1
|
Baek JM, Cha H, Moon Y, Kim L, Kwak SM, Park ES, Nam HS. A Systemic Immune Inflammation Index and PD-L1 (SP142) Expression as a Potential Combined Biomarker of the Clinical Benefit of Chemo-Immunotherapy in Extensive-Stage Small-Cell Lung Cancer. J Clin Med 2024; 13:1521. [PMID: 38592329 PMCID: PMC10932321 DOI: 10.3390/jcm13051521] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/02/2024] [Accepted: 03/03/2024] [Indexed: 04/10/2024] Open
Abstract
Background: No studies have identified combined biomarkers that may be more reasonable for the assessment of current chemo-immunotherapy in patients with extensive stage small-cell lung cancer (ES-SCLC). Methods: This study was conducted to investigate a combined biomarker with prognostic or predictive value in ES-SCLC. We determined the best independent prognostic biomarker among the four complete blood-count-derived inflammatory biomarkers (CBC-IBs). Subsequently, we analyzed the prognostic or predictive value of combining this independent CBC-IB with PD-L1 (SP142) expression. We prospectively assessed the SP142 analyses in tumor samples at diagnosis. Results: All in all, 55 patients with ES-SCLC were classified into four groups according to the systemic immune inflammation index (SII) (low/high) and SP142 (positive/negative). The best survival was observed in the low-SII/ SP142-positive group, whereas the worst survival was observed in the high-SII/SP142-negative group (p = 0.002). The combined SII-SP142 biomarker was better for predicting both survival and disease progression in patients with ES-SCLC. Conclusions: The combined SII-SP142 biomarker can be readily and universally obtained at a low cost in clinical practice, without requiring advanced genomics technology or specialized expertise. Although further studies are needed to confirm that the combined SII-SP142 biomarker is widely applicable, it should help clinicians to identify the best patients for combined chemotherapy with atezolizumab in ES-SCLC.
Collapse
Affiliation(s)
- Jong-Min Baek
- Department of General Surgery, Yeouido ST. Mary’s Hospital, The Catholic University of Korea, Seoul 07345, Republic of Korea;
| | - Hyungkeun Cha
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of Korea; (H.C.); (S.M.K.); (E.S.P.)
| | - Yeonsook Moon
- Department of Laboratory Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of Korea;
| | - Lucia Kim
- Department of Pathology, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of Korea;
| | - Seung Min Kwak
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of Korea; (H.C.); (S.M.K.); (E.S.P.)
| | - Eun Sun Park
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of Korea; (H.C.); (S.M.K.); (E.S.P.)
| | - Hae-Seong Nam
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of Korea; (H.C.); (S.M.K.); (E.S.P.)
| |
Collapse
|
2
|
Jeong BH, Lee SH, Kim HH, Yoon HI, Eom JS, Park YS, Cho J, Lee T, Kim SJ, Cho HJ, Park CK, Ko Y, Kwon YS, Kim C, Ji W, Choi CM, Seo KH, Nam HS, Kim H. Trends and an Online Survey on the Use of Rigid Bronchoscopy in Korea. J Korean Med Sci 2023; 38:e13. [PMID: 36647216 PMCID: PMC9842492 DOI: 10.3346/jkms.2023.38.e13] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 10/20/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Although almost all interventional pulmonologists agree that rigid bronchoscopy is irreplaceable in the field of interventional pulmonology, less is known about the types of diseases that the procedure is used for and what difficulties the operators face during the procedure. The purpose of this study is to evaluate what diseases rigid bronchoscopy is used for, whether it is widely used, and what challenges the operators face in Korea. METHODS We enrolled 14 hospitals in this retrospective cohort of patients who underwent rigid bronchoscopy between 2003 and 2020. An online survey was conducted with 14 operators to investigate the difficulties associated with the procedure. RESULTS While the number of new patients at Samsung Medical Center (SMC) increased from 189 in 2003-2005 to 468 in 2018-2020, that of other institutions increased from 0 to 238. The proportion of SMC patients in the total started at 100% and steadily decreased to 59.2%. The proportion of malignancy as the indication for the procedure steadily increased from 29.1% to 43.0%, whereas post-tuberculous stenosis (25.4% to 12.9%) and post-intubation stenosis (19.0% to 10.9%) steadily decreased (all P for trends < 0.001). In the online survey, half of the respondents stated that over the past year they performed less than one procedure per month. The fewer the procedures performed within the last year, the more likely collaboration with other departments was viewed as a recent obstacle (Spearman correlation coefficient, rs = -0.740, P = 0.003) and recent administrative difficulties were encountered (rs = -0.616, P = 0.019). CONCLUSION This study demonstrated that the number of patients undergoing rigid bronchoscopy has been increasing, especially among cancer patients. For this procedure to be used more widely, it will be important for beginners to systematically learn about the procedure itself as well as to achieve multidisciplinary consultation.
Collapse
Affiliation(s)
- Byeong-Ho Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Haak Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hwan Hee Kim
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ho Il Yoon
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jung Seop Eom
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Young Sik Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jaeyoung Cho
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Taehoon Lee
- Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Seung Joon Kim
- Division of Pulmonology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyeong Jun Cho
- Division of Pulmonology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chan Kwon Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yousang Ko
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Yong-Soo Kwon
- Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea
| | - Changhwan Kim
- Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Wonjun Ji
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang-Min Choi
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ki-Hyun Seo
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Hae-Seong Nam
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Hojoong Kim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| |
Collapse
|
3
|
Ryu WK, Cha H, Park MH, Kim JS, Choi JS, Kim L, Lee KH, Nam HS. Efficacy of crizotinib retreatment after crizotinib-related interstitial lung disease in a patient with ROS1-rearranged advanced lung adenocarcinoma: A case report and potential crizotinib retreatment strategy. Front Oncol 2022; 12:900966. [PMID: 36330497 PMCID: PMC9625112 DOI: 10.3389/fonc.2022.900966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/30/2022] [Indexed: 11/24/2022] Open
Abstract
Crizotinib is an oral selective small-molecular tyrosine kinase inhibitor (TKI) that suppress the activity of anaplastic lymphoma kinase (ALK) and ROS1 kinases, as well as mesenchymal-epithelial transition. The cumulative clinical trials in patients with advanced ALK- or ROS1-rearrangement NSCLC indicate that crizotinib has significant antitumor activity and a tolerable safety profile, with mild or moderate adverse events of visual disorders, diarrhea, nausea, and vomiting. As with other TKIs, however, the occurrence of crizotinib-related interstitial lung disease (crizotinib-ILD) remains a major clinical dilemma that can lead to the permanent discontinuation of TKI during cancer treatment. When there is no suitable alternative therapy for patients who develop crizotinib-ILD, some clinicians have reported successful crizotinib retreatment in cases of ALK-rearrangement NSCLC. Unfortunately, there are no specific guidelines for the treatment or retreatment of TKI-related ILD. We herein report the first successful crizotinib retreatment after crizotinib-ILD in a patient with ROS1-rearranged NSCLC, and suggest a retreatment strategy after crizotinib-ILD based on a literature review.
Collapse
Affiliation(s)
- Woo Kyung Ryu
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea
| | - Hyungkeun Cha
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea
| | - Mi Hwa Park
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea
| | - Jung Soo Kim
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea
| | - Jeong-Seok Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea
| | - Lucia Kim
- Department of Pathology, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea
| | - Kyung-Hee Lee
- Department of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea
| | - Hae-Seong Nam
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea
- *Correspondence: Hae-Seong Nam,
| |
Collapse
|
4
|
Liu Q, Xu JY, Xu YH, Chen M, Deng LC, Wu JP, Zhou T, Zhang LQ, Tan J, Pu XX, Shang YL, Hua J, Li YQ, Cai W, Gu YL, Peng XC, Chan PC, Jabbour SK, Nam HS, Hua D. Efficacy and safety of apatinib as second or later-line therapy in extensive-stage small cell lung cancer: a prospective, exploratory, single-arm, multi-center clinical trial. Transl Lung Cancer Res 2022; 11:832-844. [PMID: 35693282 PMCID: PMC9186180 DOI: 10.21037/tlcr-22-313] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/18/2022] [Indexed: 11/26/2022]
Abstract
Background A paucity of strategies exist for extensive-stage small cell lung cancer (ES-SCLC) patients who fail the first-line chemotherapy. Apatinib is a tyrosine kinase inhibitor (TKI) that selectively inhibits vascular endothelial growth factor receptor-2 (VEGFR-2), which has been demonstrated to have active anti-tumor activity in ES-SCLC when used only or combined with PD-1 inhibitors or chemotherapy with good tolerance. However, the efficacy and safety of apatinib monotherapy is unclear in second-line or beyond treatment of ES-SCLC. Methods In this prospective, exploratory, single-arm, multi-center study, eligible patients were aged 18 years or older with histologically confirmed ES-SCLC, and had progressed on, or were intolerant to previous systemic treatment. Patients received apatinib 500 mg (orally qd, every 4 weeks a cycle). The efficacy was assessed after 1 cycle and then every 2 cycles based on computed tomography imaging per the Response Evaluation Criteria in Solid Tumors (RECIST, version 1.1). The primary endpoint was progression-free survival (PFS). The adverse events (AEs) were assessed per the National Cancer Institute Common Terminology Criteria for Adverse Events 4.0 (NCI-CTCAE 4.0). This study is registered in the Chinese Clinical Trial Registry, number ChiCTR-OPC-17013964. Results From 28 July 2017 to 21 June 2019, 62 patients were screened for eligibility, among whom 57 patients were available for efficacy and safety analysis. The objective response rate (ORR) was 14.3% and disease control rate (DCR) was 79.6%. The median PFS was 5.6 months [95% confidence interval (CI): 3.3-8.0 months] and the median overall survival (OS) was 11.2 months (95% CI: 7.5-24.0 months). Among the participants who received apatinib as second-line treatment, the median PFS and OS were 6.1 months (95% CI: 2.6-7.6 months) and 12.0 months (95% CI: 7.9 months to not reached), respectively. The most common AEs of all grades were anemia (36.8%), hypertension (33.3%), fatigue (31.6%), blood bilirubin increased (22.8%), elevated transaminase (19.3%), and hand-foot syndrome (17.54%). Grade 3 AEs included 2 (3.5%) cases of hypertension and 1 (1.8%) case of fatigue. No grade 4/5 AEs were observed. Conclusions Apatinib showed encouraging anti-tumor activity in pretreated ES-SCLC patients with tolerable toxicities. Further larger scale studies are warranted to demonstrate the efficacy of apatinib.
Collapse
Affiliation(s)
- Quan Liu
- Department of Medical Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Juan-Ying Xu
- Department of Oncology, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Ye-Hong Xu
- Department of Respiratory Medicine, Anhui Provincial Cancer Hospital, Hefei, China
| | - Meng Chen
- Department of Radiation Oncology, Xuzhou Central Hospital, Xuzhou, China
| | - Li-Chun Deng
- Department of Oncology, Jiangyin People’s Hospital, Wuxi, China
| | - Jian-Ping Wu
- Department of Oncology, Changshu No. 1 People’s Hospital, Suzhou, China
| | - Tong Zhou
- Department of Medical Oncology, Changzhou Tumor Hospital, Changzhou, China
| | - Li-Qin Zhang
- Department of Respiratory Medicine, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Jie Tan
- Department of Oncology, Suzhou Municipal Hospital, Suzhou, China
| | - Xing-Xiang Pu
- Department of Medical Oncology, Hunan Cancer Hospital, Changsha, China
| | - Yu-Long Shang
- Department of Respiratory Medicine, Xuzhou Cancer Hospital, Xuzhou, China
| | - Jun Hua
- Cardio-Thoracic Surgery, The Second People’s Hospital of Wuxi, Wuxi, China
| | - Yuan-Qin Li
- Department of Respiratory Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Wei Cai
- Department of Oncology, The First People’s Hospital of Wujiang, Suzhou, China
| | - Yu-Lan Gu
- Department of Oncology, Changshu No. 2 People’s Hospital, Suzhou, China
| | - Xing-Chen Peng
- Department of Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Po-Chung Chan
- Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong, China
| | - Salma K. Jabbour
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
| | - Hae-Seong Nam
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Dong Hua
- Department of Oncology, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, China
| |
Collapse
|
5
|
Ryu WK, Moon Y, Park MH, Lim JH, Kim YS, Lee KH, Kwak SM, Kim C, Nam HS. A Preliminary Study on the Prognostic Impact of Neutrophil to Lymphocyte Ratio of the Bronchoalveolar Lavage Fluid in Patients with Lung Cancer. Diagnostics (Basel) 2021; 11:diagnostics11122201. [PMID: 34943437 PMCID: PMC8700371 DOI: 10.3390/diagnostics11122201] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/10/2021] [Accepted: 11/23/2021] [Indexed: 12/25/2022] Open
Abstract
The cumulative results indicate that the neutrophil to lymphocyte ratio of peripheral blood (pbNLR) is a useful prognostic factor in patients with various cancers. In contrast to peripheral blood, the bronchoalveolar lavage (BAL) fluid is in direct contact with the lung lesion. However, no study has reported on the clinical utility of the NLR of BAL fluid (bNLR) for patients with lung cancer. To investigate the clinical utility of the bNLR as a prognostic factor in patients with lung cancer, we conducted a retrospective review of the prospectively collected data. A total of 45 patients were classified into high bNLR (n = 29) and low bNLR (n = 16) groups. A high pbNLR and high bNLR were associated with a shorter overall survival (p < 0.001 and p = 0.011, respectively). A multivariable analysis confirmed that ECOG PS (p = 0.023), M stage (p = 0.035), pbNLR (p = 0.008), and bNLR (p = 0.0160) were independent predictors of overall survival. Similar to the pbNLR, a high bNLR value was associated with a poor prognosis in patients with lung cancer. Although further studies are required to apply our results clinically, this is the first study to show the clinical value of the bNLR in patients with lung cancer.
Collapse
Affiliation(s)
- Woo Kyung Ryu
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Korea; (W.K.R.); (M.H.P.); (J.H.L.); (S.M.K.)
| | - Yeonsook Moon
- Department of Laboratory Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Korea;
| | - Mi Hwa Park
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Korea; (W.K.R.); (M.H.P.); (J.H.L.); (S.M.K.)
| | - Jun Hyeok Lim
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Korea; (W.K.R.); (M.H.P.); (J.H.L.); (S.M.K.)
| | - Young Sam Kim
- Department of Thoracic Surgery, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Korea;
| | - Kyung-Hee Lee
- Department of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Korea;
| | - Seung Min Kwak
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Korea; (W.K.R.); (M.H.P.); (J.H.L.); (S.M.K.)
| | - Changhwan Kim
- Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju 63241, Korea
- Correspondence: (C.K.); (H.-S.N.)
| | - Hae-Seong Nam
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Korea; (W.K.R.); (M.H.P.); (J.H.L.); (S.M.K.)
- Correspondence: (C.K.); (H.-S.N.)
| |
Collapse
|
6
|
Lee YS, Lim JH, Ryu W, Park MH, Kim L, Kim K, Kim WY, Nam HS. The clinical impact of three validated PD-L1 immunohistochemistry assays as a prognostic factor in small cell lung cancer. Transl Lung Cancer Res 2021; 10:2539-2550. [PMID: 34295660 PMCID: PMC8264325 DOI: 10.21037/tlcr-21-165] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/05/2021] [Indexed: 12/14/2022]
Abstract
Background Evidence of the clinical impact of programmed death-ligand 1 (PD-L1) expression in small cell lung cancer (SCLC) is scarce and conflicting, even though atezolizumab became the first PD-L1 inhibitor approved by the US Food and Drug Administration (FDA) in recent years for the initial treatment of extensive-stage (ES)-SCLC. Methods We investigated PD-L1 expression in SCLC tumors using the three validated PD-L1 immunohistochemistry (IHC) assays (SP263, SP142, and 22C3) and assessed the correlation between PD-L1 expression and clinicopathological factors to determine the prognostic value of PD-L1 expression. The three PD-L1 IHC analyses were prospectively used to assess tumor samples of patients with SCLC at diagnosis. Results Of the total of 59 patients, 47 patients received the active treatment beyond platinum-based chemotherapy at our institution. PD-L1 expression was positive in 39.0% with SP263, 37.3% with SP142, and 22.0% with 22C3. In a univariate analysis, the positive result of at least one of the three PD-L1 assays and the positive result of the SP142 assay were associated with longer overall survival (OS). A multivariable analysis confirmed that performance status, stage, and the SP142 assay were independent predictors of OS. In subgroup analysis, these results revealed more significant prognostic factors in ES than in limited-stage (LS). In patients with SCLC, especially those with ES, the expression of the SP142 assay is a significant independent prognostic factor. Conclusions Although these results need to be further validated in larger cohorts, this information will benefit clinicians and patients in determining the immunotherapy for patients with ES-SCLC.
Collapse
Affiliation(s)
- Yong Seok Lee
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jun Hyeok Lim
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Wookyung Ryu
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Mi Hwa Park
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Lucia Kim
- Department of Pathology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Kang Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheonsarang Hospital, Incheon, Korea
| | - Woo Youl Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheonsarang Hospital, Incheon, Korea
| | - Hae-Seong Nam
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| |
Collapse
|
7
|
Jang EC, Ryu W, Woo SY, Kim JS, Lee KH, Ryu JS, Kwak SM, Lee HL, Nam HS. Diagnosis of pulmonary cement embolism using only the bone window setting on computed tomography: a case report. J Int Med Res 2021; 48:300060520926005. [PMID: 32466703 PMCID: PMC7263131 DOI: 10.1177/0300060520926005] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Pulmonary cement embolism (PCE) is one of several complications of percutaneous vertebroplasty and kyphoplasty. Generally, PCE can be easily diagnosed based on typical chest radiograph findings such as single or multiple radiographically dense opacities with a tubular or branch shape in the lung field along with a recent history of percutaneous vertebroplasty or kyphoplasty. These findings can be alarming and may be encountered on routine chest radiographs, even in asymptomatic patients. One study showed that PCEs that were not visualized on chest radiograph were also not shown on chest computed tomography. However, we encountered a patient with dyspnea who had normal chest radiograph findings but was diagnosed with PCE through only the bone window setting on chest computed tomography. The present case will be beneficial to all physicians examining older patients with dyspnea.
Collapse
Affiliation(s)
- Eun Chul Jang
- Department of Internal Medicine, The Leon Wiltse Memorial Hospital, Anyang, Korea
| | - Wookyung Ryu
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Seong Yong Woo
- Department of Internal Medicine, Daerim St. Mary's Hospital, Seoul, Korea
| | - Jung Soo Kim
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Kyung-Hee Lee
- Department of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Jeong-Seon Ryu
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Seung Min Kwak
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Hong Lyeol Lee
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Hae-Seong Nam
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| |
Collapse
|
8
|
Bae S, Ahn SS, Kim BM, Kim DJ, Kim YD, Nam HS, Heo JH, Lee SK. Hyperattenuating lesions after mechanical thrombectomy in acute ischaemic stroke: factors predicting symptomatic haemorrhage and clinical outcomes. Clin Radiol 2020; 76:80.e15-80.e23. [PMID: 32950255 DOI: 10.1016/j.crad.2020.08.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 08/19/2020] [Indexed: 11/26/2022]
Abstract
AIM To evaluate the clinical significance of hyperattenuating lesions on CT after mechanical thrombectomy for acute ischaemic stroke, and to identify imaging factors that predict symptomatic haemorrhage and unfavourable outcomes. MATERIALS AND METHODS Seventy-eight patients with acute ischaemic stroke in the anterior circulation who underwent mechanical thrombectomy were evaluated. All patients underwent post-interventional unenhanced computed tomography (CT) within 24 h and follow-up CT or magnetic resonance imaging (MRI) within 7 days. Baseline characteristics and clinical outcomes were compared between patients with and without hyperattenuating lesions. In patients with hyperattenuating lesions, clinical and imaging factors that predict symptomatic haemorrhage and unfavourable outcomes were determined. RESULTS Fifty-six of 78 patients (71.8%) demonstrated hyperattenuating lesions on post-interventional CT. Patients with hyperattenuating lesions showed lower Alberta Stroke Program Early CT score (ASPECTS), persistent/symptomatic haemorrhage, and unfavourable outcomes than those without. In patients with hyperattenuating lesions, larger hyperattenuating lesion volume (>21.3 ml; OR, 55.60, p<0.001) and perilesional oedema (OR, 46.04, p=0.015) were independent factors predicting symptomatic haemorrhage. Older age (OR, 1.2, p=0.006) and lower ASPECTS (OR, 0.45, p=0.046) were independent factors predicting unfavourable outcomes in patients with hyperattenuating lesions. Adding the volume of the hyperattenuating lesion to age and ASPECTS increased the predictive performance of unfavourable outcomes (area under the curve 0.874 versus 0.934, p=0.043). CONCLUSIONS Hyperattenuating lesions on post-interventional CT are associated with increased risk of symptomatic haemorrhage and unfavourable outcomes. Larger hyperattenuating lesion volume is an independent factor of symptomatic haemorrhage and it has added predictive value for unfavourable outcomes.
Collapse
Affiliation(s)
- S Bae
- Department of Radiology, National Health Insurance Service Ilsan Hospital, Goyang 10444, South Korea
| | - S S Ahn
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science and Center for Clinical Image Data Science, Yonsei University College of Medicine, Seoul 03722, South Korea.
| | - B M Kim
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science and Center for Clinical Image Data Science, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - D J Kim
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science and Center for Clinical Image Data Science, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - Y D Kim
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - H S Nam
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - J H Heo
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - S-K Lee
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science and Center for Clinical Image Data Science, Yonsei University College of Medicine, Seoul 03722, South Korea
| |
Collapse
|
9
|
Cho BH, Cheon K, Lee KY, Jung YH, Han SW, Park JH, Choi HY, Cho HJ, Park HJ, Nam HS, Heo JH, Lee HS, Kim S, Kim YD. Association between body mass index and stroke severity in acute ischaemic stroke with non-valvular atrial fibrillation. Eur J Neurol 2020; 27:1672-1679. [PMID: 32392368 DOI: 10.1111/ene.14304] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 04/30/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND PURPOSE The objective of this study was to investigate the association between body mass index (BMI) and both initial stroke severity at presentation and functional outcomes after acute ischaemic stroke (AIS) in patients with non-valvular atrial fibrillation (NVAF). METHODS Patients were categorized on the basis of their BMI into underweight (BMI <18.5, n = 111), normal (18.5 ≤ BMI <25, n = 1036) and overweight to obese (BMI ≥25, n = 472) groups. Initial stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) score and functional outcomes were assessed using the modified Rankin Scale score at discharge. The differences in stroke severity and functional outcomes were compared between groups using robust log-linear regression with a Poisson distribution and binary logistic regression analysis. RESULTS A total of 1619 AIS patients with NVAF from six hospitals were included. Compared with the NIHSS scores [median 5, interquartile range (IQR) 2-14] of normal-weight patients, the NIHSS scores (median 9, IQR 4-19) of underweight patients were more likely to be higher, whereas those of overweight to obese patients were lower (median 4, IQR 1-12) (P < 0.001). In terms of functional outcomes after stroke, underweight patients had a higher risk of poor functional outcomes (odds ratio 1.78, 95% confidence interval 1.09-2.56, P = 0.01) but overweight to obese patients had no significant difference in functional outcomes compared with normal-weight patients. CONCLUSION An inverse association was found between BMI and stroke severity in AIS patients with NVAF. This suggests the presence of an obesity paradox for short-term outcomes in patients with NVAF.
Collapse
Affiliation(s)
- B-H Cho
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.,Department of Neurology, Gangnam Severance Hospital, Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
| | - K Cheon
- Department of Neurology, Gangnam Severance Hospital, Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
| | - K-Y Lee
- Department of Neurology, Gangnam Severance Hospital, Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
| | - Y H Jung
- Department of Neurology, Gangnam Severance Hospital, Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea.,Department of Neurology, Changwon Fatima Hospital, Changwon, Korea
| | - S W Han
- Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - J H Park
- Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - H-Y Choi
- Department of Neurology, Kyung Hee University School of Medicine, Kyung Hee University Hospital, Gangdong, Seoul, Korea
| | - H-J Cho
- Department of Neurology, Pusan National University Hospital, Pusan National University College of Medicine and Biomedical Research Institute, Busan, Korea
| | - H J Park
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.,Department of Neurology, Brain Research Institute, Keimyung University School of Medicine, Daegu, Korea
| | - H S Nam
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - J H Heo
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - H S Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
| | - S Kim
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
| | - Y D Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
10
|
Ryu JS, Lim JH, Lee MK, Lee SJ, Kim HJ, Kim MJ, Park MH, Kim JS, Nam HS, Park N, Yong SJ. Feasibility of Bronchial Washing Fluid-Based Approach to Early-Stage Lung Cancer Diagnosis. Oncologist 2019; 24:e603-e606. [PMID: 31036768 DOI: 10.1634/theoncologist.2019-0147] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 03/30/2019] [Accepted: 04/10/2019] [Indexed: 12/22/2022] Open
Abstract
A blood-based approach such as circulating tumor DNA remains challenging in diagnosis for early-stage disease. Bronchial washing (BW) is a minimally invasive procedure that yields fluids that may contain tumor DNA. Therefore, we prospectively enrolled 12 patients with early-stage non-small cell lung cancer without endoscopically visible tumors. Somatic mutations were analyzed using ultra-deep next-generation sequencing in 48 paired specimens (primary tumor tissue, normal tissue, BW supernatant, and BW precipitate). In primary tumors, 130 missense mutations/indels (5-16 per patient) and 20 driver mutations (0-3 per patient) were found. Concordance of driver mutations between BW fluids and primary tumors was 95.0%. The allele frequencies for missense mutations/indels in BW supernatants significantly correlated with those in primary tumors and were higher than those in BW precipitates. These findings suggest that BW supernatants are reflective of tumor-associated mutations and could be used for early-stage lung cancer diagnosis.
Collapse
Affiliation(s)
- Jeong-Seon Ryu
- Department of Internal Medicine, Inha University Hospital, Incheon, South Korea
| | - Jun Hyeok Lim
- Department of Internal Medicine, Inha University Hospital, Incheon, South Korea
| | - Myoung Kyu Lee
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | | | - Hyun-Jung Kim
- Department of Internal Medicine, Inha University Hospital, Incheon, South Korea
| | - Min Jeong Kim
- Department of Internal Medicine, Inha University Hospital, Incheon, South Korea
| | - Mi Hwa Park
- Department of Internal Medicine, Inha University Hospital, Incheon, South Korea
| | - Jung Soo Kim
- Department of Internal Medicine, Inha University Hospital, Incheon, South Korea
| | - Hae-Seong Nam
- Department of Internal Medicine, Inha University Hospital, Incheon, South Korea
| | - Nuri Park
- Department of Internal Medicine, Inha University Hospital, Incheon, South Korea
| | - Seok Joong Yong
- Department of Internal Medicine, Inha University Hospital, Incheon, South Korea
| |
Collapse
|
11
|
Lim JH, Ryu JS, Cho SY, Kim HJ, Jeon SH, Kim JS, Nam HS, Cho JH, Kwak SM, Lee HL. Small-cell Lung Cancer Presenting as Fatal Pulmonary Hemorrhage. Open Med (Wars) 2018; 13:64-66. [PMID: 29607415 PMCID: PMC5874507 DOI: 10.1515/med-2018-0009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 01/29/2018] [Indexed: 12/20/2022] Open
Abstract
Small-cell lung cancer (SCLC) is a lung cancer histological subtype unusual in its favorable response to cytotoxic chemotherapy. Life-threatening manifestations at presentation are rarely reported and should be an important clinical concern. We report a case of a 63-year-old man presenting with rapid-onset refractory severe thrombocytopenia, development of massive hemoptysis, and death from respiratory failure. This case provides clinicians a reference for this unusual presentation and carries clinical implications for managing SCLC patients.
Collapse
Affiliation(s)
- Jun Hyeok Lim
- Department of Internal Medicine, Inha University Hospital, 27, Inhang-Ro, Jung-Gu, Incheon, 22332, Republic of Korea
| | - Jeong-Seon Ryu
- Department of Internal Medicine, Inha University Hospital, 27, Inhang-Ro, Jung-Gu, Incheon, 22332, Republic of Korea
| | - Sang Yong Cho
- Department of Internal Medicine, Inha University Hospital, 27, Inhang-Ro, Jung-Gu, Incheon, 22332, Republic of Korea
| | - Hyun-Jung Kim
- Department of Internal Medicine, Inha University Hospital, 27, Inhang-Ro, Jung-Gu, Incheon, 22332, Republic of Korea
| | - Sang Hoon Jeon
- Department of Internal Medicine, Inha University Hospital, 27, Inhang-Ro, Jung-Gu, Incheon, 22332, Republic of Korea
| | - Jung Soo Kim
- Department of Internal Medicine, Inha University Hospital, 27, Inhang-Ro, Jung-Gu, Incheon, 22332, Republic of Korea
| | - Hae-Seong Nam
- Department of Internal Medicine, Inha University Hospital, 27, Inhang-Ro, Jung-Gu, Incheon, 22332, Republic of Korea
| | - Jae Hwa Cho
- Department of Internal Medicine, Inha University Hospital, 27, Inhang-Ro, Jung-Gu, Incheon, 22332, Republic of Korea
| | - Seung Min Kwak
- Department of Internal Medicine, Inha University Hospital, 27, Inhang-Ro, Jung-Gu, Incheon, 22332, Republic of Korea
| | - Hong Lyeol Lee
- Department of Internal Medicine, Inha University Hospital, 27, Inhang-Ro, Jung-Gu, Incheon, 22332, Republic of Korea
| |
Collapse
|
12
|
Ryu JS, Choi CM, Yang SC, Song SY, Jeon YJ, Jang TW, Kim DJ, Jang SH, Yang SH, Lee MK, Lee KH, Jo HJ, Jang SJ, Kim YT, Cho JH, Choi YD, Nam HS, Kim HJ, Suh YJ. Prognostic Effect of Age on Survival of Patients with Stage I Adenocarcinoma of the Lung. Tumori 2018; 98:99-104. [DOI: 10.1177/030089161209800114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and Background It is still unclear whether age is an independent prognostic factor in patients with stage I NSCLC. Methods Five hundred and sixty-nine patients with stage I adenocarinoma who underwent surgical resection as first treatment were included. The effect on overall survival of age, gender, smoking habits, Charlson comorbidity index score (CCIS), type of surgery, tumor size and lymphatic or blood vessel invasion was analyzed. Results When the patients were divided into four groups according to quartiles of age, distributions of gender, smoking habit, CCIS, histology, blood vessel invasion and adjuvant chemotherapy were significantly different among the four groups. Age, gender, smoking habit, CCIS, tumor size and lymphatic and blood vessel invasion were significantly associated with overall survival of the patients in Kaplan-Meier analysis (logrank, P <0.001, P <0.001, P = 0.029, P <0.001, P = 0.001, P = 0.001 and P = 0.007, respectively). Moreover, the highest quartile of age (over 68 years old) was a prominent determinant for a worse prognosis after adjustment for the confounding variables using a Cox proportional hazard model (adjusted hazard ratio = 2.735, 95% confidence interval = 1.623–4.608, P <0.001). Conclusions The findings suggest that age is an important determinant of overall survival in patients with stage I adenocarcinoma. Therefore, age should be considered in classifying the patients into groups of higher or lower risk for death as well as in designing clinical trials.
Collapse
Affiliation(s)
- Jeong-Seon Ryu
- Center for Lung Cancer and Pulmonary Division, Department of Internal Medicine, Inha University Hospital, Inchon
| | - Chang-Min Choi
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul
| | - Seok-Chul Yang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul
| | - Sang-Yun Song
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hwasun Hospital, Hwasun-gun
| | - Young-June Jeon
- Department of Internal Medicine, School of Medicine, Keimyung University, Daegu
| | - Tae-Won Jang
- Department of Internal Medicine, College of Medicine, Kosin University, Busan
| | - Do-Jin Kim
- Division of Respiratory and Allergy Medicine, Soonchunhyang University Hospital, College of Medicine, Bucheon
| | - Seung Hun Jang
- Division of Pulmonary, Allergy & Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang
| | - Sei-Hoon Yang
- Department of Internal Medicine, Wonkwang University Hospital, Iksan
| | - Min-Ki Lee
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan
| | - Kwan-Ho Lee
- Department of Internal Medicine, School of Medicine, Yeungnam University, Daegu
| | - Hyang-Jeong Jo
- Department of Internal Medicine, Wonkwang University Hospital, Iksan
| | - Se-Jin Jang
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul
| | - Young-Tae Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul
| | - Jae-Hwa Cho
- Center for Lung Cancer and Pulmonary Division, Department of Internal Medicine, Inha University Hospital, Inchon
| | - Yoo-Duk Choi
- Department of Pathology, Chonnam National University Hwasun Hospital, Hwasun-gun
| | - Hae-Seong Nam
- Center for Lung Cancer and Pulmonary Division, Department of Internal Medicine, Inha University Hospital, Inchon
| | - Hyun-Jung Kim
- Center for Lung Cancer and Pulmonary Division, Department of Internal Medicine, Inha University Hospital, Inchon
| | - Young Ju Suh
- Clinical Research Institute, School of Medicine, Inha University, Incheon, Korea
| |
Collapse
|
13
|
Kim JS, Lim JH, Jeon SH, Choi JS, Kim YS, Nam HS. Topical mitomycin C application for the control of recurrent tracheal stenosis even after tracheal surgery. Int J Tuberc Lung Dis 2017; 21:1318-1320. [PMID: 29297460 DOI: 10.5588/ijtld.17.0386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Jung Soo Kim
- Division of Pulmonology, Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea
| | - Jun Hyeok Lim
- Division of Pulmonology, Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea
| | - Sang-Hoon Jeon
- Division of Pulmonology, Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea
| | - Jeong-Seok Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Inha University School of Medicine, Incheon, South Korea
| | - Young Sam Kim
- Department of Thoracic Surgery, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea
| | - Hae-Seong Nam
- Division of Pulmonology, Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea.
| |
Collapse
|
14
|
Ooki A, Maleki Z, Tsay JCJ, Goparaju C, Brait M, Turaga N, Nam HS, Rom WN, Pass HI, Sidransky D, Guerrero-Preston R, Hoque MO. A Panel of Novel Detection and Prognostic Methylated DNA Markers in Primary Non-Small Cell Lung Cancer and Serum DNA. Clin Cancer Res 2017; 23:7141-7152. [PMID: 28855354 DOI: 10.1158/1078-0432.ccr-17-1222] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 05/26/2017] [Accepted: 08/23/2017] [Indexed: 11/16/2022]
Abstract
Purpose: To establish a novel panel of cancer-specific methylated genes for cancer detection and prognostic stratification of early-stage non-small cell lung cancer (NSCLC).Experimental Design: Identification of differentially methylated regions (DMR) was performed with bumphunter on "The Cancer Genome Atlas (TCGA)" dataset, and clinical utility was assessed using quantitative methylation-specific PCR assay in multiple sets of primary NSCLC and body fluids that included serum, pleural effusion, and ascites samples.Results: A methylation panel of 6 genes (CDO1, HOXA9, AJAP1, PTGDR, UNCX, and MARCH11) was selected from TCGA dataset. Promoter methylation of the gene panel was detected in 92.2% (83/90) of the training cohort with a specificity of 72.0% (18/25) and in 93.0% (40/43) of an independent cohort of stage IA primary NSCLC. In serum samples from the later 43 stage IA subjects and population-matched 42 control subjects, the gene panel yielded a sensitivity of 72.1% (31/41) and specificity of 71.4% (30/42). Similar diagnostic accuracy was observed in pleural effusion and ascites samples. A prognostic risk category based on the methylation status of CDO1, HOXA9, PTGDR, and AJAP1 refined the risk stratification for outcomes as an independent prognostic factor for an early-stage disease. Moreover, the paralog group for HOXA9, predominantly overexpressed in subjects with HOXA9 methylation, showed poor outcomes.Conclusions: Promoter methylation of a panel of 6 genes has potential for use as a biomarker for early cancer detection and to predict prognosis at the time of diagnosis. Clin Cancer Res; 23(22); 7141-52. ©2017 AACR.
Collapse
Affiliation(s)
- Akira Ooki
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Zahra Maleki
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland
| | - Jun-Chieh J Tsay
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York, New York
| | - Chandra Goparaju
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Langone Medical Center, New York University of Medicine, New York, New York
| | - Mariana Brait
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Nitesh Turaga
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Hae-Seong Nam
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland.,Division of Pulmonology, Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea
| | - William N Rom
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York, New York
| | - Harvey I Pass
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Langone Medical Center, New York University of Medicine, New York, New York
| | - David Sidransky
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Rafael Guerrero-Preston
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland. .,Department of Oncology, Johns Hopkins University, Baltimore, Maryland.,Department of Obstetrics and Gynecology, University of Puerto Rico, San Juan, Puerto Rico
| | - Mohammad Obaidul Hoque
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland. .,Department of Oncology, Johns Hopkins University, Baltimore, Maryland.,Department of Urology, Johns Hopkins University, Baltimore, Maryland
| |
Collapse
|
15
|
Kim JS, Ryu JS, Jeon SH, Kim HJ, Nam HS, Cho JH, Kwak SM, Lee HL. Dramatic response of acute disseminated intravascular coagulation to erlotinib in a patient with lung adenocarcinoma with activating EGFR mutation. J Int Med Res 2017; 46:533-537. [PMID: 28730909 PMCID: PMC6011330 DOI: 10.1177/0300060517720099] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Disseminated intravascular coagulation (DIC) is a commonly encountered clinical situation characterized by thrombotic occlusion or bleeding in patients with lung cancer. DIC in patients with cancer is usually asymptomatic, taking a chronic form as a compensatory mechanism. Although acute DIC in patients with lung cancer is rarely reported, it can be fatal. We herein describe a patient with lung adenocarcinoma with an activating mutation of the epidermal growth factor receptor (EGFR) gene who developed acute DIC after minor surgical excision. The patient's condition dramatically improved immediately after administration of erlotinib. This report alerts physicians to the occurrence of acute DIC and serves as a reference in treating EGFR mutation-positive lung cancer in patients with DIC.
Collapse
Affiliation(s)
- Jung Soo Kim
- Center for Lung Cancer, Inha University Hospital, Incheon, Korea
| | - Jeong-Seon Ryu
- Center for Lung Cancer, Inha University Hospital, Incheon, Korea
| | - Sang Hoon Jeon
- Center for Lung Cancer, Inha University Hospital, Incheon, Korea
| | - Hyun-Jung Kim
- Center for Lung Cancer, Inha University Hospital, Incheon, Korea
| | - Hae-Seong Nam
- Center for Lung Cancer, Inha University Hospital, Incheon, Korea
| | - Jae Hwa Cho
- Center for Lung Cancer, Inha University Hospital, Incheon, Korea
| | - Seung Min Kwak
- Center for Lung Cancer, Inha University Hospital, Incheon, Korea
| | - Hong Lyeol Lee
- Center for Lung Cancer, Inha University Hospital, Incheon, Korea
| |
Collapse
|
16
|
Abstract
Recent advances in mitochondrial biogenesis have provided the emerging recognition that mitochondria do much more than 'simply providing energy for cellular function'. Currently, a constantly improving understanding of the mitochondrial structure and function has been providing valuable insights into the contribution of defects in mitochondrial metabolism to various human diseases, including chronic obstructive pulmonary disease and lung cancer. The growing interest in mitochondria research led to development of new biomedical fields in the two main smoking-related lung diseases. However, there is considerable paucity in our understanding of mechanisms by which mitochondrial dynamics regulate lung diseases. In this review, we will discuss our current knowledge on the role of mitochondrial dysfunction in the pathogenesis of chronic obstructive pulmonary disease and non-small-cell lung cancer.
Collapse
Affiliation(s)
- Hae-Seong Nam
- Department of Otolaryngology & Head & Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA.,Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, South Korea
| | - Evgeny Izumchenko
- Department of Otolaryngology & Head & Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA
| | - Santanu Dasgupta
- Department of Cellular & Molecular Biology, The University of Texas Health Science Center at Tyler, Tyler, TX 75708, USA
| | - Mohammad O Hoque
- Department of Otolaryngology & Head & Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA.,Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA.,Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA
| |
Collapse
|
17
|
Datta S, Nam HS, Hayashi M, Maldonado L, Goldberg R, Brait M, Sidransky D, Illei P, Baras A, Vij N, Hoque MO. Expression of GULP1 in bronchial epithelium is associated with the progression of emphysema in chronic obstructive pulmonary disease. Respir Med 2017; 124:72-78. [DOI: 10.1016/j.rmed.2017.02.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 02/08/2017] [Accepted: 02/12/2017] [Indexed: 11/16/2022]
|
18
|
Kim JS, Kim CW, Nam HS, Cho JH, Ryu JS, Lee HL. Hepatic hydrothorax without ascites as the first sign of liver cirrhosis. Respirol Case Rep 2015; 4:16-8. [PMID: 26839695 PMCID: PMC4722098 DOI: 10.1002/rcr2.140] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 11/04/2015] [Accepted: 11/05/2015] [Indexed: 12/21/2022] Open
Abstract
A 60‐year‐old woman without a history of liver diseases, but with a history of regular alcohol consumption, presented with a right‐sided transudative pleural effusion. Neither parenchymal lung lesion nor pleural thickening was seen on a chest computed tomography. On abdominal ultrasonography, the liver size and contour were normal, and ascites was not noted. Despite performing imaging and laboratory studies, we could not find a cause of the pleural effusion. Thus, due to her history of regular alcohol consumption, we decided to measure liver stiffness using a transient elastography (Fibroscan®, EchosensTM, Paris, France), which showed a value of 35.3 kPa suggestive of liver cirrhosis. An intraperitoneal injection of a radioisotope demonstrated the transdiaphragmatic flow of fluid from peritoneal cavity to pleural cavity. The diagnosis was confirmed as hepatic hydrothorax. Management consisting of restricted salt and water intake with diuretics resulted in resolution of the hepatic hydrothorax.
Collapse
Affiliation(s)
- Jung Soo Kim
- Division of Pulmonary and Critical Care Medicine Inha University College of Medicine Incheon Republic of Korea
| | - Cheol-Woo Kim
- Division of Allergy Medicine, Department of Internal Medicine Inha University College of Medicine Incheon Republic of Korea
| | - Hae-Seong Nam
- Division of Pulmonary and Critical Care Medicine Inha University College of Medicine Incheon Republic of Korea
| | - Jae Hwa Cho
- Division of Pulmonary and Critical Care Medicine Inha University College of Medicine Incheon Republic of Korea
| | - Jeong-Seon Ryu
- Division of Pulmonary and Critical Care Medicine Inha University College of Medicine Incheon Republic of Korea
| | - Hong Lyeol Lee
- Division of Pulmonary and Critical Care Medicine Inha University College of Medicine Incheon Republic of Korea
| |
Collapse
|
19
|
Lim JH, Nam HS, Kim HJ, Choi CH, Park IS, Cho JH, Ryu JS, Kwak SM, Lee HL. Migratory eosinophilic alveolitis caused by radiation therapy. J Thorac Dis 2015; 7:E117-21. [PMID: 26101656 DOI: 10.3978/j.issn.2072-1439.2015.05.05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 04/10/2015] [Indexed: 11/14/2022]
Abstract
Although radiation pneumonitis is usually confined to irradiated areas, some studies have reported that radiation-induced lymphocytic alveolitis can also spread to the non-irradiated lung. However, there have been few reports of radiation-induced eosinophilic alveolitis. We report the case of a 27-year-old female with radiation pneumonitis, occurring 4 months after radiation therapy for cancer of the left breast. Clinical and radiological relapse followed withdrawal of corticosteroids. Examination of bronchoalveolar lavage (BAL) in patchy airspace consolidations revealed increased eosinophil counts. Finally, clinical and radiological signs resolved rapidly after reintroduction of corticosteroids. Eosinophilic alveolitis may be promoted by radiation therapy. In the present case report, possible mechanisms for radiation-induced eosinophilic alveolitis are also reviewed.
Collapse
Affiliation(s)
- Jun Hyeok Lim
- 1 Division of Pulmonology, Department of Internal Medicine, 2 Department of Radiation Oncology, 3 Department of Pathology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Hae-Seong Nam
- 1 Division of Pulmonology, Department of Internal Medicine, 2 Department of Radiation Oncology, 3 Department of Pathology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Hun Jung Kim
- 1 Division of Pulmonology, Department of Internal Medicine, 2 Department of Radiation Oncology, 3 Department of Pathology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Chang-Hwan Choi
- 1 Division of Pulmonology, Department of Internal Medicine, 2 Department of Radiation Oncology, 3 Department of Pathology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - In-Suh Park
- 1 Division of Pulmonology, Department of Internal Medicine, 2 Department of Radiation Oncology, 3 Department of Pathology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Jae Hwa Cho
- 1 Division of Pulmonology, Department of Internal Medicine, 2 Department of Radiation Oncology, 3 Department of Pathology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Jeong-Seon Ryu
- 1 Division of Pulmonology, Department of Internal Medicine, 2 Department of Radiation Oncology, 3 Department of Pathology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Seung Min Kwak
- 1 Division of Pulmonology, Department of Internal Medicine, 2 Department of Radiation Oncology, 3 Department of Pathology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Hong Lyeol Lee
- 1 Division of Pulmonology, Department of Internal Medicine, 2 Department of Radiation Oncology, 3 Department of Pathology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| |
Collapse
|
20
|
Song TJ, Kim J, Lee HS, Nam CM, Nam HS, Kim EH, Lee KJ, Song D, Heo JH, Kim YD. Differential impact of unrecognised brain infarction on stroke outcome in non-valvular atrial fibrillation. Thromb Haemost 2014; 112:1312-8. [PMID: 25231184 DOI: 10.1160/th14-02-0176] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 07/30/2014] [Indexed: 02/02/2023]
Abstract
There has been little information regarding the impact of unrecognised brain infarctions (UBIs) on stroke outcome in patients with non-valvular atrial fibrillation (NVAF). By using volumetric analysis of ischaemic lesions, we evaluated the potential impact of UBIs on clinical outcome according to their presence and categorised type. This study enrolled 631 patients with NVAF having no clinical stroke history. UBIs were categorised into three types as territorial, lacunar, or subcortical. We collected stroke severity, functional outcome at three months, and the total volume of UBIs and acute infarction lesions. We investigated the association between clinical outcome and the type or volume of UBI, using a linear mixed model and logistic regression analysis. UBIs were detected in 285 (45.2 %) patients; territorial UBIs were observed in 24.4 % of patients (154/631), lacunar UBIs in 25 % (158/631), and subcortical UBIs in 15.7 % (99/631). Although initial stroke severity was not different between patients with UBIs and those without, those with UBIs had less improvement during hospitalisation, leading to poorer outcome at three months. Among the three types of UBIs, only territorial UBIs were associated with poor outcome, especially in patients with relatively smaller acute infarction volume. UBIs, in particular, territorial UBIs, may be considered as predictors for poor outcome after ischaemic stroke in patients with NVAF. Our results suggest that the impact of UBIs on clinical outcome differs according to the type of UBIs and the acute stroke severity.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Y D Kim
- Young Dae Kim, MD, PhD, Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea, Tel.: +82 2 2228 1605, Fax: +82 2 393 0705, E-mail:
| |
Collapse
|
21
|
Lee JM, Lim JH, Kim JS, Park JS, Memon A, Lee SK, Nam HS, Cho JH, Kwak SM, Lee HL, Kim HJ, Hong GJ, Ryu JS. Multiple hypercoagulability disorders at presentation of non-small-cell lung cancer. Tuberc Respir Dis (Seoul) 2014; 77:34-7. [PMID: 25114702 PMCID: PMC4127411 DOI: 10.4046/trd.2014.77.1.34] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 03/18/2014] [Accepted: 04/18/2014] [Indexed: 11/24/2022] Open
Abstract
Hypercoagulability disorders are commonly encountered in clinical situations in patients with a variety of cancers. However, several hypercoagulability disorders presenting as first symptoms or signs in cancer patients have rarely been reported. We herein described a case of a woman with adenocarcinoma of the lung presenting with deep vein thrombosis, nonbacterial thrombotic endocarditis, recurrent cerebral embolic infarction, and heart failure.
Collapse
Affiliation(s)
- Jeong Min Lee
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Jun Hyeok Lim
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Jung-Soo Kim
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Ji Sun Park
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Azra Memon
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Seul-Ki Lee
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Hae-Seong Nam
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Jae-Hwa Cho
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Seung-Min Kwak
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Hong Lyeol Lee
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Hyun-Jung Kim
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Geun-Jeong Hong
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Jeong-Seon Ryu
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| |
Collapse
|
22
|
Nam HS. Malignant pleural effusion: medical approaches for diagnosis and management. Tuberc Respir Dis (Seoul) 2014; 76:211-7. [PMID: 24920947 PMCID: PMC4050068 DOI: 10.4046/trd.2014.76.5.211] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 02/27/2014] [Accepted: 03/06/2014] [Indexed: 12/04/2022] Open
Abstract
Malignant pleural effusions (MPEs) are the second leading cause of exudative pleural effusions after parapneumonic effusions. In the vast majority of cases, a MPE signifies incurable disease associated with high morbidity and mortality. Considerable advances have been made for the diagnosis of MPEs, through the development of improved methods in the specialized cytological and imaging studies. The cytological or histological confirmation of malignant cells is currently important in establishing a diagnosis. Furthermore, despite major advancements in cancer treatment for the past two decades, management of MPE remains palliative. This article presents a comprehensive review of the medical approaches for diagnosis and management of MPE.
Collapse
Affiliation(s)
- Hae-Seong Nam
- Center for Lung Cancer and Division of Pulmonary, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Korea
| |
Collapse
|
23
|
Ryu JS, Lee SK, Memon A, Kim HJ, Nam HS, Cho JH, Oh IJ, Yang SH, Lim JH. Prognostic relevance of genetic variations of tuberous sclerosis complex gene in advanced non-small cell lung cancer patients treated with platinum doublets. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e22074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Seul-Ki Lee
- Inha University hospital, Incheon, South Korea
| | - Azra Memon
- Inha University Hospital, Incheon, South Korea
| | | | | | - Jae-Hwa Cho
- Inha University hospital, Incheon, South Korea
| | - In-Jae Oh
- Chonnam National University Medical School, Gwangju, South Korea
| | | | - Joo Han Lim
- Inha University School of Medicine, Incheon, South Korea
| |
Collapse
|
24
|
Song D, Kim BM, Kim DJ, Kim YD, Kim J, Lee HS, Nam HS, Heo JH. Comparison of stent retriever and intra-arterial fibrinolysis in patients with acute ischaemic stroke. Eur J Neurol 2014; 21:779-84. [PMID: 24612359 DOI: 10.1111/ene.12391] [Citation(s) in RCA: 7] [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] [Received: 11/17/2013] [Accepted: 01/28/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE Although the stent retriever (SR) has shown a better reperfusion rate and clinical outcome than the older generation mechanical clot retrieval device, it is uncertain whether the SR is superior to intra-arterial fibrinolysis (IAF). METHODS Ischaemic stroke patients who were treated with SR or IAF as initial endovascular treatment modality for unilateral arterial occlusion in the anterior circulation were included. Successful reperfusion was defined as Thrombolysis in Cerebral Infarction grade ≥2b. A favourable clinical outcome was defined as a modified Rankin Score ≤2 at 3 months. RESULTS Between January 2009 and May 2012, 55 patients were treated with SR and 50 patients were treated with IAF. The baseline characteristics were similar between the two groups except for the occlusion site and rescue treatment. In binary logistic regression analysis adjusted for the occlusion site and rescue treatment, SR was independently associated with increased successful reperfusion [82.0% vs. 47.3%; odds ratio (OR) 5.21; 95% confidence interval (CI) 1.92-14.14) and a more favourable clinical outcome at 3 months (54.0% vs. 43.6%; OR 3.40; 95% CI 1.31-8.84). The frequency of symptomatic intracranial haemorrhage and mortality at 3 months was not different between the two groups. CONCLUSIONS Stent retriever was as safe as and more effective than IAF. Our findings suggest that SR may be considered as an initial modality rather than IAF in acute stroke patients who undergo endovascular treatment.
Collapse
Affiliation(s)
- D Song
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | |
Collapse
|
25
|
Ryu JS, Ryu HJ, Lee SN, Memon A, Lee SK, Nam HS, Kim HJ, Lee KH, Cho JH, Hwang SS. Prognostic impact of minimal pleural effusion in non-small-cell lung cancer. J Clin Oncol 2014; 32:960-7. [PMID: 24550423 DOI: 10.1200/jco.2013.50.5453] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Minimal (< 10 mm thick) pleural effusion (PE) may represent an early phase of malignant PE, but its clinical relevance has rarely been studied. Therefore, we examined the proportion of minimal PE in patients with non-small-cell lung cancer (NSCLC) and its impact on survival. We also considered possible accumulation mechanisms in our data set. PATIENTS AND METHODS On the basis of PE status from chest computed tomography scans at diagnosis, 2,061 patients were classified into three groups: no PE, minimal PE, and malignant PE. Twenty-one variables associated with four factors-patient, stage migration, tumor, and treatment-were investigated for correlation with survival. RESULTS Minimal PE presented in 272 patients (13.2%). Of 2,061 patients, the proportion of each stage was the following: 5.2% stage I, 10.9% stage II, 13.2% stage IIIA, 23.8% stage IIIB, and 13.9% stage IV. Minimal PE correlated significantly with shorter survival time than did no PE (median survival time, 7.7 v 17.7 months; log-rank P < .001), even after full adjustment with all variables (adjusted hazard ratio, 1.40; 95% CI, 1.21 to 1.62). Prognostic impact of minimal PE was higher in early versus advanced stages (Pinteraction = .001). In 237 patients (87.8%) with minimal PE, pleural invasion or attachment as a direct mechanism was observed, and it was an independent factor predicting worse survival (P = .03). CONCLUSION Minimal PE is a commonly encountered clinical concern in staging NSCLCs. Its presence is an important prognostic factor of worse survival, especially in early-stage disease.
Collapse
Affiliation(s)
- Jeong-Seon Ryu
- Jeong-Seon Ryu, Azra Memon, Seul-Ki Lee, Hae-Seong Nam, Hyun-Jung Kim, and Jae-Hwa Cho, Center for Lung Cancer, Inha University Hospital; Si-Nae Lee, Kyung-Hee Lee, and Seung-Sik Hwang, Inha University Hospital, Incheon, S. Korea; and Hyo Jin Ryu, University of California, Los Angeles, CA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Ryu JS, Ryu HJ, Nam HS, Kim HJ. Prognostic Significance of Minimal Pleural Effusion in Non-small Cell Lung Cancer Patients. Chest 2013. [DOI: 10.1378/chest.1665939] [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] [Indexed: 11/01/2022] Open
|
27
|
Lim JH, Jeon SH, Lee JM, Kim L, Cho JH, Ryu JS, Kwak SM, Lee HL, Nam HS. Late-onset distant metastatic upper urinary tract urothelial carcinoma mimicking lung adenocarcinoma. Tuberc Respir Dis (Seoul) 2013; 75:32-5. [PMID: 23946757 PMCID: PMC3741472 DOI: 10.4046/trd.2013.75.1.32] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 01/14/2013] [Accepted: 01/17/2013] [Indexed: 12/11/2022] Open
Abstract
Urothelial carcinomas (UCs) can occur in the upper urinary tract or lower urinary tract. Upper urinary tract urothelial carcinoma (UUT-UC) is relatively a rare disease and accounts for only about 5% of UC cases. Sporadic cases of late-onset metastasis, associated with UC of the bladder, have occasionally been reported. In contrast, no late-onset distant metastatic UUT-UC without local recurrence has, to the best of our knowledge, been reported in the English literature. We report an extremely rare case of distant metastatic UC, mimicking lung adenocarcinoma that originated from UUT-UC 12 years previously.
Collapse
Affiliation(s)
- Jun-Hyeok Lim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Kim CH, Nam HS, Lee EH, Han SH, Cho HJ, Chung HJ, Lee NS, Choi SJ, Kim H, Ryu JS, Kwon J, Kim H. Overexpression of a novel regulator of p120 catenin, NLBP, promotes lung adenocarcinoma proliferation. Cell Cycle 2013; 12:2443-53. [PMID: 23839039 DOI: 10.4161/cc.25451] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
NLBP (novel LZAP-binding protein) was recently shown to function as a tumor suppressor capable of inhibiting the NFκB signaling pathway. NLBP is also known as a negative regulator of cell invasion, and its expression is reduced in several cancer cell lines that have little invasive activity. Although these phenomena suggest that NLBP may be a potential tumor suppressor, its role as a tumor suppressor in human lung cancer is not well established. In contrast to our expectation, NLBP was highly expressed in the early stage of lung adenocarcinoma tissues, and overexpression of NLBP promoted proliferation of H1299 lung adenocarcinoma cells. We also found that p120 catenin (p120ctn) was a novel binding partner of NLBP, and that NLBP binds to the regulatory domain of p120ctn, and p120ctn associates with N-terminal region of NLBP, respectively. This binding leads to p120ctn stability to inhibit proteasomal degradation of p120ctn by inhibiting its ubiqutination. In addition, we also found that overexpression of NLBP and p120ctn in human lung cancer are closely related with adenocarcinoma compared with squamous cell carcinoma. Taken together, our findings reveal that NLBP is highly overexpressed in human lung adenocarcinoma, and that overexpression of NLBP promotes the cell proliferation of lung adenocarcinoma through interacting with p120ctn and suggest that NLBP may function as an oncogene in early stage carcinogenesis of lung adenocarcinoma.
Collapse
Affiliation(s)
- Chang Hee Kim
- Department of Biological Sciences; Sungkyunkwan University; Suwon, Republic of Korea
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Ryu JS, Lee SN, Ryu HJ, Nam HS, Memon A, Kim HJ, Lim JH. Prognostic significance of minimal pleural effusion in non-small cell lung cancer patients. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e19152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e19152 Background: Malignant pleural effusion (MPE) was defined by the presence of malignant cells in pleural space. Accurate characterization of pleural effusion (PE) is an essential part in staging the disease for adequate management. At diagnostic evaluation, minimal pleural effusion (mPE) that is too small amount PE to examine the presence of malignant cells through thoracentesis is present outside scope of current staging system. Therefore whether mPE has prognostic impact or not is an important clinical issue needed to be investigated. Methods: 1,382 consecutive stage IIIB, IV NSCLC patients were retrospectively enrolled from Inha Lung Cancer Cohort. Information regarding smoking habits, ECOG PS, Charlson comorbidity index score, weight loss in 6 months before diagnosis, levels of hemoglobin, albumin, alkaline phosphatase and calcium at the time of diagnosis, treatment, followed-up and survival status was analyzed as potential confounding factors. All patients were performed staging work-up and followed-up at Inha university hospital. The mPE was defined as less than 1 cm of maximal thickness on contrast enhanced chest CT scan at diagnosis and its presence was not considered in staging the disease. Results: According to status of PE at diagnosis, patients were classified into no PE, mPE and MPE. No PE was presented in 614 patients (44.4%); mPE in 339 patients (24.5%); malignant PE in 356 patients (25.8%). PEs of 73 (5.3%) patients was not evaluated. Overall survival of patients with mPE or MPE was shown to be significantly shorter than those of patients with no PE (MST, 9.67 for no PE, v 6.60 for mPE v 5.37 months for MPE, log-rank p<.0001), even after adjustment for age, smoking habits, ECOG PS, Charlson comorbidity index score, weight loss, hemoglobin, albumin, alkaline phosphatase, calcium, histology, T subset, N subset, M subset, and treatment status (hazard ratios, 95% CIs and Cox p: 1.18, 1.023 to 1.373 and .024 for mPE; 1.545, 1.314 to 1.816 and <.0001 for MPE). Conclusions: The mPE is commonly encountered clinical situation in advanced stage NSCLC patients. These results suggest that presence of mPE at diagnosis confers grave prognosis like MPE, in spite of its nature.
Collapse
Affiliation(s)
| | | | - Hyo-Jin Ryu
- Undergraduate School, University of California, Los Angeles, Los Angeles, CA
| | | | - Azra Memon
- Inha University Hospital, Incheon, South Korea
| | | | - Joo Han Lim
- Inha University School of Medicine, Incheon, South Korea
| |
Collapse
|
30
|
Jang EC, Choi SJ, Cho JH, Ryu JS, Kwak SM, Lee HL, Nam HS. Organizing pneumonia presenting after ulcerative colitis remission. J Thorac Dis 2013; 5:E71-3. [PMID: 23585964 DOI: 10.3978/j.issn.2072-1439.2013.03.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 03/27/2013] [Indexed: 12/24/2022]
Abstract
Ulcerative colitis (UC) is the most common form of inflammatory bowel disease worldwide, and extraintestinal manifestations (EIMs) involving various organs and systems occur in 10% to 30% of patients. Recently, although the pulmonary manifestation of UC is being increasingly recognized, these manifestations are described much less frequently than other EIMs. Furthermore, organizing pneumonia (OP) involving the lung parenchyma is a relatively uncommon pulmonary manifestation of UC, and to our knowledge, no case of OP after histologically confirmed UC remission has been previously reported in the English literature. Here, we present a case of OP after remission in an elderly female with a history of UC.
Collapse
Affiliation(s)
- Eun Chul Jang
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Korea
| | | | | | | | | | | | | |
Collapse
|
31
|
Cha MJ, Lee HS, Kim YD, Nam HS, Heo JH. The association between asymptomatic coronary artery disease and CHADS2 and CHA2 DS2 -VASc scores in patients with stroke. Eur J Neurol 2013; 20:1256-63. [PMID: 23560528 DOI: 10.1111/ene.12158] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [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: 11/29/2012] [Accepted: 02/28/2013] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE CHADS2 and CHA2 DS2 -VASc scores are measurement tools that stratify thromboembolic risk in patients with non-valvular atrial fibrillation, and are predictive of cerebral atherosclerosis, fatal stroke and ischaemic heart disease. Patients with higher CHADS2 and CHA2 DS2 -VASc scores are more likely to have had an akinetic/hypokinetic left ventricular segment or a recent myocardial infarction, all of which are associated with coronary artery disease (CAD). Most of the CHADS2 score components are also risk factors for atherosclerosis. Thus, CHADS2 and CHA2 DS2 -VASc scores may be predictive of CAD. METHODS In all, 1733 consecutive patients with acute ischaemic stroke who underwent multi-slice computed tomography coronary angiography were enrolled. The association of CHADS2 and CHA2 DS2 -VASc scores with the presence and severity of CAD was investigated. RESULTS Of the 1733 patients, 1220 patients (70.4%) had any degree of CAD and 576 (33.3%) had significant CAD (≥ 50% stenosis in at least one coronary artery). As the CHADS2 and CHA2 DS2 -VASc scores increased, the presence of CAD also increased (P < 0.001). The severity of CAD was correlated with CHADS2 score (Spearman coefficient 0.229, P < 0.001) and CHA2 DS2 -VASc score (Spearman coefficient 0.261, P < 0.001). In multivariate analysis, after adjusting for confounding factors, CHADS2 and CHA2 DS2 -VASc scores ≥2 were independently associated with CAD. The CHA2 DS2 -VASc score was a better predictor of the presence of CAD than the CHADS2 score on area under the curve analysis. CONCLUSION CHADS2 and CHA2 DS2 -VASc scores were predictive of the presence and severity of CAD in patients with stroke. When a patient has high CHADS2 or CHA2 DS2 -VASc scores, physicians should consider coronary artery evaluation.
Collapse
Affiliation(s)
- M-J Cha
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | | | | | | | | |
Collapse
|
32
|
Jeon SH, Ryu JS, Choi GS, Kim JS, Kwon HY, Kim MS, Nam HS, Cho JH, Kwak SM, Lee HL, Kim HJ, Hong GJ. Erlotinib induced trichomegaly of the eyelashes. Tuberc Respir Dis (Seoul) 2013; 74:37-40. [PMID: 23390452 PMCID: PMC3563702 DOI: 10.4046/trd.2013.74.1.37] [Citation(s) in RCA: 6] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 07/15/2012] [Accepted: 07/16/2012] [Indexed: 11/24/2022] Open
Abstract
Epithelial growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have been widely used for non-small-cell lung cancer patients. Its untoward cutaneous effects are largely well known and developed in many patients treated with EGFR TKIs. However trichomegaly of eyelash is rarely reported. Although trichomegaly is not a drug-limiting side effect, it could be troublesome of continuing the treatment because of cosmetic issue or eyeball irritation by long eyelashes. Therefore clinicians are needed to pay attention to this uncommon effect. We herein describe erlotinib induced trichomegaly of eyelashes in a woman with adenocarcinoma of the lung.
Collapse
Affiliation(s)
- Sang-Hoon Jeon
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Ryu JS, Kim HJ, Shin ES, Nam HS, Cho JH, Lee JE. Lack of association of genetic variations of deoxycytidine kinase with toxicity or survival of non-small-cell lung cancer patients treated with gemcitabine plus cisplatin. Oncol Res 2012; 20:25-30. [PMID: 23035362 DOI: 10.3727/096504012x13425470196137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The aim of this study was to determine whether tagging polymorphisms (tSNPs) of deoxycytidine kinase (DCK) have an effect on toxicity or prognosis in patients with non-small-cell lung cancer (NSCLC) treated with gemcitabine plus cisplatin. Three tSNPs (-201 C>T, rs2306744; IVS2+9846 G>A, rs12648166; IVS6+1392 T>C, rs4694362) were chosen using the international HapMap Project and Japanese Single-Nucleotide Polymorphisms. We evaluated the associations of the tSNPs with hematologic toxicity or overall survival of 139 NSCLC patients at stages IIIA/IIIB (59) and IV (80). Hematologic toxicity such as neutropenia, thrombocytopenia, and anemia were not different by the three tSNPs or haplotypes (CGT, CAT, and CAC) of DCK. The genetic variations did not affect survival of the patients (log-rank p: 0.248 for -201 C>T, 0.571 for IVS2+9846 G>A, 0.686 for IVS6+1392 T>C, 0.556 for CGT, 0.453 for CAT, and 0.845 for CAC). In a Cox model, these tSNPs and haplotypes did not reveal prognostic relevance (aHR and 95% CI: 0.954 and 0.611 to 1.489 for -201 C>T; 1.193 and 0.719 to 1.979 for IVS2+9846 G>A; 1.072 and 0.674 to 1.706 for IVS6+1392 T>C, 0,668 and 0.205 to 2.175 for CGT, 1.043 and 0.713 to 1.525 for CAT, and 1.043 and 0.701 to 1.550 for CAC). This is the first study to focus on the association of tSNPs and their haplotypes of DCK with toxicity and survival in NSCLC patients. This suggests that genetic variations of DCK have no effect on the outcomes in the patients treated with gemcitabine-based chemotherapy.
Collapse
Affiliation(s)
- Jeong-Seon Ryu
- Department of Internal Medicine and Center for Lung Cancer, Inha University Hospital, Incheon, South Korea.
| | | | | | | | | | | |
Collapse
|
34
|
Song TJ, Kim J, Lee HS, Nam CM, Nam HS, Heo JH, Kim YD. The frequency of cerebral microbleeds increases with CHADS(2) scores in stroke patients with non-valvular atrial fibrillation. Eur J Neurol 2012; 20:502-508. [PMID: 23057579 DOI: 10.1111/ene.12003] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 09/06/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Cerebral microbleeds (CMBs) are extravasations of blood from lipohyalinized or amyloid angiopathic cerebral arterioles, and the presence and numbers of CMBs are significantly associated with the development of oral anticoagulation (OA)-related intracranial haemorrhage (ICH). The aim of this study was to investigate whether there is a difference in CMBs burden according to CHADS(2) scores or CHA(2) DS(2) -VASc scores in non-valvular atrial fibrillation (NVAF) patients. METHODS We included 550 ischaemic stroke patients who had NVAF and who had undergone brain magnetic resonance imaging (MRI) with gradient-recalled echo (GRE) T2 sequences from our prospective stroke registry between January 2005 and November 2011. We calculated CHADS(2) scores and CHA(2) DS(2) -VASc scores for all patients based on their underlying cardiovascular diseases. The presence, location and number of CMBs were assessed in each patient. We also investigated whether the CMBs were actually associated with the development of ICH during follow-up. RESULTS The mean patient age was 70.4 ± 10.5 years, and 324 (58.9%) patients were men. One-hundred and seventy-three patients (31.5%) had CMBs detected on GRE MRI. Higher CHADS(2) scores or CHA(2) DS(2) -VASc scores were strongly associated with the presence and number of CMBs. During follow-up of median 3.1 ± 1.6 years, the presence of CMBs was independently associated with the development of ICH, whilst the CHADS(2) scores or CHA(2) DS(2) -VASc scores were not. CONCLUSIONS Considering the positive association between the presence of CMBs and OA-related ICH, our results suggest that the increase in ICH in high-risk groups during OA may be related to an increased burden of CMBs.
Collapse
Affiliation(s)
- T-J Song
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - J Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - H S Lee
- Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea
| | - C M Nam
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - H S Nam
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - J H Heo
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Y D Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
35
|
Choi SH, Kim L, Lee KH, Cho JH, Ryu JS, Kwak SM, Nam HS. Mediastinal lymphangioma treated using endobronchial ultrasound-guided transbronchial needle aspiration. Respiration 2012; 84:518-21. [PMID: 23018866 DOI: 10.1159/000342872] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2012] [Accepted: 08/20/2012] [Indexed: 11/19/2022] Open
Abstract
Lymphangiomas are localized malformations of the lymphatic system that most commonly occur in the head and neck. However, less than 1% of all lymphangiomas are confined to the mediastinum. The standard treatment has been surgical excision, but the involvement of vital structures in the area local to the lymphangioma makes total excision virtually impossible in most cases. To our knowledge, there has been no report of mediastinal lymphangioma treated with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). We report here the first case of safe, effective treatment of a very large mediastinal lymphangioma using EBUS-TBNA in a 29-year-old man.
Collapse
Affiliation(s)
- Seong Huan Choi
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | | | | | | | | | | | | |
Collapse
|
36
|
Choi CM, Yang SC, Jo HJ, Song SY, Jeon YJ, Jang TW, Kim DJ, Jang SH, Yang SH, Kim YD, Lee KH, Jang SJ, Kim YT, Kim DK, Chung DH, Kim L, Nam HS, Cho JH, Kim HJ, Ryu JS. Proteins involved in DNA damage response pathways and survival of stage I non-small-cell lung cancer patients. Ann Oncol 2012; 23:2088-2093. [PMID: 22317771 DOI: 10.1093/annonc/mdr606] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [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: 01/09/2023] Open
Abstract
BACKGROUND Biological complexity leads to significant variation in the survival of patients with stage I non-small-cell lung cancer (NSCLC). DNA damage response (DDR) pathways play a critical role in maintaining genomic stability and in the progression of NSCLC. Therefore, the development of a prognostic biomarker focusing on DDR pathways is an intriguing issue. PATIENTS AND METHODS Expression of several proteins (ATM, ATMpS1981, γH2AX, 53BP1, 53BP1pS25, Chk2, Chk2pT68, MDC1, MDC1pS964, BRCA1pS1423, and ERCC1) and overall survival were investigated in 889 pathological stage I NSCLC patients. RESULTS Low expression of BRCA1pS1423 or ERCC1 was significantly associated with worse survival in the whole cohort of patients. Analysis performed based on histology revealed that low expression of γH2AX, Chk2pT68, or ERCC1 was a poor prognostic factor in squamous cell carcinoma patients [adjusted hazard ratio (aHR), Cox P: 1.544, 0.012 for γH2AX; 1.624, 0.010 for Chk2pT68; 1.569, 0.011 for ERCC1]. The analysis of the interaction between two proteins showed that this effect was more pronounced in squamous cell carcinoma patients. However, these effects were not detected in adenocarcinoma patients. CONCLUSIONS The proteins involved in DDR pathways exhibited differential expression between squamous cell carcinoma and adenocarcinoma and were important determinants of survival in stage I squamous cell carcinoma patients.
Collapse
Affiliation(s)
- C M Choi
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul
| | - S C Yang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul
| | - H J Jo
- Department of Pathology, College of Medicine, Wonkwang University, Iksan
| | - S Y Song
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hwasun Hospital, Hwasun-gun
| | - Y J Jeon
- Department of Internal Medicine, School of Medicine, Keimyung University, Daegu
| | - T W Jang
- Department of Internal Medicine, College of Medicine, Kosin University, Busan
| | - D J Kim
- Division of Respiratory and Allergy Medicine, Soonchunhyang University Hospital, College of Medicine, Bucheon
| | - S H Jang
- Division of Pulmonary, Allergy & Critical Care Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang
| | - S H Yang
- Department of Internal Medicine, Wonkwang University Hospital, Iksan
| | - Y D Kim
- Department of Thoracic Surgery, School of Medicine, Pusan National University, Busan
| | - K H Lee
- Department of Internal Medicine, Yeungnam University School of Medicine, Daegu
| | - S J Jang
- Department of Pathology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul
| | - Y T Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul
| | - D K Kim
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul
| | - D H Chung
- Department of Pathology, Seoul National University College of Medicine, Seoul
| | | | - H S Nam
- Pulmonary Division, Department of Internal Medicine, Inha University Hospital, Incheon, Korea
| | - J H Cho
- Pulmonary Division, Department of Internal Medicine, Inha University Hospital, Incheon, Korea
| | - H J Kim
- Pulmonary Division, Department of Internal Medicine, Inha University Hospital, Incheon, Korea
| | - J S Ryu
- Pulmonary Division, Department of Internal Medicine, Inha University Hospital, Incheon, Korea.
| |
Collapse
|
37
|
Ryu JS, Shin ES, Kim HJ, Nam HS, Lee JE, Lim JH. Lack of association of genetic variations of deoxycytidine kinase with toxicity or survival of non-small cell lung cancer patients treated with gemcitabine plus cisplatin. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e13065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e13065 Background: To determine whether tagging polymorphisms (tSNPs) of deoxycytidine kinase (DCK) have an effect on toxicity or prognosis in patients with non–small-cell lung cancer (NSCLC) treated with gemcitabine plus cisplatin. Methods: Three tSNPs (−201 C>T, rs2306744; IVS2+9846 G>A, rs12648166; IVS6+1392 T>C, rs4694362) were chosen using two databases, the international HapMap Project and Japanese Single-Nucleotide Polymorphisms. Genotyping was performed using the Genome Lab SNPstream Genotyping System and SNaPShot assay kit. We evaluated the associations of the tSNPs with hematologic toxicity or overall survival of 139 NSCLC patients at stages IIIA/IIIB (59) and IV (80). Results: The median survival time of the patients was 11.9 months. Hematologic toxicity such as neutropenia, thrombocytopenia and anemia were not different by the three tSNPs or haplotypes (CGT, CAT and CAC) of DCK. The genetic variations did not affect on survival of the patients (log-rank P: 0.248 for −201 C>T, 0.571 for IVS2+9846 G>A, 0.686 for IVS6+1392 T>C, 0,556 for CGT, 0.453 for CAT and 0.845 for CAC). In Cox model, these tSNPs and haplotypes did not reveal prognostic relevance (aHR and 95%CI: 0.954 and 0.611 to 1.489 for −201 C>T; 1.193 and 0.719 to 1.979 for IVS2+9846 G>A; 1.072 and 0.674 to 1.706 for IVS6+1392 T>C, 0,668 and 0.205 to 2.175 for CGT, 1.043 and 0.713 to 1.525 for CAT and1.043 and 0.701 to 1.550 for CAC). Conclusions: This is the first study to focus on the association of tSNPs and their haplotypes of DCK with toxicity and survival in NSCLC patients. This suggests that genetic variations of DCK have no effect on the outcomes in the patients treated with gemcitabine-based chemotherapy.
Collapse
Affiliation(s)
| | | | | | | | | | - Joo Han Lim
- Inha University School of Medicine, Incheon, South Korea
| |
Collapse
|
38
|
Ryu JS, Choi CM, Yang SC, Song SY, Jeon YJ, Jang TW, Kim DJ, Jang SH, Yang SH, Lee MK, Lee KH, Jo HJ, Jang SJ, Kim YT, Cho JH, Choi YD, Nam HS, Kim HJ, Suh YJ. Prognostic effect of age on survival of patients with stage I adenocarcinoma of the lung. Tumori 2012. [PMID: 22495709 DOI: 10.1700/1053.11507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS AND BACKGROUND It is still unclear whether age is an independent prognostic factor in patients with stage I NSCLC. METHODS Five hundred and sixty-nine patients with stage I adenocarinoma who underwent surgical resection as first treatment were included. The effect on overall survival of age, gender, smoking habits, Charlson comorbidity index score (CCIS), type of surgery, tumor size and lymphatic or blood vessel invasion was analyzed. RESULTS When the patients were divided into four groups according to quartiles of age, distributions of gender, smoking habit, CCIS, histology, blood vessel invasion and adjuvant chemotherapy were significantly different among the four groups. Age, gender, smoking habit, CCIS, tumor size and lymphatic and blood vessel invasion were significantly associated with overall survival of the patients in Kaplan-Meier analysis (logrank, P <0.001, P <0.001, P = 0.029, P <0.001, P = 0.001, P = 0.001 and P = 0.007, respectively). Moreover, the highest quartile of age (over 68 years old) was a prominent determinant for a worse prognosis after adjustment for the confounding variables using a Cox proportional hazard model (adjusted hazard ratio = 2.735, 95% confidence interval = 1.623-4.608, P <0.001). CONCLUSIONS The findings suggest that age is an important determinant of overall survival in patients with stage I adenocarcinoma. Therefore, age should be considered in classifying the patients into groups of higher or lower risk for death as well as in designing clinical trials.
Collapse
Affiliation(s)
- Jeong-Seon Ryu
- Center for Lung Cancer and Pulmonary Division, Department of Internal Medicine, Inha University Hospital, Inchon, Korea.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Ryu JS, Jeon SH, Kim JS, Lee JH, Kim SH, Hong JT, Jeong JH, Jeong JJ, Lee MD, Min SJ, Nam HS, Cho JH, Kwak SM, Lee HL, Kim HJ. Gender differences in susceptibility to smoking among patients with lung cancer. Korean J Intern Med 2011; 26:427-31. [PMID: 22205843 PMCID: PMC3245391 DOI: 10.3904/kjim.2011.26.4.427] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [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: 09/26/2011] [Revised: 10/12/2011] [Accepted: 10/17/2011] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS To determine whether female smokers are more or less susceptible to the detrimental pulmonary-function effects of smoking when compared to male smokers among patients with lung cancer. METHODS Pack-years and pulmonary function indices were compared between 1,594 men and women with lung cancer who were smokers or had a history of smoking. Differences in individual susceptibility to smoking were estimated using a susceptibility index formula. RESULTS Of the patients, 959 (92.8%) men and 74 (7.2%) women were current smokers. Common histological types of lung cancer were squamous cell carcinoma, adenocarcinoma, and small cell carcinoma, among others. Women had a lower number of pack-years, forced expiratory volume in 1 second (FEV(1), liters), forced vital capacity (FVC, liters), and total lung capacity (TLC, liters) compared to those of men (25.0 ± 19.2 vs. 42.9 ± 21.7 for pack-years; 1.4 ± 0.5 vs. 2.0 ± 0.6 for FEV(1); 3.0 ± 0.7 vs. 2.0 ± 0.6 for FVC; 4.5 ± 0.8 vs. 5.7 ± 1.0 for TLC; all p < 0.001). The susceptibility index for women was significantly higher compared to that of men (1.1 ± 4.1 vs. 0.7 ± 1.1; p = 0.001). A significant inverse association was shown between the susceptibility index and TLC and FVC (r = -0.200 for TLC, -0.273 for FVC; all p < 0.001). CONCLUSIONS The results suggest that the detrimental effects of smoking on pulmonary function are greater in women, as compared to those in men, among patients with lung cancer.
Collapse
Affiliation(s)
- Jeong-Seon Ryu
- Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Korea.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Nam HS, Cha MJ, Kim YD, Kim EH, Park E, Lee HS, Nam CM, Heo JH. Use of a handheld, computerized device as a decision support tool for stroke classification. Eur J Neurol 2011; 19:426-30. [PMID: 21951521 DOI: 10.1111/j.1468-1331.2011.03530.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification has been widely used to determine etiology of ischemic stroke. However, interrater reliability is known to be modest. The complexity of abstraction and the interpretation of various clinical and laboratory data might limit the accuracy of the TOAST classification. In this study, we developed a computerized clinical decision support system for stroke classification that can be used in a handheld device and tested whether this system can improve diagnostic accuracy and reliability. METHODS Based on the TOAST classification, a logical algorithm was developed and implemented on a handheld device, named iTOAST. After answering six questions using the touch interface, the stroke subtype result is displayed on the screen. Four neurology residents were randomly assigned to classify stroke subtypes using iTOAST or the conventional method (cTOAST). Using a crossover design, they classified the stroke subtypes of 70 patients. The standard subtypes were determined by three stroke experts. Correlated kappa coefficients using iTOAST compared with cTOAST were determined. RESULTS The kappa (SE) value of iTOAST [0.790 (0.041), 95% CI: 0.707-0.870] was higher than that of cTOAST [0.692 (0.046), 95% CI: 0.600-0.782] (P<0.001). Neither sequence (P=0.857) nor period effect (P=0.999) was observed. CONCLUSIONS The stroke classification tool using a handheld, computerized device was easy, accurate, and reliable over the conventional method. It may have additional benefit because a handheld, computerized device is accessible anytime and anywhere.
Collapse
Affiliation(s)
- H S Nam
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Hong HJ, Kim YD, Cha MJ, Kim J, Lee DH, Lee HS, Nam CM, Nam HS, Heo JH. Early neurological outcomes according to CHADS2 score in stroke patients with non-valvular atrial fibrillation. Eur J Neurol 2011; 19:284-90. [PMID: 21914056 DOI: 10.1111/j.1468-1331.2011.03518.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE A higher CHADS(2) score or CHA(2)DS(2)-VASc score is associated with an increased risk of ischaemic stroke in patients with non-valvular atrial fibrillation (NVAF). However, there are no data regarding early neurological outcomes after stroke according to the risk levels. METHODS In this study, a total of 649 stroke patients with NVAF were enrolled and categorized into three groups: low-risk (CHADS(2) score of 0-1), moderate-risk (CHADS(2) score 2-3), or high-risk group (CHADS(2) score ≥4). CHA(2)DS(2)-VASc score was divided into four groups including 0-1, 2-3, 4-5, and ≥6. We investigated whether there were differences in initial stroke severity, early neurological outcome, and infarct size according to CHADS(2) score or CHA(2)DS(2)-VASc score in stroke patients with NVAF. RESULTS The initial National Institutes of Health Stroke Scale (NIHSS) score was highest in high-risk group [9.5, interquartile range (IQR) 4-18], followed by moderate-risk (8, IQR 2-17) and low-risk group (6, IQR 2-15) (P=0.012). Likewise, initial stroke severity increased in a positive fashion with increasing the CHA(2)DS(2)-VASc score. During hospitalization, those in the high-risk group or higher CHA(2)DS(2)-VASc score had less improvement in their NIHSS score. Furthermore, early neurological deterioration (END) developed more frequently as CHADS(2) score or CHA(2)DS(2)-VASc score increased. Multivariate analysis showed being in the high-risk group was independently associated with END (OR 2.129, 95% CI 1.013-4.477). CONCLUSIONS Our data indicate that patients with NVAF and higher CHADS(2) score or CHA(2)DS(2)-VASc score are more likely to develop severe stroke and a worse clinical course is expected in these patients after stroke presentation.
Collapse
Affiliation(s)
- H J Hong
- Department ofNeurology, Yonsei University College of Medicine, Seoul, South Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Abstract
BACKGROUND Expression of Runt-related transcription factor 3 (RUNX3) is reduced in a large number of cancers. However, a few studies have reported higher expression of RUNX3 in several cancers, including basal cell carcinoma (BCC). In light of this, we explored the expression of RUNX3 in skin cancers generally, to determine whether it acts as an oncogene or a tumour-suppressor gene in skin tumours. AIM To investigate the expression of RUNX3 in normal skin and malignant skin tumours. METHODS RUNX3 expression was evaluated by western blotting in 24 specimens, comprising 6 malignant melanoma (MM), 6 squamous cell carcinoma (SCC), 6 BCC and 6 normal skin specimens. Immunohistochemical staining was carried out to analyse RUNX3 expression in 16 MM, 16 SCC and 16 BCC specimens. To identify where the protein was expressed, the cytoplasmic and nuclear protein expression of RUNX3 in skin cancer tissues was determined. A cell-proliferation study was performed on an MM line (G361) by small interfering (si)RNA transfection. RESULTS The western blotting experiments showed that RUNX3 was not expressed in normal skin tissues, but it was overexpressed in all MM and SCC samples, and in five of the six BCC samples. Using immunochemistry, RUNX3 was found to be overexpressed in all cancer tissues analysed. Subcellular fraction analysis revealed that RUNX3 was expressed in the nuclei but not the cytoplasm of all the skin cancer tissues analysed, and RUNX3 silencing by siRNA in G361 cells resulted in a decrease in proliferation. CONCLUSIONS Based on these results, we suggest that RUNX3 has an oncogenic potential and does not act as a tumour suppressor in skin cancers.
Collapse
Affiliation(s)
- J H Lee
- Department of Plastic and Reconstructive Surgery, Hanyang University Guri Hospital, Guri, Korea
| | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Kim YD, Lee JH, Jung YH, Cha MJ, Choi HY, Nam CM, Yang JH, Cho HJ, Nam HS, Lee KY, Heo JH. Effect of warfarin withdrawal on thrombolytic treatment in patients with ischaemic stroke. Eur J Neurol 2011; 18:1165-70. [PMID: 21314856 DOI: 10.1111/j.1468-1331.2011.03363.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Abruptly discontinuing warfarin may induce a rebound prothrombotic state. Thrombolytic agents may also paradoxically induce prothrombotic conditions, which include platelet activation and thrombin generation. Therefore, prothrombotic states may be enhanced by withdrawing warfarin in patients under thrombolytic treatment. This study was aimed to determine whether patients with warfarin withdrawal have different clinical outcomes from those without warfarin use after thrombolytic treatment. METHODS A total of 148 consecutive patients with atrial fibrillation who were not on anticoagulants at admission and who received thrombolysis were included in this study. We compared the outcomes between a warfarin withdrawal group and a no-warfarin group. RESULTS Fourteen patients (9.5%) were included in the warfarin withdrawal group. Although baseline National Institute of Health Stroke Scale (NIHSS) scores, recanalization rates, and hemorrhage frequencies did not differ between the groups, the warfarin withdrawal group showed poorer outcomes. Increased NIHSS scores during the first 7days were more frequent in the warfarin withdrawal group (57.1% vs. 26.9%, P=0.029). The median percent improvement in NIHSS scores at 24h after thrombolysis was also lower in the warfarin withdrawal group. After adjusting for covariates, warfarin withdrawal was a strong predictor of poor functional outcome at 3months (modified Rankin score≥3) (odds ratio, 17.067, 95% CI 2.703-107.748). CONCLUSIONS Discontinuing warfarin was associated with early neurologic deterioration and poor long-term outcomes after thrombolytic treatment.
Collapse
Affiliation(s)
- Y D Kim
- Department of Neurology, Severance Hospital Integrative Research Institute for Cerebral and Cardiovascular Diseases, Yonsei University College of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Nam HS, Lee KY, Kim YD, Choi HY, Cho HJ, Cha MJ, Nam CM, Heo JH. Failure of complete recanalization is associated with poor outcome after cardioembolic stroke. Eur J Neurol 2011; 18:1171-8. [PMID: 21309926 DOI: 10.1111/j.1468-1331.2011.03360.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Recanalization is strongly associated with outcomes after thrombolytic treatment. Cardiac emboli are known as better response to fibrinolytic agents because they are fibrin-rich; however, cardioembolic stroke itself is associated with poor outcomes and high mortality. Completeness of recanalization may therefore affect the outcome of cardioembolic stroke. We investigated whether degree of recanalization influences outcomes following fibrinolytic therapy in cardioembolic stroke. METHODS Consecutive stroke patients with relevant artery occlusions on baseline CT angiography who had received thrombolytic treatment were enrolled. Completeness of recanalization was assessed by the Thrombolysis in Myocardial Infarction (TIMI) grade, which was compared between patients with and without cardiac sources of embolism (CSE). We also investigated independent predictors of poor outcome (modified Rankin scale score 3-6) at 3 months. RESULTS Of the 127 patients enrolled, 65 (51%) had one or more CSE. Although the overall recanalization rates (TIMI 2 or 3) in patients with CSE (65%) and patients without CSE (68%) were similar (P=0.710), patients with CSE were less likely to show complete recanalization (TIMI 3) compared with those without CSE (19% vs. 39%, P=0.011). Multivariate analysis revealed that CSE was associated with failure of complete recanalization (OR 2.809, 95% CI 1.097-7.192) and was an independent predictor of poor outcome at 3months (OR 3.629, 95% CI 1.205-8.869). CONCLUSIONS In cardioembolic strokes, failure of complete recanalization following thrombolytic therapy was frequent and was associated with poor outcome after thrombolysis.
Collapse
Affiliation(s)
- H S Nam
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Moon GJ, Shin DH, Im DS, Bang OY, Nam HS, Lee JH, Joo IS, Huh K, Gwag BJ. Identification of oxidized serum albumin in the cerebrospinal fluid of ischaemic stroke patients. Eur J Neurol 2011; 18:1151-8. [PMID: 21299736 DOI: 10.1111/j.1468-1331.2011.03357.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Extensive evidence has shown that oxidative stress mediates neuronal death in animal models of hypoxic-ischaemia. Brain biomarkers of oxidative stress need to be identified in order to better understand and treat brain damage in human stroke patients. The present study was conducted to identify potential target proteins of oxidative stress in the cerebrospinal fluid (CSF) of stroke patients with acute ischaemic brain injury. METHODS We performed two-dimensional polyacrylamide gel electrophoresis to separate protein samples obtained from the CSF of control and stroke patients. To determine protein oxidation levels, oxyblot was then used to detect protein carbonyls that were determined by formation of a stable 2,4-dinitrophenylhydrazine (DNP) product using an anti-DNP antibody. RESULTS We found that oxidation of serum albumin was increased in the CSF from stroke patients as well as rats who underwent permanent middle cerebral artery occlusion (6.5%, 23%, respectively). In stroke patients, oxidized albumin levels correlated to neurologic indications. CONCLUSIONS The present study suggests that oxidized albumin in CSF can be utilized as an oxidative stress marker in human stroke patients.
Collapse
Affiliation(s)
- G J Moon
- Research Institute for Neural Science and Technology, Ajou University School of Medicine, Suwon, South Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Cha MJ, Kim SW, Kim EH, Kim YD, Nam HS, Heo JH. Teaching NeuroImages: isolated sensory loss of the arm sparing the hand in cortical infarction. Neurology 2011; 76:e3. [PMID: 21205685 DOI: 10.1212/wnl.0b013e318203e98b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- M-J Cha
- Department of Neurology, Yonsei University College of Medicine, 250 Seongsan-no, Seodaemoon-ku, 120-752, Seoul, Korea
| | | | | | | | | | | |
Collapse
|
47
|
Cho HJ, Jung YH, Kim YD, Nam HS, Kim DS, Heo JH. The different infarct patterns between adulthood-onset and childhood-onset moyamoya disease. J Neurol Neurosurg Psychiatry 2011; 82:38-40. [PMID: 20587492 DOI: 10.1136/jnnp.2009.181487] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND AND PURPOSE The pattern of infarctions based on the findings of diffusion-weighted image was assessed, and it was also investigated whether there are any age-specific differences in patients with moyamoya disease (MMD). METHODS The subjects were 66 consecutive patients with MMD who had an acute cerebral infarction. Each ischaemic lesion was categorised into one of seven patterns (gyral, atypical territorial, honeycomb, classic territorial, multiple-dot, borderzone, deep lacunar) based on diffusion-weighted image findings. The patterns were compared between adulthood-onset MMD (A-MMD, ≥20 years old, 34 patients) and childhood/adolescent-onset MMD (C-MMD, <20 years old, 32 patients) according to their ages of infarct presentation. RESULTS A total of 91 infarct patterns were observed from 66 patients. The gyral, atypical territorial, and honeycomb patterns, which are not usually seen in conventional stroke patients, were common in MMD (68.1%). Among all patterns, a gyral pattern was most common (40/91, 44.0%). Borderzone and deep lacunar patterns were infrequent. Gyral and borderzone patterns were more frequently seen in the C-MMD group, whereas a honeycomb pattern was not seen in young patients. Honeycomb pattern was more common at advanced vascular stages. Infarctions confined to the cortex were more common in the C-MMD group (26/32, 75.0%) than in A-MMD patients (14/34, 41.2%). CONCLUSIONS Moyamoya disease showed various characteristic and age-specific infarct patterns. Different infarct patterns between the A-MMD and C-MMD groups may be associated with age-specific vulnerability of the brain to ischaemia, stage of arteriopathy or changes of abnormal collateral pathways.
Collapse
Affiliation(s)
- H J Cho
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | | | | | | | | | | |
Collapse
|
48
|
Park HY, Nam HS, Chung MP, Jeong SH, Kim YJ, Cha SI, Kim YW, Park JS, Uh ST, Park CS, Park MS, Moon JA, Jung KS, Jegal YJ, Kim DS, Song JW, Yum HK, Park YB. A nationwide survey of lymphangioleiomyomatosis in Korea: recent increase in newly diagnosed patients. J Korean Med Sci 2010; 25:1182-6. [PMID: 20676330 PMCID: PMC2908788 DOI: 10.3346/jkms.2010.25.8.1182] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [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: 10/29/2009] [Accepted: 01/25/2010] [Indexed: 11/27/2022] Open
Abstract
In 2007, the Korean Interstitial Lung Disease Society had collected clinical data of patients who have diagnosed as Lymphangioleiomyomatosis (LAM) since 1990 through nationwide survey, which showed that LAM patients had increased sharply after 2004. The present study was performed to show the clinical features of Korean patients with LAM, and to establish the reason for the recent increase in the diagnosis. All 63 patients were women and the mean age at diagnosis was 36 yr. The most common presenting symptom was dyspnea and 8 patients had tuberous sclerosis complex. The survival rate at 5 yr after diagnosis was 84%. Compared with patients diagnosed after 2004 (n=34), the patients diagnosed before 2004 (n=29) complained with dyspnea more (P=0.016) and had lower FEV(1)% predicted (P=0.003), and DLco% predicted (P=0.042). The higher proportion of patients diagnosed after 2004 showed the normal chest radiography, and they were detected by routine chest CT screening (P=0.016). This study showed that clinical features of Korean patients with LAM were not different from those reported elsewhere. It is concluded that the reason for the increase of newly diagnosed patients is the result of increase in detection of the early stage LAM by the widespread use of chest CT screening.
Collapse
Affiliation(s)
- Hye Yun Park
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hae-Seong Nam
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Man Pyo Chung
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Hwan Jeong
- Division of Pulmonary Medicine, Department of Internal Medicine, Gachon Medical School Gil Medical Center, Incheon, Korea
| | - Yu Jin Kim
- Division of Pulmonary Medicine, Department of Internal Medicine, Gachon Medical School Gil Medical Center, Incheon, Korea
| | - Seung-Ick Cha
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Young Whan Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, and Lung Institute, Seoul National University Hospital, Seoul, Korea
| | - Jong Sun Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, and Lung Institute, Seoul National University Hospital, Seoul, Korea
| | - Soo-Taek Uh
- Division of Respiration and Allergy Medicine, Soonchunhyang University Hospital, Seoul, Korea
| | - Choon-Sik Park
- Department of Internal Medicine, Bucheon Hospital, Soonchunhyang University School of Medicine, Bucheon, Korea
| | - Moo Suk Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Ae Moon
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Soo Jung
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Yang Jin Jegal
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Dong Soon Kim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Woo Song
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ho-Kee Yum
- Department of Internal Medicine, Seoul Paik Hospital, Inje University, Seoul, Korea
| | - Young Bum Park
- Department of Internal Medicine, Hallym University College of Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea
| |
Collapse
|
49
|
Nam HS, Jeon K, Um SW, Suh GY, Chung MP, Kim H, Kwon OJ, Koh WJ. Clinical characteristics and treatment outcomes of chronic necrotizing pulmonary aspergillosis: a review of 43 cases. Int J Infect Dis 2010; 14:e479-82. [DOI: 10.1016/j.ijid.2009.07.011] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2009] [Accepted: 07/23/2009] [Indexed: 10/20/2022] Open
|
50
|
Jeong WC, Kim YT, Minhas AS, Lee TH, Kim HJ, Nam HS, Kwon O, Woo EJ. In vivoconductivity imaging of human knee using 3 mA injection current in MREIT. ACTA ACUST UNITED AC 2010. [DOI: 10.1088/1742-6596/224/1/012148] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|