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Kim H, Kim TG, Park B, Kim J, Jun SY, Lee JH, Choi HJ, Jung CS, Lee HW, Lee JS, Nam HY, Shin S, Kim SM, Kim H. Tailored radiation dose according to margin width for patients with ductal carcinoma in situ after breast-conserving surgery. Sci Rep 2024; 14:300. [PMID: 38168758 PMCID: PMC10761984 DOI: 10.1038/s41598-023-50840-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/27/2023] [Indexed: 01/05/2024] Open
Abstract
A 2 mm resection margin is considered adequate for ductal carcinoma in situ (DCIS). We assessed the effectiveness of a tailored radiation dose for margins < 2 mm and the appropriate margin width for high-risk DCIS. We retrospectively evaluated 137 patients who received adjuvant radiotherapy after breast-conserving surgery for DCIS between 2013 and 2019. The patients were divided into three- positive, close (< 2 mm), and negative (≥ 2 mm) margin groups. Radiation dose to the tumor bed in equivalent dose in 2 Gy fractions were a median of 66.25 Gy, 61.81 Gy, and 59.75 Gy for positive, close, and negative margin groups, respectively. During a median follow-up of 58 months, the crude rates of local recurrence were 15.0%, 6.7%, and 4.6% in the positive, close, and negative margin groups, respectively. The positive margin group had a significantly lower 5-year local recurrence-free survival (LRFS) rate compared to the close and negative margin groups in propensity-weighted log-rank analysis (84.82%, 93.27%, and 93.20%, respectively; p = 0.008). The difference in 5-year LRFS between patients with the high- and non-high-grade tumors decreased as the margin width increased (80.4% vs. 100.0% for margin ≥ 2 mm, p < 0.001; 92.3% vs. 100.0% for margin ≥ 6 mm, p = 0.123). With the radiation dose tailored for margin widths, positive margins were associated with poorer local control than negative margins, whereas close margins were not. Widely clear margins (≥ 2 mm) were related to favorable local control for high-grade DCIS.
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Affiliation(s)
- Hyunjung Kim
- Departments of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, 630-522, South Korea
| | - Tae Gyu Kim
- Departments of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, 630-522, South Korea.
| | - Byungdo Park
- Departments of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, 630-522, South Korea
| | - Jeongho Kim
- Departments of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, 630-522, South Korea
| | - Si-Youl Jun
- Departments of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Jun Ho Lee
- Departments of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Hee Jun Choi
- Departments of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Chang Shin Jung
- Departments of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Hyoun Wook Lee
- Departments of Pathology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Jae Seok Lee
- Departments of Pathology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Hyun Yeol Nam
- Departments of Nuclear Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Seunghyen Shin
- Departments of Nuclear Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Sung Min Kim
- Departments of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Haeyoung Kim
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Kim H, Kim TG, Park B, Kim JH, Jun SY, Lee JH, Choi HJ, Jung CS, Bang YJ, Lee HW, Lee JS, Nam HY, Shin S, Kim SM, Kim H. Effect of high-dose radiation therapy on positive margins after breast-conserving surgery for invasive breast cancer. Breast 2023; 71:106-112. [PMID: 37572626 PMCID: PMC10425380 DOI: 10.1016/j.breast.2023.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/28/2023] [Accepted: 08/05/2023] [Indexed: 08/14/2023] Open
Abstract
PURPOSE Positive margins after breast-conserving surgery are associated with poor oncological outcomes and warrant additional surgery. This study aimed to evaluate the effectiveness of high-dose radiation therapy for positive margins by comparing local recurrence between patients with positive and negative margins. METHODS We retrospectively evaluated 550 patients treated with adjuvant radiation therapy after breast-conserving surgery for invasive breast cancer between 2013 and 2019. The total equivalent dose in 2 Gy fractions (EQD2) to the tumor bed ranged from 65.81 to 66.25 Gy for positive margins and 59.31-61.81 Gy for negative margins. The differences in local recurrence between the positive and negative margin groups were analyzed. RESULTS After a median follow-up of 58 months, the crude local recurrence rate was 7.3% in the positive margin group (n = 55) and 2.4% in the negative margin group (n = 495). Positive margins were associated with higher local recurrence without statistical significance in the entire cohort (p = 0.062). Among patients aged <60 years, those with positive margins had a significantly lower 5-year local recurrence-free survival rate than those with negative margins (89.16% vs. 97.57%, respectively; p = 0.005). In contrast, there was no significant difference in the 5-year local recurrence-free survival rate between patients with positive and negative margins among those aged ≥60 years (100.00% vs. 94.38%, respectively; p = 0.426). CONCLUSION In this study, positive margins were not associated with poor local control in older patients after a high-dose boosts. Further prospective studies are needed to verify our findings.
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Affiliation(s)
- Hyunjung Kim
- Department of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Tae Gyu Kim
- Department of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea.
| | - Byungdo Park
- Department of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Jeong Ho Kim
- Department of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Si-Youl Jun
- Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Jun Ho Lee
- Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Hee Jun Choi
- Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Chang Shin Jung
- Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Yoon Ju Bang
- Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Hyoun Wook Lee
- Department of Pathology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Jae Seok Lee
- Department of Pathology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Hyun Yeol Nam
- Department of Nuclear Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Seunghyeon Shin
- Department of Nuclear Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Sung Min Kim
- Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Haeyoung Kim
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Nam HY, Lee HW. Relationship between 18F-FDG uptake and heat shock protein 90α expression in colorectal cancer. Hell J Nucl Med 2021; 24:10-17. [PMID: 33866334 DOI: 10.1967/s002449912301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/10/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We investigated whether heat shock protein 90α (HSP90α) expression is associated with fluorine-18-labeled fluoro-2-deoxy-D-glucose (18F-FDG) uptake and whether 18F-FDG positron emission tomography/computed tomography (PET/CT) can be used to predict the status of HSP90α expression in colorectal cancer (CRC). SUBJECTS AND METHODS The medical records and preoperative 18F-FDG PET/CT studies of 51 patients with newly diagnosed CRC who underwent surgical treatment were retrospectively reviewed. The maximum standardized uptake value (SUVmax) of the primary tumor was calculated from the level of 18F-FDG uptake. HSP90α expression was determined by immunohistochemistry. The relationship between SUVmax and HSP90α expression was analyzed. RESULTS Colorectal cancer with high HSP90α expression had significantly higher SUVmax than CRC with low HSP90α expression (18.88±10.06 vs. 12.38±5.04, P=0.003). There was a significant correlation between HSP90α expression and 18F-FDG uptake (r=0.354, P=0.011). The highest accuracy for determining HSP90α status (68.6%) was obtained with a SUVmax cut-off of 15.4. Maximum SUV was the only predictor of HSP90α expression on multivariate logistic regression analysis (Odds Ratio=5.384, P=0.016). CONCLUSION The expression status of HSP90α was significantly related to 18F-FDG uptake in CRC.
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Affiliation(s)
- Hyun Yeol Nam
- Department of Nuclear Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 158, Paryong-ro, Masanhoewon-gu, Changwon, 51353, South Korea.
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Nam HY, Kim KS, Lee JH. Population genetic structure and putative migration pathway of Sogatella furcifera (Horváth) (Hemiptera, Delphacidae) in Asia. Bull Entomol Res 2019; 109:453-462. [PMID: 30301481 DOI: 10.1017/s0007485318000755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The white-backed planthopper, Sogatella furcifera (Horváth) (Hemiptera, Delphacidae), has emerged as a serious rice pest in Asia. In the present study, 12 microsatellite markers were employed to investigate the genetic structure, diversity and migration route of 43 populations sampled from seven Asian countries (Bangladesh, China, Korea, Laos, Nepal, Thailand, and Vietnam). According to the isolation by distance analysis, a significant positive correlation was observed between genetic and geographic distances by the Mantel test (r2 = 0.4585, P = 0.01), indicating the role of geographic isolation in the genetic structure of S. furcifera. A population assignment test using the first-generation migrants detection method (thresholds a = 0.01) revealed southern China and northern Vietnam as the main sources of S. furcifera in Korea. Nepal and Bangladesh might be additional potential sources via interconnection with Vietnam populations. This paper provides useful data for the migration route and origin of S. furcifera in Korea and will contribute to planthopper resistance management.
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Affiliation(s)
- H Y Nam
- Entomology Program, Department of Agricultural Biotechnology, Seoul National University, Seoul 08826, Republic Korea
| | - K S Kim
- Iowa State University, Department of Natural Resource Ecology and Management, Ames, IA, 50011, USA
| | - J-H Lee
- Entomology Program, Department of Agricultural Biotechnology, Seoul National University, Seoul 08826, Republic Korea
- Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul 08826, Republic of Korea
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Seo Y, Pak K, Nam HY, Seok JW, Lee MJ, Kim EJ, Lee JM, Kim SJ, Kim IJ. Effect of rs3910105 in the Synuclein Gene on Dopamine Transporter Availability in Healthy Subjects. Yonsei Med J 2018; 59:787-792. [PMID: 29978616 PMCID: PMC6037603 DOI: 10.3349/ymj.2018.59.6.787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 06/01/2018] [Accepted: 06/15/2018] [Indexed: 12/03/2022] Open
Abstract
PURPOSE The present study investigated associations between dopamine transporter (DAT) availability and α-synuclein levels in cerebrospinal fluid, as well as synuclein gene (SNCA) transcripts, and the effect of single nucleotide polymorphism of SNCA on DAT availability in healthy subjects. MATERIALS AND METHODS The study population comprised healthy controls who underwent ¹²³I-FP-CIT single-photon emission computed tomography screening. Five SNCA probes were used to target the boundaries of exon 3 and exon 4 (SNCA-E3E4), transcripts with a long 3'UTR region (SNCA-3UTR-1, SNCA-3UTR-2), transcripts that skip exon 5 (SNCA-E4E6), and the rare short transcript isoforms that comprise exons 1-4 (SNCA-007). RESULTS In total, 123 healthy subjects (male 75, female 48) were included in this study. DAT availability in the caudate nucleus (p=0.0661) and putamen (p=0.0739) tended to differ according to rs3910105 genotype. In post-hoc analysis, DAT availability in the putamen was lower in subjects of TT genotype than those of CC/CT (p=0.0317). DAT availability in the caudate nucleus also showed a trend similar to that in the putamen (p=0.0597). Subjects of CT genotype with rs3910105 showed negative correlations with DAT availability in the putamen with SNCA-E3E4 (p=0.037, rho=-0.277), and SNCA-E4E6 (p=0.042, rho=-0.270), but not those of CC/TT genotypes. CONCLUSION This is the first study to investigate the association of rs3910105 in SNCA with DAT availability. rs3910105 had an effect on DAT availability, and the correlation between DAT availability and SNCA transcripts were significant in CT genotypes of rs3910105.
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Affiliation(s)
- Youngduk Seo
- Department of Nuclear Medicine, Busan Seongso Hospital, Busan, Korea
| | - Kyoungjune Pak
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
| | - Hyun Yeol Nam
- Department of Nuclear Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Ju Won Seok
- Department of Nuclear Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
| | - Myung Jun Lee
- Department of Neurology and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Eun Joo Kim
- Department of Neurology and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jae Meen Lee
- Department of Neurosurgery and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Seong Jang Kim
- Department of Nuclear Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - In Joo Kim
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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Kwong PJ, Nam HY, Wan Khadijah WE, Kamarul T, Abdullah RB. Comparison of in vitro developmental competence of cloned caprine embryos using donor karyoplasts from adult bone marrow mesenchymal stem cells vs ear fibroblast cells. Reprod Domest Anim 2014; 49:249-53. [PMID: 24456113 DOI: 10.1111/rda.12262] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 11/07/2013] [Indexed: 01/04/2023]
Abstract
The aim of this study was to produce cloned caprine embryos using either caprine bone marrow-derived mesenchymal stem cells (MSCs) or ear fibroblast cells (EFCs) as donor karyoplasts. Caprine MSCs were isolated from male Boer goats of an average age of 1.5 years. To determine the pluripotency of MSCs, the cells were induced to differentiate into osteocytes, chondrocytes and adipocytes. Subsequently, MSCs were characterized through cell surface antigen profiles using specific markers, prior to their use as donor karyoplasts for nuclear transfer. No significant difference (p > 0.05) in fusion rates was observed between MSCs (87.7%) and EFCs (91.3%) used as donor karyoplasts. The cleavage rate of cloned embryos derived with MSCs (87.0%) was similar (p > 0.05) to those cloned using EFCs (84.4%). However, the in vitro development of MSCs-derived cloned embryos (25.3%) to the blastocyst stage was significantly higher (p < 0.05) than those derived with EFCs (20.6%). In conclusion, MSCs could be reprogrammed by caprine oocytes, and production of cloned caprine embryos with MSCs improved their in vitro developmental competence, but not in their fusion and cleavage rate as compared to cloning using somatic cells such as EFCs.
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Affiliation(s)
- P J Kwong
- Animal Biotechnology-Embryo Laboratory, Faculty of Science, Institute of Biological Sciences, University of Malaya, Kuala Lumpur, Malaysia; Department of Agricultural and Food Science, Faculty of Science, Universiti Tunku Abdul Rahman, Perak, Malaysia
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Abstract
The value of (18)F-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in the detection of carcinoma of unknown primary (CUP) differs among the studies. This study aimed to evaluate the role of (18)F-FDG PET/CT in CUP. Fifty-one patients (19 women, 32 men) with metastasis confirmed by histopathology from an unknown primary tumor were included in this study. Patients received 370 MBq of (18)F-FDG intravenously, and PET/CT was performed at 60 minutes after injection. Primary tumor sites were detected in 5 of 51 patients (9.6%): in 2 patients with carcinoma of the lung, in 1 patient with carcinoma of the gallbladder, in 1 patient with carcinoma of the esophagus, and in 1 patient with carcinoma of the stomach. No primary tumor was discovered in the remaining 46 patients (90.4%) during the follow-up. The sensitivity, specificity, and accuracy of (18)F-FDG PET/CT were 100%, 80.4%, and 82.4%. The positive and negative predictive values were 35.7 and 100%, respectively. Based on the data presented, (18)F-FDG PET/CT has a clinical implicative value in detecting the primary tumor of CUP. PET/CT can be useful to rule out the possibility of detecting the primary tumor during the follow-up.
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Affiliation(s)
- K Pak
- Department of Nuclear Medicine and Medical Research Institute, Pusan National University Hospital, Busan, South Korea
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Chan CYW, Nam HY, Raveenthiran R, Choon SK, Tai CC. Outpatient pre-operative assessment in joint replacement surgery. Med J Malaysia 2008; 63:100-103. [PMID: 18942292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
An anaesthetist-led outpatient pre-operative assessment (OPA) clinic was introduced in our unit in an effort to improve patient care and cost-effectiveness. To assess the efficiency of the clinic, 112 patients who attended the OPA clinic (attendance rate 98%) during the first year were assessed prospectively and compared with 118 patients who did not undergo OPA the year before. There were fewer cancellations among those who attended the OPA clinic (13.6% compared to 3.6%), and the hospital stay was shortened from an average of 10.7 days to 7.0 days. This has resulted in more efficient utilization of operating theatre, reduced hospital costs and improved patient satisfaction. More extensive use of the pre-admission clinic is recommended and should be explored in other clinical settings.
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Affiliation(s)
- C Y W Chan
- Department of Orthopaedic Surgery, University Malaya Medical Centre, 50603 Kuala Lumpur, Malaysia
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Tai CC, Tan SH, Misnan NA, Nam HY, Choon SK. Thirty-Day Morbidity and Mortality after Simultaneous Bilateral Total Knee Arthroplasty. Malays Orthop J 2008. [DOI: 10.5704/moj.0804.007] [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: 11/05/2022] Open
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