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Volume 35(1); June 2020
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Original articles
Expressions of miRNAs in Papillary Thyroid Carcinoma and Their Associations with the BRAFV600E Mutation and Clinicopathological Features
Song I Yang, Young Sik Choi
Kosin Med J. 2020;35(1):1-14.   Published online June 30, 2020
DOI: https://doi.org/10.7180/kmj.2020.35.1.1
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Objectives

The microRNAs (miRNAs) are known to be commonly expressed in papillary thyroid carcinoma. The BRAFV600E mutation is the most common genetic mutation in thyroid cancer. The main aim of this study was to determine the possible association between expression of the three miRNAs and that of BRAFV600E mutation and the clinicopathological features in papillary thyroid carcinoma.

Methods

This study was conducted on 51 paraffin-embedded tissues (42 thyroid cancer, 9 benign tumor) obtained from patients undergoing thyroidectomy at the Endocrine Center of OOO University Hospital.

Results

miRNAs expression was significantly high in patients with cervical lymph node metastasis and advanced TNM stage. In addition, miR-146b expression levels were significantly higher in papillary thyroid carcinoma patients with BRAFV600E mutation. The relative quantification (2-ΔΔCt) of miR-146b was also high among the miRNAs. Individually, the AUCs for miRNA-146b was 0.923 (cutoff value −1.97, sensitivity 88.9%, specificity 85.7%).

Conclusions

Especially, expression of miR-146b increased higher in PTC patients with BRAFV600E mutation. These findings showed a role of miR-146b as potential biomarkers in differentiating PTC from benign tumor and as a prognostic indicator of PTCs. Further investigation will need for the roles of miRNAs in the pathogenesis of papillary thyroid carcinomas.

Influences of Socioeconomic Status on Short Stature in Childhood
Sun Bok Suh, Hyung Su Kim
Kosin Med J. 2020;35(1):15-25.   Published online June 30, 2020
DOI: https://doi.org/10.7180/kmj.2020.35.1.15
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Objectives

Short stature in childhood is defined to the cases in which the stature is below 3 percentiles of the standard value in accordance with that of those in the same age and gender group. The influence of the socioeconomic status on the short stature in childhood are analyzed.

Methods

154 children from the community child center in a region of poor socioeconomic status and 78 children in normal socioeconomic status who visited the Busan Medical Center due to the issue of short stature were selected for examination and analysis.

Results

The prevalence rate of short stature at the community child center in 2 municipalities in Busan was confirmed to be 7.3%. In the comparison of the average growth parameters of poor socioeconomic status and normal socioeconomic status in the short stature group, there was no observation of significant difference in terms of the chronological age, mid-parental height, bone age, bone age/chronological age, height standard deviation score (SDS), body mass index(BMI) percentile and insulin like growth factor binding protein 3 (IGFBP3) SDS. In the short stature suspicious group, there was observation of significant difference in the averages of bone age, weight, BMI percentile, IGFBP3 and IGFBP3 SDS.

Conclusions

Although the prevalence rate of short stature in children belonging to the poor socioeconomic class was observed to be higher than the existing results, there was no significant difference in the growth parameters associated with the growth of the height from those of the children in normal socioeconomic status.

Influence of Cold Ischemia Time and Storage Period on DNA Quality and Biomarker Research in Biobanked Colorectal Cancer Tissues
Min Gyoung Pak, Mee Sook Roh
Kosin Med J. 2020;35(1):26-37.   Published online June 30, 2020
DOI: https://doi.org/10.7180/kmj.2020.35.1.26
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Objectives

Biobanking plays an important role in future research. Assessment and control of the preanalytical variables of biobanked tissues are fundamentals for the optimal use of biospecimens.

Methods

Forty-five colorectal cancer (CRC) tissues stored at −80°C in Bio-Resource Bank were evaluated to define the influence of cold ischemia time (CIT) and storage period (SP) on DNA quality in biobanked tissues. Three CITs (less than 30 minutes (CIT-1), 30–45 minutes (CIT-2), and 45–60 minutes (CIT-3)) and three SPs (less than 1 year (SP-1), 2–3 years (SP-2), and 4–5 years (SP-3)) were chosen. NanoDrop spectrophotometer was used to determine the 260/280 ratio for DNA purity. DNA integrity was analyzed by a UV transilluminator following electrophoresis on 2% agarose gel. To evaluate the practical usability of DNA for biomarker research, KRAS mutation status was assessed by PCR amplification.

Results

All DNA specimens had a 260/280 ratio ranging between 1.8 and 2.0 with the exception of one specimen (CIT-2/SP-2 group). For DNA integrity, DNA appeared as a compact, high-molecular-weight band with no or scanty low-molecular-weight smears. The concordance of KRAS mutation status between paired biobanked frozen tissues and formalin-fixed paraffin-embedded tissues was 100%. DNA remained stable in CRC tissues kept at room temperature for up to 1 hour and long-term storage up to 5 years.

Conclusions

Storage conditions of our biobank are suitable for long-term (at least five years) specimen preservation with high DNA quality. These results have practical implications that could affect banking guidelines.

Clinical Usefulness of Contrast-Enhanced Computed Tomography in Patients with Non-Obstructive Acute Pyleonephritis
In O Sun, Ji Hye Lim, Ju Hwan Oh, A Young Cho, Beum Jin Kim, Kwang Young Lee, Mi Sook Lee
Kosin Med J. 2020;35(1):38-46.   Published online June 30, 2020
DOI: https://doi.org/10.7180/kmj.2020.35.1.38
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Objectives

The aim of this study is to investigate the clinical utility of contrast-enhanced computed tomography (CE-CT) in patient with non-obstrcutive acute pyelonephritis (APN).

Methods

From 2007 to 2013, 537 APN patients who underwent a CE-CT scan within 24 hours after hospital admission were enrolled. We divided these patients into greater (50% or greater involvment, n = 143) and lesser (less than 50% involvement, n = 394) groups based on renal parenchymal involvement in CE-CT examination. We compared clinical characteristics between two groups and analyzed the clinical value of CE-CT scan as a reliable marker for predicting clinical severity and disease course in patient with non-obstructive APN.

Results

The mean estimated glomerular filtration rate was 70.6 ± 25.5 mL/min/1.73m2. Compared with patients in lesser group, the patients in greater group had lower serum albumin levels (3.5 ± 0.5 vs 3.8 ± 0.6, P < 0.01) and longer hosptal stay (10.1 ± 4.7 vs 8.8 ± 4.5, P < 0.05). In addition, acute kidney injury (AKI) (23.1% vs 11.4%, P < 0.005) and bacteremia (36.4% vs 26.8%, P = 0.02) were frequently developed in greater group, respectively. The overall incidence of AKI was 14.8% based on RIFLE criteria. In a multivariate logistic regression analysis for predciting AKI, age, presence of diabetes mellitus and the presence of renal parenchymal involvement of greater than 50% in CE-CT were significant predictors of AKI.

Conclusions

The CE-CT scan could be useful to predict the clinical severity and course in non-obstructive APN patients with preserved renal function.

Case reports
Dynamic Change of Ischemic Mitral Regurgitation in a Patient with Acute Coronary Syndrome
Hye Ree Kim, Min Gyu Kang, Kyehwan Kim, Hyun Woong Park, Jin-Yong Hwang, Jeong Rang Park
Kosin Med J. 2020;35(1):47-51.   Published online June 30, 2020
DOI: https://doi.org/10.7180/kmj.2020.35.1.47
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

Ischemic mitral regurgitation (IMR) is commonly known as a chronic complication of left ventricular remodeling due to coronary artery disease. Acute IMR after coronary artery disease, such as acute myocardial infarction particular, could also develop as a mechanical complication involving papillary muscle rupture. However, the clinical significance of acute transient IMR and the therapeutic intervention in coronary artery disease is infrequently reported. We describe a patient with acute pulmonary edema due to acute IMR, which resolved immediately after coronary revascularization.

A Case of unexpected Fatal Hemoperitoneum in Non-severe Acute Pancreatitis
Seong Jin Choi, Eileen L. Yoon, Jong Ho Lee, Kye Yeon Kim, Soo In Choi, Won-choong Choi
Kosin Med J. 2020;35(1):52-57.   Published online June 30, 2020
DOI: https://doi.org/10.7180/kmj.2020.35.1.52
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

Acute pancreatitis (AP) severity is determined by associated organ failure (OF). However, enzymatic erosion of peripancreatic vessels can lead to life-threatening hemoperitoneum in clinically non-severe AP without OF. We herein report a case of unexpected hemoperitoneum which developed in a patient with clinically resolving AP without OF. A 36-year-old woman with alcohol use disorder presented with resolving epigastric pain and sustained abdominal distension of 2 weeks’ duration. Ranson’s score on admission was 1 and Computed tomography (CT) revealed non-necrotic AP with peripancreatic fluid collection. She showed sudden hypotension with an abrupt decrease in serum hemoglobin within 24 hours after admission. She was suspected to have an acute hemoperitoneum associated with venous bleeding from AP based on repeated CT. Venous bleeding from the splenic branch was ligated during surgery. The possibility of bleeding at the pancreatic bed should be considered even if the pancreatitis is not severe.

Atypical Lipomatous Tumor/Well-Differentiated Liposarcoma Arising from the Tongue: case report
Young Chul Kim, Somi Ryu, Seong Jun Won, Jung Je Park
Kosin Med J. 2020;35(1):58-63.   Published online June 30, 2020
DOI: https://doi.org/10.7180/kmj.2020.35.1.58
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

Liposarcomas are common mesenchymal malignant tumors arising from adipose tissue. Although liposarcomas are the most frequent type of soft tissue sarcomas, accounting for approximately 20% of all soft tissue sarcomas, they are rare in the head and neck, particularly in the oral cavity. Oral liposarcomas have been reported to occur mainly on the buccal mucosa, with other sites including the floor of the mouth, tongue, palate, and mandible. This report describes a 76-year-old male patient with an atypical lipomatous tumor/well-differentiated liposarcoma of the tongue that underwent surgical excision. This report also reviews published data on these rare tumors.

General Anesthesia for a Patient with GNE Myopathy: a case report
Christine Kang, Ji-hye An, Jae-Young Kwon, Boo-Young Hwang
Kosin Med J. 2020;35(1):64-68.   Published online June 30, 2020
DOI: https://doi.org/10.7180/kmj.2020.35.1.64
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

GNE, or bifunctional UDP-N-acetylglucosamine 2-epimerase/N-acetylmannosamine kinase, myopathy presents with symptoms of foot drop, followed by lower and upper extremity muscle weaknesses and sparing of the quadriceps. Myopathies usually increase the risks of complications related to general anesthesia. The anesthetic management of patients with GNEmyopathy has not been previously reported. Herein, we report a case of GNEmyopathy in a 37-year-old woman and discuss anesthetic considerations for elective laparoscopic hysterectomy and bilateral salpingectomy, focusing on the postoperative airway management. We avoided administering neuromuscular-blocking agents and instead used a laryngeal mask airway.

The anesthetic management combining the use of a laryngeal mask airway and desflurane without neuromuscular-blocking agents provided sufficient abdominal and diaphragmatic muscle relaxations for sustaining the pneumoperitoneum for laparoscopic surgery.

Klebsiella pneumoniae-induced Liver Abscess Complicated with Septic Pulmonary Embolism in a Non-diabetic Adult
Byung Hun Lim, Song-I Lee
Kosin Med J. 2020;35(1):69-75.   Published online June 30, 2020
DOI: https://doi.org/10.7180/kmj.2020.35.1.69
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

A 72-year-old non-diabetic man was admitted to the intensive care unit because of liver abscess, cholecystitis, and septic shock. He underwent percutaneous catheter drainage and received intravenous antibiotics. Shock was improved, and the patient’s fever subsided. Klebsiella pneumoniae was isolated in blood and bile cultures. However, he suddenly developed dyspnea and oxygen desaturation. Chest computed tomography scan revealed multifocal ground-glass opacities with consolidation with peripheral preponderance. Appropriate antibiotic therapy was provided for 2 weeks. The patient recovered fully, and cholecystectomy was then performed. Herein, we report a case of K. pneumoniae-induced liver abscess complicated with septic pulmonary embolism in a non-diabetic patient.


KMJ : Kosin Medical Journal