Citations
Breast cancer is a complex disease influenced by environmental, genetic, dietary, and hormonal factors. This underscores the importance of postoperative nutritional management in supporting recovery, minimizing complications, and enhancing long-term outcomes. This review synthesizes clinical guidelines, expert recommendations, and observational studies to provide a comprehensive overview of dietary interventions for breast cancer patients following surgery. Post-surgical nutritional care is centered around three primary objectives: supporting wound healing through high-quality protein intake, maintaining optimal nutritional status to prevent malnutrition, and promoting healthy lifestyle habits to reduce the risk of recurrence. To achieve these objectives, postoperative dietary strategies focus on several key components: ensuring adequate hydration for metabolic processes and tissue repair, consuming a balanced diet rich in fresh vegetables and fruits to mitigate oxidative stress, incorporating whole grains to support overall healing, and maintaining sufficient intake of high-quality protein from sources such as fish, meat, and dairy products to aid tissue repair and immune system recovery. Patients are also advised to avoid alcohol, limit saturated fats, and reduce intake of salty, sugary, and smoked foods to minimize inflammation. As research progresses, the implementation of personalized dietary plans remains essential for optimizing recovery outcomes in breast cancer patients.
, Hyeonuk Hwang, Hyungju Kwon Conventional open thyroidectomy is a safe procedure, but it has the disadvantage of leaving noticeable scars on the neck. Bilateral axillo-breast approach (BABA) robotic thyroidectomy was developed as an alternative technique to remove thyroid glands without making incisions in the neck. In traditional BABA robotic thyroidectomy, dividing the isthmus is a routine step to improve the efficiency of the dissection during thyroid surgery. However, there are safety concerns when performing this procedure on patients with thyroid cancer located in the isthmus. We report a case of BABA robotic total thyroidectomy carried out without dividing the isthmus in a patient with isthmic papillary thyroid carcinoma. Our experience suggests that BABA robotic surgery can be a feasible and safe option for selected patients with isthmic papillary thyroid carcinoma.
, Kang-Sup Shim, Sung-Sook Kim, Heasoo Koo, Eung-Bum Park Apoptosis is a specific mode of cell death recognized by a characteristic pattern of morphological, biochemical, and molecular changes, There are several methods of detection of apoptosis. Morphological changes involve a characteristic pattern of chromation and cytoplasm. The landmark of apoptosis is endonucleolysis, with nuclear DNA initially degraded at the linker sections to fragments equivalent to single and multiple nucleosomes. Detection of DNA fragments is situ using the terminal deoxyribonucleotidyl transferase(TDT)-mediated dUTP-digoxigenin nick end labeling (TUNEL) assay is increasingly applied to investigate apoptosis. We studied the detection method of apoptosis morphologically and by using TUNEL assay and examined the correlation of p53 expression and apoptosis.
Forty-five cases of colorectal cancer were selected. The number of apoptotic bodies was expressed as a number per 100 cancer cells. The TUNEL assay was performed with in situ Apoptag kit®.
The mean number of the apoptotic bodies was 2.28 in the patients who survived over 5 years after curative resection and 3.55 in the patients who died within 5 years(p=0.001). There was a relationship between the number of apoptotic bodies which were measured by morphologic study and the results which were measured by TUNEL assay. There was no relationship between p53 expression and apoptosis.
These results suggest that the frequency of apoptotic bodies may be a prognostic factor for colorectal cancer and apoptosis could be measured by morphological study without special study.
, Na-Young Lee, Hyo-Jin Lee, Sun-Young Lee, Jin-Hyuk Choi, Soon-Nam Lee, Kang Sup Shim, Sun-Hee Sung, Woon-Sup Han Multiple primary cancer means that more that two cancers occur independently in an individual. Recently, the incidence of multiple primary cancer has increased with lengthened survival, of cancer patients, development of new diagnostic technique and increased clinical evaluation. We report a patient who had adenocarcinoma of stomach combined with squamous cell carcinoma of esophagus simultaneously.
Phospholipase C isozymes(PLCs) paly a central role in ligand-mediated signal transduction for cellular activity such as proliferation and differentiation. However, the biolog-ical significance of their molecules in carcinogenesis or tumor progression is not determined precisely yet.
Usnig PLC-γ1 specific antibody, we have examined the relative contents of PLC-γ1 in various types of human cancer tissue, by immunoblotting and imm-unohistochemistry techniques. Several oncogene studies and DNA ploidy sutdy were per-formed additionally insome tumors.
Most malignancy showed elevated contentesof PLC-γ1, especially in colorectal and breast cancer, whereas hepatocellular carcinoma revealed decreased expression pf PLC-γ1. onco-protein expression was correlated with PLC-γ1 expression in some tumors. In hepatocellular carcinoma, DNA ploidy has an influenc to PLC-γ1 expression in most of the cases.
In conclusion, alteration or imbalance of the PLC-γ1 mediated signal trans-duction may have a significant role in the devlelopment or progression of cancer. These findings not only have important implications for increasing our understanding of multistage car-cinogenesis but they also have an impact on strategies for diagnosis and theraly of cancers.
Currently D2 lymph node dissection is considered as minimal extent of dissection in curative resection of gastric cancer. This study was conducted to investigated the patterns of lymph node metastasis of gastric cancer and to validate extent of lympn node dissection.
Among 117 patients with gastric cancer, 35 patients with early gastric cancer and 45 with advanced gastric cancer underwent curative gastric resection were enrolled in this study. Removed lymph nodes were classified as N1(1~6), N2(7~11), N3(12~16) and the boundary of dissection was classified as D1, D2, D3, D3+α according to classification of stomach cancer research association in Korea.
The priportion of early gastric cancer was 30%(35/117). Average number of metas-tatic lymph nodes was 2 in stage II, 6 in stage IIIa, 13 in stage IIIb, 21 in stage IV(p<0.05). 2 patients with early gastric cancer had metastatic lymph node(N1) and their lesions were over 3.0cm in size, depressed in shape. In terms of differentiation, 25(62%) patients with stage I, D1 dissection was carried out in two(5%), D2 dissection in eleven(28%), D3 or D3+α dissection in twenty seven (67%). In the patients with over stage II, there was no D1 dissection, D2 dissection was performed only in 3(7%), D3 or D3+α dissection in 37(92%). Extended lymph node dissection was significantly much higher in advanced cases than in early cases. The average number of resected positive lymph nodes were higher in BORRMANN type III or type IV than in type II(p<0.01, p<0.05 respectively). All patients with positive N2 or N3 lymph nodes revealed the positive N1 lymph nodes. There were 2(25%) skipped metastasis among 8 patients with positive N3 lymph nodes.
At least D2 lymph node dissection is needed for curative resection of gastric cancer in the patients with possible metastasis of N1 lymph nodes, even in the those we early gastric cancer. D3 or D3+α dissection should be performed in the patients with possible metastasis of N2 lymph nodes among advanced gastric cancer, even in the patients without metastasis of N2 lymph nodes selectiely because of skipped metastasis.
Estrogen receptor-related protein was examined on gastrectomy specime from 16 cases of advaced gastric adenocarcinoma and 7 cases of early gastric carcinoma(EGC) by using peroxidase-anti-peroxidase method on formalin-fixed paraffin-embedded sections. Positive reaction was seen in 7 out of 16 cases of advanced carcinoma and in 4 out of 8 cases of EGC(50%). Among advanced carcinoma, 3 cases of mucinous carcinoma were negative and 2 cases of signet ring cell carcinoma(SRC) showed focal positive reaction only in combined poorly differentiated(PD) area(10% of tumor cells). PD advanced carcinoma consisted of 4 cases of medullary type and 3 cases of individual cell type. Two out of 4 medullary type showed positive reaction in 20 and 80% of tumor cells and 2 out of 3 individual cell type showed positive reaction in 50 and 70% of tumor cells. Gland-forming type of advanced carcinoma consisted of 1 each case of intestinal and cardiac type and 1 mixed intestinal and cardiac type. Only 1 case of intestinal type showed positive reaction in 50% of tumor cells Among EGC, 2 cases of SRC were negative and 2 cases of PD carcinoma showed 5 and 10% positivity in PD area and 20 and 40% positivity in admixed gland-forming area. Gland-forming EGC consisted of 3 cased of intestinal type and 1 case of cardiac type. One case from each group showed positive reaction in 50 and 20% of tumor cells, respectively. In summary, positive reaction to antibody to estrogen receptor-related protein(P29) was expressed in PD(66.7%), gland-forming(50%), SRC, and mucinous type in order in both early and advanced carcinoma. The difference between age, sex, and other factors was not clear due to limitation of specimen.
, Seung Taek Lim, Yeon Seok Choi, Tae Soo Jang, Sun Hee Oh, Joo Ah Lee, Do Yeun Cho Ovarian cancer is generally primary cancer and less frequently originates from metastasis from non-gynecological cancer. Ovarian metastasis from lung cancer represents only 2~4% of all ovarian metastatic cancers. We report a case of ovarian metastasis of non-small cell lung cancer with epidermal growth factor receptor mutation. The patient underwent cytoreductive surgery for the ovarian mass and erlotinib therapy for the metastatic lung cancer. Erlotinib therapy markedly decreased the size of lung mass.
, Ah Young Leem, Young Jae Kim, Eudong Hwang, Yujung Yun, Sun Wook Kim, Hyo Song Kim Radiation recall dermatitis refers to an acute inflammatory reaction in a previously irradiated field triggered by the administration of certain drugs days to years after the exposure to radiation. Gefitinib is an epidermal growth factor receptor tyrosine kinase inhibitor and is an effective treatment for patients with advanced stage of non small cell lung cancer (NSCLC). Here, we report a rare case of gefitinib induced radiation recall dermatitis. A 52-year-old woman with a metastatic NSCLC had received a palliative radiation therapy of 20 cGy on spine metastasis area (C6-T6). After 24 days of receiving radiation therapy, she had started to take gefitinib. Eight months after taking drug, pain, swelling and erythema of skin were occurred on previously irradiated field. These symptoms were resolved after the cessation of gefitinib for 6 days and the topical use of steroid.
Citations
, Ryung-Ah Lee, Soon-Sup Chung, Kwang Ho Kim The EGFR plays an important role in tumorigenesis and tumor progression of colorectal cancer, and leads to the activation of intracellular signaling pathways. The use of anti-EGFR-targeted therapy has increased for patients with colorectal cancer, but patients with EGFR mutations will be resistant to anti-EGFR-targeted therapy. The identification of gene mutations is critical in cancer treatment; therefore, the aim of this study is to investigate the incidences of EGFR mutations in colorectal cancer patients in Korea.
We reviewed 58 colorectal cancer patients who underwent operations between 2003 and 2006, retrospectively. We analyzed their EGFR mutations in 4 loci by DNA sequencing. In addition, we analyzed the correlation between the presence of EGFR mutation and patients' clinicopathologic features.
Of the 58 patients, 35 patients were male and 23 were female. Their mean age was 63.28±11.18 years. Two patients (3.45%) were diagnosed as stage Tis, 7 patients (12.07%) had stage I, 24 patients (41.38%) had stage II, 20 patients (34.48%) had stage III, and 5 patients (8.62%) had stage IV. As a result of mutational analysis, EGFR mutations on exon 20 were detected in 13 patients (22.41%, G→A transitions). EGFR mutations on exon 18, 19 and 21 were not detected. EGFR mutation increased in the earlier stage and the absence of lymph node metastasis (P=0.028).
The incidence of EGFR mutation in Korean colorectal cancer patients is 22.41%. In addition, EGFR mutation significantly increased in the earlier stage and the absence of lymph node metastasis.
, Kyoung Tae Noh, Ryung-Ah Lee, Kwang Ho Kim Cancer prevention by vegetable diet has received considerable attention in recent years. In the past these attributes of vegetables were based more on beliefs than on scientific evidences. But over the past few decades many studies have been performed about that. Cancer preventive components of many vegetables have been studied in experimental carcinogenesis models. These studies have reported on these components influence carcinogenesis during initiation and promotion phases of cancer development. Also, epidemiological studies and clinical trials have reported cancer preventive effects of vegetables. However, there is no comprehensive summary of cancer preventive effects with the types of vegetables. In this review, we classified the vegetables and described the mechanism of action of active components of vegetables, experimental studies, and clinical trials. Results revealed a negative correlation between consumption of vegetables and cancer risk. But we can't still conclude the effects of vegetables yet, so further studies would be necessary for final conclusion.
Citations
, Tae-Hun Kim, Min-sun Ryu, Da-Yeon Oh, Myung-Eun Song, Shina Lee, Jae-In Ryu, Hye-In Kim, Il-Hwan Moon, Kwon Yoo The causes of pyogenic liver abscess has been known as biliary tract disease or intrabadominal infection but the large proportions of the patients has no apparent underlying disorders. Recently colonic mucosal lesions were reported in patients with cryptogenic liver abscess and it has been suggested that colonic mucosal break may play a role in developing liver abscess in otherwise healthy patients. We experienced a patient of severe recurrent liver abscess complicated with endophthalmitis only 3 months after successful treatment of initial cryptogenic liver abscess and a polypoid colon cancer was discovered by chance. It seems prudent to proceed colonoscopic examination in patients with cryptogenic liver abscess especially when it is recurrent.
, Kyoung Tae Noh, Boyoung Oh, Ryung-Ah Lee, Soon-Sup Chung, Kwang Ho Kim Hand-assisted laparoscopic surgery had both technical advantages of open surgery and better postoperative short-term follow-up results of laparoscopic surgery. We compared open colectomy, laparoscopic colectomy and hand-assisted laparoscopic colectomy, and tried to find the most effective operative modality.
90 patients, who were diagnosed with colorectal cancer and underwent colectomy in our institution, were categorized as 3 groups of open colectomy (OC) group, laparoscopic colectomy (LC) group and hand-assisted laparoscopic colectomy (HALC) group by the surgical modality.
In this study, ratio of male and female was 57 : 37, and mean age was 64.1 years old. LC group and HALC group showed longer operation time, shorter hospital stay after operation, lesser pain and earlier removal of closed drainage catheter than OC group. Amount of bleeding during operation, frequency of transfusion and incidence of complication showed no significant difference. In permanent pathologic results, the number of harvested lymph nodes had significant difference between OC group and other groups (P=0.030), but it was probably caused by the bias of the different distribution of the stages in each group. Overall 14 of the cases resulted in complications while there was no mortality.
Laparoscopic colectomy and hand-assisted laparoscopic colectomy showed better short-term follow-up results rather than open colectomy. And hand-assisted laparoscopic surgery could provide tactile sensation to operator, which lacked in laparoscopic surgery. Hand-assisted laparoscopic colectomy could be an alternative surgical option for colorectal cancer with these advantages.
, Kyu Won Chung, Jae Jung Park, Suh Eun Bae, Il Hwan Moon, Kwon Yoo, Min Sun Cho Small cell lung cancer accounts for about 20% of all lung cancers. At the time of diagnosis, the majority of patients already have metastasis. The liver is one of the most common sites of distant metastasis of lung cancer. Small cell lung cancer arises from neuroendocrine cells which produce hormone, hormone producing granules can be seen under electron microscope . A 65-year-old male was admitted to hospital because of jaundice and right upper quadrant pain. The chest roentgenogram and chest computed tomography(CT) scan showed a 3 cm mass in right upper lobe with bilateral mediastinal lymphadenopathy and right pleural effusion. The abdomen CT scan revealed multiple masses in the liver with heterogenous pattern suggesting metastatic orgin. Though the immunohistochemistry and electron miscroscopy, he was diagnosed as metastatic small cell lung cancer of liver. We report a case of the Immunohistochemical and Electron Microscopic Observation of Metastatic Small Cell Lung Cancer of Liver.
The role of Helicobacter pylori(HP) in benign and malignant pancreatico-biliary tract disease is concerned in recent papers. The urease gene of Hp were found in human bile, and bacteria morphologically resembling Hp were found in resected gallbladder mucosa from patients with gallbladder disease. It was hypothesized that there is an association between the presence of Hp in bile and pancreatico-biliary disease. The aims of this study are to examine if Hp exist in the bile juice and to investigate whether Hp plays a role in the pancreatico-biliary disease.
Thirty-eight patients (18 males and 20 females, mean age 71 ?27yr ; range 45-92yr) with gallstone and malignant pancreatico-biliary disease were enrolled in this study ; 23 cases were gallstone diseases, 10 cases were cholangiocarcinomas, and 5 cases were pancreatic cancers. Thirty-eight controls were age- and sex-matched and enrolled from subject attending routine medical check-up. The presence of Hp in stomach was confirmed by ?4C-breath test. The polymerase chain reaction (PCR) assay was used to detect the Hp in bile.
The Hp-positive rate in stomach was much higher in control (26/38,68.4%) than the patients with pancreatico-biliary disease(l1/38, 28.9%) (p<0.01). The Hp-positive rate in bile of pancreatico-biliary disease was 18.4% but, there is no relation between of the presence of Hp in the stomach and in the bile (p=0.33). Also there was no significant difference of the presence of Hp in bile (p>0.05) and stomach (p=0.28) between benign and malignant disease.
The Hp-positive rate in bile was similar in benign and malignant pancreatico-biliary disease. But Hp may not be important risk factor in pancreatico-biliary disease in Hp-prevatent country like south Korea.
The purpose of this study was to evaluate MSI status in sporadic colorectal cancer and to correlate it with clinicopathologic variables.
Total 45 cases of surgically resected colorectal cancers retrospectively were reviewed about clinicopathologic findings and analyzed for micro satellite instability.
The microsatellite instability (MSI) was found in 5 of 45 cases (11.1%) . A significant association was found between MSI+ tumors and location in the right colon (40%), and high histological grade (100.0%), and mucinous phenotype (33.3%). There was no significant difference for age, sex, growth pattern, lymph node metastases, vessel invasion, or Duke's stage.
These data indicate that MSI frequently occur in colorectal cancers of the right side and in tumors with poorly differentiated or mucinous histology.
The cytochrome P450(P450) are a large group of constitutive and inducible heme-containing enzymes, which have a central role in the oxidative metabolism of a diverse range of xenobiotics. The majority of chemical carcinogens require metabolic activation before they interact with cellular macromolecules and can cause cancer initiation. The xenobiotic-metabolizing machinery contains two main types of enzymes : the phase I P450 mediating oxidative metabolism, and phase II containing enzymes. Activity of some enzymes implicated in the metabolism of carcinogens presents a great variability between individuals due to the existence of a polymorphism in gene coding for P450. Individual P450s, especially CYP1B1, are overexpressed in different types of tumors. The increased expressons of P450s in tumors is highly significant and is important for understanding rumor development and progression. The tumor-specific expression of P450s provides the basis for the development of movel diagnostic and therapeutic strategies.
, Sun Young Yi, Kyung Eun Lee Unexpected carcinoma of gallbaldder(GB) can be found in 1-2% of specimens after surgery of benign biliary disease. This study was designed to investigate the clinicopathological and radiological characteristics of unexpected GB cancer presumed benign biliary disease and compare with originally diagnosed GB cancer.
The modical records of nineteen patients(5 males and 14 females, mean age : 64±9 years) with unexpected GB cancer diagnosed postoperatively(Group 1 : cholecystitis, 12 cases ; GB empyema, 4 cases ; cholecystitis with bile duct stone, 3 cases) and thirty seven patients (12males and 25 females, mean age : 68±11 years) with originally diagnosed GB cancer(Group 2) were retrospectively reviewed at Ewha Womans university Mokdong hospital from October, 1993 to March, 1999.
Clinical findings including right upper quadrant pain, fever, and chilling were pre-dominant in group 1 and general weakness, anorexia, and weight loss were predominant in group 2. Ultrasonographic findings of the group 1 were not typical to detect GB cacer Diffuse thickened GB wall showed 47.3% and the gallstone showed 89.5% in group 1. The mass of thickened GB wall irregularly revealed in all and gallstone showed in 50% of group 2. The TMN stage of goup 1 revealed earlier stage than group 2. The curative resection was performed in 84.2% and 10% in group 1 and 2, respectively.
The stage of unexpected GB cancer revealed relatively early stage and the curative resection rate was higher than originally diagnosed GB cancer. Therefore, the careful and detail intraoperative histologic examination of considered in patient with clinical features of benign biliary disease to detect early and improve prognosis in the patients of GB cancer.
, Kum-Hei Ryu, Su-Hyun Kim, Su-Jin Yoon, Do-Yeun Kim, Seock-Ah Im, Chu-Myong Seong, Heasoo Koo, Soon-Nam Lee We report a case of extensive stage SCLC with EAS confirmed by immunohistochemical stain of ACTH in tumor cells who died early due to rapidly progressive acute respiratory distress and pneumonia before the start of chemotherapy and corticosteroid blocking agent. Through our case, we learn how important early diagnosis and treatment of EAS associated with SCLC are and hope to apply to other cases from now on.
, Sung-Ae Jung, Seong-Eun Kim, Jong Soo Lee, Seung Hyun Nam, Jeong Eun Shin, Hae Sung Moon, Seung Cheol Kim, Kwon Yoo In Lynch syndrome II, colon cancer was associated with endometrial and ovarian cancer. The aim of this study was an evaluation for the clinicopathologic characteristics of rectosigmoid adenomas on preoperative sigmoidoscopy in gynecologic cancer patients.
A total 187 gynecologic cancer patients(139 cervical, 35 ovarian, 13 endometrial cancer) and 58 normal controls were reviewed sigmoidscopic finding and pathologic reports retrospectively from September 1993 to March 2001.
The mean age of gynecologic cancer patients was 54(38-82) year-old and normal controls was 50(20-68) year-old. Total 26 adenomas were in 21 patients(11.2%) and 3 adenomas were in 3 normal controls(5.2%). The incidence of adenomas was 9.4% in cervical cancer, 8.6% in ovarian cancer and 38.5% in endometrial cancer. Multiple adenomas were in 5 gynecologic cancer patients and 0 normal controls. The incidence of advanced adenoma was 12.5% in cervical cancer, 25.5% in ovarian cancer, 83.5% in endometrial cancer and 33.3% in normal controls. The location of adenoma was 23.1% in rectum and 76.9% in sigmoid colon.
The incidence of adenomas and multiple adenomas were higher in gynecologic cancer patients than normal controls but not significantly. The incidence of advanced adenoma and adenomas were significantly higher in endometrial cancer than normal controls. Colonoscopic evaluation of whole colon will be recommanded in gynecologic cancer than sigmoidoscopy.
, Hye Young Son, Hye Kyoung Jung, Sun Young Yi The aims of this study were to assess the clinical observation of outpatient who showed hematochezia, and to determine whether specific clinical symptoms associated with hematochezia were predictive of important gastrointestinal pathology.
Prospective study was carried out from July 1998 to July 1999 with sixty-five outpatients(35 males and 30 females with mean age, 43±11 years) who had no evidence of recent bleeding. Patients were interviewed by questionnaires about the amount and frequency of bleeding, change in bowel habits, weight loss, usage of aspirin/NSAIDs, and family history, prior gastrointestinal pathologic illness before colonoscopy. Based on this information, endoscopist were asked to predict whether the bleeding was from a benign perianal or other lesion. Important gastrointestinal pathology was defined as carcinoma, adenomas more than 1cm, active ulcerative colitis, and active tuberculosis by colonoscopy.
Colonoscopic findings were as follows : 27 cases of benign anorectal lesion ; 16 cases of polyps, 10 cases of normal ; 8 cases of acute colitis and nonspecific colitis ; 7 cases of coloerctal cancer, 7 cases of ulcerative colitis and intestinal tuberculosis ; and other cases. Important gastrointestinal pathology was 17 cases. Variables including duration, type and frequency of bleeding, weight loss and change in bowel habit did not predict the colonoscopic diagnosis. Of the 35 patients diagnosed clinically by endoscopist to begin anorectal lesion alone, 18 patients were found to have benign anorectal lesion, 2 patients had cancer, 2 patient had polyp(bigger than 1cm), and 1 patient had ulcerative colitis.
In outpatients with hematochezia, the incidence of colon cancer was 10.8%. Clinicians were unable to distinguish significant colonic lesions by history. Therefore accurate diagnostic workup is needed for this group of patients.
The production of basic fibroblast growth factor(bFGF), which is known to have strong angiogenic activity in gastric cancer, was evaluated.
Using Alkaline phosphoatase-labelled, synthetic oligonucleotide probe of bFGF genes, the expression of the gene was evaluated with in situ hybridization method in 9 fresh advanced gastric cancer tissues.
In situ Hybridization of bFGF mRNA showed positive reaction in 8 of 9 patients.
In view of profuse expression of angiogenic growth factor, future therapeutic targeting for angiogenesis could be reasonable in patients with gastric cancer.
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