Clinical Impact of Desensitization in HLA-Incompatible Liver Transplantation: A Propensity Score-Matched Multicenter Analysis
Minjee Kim, Dokyun Kim, Gonhyung Kim, So Yeon Park, Jae Hwan Kim, Jae Hwan Kim, John R. Lee, Sung Joon Hong, Kyung Kwan Lee, Kyung‐Suk Suh, Dong Jin Joo, YoungRok Choi
7479 An Uncommon Indolent Form Of Adrenocortical Carcinoma
Mohan Arumugam, Gonhyung Kim
IF 3.1
Journal of the Endocrine Society
Abstract Disclosure: M. Arumugam: None. G. Kim: None. Introduction: Adrenocortical carcinoma (ACC) is a rare endocrine malignancy that typically presents with characteristic clinical and biochemical manifestations that are aggressive in nature. We present a case of ACC which was incidentally noted on imaging with no symptoms or signs of hormone excess. Case report: A 62-year-old male was noted to have an adrenal mass during evaluation of 30 lb unintentional weight loss and failure to thrive. The adrenal mass measured 18.3 x 14.4 x 6.8 cm with central necrosis and demonstrated extrinsic mass effect on surrounding structures. He denied any symptoms of hypercortisolism or clinically apparent androgen excess. He quit smoking 31 years ago and occasionally chews tobacco. Overnight dexamethasone suppression test with 2 mg dexamethasone showed an appropriately suppressed cortisol of 1.3. Androgen levels including DHEA-S, androstenedione, testosterone, and 17 hydroxy-progesterone were all within the normal range. PET CT revealed intensely increased radiotracer uptake in a large central necrotic mass in left adrenal gland, suggestive of malignant neoplasm. No other abnormal radiotracer activity was noted to suggest metastasis. The patient underwent left adrenalectomy. Intraoperatively, invasion of left kidney and tail of the pancreas was noted. Left nephrectomy was performed, and the pancreas was dissected off. The pathologist used three different staging systems to characterize the adrenal tumor. The Helsinki scoring system and Reticulin Algorithm were consistent with Adrenocortical Carcinoma. The Lin-Weiss-Bisceglia grading interpreted it as adrenal oncocytic neoplasm of uncertain malignant potential. Given the latter interpretation, the case was sent to Massachusetts General Hospital (MGH) for expert opinion. MGH deemed the tumor to be low-grade adrenocortical carcinoma. Conclusion: This is an uncommon presentation of adrenocortical carcinoma with patient presenting with weight loss and failure to thrive but without biochemical findings such as elevated cortisol or androgens. Presentation: 6/1/2024
Clinical Impact of Desensitization in HLA-Incompatible Liver Transplantation: A Propensity Score-Matched Multicenter Analysis
Minjee Kim, Dokyun Kim, Gonhyung Kim, So Yeon Park, Jae Hwan Kim, Jae Hwan Kim, John R. Lee, Sung Joon Hong, Kyung Kwan Lee, Kyung‐Suk Suh, Dong Jin Joo, YoungRok Choi
7479 An Uncommon Indolent Form Of Adrenocortical Carcinoma
Mohan Arumugam, Gonhyung Kim
IF 3.1
Journal of the Endocrine Society
Abstract Disclosure: M. Arumugam: None. G. Kim: None. Introduction: Adrenocortical carcinoma (ACC) is a rare endocrine malignancy that typically presents with characteristic clinical and biochemical manifestations that are aggressive in nature. We present a case of ACC which was incidentally noted on imaging with no symptoms or signs of hormone excess. Case report: A 62-year-old male was noted to have an adrenal mass during evaluation of 30 lb unintentional weight loss and failure to thrive. The adrenal mass measured 18.3 x 14.4 x 6.8 cm with central necrosis and demonstrated extrinsic mass effect on surrounding structures. He denied any symptoms of hypercortisolism or clinically apparent androgen excess. He quit smoking 31 years ago and occasionally chews tobacco. Overnight dexamethasone suppression test with 2 mg dexamethasone showed an appropriately suppressed cortisol of 1.3. Androgen levels including DHEA-S, androstenedione, testosterone, and 17 hydroxy-progesterone were all within the normal range. PET CT revealed intensely increased radiotracer uptake in a large central necrotic mass in left adrenal gland, suggestive of malignant neoplasm. No other abnormal radiotracer activity was noted to suggest metastasis. The patient underwent left adrenalectomy. Intraoperatively, invasion of left kidney and tail of the pancreas was noted. Left nephrectomy was performed, and the pancreas was dissected off. The pathologist used three different staging systems to characterize the adrenal tumor. The Helsinki scoring system and Reticulin Algorithm were consistent with Adrenocortical Carcinoma. The Lin-Weiss-Bisceglia grading interpreted it as adrenal oncocytic neoplasm of uncertain malignant potential. Given the latter interpretation, the case was sent to Massachusetts General Hospital (MGH) for expert opinion. MGH deemed the tumor to be low-grade adrenocortical carcinoma. Conclusion: This is an uncommon presentation of adrenocortical carcinoma with patient presenting with weight loss and failure to thrive but without biochemical findings such as elevated cortisol or androgens. Presentation: 6/1/2024
An Undetermined Osteoporotic Disease Managed with IM Rod in a Dog
Hye-Jong Oh, Byoungho An, Dongwook Kim, Heesoo Ahn, Dongwoo Chang, Gonhyung Kim
The Thai Journal of Veterinary Medicine
Osteoporosis is a systemic bone disorder characterized by decreased bone density, which can weaken bone strength and increase the risk of fractures. Osteogenesis imperfecta (OI), one of the main causes of osteoporosis in children, results in fragile bones and multiple fractures. The present study documented the case of a dog with an undetermined osteoporotic disease managed with intramedullary rod fixation. A 3-month-old intact male Alaskan Malamute dog, weighing 11.6 kg, was presented with lameness in the left pelvic limb. Radiography revealed left pelvic and femoral fractures, and the cortex of the long bones was thin. On CT scanning, a significant decrease in trabecular bone mineral density (BMD) was observed compared with normal dogs. Hyperparathyroidism was ruled out on the basis of blood tests and ultrasonography. Histopathological examination of the fragmented bone revealed remodeling with no evidence of neoplasia. Genetic testing could not differentiate OI in the dog, therefore an undetermined osteoporotic disease was tentatively diagnosed. Fractures were managed using multiple intramedullary rods. Although the trabecular BMD further decreased and additional surgery was required due to the migration of inserted rod and additional fracture, body weight of the dog was increased from 11.6 kg to 28.6 kg during the follow-up. The clinical symptoms, including pain and lameness, improved. Taken together, rodding surgery might be a viable option for dogs with pathological fractures due to osteoporotic disease by distributing weight and preventing bending force.
Effect of leash walking on weight loss and assessment of hair cortisol in overweight dogs
K. Kim, Bo Song, Dong‐Hyun Kim, Dae Hyun Kim, Hyun Jik Lee, Gonhyung Kim
Comparative Exercise Physiology
Abstract Obesity results from excessive body fat accumulation. Leash-walking is a practical way to increase activity in treating obesity; however, limited studies have focused on the frequency and duration of dog leash-walking. There is few research reporting on whether initiating exercise or increasing physical activity in obese dogs can induce stress. Therefore, the present study conducted a clinical trial of the leash-walking effect on weight management and identified the relationship between stress and weight management. Thirty-one dogs participated in a 4-week weight management and were divided into four groups according to their leash-walking frequency and duration. Low walking group (LW): approximately 30 min, 3 times per week; Group 1: approximately 60 min, 3 times per week; Group 2: approximately 30 min, 5 to 7 times per week; Group 3: approximately 60 min, 5 to 7 times per week. Body weight and hair cortisol concentrations of participated dogs were also evaluated. There were significant ( ) differences in the weight loss rate between the Group 2 (−1.08 ± 0.34%/week) and Group 3 (−1.26 ± 0.54%/week) compared to the LW (−0.13 ± 0.49%/week). However, there was an increasing tendency of hair cortisol concentration in Group 1 (0.15 ± 0.10 μg/dl to 0.20 ± 0.19 μg/dl) and Group 3 (0.19 ± 0.19 μg/dl to 0.45 ± 0.76 μg/dl) which are approximately 60 min of leash-walking duration groups. The results of this study suggest that it is more efficient to increase leash-walking frequency than duration for weight loss. However, suddenly increasing leash-walking may be a stress-inducing factor during weight management in overweight dogs. Therefore, it is important to start weight management with appropriate frequency and manageable duration of leash-walking and gradually increase the leash-walking times step by step.
Application of a Modified Dorsal Wiring Method in Toy Breed Dogs With Atlantoaxial Subluxation
Dongwook Kim, SEOUNGJIN LEE, Gonhyung Kim
IF 1.8
In Vivo
Clinical results with the modified dorsal wiring method were similar to those with the Kishigami AATB. The modified dorsal wiring method is versatile as it could be applied to various shapes of dogs' atlas. Considering the shape of the atlas, it is recommended to apply the implant as far from the midline of the dorsal arch as possible to avoid fractures. With selection of suitable patients, this modified dorsal wiring method can be applied to dorsal stabilization of AAS in toy breed dogs.
Evaluating Disease Patterns of Military Working Dogs in the Republic of Korea: A Retrospective Study
Sanghyeon Park, Gyeonggook Park, Mi-Sun Rieu, Taewoo Kim, Dongwook Kim, Sungin Lee, Gonhyung Kim
IF 2.7
Animals
The purpose of this study was to evaluate disease patterns among military working dogs (MWDs) at the Armed Forces Medical Research Institute (AFMRI) to provide basic medical data on Korean MWDs. The medical records of procedures performed at AFMRI between November 2017 and March 2021 were reviewed. Physical examination, diagnostic imaging, and laboratory tests were performed according to the status of each dog. A total of 353 MWDs (215 males and 138 females; mean age, 6 ± 3 years) were analyzed in this study. Among Korean MWDs, gastrointestinal (GI) disorders are the most frequently diagnosed, followed by dental and musculoskeletal disorders. Foreign body (FB) ingestion had the highest prevalence of GI disorders, with the most common FB being a leather collar or leash. General and dental surgeries, including removal of gastric FB and tooth extraction, were routinely performed at the AFMRI. Preventative care focusing on dental disease and FB ingestion may be helpful for effective performance and good quality of life in MWDs, with the regular assessment and prevention of environmental factors that may contribute to behavioral problems such as FB ingestion, coprophagy, and anorexia.
Biomechanical analysis of atlantoaxial dorsal fixation using finite element models
Beomju Bae, Dong Wook Kim, Hyejong Oh, Gonhyung Kim
The Thai Journal of Veterinary Medicine
Atlantoaxial instability can cause spinal cord compression with clinical signs ranging from cervical pain to tetraplegia and death. Although a variety of dorsal fixation techniques have been described, some of them have been related to the fracture of the dorsal arch of the atlas, leading to surgical failure. Under the hypothesis that the shape of the dorsal arch of the atlas and types of implants might affect these bone fractures, the objective of this study was to analyze bone stresses through simulations of the dorsal fixation using finite element models. Arbitrary tension forces were given to implants for simulations of the dorsal fixation and the maximum von Mises stress of the bone was analyzed. The maximum bone stress increased as the bone got thinner and the angle of the notch got steeper. The width between wires and the length of the bone did not affect the maximum stress on the bone. Bone with band implant had lower maximum bone stress than that with wire implants. When using wire implants, wires applied beyond the notch of the dorsal arch reduced the maximum bone stress more than wires positioned within it. Therefore, the fracture of the dorsal arch of the atlas was related to the shape of the bone and types of implant applied. Band implant can effectively reduce fracture of the dorsal arch compared to wire implant in atlantoaxial dorsal fixation. When considering wire implant, it is recommended to apply wires beyond the notch of the atlas.
Apocrine Gland Adenocarcinoma in a Djungarian Hamster (<i>Phodopus sungorus</i>)
Sungryong Kim, Sunghyun S. Hong, Gonhyung Kim, Ki‐Jeong Na
Journal of Veterinary Clinics
A 17-month-old intact male Djungarian hamster (Phodopus sungorus) was presented with an axillary mass. Fine needle aspiration cytology of the mass showed a malignant epithelial cell tumor. Histopathological examination of the surgically removed mass confirmed a complex apocrine gland adenocarcinoma. Twenty days postoperatively, the mass recurred in the same area, and the patient died while waiting for the second surgical removal. This is the first report of the cytology, histopathology, and postoperative recurrence of apocrine gland adenocarcinoma in a Djungarian hamster.
