The Distribution Strategy Of A Representative Fair Trade Organization In Korea: The Case Of Beautiful Coffee

This case study analyzes the distribution strategy of Beautiful Coffee, a leading fair trade organization in Korea. Because of their focus on matters of public interest, fair trade organizations often face financial difficulties, and such difficulties can limit their growth and force them to pursue differentiated distribution strategies. The results indicate that Beautiful Coffee can serve as a good role model for fair trade organizations and have important practical implications for firms pursuing sustainable growth as a social enterprise

Primary renal well-differentiated neuroendocrine tumors: report of six cases with an emphasis on the Ki-67 index and mitosis

Background Primary renal well-differentiated neuroendocrine tumors (WDNETs) also called carcinoid and atypical carcinoid are extremely rare, and little is known about parameters that may predict prognosis at diagnosis. Methods Six cases of primary renal WDNET were collected. After reviewing slides stained with hematoxylin and eosin, proportions of each growth pattern were determined. Synaptophysin, chromogranin, CD56, and Ki-67 immunostaining and Ki-67 morphometric analysis were performed. Results Patients included three female and three males, mean age was 53.3 years. The mean tumor size was 4.5 cm, three cases were greater than 5 cm. At the time of initial surgery, lymph node and/or distant metastasis was confirmed in two cases. In a third case, no metastasis was initially found, but lymph node metastasis was identified during follow-up. The remaining three cases did not exhibit metastasis. Histopathologically, the renal WDNETs were primarily composed of ribbon-like and sheet-like growth patterns. Most of the tumors were diffusely positive for neuroendocrine markers. Mitotic count was high (≥2/10HPF) in cases with lymph node or distant metastasis but was low (< 2/10HPF) in non-metastatic cases. Furthermore, the Ki-67 index was also higher (≥3%) in the cases with metastases than in cases without metastasis. Conclusion Three out of the six primary renal WDNETs demonstrated aggressive behavior and exhibited increased mitotic counts and Ki-67 indices. These results suggest that mitosis and the Ki-67 index could be used as prognostic indicators for renal WDNET.This work was supported by grant 04–2016-0460 from the Seoul National University Hospital Research Fund

The Prognostic Implications of Cystic Change in Clear Cell Renal Cell Carcinoma

Background : Cystic renal cell carcinoma has been reported to have a good prognosis. However, previous studies included cases of multilocular cystic renal cell carcinoma, which has an excellent prognosis, and renal cell carcinoma with cystic necrosis, which has an adverse prognosis. Therefore, we analyzed the prognostic influence of cystic change in clear cell renal cell carcinoma after excluding those morphological features. Methods : We identified 225 patients with clear cell renal cell carcinoma who underwent nephrectomy between 2001 and 2003. The clinicopathologic features were compared with clinical outcomes. Results : Cystic change in clear cell renal cell carcinoma (n = 66) was significantly associated with younger patient age (< 55), smaller tumor size (<= 4 cm), lower pT stage (pT1, T2), M0 stage at initial diagnosis, lower tumor, node, and metastasis stage (I, II), and lower nuclear grade (1, 2). Patients with cystic change in clear cell renal cell carcinoma had significantly longer cancer-specific (p = 0.015) and progression-free survival (p = 0.004) than those without cystic change, by univariate analysis. Multivariate analysis revealed that cystic change significantly decreased the risk of cancer progression (risk ratio, 0.27; 95% confidence interval, 0.11 to 0.69). Conclusions : In patients with clear cell renal cell carcinoma, cystic change is a good independent predictor for survival.This work was supported by grant No. 04-2009-007 from the SNUH Research Fund.Jemal A, 2009, CA-CANCER J CLIN, V59, P225, DOI 10.3322/caac.20006Lopez-Beltran A, 2009, INT J UROL, V16, P432, DOI 10.1111/j.1442-2042.2009.02302.xGobbo S, 2008, AM J SURG PATHOL, V32, P1239Gong K, 2008, J CANCER RES CLIN, V134, P433, DOI 10.1007/s00432-007-0302-1Webster WS, 2007, UROLOGY, V70, P900, DOI 10.1016/j.urology.2007.05.029Lopez-Beltran A, 2006, EUR UROL, V49, P798, DOI 10.1016/j.eururo.2005.11.035Suzigan S, 2006, AM J CLIN PATHOL, V125, P217, DOI 10.1039/AH6FC77PYR2V6YAYFrank I, 2005, J UROLOGY, V173, P1889, DOI 10.1097/01.ju.0000158043.94525.d6Patard JJ, 2005, J CLIN ONCOL, V23, P2763, DOI 10.1200/JCO.2005.07.055Kim H, 2004, HUM PATHOL, V35, P1556, DOI 10.1016/j.humpath.2004.06.011Ficarra V, 2004, EUR UROL, V46, P559, DOI 10.1016/j.eururo.2004.07.002Han KR, 2004, UROL ONCOL-SEMIN ORI, V22, P410, DOI 10.1016/S1078-1439(03)00173-XImura J, 2004, APMIS, V112, P183Cheville JC, 2003, AM J SURG PATHOL, V27, P612Frank I, 2002, J UROLOGY, V168, P2395, DOI 10.1097/01.ju.0000035885.91935.d5Nassir A, 2002, UROLOGY, V60, P421GREENE FL, 2002, AJCC CANC STAGING MACorica FA, 1999, J UROLOGY, V161, P408Bielsa O, 1998, BRIT J UROL, V82, P16USUBUTUN A, 1998, INT UROL NEPHROL, V30, P391LYNCH CF, 1995, CANCER, V75, P316HARTMAN DS, 1986, UROLOGY, V28, P145

Clinicopathological characteristics of light chain proximal tubulopathy in Korean patients and the diagnostic usefulness of immunohistochemical staining for immunoglobulin light chain

Light chain proximal tubulopathy (LCPT) is a rare paraproteinemic renal disease that has been mostly reported in Western patients. LCPT is characterized by the accumulation of immunoglobulin (Ig)-light chain (LC) in the proximal tubule. Immunohistochemical staining for Ig-LC has not been investigated in the context of LCPT. We reported the clinicopathological characteristics and Ig-LC immunoexpression of patients with LCPT for the first time in Korea. We reviewed the clinicopathological findings of 5 Korean patients diagnosed with LCPT between 2016 and 2018. In addition, immunohistochemical staining for κ-LC and λ-LC was conducted on paraffin-embedded tissues. The median age was 63 years, and the male-to-female ratio was 3:2. The primary renal manifestations were either azotemia or tubular proteinuria. All patients were diagnosed with multiple myeloma with monoclonal κ-LC (#1–2) or λ-LC (#3–5) in the serum and urine. Kidney biopsies revealed diverse and subtle alterations of the proximal tubule, including crystallization, vacuolization, and/or swelling. Electron microscopy revealed crystals in patients #1–2 and non-crystalline particles within numerous/large/dysmorphic lysosomes in patients #3–5. Ig-LC restriction was demonstrated in the proximal tubule as κ-type in patients #1–2 and as λ-type in patients #3–5 by immunohistochemistry and immunofluorescence. Immunohistochemical staining showed diffuse positivity to κ- and λ-LC, although immunofluorescent staining for κ-LC was focal and weak. LCPT has diverse clinicopathological characteristics and subtle morphological alterations, which necessitate ancillary tests for diagnosis. We introduced immunohistochemical staining for Ig-LC as a useful tool for the diagnosis of LCPT, especially in the case of κ-type crystals

Loss of aquaporin-1 expression is associated with worse clinical outcomes in clear cell renal cell carcinoma: an immunohistochemical study

Background Aquaporin (AQP) expression has been investigated in various malignant neoplasms, and the overexpression of AQP is related to poor prognosis in some malignancies. However, the expression of AQP protein in clear cell renal cell carcinoma (ccRCC) has not been extensively investigated by immunohistochemistry with large sample size. Methods We evaluated the AQP expression in 827 ccRCC with immunohistochemical staining in tissue microarray blocks and classified the cases into two categories, high and low expression. Results High expression of aquaporin-1 (AQP1) was found in 320 cases (38.7%), but aquaporin-3 was not expressed in ccRCC. High AQP1 expression was significantly related to younger age, low TNM stage, low World Health Organization/International Society of Urologic Pathology nuclear grade, and absence of distant metastasis. Furthermore, high AQP1 expression was also significantly associated with longer overall survival (OS; p<.001) and progression-specific survival (PFS; p<.001) and was an independent predictor of OS and PFS in ccRCC. Conclusions Our study revealed the prognostic significance of AQP1 protein expression in ccRCC. These findings could be applied to predict the prognosis of ccRCC

Concurrent Multilocular Cystic Renal Cell Carcinoma and Leiomyoma in the Same Kidney: Previously Unreported Association

We present an unusual case of concurrent occurrence of a multilocular cystic renal cell carcinoma and a leiomyoma in the same kidney of a patient with no evident clinical symptoms. A 38-year-old man was found incidentally to have a cystic right renal mass on computed tomography. Laparoscopic radical nephrectomy was performed under a preoperative diagnosis of cystic renal cell carcinoma. Histology revealed a multilocular cystic renal cell carcinoma and a leiomyoma. This is the first report of this kind of presentation

Renal transplantation in a patient with Bartter syndrome and glomerulosclerosis

Bartter syndrome (BS) is a clinically and genetically heterogeneous inherited renal tube disorder characterized by renal salt wasting, hypokalemic metabolic alkalosis and normotensive hyperreninemic hyperaldosteronism. There have been several case reports of BS complicated by focal segmental glomerulosclerosis (FSGS). Here, we have reported the case of a BS patient who developed FSGS and subsequent end-stage renal disease (ESRD) and provided a brief literature review. The patient presented with classic BS at 3 months of age and developed proteinuria at 7 years. Renal biopsy performed at 11 years of age revealed a FSGS perihilar variant. Hemodialysis was initiated at 11 years of age, and kidney transplantation was performed at 16 years of age. The post-transplantation course has been uneventful for more than 3 years with complete disappearance of BS without the recurrence of FSGS. Genetic study revealed a homozygous p.Trp(TGG)610Stop(TGA) mutation in the CLCNKB gene. In summary, BS may be complicated by secondary FSGS due to the adaptive response to chronic salt-losing nephropathy, and FSGS may progress to ESRD in some patients. Renal transplantation in patients with BS and ESRD results in complete remission of BS

Realization of Non-Hermitian Hopf Bundle Matter

Line excitations in topological phases are a subject of particular interest because their mutual linking structures encode robust topological information of matter. It has been recently shown that the linking and winding of complex eigenenergy strings can classify one-dimensional non-Hermitian topological matter. However, in higher dimensions, bundles of linked strings can emerge such that every string is mutually linked with all the other strings. Interestingly, despite being an unconventional topological structure, a non-Hermitian Hopf bundle has not been experimentally clarified. Here, we make the first attempt to explore the non-Hermitian Hopf bundle by visualizing the global linking structure of spinor strings in the momentum space of a two-dimensional electric circuit. By exploiting the flexibility of reconfigurable couplings between circuit nodes, we can study the non-Hermitian topological phase transition and gain insight into the intricate structure of the Hopf bundle. Furthermore, we find that the emergence of a higher-order skin effect in real space is accompanied by the linking of spinor strings in momentum space, revealing a bulk-boundary correspondence between the two domains. The proposed non-Hermitian Hopf bundle platform and visualization methodology pave the way to design new topologically robust non-Hermitian phases of matter