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Yun W.J.,Seoul National University | Shin E.,Seoul National University | Lee K.,Seoul National University | Jung H.Y.,Seoul National University | And 4 more authors.
Pathology Research and Practice | Year: 2013

Hepatic progenitor cells (HPCs) are thought to play a role in hepatoblastoma, as hepatoblastomas are characterized by an immature histology and a wide variety of cell lineages. We aimed to investigate the extent of expression of HPCs marker and its clinical implication in hepatoblastoma. We collected 61 hepatoblastomas and 9 childhood hepatocellular carcinomas (HCCs) and performed immunohistochemistry for HPC markers, including cytokeratin 19 (CK19), octamer-binding transcription factor 3/4 (Oct-3/4), epithelial cell adhesion molecule (EpCAM), and delta-like 1 homolog (DLK1). Of the hepatoblastoma samples, 27/61 (44.3%), 21/61 (34.4%), 51/61 (83.6%) and 56/61 (91.8%) exhibited positivity for CK19, Oct-3/4, EpCAM and DLK-1, respectively. For HCCs, the rates of expression were 22.2% (CK19), 77.8% (EpCAM) and 77.8% (DLK-1). Oct-3/4 was not expressed in HCC cells. Hepatoblastomas with a poorly differentiated epithelial component had a higher incidence of CK19 and Oct-3/4 expression than those with a well differentiated epithelial component (. p=. 0.005 and 0.037, respectively). Higher disease stage of hepatoblastoma was correlated with CK19 expression (. p=. 0.043). Oct-3/4-positive hepatoblastomas were associated with short disease-free survival (. p=. 0.035). Both hepatoblastomas and childhood HCCs, therefore, exhibit characteristics of HPCs, and the poor prognosis of patients with Oct-3/4-positive hepatoblastoma suggests that stem-like properties affect hepatoblastoma pathogenicity. © 2013 Elsevier GmbH.

Kim K.W.,Dana-Farber Cancer Institute | Kim K.W.,Seoul Asan Medical Center | Krajewski K.M.,Dana-Farber Cancer Institute | Jagannathan J.P.,Dana-Farber Cancer Institute | And 4 more authors.
American Journal of Roentgenology | Year: 2013

OBJECTIVE. In this article, we review the role of imaging in cancer of unknown primary site (CUP) diagnosis and management and the utility of immunohistochemistry, serum tumor markers, and molecular profiling in the optimized care of CUP patients. CONCLUSION. With advances in imaging, pathology, and molecular medicine, the diagnosis and management of CUP have evolved into more personalized and site-specific therapies. A multidisciplinary integrated approach among oncologists, pathologists, and radiologists is extremely important.

Shin E.,Seoul National University | Lee K.-B.,Seoul National University | Park S.-Y.,Seoul National University | Kim S.-H.,Seoul National University | And 4 more authors.
Virchows Archiv | Year: 2011

We elucidated the genetic profile of hepatoblastomas (HBLs) to identify diagnostic and prognostic markers. RNA was extracted from 32 formalin-fixed, paraffin-embedded HBLs and corresponding nonneoplastic liver (NNL) tissues, and cDNA-mediated annealing, selection, extension, and ligation (DASL) chip assays were performed. Immunohistochemistry was performed to confirm the expression of Yin Yang 1 (YY1) protein in HBL. Twenty-four genes that were associated with signal transduction, cell-cell adhesion, cell cycle regulation, and apoptosis were differentially expressed in HBL and NNL tissues. Two apoptosisassociated genes, MYCN and BIRC5, were highly upregulated in HBL. Eight genes, including YY1 and IGF1, were upregulated in HBL cases that had a poor prognosis. Thirty-eight genes, including YY1, were differentially expressed according to histologic differentiation of HBL, and the immunohistochemical expression of YY1 was correlated with poor HBL differentiation. Thus, using DASL chip assays, we report the gene expression profiles of HBL, which suggest new candidate prognostic and diagnostic genetic markers and putative therapeutic targets for HBL. © Springer-Verlag 2011.

Kim H.Y.,Eulji University | Kim J.H.,Randnter for Interoperable | Cho I.,Inha University | Lee J.H.,Seoul Asan Medical Center | Kim Y.,Seoul National University
Studies in Health Technology and Informatics | Year: 2010

To implement a knowledge-based clinical decision support system for clinical information systems, it is crucial to verify and validate the knowledge base. This study developed and tested the hypertension management CDSS, named LIGHT. This study used a knowledge representation framework based on SAGE and developed a knowledge converter to translate knowledge encoded into the knowledge engine. To verify knowledge converted through the knowledge converter that is included in the knowledge representation framework, expected recommendations were made according to the knowledge encoded based on 201 test cases. The expected recommendations were compared to those generated by the knowledge engine. To validate the knowledge base, two physicians reviewed the test cases and made medication orders according to the knowledge base. These medication orders were compared to recommendations generated by the LIGHT. The concordance rates for compelling indication and absolute contraindication were 85% and 100%, respectively. Another senior physician reviewed and analyzed the discrepancy cases between the orders of the two other physicians and system recommendations. Accordingly, the authors conclude that the knowledge base for hypertension management became more accurate and practical through the testing process. © 2010 IMIA and SAHIA. All rights reserved.

Cho H.,University of Ulsan | Kwon J.-H.,University of Ulsan | Seo H.-J.,University of Ulsan | Kim J.-S.,Seoul Asan Medical Center
Archives of Gerontology and Geriatrics | Year: 2010

This study is to investigate changes in regional cerebral blood flow (rCBF) of Alzheimer's disease (AD) in short-term treatment with acetylcholinesterase inhibitor (ChEI). rCBF was measured by single photon emission computed tomography (SPECT). CBF measurements were performed in 13 AD patients before treatment and 4 months later, while the control group with syncope or headache consisted of 17 patients. The clinical diagnosis of AD was based on the NINCDS-ADRDA criteria. Significant increases in rCBF were noted in the left angular, the right superior frontal gyrus, the right occipital, the left temporal lobe and the left orbital gyrus at the end of short-term therapy. Reduction in the rCBF before treatment is more profound in the left superior temporal, the right precentral and the both inferior frontal gyri compared with the control group. It achieved increase of rCBF after ChEI treatment. Also it overall increased in global cognitive functions including Korean Version Mini Mental State Examination (K-MMSE) and Clinical Dementia Rating (CDR). Treatment with ChEI for 4 months could increase rCBF and improve cognitive function of patients with AD. © 2009 Elsevier Ireland Ltd.

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