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Kim H, Kim TG, Park B, Kim J, Jun SY, Lee JH, Choi HJ, Jung CS, Lee HW, Lee JS, Nam HY, Shin S, Kim SM, Kim H. Tailored radiation dose according to margin width for patients with ductal carcinoma in situ after breast-conserving surgery. Sci Rep 2024; 14:300. [PMID: 38168758 PMCID: PMC10761984 DOI: 10.1038/s41598-023-50840-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/27/2023] [Indexed: 01/05/2024] Open
Abstract
A 2 mm resection margin is considered adequate for ductal carcinoma in situ (DCIS). We assessed the effectiveness of a tailored radiation dose for margins < 2 mm and the appropriate margin width for high-risk DCIS. We retrospectively evaluated 137 patients who received adjuvant radiotherapy after breast-conserving surgery for DCIS between 2013 and 2019. The patients were divided into three- positive, close (< 2 mm), and negative (≥ 2 mm) margin groups. Radiation dose to the tumor bed in equivalent dose in 2 Gy fractions were a median of 66.25 Gy, 61.81 Gy, and 59.75 Gy for positive, close, and negative margin groups, respectively. During a median follow-up of 58 months, the crude rates of local recurrence were 15.0%, 6.7%, and 4.6% in the positive, close, and negative margin groups, respectively. The positive margin group had a significantly lower 5-year local recurrence-free survival (LRFS) rate compared to the close and negative margin groups in propensity-weighted log-rank analysis (84.82%, 93.27%, and 93.20%, respectively; p = 0.008). The difference in 5-year LRFS between patients with the high- and non-high-grade tumors decreased as the margin width increased (80.4% vs. 100.0% for margin ≥ 2 mm, p < 0.001; 92.3% vs. 100.0% for margin ≥ 6 mm, p = 0.123). With the radiation dose tailored for margin widths, positive margins were associated with poorer local control than negative margins, whereas close margins were not. Widely clear margins (≥ 2 mm) were related to favorable local control for high-grade DCIS.
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Affiliation(s)
- Hyunjung Kim
- Departments of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, 630-522, South Korea
| | - Tae Gyu Kim
- Departments of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, 630-522, South Korea.
| | - Byungdo Park
- Departments of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, 630-522, South Korea
| | - Jeongho Kim
- Departments of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, 630-522, South Korea
| | - Si-Youl Jun
- Departments of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Jun Ho Lee
- Departments of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Hee Jun Choi
- Departments of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Chang Shin Jung
- Departments of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Hyoun Wook Lee
- Departments of Pathology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Jae Seok Lee
- Departments of Pathology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Hyun Yeol Nam
- Departments of Nuclear Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Seunghyen Shin
- Departments of Nuclear Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Sung Min Kim
- Departments of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Haeyoung Kim
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Kim H, Kim TG, Park B, Kim JH, Jun SY, Lee JH, Choi HJ, Jung CS, Bang YJ, Lee HW, Lee JS, Nam HY, Shin S, Kim SM, Kim H. Effect of high-dose radiation therapy on positive margins after breast-conserving surgery for invasive breast cancer. Breast 2023; 71:106-112. [PMID: 37572626 PMCID: PMC10425380 DOI: 10.1016/j.breast.2023.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/28/2023] [Accepted: 08/05/2023] [Indexed: 08/14/2023] Open
Abstract
PURPOSE Positive margins after breast-conserving surgery are associated with poor oncological outcomes and warrant additional surgery. This study aimed to evaluate the effectiveness of high-dose radiation therapy for positive margins by comparing local recurrence between patients with positive and negative margins. METHODS We retrospectively evaluated 550 patients treated with adjuvant radiation therapy after breast-conserving surgery for invasive breast cancer between 2013 and 2019. The total equivalent dose in 2 Gy fractions (EQD2) to the tumor bed ranged from 65.81 to 66.25 Gy for positive margins and 59.31-61.81 Gy for negative margins. The differences in local recurrence between the positive and negative margin groups were analyzed. RESULTS After a median follow-up of 58 months, the crude local recurrence rate was 7.3% in the positive margin group (n = 55) and 2.4% in the negative margin group (n = 495). Positive margins were associated with higher local recurrence without statistical significance in the entire cohort (p = 0.062). Among patients aged <60 years, those with positive margins had a significantly lower 5-year local recurrence-free survival rate than those with negative margins (89.16% vs. 97.57%, respectively; p = 0.005). In contrast, there was no significant difference in the 5-year local recurrence-free survival rate between patients with positive and negative margins among those aged ≥60 years (100.00% vs. 94.38%, respectively; p = 0.426). CONCLUSION In this study, positive margins were not associated with poor local control in older patients after a high-dose boosts. Further prospective studies are needed to verify our findings.
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Affiliation(s)
- Hyunjung Kim
- Department of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Tae Gyu Kim
- Department of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea.
| | - Byungdo Park
- Department of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Jeong Ho Kim
- Department of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Si-Youl Jun
- Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Jun Ho Lee
- Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Hee Jun Choi
- Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Chang Shin Jung
- Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Yoon Ju Bang
- Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Hyoun Wook Lee
- Department of Pathology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Jae Seok Lee
- Department of Pathology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Hyun Yeol Nam
- Department of Nuclear Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Seunghyeon Shin
- Department of Nuclear Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Sung Min Kim
- Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Haeyoung Kim
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Choi HJ, Lee JH, Jung CS, Ryu JM, Chae BJ, Lee SK, Yu JH, Kim SW, Nam SJ, Lee JE, Jung YJ, Kim HY. Oncologic efficacy of gonadotropin-releasing hormone agonist in hormone receptor-positive very young breast cancer patients treated with neoadjuvant chemotherapy. World J Clin Cases 2023; 11:6398-6406. [PMID: 37900220 PMCID: PMC10601015 DOI: 10.12998/wjcc.v11.i27.6398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/17/2023] [Accepted: 08/25/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Breast cancer in young women has been shown to have an aggressive behavior and poor prognosis. AIM To evaluate the outcomes of young hormone receptor (HR)-positive patients with breast cancer treated with neoadjuvant chemotherapy (NAC), and the oncologic efficacy of gonadotropin-releasing hormone (GnRH) agonists. METHODS This retrospective study involved a prospectively enrolled cohort. We included patients diagnosed with invasive breast cancer who were treated with NAC followed by curative surgery at the Samsung Medical Center and Samsung Changwon Hospital between January 2006 and December 2017. Among patients with HR-positive and human epidermal grow factor 2 (HER2)-negative breast cancer, we analyzed the characteristics and oncology outcomes between the patients equal to or younger than 35 years and the patients older than 35 years. RESULTS Among 431 patients with NAC and HR-positive/HER2-negative breast cancer, 78 were 35 years old or younger, and 353 patients were older than 35 years. The median follow-up was 71.0 months. There was no statistically significant difference in disease free survival (DFS, P = 0.565) and overall survival (P = 0.820) between the patients equal to or younger than 35 years and the patients older than 35 years. The two groups differed in that the GnRH agonist was used more frequently in the group of patients equal to or younger than 35 years than in the other group (52.4% vs 11.2%, P < 0.001). Interestingly, for the DFS according to the GnRH agonist in the group of patients equal to or younger than 35 years, patients treated with the GnRH agonist had better DFS (P = 0.037). CONCLUSION Administration of GnRH agonists might improve the DFS rate of HR-positive/HER2-negative breast cancer in the equal to or younger than 35 years group of patients with NAC.
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Affiliation(s)
- Hee Jun Choi
- Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, South Korea
| | - Jun Ho Lee
- Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, South Korea
| | - Chang Shin Jung
- Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, South Korea
| | - Jai Min Ryu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Byung Joo Chae
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Se Kyung Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Jong Han Yu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Seok Won Kim
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Seok Jin Nam
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Jeong Eon Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Youn Joo Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Gyeongnam 50612, South Korea
| | - Hyun Yul Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Gyeongnam 50612, South Korea
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Kim HY, Lee S, Kim DI, Jung CS, Kim JY, Nam KJ, Choo KS, Jung YJ. Male metaplastic breast cancer with poor prognosis: A case report. World J Clin Cases 2022; 10:4964-4970. [PMID: 35801042 PMCID: PMC9198856 DOI: 10.12998/wjcc.v10.i15.4964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/15/2021] [Accepted: 03/26/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Metaplastic breast cancer (MBC) is a rare subtype of breast cancer. They constitute less than 1% of breast cancer cases and are much rarer in males. There are few reports of MBC because of its rarity. MBC, an aggressive type of cancer, is refractory to common treatment modalities of breast cancer and has a poor prognosis.
CASE SUMMARY We report a case of MBC in a 78-year-old man. He visited our clinic with a palpable mass on the left breast with no masses in the axillary areas. He had previously undergone robot-assisted laparoscopic radical prostatectomy for prostate cancer, but there was no family history of malignancy. The breast mass was visible on ultrasonography, mammography, and magnetic resonance imaging, and chest computed tomography revealed a lung mass in the posterior basal segment of the right lower lobe. The patient was diagnosed with metaplastic carcinoma on core needle biopsy with lung metastasis. Total mastectomy with sentinel lymph node biopsy and video-assisted segmentectomy of the right lung was performed. However, multiple metastases appeared 3 mo after surgery in the brain, chest, and abdomen, and the patient died 5 mo after the initial diagnosis.
CONCLUSION MBC is an aggressive and extremely rare breast cancer type. Further case reports are needed to determine the optimal treatment.
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Affiliation(s)
- Hyun Yul Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Gyeongnam 50612, South Korea
| | - Seungju Lee
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Gyeongnam 50612, South Korea
| | - Dong-il Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Gyeongnam 50612, South Korea
| | - Chang Shin Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Gyeongnam 50612, South Korea
| | - Jee Yeon Kim
- Department of Pathology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Gyeongnam 50612, South Korea
| | - Kyung Jin Nam
- Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Gyeongnam 50612, South Korea
| | - Ki Seok Choo
- Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Gyeongnam 50612, South Korea
| | - Youn Joo Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Gyeongnam 50612, South Korea
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Lee S, Yul Kim H, Joo Jung Y, Shin Jung C, Im D, Yeon Kim J, Min Lee S, Hwan Oh S. Comparison of mutational profiles between triple-negative and hormone receptor-positive/human epidermal growth factor receptor 2-negative breast cancers in T2N0-1M0 stage: Implications of TP53 and PIK3CA mutations in Korean early-stage breast cancers. Curr Probl Cancer 2022; 46:100843. [DOI: 10.1016/j.currproblcancer.2022.100843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/03/2021] [Accepted: 01/03/2022] [Indexed: 11/03/2022]
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Choi HJ, Lee JH, Jung CS, Lee JE, Jung YJ, Lee S, Kang SK, Kim HY. Factors Affecting Pathologic Complete Remission in Patients with Hormone Receptor-Positive and Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer Receiving Neoadjuvant Chemotherapy. Oncology 2022; 100:529-535. [DOI: 10.1159/000526155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/15/2022] [Indexed: 11/19/2022]
Abstract
<b><i>Introduction:</i></b> Pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) is associated with improvement in survival outcomes. This study evaluated the pCR in patients with hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative breast cancer after NAC. <b><i>Methods:</i></b> We evaluated 417 patients who were diagnosed with invasive breast cancer and treated with NAC followed by curative surgery between January 2007 and December 2020 and analyzed the pCR for HR-positive and HER2-negative breast cancer. <b><i>Results:</i></b> The median age at the time of surgery was 45.4 years, and 9.1% of patients (38 of 417) with HR-positive/HER2-negative status had pCR. Among patients with HR-positive/HER2-negative breast cancer, patients with single HR-positivity had a 20.2% pCR rate, and patients with double HR-positivity had a 4.4% pCR rate. Patients with a high Ki-67 index exhibited a higher pCR rate than those with a lower Ki-67 index (14.5% vs. 3.2%). Patients with single HR-positive and high Ki-67 values exhibited a significantly higher pCR rate than those with double HR-positive and low Ki-67 values (27.8% vs. 2.1%; <i>p</i> < 0.001). <b><i>Conclusion:</i></b> NAC could improve prognosis in patients with HR-positive/HER2-negative breast cancer with a single HR-positive and high Ki-67 values.
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Kim HY, Kim DI, Jung CS, Lee SJ, Im DW, Jung YJ, Yeom JA, Choi JB. Utility of sentinel lymph node biopsy in papillary thyroid microcarcinoma. Korean J Clin Oncol 2021; 17:117-121. [PMID: 36945673 PMCID: PMC9942750 DOI: 10.14216/kjco.21018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/06/2021] [Accepted: 12/06/2021] [Indexed: 06/18/2023]
Abstract
PURPOSE There are many studies on sentinel lymph node (SLN) biopsy in thyroid carcinoma but SLN biopsy (SLNB) in papillary thyroid carcinoma (PTC) remains open to debate. Therefore in this retrospective study, the usefulness of SLNB in thyroid carcinoma patients who had micro-PTC without cervical lymphadenopathy was assessed. METHODS SLNB was performed in 114 patients who were diagnosed with micro-PTC in a single lobe without palpable or ultrasound-detected lymph node at the tertiary center between January 2012 and December 2013. After SLNB, all patients underwent total thyroidectomy and central neck dissection or thyroid lobectomy and central neck dissection of the single side. RESULTS SLNs were identified in 112 of 114 patients with 41 positive SLNs and 71 negative SLNs on intraoperative frozen sections. However, eight negative patients were found to be positive in the final pathology. Sentinel node identification rate and false negative value of SLNB were 98.2% and 11.3%, respectively. In the univariate analysis, higher lymph node metastasis was detected in men than in women. Higher detection number of SLN showed higher probability of lymph node metastasis. CONCLUSION SLNB may be helpful in papillary thyroid cancer, especially in male patients. Also, it is useful for the staging of nodal status and clearance of persistent disease.
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Affiliation(s)
- Hyun Yul Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Dong-il Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Chang Shin Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seung Joo Lee
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Dong Won Im
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Youn Joo Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jeong-a Yeom
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jeong Bum Choi
- Department of Surgery, Pusan National University Hospital, Busan, Korea
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Lee MI, Jung YJ, Kim DI, Lee S, Jung CS, Kang SK, Pak K, Kim SJ, Kim HY. Prognostic value of SUVmax in breast cancer and comparative analyses of molecular subtypes: A systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e26745. [PMID: 34397816 PMCID: PMC8341324 DOI: 10.1097/md.0000000000026745] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 06/29/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND To assess the prognostic capability of the maximum standardized uptake values (SUVmax) measured in the primary tumor and axillary lymph nodes (ALNs) by pretreatment fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography and analyze outcomes according to the molecular breast cancer subtypes. METHODS The databases were systematically searched using keywords for breast cancer, positron emission tomography/computed tomography, and SUVmax; the extracted studies reported at least 1 form of survival data, event-free survival (EFS) and overall survival. Comparative analyses of the pooled hazard ratios (HRs) for EFS and overall survival were performed to assess their correlations with SUVmax. The pooled HR was estimated using random-effects model according to the results of heterogeneity. RESULTS Thirteen eligible studies comprising 3040 patients with breast cancer were included. The pooled HRs of high SUVmax in the primary tumor and ALN were 3.01 (95% CI 1.83-4.97, P < .00001; I2 = 82%) and 3.72 (95% CI 1.15-12.01; I2 = 92%; P = .03), respectively. Patients with higher SUVmax demonstrated a poorer survival prognosis. Furthermore, comparative analyses according to the molecular subtypes demonstrated that the SUVmax in the primary tumor or ALN can be a predictive parameter in patients with the luminal subtype disease. Subtype analysis results indicated a significant association of the luminal group, with a HR of 2.65 (95% CI 1.31-5.37; I2 = 27%; P = .007). CONCLUSIONS SUVmax from pretreatment is a significant prognostic factor for EFS in patients with breast cancer. Despite several limitations, correlation with molecular subtype (luminal type) was demonstrated. Further large-scale studies are required to investigate the precise prognostic capability of SUVmax.
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Affiliation(s)
- Moon il Lee
- Breast Surgery, Hwamyoung Ilsin Christian Hospital, Pusan, Republic of Korea
| | - Youn Joo Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Dong Il Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Seungju Lee
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Chang Shin Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Seok Kyung Kang
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Kyoungjune Pak
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Seong Jang Kim
- Department of Nuclear Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Hyun Yul Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
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Paik HJ, Jung YJ, Kim DI, Lee S, Jung CS, Kang SK, Kim JJ, Oh SY, Joo JH, Kim HY. Clinicopathological Features of BRCA1/2 Mutation-Positive Breast Cancer. Oncology 2021; 99:499-506. [PMID: 34098565 DOI: 10.1159/000515790] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/10/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE The BRCA1/2 gene is the most well-known and studied gene associated with hereditary breast cancer. BRCA1/2 genetic testing is widely performed in high-risk patients of hereditary breast cancer in Korea. This study aimed to investigate the clinicopathological characteristics of BRCA1/2 mutation-positive breast cancer patients. METHODS The clinical data of 188 Korean breast cancer patients who underwent genetic testing of BRCA1/2 mutation between March 2015 and February 2020 at Pusan National University Yangsan Hospital were retrospectively reviewed. The characteristics of breast cancer according to the expression of BRCA1 and BRCA2 mutations were analyzed using the Health Insurance Review and Assessment Service guideline criteria and other clinicopathological factors. RESULTS The factor associated with BRCA1/2 gene expression was cancer stage, and mutation expression was significantly decreased in stage I compared to stage 0 (p = 0.033; odds ratio [OR], 0.169; 95% confidence interval [CI], 0.033-0.867), and there was a tendency to increase in stage II (p = 0.780; OR, 1.150; 95% CI, 0.432-3.064). BRCA1 was significantly associated with triple-negative breast cancer (TNBC) (p = 0.004; OR, 5.887; 95% CI, 1.778-19.498). Gene expression of BRCA2 was significantly reduced under 40 years of age (p = 0.040; OR, 0.198; 95% CI, 0.042-0.930). There was no difference in disease-free survival (p = 0.900) and overall survival (p = 0.733) between the BRCA1/2 mutation-positive and -negative groups. CONCLUSION In this study, the clinicopathological characteristics of breast cancer patients with BRCA1/2 gene mutations were identified. BRCA1 gene expression was highly correlated with TNBC. BRCA1/2 mutation did not have a poor prognosis regarding recurrence and death.
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Affiliation(s)
- Hyun-June Paik
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Youn Joo Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Dong Il Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Seungju Lee
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Chang Shin Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Seok Kyung Kang
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Jae-Joon Kim
- Hemato-Oncology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - So Yeon Oh
- Hemato-Oncology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Ji Hyeon Joo
- Department of Radiation Oncology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Hyun Yul Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
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Jung CS, Jung YJ, Kim DI, Lee S, Kang SK, Nam SB, Kim HY. A comparative study of the clinical characteristics and outcomes of HR-positive HER2-negative breast cancer patients over and under 65 years old. Korean J Clin Oncol 2021; 17:1-7. [PMID: 36945204 PMCID: PMC9942741 DOI: 10.14216/kjco.21001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/21/2021] [Accepted: 05/31/2021] [Indexed: 11/07/2022]
Abstract
Purpose The purpose of this study was to compare the clinical characteristics and outcomes of hormone receptor-positive (HR+) human epidermal growth factor 2-negative (HER2-) breast cancer among elderly patients (over 65 years old) and younger patients. Methods This was a retrospective cohort study of 328 patients who were treated for breast cancer at Pusan National University Yangsan Hospital between January 2009 and December 2014. Tumor characteristics, surgical methods, and survival outcomes were compared between the two age groups (<65 and ≥65 years old). Kaplan-Meier curves for disease-free survival (DFS) and overall survival (OS) were also constructed according to the age groups. Results Among the 328 patients with HR+ HER2- breast cancer, 184 (56.1%) were <65 years old and 144 (43.9%) were ≥65 years old. Breast cancer stages were similar between the two age groups, but the older patients were treated less often with chemotherapy (81% vs. 66%, P=0.002). During the follow-up period, 17 deaths and 36 cases of recurrence or metastasis were reported. There was no difference in DFS between the two groups (P=0.840); however, the OS of the older age group was significantly lower than that of the younger age group (P=0.015). Conclusion This study suggested that HR+ HER2- breast cancer patients belonging to the two age groups had no significant difference in DFS. However, older age is an independent factor affecting OS rate. Therefore, even if patients are old, but their physical condition is satisfactory, standard and active treatment may be necessary, similar to that given to younger patients.
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Affiliation(s)
- Chang Shin Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Youn Joo Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Dong Il Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seungju Lee
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seok Kyung Kang
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Su Bong Nam
- Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Yangsan, Korea
| | - Hyun Yul Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
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Lee MI, Jung YJ, Kim DI, Paik HJ, Lee S, Jung CS, Kim JY, Kim HY. Metastasis to breast from ovarian cancer and primary ovarian cancer concurrently diagnosis. Gland Surg 2021; 10:1806-1811. [PMID: 34164325 DOI: 10.21037/gs-20-640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Metastasis to breast from ovarian cancer is very rare, and it is very difficult to distinguish the primary breast cancer from the secondary one. In our case, a 61-year-old woman presented to the hospital with complaints of lower abdominal pain and distention. Abdominal-pelvic computed tomography (CT) imaging revealed a solid ovarian cystic tumor with numerable ascites in the abdominal cavity and disseminated peritoneal carcinomatosis. To confirm the presence of metastasis in other organs, a preoperative imaging studies including chest CT was performed. Chest CT imaging revealed an enlargement of both the axillary lymph nodes (r/o metastatic lymphadenopathy) and breast imaging studies (breast sonography and mammography) revealed masses penetrated the pectoralis major muscle in the left breast and metastatic lymphadenopathy in Lt axilla. The core needle biopsy result of breast lesion showed unknown origin carcinoma with micropapillary features and no psammoma bodies. So, we could not distinguish primary breast cancer and breast metastasis from ovarian cancer because breast metastasis from ovary could be contained psammoma bodies, generally. Although the possibility of primary breast cancer could not be ruled out absolutely, the neoadjuvant chemotherapy included Paclitaxel and Carboplatin is known to be effective for both breast and ovarian cancer. So after neoadjuvant chemotherapy, mastectomy concurrently with ovarian cancer surgery was performed. The histopathologic features of the ovaries and breast were similar and psammoma bodies also could be observed, which were not detected in previous core needle biopsied specimen. And lymph nodes from the breast and the ovaries also showed consistent findings. Combined with histopathologic report and medical records, the final diagnosis confirmed as a metastasis of ovarian cancer to breast. After surgery, the patient has continued with metastatic ovarian cancer specific treatment. Breast metastatic tumors must be distinguished from primary breast tumors to avoid any unnecessary surgery. It might be difficult to diagnosis precisely by using only core needle biopsy because of inadequate specimen volume. Although surgical resection may be effective for both diagnosis and palliative treatment, further studies focused on less invasive biopsy are needed for exact histopathological diagnosis.
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Affiliation(s)
- Moon Il Lee
- Breast Surgery, Hwamyoung Ilsin Christian Hospital, Pusan, Korea
| | - Youn Joo Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Dong Il Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hyun-June Paik
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seungju Lee
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Chang Shin Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jee Yeon Kim
- Department of Pathology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hyun Yul Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
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Choi JB, Kim DI, Paik HJ, Lee SJ, Jung CS, Kang SK, Jung YJ, Kim HY. Thyrotropin suppression therapy for papillary thyroid carcinoma with a huge recurred neck lymph node. Korean J Clin Oncol 2020; 16:145-147. [PMID: 36945712 PMCID: PMC9942732 DOI: 10.14216/kjco.20023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/13/2020] [Accepted: 10/26/2020] [Indexed: 11/07/2022]
Abstract
Differentiated thyroid cancer (DTC) originating from thyroid tissue is affected by thyrotropin (TSH). TSH suppression therapy is usually recommended after thyroidectomy in cases of DTC. A 57-year-old woman who harbored a very huge recurred lymph node underwent TSH suppression therapy because of the risk of surgical complications. After TSH suppression, the huge neck lymph node exhibited a response and decreased in size. She had been followed up for 144 months. TSH suppression therapy could be considered as an alternative treatment option in a recurred DTC patient with a high perioperative risk.
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Affiliation(s)
- Jung Bum Choi
- Department of Surgery, Pusan National University Hospital, Busan, Korea
| | - Dong-il Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hyun-june Paik
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seung Joo Lee
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Chang Shin Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seok Kyung Kang
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Youn Joo Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hyun Yul Kim
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
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13
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Jung YJ, Lee S, Kim HY, Paik HJ, Jung CS, Kim JY, Jung HJ, Lee S, Kim C. What predicts better prognosis in elderly breast cancer patients? Korean J Clin Oncol 2020; 16:52-56. [PMID: 36945300 PMCID: PMC9942720 DOI: 10.14216/kjco.20009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/29/2020] [Accepted: 06/11/2020] [Indexed: 11/07/2022]
Abstract
Purpose As we enter an aging society, the number of elderly patients with breast cancer is increasing. We assessed the prognostic factors for breast cancer recurrence or metastasis in patients over the age of 65 years by analyzing tumor characteristics and long-term clinical outcomes. Methods In this retrospective study, the data of 286 breast cancer patients aged 65 years and older, who underwent treatment at the Pusan National University Hospital and Pusan National University Yangsan Hospital from 2008 to 2014, were analyzed. The patients were divided into two groups: those with recurrence or metastasis and those without. Cox-regression model was used to analyze the risk factors for recurrence or metastasis. Kaplan-Meier method was used to analyze survival rates by the log-rank test. Results Among the 286 patients with invasive breast cancer, 43 patients (15.0%) had recurrence or distant metastasis during a median follow-up period of 61 months. Advanced stages of breast cancer and patients who are not adapted to endocrine therapy were associated with poor prognosis. Conclusion In this study, advanced stages of breast cancer and endocrine therapy were the prognostic factors for breast cancer recurrences or metastases. Early detection of elderly breast cancer generally increases the possibility of diagnosis at an earlier stage, which can lead to a better prognosis. Moreover, endocrine therapy should be administered to elderly patients who manifest favorable intrinsic subtypes of breast cancer.
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Affiliation(s)
- Youn Joo Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Seungju Lee
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Hyun Yul Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Hyun-June Paik
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Chang Shin Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Jee Yeon Kim
- Department of Pathology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Hyuk Jae Jung
- Department of Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Seokwon Lee
- Department of Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Choongrak Kim
- Department of Statistics, Pusan National University, Busan, Korea
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Abstract
We report the electro-optical (E/O) characteristics of the Langmuir-Blodgett film of poly(vinylidene fluoride with trifluoroethylene) copolymers. The structural origin of E/O response of nano LB films was discussed with the result of temperature dependent E/O response at a temperature range from 20 to 100 degrees C. Thermal hysteresis of E/O response and the ferroelectric-paraelectric phase transition were observed at a 20 monomolecular layers Langmuir-Blodgett films.
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Affiliation(s)
- C S Jung
- Department of Laser and Optical Information Engineering, Cheongju University, Cheongju, 360-764, Republic of Korea
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15
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Abstract
Glioblastoma (GBM) is the most malignant form of cerebral gliomas, and despite distinct progress in surgical resection, radiation and chemotherapy, the prognosis of patients with GBM is still very poor. In the past decades knowledge of genomics and proteomics and of diagnostic, prognostic, predictive and pharmakodynamic markers measured in cerebrospinal-fluid (CSF), serum, or tumor tissue biomarkers has improved. This review briefly compiles our concepts on diagnostic markers for GBM, focusing on the latest developments.
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Affiliation(s)
- C S Jung
- Department of Neurosurgery, Institute of Pathology, Ruprecht-Karls-University Heidelberg and Clinical Cooperation Unit Neuropathology, German Cancer Research Center, Germany.
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16
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Abstract
L-arginine is a source of nitric oxide (NO) that is cleaved from the terminal guanidino nitrogen atom by nitric oxide synthase (NOS). NO evokes, because of its free radical properties and affinity to heme, ferrous iron and cysteine, a wide spectrum of physiological and pathophysiological effects. For many years, different exogenous NOS inhibitors were used to elucidate the role of NOS and NO in health and disease. Later, endogenous NOS inhibitors, as asymmetric dimethylarginine (ADMA) were discovered. Endogenous inhibitors as ADMA are produced by post-translational methylation of L-arginine which is catalyzed by a family of protein N-methyltransferases (PRMT), using S-adenosylmethionine as a methyl group donor. ADMA is eliminated by dimethylarginine dimethylaminohydrolases (DDAH I or II). ADMA hydrolysis increases NOS activity and NO production. Furthermore, L-citrulline, a by-product of ADMA hydrolysis as well as of NO production by NOS, can in turn inhibit DDAH. Therefore, endogenous inhibition of NOS can be modified via different ways (1) changing the availability of L-arginine and/or of L-citrulline; (2) stimulating or inhibiting DDAH activity; (3) modifying methylation via regulating availability of adenosylmethionine; or (4) modifying PRMT activity. Research elucidating the role of NOS inhibitors in respect of delayed cerebral vasospasm after subarachnoid hemorrhage is summarized.
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Affiliation(s)
- C S Jung
- Department of Neurosurgery, Ruprecht-Karls-University Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
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Jung CS, Foerch C, Schänzer A, Heck A, Plate KH, Seifert V, Steinmetz H, Raabe A, Sitzer M. Serum GFAP is a diagnostic marker for glioblastoma multiforme. Brain 2007; 130:3336-41. [PMID: 17998256 DOI: 10.1093/brain/awm263] [Citation(s) in RCA: 160] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A serum marker for malignant cerebral astrocytomas could improve both differential diagnosis and clinical management of brain tumour patients. To evaluate whether the serum concentration of glial fibrillary acidic protein (GFAP) may indicate glioblastoma multiforme (GBM) in patients with single supratentorial space-occupying lesions, we prospectively examined 50 consecutive patients with histologically proven GBM, World Health Organization (WHO) grade IV, 14 patients with anaplastic astrocytoma (WHO grade III), 4 patients with anaplastic oligodendroglioma, 13 patients with diffuse astrocytoma (WHO grade II), 17 patients with a single cerebral metastasis and 50 healthy controls. Serum was taken from the patients before tumour resection or stereotactic biopsy. Serum GFAP levels were determined using a commercially available ELISA test and were detectable in 40 out of the 50 GBM patients (median: 0.18 microg/l; range: 0-5.6 microg/l). The levels were significantly elevated compared with those of the non-GBM tumour patients and healthy controls (median: 0 mug/l; range: 0-0.024 microg/l; P < 0.0001, respectively). Non-GBM tumour patients and all healthy subjects showed zero serum GFAP levels. There was a significant correlation between tumour volume (Spearman Rho, CC = 0.47; 95% confidence interval, 0.2-0.67; P < 0.001), tumour necrosis volume (CC = 0.49; 95% confidence interval, 0.2-0.72; P = 0.004), the amount of necrotic GFAP positive cells (CC = 0.61; 95% confidence interval, 0.29-0.81; P = 0.007) and serum GFAP level among the GBM patients. A serum GFAP level of >0.05 microg/l was 76% sensitive and 100% specific for the diagnosis of GBM in patients with a single supratentorial mass lesion in this series. Therefore, it can be concluded that serum GFAP constitutes a diagnostic biomarker for GBM. Future studies should investigate whether serum GFAP could also be used to monitor therapeutic effects and whether it may have a prognostic value.
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Affiliation(s)
- C S Jung
- Department of Neurosurgery, Ruprecht Karls University Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
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18
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Kim JI, Jung CS, Koh YH, Lee SH. Molecular, biochemical and histochemical characterization of two acetylcholinesterase cDNAs from the German cockroach Blattella germanica. Insect Mol Biol 2006; 15:513-22. [PMID: 16907838 DOI: 10.1111/j.1365-2583.2006.00666.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Full length cDNAs encoding two acetylcholinesterases (AChEs; Bgace1 and Bgace2) were cloned and characterized from the German cockroach, Blattella germanica. Sequence analyses showed that both genes possess all the typical features of ace, and that Bgace1 is orthologous to the insect ace1 whereas Bgace2 is to the insect ace2. Transcript level of Bgace1 was significantly higher (c. 10 fold) than that of Bgace2 in all 11 tissues examined, suggesting that Bgace1 likely encodes a predominant AChE. Multiple AChE bands were identified by native polyacrylamide gel electrophoresis and isoelectricfocusing from various tissue preparations, among which ganglia produced distinct two major and two minor AChE bands, indicative of the presence of at least two active AChEs. B. germanica AChEs appeared to be mainly localized in the central nervous system as demonstrated by histochemical activity staining, together with quantitative analysis of Bgace transcripts. Fluorescence in situ hybridization of the 1st thoracic ganglion confirmed that Bgace1 is predominantly transcribed and further showed that its transcript is found in almost entire region of inter or motor neurones including the cell bodies and axonal/dendritic branches. Bgace2 transcript is found only in the subset of neurones, particularly in the cell body. In addition, certain neurones were observed to express Bgace1 only.
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Affiliation(s)
- J I Kim
- School of Agricultural Biotechnology, Seoul National University, Seoul, Korea
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Abstract
The incidence of diagnosed xanthogranuloma of the sellar region is very low [1, 2, 5, 6]. We report about two cases 1) in a 57-year-old female and 2) in a 5-year-old boy. In both cases radiographic findings revealed an inhomogeneous, contrast enhancing sellar lesion. Histopathology showed the typical features of a xanthogranuloma of the sellar region with cholesterol clefts, lympho-plasmacellular infiltrates, marked hemosiderin deposits, multinucleated foreign body giant cells around cholesterol clefts, accumulation of macrophages and only small epithelial cell clusters [6]. As xanthogranuloma of the sellar region are rarely diagnosed we want to draw attention to this rather unusual diagnosis.
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Affiliation(s)
- C S Jung
- Department of Neurosurgery, Johann-Wolfgang Goethe University Frankfurt, Frankfurt, Germany.
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20
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Abstract
Lymphoma as primary infiltration of the skull base, especially the clivus, is unusual and rare. However, increasing incidence of atypical lymphoma manifestations have been reported. As cranial base surgery becomes more common, it is important to be aware of lymphoma as a possible differential diagnosis of clivus lesions. This case presents a primary malignant lymphoma of the clivus, histologically confirmed after intra-operative MRI-guided transnasal-transsphenoidal biopsy.
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Affiliation(s)
- C S Jung
- Department of Neurosurgery, Johann-Wolfgang Goethe University, Frankfurt, Germany.
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21
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Abstract
This study was carried out to determine the cholesterol removal rate and resulting changes in flavor, fatty acid and bitter amino acid production in reduced-cholesterol Cheddar cheese, made by cream separation followed by 10% beta-cyclodextrin (beta-CD) treatment. The cholesterol removal from the cheese was 92.1%. The production of short-chain free fatty acids (FFAs) increased the ripening time in control and cream-treated cheeses. The quantity of short-chain FFAs released between treatments during ripening was different, while not much difference was found in the production of neutral volatile compounds in the samples. Reduced-cholesterol cheese produced much higher levels of bitter amino acids than the control. In sensory analysis, the texture score of control Cheddar cheese increased significantly with ripening time; however, that of the cream treatment group decreased dramatically with ripening time. On the basis of our results, we conclude that the cheese made from beta-CD-treated cream had a higher rate of cholesterol removal and ripened rapidly.
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Affiliation(s)
- H S Kwak
- Department of Food Science and Technology, Sejong University, 98 Kunja-dong, Kwangjin-ku, Seoul, 143-747, Korea.
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Zimmermann M, Jung CS, Vatter H, Raabe A, Seifert V. Effect of endothelin-converting enzyme inhibitors on big endothelin-1 induced contraction in isolated rat basilar artery. Acta Neurochir (Wien) 2002; 144:1213-9. [PMID: 12434178 DOI: 10.1007/s00701-002-1000-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The aim of this study was to investigate whether blocking functional endothelin-converting enzyme (ECE) activity may offer a new approach to inhibit the development of cerebral vasopasm after subarachnoid hemorrhage (SAH) by preventing transformation of big Endothelin-1 (big ET-1) to vasoactive Endothelin-1 (ET-1). METHODS In vitro, the effect of potential ECE inhibitors was determined by measurement of isometric contractions, induced by big ET-1, in isolated rat basilar arteries. Endothelium intact (E+) and de-endothelialized (E-) segments were examined after pre-incubated with the putative ECE inhibitors: Phosphoramidon (10(-4) M), Captopril (10(-3) M and 10(-4) M) and [(22)D-Val] big ET-1 (16-38) (10(-5) M and 10(-6) M). RESULTS Application of 10(-4) M Phosphoramidon resulted in a statistically significant decrease in big ET-1 induced contraction in endothelium intact (E+) and de-endothelialized (E-) segments; 10(-3) M Captopril in E- segments caused a statistically significant inhibitory effect; 10(-4) M and 10(-3) M Captopril in E+ segments showed no statistically significant effect; 10(-5) M and 10(-6) M [(22)D-Val] big ET-1 (16-38) in E- segments produced no statistically significant effect. The application of 10(-6) M [(22)D-Val] big ET-1 (16-38) in E+ segments caused increased contractions as shown by the shift to the left of the concentration-effect curve (CEC). CONCLUSION The present study indicates the existence of functional ECE activity in rat basilar artery, which is different in the endothelium and the smooth muscle layer. This ECE-activity could be inhibited by Captopril and Phosporamidon, suggesting a potency for prevention and therapy of cerebral vasospasm. However, the structural analogue of big ET-1, [(22)D-Val] big ET-1 (16-38), was ineffective in reducing big ET-1 induced vasoconstriction and rather increased contraction in E+ vessels. Therefore further studies of the biochemical nature of the functional relevant cerebrovascular ECE activity are required for better understanding and development of other efficient ECE inhibitors.
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Affiliation(s)
- M Zimmermann
- Department of Neurosurgery, Johann Wolfgang Goethe - University Frankfurt/Main, Germany
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Jung CS, Lee SJ, Paik SS, Bai SH. Run-up of gamma-aminobutyric acid(C) responses in catfish retinal cone-horizontal cell axon-terminals is modulated by protein kinase A and C. Neurosci Lett 2000; 282:53-6. [PMID: 10713394 DOI: 10.1016/s0304-3940(00)00864-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Using whole-cell voltage-clamp techniques, we investigated the protein kinase modulation of gamma-aminobutyric acid(C) (GABA(C))-activated currents relating to run-up regulation in dissociated cone-horizontal cell (HC) axon-terminals from catfish retina. GABA induced an inward chloride current in cells voltage-clamped at -70 mV. With repetitive applications of 10 microM GABA, the peaks of the GABA responses increased up to approximately 135% of the control responses during a period of 10 min. Intracellular application of forskolin, an adenylate cyclase activator, decreased the run-up of GABA(C) responses. H8 dihydrochloride, a cAMP inhibitor, enhanced this run-up to 190% of the control responses. 1-oleoyl-2-acetyl-sn-glycerol, a protein kinase C activator, accelerated the run-up of GABA(C) responses. GF 109203X, a PKC inhibitor, decreased the run-up. These results suggest that retinal GABA(C) responses in cone-HC axon-terminals are modulated by both protein kinase A and C.
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Affiliation(s)
- C S Jung
- Department of Physics, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Socho-gu, Seoul, South Korea
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Abstract
Whole cell voltage-clamp recordings were performed on isolated terminals and somata from catfish retina to compare the distribution of excitatory and inhibitory receptors in both structures. Saturating concentrations of glutamate or kainate produced small currents in axon terminals, averaging less than 8% of the current evoked in the soma. In contrast, application of high concentrations of gamma-aminobutyric acid (GABA) produced approximately similar current amplitudes in both structures. Based on estimates of membrane surface area, GABA-induced current densities were around 0.05 pA/microm2 for both structures. The GABA-activated current in the axon terminal was not blocked by bicuculline or SR95531, but was completely inhibited by picrotoxin. Baclofen did not mimic the GABA effect, but trans-4-aminocrotonic acid (TACA, 300 microM) and muscimol (1 mM) elicited currents of 100 and 40 pA, respectively. These results suggest that the axon terminals of cone-horizontal cells possess GABA(C) receptors at a high density, do not possess GABA(A) or GABA(B) receptors, and have few glutamate receptors. The GABA(C) receptors could function as postsynaptic receptors in the inner plexiform layer or as autoreceptors.
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Affiliation(s)
- C S Jung
- Department of Physics and Biophysics, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
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25
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Abstract
Whole-cell voltage clamp in the retinal slice and intracellular current clamp in the intact retina were used to study inhibitory interactions in the inner plexiform layer. Picrotoxin or strychnine reduced inhibitory, light-evoked currents in a majority of ganglion cells. However, in nearly a third of the ganglion cells, each of these antagonists enhanced the inhibitory synaptic current. All inhibitory current was blocked by the addition of the other antagonist. This indicates a cross-inhibition between GABAergic and glycinergic feedforward pathways. Blocking of GABAARs with SR95531 shortened the time course of both excitatory and inhibitory synaptic currents in ganglion cells. Application of picrotoxin, which blocked both GABAARs and GABACRs, produced the opposite effect. Recordings in the intact retina indicated that the light responses of ON bipolar cells, sustained ON, and transient ON-OFF third-order neurons were all made more transient by SR95531 and made more sustained by picrotoxin. The data suggest that a GABAC feedback pathway to bipolar cells makes light responses more phasic and that this feedback is inhibited through a GABAAR pathway. Consequently, the balance between GABAAR and GABACR inhibition regulates the time course of inputs to ganglion cells.
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Affiliation(s)
- J Zhang
- Department of Physiology, School of Medicine, State University of New York, Buffalo 14214, USA
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