Yong Mee Cho

Ulsan University Hospital, Urusan, Ulsan, South Korea

Are you Yong Mee Cho?

Claim your profile

Publications (40)95.27 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Hepatoid adenocarcinoma is a rare extrahepatic aggressive tumor defined by morphologic and immunohistochemical evidences of hepatoid differentiation. In this study, clinicopathologic features of three cases of hepatoid renal cell carcinoma (RCC) were analyzed. Case I was a 53-year-old man with stage III, 12 cm-sized RCC showing combined clear cell and papillary RCC with sarcomatoid dedifferentiation, and 1,460 ng/ml of serum alpha-fetoprotein (AFP). Case II was a 62-year-old woman with stage IV, 6.5 cm-sized clear cell RCC, and 40,800 ng/ml of serum AFP. Case III was a 51-year-old woman with stage I, 1.6 cm-sized, Xp11 translocation RCC and 313.3 ng/ml of serum AFP. Cases I and II died of the disease at 26 and 21 months after radical nephrectomy, in each. Case III was alive without the disease for 20 months at the last follow-up. Microscopically, three cases show hepatoid carcinoma areas with eosinophilic to clear tumor cells, arranged in trabeculae separated by thin sinusoidal vessels, in addition to characteristic features of RCC subtypes. Tumor cells in these hepatoid carcinoma areas as well as at least focal corresponding RCC areas were immunopositive for AFP in all three cases, but, immunonegative for other hepatic markers (Hep Par1, polyclonal CEA, and glypican 3). This report suggests that the hepatoid features with AFP production are aberrant differentiation that can be developed in various RCC subtypes. Recognizing hepatoid RCC will help explain abnormal elevation of serum AFP level, which can be used as a serum surveillance marker.
    Annals of Diagnostic Pathology. 10/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: We analyzed the clinicopathological data of patients undergoing radical nephrectomy for clear cell type renal cell carcinoma (RCC) who presented with metastasis and were subsequently treated with sunitinib and identified molecular markers in nephrectomy specimens to predict susceptibility to sunitinib. The medical records of 65 patients who underwent nephrectomy for metastatic clear cell type RCC and were then treated with sunitinib were reviewed. The nephrectomy specimens were subjected to prospective immunohistochemical staining for vascular endothelial growth factor, vascular endothelial growth factor receptor-2 (VEGFR-2), platelet-derived growth factor-B, and platelet-derived growth factor receptor-β expression. In 58 evaluable patients, the median value of initial and best overall response was -9.69 and -24.04 %, respectively. VEGFR-2 expression was associated significantly with initial and best overall responses to sunitinib, along with Karnofsky performance status and Memorial Sloan-Kettering Cancer Center prognostic risk group. Multiple linear regression analyses revealed that strong VEGFR-2 expression was positively associated with the best reduction in tumor response (β = -0.275, P = 0.016) and poor Karnofsky performance status was negatively associated it (β = 0.477, P < 0.001). Karnofsky performance status and retroperitoneal lymph node involvement associated independently with progression-free- and overall survivals. None of the molecular markers associated significantly with survival. VEGFR-2 expression might be a useful biomarker for predicting the response to sunitinib by patients with metastatic RCC. Karnofsky performance status and retroperitoneal lymph node involvement were predictive of disease progression and death.
    World Journal of Urology 04/2014; · 2.89 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: One of the major challenges in prostate cancer research is to identify prognostic/predictive factors to distinguish aggressive disease from indolent one. To select prognostic/predictive markers of postoperative biochemical recurrence (BCR) that could be easily performed in daily pathology practice, the expression of 6 immunohistochemical markers including zinc-α-2-glycoprotein (AZGP-1), hCAP-D3, mucin 1, vimentin, E-cadherin, and ERG was assessed in a tissue microarray of 400 radical prostatectomy specimens. The expression levels were correlated with clinicopathologic factors and BCR. During the median follow-up period of 55 months, BCR occurred in 70 cases (17.5%). Low expression of AZGP-1 was noted in 76 cases (19.0%), whereas high expression of hCAP-D3, mucin 1, vimentin, and ERG was observed in 205 (51.3%), 81 (20.3%), 33 (8.3%), and 58 (14.5%) cases, respectively. Aberrant E-cadherin expression was noted in 29 cases (7.3%). By univariate analysis, BCR was associated with low expression of AZGP-1, high expression of hCAP-D3, and aberrant expression of E-cadherin. By multivariate analysis, only AZGP-1 remained an independent immunohistochemical factor, in addition to age, preoperative serum prostate-specific antigen level, Gleason score, tumor stage, and resection margin status. These results show that AZGP-1, hCAP-D3, and E-cadherin are potentially useful immunohistochemical markers to predict BCR, and that AZGP-1 can be used as an independent prognostic marker of aggressive prostate cancer.
    Applied immunohistochemistry & molecular morphology: AIMM / official publication of the Society for Applied Immunohistochemistry 02/2014; · 1.63 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Various clinical and laboratory parameters are used to determine the prognosis of patients with renal cell carcinoma (RCC) but prognostic significance of histologic features has not been fully examined in patients with metastatic clear cell RCC receiving vascular endothelial growth factor (VEGF)-tyrosine kinase inhibitor (TKI) (VEGF-TKI)-targeted therapy. To define prognostic clinicopathologic factors, 83 such patients were retrospectively analyzed. Of these patients, 38 (45.8%) showed response to VEGF-TKI, whereas 45 (54.2%) were non-responsive. Response to VEGF-TKI was associated with < 10% sarcomatoid features and < 10% tumor necrosis. Multivariate analysis showed that tumor necrosis was independently prognostic of VEGF-TKI response. During a median follow-up of 18 months (range, 1–62 months), 54 patients (65.1%) showed disease progression and 44 (53.0%) died. Shorter progression-free survival (PFS) and overall survival (OS) were associated with a time period less than 1 year from initial diagnosis to VEGF-TKI initiation, high Fuhrman grade, ≥ 10% sarcomatoid features and ≥ 10% tumor necrosis. In addition, thrombocytosis was associated with shorter OS. Multivariate analysis showed that sarcomatoid features was independently prognostic of PFS, whereas time from initial diagnosis to VEGF-TKI initiation and sarcomatoid features were independent prognostic factors of OS. In summary, sarcomatoid features, tumor necrosis, and tumor grade are histologic prognostic factors and should be considered in determining whether to initiate targeted treatment in patients with metastatic clear cell RCC.
    Human pathology 01/2014; · 3.03 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the impact of percent tumor volume and surgical margin status on biochemical recurrence in pT3-T4 prostate cancer. A total of 397 patients who had pT3-T4N0 diseases and did not receive neoadjuvant or adjuvant therapy were included for analysis. In the entire cohort, prostate-specific antigen (per 1 ng/mL increase; hazard ratio 1.019; P = 0.002), pathological stage (T3b-T4 vs T3a; hazard ratio 2.283; P < 0.001), Gleason score (≥8 vs ≤6; hazard ratio 5.290; P = 0.005), surgical margin status (multiple positive vs negative; hazard ratio 1.839; P = 0.003) and lymphovascular invasion (present vs absent; hazard ratio 1.641; P = 0.008) were independent predictors of recurrence. Percent tumor volume was an independent predictor of recurrence in T3a diseases with negative surgical margins. In analysis using receiver operating characteristic curve, a threshold of 12% showed the best balance of sensitivity and specificity, 66% and 67%, respectively. The 5-year recurrence-free survival rates of pT3a diseases with negative surgical margin were 85.2% for percent tumor volume ≤12% and 57.7% for percent tumor volume >12% (P < 0.001). Patients with pT3a with negative surgical margins and percent tumor volume >12% showed comparable 5-year recurrence-free survival rate compared with those with pT3a with positive surgical margin (57.7% vs 57.6%; P = 0.763). Despite having less impact on recurrence than other clinicopathological variables in pT3-T4 prostate cancer, percent tumor volume can further improve recurrence risk stratification in pT3a diseases with negative surgical margins.
    International Journal of Urology 11/2013; · 1.73 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Overactive bladder (OAB), which is characterized by the sudden and uncomfortable need to urinate with or without urinary leakage, is a challenging urological condition. The insufficient efficacy of current pharmacotherapies that use antimuscarinic agents has increased the demand for novel long-term/stable therapeutic strategies. Here, we report the superior therapeutic efficacy of using mesenchymal stem-cells (MSCs) for the treatment of OAB and a novel therapeutic mechanism that activates endogenous Oct4+ primitive stem-cells. We induced OAB using bladder-outlet-obstruction (BOO) in a rat model and either administered a single transplantation of human adipose-derived MSCs or daily intravenously injections of solifenacin, an antimuscarinic agent, for 2-weeks. Within 2-weeks, both the MSC- and solifenacin-treated groups similarly demonstrated relief from BOO-induced detrusor overactivity, hypertrophic smooth muscle, and neurological injuries. In contrast with the solifenacin-treated groups, a single transplantation of MSCs improved most OAB parameters to normal levels within 4-weeks. Although the transplanted human MSCs were hardly engrafted into the damaged bladders, the bladder tissues transplanted with MSCs increased rat sequence-specific transcription of Oct4, Sox2, and Stella, which are surrogate markers for primitive pluripotent stem-cells. In addition, MSCs enhanced the expression of several genes, responsible for stem-cell trafficking including SDF-1/CXCR4, HGF/cMet, PDGF/PDGFR, and VEGF/VEGFR signaling axis. These changes in gene expression were not observed in the solifenacin-treated group. Therefore, we suggest the novel mechanisms for the "paracrine effect" of MSCs as unleashing/mobilizing primitive endogenous stem-cells, which could not only explain the long-term/stable therapeutic efficacy of MSCs but also provide promising new therapies for the treatment of OAB.
    Stem cells and development 11/2013; · 4.15 Impact Factor
  • Young Seok Kim, Mun Jung Kang, Yong Mee Cho
    [Show abstract] [Hide abstract]
    ABSTRACT: Cancer stem cells (CSCs) are resistant to radiotherapy and are responsible for tumor recurrence of various malignant tumors, including prostate cancer. In order to define the radioresistance mechanism of prostate CSCs, their proliferative activity, cell cycle distribution, expression of CD133 stem cell marker, reactive oxygen species (ROS) production, and DNA repair efficiency were examined using prostatospheres and adherent LNCaP cells as a model of prostate CSC and bulk model of differentiated cells, respectively. Compared to adherent cells, prostatospheres exhibited greater number of low-to-intermediate ROS-producing cells and CD133-positive cells. Prostatospheres showed higher expression of DNA repair proteins after ionizing radiation (IR). Low vulnerability to ROS-induced cellular damage and the efficient repair of IR-induced DNA injury may explain the radioresistance of prostate CSCs. Therefore, increasing ROS-induced cytotoxicity and inhibition of DNA repair in prostate CSCs may help achieve complete eradication of prostate CSCs by radiotherapy.
    Anticancer research 10/2013; 33(10):4469-4474. · 1.71 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective Prostate cancer (PCa) incidence has been rising rapidly in Korea with aggressive clinicopathologic features compared to those observed in Western countries. Our aim was to develop a predictive nomogram for BCR-free survival based on the characteristics of PCa in Korean men and compared its predictive accuracy to an established Western nomogram. Methods A nationwide multicenter study was designed involving 723 Korean men with clinically localised PCa that had undergone radical prostatectomy. The Cox proportional hazards model was applied to 549 cases from four heavy volume institutions to define prognostic factors and develops the Korean nomogram, which was subjected to internal validation, external validation using a separate cohort of 295 cases, and head-to-head comparison with the updated Kattan nomogram. Results During the mean follow-up period of 44.8 months, BCR occurred in 251 patients (35.4 %) with aggressive clinicopathologic features. Similar to Western cases, preoperative prostate-specific antigen (PSA), pathologic tumour stage (pT), and Gleason score (GS) were independent prognostic factors and used to develop the Korean nomogram in conjunction with age and surgical margin status. The Korean nomogram performed well for predicting BCR-free 5- and 10-year survival on internal validation. On external validation, the Korean nomogram showed better calibration than the updated Kattan nomogram. Conclusions Preoperative PSA, pT, and GS were independent prognostic factor for BCR in clinically localised PCa in Korean men. The superior performance of the Korean nomogram for Korean PCa patients suggests that geographic variation in clinicopathologic factors should be considered in a predictive nomogram.
    World Journal of Urology 06/2013; · 2.89 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Acquired cystic disease-associated renal cell carcinoma (ACD-RCC) is a subtype of renal cell carcinoma (RCC) with unique morphologic features found exclusively in the background of end-stage renal disease. We analyzed the clinicopathologic features and immumoreactive profiles of 12 cases of ACD-RCC to further characterize this recently recognized entity. Review of histologic slides was performed in conjunction with immunohistochemical staining directed to the contemporary diagnostic antibodies and the putative target therapy-related markers. Histologically, the tumors showed characteristic inter-or intracellular microlumens and eosinophilic tumor cells. Intratumoral hemosiderin deposition and degenerating foamy tumor cells were consistent findings which were not previously described. Immunohistochemically, all the tumors were positive for alpha-methylacyl-CoA-racemase, CD10, pan-cytokeratin, PTEN (phosphatase and tensin homolog deleted on chromosome 10) and c-met, while negative for carbonic anhydrase-9, CD57, CD68, c-kit, pax-2, platelet-derived growth factor receptor (PDGFR)-α or vascular endothelial growth factor receptor (VEGFR)-2. Heterogenous staining was found for CK7 and kidney-specific cadherin. Positive reaction to c-met suggests its utility as a plausible therapeutic target in ACD-RCC. Thus, we present the unique morphologic and immunopathologic features of ACD-RCC, which may be helpful in both diagnostic and therapeutic aspects.
    Medical Molecular Morphology 03/2013; · 1.17 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE: To evaluate clinical characteristics including the response to targeted therapy, the benefits of cytoreductive nephrectomy, or the prognostic factors in advanced renal cell carcinoma (RCC) with extensive sarcomatoid component (ESC), a rare but fatal disease. METHODS: Data from 37 consecutive patients with metastatic or recurrent RCC with ESC (≥25 % on resected kidney or exclusive sarcomatoid histology on needle biopsy) were analyzed. RESULTS: Of the 37 patients, 27 patients (73 %) had synchronous metastatic disease. The median percentage of sarcomatoid component (PSC) was 50 % (range 25-93 %). Twenty (74 %) of the 27 synchronous metastatic patients underwent cytoreductive nephrectomy. Of the nine patients undergoing cytokine therapy, none showed objective responses. Two (15 %) of the 13 patients undergoing targeted agent therapy had partial responses, and five patients (38 %) achieved stable disease. The median overall survival for all patients was 5.9 months [95 % confidence interval (CI) 1.0-10.9]. In multivariate analysis, age (>58 years), ECOG performance status (>1), PSC (>50 %), and time from first diagnosis to advanced disease (<6 months) remained independent prognostic factors. Neither the type of systemic therapy nor cytoreductive nephrectomy had an effect on survival. CONCLUSIONS: Patients with RCC with ESC have a dismal clinical course, and the majority of patients have rapid disease progression, especially in response to immunotherapy. Four clinical factors can be used to model survival outcomes for advanced RCC with ESC and may be helpful in selecting patients for aggressive treatment.
    Journal of Cancer Research and Clinical Oncology 02/2013; · 2.91 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: WE ENCOUNTERED AN UNDESCRIBED HISTOLOGIC FEATURE OF PAPILLARY UROTHELIAL NEOPLASMS: "urothelial eddy", which was histologically reminiscent of squamous eddy of irritated follicular keratosis of the skin. A review of 756 patients with transurethral resection of bladder tumor revealed 10 patients (1.3%) of papillary urothelial neoplasms with urothelial eddies. All cases were male with a median age of 65 years. Urothelial eddies were characterized by small ovoid nests of ovoid to spindle cells arranged in an onion-skin pattern with fine cytoplasmic processes within wide intercellular space. The cytoplasmic processes mimicked intercellular bridges but ultrastructurally were cytoplasmic microvillous projections. They were of papillary urothelial neoplasm of low malignant potential in seven patients and low-grade urothelial carcinoma in three patients. Nine patients presented as non-invasive tumor and one patient showed microinvasion within papillary stalks. Six patients showed an inverted growth pattern. Their immunoprofile was more similar to that of conventional urothelial carcinoma rather than squamous cell carcinoma: high expressions of GATA3, S100P, uroplakin III, and cytokeratin 7; and low expressions of high molecular weight cytokeratin and p53. The Ki-67 labeling index was low (mean and median values, 2% each). During the follow-up period (mean, 88.7 months), four patients, including the microinvasive patient, showed recurrence with the same grade and stage but neither progressed into muscle-invasive tumor nor caused death. Our results suggest that urothelial eddy is a rare aberrant histology of papillary urothelial neoplasms with indolent behavior and should be discriminated from squamous differentiation of urothelial carcinoma, which has a poor prognosis.
    International journal of clinical and experimental pathology 01/2013; 6(8):1458-66. · 2.24 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Study Type - Prognosis (case series) Level of Evidence 4 What's known on the subject? and What does the study add? In patients with pRCC, the presence of venous tumour thrombus is known to be a predictor of poorer outcomes. However, a paucity of data is available regarding the prognostic significance of histology in patients with RCC and IVC thrombus. In our series, we found that patients with type II pRCC had significantly poorer outcomes when compared to those with cRCC. Although the lack of effective treatment for patients with metastatic pRCC may have contributed to these adverse outcomes, type II papillary histology was independent predictor not only of CSS but also of RFS. OBJECTIVE: •  To analyze the prognostic impact of papillary histology on oncological outcomes in patients with renal cell carcinoma (RCC) and inferior vena cava (IVC) thrombus. PATIENTS AND METHODS: •  We reviewed the medical records of 74 patients who underwent radical nephrectomy and IVC thrombectomy between 1990 and 2010 for clear cell or papillary RCC. •  We compared the clinicopathological features and clinical outcomes of 62 patients with clear cell RCC (cRCC) and 12 with papillary RCC (pRCC). •  All cases of pRCC were subdivided into type I or type II. •  The prognostic role of papillary histology on recurrence-free survival (RFS) and cancer-specific survival (CSS) was estimated using Cox's regression models. RESULTS: •  Upon reclassification of the pRCC subtype, all 12 patients with pRCC had type II tumours. •  Patients with type II pRCC were significantly younger (P = 0.028) and were more probably women (P = 0.025) than those with cRCC •  The 2- and 5-year CSS rates were 81.1% and 53.6% in cRCC patients, and 28.1% and 0% in type II pRCC patients, respectively. All eight patients with non-metastatic type II pRCC developed disease recurrence at a median interval of 6 months after surgery, whereas 25 of 44 (56.8%) patients with non-metastatic cRCC experienced such recurrence at a median interval of 10 months after surgery. •  Patients with type II pRCC showed significantly lower CSS (P < 0.001) and RFS (P = 0.002) than those with cRCC. •  On multivariate analysis, type II papillary histology was an independent predictor of CSS (hazard ratio, 3.73; P = 0.003) and RFS (hazard ratio, 3.15; P = 0.015). CONCLUSIONS: •  Type II papillary histology appears to be predominant in cases of pRCC with IVC thrombus. •  Patients with type II pRCC who presented with IVC thrombus had significantly worse outcomes than those with cRCC, and histology is an important prognostic factor in patients with RCC and IVC thrombus.
    BJU International 09/2012; · 3.05 Impact Factor
  • Kyungeun Kim, Jae Y Ro, Seulgi Kim, Yong Mee Cho
    [Show abstract] [Hide abstract]
    ABSTRACT: Except for tumor stage and histologic subtype, the prognostic factors of papillary renal cell carcinoma remain controversial. To the best of our knowledge, the prognostic significance of the expression of stem cell markers, OCT-4 and CD133, has not yet been studied in papillary renal cell carcinoma. Expressions of OCT-4 and CD133 were examined immunohistochemically in a tissue microarray construct generated from 119 cases of papillary renal cell carcinoma, collected from November 1996 to December 2008, and then the results were correlated with the clinicopathologic findings. OCT-4 was expressed at the nuclei of tumor cells in 26 cases (22%). The high expression of OCT-4 with a cut-off value of 12.5%, was associated with frequent microscopic lymphovascular invasion and poor disease-specific survival. CD133 was expressed in the apicolateral cell membrane of tumor cells in 21 cases (17.8%) with a cut-off value of 5%. The CD133 expression was correlated with small tumor size and lack of microscopic lymphovascular invasion, and it tended to be associated with a low Fuhrman nuclear grade and prolonged disease-specific survival. On multivariate analysis, tumor stage, histologic subtype, and OCT-4 expression, but not CD133 expression, were independent prognostic factors for disease-specific survival. OCT-4-expressing and CD133-nonexpressing papillary renal cell carcinoma showed the shortest disease-specific survival. These results showed that the expression of stem cell markers, OCT-4 and CD133, may serve, respectively, as a poor and favorable prognostic marker, in papillary renal cell carcinoma.
    Human pathology 08/2012; · 3.03 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Despite improvements in treatment, prostate cancer (PC) remains the second-leading cause of cancer death in men. Radiotherapy is among the first-line treatments for PC, but a significant number of patients relapse. Recent evidence supports the idea that PC is initiated by a subset of cells, termed cancer stem cells (CSCs). CSCs have also been implicated in radioresistance in various malignancies, but their role in PC has not yet been investigated. We compared the relative radiosensitivity of isolated CSCs to the total population of their corresponding cell lines, and examined the relative numbers of CSCs in irradiated cell lines following long-term recovery and in recurrent human PC. Here, we show that while irradiation does not immediately favor increased survival of CSCs, irradiated PC cell lines showed an increase in CSC properties with long-term recovery. These data suggest that, although CSCs are initially damaged by radiation, they possess a greater capacity for recovery and regrowth. The combination of radiotherapy with a CSC-targeted therapeutic strategy may prevent tumor recurrence. Prostate 72:1746-1756, 2012. © 2012 Wiley Periodicals, Inc.
    The Prostate 04/2012; 72(16):1746-56. · 3.84 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We compared the microscopic and nuclear morphometric characteristics of classical chromophobe renal cell carcinoma (C-ChRC) and renal oncocytoma (RO) and applied meaningful characteristics to differentiate eosinophilic chromophobe renal cell carcinoma (E-ChRC) from RO that has overlapping histology (RO-OH) with E-ChRC to know the usefulness of nuclear morphometry. Microscopic and morphometric characteristics were evaluated in 24 C-ChRCs, 6 E-ChRCs, 5 RO-OHs, and 25 classical ROs (C-ROs). The microscopic findings favoring C-ChRC were rasinoid nuclei, perinuclear halo, and distinct cytoplasmic membrane. Characteristic for C-RO was either stromal edema or hyalinization. The morphometric values of nearest nuclear distance, shortest nuclear diameter, and nuclear diameter ratio were significantly different between C-ChRC and C-RO. However, it was impossible to distinguish E-ChRC from RO-OH by histology and nuclear morphometry. The results of our study show that nuclear morphometry and histomorphology can distinguish between C-ChRC and C-RO but not between E-ChRC and RO-OH.
    Annals of diagnostic pathology 04/2012;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Current guidelines recommend routine second transurethral resection (TUR) for accurate diagnosis and to prevent understaging of muscle-invasive bladder cancer. We evaluated the diagnostic accuracy of immediate second resection of the tumor bed during initial TUR and its prognostic significance. Patients (n=126) undergoing TUR were prospectively randomized to undergo (n=63) or not undergo (n=63) immediate second resection of the tumor bed after complete TUR. Second resection was repeated until muscularis propria (MP) was identified in the specimen and the depth of tumor invasion was inspected. The results of second resection were compared with final pathology results for diagnostic accuracy. Recurrence and progression rates were compared in the two groups, and factors affecting recurrence were evaluated. Patient age, sex distribution, number of tumors, pathologic T stage and grade were similar in the groups. MP was included in all TUR specimens in the immediate second resection group, compared with 41 of 63 (65.1%) in the nonsecond resection group. The concordance rate of second resection with final pathology was r=0.810 (P<0.01). The sensitivity and specificity of second resection for T(2) disease were 90.9% and 98.0%, respectively, and the positive and negative predictive values of second resection for T(2) disease were 90.0% and 96.2%, respectively. Among the 94 patients followed up, those in the second resection group had significantly higher 2-year recurrence-free survival rate (77.0% vs 45.8%, P=0.025), but there was no difference in progression-free survival rate. Immediate second resection of the tumor bed after complete TUR improves the effectiveness of resection by immediately confirming the presence of MP in the specimen and accurately differentiating muscle-invasive disease. The advantages of immediate second resection were precise prediction of final pathology results and reduced early recurrence.
    Journal of endourology / Endourological Society 03/2012; 26(8):1059-64. · 1.75 Impact Factor
  • Source
    Kyungeun Kim, Hyojin Ihm, Jae Y Ro, Yong Mee Cho
    [Show abstract] [Hide abstract]
    ABSTRACT: The cancer stem cell (CSC) model suggests that high levels of CSCs within a tumor are associated with poor prognosis. The aim of this study was to investigate the expression of the stem cell marker CD133 in clear cell renal cell carcinoma (ccRCC), and its prognostic significance. The expression of CD133 was examined in 140 cases of ccRCC using immunohistochemistry. Ki-67 and Oct-4 were double-immunostained with CD133 to evaluate the proliferative activity and the stemness of CD133-expressing cells, respectively. CD133 expression was observed in 45 cases (32.1%) and high levels of expression were found to be associated with a macro-/microcystic pattern, non-sarcomatoid changes and non-metastatic disease. The Ki-67 labeling index tended to be lower in CD133-expressing ccRCCs compared to non-expressing tumors. CD133-expressing tumor cells rarely expressed Oct-4. A high degree of CD133 expression was observed in ccRCC with more differentiated morphology and non-metastatic disease, suggesting that CD133 is a favorable prognostic marker. These results also indicate that CD133 as a single marker may not be sufficient for CSC identification in ccRCC and, therefore, more specific CSC markers should be developed.
    Oncology letters 11/2011; 2(6):1095-1100. · 0.24 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The identification of prostate-specific antigen (PSA)-producing glands in prostatic urethral margins is often challenging, especially when examined as intraoperative frozen sections. To assess the histology of periurethral prostatic urethral glands and their expression of PSA and cytokeratins 7 and 20, we examined prostatic urethras of frozen and permanent sections of radical prostatectomy specimens. We observed 3 types of prostatic urethral glands: urethral mucosal, prostatic acinar, and mixed. The urethral mucosal type consisted of a single layer of surface cuboidal to columnar cells with densely eosinophilic luminal cytoplasm and underlying urothelial cells. The prostatic acinar type was lined by prostatic-type secretory cells and basal cells. The mixed type showed luminal secretory cells and underlying urothelial cells. The gland types were correctly assigned in most frozen section slides. The proximal segment of the prostatic urethra and the bladder neck consisted mostly of the urethral mucosal type, whereas the distal segment and apical margins consisted mostly of the prostatic acinar type. Prostate-specific antigen was expressed in secretory cells in prostatic acinar and mixed types, whereas cytokeratin 7 was expressed by urothelial cells and surface cells of the urethral mucosal type. Cytokeratin 20 was not expressed in any of these cells. These results indicate that PSA-expressing cells are abundant in the distal segment of the prostatic urethra and apical margin and share histologic features of prostatic secretory cells. These PSA-expressing prostatic acinar and mixed-type glands should be reported as a potential source of PSA-secreting benign glands.
    Annals of diagnostic pathology 11/2011; 16(2):79-84.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Lupus nephritis (LN) class II has generally been considered a mild form of LN with a good response to treatment. Although the number was small, there have also been reports on later progression to class III or IV, resulting in poor renal and patient outcome. This study aims to review cases of LN class II to analyze differences between cases that progressed to class III or IV and cases that did not. We retrospectively analyzed 15 cases of LN class II among 277 cases of biopsy-proven lupus nephritis diagnosed in a tertiary medical center over about 14 years. Among the 15 patients, 5 patients progressed to class III or IV. Biopsy specimens were reviewed by a pathologist according to the ISN/RPS 2003 classification. Response to treatment was evaluated at 6 months after treatment. On fluorescence microscopy (IF), there was significantly higher degree of deposition in the glomeruli of IgM, IgA and C4 in the progression group than in the non-progression group. At 6 months after treatment, there was a trend toward higher rates of complete remission in the non-progression group (90%) compared with those in the progression group (40%, p = 0.077). Five of the 15 cases of ISN/RPS 2003 class II glomerulonephritis progressed to class III or IV over a mean of 5 years. The degree of immune-complex deposition for IgM, IgA and C4 in the glomeruli was significantly higher in the progression group.
    Rheumatology International 07/2011; 32(8):2459-64. · 2.21 Impact Factor
  • European Urology 06/2011; · 10.48 Impact Factor

Publication Stats

243 Citations
95.27 Total Impact Points


  • 2008–2014
    • Ulsan University Hospital
      Urusan, Ulsan, South Korea
  • 2006–2013
    • Asan Medical Center
      • • Department of Pathology
      • • Department of Urology
      Sŏul, Seoul, South Korea
  • 2012
    • National Institutes of Health
      • Laboratory of Cancer Prevention
      Bethesda, MD, United States
  • 2011–2012
    • Kangbuk Samsung Hospital
      Sŏul, Seoul, South Korea
    • Inje University Paik Hospital
      • Department of Urology
      Goyang, Gyeonggi, South Korea
    • Inje University
      Kŭmhae, South Gyeongsang, South Korea