배경/목적: 본 연구에서는 췌장 낭종을 가진 환자들 중 임상적 으로 분지형 췌관내유두상점액종양(branch-duct intraductal papillary mucinous neoplasm)으로 여겨지는 환자에서 췌장암 및 우려되는 특징의 누적 발생률을 조사하였다. 방법: 분지형 췌관내유두상점액종양으로 추적관찰한 환자 177명의 자료를 후향적으로 분석하였다. 영상 검사를 통해 주췌관과의 소통이 확인된 췌장 낭종을 ‘분지형 췌관내유두상 점액종양 의심’으로 정의하였고, 주췌관과의 명확한 소통이 없는 경우를 ‘분지형 췌관내유두상점액종양 추정’으로 정의 하였다. 결과: 환자 중 30.5%가 분지형 췌관내유두상점액종양 의심으로 분류되었다. 진단 시의 중위 연령은 64세였으며, 낭종 크기의 중앙값은 13 mm였다. 진단 시 19명(10.7%)의 환자가 우려되는 특징을 보였으며, 고위험 인자(high risk stigmata)를 보인 환자는 없었다. 70.5개월의 추적 기간 동안 3명의 환자에게서 췌장암이 발생하였으며 96개월 시점의 누적 발생률은 4.0% (95% 신뢰 구간[confidence interval, CI], 0.98-10.76%)였다. 진단 시 우려되는 특징이 없는 158명의 환자에서 우려되는 특징의 누적 발생률은 24개월 시점에 5.1% (95% CI, 2.37-9.28%)였고, 96개월 시점에 11.2% (95% CI, 6.34-17.53%)였다. 우려되는 특징의 발생은 분지형 췌관내 유두상점액종양 추정 군(p=0.102)과 75세 미만 환자(p=0.463) 에서 더 낮았으나, 이러한 차이는 통계적으로 유의하지 않았다. 특히, 75세 이상 환자 군에서는 2년이 지난 이후 우려되는 특징은 발생하지 않았다. 결론: 저위험 췌장 낭종 환자에서 췌장암 및 우려되는 특징의 누적 발생률은 현저히 낮았다. 또한, 첫 2년 동안 변화가 없는 고령 환자의 경우 감시를 중단하는 것을 고려할 수 있다.

SOCS3, a suppressor of cytokine signaling 3, is known as a negative regulator of various cytokines and a tumor suppressor gene in human tumors. This study aimed to investigate the role of SOCS3 in oral squamous cell carcinoma (OSCC) and its impact on epithelial-mesenchymal transition (EMT) in OSCC cells. Although SOCS3 is recognized as a negative regulator of various cytokines and a tumor suppressor gene in human tumors, its specific effects on OSCC remain poorly understood. For the assessment of SOCS3 expression in OSCC, the UALCAN website and TCGA data were used to evaluate its expression in head and neck cancer. Additionally, immunohistochemical staining was conducted to determine the SOCS3 expression specifically in OSCC. The findings indicated a significant decrease in SOCS3 expression in tumor tissue compared to that in normal tissues. To investigate the enhancement of SOCS3 expression in OSCC cancer cell lines, IL6 treatment was administered to MC3 cells. However, no significant differences were observed in cell viability, wound healing assay, and invasion assay. Conversely, the transfection of SOCS3 siRNA into OSCC cells led to a notable increase in cell viability and statistically significant increases in wound healing and invasion assays. These results suggest that SOCS3 plays a crucial role in cell viability and EMT in OSCC, thereby contributing to oral carcinogenesis. Further research is necessary to elucidate the precise role of SOCS3 in OSCC.

EBV-positive mucocutaneous ulcer (EBVMCU) is an indolent, superficial lymphoproliferative disorder that occurs in either iatrogenic or age-associated immunocompromised patients with latent Epstein-Barr virus (EBV) infection. Although EBVMCU is histologically similar with other lymphoproliferative disorders, such as EBV-positive diffuse large B cell lymphoma, the diseases are classified as distinct entities by the World Health Organization with different clinical manifestations, prognosis, and genetic profiles. EBVMCU commonly shows spontaneous regression by conservative management, reduction or cessation of immunosuppressive treatment, but local progression is possible. Complete remission of disease can be achieved with combination of surgical resection, chemotherapy and local radiation therapy. Herein, we report 2 cases of oral superficial lymphoproliferative disorders arising adjacent to the gnathic bone with striking differences in prognosis and bone involvement. One of the cases induced extensive osteomyelitis in the underlying bone. Furthermore, we discussed the differential diagnosis of EBVMCU and reviewed the former literature.

Background/Aim: In gallbladder cancer (GBC), gender differences in incidence and mortality rates have been reported with geographic variation. However, there is little known about sex-related difference in GBC prognosis. This study compares prognostic factors according to gender for GBC. Methods: We searched clinicopathological factors in all stages of 952 GBC patients from seven medical centers in Korea. A total of 927 patients were enrolled and surgery with curative resection was performed in 499 patients. Results: Carbohydrate antigen (≥37 U/mL) was a significant prognostic factor in both females and males (odd ratio [OR], 4.30; 95% confidence interval [CI], 3.13-5.89; p<0.001). Age was a significant factor only in female patients, elderly patients were associated with low resectability and the likelihood of T-stage >2; an independent predictor of poor prognosis via multivariate analysis (OR, 1.03; 95% CI, 1.01-1.05; p=0.005, OR, 1.05; 95% CI, 1.02-1.08; p=0.002). Body mass index (BMI) also showed gender difference, and lower BMI (≤25 kg/m2) was the significant good indicator of multivariate analysis for lymph node metastasis in female patients (OR, 0.42; 95% CI, 0.23-0.77; p=0.005) but, the significant poor indicator of univariate analysis for advanced T-stage in male (OR, 2.79; 95% CI, 1.40-5.54; p=0.003). Conclusions: These results suggest that there is a possibility of gender difference in GBC prognosis. Age and high BMI were poor prognostic factors for curative resection for female GBC patients.

Perineural invasion (PNI) is the underestimated metastatic pathway and has been widely recognized as a negative prognostic factor in many human cancers. L1CAM is one of members of the immunoglobulin-like cell adhesion molecule (CAM) family, which play a role in neural development. Moreover, a new role of L1CAM outside the nervous system has been revealed. Overexpression of L1CAM was involved in the tumor progression and LN metastasis in various malignancies. In the present study, presence of PNI and L1CAM expression were examined to define their prognostic values in OSCC. In addition, association of L1CAM expression with presence of PNI was assessed to define the value as a candidate molecule supporting the diagnosis of PNI. We found that presence of PNI significantly correlated with LN metastasis and advanced clinical stage. L1CAM expression also significantly correlated with differentiation, lymph node metastasis, advanced clinical stage, as well as presence of PNI. Our results suggest that L1CAM seems to play a role in tumor progression, possibly through the PNI-related mechanism and could be a molecular marker for supporting the presence of PNI and predicting clinical outcome in OSCC.

Mucinous adenocarcinoma (MAC) refers to a malignant neoplasm that belongs to a subtype of adenocarcinoma which produces mucin. The World Health Organization has classified MAC as a tumor of salivary gland origin and it is extremely rare. Therefore, its characteristics are not well-known. This study reports a case of MAC of minor salivary gland origin, which occurred in the oral commissure of an 82-year-old female patient, and a systematic review on existing cases of MAC of salivary origin. Based on the study’s findings, it is safe to assume that the occurrence of lymph node metastasis is an important factor in determining the prognosis of patients with MAC.

Recurrence-metastasis status of squamous cell carcinoma of tongue is a challenging oncologic problem. This study examined the expression of E-cadherin/β-catenin cell adhesion complex in squamous cell carcinoma of the tongue through an immunohistochemical study. Twenty samples from 15 patients with squamous cell carcinoma of the tongue, who were treated at the Department of Oral and Maxillofacial Surgery, consisted of primary or recurrent tumors along with matched metastatic lymph nodes were retrieved for immunohistochemical staining and grouped based on recurrence-metastasis status.Differences in stain localization were noted in E-cadherin, β–catenin and phospho β–catenin staining between different tumor groups based on the recurrence-metastasis status. The number of phospho β-catenin stain positive cells was found to have a significant role in survival. E-cadherin confirms its role as a powerful individual differentiation indicator and the role of β-catenin specially the phospho type elicts interest

Adenoid cystic carcinoma(ACC) is one of the most common malignant tumors of minor salivary glands and can also arise in a variety of sites in the head and neck including the major salivary glands, the esophagus, the lacrimal glands. ACC shows slow but relentless growth, so it shows long-term recurrence. The various reports about prognostic factors which influence the recurrence pattern are introduced but the reports about prognostic factors are rare in Korean adenoid cystic carcinoma patients. We examined 40 ACC patients who finally diagnosed at Department of Oral Pathology, Seoul National University Dental Hospital. Clinicopathologic and immunohistochemical features were reviewed and factors correlated with recurrence and survival were analyzed. The 5-year survival rate of T3,T4 stage was 31.2%, while that of the T1,T2 stage was 88.2%, and the difference 5-year survival and T stage was statistically significant. The rate of local recurrence was 20% and the rate of distant metastasis was 27.5%. Mean recurrence time were 4.8 years and 5.2 years. There was no significant difference between age, sex, T stage, TNM stage, histologic type and recurrence. But the high T stage and the solid type recurred more frequently. There was no significant difference between recurrence rate, 5-year survival rate and Ki-67, MVD expression. But the higher expression of Ki-67, MVD show the higher recurrence rate and the lower 5-year survival rate

약물용출 스텐트(drug-eluting stents, DES)는 일반 금속 스텐트에 비하여 재협착을 현저하게 줄였지만, 여전히 관상동맥 스텐트 재협착은 비율이 높다. 2012년 11월부터 2016년 12월까지의 일 대학교병원 심혈관센터에서 경피적 관상동맥 스텐트 삽입술 후 관상동맥 조영술에서 스텐트 재협착 환자 187명 그룹 I (약물코 팅 풍선카테터 사용, n=127명), 그룹 II (약물용출 스텐트 사용, n=60명)로 분류하여 치료효과, 주요심장사건, 사망 발생률, 심근경색, 표적병변 재개통술 그리고 스텐트 혈전등을 2년 동안 추적 분석하였다. 임상적 특성는 두 그룹간 차이는 없었고(21.1 ± 5.3 vs. 25.3 ± 9.6 mm, p<0.002), 혈관조영검사에서 약물코팅 풍선 카테터 사용 그룹에서 스텐트 재협착 길이가 짧았다. 주요심장사건은 8.7%vs.10.0%, p=0.789, 사망발생률 0%vs.0%,p=1.000, 심근경색 1.6%vs.6.7%, p=0.085, 표적병변 재개통술 8.7% vs. 10.0%, p=0.789 그리고 스텐트 혈전증 0% vs. 0%, p=1000에서 양군 간에 차이를 보이지 않았다. 약물코팅 풍선카테터가 약물방출 스텐트와 비교하여 2년 추적 검사 결과 주요심장사건에서 차이가 없었고, 약물코팅 풍선카테터는 스텐트 재협착 병변에서 약물방출 스텐트와 함께 선택할 수 있는 좋은 치료방법이라고 사료된다.

The present study aimed to identify the factors that can clinically predict responses to macrolides treatment in patients with Mycoplasma pneumoniae pneumonia. Of the patients admitted to the pediatrics department of Kwangju Christian Hospital during December 2012 to March 2015, 195 patients who had pneumonia according to findings of chest radiography, positive Mycoplasma IgM, and fever at the time of admission were selected as study subjects. Patients were divided into one group wherein the duration of fever after macrolides treatment was 3 days or less and another group wherein the duration of fever was 4 days or more (169 patients [86.7%] vs 26 patients [13.3%]). In the group with fever duration of 4 days or more, a greater number of patients had a history of atopic dermatitis (3.6% vs 15.4%, p=0.11), and the symptom duration before admission was longer (cough: 4.04 days vs 6.38 days, p<0.001; fever: 3.96 days vs 6.08 days, p<0.001). Moreover, according to laboratory test results in the group with fever duration of 4 days or more, LDH levels were high (648.16 IU/L vs 829.92 IU/L, p=0.001), and there was a significant correlation between LDH levels and the duration of fever after macrolides treatment.

Proportion of elderly patients is gradually increasing in the republic of Korea. However, intravenous recombinant tissue plasminogen activator (rt-PA) therapy is recently not recommended in elderly acute ischemic stroke patients, although old age is not a proven contraindication to intravenous rt-PA. The purpose of this study was to investigate the safety and prognosis of intravenous thrombolysis in elderly patients.

Retrospective analysis was conducted on the clinical data of 38 cases of bacterial meningitis that were proven by cerebrospinal fluid culture. Each case occurred by GBS (68.4%), Pneumococcus (15.8%), E. coli (5.3%), Streptococcus mitis (5.3%), Streptococcus bovis (2.6%), and Staphylococcus xylosus (2.6%). Compared to 28 cases with normal outcome, 10 cases who died or had adverse outcomes at hospital discharge were more likely to present with coma, seizure (before or within admission, focal, status epilepticus), require pressor or ventilator support, have initial peripheral blood leukocyte count less than 4,000/mm3 or neutrophil count less than 1,000/mm3, and have hydrocephalus or cerebral infarction by brain imaging.

확산 텐서 영상을 이용하여 뇌경색 환자의 손상된 백질 섬유를 시각화할 수 있게 되었다. 본 연구의 목적은 뇌경색 환자에서 NIHSS와 분할 비등방도의 상관을 평가하고자 하였다. MR 확산영상에서 뇌경색이 확인된 16명(남:11, 여:5, 평균연령 61세) 환자를 대상으로 24방향 DTI를 시행하였다. 뇌경색 발발 후 2주 이내에 증상이 개선된 환자 9명과 증 세가 악화된 환자 7명으로 구분하였다. FA값의 정량측정을 위해 병소와 병소 반대측이 통계적으로 유의한 차이가 있 음을 확인하였다. 확산강조영상에서는 병소가 고신호로 보였으나, FA값은 정상측 보다 낮게 측정되었다. NIHSS상의 임상증상이 개선된 환자들의 FA값은 0.41, 반대측 정상부는 0.49로 병소측이 15%정도 낮게 측정되었다. 그러나 NIHSS상 증상이 악화된 환자들의 경우 병소측 FA값이 0.28, 반대측 정상부는 0.56으로 큰 차이를 보였다. 결론적으 로 DTI에서의 FA값은 뇌경색 환자의 예후를 평가하는데 매우 유용한 지표로 이용될 수 있을 것이다.