surgery, Hallym University College of Medicine, Hwaseong, Korea
| | - Kwang-Woong Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Nam-Joon Yi
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Young Rok Choi
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyeyoung Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Suk-Won Suh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Hong Jeong
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong-Moo Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Suk Suh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
18
|
|
19
|
Affiliation(s)
- Young Rok Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Seoul National University College of Medicine, Seoul, Korea
| | - Kwang-Woong Lee
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
- Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
20
|
Choi YR, Lee KW. Correction: Liver Procurement. Korean J Transplant 2015. [DOI: 10.4285/jkstn.2015.29.4.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Young Rok Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Seoul National University College of Medicine, Seoul, Korea
| | - Kwang-Woong Lee
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
- Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
21
|
Park H, Lee H, Seo AN, Cho JY, Choi YR, Yoon YS, Han HS, Park YN, Kim H. SALL4 Expression in Hepatocellular Carcinomas Is Associated with EpCAM-Positivity and a Poor Prognosis. J Pathol Transl Med 2015; 49:373-81. [PMID: 26265684 PMCID: PMC4579277 DOI: 10.4132/jptm.2015.07.09] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/01/2015] [Accepted: 07/08/2015] [Indexed: 02/06/2023] Open
Abstract
Background: There is increasing interest in hepatocellular carcinomas (HCC) expressing “stemness”-related markers, as they have been associated with aggressive behavior and poor prognosis. In this study, we investigated the usefulness of Sal-like protein 4 (SALL4), a recently proposed candidate marker of “stemness.” Methods: Immunohistochemical stains were performed for SALL4, K19, and epithelial cellular adhesion molecule (EpCAM) on tissue microarrays constructed from 190 surgically resected HCCs, and the results were correlated with the clinicopathological features and patient survival data. Results: Nuclear SALL4 expression was observed in 39/190 HCCs (20.5%), while K19 and EpCAM were expressed in 30 (15.9%) and 92 (48.7%) HCCs, respectively. The nuclear expression was generally weak, punctate or clumped. SALL4 expression was significantly associated with a poor overall survival compared to SALL4-negative HCCs (p = .014) compared to SALL4-negative HCCs. On multivariate analysis adjusted for tumor size, multiplicity, vascular invasion, and pathological tumor stage, SALL4 remained as a significant independent predictor of decreased overall survival (p= .004). SALL4 expression was positively correlated with EpCAM expression (p = .013) but not with K19 expression. HCCs that expressed both SALL4 and EpCAM were associated with significantly decreased overall survival, compared to those cases which were negative for both of these markers (p = .031). Conclusions: Although SALL4 expression was not significantly correlated with other clinicopathological parameters suggestive of tumor aggressiveness, SALL4 expression was an independent predictor of poor overall survival in human HCCs, and was also positively correlated with EpCAM expression.
Collapse
Affiliation(s)
- Hyunjin Park
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyejung Lee
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - An Na Seo
- Department of Pathology, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jai Young Cho
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Young Rok Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yoo-Seok Yoon
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ho-Seong Han
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Young Nyun Park
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Haeryoung Kim
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
22
|
Nahm JH, Kim H, Lee H, Cho JY, Choi YR, Yoon YS, Han HS, Park YN. Transforming acidic coiled-coil-containing protein 3 (TACC3) overexpression in hepatocellular carcinomas is associated with “stemness” and epithelial-mesenchymal transition-related marker expression and a poor prognosis. Tumour Biol 2015. [DOI: 10.1007/s13277-015-3810-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
23
|
Malikov M, Shin E, Cho JY, Han HS, Yoon YS, Choi YR, Jang JY, Choi H, Jang JS, Kwon SU, Kim H. Primary hepatic choriocarcinoma in a female patient. ACTA ACUST UNITED AC 2015. [DOI: 10.14216/kjco.15007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
24
|
Suh KS, Suh SW, Lee JM, Choi YR, Yi NJ, Lee KW. Living donor liver transplantation using a left liver extended to right anterior sector. Transpl Int 2015; 28:765-9. [DOI: 10.1111/tri.12559] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 12/30/2014] [Accepted: 02/27/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Kyung-Suk Suh
- Department of Surgery; College of Medicine; Seoul National University; Seoul Korea
| | - Suk-Won Suh
- Department of Surgery; College of Medicine; Seoul National University; Seoul Korea
| | - Jeong-Moo Lee
- Department of Surgery; College of Medicine; Seoul National University; Seoul Korea
| | - Young Rok Choi
- Department of Surgery; College of Medicine; Seoul National University; Seoul Korea
| | - Nam-Joon Yi
- Department of Surgery; College of Medicine; Seoul National University; Seoul Korea
| | - Kwang-Woong Lee
- Department of Surgery; College of Medicine; Seoul National University; Seoul Korea
| |
Collapse
|
25
|
Choi JH, Seo JD, Kim MJ, Choi BY, Choi YR, Cho BM, Kim JS, Choi KD. Vertigo and nystagmus in orthostatic hypotension. Eur J Neurol 2014; 22:648-55. [PMID: 25641037 DOI: 10.1111/ene.12622] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Accepted: 10/07/2014] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND PURPOSE Generalized cerebral ischaemia from cardiovascular dysfunction usually leads to presyncopal dizziness, but several studies reported a higher frequency of rotatory vertigo in cardiovascular patients. Whether generalized cerebral ischaemia due to cardiovascular disorders may produce objective vestibular dysfunction was investigated. METHODS Thirty-three patients with orthostatic dizziness/vertigo due to profound orthostatic hypotension and 30 controls were recruited. All participants underwent recording of eye movements during two orthostatic challenging tests: the Schellong and the squatting-standing tests. Most patients had neuroimaging, and patients with abnormal eye movements were subjected to follow-up evaluations. RESULTS Symptoms associated with orthostatic dizziness/vertigo included blurred vision, fainting and tinnitus. Ten (30%) of 33 patients developed rotatory vertigo and nystagmus during the Schellong (n = 5) or squatting-standing test (n = 5). Four of them showed pure downbeat nystagmus whilst five had downbeat and horizontal nystagmus with or without torsional component. Patients with orthostatic nystagmus had shorter duration of orthostatic intolerance than those without nystagmus (1.0 ± 1.6 vs. 11.0 ± 9.7 months, P < 0.001). In two patients, orthostatic nystagmus disappeared during follow-up despite the persistence of profound orthostatic hypotension. CONCLUSIONS Generalized cerebral ischaemia caused by orthostatic hypotension induces rotatory vertigo due to objective vestibular dysfunction. The presence of orthostatic vertigo and nystagmus has an association with the duration of orthostatic intolerance.
Collapse
Affiliation(s)
- J-H Choi
- Department of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | | | | | | | | | | | | | | |
Collapse
|
26
|
Youn JK, Lee JM, Yi NJ, Choi YR, Suh SW, You T, Lee KW, Jung CW, Lee JW, Bae EJ, Ko JS, Kim WH, Park KW, Suh KS. Pediatric split liver transplantation after Fontan procedure in left isomerism combined with biliary atresia: a case report. Pediatr Transplant 2014; 18:E274-9. [PMID: 25263970 DOI: 10.1111/petr.12364] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2014] [Indexed: 11/29/2022]
Abstract
LI is a subset of the heterotaxy syndrome and a rare birth defect that involves the heart and other organs. It can be combined with extracardiac abnormalities, especially BA. CHD can be associated with LI in up to 15% of cases, although it is rare in BA. Pediatric LT for a child with ESLD due to BA combined with LI and CHD is a challenging issue for a transplant surgeon. Herein, we report a successful split LT on a three-yr-old boy with LI who survived after a Fontan procedure due to single ventricle, but who suffered from HPS associated with BA.
Collapse
Affiliation(s)
- Joong Kee Youn
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Garcia A, Yi NJ, Lee KB, Lee JM, Choi YR, Suh SW, You T, Lee KW, Park JD, Kang HJ, Kim JG, Kang EK, Hong G, Suh KS. Fulminant hepatitis linked to dapsone hypersensitivity syndrome requiring urgent living donor liver transplantation: a case report. Pediatr Transplant 2014; 18:E240-5. [PMID: 25156688 DOI: 10.1111/petr.12343] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/23/2014] [Indexed: 11/28/2022]
Abstract
Dapsone is a sulfone-type drug used widely for different infectious, immune, and hypersensitivity disorders as an antibacterial treatment alone or in combination for leprosy and sometimes for infected skin lesions. DHS is a severe idiosyncratic adverse reaction with multi-organ involvement. However, acute necrotic hepatitis requiring an emergent LT is rare. Herein, we report a case of 12-yr-old girl who suffered from fulminant hepatitis and multi-organ failure due to DHS for PPD. She was saved by emergent LDLT. A high index of suspicion and rapid diagnosis are necessary not to miss this potentially lethal but rare disease.
Collapse
Affiliation(s)
- Angelica Garcia
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Park MS, Lee KW, Yi NJ, Choi YR, Kim H, Hong G, Suh KS, Kwon CHD, Joh JW, Lee SK. Optimal tailored screening protocol after living donor liver transplantation for hepatocellular carcinoma. J Korean Med Sci 2014; 29:1360-6. [PMID: 25368488 PMCID: PMC4214935 DOI: 10.3346/jkms.2014.29.10.1360] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 07/03/2014] [Indexed: 12/12/2022] Open
Abstract
The indication for hepatocellular carcinoma (HCC) is expanding in living donor liver transplantation (LDLT). Early detection and effective management of recurrence has become an important issue in LDLT for HCC. This study aimed to find an optimal screening protocol in terms of screening interval and screening tools by analyzing recurrence pattern after LDLT for HCC. A total of 205 LDLT patients in two centers from February 1999 to October 2010 was reviewed. Recurrence appeared in 55 cases. Six risk factors for recurrence were identified: preoperative alpha-fetoprotein >400, Edmonson grade 3 or 4, tumor size >7 cm, tumor number ≥7, minimal tumor necrosis in the transarterial chemoembolization group and positive micro-vascular invasion. Four groups with different ranges of index scores showed different recurrence-free survival and median time to recurrence. Group I showed low and late recurrence. Groups II and III showed linearly increased rate of recurrence until 18 months. Group IV showed very early recurrence within 6 months. Across the groups, extra-hepatic recurrence developed in more than 40% of cases and multi-organ recurrence rate was 20%. The screening interval should be different based on the risk of recurrence. Screening should include work-up for extra-hepatic recurrence as well as intra-hepatic recurrence.
Collapse
Affiliation(s)
- Min-Su Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kwang-Woong Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Nam-Joon Yi
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Young Rok Choi
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyeyoung Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Geun Hong
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Suk Suh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Choon-Hyuck David Kwon
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Won Joh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Suk-Koo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
29
|
Suh SW, Lee JM, You T, Choi YR, Yi NJ, Lee KW, Suh KS. Hepatic venous congestion in living donor grafts in liver transplantation: is there an effect on hepatocellular carcinoma recurrence? Liver Transpl 2014; 20:784-90. [PMID: 24668935 DOI: 10.1002/lt.23877] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 03/21/2014] [Indexed: 02/07/2023]
Abstract
A certain degree of graft congestion in living donor liver transplantation (LDLT) using a right liver graft may be inevitable because of the mismatch between the inflow and outflow structures of the liver. The subsequent inflammatory reaction and rapid regeneration of the graft have been suggested as causes of tumor recurrence. Therefore, we investigated the influence of graft congestion on hepatocellular carcinoma (HCC) recurrence after LDLT. Two hundred eighty-nine LDLT patients for HCC within the University of California San Francisco criteria between November 1999 and February 2012 were investigated. Patients were assigned to groups on the basis of the degree of congestion (≤10% for group A and >10% for group B), which was determined by 3-dimensional reconstruction of posttransplant multidetector helical computed tomography within 2 weeks. Perioperative characteristics, regeneration rates after 6 months, and recurrence rates were compared between the groups, and a multivariate analysis of the influence of congestion on tumor recurrence was subsequently completed. No significant difference in demographics was found. Group B had more elevated peak posttransplant levels of aspartate aminotransferase (296.26 versus 227.53, P = 0.05), alanine aminotransferase (382.91 versus 276.98, P = 0.04), and highly selective C-reactive protein (5.41 versus 3.55, P < 0.001); a higher noncongestive section regeneration rate (25.8% versus 13.6%, P = 0.012); and a higher recurrence rate (30.4% versus 9.7%, P = 0.01) than group A. Graft congestion > 10% [hazard ratio (HR) = 3.10, 95% confidence interval (CI) = 1.15-8.35, P = 0.03], microvascular invasion (HR = 5.43, 95% CI = 2.04-14.44, P < 0.01), and an alpha-fetoprotein level > 200 IU/L (HR = 2.98, 95% CI = 1.10-8.03, P = 0.03) were significantly related to tumor recurrence. Liver congestion may promote the recurrence of HCC after LDLT; therefore, it should be minimized.
Collapse
Affiliation(s)
- Suk-Won Suh
- Department of Surgery, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | | | | | | | | | | | | |
Collapse
|
30
|
Lee JY, Kim YH, Yi NJ, Kim HS, Lee HS, Lee BK, Kim H, Choi YR, Hong G, Lee KW, Suh KS. Impact of immunosuppressant therapy on early recurrence of hepatocellular carcinoma after liver transplantation. Clin Mol Hepatol 2014; 20:192-203. [PMID: 25032186 PMCID: PMC4099335 DOI: 10.3350/cmh.2014.20.2.192] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 06/07/2014] [Accepted: 06/10/2014] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/AIMS The most commonly used immunosuppressant therapy after liver transplantation (LT) is a combination of tacrolimus and steroid. Basiliximab induction has recently been introduced; however, the most appropriate immunosuppression for hepatocellular carcinoma (HCC) patients after LT is still debated. METHODS Ninety-three LT recipients with HCC who took tacrolimus and steroids as major immunosuppressants were included. Induction with basiliximab was implemented in 43 patients (46.2%). Mycophenolate mofetil (MMF) was added to reduce the tacrolimus dosage (n=28, 30.1%). The 1-year tacrolimus exposure level was 7.2 ± 1.3 ng/mL (mean ± SD). RESULTS The 1- and 3-year recurrence rates of HCC were 12.9% and 19.4%, respectively. Tacrolimus exposure, cumulative steroid dosages, and MMF dosages had no impact on HCC recurrence. Induction therapy with basiliximab, high alpha fetoprotein (AFP; >400 ng/mL) and protein induced by vitamin K absence/antagonist-II (PIVKA-II; >100 mAU/mL) levels, and microvascular invasion were significant risk factors for 1-year recurrence (P<0.05). High AFP and PIVKA-II levels, and positive (18)fluoro-2-deoxy-d-glucose positron-emission tomography findings were significantly associated with 3-year recurrence (P<0.05). CONCLUSIONS Induction therapy with basiliximab, a strong immunosuppressant, may have a negative impact with respect to early HCC recurrence (i.e., within 1 year) in high-risk patients.
Collapse
Affiliation(s)
- Ju-Yeun Lee
- Department of Pharmacy, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. ; College of Pharmacy, Hanyang University, Gyeonggi-do, Korea
| | - Yul Hee Kim
- Ewha Graduate School of Clinical Health Sciences, Ewha Women's University, Seoul, Korea
| | - Nam-Joon Yi
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyang Sook Kim
- Department of Pharmacy, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hye Suk Lee
- Department of Pharmacy, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Byung Koo Lee
- Ewha Graduate School of Clinical Health Sciences, Ewha Women's University, Seoul, Korea
| | - Hyeyoung Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Young Rok Choi
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Geun Hong
- Department of Surgery, Ewha Women's University College of Medicine, Seoul, Korea
| | - Kwang-Woong Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Suk Suh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
31
|
Park MS, Yi NJ, Son SY, You T, Suh SW, Choi YR, Kim H, Hong G, Lee KB, Lee KW, Jeong SY, Park KJ, Suh KS, Park JG. Histopathologic factors affecting tumor recurrence after hepatic resection in colorectal liver metastases. Ann Surg Treat Res 2014; 87:14-21. [PMID: 25025022 PMCID: PMC4091444 DOI: 10.4174/astr.2014.87.1.14] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 03/04/2014] [Accepted: 03/06/2014] [Indexed: 02/08/2023] Open
Abstract
Purpose Hepatic resection is a standard method of treatment for colorectal liver metastases (CRLM). However, the pathologic factors of metastatic lesions that affect tumor recurrence are less well defined in CRLM. The aim of this study was to evaluate the risk factors for recurrence of CRLM, focusing on histopathologic factors of metastatic lesions of the liver. Methods From January 2003 to December 2008, 117 patients underwent curative hepatic resection for CRLM were reviewed. Tumor size and number, differentiation, tumor budding, angio-invasion, dedifferentiation and tumor infiltrating inflammation of metastatic lesions were investigated. Results The mean number of hepatic tumors was 2 (range, 1-8). The mean size of the largest tumor was 2.9 cm (range, 0.3-18.5 cm) in diameter. The moderate differentiation of the hepatic tumor was the most common in 86.3% of the patients. Tumor budding, angio-invasion, and dedifferentiation were observed in 81%, 34%, and 12.8% of patients. Inflammation infiltrating tumor was detected in 6.8% of patients. Recurrence after hepatic resection appeared in 69 out of 117 cases (58.9%). Recurrence-free survival at 1, 2 and 5 years were 62.4%, 43.6%, and 34.3%. The multivariate analysis showed the number of metastases ≥3 (P = 0.007), the tumor infiltrating inflammation (P = 0.047), and presence of dedifferentiation (P = 0.020) to be independent risk factors for tumor recurrence. Conclusion Histopathological factors, i.e., dedifferentiation and tumor infiltrating inflammation of the metastatic lesion, could be one of the risk factors of aggressive behavior as well as the number of metastases even after curative resection for CRLM.
Collapse
Affiliation(s)
- Min-Su Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Nam-Joon Yi
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Sang-Yong Son
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae You
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Suk-Won Suh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Young Rok Choi
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyeyoung Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Geun Hong
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyoung Bun Lee
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Kwang-Woong Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Seung-Yong Jeong
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyu Joo Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Suk Suh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Gahb Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
32
|
Abstract
The purpose of this study was to compare the outcome and complications of endoscopic versus open release for the treatment of de Quervain's tenosynovitis. Patients with this condition were randomised to undergo either endoscopic (n = 27) or open release (n = 25). Visual Analogue Scale (VAS) pain and Disabilities of Arm, Shoulder, and Hand (DASH) scores were measured at 12 and 24 weeks after surgery. Scar satisfaction was measured using a VAS scale. The mean pain and DASH scores improved significantly at 12 weeks and 24 weeks (p < 0.001) in both groups. The scores were marginally lower in the endoscopic group compared to the open group at 12 weeks (p = 0.012 and p = 0.002, respectively); however, only the DASH score showed a clinically important difference. There were no differences between the groups at 24 weeks. The mean VAS scar satisfaction score was higher in the endoscopic group at 24 weeks (p < 0.001). Transient superficial radial nerve injury occurred in three patients in the endoscopic group compared with nine in the open release group (p = 0.033). We conclude that endoscopic release for de Quervain's tenosynovitis seems to provide earlier improvement after surgery, with fewer superficial radial nerve complications and greater scar satisfaction, when compared with open release.
Collapse
Affiliation(s)
- H J Kang
- Yonsei University College of Medicine, Department of Orthopaedic Surgery, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, South Korea
| | | | | | | |
Collapse
|
33
|
Yi NJ, Suh KS, Suh SW, Chang YR, Hong G, Yoo T, Kim H, Park MS, Choi YR, Lee KW, Jung CW, Lee JH, Kim YJ, Yoon JH, Lee HS. Excellent Outcome in 238 Consecutive Living Donor Liver Transplantations Using the Right Liver Graft in a Large Volume Single Center. World J Surg 2013; 37:1419-29. [DOI: 10.1007/s00268-013-1976-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
34
|
Han EC, Yi NJ, Hong G, Park MS, Choi YR, Kim H, Lee KW, Kim IH, Kim YJ, Ko JS, Park KD, Lee HJ, Choi EH, Seo JK, Lee KB, Suh KS. Serongative Acute Hepatic Failure-associated Aplastic Anemia in Pediatric Liver Transplantation. Korean J Transplant 2011. [DOI: 10.4285/jkstn.2011.25.4.276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Eon Chul Han
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Nam-Joon Yi
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Geun Hong
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Min Su Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Young Rok Choi
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Heyoung Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kwang Woong Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - In Ho Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon Jun Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Sung Ko
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung Duk Park
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Hoan Jong Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Eun Hwa Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong Kee Seo
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Kyoung-Bun Lee
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung Suk Suh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
35
|
Son SY, Yi NJ, Hong G, Kim H, Park MS, Choi YR, Suh KS, Kim DW, Jeong SY, Park KJ, Park JG, Lee KU. Is neoadjuvant chemotherapy necessary for patients with initially resectable colorectal liver metastases in the era of effective chemotherapy? Korean J Hepatobiliary Pancreat Surg 2011; 15:206-17. [PMID: 26421041 PMCID: PMC4582468 DOI: 10.14701/kjhbps.2011.15.4.206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2011] [Revised: 10/04/2011] [Accepted: 10/21/2011] [Indexed: 12/21/2022]
Abstract
Backgrounds/Aims Hepatic resection has only guaranteed long-term survival in patients with colorectal liver metastasis (CRLM) even in the era of effective chemotherapy. The definite role of neoadjuvant chemotherapy (NCT) is to improve outcomes of unresectable CRLMs, but it its role has not been defined for initially resectable CRLMs (IR-CRLMs). Methods We reviewed the medical records of 226 patients, who had been diagnosed and treated for IR-CRLM between 2003 and 2008; the patients had the following pathologies: 10% had more than 4 nodules, 11% had tumors larger than 5 cm, and 61% had synchronous CRMLs. Among these patients, 20 patients (Group Y) were treated with NCT, and 206 (Group N) did not receive NCT according to their physician's preference. The median follow-up time was 34.1 months. Results The initial surgical plans were changed after NCT to further resection in 20% and to limited resection in 10% of 20 patients. Complication rates of Groups Y (30%) were indifferent from Group N (23%) (p=0.233), but intraoperative transfusions were more frequent in Group N (15%) than in Group Y (5%) (p=0.006). There was one case of hospital mortality (0.44%). Disease-free survival rates in Groups Y and N were 23% and 39%, respectively, and patient survival rates were 42% and 66% (p>0.05). By multivariate analysis, old age (≥60 years), differentiation of primary tumor (poorly/mucinous), resection margin involvement, and no adjuvant chemotherapy were associated with poor patient survival; the number of CRLMs (≥4) was associated with poor disease-free survival. Conclusions NCT had neither a positive impact nor a negative impact on survival, even with intraoperative transfusion, as observed on operative outcomes for patients with IR-CRLM. Further study is required to elucidate the role of NCT for treatment of patient with IR-CRLMs.
Collapse
Affiliation(s)
- Sang-Yong Son
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Nam-Joon Yi
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Geun Hong
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyeyoung Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Min Su Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Young Rok Choi
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Suk Suh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Duck-Woo Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Seung-Yong Jeong
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyu-Joo Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Gahb Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kuhn-Uk Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
36
|
Choi KJ, Lee HS, Yoon YS, Park SS, Kim JS, Jeong JJ, Choi YR. Distal metatarsal osteotomy for hallux varus following surgery for hallux valgus. ACTA ACUST UNITED AC 2011; 93:1079-83. [PMID: 21768632 DOI: 10.1302/0301-620x.93b8.26430] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We reviewed the outcome of distal chevron metatarsal osteotomy without tendon transfer in 19 consecutive patients (19 feet) with a hallux varus deformity following surgery for hallux valgus. All patients underwent distal chevron metatarsal osteotomy with medial displacement and a medial closing wedge osteotomy along with a medial capsular release. The mean hallux valgus angle improved from -11.6° pre-operatively to 4.7° postoperatively, the mean first-second intermetatarsal angle improved from -0.3° to 3.3° and the distal metatarsal articular angle from 9.5° to 2.3° and the first metatarsophalangeal joints became congruent post-operatively in all 19 feet. The mean relative length ratio of the metatarsus decreased from 1.01 to 0.99 and the mean American Orthopaedic Foot and Ankle Society score improved from 77 to 95 points. In two patients the hallux varus recurred. One was symptom-free but the other remained symptomatic after a repeat distal chevron osteotomy. There were no other complications. We consider that distal chevron metatarsal osteotomy with a medial wedge osteotomy and medial capsular release is a useful procedure for the correction of hallux varus after surgery for hallux valgus.
Collapse
Affiliation(s)
- K J Choi
- Choi Kyung Jin Orthopaedic Hospital, 369-26 Woobong Building 3F, Shindang-dong, Jung-gu, Seoul, Korea
| | | | | | | | | | | | | |
Collapse
|
37
|
Kim SH, Choi EM, Chang CH, Kim HK, Chung MH, Choi YR. Comparison of the effect-site concentrations of remifentanil for Streamlined Liner of the Pharynx Airway (SLIPA) versus laryngeal mask airway SoftSealTM insertion during target-controlled infusion of propofol. Anaesth Intensive Care 2011; 39:611-7. [PMID: 21823378 DOI: 10.1177/0310057x1103900412] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study was designed to determine the optimal dose of remifentanil required for the successful insertion of Streamlined Liner of the Pharynx Airway (SLIPA) and to compare it to that required for laryngeal mask airway (LMA) insertion in patients receiving a propofol infusion at a standard effect-site concentration. Fifty-eight patients scheduled to undergo general anaesthesia were randomly assigned to either the SLIPA (n = 29) or LMA (n = 29) group. All patients were premedicated with midazolam 0.05 mg x kg(-1) and glycopyrrolate 0.004 mg x kg(-1) intramuscularly. After the administration of lignocaine 1 mg x kg(-1) intravenously, a propofol infusion was started at an effect-site concentration of 3.5 microg x ml(-1) with a remifentanil infusion without a neuromuscular blocking agent. The remifentanil dose was determined by the modified up-and-down method starting in each group at 4 ng x ml(-1). Six minutes after induction, the airway device was inserted. Airway device insertion was classified as 'success' or 'failure' based on patient response. From the isotonic regression analysis and bootstrap distribution, the EC50 of remifentanil for SLIPA and LMA were 0.93 ng x ml(-1) (95% confidence interval [CI] 0.81 to 1.50 ng x ml(-1) and 1.36 ng x ml(-1) (95% CI 1.19 to 2.06 ng x ml(-1)) respectively, and the EC95 for SLIPA and LMA insertions were 1.90 ng x ml(-1) (95% CI 1.39 to 1.95) and 2.43 ng x ml(-1) (95% CI 1.80 to 2.46 ng x ml(-1)) respectively. Using the 83% CIs from the bootstrap distribution, EC50 for SLIPA was significantly less than that of LMA (0.83 to 1.23 vs 1.26 to 2.00, respectively) (P < 0.05). These findings suggest that the insertion of SLIPA needs about a 32% lower depth of anaesthesia than LMA insertion.
Collapse
Affiliation(s)
- S H Kim
- Department of Anesthesiology and Pain Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | | | | | | | | | | |
Collapse
|
38
|
Kim NG, Choi YR, Baek MJ, Kim YH, Kang H, Kim NK, Min JS, Kim H. Frameshift mutations at coding mononucleotide repeats of the hRAD50 gene in gastrointestinal carcinomas with microsatellite instability. Cancer Res 2001; 61:36-8. [PMID: 11196187 PMCID: PMC3300545 DOI: 10.1186/bcr362] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2001] [Indexed: 11/25/2022]
Abstract
Microsatellite instability (MSI) and frameshift mutations in genes containing nucleotide repeats have been reported in a subset of colorectal and gastric carcinomas. This study describes the analysis of MSI-positive colorectal (39 cases) and gastric carcinomas (36 cases) for the presence of frameshift mutations of the six genes known to be involved in DNA repair and containing mononucleotide repeats in their coding region. Our mutational study of the 75 MSI-positive tumors revealed frequent mutations in hRAD50 (23 cases, 31%), BLM (16 cases, 21%), and hMSH6 (16 cases, 21%); rare mutations in BRCA1 (1 case, 1%) and ATM (3 cases, 4%); and no mutation in NBS1. In contrast, no frameshift mutation was found in 60 MSI-negative colorectal and gastric carcinomas. The mutation of hRAD50, a gene that is involved in the response to cellular DNA damage and forms a complex with hMRE11 and NBS1, has not been reported previously. Our results suggest that frameshift mutations of hRAD50, BLM, and hMSH6 are selected and play a role in the tumorigenesis of colorectal and gastric carcinomas with MSI. The MSI targeting of the hRAD50 and BLM genes represents an additional link between MSI and DNA repair because alteration of these genes could accelerate defective DNA repair.
Collapse
Affiliation(s)
- N G Kim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | |
Collapse
|
39
|
Abstract
Activity-dependent changes of conduction velocity (CV) and conduction block in single A(delta) fibers of primary afferent neurons were characterized in a rat model of neuropathy (NP). Injured dorsal root (DR) fiber in NP rats exhibited profoundly greater decreases of CV following impulse activity than did DR fiber in normal rats. Activity-dependent conduction block was absent up to 100 Hz of activity rate in DR fiber of NP rats, but was present above 25 Hz in normal rats. Profiles of activity dependence in sciatic fibers were similar in both NP and normal rats. These results suggest that nerve injury may alter activity-dependent hypoexcitability of A(delta) DR fibers. Furthermore, this excitability change may be responsible for the elevated pain perception in neuropathy.
Collapse
Affiliation(s)
- C K Won
- Department of Pharmacology, College of Medicine, Korea University, Seoul
| | | | | | | | | | | | | |
Collapse
|
40
|
Abstract
Activity-dependent changes of the conduction latency of single A beta fibers of primary afferent neurons were characterized in both neuropathic (L4 and L6 ligated) and normal rats. Activity-dependent increases in conduction latency of dorsal root fibers in neuropathic rats were significantly stronger than those in normal rats. Different profiles of activity dependence were also observed between injured and adjacent intact dorsal root fibers of neuropathic rats. However, activity-dependent latency changes in sciatic nerves distal to the dorsal root ganglion were not different between neuropathic and normal rats. These results suggest that partial nerve injury induces activity-dependent excitability changes in the dorsal root fibers of neuropathic rat and that these changes may be responsible for the altered sensory processing such as those seen in allodynia.
Collapse
Affiliation(s)
- H C Shin
- Department of Physiology, College of Medicine, Chunchon Sacred Heart Hospital, Hallym University, Kangwondo, Korea
| | | | | | | | | | | |
Collapse
|
41
|
Bieber LL, Helmrath T, Dolanski EA, Belanger LL, Choi YR. Studies on the formation of phosphoenolpyruvate and citric acid cycle intermediates by neonatal piglet liver mitochondria. Biol Neonate 1980; 37:197-203. [PMID: 7362856 DOI: 10.1159/000241274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The capacity of mitochondria isolated from livers of 5-day-old piglets to convert pyruvate to phosphoenolpyruvate, malate and citrate has been investigated. These mitochondria have a large capacity to flux pyruvate through the pyruvate carboxylase reaction causing an accumulation of malate, citrate and phosphoenolpyruvate. As much as 70% of the pyruvate utilized during state 3 respiration can flux through the pyruvate carboxylase reaction. The data indicate that phosphoenolpyruvate from mitochondria can contribute a significant fraction of the carbon skeletons of pyruvate converted to glucose by piglet liver (estimated to be 30%).
Collapse
|
42
|
|
43
|
Choi YR, Clarke PR, Bieber LL. Studies on the oxidation of isobutyrylcarnitine by beef and rat liver mitochondria. J Biol Chem 1979; 254:5580-3. [PMID: 447666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Mitochondria from beef liver oxidize isobutyrylcarnitine at approximately 50% the rate of succinate in the presence of rotenone. However, the oxidation rate of isobutyryl coenzyme A in the presence of l(-)-carnitine is very low and can be negligible in both rat and beef liver mitochondria. The limited stimulation of isobutyryl-CoA oxidation by l(-)-carnitine appears to be due to inhibition of isobutyrylcarnitine translocation rather than lack of formation of isobutyrylcarnitine. This conclusion is supported by the fact that: 1) isobutyrylcarnitine oxidation is inhibited by l(-)-carnitine; 2) some oxidation of isobutyryl-CoA is obtained when a low concentration (50 microM) of l(-)-carnitine is used; and 3) under conditions of high isobutyryl-coenzyme A and l(-)-carnitine concentrations (1 mM), isobutyryl-carnitine is produced in near theoretical amounts by these rat liver mitochondria. Other studies demonstrated that less than 25% of the carnitine isobutyryl transferase activity of beef liver mitochondria and rat liver mitochondria is located on the cytosol side of the acylcoenzyme A barrier of these mitochondria.
Collapse
|
44
|
Choi YR, Fogle PJ, Bieber LL. The effect of long-term fasting on the branched chain acylcarnitines and branched chain carnitine acyltransferases. J Nutr 1979; 109:155-61. [PMID: 430209 DOI: 10.1093/jn/109.1.155] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The effect of fasting for 8 days on the levels of carnitine acyltransferases in heart, liver, liver mitochondria, skeletal muscle, skeletal muscle mitochondria, kidney, and testes in young adult male rats was determined. The specific activities of acetyl-, octanyl-, isobutyryl-, and isovaleryl-carnitine acyltransferase in mitochondria isolated from the livers of fasted animals were significantly higher than the levels of the transferases isolated from livers of fed animals. Similar results were obtained with the 500 x g supernatant fluids from liver. In contrast, the specific activities of carnitine acyltransferases of 500 x g supernatant fractions isolated from heart, skeletal muscle, kidney, and testes were the same for fed as fasted animals. The total carnitine content of liver, muscle, heart, and kidney was less in animals fasted for 8 days than in fed animals, but the amount/g of organ was higher in the animals fasted for 8 days. The amount of specific short-chain acylcarnitines in liver, muscle, and heart was determined for both fed and fasted animals. The amount of isobutyrylcarnitine and isovalerylcarnitine increased significantly in muscle from fasted animals. These data are consistent with the previous suggestion that carnitine may have a role in the metabolism of the branched-chain amino acids.
Collapse
|
45
|
Choi YR, Akera T. Membrane (Na+ + K+)-ATPase of canine brain, heart and kidney. Tissue-dependent differences in kinetic properties and the influence of purification procedures. Biochim Biophys Acta 1978; 508:313-27. [PMID: 147705 DOI: 10.1016/0005-2736(78)90334-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Effects of commonly used purification procedures on the yield and specific activity of (Na+ + K+)-ATPase (Mg2+-dependent, Na+ + K+-activated ATP phosphohydrolase, EC 3.6.1.3), the turnover number of the enzyme, and the kinetic parameters for the ATP-dependent ouabain-enzyme interaction were compared in canine brain, heart and kidney. Kinetic parameters were estimated using a graphical analysis of non-steady state kinetics. The protein recovery and the degree of increase in specific activity of (Na+ + K+)-ATPase and the ratio between (Na+ + K+)-ATPase and Mg2+-ATPase activities during the successive treatments with deoxycholate, sodium iodide and glycerol were dependent on the source of the enzyme. A method which yields highly active (Na+ + K+)-ATPase preparations from the cardiac tissue was not suitable for obtaining highly active enzyme preparations from other tissues. Apparent turnover numbers of the brain (Na+ + K+)-ATPase preparations were not significantly affected by the sodium iodide treatment, but markedly decreased by deoxycholate or glycerol treatments. Similar glycerol treatment, however, failed to affect the apparent turnover number of cardiac enzymes preparations. Cerebral and cardiac enzyme preparations obtained by deoxycholate, sodium iodide and glycerol treatments had lower affinity for ouabain than renal enzyme preparations, primarily due to higher dissociation rate constants for the ouabain.enzyme complex. This tissue-dependent difference in ouabain sensitivity seems to be an artifact of the purification procedure, since less purified cerebral or cardiac preparations had lower dissociation rate constants. Changes in apparent association rate constants were minimal during the purfication procedure. These results indicate that the presentyl used purification procedures may alter the properties of membrane (Na+ + K+)-ATPase and affect the interaction between cardiac glycosides and the enzyme. The effect of a given treatment depends on the source of the enzyme. For the in vitro studies involving purified (Na+ + K+)-ATPase preparations, the influence of the methods used to obtain the enzyme preparation should be carefully evaluated.
Collapse
|
46
|
Choi YR, Fogle PJ, Clarke PR, Bieber LL. Quantitation of water-soluble acylcarnitines and carnitine acyltransferases in rat tissues. J Biol Chem 1977; 252:7930-1. [PMID: 914851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The water-soluble acylcarnitines isolated from rat heart, skeletal muscle, liver, and testis have been characterized. The following acyl residues derived from the acylcarnitine fraction were found: acetyl, propionyl, isobutyryl, butyryl, alpha-methylbutyryl, isovaleryl, tiglyl, caproyl, beta-methylcrotonyl and methacrylyl. The amounts of these acylcarnitines in heart, liver, testis and skeletal muscle from fed rats were determined. Acetylcarnitine was the most abundant acylcarnitine; however, appreciable quantities of propionyl-, isobutyryl-, isovaleryl-, and tiglyl-carnitine were found. The levels of carnitine octanyltransferse, carnitine acetyltransferase and carnitine palmityltransferase activities were determined in several tissues. In addition, carnitine isovaleryltransferase and isobutyryltransferase activities were measured in heart, skeletal muscle, liver, testis and kidney. In all instances the specific activity of isobutyryltransferase was similar to the specific activity of acetyltransferase. The results are consistent with the proposal that carnitine is involved in the catabolism of branched-chain amino acids.
Collapse
|
47
|
Bieber LL, Choi YR. Isolation and identification of aliphatic short-chain acylcarnitines from beef heart: possible role for carnitine in branched-chain amino acid metabolism. Proc Natl Acad Sci U S A 1977; 74:2795-8. [PMID: 268629 PMCID: PMC431294 DOI: 10.1073/pnas.74.7.2795] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Aliphatic acylearnitines isolated from a water-soluble fraction of beef heart have been characterized by gas chromatography and mass spectrometry. The following acyl residues derived from the acylcarnitine fraction were unequivocally identified: acetyl, propionyl, isobutyryl, butyryl, alpha-methylbutyryl, valeryl, isovaleryl, tiglyl, and caproyl. beta-methylcrotonyl and methacrylyl were tentatively identified. This occurrence of considerable quantities of branched-chain acylcarnitines indicates a role for carnitine in branched-chain amino acid metabolism.
Collapse
|
48
|
|
49
|
Abstract
The association and dissociation rate constants for the interaction of [3H]-ouabain with partially purified rat brain (Na+,K+)-ATPase (ATP phosphohydrolase, EC 3.6.1.3) in vitro were estimated from the time course of the [3H]-ouabain binding observed in the presence of Na+, Mg2+ and ATP by a polynomial approximation-curve-fitting technique. The reduction of the association rate constant by K+ was greater than its reduction of the dissociation rate constant. Thus, the affinity of Na+,K+)-ATPase for ouabain was reduced by K+. The binding-site concentration was unaffected by K+. Consistent with these findings, the addition of KCl to an incubation mixture at the time when [3H]-ouabain binding to (Na+,K+)ATPase is close to equilibrium, caused an immediate decrease in bound ouabain concentration, apparently shifting towards a new, lower equilibrium concentration. Dissociation rate constants which were estimated following the termination of the ouabain-binding reaction were different from those estimated with above methods and may not be useful in predicting the ligand effects on equilibrium of the ouabain-enzyme interaction.
Collapse
|