1
|
Lee JM, Cho HJ, Moon JH, Sohn SK, Park B, Baek DW. Clinical impact of spine magnetic resonance imaging as a valuable prognostic tool for patients with multiple myeloma: a retrospective study. J Yeungnam Med Sci 2022; 39:300-308. [PMID: 35316889 PMCID: PMC9580056 DOI: 10.12701/jyms.2021.01648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/17/2022] [Indexed: 11/04/2022]
Abstract
Background This study investigated the prognostic impact of spine magnetic resonance imaging (MRI) in patients newly diagnosed with multiple myeloma (MM). Methods We retrospectively evaluated 214 patients who were newly diagnosed with MM between March 2015 and December 2019. The patients were classified into five different infiltration patterns based on spine MRI as follows: (1) normal appearance, (2) focal, (3) diffuse, (4) combined focal and diffuse infiltration, and (5) “salt-and-pepper.” Results Forty patients (18.7%) showed a normal appearance, whereas focal, diffuse, combined focal and diffuse infiltration, and “salt-and-pepper” patterns were identified in 68 (31.8%), 40 (18.7%), 52 (24.3%), and 14 patients (6.5%), respectively. The patients with normal and “salt-and-pepper” patterns were younger than patients with other patterns (median age, 61.6 vs. 66.8 years; p=0.001). Moreover, 63% and 59.3% of patients with normal and “salt-and-pepper” patterns were scored International Staging System (ISS) stage I and revised ISS (R-ISS) stage I, respectively, whereas only 12.5% of patients with other patterns were scored ISS stage I and R-ISS stage I. Patients with normal and “salt-and-pepper” patterns had a better prognosis than those with other patterns, whereas relapse and death rates were significantly higher in patients with focal, diffuse, and combined MRI patterns. Conclusion Characteristic MRI findings have a significant prognostic value for long-term survival in patients newly diagnosed with MM. In particular, focal, diffuse, and combined focal and diffuse infiltration patterns are unfavorable prognostic factors.
Collapse
Affiliation(s)
- Jung Min Lee
- Department of Hematology-Oncology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hee Jeong Cho
- Department of Hematology-Oncology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Joon-Ho Moon
- Department of Hematology-Oncology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sang Kyun Sohn
- Department of Hematology-Oncology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Byunggeon Park
- Department of Radiology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong Won Baek
- Department of Hematology-Oncology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
- Corresponding author: Dong Won Baek, MD, PhD Department of Hematology/Oncology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea Tel: +82-53-200-5568 • Fax: +82-53-426-2046 • E-mail:
| |
Collapse
|
2
|
Baek DW, Hwang S, Kim J, Lee JM, Cho HJ, Moon JH, Hwang N, Jeong JY, Lee SW, Sohn SK. Patients presenting high fever with lymphadenopathy after COVID-19 vaccination were diagnosed with hemophagocytic lymphohistiocytosis. Infect Dis (Lond) 2021; 54:303-307. [PMID: 34854350 DOI: 10.1080/23744235.2021.2010801] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still continuing worldwide. Currently, two mRNA-based vaccines and two DNA vaccines using an adenovirus vector are representative vaccines. Since the SARS-CoV-2 vaccines began to be administered, a significant decrease in new infections and COVID-19-associated death has been reported. However, various adverse events from mild symptoms to death have also been described after vaccination. CASE DESCRIPTION Patients with high fever and lymphadenopathy who are diagnosed with hemophagocytic lymphohistiocytosis (HLH) after COVID-19 vaccination are very rare, and there is no standard management guideline for these patients thus far. Herein, we described two cases of HLH after the administration of an mRNA-based vaccine and adenovirus vector vaccine. DISCUSSION HLH is a life-threatening hyperinflammatory syndrome that occurs due to persistent stimulation of lymphocytes and histiocytes in various underlying conditions at all ages. Although the exact mechanisms and risk factors of COVID-19 vaccination-related HLH are still unknown, vigorous immune stimulation may trigger a huge cytokine storm, rarely resulting in HLH. It is important to note that early suspicion by clinicians can lower the mortality rate.
Collapse
Affiliation(s)
- Dong Won Baek
- Department of Hematology/Oncology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Soyoon Hwang
- Department of Infectious Disease, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Juhyung Kim
- Department of Hematology/Oncology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jung Min Lee
- Department of Hematology/Oncology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hee Jeong Cho
- Department of Hematology/Oncology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Joon-Ho Moon
- Department of Hematology/Oncology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Narae Hwang
- Department of Laboratory Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ji Yun Jeong
- Department of Pathology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sang-Woo Lee
- Department of Nuclear Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sang Kyun Sohn
- Department of Hematology/Oncology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| |
Collapse
|
3
|
Gim GM, Kwon DH, Eom KH, Moon J, Park JH, Lee WW, Jung DJ, Kim DH, Yi JK, Ha JJ, Lim KY, Kim JS, Jang G. Production of MSTN-mutated cattle without exogenous gene integration using CRISPR-Cas9. Biotechnol J 2021; 17:e2100198. [PMID: 34247443 DOI: 10.1002/biot.202100198] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/05/2021] [Accepted: 07/09/2021] [Indexed: 11/06/2022]
Abstract
Many genome-edited animals have been produced using clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9 technology to edit specific genes. However, there are few guidelines for the application of this technique to cattle. The goal of this study was to produce trait-improved cattle using the genome-editing technology CRISPR-Cas9. Myostatin (MSTN) was selected as a target locus, and synthetic mRNA of sgRNA and Cas9 were microinjected into fertilized bovine embryos in vitro. As a result, 17 healthy calves were born, and three of them showed MSTN mutation rates of 10.5%, 45.4%, and 99.9%, respectively. Importantly, the offspring with the 99.9% MSTN mutation rate had a biallelic mutation (-12 bps) and a double-muscling phenotype. In conclusion, we demonstrate that the genome-editing technology CRISPR-Cas9 can produce genetically modified calves with improved traits.
Collapse
Affiliation(s)
- Gyeong-Min Gim
- Laboratory of Theriogenology and Biotechnology, Department of Veterinary Clinical Science, College of Veterinary Medicine and the Research Institute of Veterinary Science, Seoul National University, Seoul, Republic of Korea.,BK21 Plus Program, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Dong-Hyeok Kwon
- Laboratory of Theriogenology and Biotechnology, Department of Veterinary Clinical Science, College of Veterinary Medicine and the Research Institute of Veterinary Science, Seoul National University, Seoul, Republic of Korea.,BK21 Plus Program, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Kyeong-Hyun Eom
- Laboratory of Theriogenology and Biotechnology, Department of Veterinary Clinical Science, College of Veterinary Medicine and the Research Institute of Veterinary Science, Seoul National University, Seoul, Republic of Korea.,BK21 Plus Program, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | | | | | | | - Dae-Jin Jung
- Gyeongsangbukdo Livestock Research Institute, Yeongju, Republic of Korea
| | - Dae-Hyun Kim
- Gyeongsangbukdo Livestock Research Institute, Yeongju, Republic of Korea
| | - Jun-Koo Yi
- Gyeongsangbukdo Livestock Research Institute, Yeongju, Republic of Korea
| | - Jae-Jung Ha
- Gyeongsangbukdo Livestock Research Institute, Yeongju, Republic of Korea
| | - Ka-Yeong Lim
- Center for Genome Engineering, Institute for Basic Science (IBS), Seoul, Republic of Korea
| | - Jin-Soo Kim
- Center for Genome Engineering, Institute for Basic Science (IBS), Seoul, Republic of Korea
| | - Goo Jang
- Laboratory of Theriogenology and Biotechnology, Department of Veterinary Clinical Science, College of Veterinary Medicine and the Research Institute of Veterinary Science, Seoul National University, Seoul, Republic of Korea.,BK21 Plus Program, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| |
Collapse
|
4
|
Baek DW, Cho HJ, Kim JH, Sohn SK, Song GY, Ahn SY, Jung SH, Ahn JS, Lee JJ, Kim HJ, Jeong SY, Hong CM, Min JJ, Moon JH, Yang DH. Quantitative Assessment of Interim PET/CT Could Have More Prognostic Relevance than Visual Assessment for Predicting Clinical Outcome of Extranodal Diffuse Large B Cell Lymphoma. In Vivo 2020; 34:2127-2134. [PMID: 32606193 DOI: 10.21873/invivo.12018] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND/AIM The present study retrospectively investigated the predictive accuracy of interim positron emission tomography/computed tomography (iPET/CT) based on the Deauville 5-point scale (5-PS) and a quantitative SUV-based assessment in patients with extranodal (EN) diffuse large B cell lymphoma (DLBCL). PATIENTS AND METHODS The Deauville 5-PS and the SUVmax reduction (ΔSUVmax) assessment for interpreting the response to iPET/CT were used. RESULTS A total of 163 patients were enrolled in this study. With a median follow-up of 52.5 months, ΔSUVmax successfully predicted the survival outcomes of patients with one extranodal (EN) involvement in terms of overall survival (OS) (p=0.012) and progression-free survival (PFS) (p<0.001). Visual assessment using the Deauville 5-PS did not predict survival outcomes in patients with one or more EN involvements in terms of OS and PFS. CONCLUSION The quantitative SUV-based assessment with iPET/CT was a significant prognosticator for long-term survival outcomes, especially in patients with one EN involvement.
Collapse
Affiliation(s)
- Dong Won Baek
- Department of Hematology/Oncology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hee Jeong Cho
- Department of Hematology/Oncology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Ju-Hyung Kim
- Department of Hematology/Oncology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Sang Kyun Sohn
- Department of Hematology/Oncology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Ga-Young Song
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, School of Medicine, Chonnam National University, Hwasun, Republic of Korea
| | - Seo-Yeon Ahn
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, School of Medicine, Chonnam National University, Hwasun, Republic of Korea
| | - Sung-Hoon Jung
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, School of Medicine, Chonnam National University, Hwasun, Republic of Korea
| | - Jae Sook Ahn
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, School of Medicine, Chonnam National University, Hwasun, Republic of Korea
| | - Je-Jung Lee
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, School of Medicine, Chonnam National University, Hwasun, Republic of Korea
| | - Hyeoung-Joon Kim
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, School of Medicine, Chonnam National University, Hwasun, Republic of Korea
| | - Shin-Young Jeong
- Department of Nuclear Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Chae Moon Hong
- Department of Nuclear Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Jung-Joon Min
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, School of Medicine, Chonnam National University, Hwasun, Republic of Korea
| | - Joon-Ho Moon
- Department of Hematology/Oncology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Deok-Hwan Yang
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, School of Medicine, Chonnam National University, Hwasun, Republic of Korea
| |
Collapse
|
5
|
Kim EY, Do SI, Yun JS, Park YL, Park CH, Moon JH, Youn I, Choi YJ, Ham SY, Kook SH. Preoperative evaluation of mammographic microcalcifications after neoadjuvant chemotherapy for breast cancer. Clin Radiol 2020; 75:641.e19-641.e27. [PMID: 32291081 DOI: 10.1016/j.crad.2020.03.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 03/11/2020] [Indexed: 12/20/2022]
Abstract
AIM To assess the predictive value of preoperative residual mammographic microcalcifications for residual tumours after neoadjuvant chemotherapy (NAC) for breast cancer. MATERIALS AND METHODS This single-centre retrospective study included breast cancer patients who underwent NAC and demonstrated suspicious microcalcifications within or near the tumour bed on mammography from June 2015 to August 2018. The residual microcalcifications and remnant lesion on magnetic resonance imaging (MRI) were correlated with histopathological findings of residual tumours and immunohistochemical markers. RESULTS A total of 96 patients were included. Ten patients achieved pathological complete response (pCR) and previous suspicious microcalcifications were associated with benign pathology in 10.4% (10/96) of the patients. In the remaining 86 patients who did not achieve pCR, 61.5% (59/96) of the residual microcalcifications were associated with invasive or in situ carcinoma and 28.1% (27/96) with benign pathology. Hormone receptor-positive (HR+) patients had the highest proportion of residual malignant microcalcifications compared to HR- patients (48.9% versus 13.5%, respectively; p=0.019). MRI correlated better than residual microcalcifications on mammography in predicting residual tumour extent in all subtypes (ICC=0.709 versus 0.365). MRI also showed higher correlation with residual tumour size for the HR-/HER2+ and HR-/HER2- subtype (ICC=0.925 and 0.876, respectively). CONCLUSION The extent of microcalcifications on mammography after NAC did not correlate with the extent of residual cancer in 38.5% of women. Regardless of the extent of microcalcifications, residual tumour extent on MRI after NAC and molecular subtype could be an accurate tool in evaluating residual cancer after NAC.
Collapse
Affiliation(s)
- E Y Kim
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S-I Do
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - J-S Yun
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Y L Park
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - C H Park
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J H Moon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - I Youn
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Y J Choi
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S-Y Ham
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S H Kook
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
6
|
Kim T, Choi Y, Lee JH, Park S, Ahn JS, Moon JH, Shin HJ, Lee WS, Kim D, Lee HS. Clinical impact of anti-thymocyte globulin on survival and graft-versus-host disease in patients undergoing human leukocyte antigen mismatched allogeneic stem cell transplantation. Korean J Intern Med 2020; 35:429-437. [PMID: 30616303 PMCID: PMC7061010 DOI: 10.3904/kjim.2018.317] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 05/04/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND/AIMS Rabbit anti-thymocyte globulin (ATG) is usually incorporated in hematopoietic stem cell transplantation (HSCT) to reduce the incidence of graft-versus-host disease (GVHD). This study aimed to find optimal ATG doses in patients undergoing human leukocyte antigen (HLA)-mismatched allogeneic HSCT. METHODS We retrospectively collected medical records from 352 consecutive patients with acute myeloid leukemia (n = 214), acute lymphoblastic leukemia (n = 62), or myelodysplastic syndrome (n = 76) in eight centers of Korea between 2005 and 2015. All patients received busulfan-based conditioning without total body irradiation (TBI) and received stem cells from HLA-mismatched donors. RESULTS In the current study, 5-year overall survival rates of patients receiving low to medium doses of ATG (2.5 to 7.5 mg/kg) were higher than those receiving other doses of ATG (hazard ratio [HR], 0.528; 95% confidence interval [CI], 0.311 to 0.897; p = 0.018). The incidence rates of extensive chronic GVHD (ecGVHD) after administration of low to medium doses of ATG were lower than those after other doses of ATG (HR, 0.447; 95% CI, 0.224 ton 0.889; p = 0.022). CONCLUSION The low to medium doses of ATG may be associated with improving survival outcomes and reducing incidence of ecGVHD without enhancing the chances of relapse in patients with acute leukemia or myelodysplastic syndrome undergoing non-TBI-based HLA-mismatched allogeneic HSCT.
Collapse
Affiliation(s)
- Taeyun Kim
- Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Yunsuk Choi
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Je-Hwan Lee
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Silvia Park
- Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Sook Ahn
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Joon-Ho Moon
- Department of Hematology, Kyungpook National University Hospital, Daegu, Korea
| | - Ho-Jin Shin
- Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
| | - Won Sik Lee
- Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea
| | - Dajung Kim
- Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Ho Sup Lee
- Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
- Correspondence to Ho Sup Lee, M.D. Department of Internal Medicine, Kosin University Gospel Hospital, 262 Gamcheon-ro, Seo-gu, Busan 49267, Korea Tel: +82-51-990-5820 Fax: +82-51-990-5820 E-mail:
| |
Collapse
|
7
|
An JS, Rho YS, Moon JH, Lim YC. Notch1 inactivation promotes invasion and metastasis of nasopharyngeal carcinoma cells partly through Slug activation. Neoplasma 2019; 67:259-266. [PMID: 31777263 DOI: 10.4149/neo_2019_190313n220] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/19/2019] [Indexed: 11/08/2022]
Abstract
Nasopharyngeal carcinoma (NPC) is a rare form of the head and neck cancer of the epithelial lining of the nasopharynx and exhibits the highest metastatic rate among head and neck cancers. Underlying mechanisms of metastasis remain largely unknown. Here, we explored whether Notch1 affects the invasion and metastasis of NPC cells. In vitro migration and invasion capacities were evaluated after the knockdown of Notch1 expression in NPC cells. To investigate the role of Notch1 in in vivo metastasis, we examined the metastatic ability to the lungs following administration of cancer cells via mouse tail vein. The expression of epithelial-mesenchymal transition (EMT) markers associated with Notch1-mediated metastasis was investigated, and their roles in metastasis and relationship with Notch1 expression were investigated. Suppression of Notch1 expression increased the ability of NPC cells to invade Matrigel in vitro. Knockdown of Notch1 expression in NPC cells resulted in extensive lung metastasis in a mouse model and increased the mRNA expression of Slug in NPC cells. Slug-specific RNA interference resulted in the loss of the metastatic and invasion capacities in Notch1-suppressed NPC cells. These findings show that Notch1 has a significant suppressive role in the regulation of metastasis in NPCs, suggestive of its prudent use in clinical trials.
Collapse
Affiliation(s)
- J S An
- Department of Otorhinolaryngology - Head and Neck Surgery, School of Medicine, Konkuk University, Seoul, South Korea
| | - Y S Rho
- Department of Otorhinolaryngology - Head and Neck Surgery, College of Medicine, Hallym University, Seoul, South Korea
| | - J H Moon
- Department of Otorhinolaryngology - Head and Neck Surgery, School of Medicine, Konkuk University, Seoul, South Korea
| | - Y C Lim
- Department of Otorhinolaryngology - Head and Neck Surgery, School of Medicine, Konkuk University, Seoul, South Korea
| |
Collapse
|
8
|
Kim SJ, Kwon HS, Kwon DK, Koo OJ, Moon JH, Park EJ, Yum SY, Lee BC, Jang G. Production of Transgenic Porcine Embryos Reconstructed with Induced Pluripotent Stem-Like Cells Derived from Porcine Endogenous Factors Using piggyBac System. Cell Reprogram 2019; 21:26-36. [DOI: 10.1089/cell.2018.0036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
- Su-Jin Kim
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Research Institute of Veterinary Science, Seoul National University, Seoul, Republic of Korea
| | - Hee-Sun Kwon
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Research Institute of Veterinary Science, Seoul National University, Seoul, Republic of Korea
| | - Dae-kee Kwon
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Research Institute of Veterinary Science, Seoul National University, Seoul, Republic of Korea
| | | | - Joon-Ho Moon
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Research Institute of Veterinary Science, Seoul National University, Seoul, Republic of Korea
| | - Eun-Jung Park
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Research Institute of Veterinary Science, Seoul National University, Seoul, Republic of Korea
| | - Soo-Young Yum
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Research Institute of Veterinary Science, Seoul National University, Seoul, Republic of Korea
| | - Byeong-Chun Lee
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Research Institute of Veterinary Science, Seoul National University, Seoul, Republic of Korea
| | - Goo Jang
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Research Institute of Veterinary Science, Seoul National University, Seoul, Republic of Korea
- BK21 Plus program, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
- Emergence Center for Food-Medicine Personalized Therapy System, Advanced Institutes of Convergence Technology, Seoul National University, Gyeonggi-do, Republic of Korea
| |
Collapse
|
9
|
Moon JH, Huh JS, Won CW, Kim HJ. Is Polypharmacy Associated with Cognitive Frailty in the Elderly? Results from the Korean Frailty and Aging Cohort Study. J Nutr Health Aging 2019; 23:958-965. [PMID: 31781725 DOI: 10.1007/s12603-019-1274-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Cognitive frailty-the coexistence of physical frailty and cognitive impairment-is a phenotype of frailty in the elderly. The coexistence of physical frailty and cognitive impairment, known as cognitive frailty, is one of the phenotypes of frailty in the elderly. Cognitive frailty predicts adverse health outcome more accurately than does physical frailty. In this study, we aim to determine whether the polypharmacy common among the elderly is linked with cognitive frailty. DESIGN, SETTING, AND PARTICIPANTS The elderly, aged between 70 and 84 years, who participated in the cross-sectional Korean Frailty and Aging Cohort Study were included in the present study. MEASUREMENTS Polypharmacy and hyperpolypharmacy were defined as the use of at least five and ten medications, respectively. Physical frailty was assessed by the Korean version of the FRAIL scale, and cognitive status was measured by the Trail Making Test part A, word list recall test, the Korean version of the Frontal Assessment Battery, and the Digit Span Backward test. RESULTS Among the 2,392 participants, 26.8% and 4.1% took more than five and ten prescribed medications, respectively. Polypharmacy and hyperpolypharmacy participants tend to have more cognitive impairment and physical frailty. Participants with cognitive frailty had the highest polypharmacy rate regardless of medication type. After controlling for the potential confounders including severity of comorbidities, frailty was found to be significantly related to polypharmacy, as defined by prescribed as well as total medications, including non-prescribed medications. However, cognitive impairment only showed a linkage to polypharmacy of prescribed medications, which-according to the results of multivariable analysis- could increase cognitive frailty, with an odds ratio of 2.70. CONCLUSION Although the elderly tend to depend on various medications, they should seriously consider the risk of polypharmacy for better health outcomes.
Collapse
Affiliation(s)
- J H Moon
- Chang Won Won and Hyeon Ju Kim, Department of Family Medicine, Jeju National University School of Medicine, Jeju, Republic of Korea, ; Tel.: +82-64-754-8153 (H.J.K.), ; Tel.:+82-2-958-8700 (C.W.W.)
| | | | | | | |
Collapse
|
10
|
Yhim HY, Park Y, Han YH, Kim S, Kang SR, Moon JH, Jeong JH, Shin HJ, Kim K, Choi YS, Kim K, Kim MK, Kong E, Kim DS, Eo JS, Lee JH, Kang DY, Lee WS, Lee SM, Do YR, Ham JS, Kim SJ, Kim WS, Choi JY, Yang DH, Kwak JY. Correction to: a risk stratification model for nodal peripheral T-cell lymphomas based on the NCCN-IPI and posttreatment Deauville score. Eur J Nucl Med Mol Imaging 2018; 45:2482-2483. [PMID: 30221329 DOI: 10.1007/s00259-018-4163-4] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Unfortunately, the original version of this article contained several errors made during final step of article production. In the results section (fourth sentence) of the Abstract, the incomplete sentence,", 31.4% in high-risk group and 4.7% in treatment failure group.
Collapse
Affiliation(s)
- Ho-Young Yhim
- Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, South Korea
- Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea
| | - Yong Park
- Department of Internal Medicine, Korea University Anam Hospital College of Medicine, Seoul, South Korea
| | - Yeon-Hee Han
- Department of Nuclear Medicine, Chonbuk National University Hospital, Jeonju, South Korea
| | - Sungeun Kim
- Department of Nuclear Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - Sae-Ryung Kang
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Jeollanam-do, South Korea
| | - Joon-Ho Moon
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea
| | - Ju Hye Jeong
- Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, South Korea
| | - Ho-Jin Shin
- Department of Internal Medicine, Pusan National University Hospital, Busan, South Korea
| | - Keunyoung Kim
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Yoon Seok Choi
- Department of Internal Medicine, Chungnam National University Hospital, Daejeon, South Korea
| | - Kunho Kim
- Department of Nuclear Medicine, Chungnam National University Hospital, Daejeon, South Korea
| | - Min Kyoung Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, South Korea
| | - Eunjung Kong
- Department of NuclearMedicine, Yeungnam University College of Medicine, Daegu, South Korea
| | - Dae Sik Kim
- Department of Internal Medicine, Korea University Guro Hospital College of Medicine, Seoul, South Korea
| | - Jae Seon Eo
- Department of Nuclear Medicine, Korea University Guro Hospital College of Medicine, Seoul, South Korea
| | - Ji Hyun Lee
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, South Korea
| | - Do-Young Kang
- Department of Nuclear Medicine, Dong-A University College of Medicine, Busan, South Korea
| | - Won Sik Lee
- Department of Internal Medicine, Inje University College of Medicine, Inje University Busan Paik Hospital, Busan, South Korea
| | - Seok Mo Lee
- Department of Nuclear Medicine, Inje University College of Medicine, Inje University Busan Paik Hospital, Busan, South Korea
| | - Young Rok Do
- Department of Internal Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea
| | - Jun Soo Ham
- Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seok Jin Kim
- Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Won Seog Kim
- Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Joon Young Choi
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Deok-Hwan Yang
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun, Jeollanam-do, 519-763, Republic of Korea.
| | - Jae-Yong Kwak
- Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, South Korea
- Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea
| |
Collapse
|
11
|
Yhim HY, Park Y, Han YH, Kim S, Kang SR, Moon JH, Jeong JH, Shin HJ, Kim K, Choi YS, Kim K, Kim MK, Kong E, Kim DS, Eo JS, Lee JH, Kang DY, Lee WS, Lee SM, Do YR, Ham JS, Kim SJ, Kim WS, Choi JY, Yang DH, Kwak JY. A risk stratification model for nodal peripheral T-cell lymphomas based on the NCCN-IPI and posttreatment Deauville score. Eur J Nucl Med Mol Imaging 2018; 45:2274-2284. [PMID: 30056546 DOI: 10.1007/s00259-018-4093-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 04/18/2018] [Accepted: 07/11/2018] [Indexed: 02/01/2023]
Abstract
PURPOSE The aim of this study was to establish a risk-stratification model integrating posttreatment metabolic response using the Deauville score and the pretreatment National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI) in nodal PTCLs. METHODS We retrospectively analysed 326 patients with newly diagnosed nodal PTCLs between January 2005 and June 2016 and both baseline and posttreatment PET/CT data. The final model was validated using an independent prospective cohort of 79 patients. RESULTS Posttreatment Deauville score (1/2, 3, and 4/5) and the NCCN-IPI (low, low-intermediate, high-intermediate, and high) were independently associated with progression-free survival: for the Deauville score, the hazard ratios (HRs) were 1.00 vs. 2.16 (95% CI 1.47-3.18) vs. 7.86 (5.66-10.92), P < 0.001; and for the NCCN-IPI, the HRs were 1.00 vs. 2.31 (95% CI 1.20-4.41) vs. 4.42 (2.36-8.26) vs. 7.09 (3.57-14.06), P < 0.001. Based on these results, we developed a simplified three-group risk model comprising a low-risk group (low or low-intermediate NCCN-IPI with a posttreatment Deauville score of 1 or 2, or low NCCN-IPI with a Deauville score of 3), a high-risk group (high or high-intermediate NCCN-IPI with a Deauville score of 1/2 or 3, or low-intermediate NCCN-IPI with a Deauville score of 3), and a treatment failure group (Deauville score 4 or 5). This model was significantly associated with progression-free survival (5-year, 70.3%, 31.4%, and 4.7%; P < 0.001) and overall survival (5-year, 82.1%, 45.5%, and 14.7%; P < 0.001). Similar associations were also observed in the independent validation cohort. CONCLUSION The risk-stratification model integrating posttreatment Deauville score and pretreatment NCCN-IPI is a powerful tool for predicting treatment failure in patients with nodal PTCLs.
Collapse
Affiliation(s)
- Ho-Young Yhim
- Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, South Korea
- Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea
| | - Yong Park
- Department of Internal Medicine, Korea University Anam Hospital College of Medicine, Seoul, South Korea
| | - Yeon-Hee Han
- Department of Nuclear Medicine, Chonbuk National University Hospital, Jeonju, South Korea
| | - Sungeun Kim
- Department of Nuclear Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - Sae-Ryung Kang
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Jeollanam-do, South Korea
| | - Joon-Ho Moon
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea
| | - Ju Hye Jeong
- Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, South Korea
| | - Ho-Jin Shin
- Department of Internal Medicine, Pusan National University Hospital, Busan, South Korea
| | - Keunyoung Kim
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Yoon Seok Choi
- Department of Internal Medicine, Chungnam National University Hospital, Daejeon, South Korea
| | - Kunho Kim
- Department of Nuclear Medicine, Chungnam National University Hospital, Daejeon, South Korea
| | - Min Kyoung Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, South Korea
| | - Eunjung Kong
- Department of Nuclear Medicine, Yeungnam University College of Medicine, Daegu, South Korea
| | - Dae Sik Kim
- Department of Internal Medicine, Korea University Guro Hospital College of Medicine, Seoul, South Korea
| | - Jae Seon Eo
- Department of Nuclear Medicine, Korea University Guro Hospital College of Medicine, Seoul, South Korea
| | - Ji Hyun Lee
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, South Korea
| | - Do-Young Kang
- Department of Nuclear Medicine, Dong-A University College of Medicine, Busan, South Korea
| | - Won Sik Lee
- Department of Internal Medicine, Inje University College of Medicine, Inje University Busan Paik Hospital, Busan, South Korea
| | - Seok Mo Lee
- Department of Nuclear Medicine, Inje University College of Medicine, Inje University Busan Paik Hospital, Busan, South Korea
| | - Young Rok Do
- Department of Internal Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea
| | - Jun Soo Ham
- Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seok Jin Kim
- Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Won Seog Kim
- Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Joon Young Choi
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Deok-Hwan Yang
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun, Jeollanam-do, 519-763, Republic of Korea.
| | - Jae-Yong Kwak
- Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, South Korea
- Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea
| |
Collapse
|
12
|
Sun B, Moon JH, Cai Q, Rerknimitr R, Ma S, Lakhtakia S, Ryozawa S, Kutsumi H, Yasuda I, Shiomi H, Li X, Li W, Zhang X, Itoi T, Wang HP, Qian D, Wong Lau JY, Yang Z, Ji M, Hu B. Review article: Asia-Pacific consensus recommendations on endoscopic tissue acquisition for biliary strictures. Aliment Pharmacol Ther 2018; 48:138-151. [PMID: 29876948 DOI: 10.1111/apt.14811] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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] [Received: 03/03/2018] [Revised: 03/23/2018] [Accepted: 04/26/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Pre-operative tissue diagnosis for suspected malignant biliary strictures remains challenging. AIM To develop evidence-based consensus statements on endoscopic tissue acquisition for biliary strictures. METHODS The initial draft of statements was prepared following a systematic literature review. A committee of 20 experts from Asia-Pacific region then reviewed, discussed, and modified the statements. Two rounds of independent voting were conducted to reach a final version. Consensus was considered to be achieved when 80% or more of voting members voted "agree completely" or "agree with some reservation." RESULTS Eleven statements achieved consensus. The choice of tissue sampling modalities for biliary strictures depends on the clinical setting, the location of lesion, and availability of expertise. Detailed radiological and endoscopic evaluation is useful to guide the selection of appropriate tissue acquisition technique. Standard intraductal biliary brushing and/or forceps biopsy is the first option when endoscopic biliary drainage is required with an overall (range) sensitivity and specificity of 45% (26%-72%) and 99% (98%-100%), and 48% (15%-100%) and 99% (97%-100%), respectively, in diagnosing malignant biliary strictures. Probe-based confocal laser endomicroscopy and fluorescence in situ hybridisation using 4 fluorescent-labelled probes targeting chromosomes 3, 7, 17 and 9p21 locus may be added to improve the diagnostic yield. Cholangioscopy-guided biopsy and EUS-guided tissue acquisition can be considered after prior negative conventional tissue sampling with an overall (range) sensitivity and specificity of 60% (38%-88%) and 98% (83%-100%), and 80% (46%-100%) and 97% (92%-100%), respectively, in diagnosing malignant biliary strictures. CONCLUSION These consensus statements provide evidence-based recommendations for endoscopic tissue acquisition of biliary strictures.
Collapse
|
13
|
Cho HJ, Seo SK, Baek DW, Park SW, Lee YJ, Sohn SK, Lee HS, Lee WS, Lee JH, Kim SH, Moon JH. Chemotherapy adherence is a favorable prognostic factor for elderly patients with multiple myeloma who are treated with a frontline bortezomib-containing regimen. Yeungnam Univ J Med 2018; 35:76-83. [PMID: 31620574 PMCID: PMC6784679 DOI: 10.12701/yujm.2018.35.1.76] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 06/08/2018] [Accepted: 06/08/2018] [Indexed: 01/10/2023] Open
Abstract
Background Elderly patients with multiple myeloma (MM) are vulnerable to adverse events (AEs). This study evaluated adherence to chemotherapy and treatment outcomes in elderly patients treated with a frontline bortezomib (BTZ), melphalan, and prednisone (VMP) regimen and regimens without BTZ. Methods One-hundred and forty elderly patients who were diagnosed with MM from March 2007 to March 2015 were included in this retrospective study. To evaluate regimen adherence, patients who were treated with more than 4 cycles were assigned to the good adherence group. Results Among the 140 patients, 71 were treated with a frontline VMP and 69 with non-BTZ regimens. The median age was 71 years (range, 65-90 years). The VMP group showed a higher complete response rate than the non-BTZ group: 26.8% vs. 7.2%. More patients in the VMP group achieved ≥very good partial response (VGPR) and ≥PR. In the VMP group, 27 patients (38.0%) received less than 4 cycles. The VMP good adherence group showed a higher 3-year overall survival (OS) rate (70.9%) than the poor adherence group (60.2%, p=0.059). In the multivariate analysis, treatment with ≥4 cycles of VMP was a favorable factor for OS. Conclusion A good adherence to a frontline VMP regimen resulted in favorable long-term survival. Adequate management of AEs will be needed to achieve favorable outcomes in elderly patients with MM.
Collapse
Affiliation(s)
- Hee-Jeong Cho
- Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Korea
| | - Sang-Kyung Seo
- Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Korea
| | - Dong Won Baek
- Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Korea
| | - Sung-Woo Park
- Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Korea
| | - Yoo-Jin Lee
- Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Korea
| | - Sang-Kyun Sohn
- Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Korea
| | - Ho-Sup Lee
- Department of Hematology/Oncology, Kosin University Gospel Hospital, Busan, Korea
| | - Won Sik Lee
- Department of Hematology-Oncology, Inje University Pusan Baik Hospital, Busan, Korea
| | - Ji Hyun Lee
- Department of Hematology-Oncology, Dong-A University Hospital, Busan, Korea
| | - Sung Hyun Kim
- Department of Hematology-Oncology, Dong-A University Hospital, Busan, Korea
| | - Joon-Ho Moon
- Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Korea
| |
Collapse
|
14
|
Kim DJ, Lee HS, Moon JH, Sohn SK, Kim HJ, Cheong JW, Jo DY, Kim H, Lee H, Bang SM, Lee WS, Park Y, Lee MH, Lee JH, Bae SH, Kim MK. Can we consider discontinuation of hypomethylating agents in patients with myelodysplastic syndrome : a retrospective study from The Korean Society of Hematology AML/MDS Working Party. Oncotarget 2017; 8:79414-79424. [PMID: 29108320 PMCID: PMC5668053 DOI: 10.18632/oncotarget.18258] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 04/28/2017] [Indexed: 11/25/2022] Open
Abstract
It is often difficult to continue treatment with hypomethylating agent(HMA) in clinical practice because of problems such as toxicities, poor economics, etc. We compared clinical outcomes of those patients who continued HMA and those who discontinued HMA because of other causes, and evaluated factors associated with survival in those patients who discontinued HMA. Patients were divided into two groups: treatment failure, those who stopped treatment due to disease progression; and discontinuation, those who discontinued treatment because of other causes. The median progression free survival(PFS) was 9.2 months (range 7.7 – 10.7 months) vs 28.9 months (range 22.6 – 35.2) in the treatment failure and discontinuation groups, respectively (P < 0.001). In a multivariate analysis, a lower risk by WPSS was an independent predictive factor for a longer PFS, and a lower risk by WPSS and median number of HMA cycles greater than seven were independent predictive factors for longer overall survival(OS) only in the discontinuation group. Patients who discontinued HMA without disease progression showed a prolonged survival than those who failed HMA treatment. Especially, a lower risk by WPSS and longer duration of HMA treatment may be predictive factors for a longer PFS and OS in patients who discontinued HMA.
Collapse
Affiliation(s)
- Da Jung Kim
- Department of Internal Medicine, Kosin University College of Medicine, Kosin University Gospel Hospital, Busan, South Korea
| | - Ho Sup Lee
- Department of Internal Medicine, Kosin University College of Medicine, Kosin University Gospel Hospital, Busan, South Korea
| | - Joon-Ho Moon
- Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, South Korea
| | - Sang Kyun Sohn
- Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, South Korea
| | - Hyeoung Joon Kim
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Jeollanamdo, South Korea
| | - June-Won Cheong
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Deog-Yeon Jo
- Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University, Daejeon, South Korea
| | - Hawk Kim
- Division of Hematology and Cellular Therapy, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Hyewon Lee
- Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang, South Korea
| | - Soo-Mee Bang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul, South Korea
| | - Won Sik Lee
- Department of Internal Medicine, Busan Paik Hospital, Busan, South Korea
| | - Yong Park
- Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Mark Hong Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea
| | - Jae Hoon Lee
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, South Korea
| | - Sung Hwa Bae
- Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, South Korea
| | - Min Kyoung Kim
- Department of Hematology-Oncology, Yeungnam University Medical Center, Yeungnam University School of Medicine, Daegu, South Korea
| | | |
Collapse
|
15
|
Choi JK, Cho SY, Yoon SS, Moon JH, Kim SH, Lee JH, Kim JS, Cheong JW, Jang JH, Seo BJ, Kim YJ, Lee HJ, Lee J, Lee JW, Lee DG. Epidemiology and Risk Factors for Invasive Fungal Diseases among Allogeneic Hematopoietic Stem Cell Transplant Recipients in Korea: Results of "RISK" Study. Biol Blood Marrow Transplant 2017; 23:1773-1779. [PMID: 28668492 DOI: 10.1016/j.bbmt.2017.06.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 02/02/2017] [Accepted: 06/20/2017] [Indexed: 11/24/2022]
Abstract
Incidence, epidemiology, and risk factors of invasive fungal diseases (IFDs) in allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients can vary from different cohorts and countries. Therefore, we performed a nationwide study to establish a proper antifungal prophylaxis strategies based on risk stratifications of IFDs after all-HSCT in Korea (RISK study). This was a multicenter, retrospective, and observational study in Korea. All consecutive adult patients who received allo-HSCT in 2013 were included. The 12-month cumulative incidence of proven/probable IFDs (PP-IFDs) was calculated during the early (days 0 to 40), late (days 41 to 100), and very late (days 101 to 365) phases after allo-HSCT. Cox proportional hazard regression analysis was performed to identify risk factors for PP-IFDs at each phase. A total 521 allo-HSCT cases in 518 patients were analyzed. Overall cumulative incidence of PP-IFDs were 4.09% (95% confidence interval [CI], 2.38 to 5.81), 7.38% (95% CI, 5.09 to 9.67), and 15.36% (95% CI, 12.04 to 18.68) at the early, late and very phases, respectively. In multiple Cox regression analysis, variables were associated with PP-IFDs in each period were identified. Variables associated with early phase include underlying pulmonary diseases, underlying nonmalignant stable or chronic disease at allo-HSCT, unrelated or family mismatched donor, and prolonged neutropenia. Variables associated with the late phase include high ferritin level at the time point of allo-HSCT, use of secondary immunosuppressive agents due to refractory graft-versus-host disease (GVHD), and cytomegalovirus reactivation. For the very late phase, variables were secondary neutropenia, severe chronic GVHD, and use of TNF-alpha inhibitor for refractory GVHD. This study revealed the high cumulative incidence of IFDs in Korean allo-HSCT recipients, which have distinct risk factors in each phase after allo-HSCT. Our findings indicate that tailored antifungal prophylaxis is necessary for high-risk patients. Clinicians should consider using mold-active antifungal prophylaxis in allo-HSCT recipients who have high risks at different treatment period.
Collapse
Affiliation(s)
- Jae-Ki Choi
- Division of Infectious Diseases, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Yeon Cho
- Division of Infectious Diseases, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea; The Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Soo Yoon
- Division of Hematology/Medical Oncology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Joon-Ho Moon
- Division of Hematology/Medical Oncology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Je-Hwan Lee
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jin Seok Kim
- Division of Hematology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - June-Won Cheong
- Division of Hematology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jun-Ho Jang
- Division of Hematology/Medical Oncology, Samsung Medical Center, Seoul, Republic of Korea
| | - Bo-Jeong Seo
- Outcomes Research/Real World Data, Corporate Affairs and Health and Value, Pfizer Pharmaceuticals Korea Ltd., Republic of Korea
| | - Young-Joo Kim
- Outcomes Research/Real World Data, Corporate Affairs and Health and Value, Pfizer Pharmaceuticals Korea Ltd., Republic of Korea
| | - Hye-Jung Lee
- Pfizer Essential Health-Medical, Pfizer Pharmaceuticals Korea Ltd., Republic of Korea
| | - Juneyoung Lee
- Department of Biostatistics, College of Medicine, Korea University, Republic of Korea
| | - Jong Wook Lee
- The Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong-Gun Lee
- Division of Infectious Diseases, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea; The Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| |
Collapse
|
16
|
Moon JH, Lee BH, Kim JA, Lee YJ, Chae YS, Yhim HY, Kwak JY, Do YR, Park Y, Song MK, Shin HJ, Kim T, Lee JJ, Yang DH. Clinical impact of induction treatment modalities and optimal timing of radiotherapy for the treatment of limited-stage NK/T cell lymphoma. Leuk Res 2016; 49:80-7. [DOI: 10.1016/j.leukres.2016.08.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 08/28/2016] [Accepted: 08/30/2016] [Indexed: 12/23/2022]
|
17
|
Jung SA, Lee DH, Moon JH, Hong SW, Shin JS, Hwang IY, Shin YJ, Kim JH, Gong EY, Kim SM, Lee EY, Lee S, Kim JE, Kim KP, Hong YS, Lee JS, Jin DH, Kim T, Lee WJ. Corrigendum to 'L-Ascorbic acid can abrogate SVCT-2-dependent cetuximab resistance mediated by mutant KRAS in human colon cancer cells': [Free Radic. Biol. Med. 95 (2016) 200-208]. Free Radic Biol Med 2016; 97:620. [PMID: 27476024 DOI: 10.1016/j.freeradbiomed.2016.07.017] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- S A Jung
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Innovative Cancer Research, Asan Institute for Life Science, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea
| | - D H Lee
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Innovative Cancer Research, Asan Institute for Life Science, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Biomedical Science and Engineering Interdisciplinary Program, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon, Republic of Korea
| | - J H Moon
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Innovative Cancer Research, Asan Institute for Life Science, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea
| | - S W Hong
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Innovative Cancer Research, Asan Institute for Life Science, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea
| | - J S Shin
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Innovative Cancer Research, Asan Institute for Life Science, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea
| | - I Y Hwang
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Innovative Cancer Research, Asan Institute for Life Science, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea
| | - Y J Shin
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Innovative Cancer Research, Asan Institute for Life Science, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea
| | - J H Kim
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Innovative Cancer Research, Asan Institute for Life Science, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea
| | - E Y Gong
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Innovative Cancer Research, Asan Institute for Life Science, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea
| | - S M Kim
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Innovative Cancer Research, Asan Institute for Life Science, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea
| | - E Y Lee
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Innovative Cancer Research, Asan Institute for Life Science, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea
| | - S Lee
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Innovative Cancer Research, Asan Institute for Life Science, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea
| | - J E Kim
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Innovative Cancer Research, Asan Institute for Life Science, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea
| | - K P Kim
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Innovative Cancer Research, Asan Institute for Life Science, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea
| | - Y S Hong
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Innovative Cancer Research, Asan Institute for Life Science, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea
| | - J S Lee
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Innovative Cancer Research, Asan Institute for Life Science, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea
| | - D H Jin
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Innovative Cancer Research, Asan Institute for Life Science, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Department of Convergence Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea.
| | - T Kim
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea; Innovative Cancer Research, Asan Institute for Life Science, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea.
| | - W J Lee
- Department of Anatomy and Tumor Immunity Medical Research Center, Seoul National University College of Medicine, Seoul 110-744, Republic of Korea
| |
Collapse
|
18
|
Kim KM, Kim YJ, Choi SH, Lim S, Moon JH, Kim JH, Kim SW, Jang HC, Shin CS. The effects of body mass index on the hereditary influences that determine peak bone mass in mother-daughter pairs (KNHANES V). Osteoporos Int 2016; 27:2057-64. [PMID: 26809191 DOI: 10.1007/s00198-016-3487-9] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 01/06/2016] [Indexed: 12/26/2022]
Abstract
UNLABELLED A daughter's bone mineral density (BMD) is significantly correlated with her mother's BMD, but the daughter's body mass index (BMI) could modulate this association. Maternal inheritance dominantly affects daughters with a lower BMI, but BMI could compensate for hereditary influences in daughters with a higher BMI in terms of daughter's BMD. INTRODUCTION Achieving optimal peak bone mass at a young age is the best way to protect against future osteoporosis and subsequent fractures. Although environmental components influence bone mass accrual, but peak bone mass is largely programmed by inheritance. The aims of this study were to investigate the influence of maternal inheritance on the daughter's bone mass and to assess whether these influences differ according to the daughter's body mass index (BMI). METHODS We used data obtained from the 2010 Korean National Health and Nutrition Examination Survey V and included 187 mother-daughter pairs. Bone mineral density (BMD) was measured at the lumbar spine (LS), femur neck (FN), and total hip (TH) by using dual-energy X-ray absorptiometry (DXA). The daughter group was stratified into two groups according to the mean BMI (21.4 kg/m(2)). RESULTS The daughters' BMD correlated significantly with both their BMI and their mothers' Z-score for each skeletal site. In the daughters with a lower BMI (≤21.4 kg/m(2)), the BMDs at the FN and TH were affected more by the mothers' Z-score than by the daughters' BMI. Meanwhile, the influence of the daughters' BMI on their BMD was higher than that of their mothers' Z-score in daughters with a higher BMI (>21.4 kg/m(2)). Moreover, the mothers' Z-scores were a significant predictor of their daughters having Z-scores < -1.0 only in daughters with a lower BMI. CONCLUSIONS This study suggests that maternal inheritance is an important determinant of the daughters' bone mass, but that this hereditary factor may vary according to the daughters' BMI.
Collapse
Affiliation(s)
- K M Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Y J Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - S H Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - S Lim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - J H Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - J H Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - S W Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Borame Hospital, Seoul, Korea
| | - H C Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - C S Shin
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
| |
Collapse
|
19
|
Choi W, Kim E, Yum SY, Lee C, Lee J, Moon J, Ramachandra S, Malaweera BO, Cho J, Kim JS, Kim S, Jang G. Efficient PRNP deletion in bovine genome using gene-editing technologies in bovine cells. Prion 2016. [PMID: 26217959 DOI: 10.1080/19336896.2015.1071459] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Even though prion (encoded by the PRNP gene) diseases like bovine spongiform encephalopathy (BSE) are fatal neurodegenerative diseases in cattle, their study via gene deletion has been limited due to the absence of cell lines or mutant models. In this study, we aim to develop an immortalized fibroblast cell line in which genome-engineering technology can be readily applied to create gene-modified clones for studies. To this end, this study is designed to 1) investigate the induction of primary fibroblasts to immortalization by introducing Bmi-1 and hTert genes; 2) investigate the disruption of the PRNP in those cells; and 3) evaluate the gene expression and embryonic development using knockout (KO) cell lines. Primary cells from a male neonate were immortalized with Bmi-1and hTert. Immortalized cells were cultured for more than 180 days without any changes in their doubling time and morphology. Furthermore, to knockout the PRNP gene, plasmids that encode transcription activator-like effector nuclease (TALEN) pairs were transfected into the cells, and transfected single cells were propagated. Mutated clonal cell lines were confirmed by T7 endonuclease I assay and sequencing. Four knockout cell lines were used for somatic cell nuclear transfer (SCNT), and the resulting embryos were developed to the blastocyst stage. The genes (CSNK2A1, FAM64A, MPG and PRND) were affected after PRNP disruption in immortalized cells. In conclusion, we established immortalized cattle fibroblasts using Bmi-1 and hTert genes, and used TALENs to knockout the PRNP gene in these immortalized cells. The efficient PRNP KO is expected to be a useful technology to develop our understanding of in vitro prion protein functions in cattle.
Collapse
Affiliation(s)
- WooJae Choi
- a Laboratory of Theriogenology and Biotechnology; Department of Veterinary Clinical Science ; College of Veterinary Medicine and the Research Institute of Veterinary Science; Seoul National University ; Seoul , Republic of Korea
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Jais B, Rebours V, Malleo G, Salvia R, Fontana M, Maggino L, Bassi C, Manfredi R, Moran R, Lennon AM, Zaheer A, Wolfgang C, Hruban R, Marchegiani G, Fernández Del Castillo C, Brugge W, Ha Y, Kim MH, Oh D, Hirai I, Kimura W, Jang JY, Kim SW, Jung W, Kang H, Song SY, Kang CM, Lee WJ, Crippa S, Falconi M, Gomatos I, Neoptolemos J, Milanetto AC, Sperti C, Ricci C, Casadei R, Bissolati M, Balzano G, Frigerio I, Girelli R, Delhaye M, Bernier B, Wang H, Jang KT, Song DH, Huggett MT, Oppong KW, Pererva L, Kopchak KV, Del Chiaro M, Segersvard R, Lee LS, Conwell D, Osvaldt A, Campos V, Aguero Garcete G, Napoleon B, Matsumoto I, Shinzeki M, Bolado F, Fernandez JMU, Keane MG, Pereira SP, Acuna IA, Vaquero EC, Angiolini MR, Zerbi A, Tang J, Leong RW, Faccinetto A, Morana G, Petrone MC, Arcidiacono PG, Moon JH, Choi HJ, Gill RS, Pavey D, Ouaïssi M, Sastre B, Spandre M, De Angelis CG, Rios-Vives MA, Concepcion-Martin M, Ikeura T, Okazaki K, Frulloni L, Messina O, Lévy P. Serous cystic neoplasm of the pancreas: a multinational study of 2622 patients under the auspices of the International Association of Pancreatology and European Pancreatic Club (European Study Group on Cystic Tumors of the Pancreas). Gut 2016; 65:305-12. [PMID: 26045140 DOI: 10.1136/gutjnl-2015-309638] [Citation(s) in RCA: 173] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 05/11/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Serous cystic neoplasm (SCN) is a cystic neoplasm of the pancreas whose natural history is poorly known. The purpose of the study was to attempt to describe the natural history of SCN, including the specific mortality. DESIGN Retrospective multinational study including SCN diagnosed between 1990 and 2014. RESULTS 2622 patients were included. Seventy-four per cent were women, and median age at diagnosis was 58 years (16-99). Patients presented with non-specific abdominal pain (27%), pancreaticobiliary symptoms (9%), diabetes mellitus (5%), other symptoms (4%) and/or were asymptomatic (61%). Fifty-two per cent of patients were operated on during the first year after diagnosis (median size: 40 mm (2-200)), 9% had resection beyond 1 year of follow-up (3 years (1-20), size at diagnosis: 25 mm (4-140)) and 39% had no surgery (3.6 years (1-23), 25.5 mm (1-200)). Surgical indications were (not exclusive) uncertain diagnosis (60%), symptoms (23%), size increase (12%), large size (6%) and adjacent organ compression (5%). In patients followed beyond 1 year (n=1271), size increased in 37% (growth rate: 4 mm/year), was stable in 57% and decreased in 6%. Three serous cystadenocarcinomas were recorded. Postoperative mortality was 0.6% (n=10), and SCN's related mortality was 0.1% (n=1). CONCLUSIONS After a 3-year follow-up, clinical relevant symptoms occurred in a very small proportion of patients and size slowly increased in less than half. Surgical treatment should be proposed only for diagnosis remaining uncertain after complete workup, significant and related symptoms or exceptionally when exists concern with malignancy. This study supports an initial conservative management in the majority of patients with SCN. TRIAL REGISTRATION NUMBER IRB 00006477.
Collapse
Affiliation(s)
- B Jais
- Department of Gastroenterology and Pancreatology, Beaujon Hospital, AP-HP, Clichy, France
| | - V Rebours
- Department of Gastroenterology and Pancreatology, Beaujon Hospital, AP-HP, Clichy, France
| | - G Malleo
- The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy
| | - R Salvia
- The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy
| | - M Fontana
- The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy
| | - L Maggino
- The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy
| | - C Bassi
- The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy
| | - R Manfredi
- The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy
| | - R Moran
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Division of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - A M Lennon
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Division of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - A Zaheer
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Division of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - C Wolfgang
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Division of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - R Hruban
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Division of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - G Marchegiani
- Departments of Surgery and Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - C Fernández Del Castillo
- Departments of Surgery and Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - W Brugge
- Departments of Surgery and Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Y Ha
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - M H Kim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - D Oh
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - I Hirai
- First Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - W Kimura
- First Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - J Y Jang
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - S W Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - W Jung
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - H Kang
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - S Y Song
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - C M Kang
- Department of Surgery, Yonsei University College of Medicine, Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea
| | - W J Lee
- Department of Surgery, Yonsei University College of Medicine, Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea
| | - S Crippa
- Pancreatic Surgery Unit, Department of Surgery, Polytechnic University of Marche Region, Ancona-Torrette, Italy
| | - M Falconi
- Pancreatic Surgery Unit, Department of Surgery, Polytechnic University of Marche Region, Ancona-Torrette, Italy
| | - I Gomatos
- NIHR Pancreas Biomedical Research Unit, Department of Molecular and Clinical Cancer Medicine, Royal Liverpool University Hospital, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - J Neoptolemos
- NIHR Pancreas Biomedical Research Unit, Department of Molecular and Clinical Cancer Medicine, Royal Liverpool University Hospital, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - A C Milanetto
- Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, Padua, Italy
| | - C Sperti
- Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, Padua, Italy
| | - C Ricci
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - R Casadei
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - M Bissolati
- Pancreatic Surgery Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - G Balzano
- Pancreatic Surgery Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - I Frigerio
- Hepato-Pancreato-Biliary Unit, Pederzoli Hospital, Peschiera del Garda, Italy
| | - R Girelli
- Hepato-Pancreato-Biliary Unit, Pederzoli Hospital, Peschiera del Garda, Italy
| | - M Delhaye
- Department of Gastroenterology, Hepatopancreatology and GI Oncology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - B Bernier
- Department of Gastroenterology, Hepatopancreatology and GI Oncology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - H Wang
- Institute of Hepatopancreatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - K T Jang
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - D H Song
- Department of Pathology, Gyeongsang National University School of Medicine, Jinju, Korea
| | - M T Huggett
- Hepato-Pancreato-Biliary Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - K W Oppong
- Hepato-Pancreato-Biliary Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - L Pererva
- National Institute of Surgery and Transplantology named after Shalimov, Kiev, Ukraine
| | - K V Kopchak
- National Institute of Surgery and Transplantology named after Shalimov, Kiev, Ukraine
| | - M Del Chiaro
- Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - R Segersvard
- Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - L S Lee
- Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - D Conwell
- Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - A Osvaldt
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - V Campos
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - B Napoleon
- Hôpital Privé Mermoz, Gastroentérologie, Lyon, France
| | - I Matsumoto
- Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - M Shinzeki
- Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - F Bolado
- Gastroenterology Department, Hospital de Navarra, Pamplona, Spain
| | | | - M G Keane
- Department of Gastroenterology and Hepatology, University College Hospital, London, UK
| | - S P Pereira
- Department of Gastroenterology and Hepatology, University College Hospital, London, UK
| | - I Araujo Acuna
- Department of Gastroenterology, Hospital Clinic, CIBEREHD, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - E C Vaquero
- Department of Gastroenterology, Hospital Clinic, CIBEREHD, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - M R Angiolini
- Department of Pancreatic Surgery, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - A Zerbi
- Department of Pancreatic Surgery, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - J Tang
- Gastroenterology and Liver Services, Concord Hospital, Sydney, New South Wales, Australia
| | - R W Leong
- Gastroenterology and Liver Services, Concord Hospital, Sydney, New South Wales, Australia
| | - A Faccinetto
- Radiological Department, General Hospital Cá Foncello, Treviso, Italy
| | - G Morana
- Radiological Department, General Hospital Cá Foncello, Treviso, Italy
| | - M C Petrone
- Division of Gastroenterology and Gastrointestinal Endoscopy, San Raffaele Scientific Institute, Milan, Italy
| | - P G Arcidiacono
- Division of Gastroenterology and Gastrointestinal Endoscopy, San Raffaele Scientific Institute, Milan, Italy
| | - J H Moon
- Department of Internal Medicine, Digestive Disease Center and Research Institute, SoonChunHyang University School of Medicine, Bucheon, Korea
| | - H J Choi
- Department of Internal Medicine, Digestive Disease Center and Research Institute, SoonChunHyang University School of Medicine, Bucheon, Korea
| | - R S Gill
- Department of Gastroenterology, Bankstown-Lidcombe Hospital, Bankstown, New South Wales, Australia
| | - D Pavey
- Department of Gastroenterology, Bankstown-Lidcombe Hospital, Bankstown, New South Wales, Australia
| | - M Ouaïssi
- Department of Digestive Surgery, Timone Hospital, Marseille, France
| | - B Sastre
- Department of Digestive Surgery, Timone Hospital, Marseille, France
| | - M Spandre
- Gastrohepatology Department, San Giovanni Battista Molinette Hospital, University of Turin, Turin, Italy
| | - C G De Angelis
- Gastrohepatology Department, San Giovanni Battista Molinette Hospital, University of Turin, Turin, Italy
| | - M A Rios-Vives
- Gastroenterology Department, Hospital de la Santa Creu i Sant Pau, Institut de Reçerca-IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Concepcion-Martin
- Gastroenterology Department, Hospital de la Santa Creu i Sant Pau, Institut de Reçerca-IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - T Ikeura
- The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan
| | - K Okazaki
- The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan
| | - L Frulloni
- Department of Medicine, Pancreas Center, University of Verona, Verona, Italy
| | - O Messina
- Department of Medicine, Pancreas Center, University of Verona, Verona, Italy
| | - P Lévy
- Department of Gastroenterology and Pancreatology, Beaujon Hospital, AP-HP, Clichy, France
| |
Collapse
|
21
|
Moon JH, Moon JH, Kim KM, Choi SH, Lim S, Park KS, Kim KW, Jang HC. Sarcopenia as a Predictor of Future Cognitive Impairment in Older Adults. J Nutr Health Aging 2016; 20:496-502. [PMID: 27102786 DOI: 10.1007/s12603-015-0613-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES We investigated the association between the indices of sarcopenia and future risk of cognitive impairment in older adults. DESIGN Community-based prospective cohort study. SETTING Community. PARTICIPANTS A total of 297 participants aged ≥65 years without cognitive impairment at baseline (mean age, 71.9 ± 6.6 years; men:women, 158:139) and who underwent cognitive evaluation at the 5-year follow-up. MEASUREMENTS Sarcopenia parameters including appendicular lean mass (ALM), handgrip strength, and the Short Physical Performance Battery (SPPB) score at baseline were compared according to the later progression of mild cognitive impairment (MCI) and/or dementia. The operational criteria suggested by the Foundation for the National Institutes of Health Sarcopenia Project were used. We performed multivariate logistic regression analysis to identify the independent indicators of the progression of cognitive impairment. RESULTS Among the 297 participants, 242 (81.5%) remained cognitively normal (nonprogression group), whereas 55 (18.5%) showed progression of cognitive impairment (50 subjects (16.8%) to MCI and 5 subjects (1.7%) to dementia) (progression group). Compared with the nonprogression group, subjects in the progression group were older, had a lower educational level, and had lower physical function as assessed by the SPPB; a higher percentage were depressed. Other baseline markers of sarcopenia, including the ALM-to-body mass index ratio and handgrip strength did not differ significantly between the groups. The association between a low SPPB score (<9) and progression of cognitive impairment was maintained after adjustment for conventional risk factors for cognitive impairment (hazard ratio 2.222, 95% confidence interval 1.047-4.716, P = 0.038). CONCLUSION Decreased physical performance, as assessed by the SPPB, but not other markers of sarcopenia, was independently associated with the risk of later cognitive impairment in older adults.
Collapse
Affiliation(s)
- J H Moon
- Hak Chul Jang, MD, PhD, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro, 173 beon-gil, Bundang-gu, Seongnam, Gyeonggi-do, 463-707, Korea, Tel: +82-31-787-7005, Fax: +82-31-787-4051, E-mail:
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Ham JY, Yoon CE, Moon JH, Won DI, Suh JS. Identification of a novel HLA-B*15 variant, B*15:367, using sequence-based typing in a Korean woman. ACTA ACUST UNITED AC 2015; 86:451-2. [PMID: 26514328 DOI: 10.1111/tan.12687] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 09/08/2015] [Accepted: 09/28/2015] [Indexed: 11/29/2022]
Abstract
New allele, B*15:367, differs from B*15:11:01 by a single nucleotide exchange at codon 222 (GAG→AAG).
Collapse
Affiliation(s)
- J Y Ham
- Department of Laboratory Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - C E Yoon
- Department of Molecular Genetics, Biowithus Life Science Institute, Seoul, Korea
| | - J H Moon
- Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Korea
| | - D I Won
- Department of Laboratory Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - J S Suh
- Department of Laboratory Medicine, Kyungpook National University Hospital, Daegu, Korea
| |
Collapse
|
23
|
Park SR, Kim HJ, Park HK, Kim JY, Kim NS, Byun KS, Moon TK, Byun JW, Moon JH, Choi GS. Classification by causes of dark circles and appropriate evaluation method of dark circles. Skin Res Technol 2015; 22:276-83. [PMID: 26346687 DOI: 10.1111/srt.12258] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Dark circles refer to a symptom that present darkness under the eyes. Because of improvement in the quality of life, the dark circles have been recognized as one of major cosmetic concerns. However, it is not easy to classify the dark circles because they have various causes. METHODS To select suitable instruments and detailed evaluation items, the dark circles were classified according to the causes through visual assessment, Wood's lamp test, and medical history survey for 100 subjects with dark circles. After the classification, were newly recruited for instrument conformity assessment. Through this, suitable instruments for dark circle evaluation were selected. We performed a randomized clinical trial for dark circles, a placebo-controlled double-blind study, using effective parameters of the instruments selected from the preliminary test. RESULTS Dark circles of vascular type (35%) and mixed type (54%), a combination of pigmented and vascular types, were the most common. Twenty four subjects with the mixed type dark circles applied the test product (Vitamin C 3%, Vitamin A 0.1%, Vitamin E 0.5%) and placebo on randomized split-face for 8 weeks. The effective parameters (L*, a, M.I., E.I., quasi L*, quasi a* and dermal thickness) were measured during the study period. Result showed that the L* value of Chromameter(®) , Melanin index (M.I.) of Mexameter(®) and quasi L* value obtained by image analysis improved with statistical significance after applying the test product compared with the placebo product. CONCLUSION We classified the dark circles according to the causes of the dark circles and verified the reliability of the parameter obtained by the instrument conformity assessment used in this study through the efficacy evaluation. Also based on this study, we were to suggest newly established methods which can be applied to the evaluation of efficacy of functional cosmetics for dark circles.
Collapse
Affiliation(s)
- S R Park
- Ellead Skin and Bio Research, Gyeonggi-do, Korea
| | - H J Kim
- Ellead Skin and Bio Research, Gyeonggi-do, Korea
| | - H K Park
- Ellead Skin and Bio Research, Gyeonggi-do, Korea
| | - J Y Kim
- Ellead Skin and Bio Research, Gyeonggi-do, Korea
| | - N S Kim
- Ellead Skin and Bio Research, Gyeonggi-do, Korea
| | - K S Byun
- Ellead Skin and Bio Research, Gyeonggi-do, Korea
| | - T K Moon
- Ellead Skin and Bio Research, Gyeonggi-do, Korea
| | - J W Byun
- Department of Dermatology, Inha University College of Medicine, Incheon, Korea
| | - J H Moon
- Department of Dermatology, Inha University College of Medicine, Incheon, Korea
| | - G S Choi
- Department of Dermatology, Inha University College of Medicine, Incheon, Korea
| |
Collapse
|
24
|
Kim YA, Kim KM, Lim S, Choi SH, Moon JH, Kim JH, Kim SW, Jang HC, Shin CS. Favorable effect of dietary vitamin C on bone mineral density in postmenopausal women (KNHANES IV, 2009): discrepancies regarding skeletal sites, age, and vitamin D status. Osteoporos Int 2015; 26:2329-37. [PMID: 25906241 DOI: 10.1007/s00198-015-3138-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 04/07/2015] [Indexed: 01/30/2023]
Abstract
UNLABELLED Dietary vitamin C intake showed significant positive associations with BMD in postmenopausal women, especially with vitamin D deficiency. INTRODUCTION Although there is a positive role of vitamin C in osteoblastogenesis, debate remains about the contribution of vitamin C to bone mineral density (BMD) in humans. METHODS Data were derived from the Fourth Korean National Health and Nutrition Examination Survey. Dietary information was assessed using a 24-h dietary recall questionnaire. BMD was measured by dual-energy X-ray absorptiometry at the lumbar and hip. RESULTS A total of 1,196 postmenopausal women aged 50 years and older were stratified into tertiles by daily dietary vitamin C intake. After adjusting for traditional confounders, dietary vitamin C intake tertile was significantly positively associated with BMD at all sites (R = 0.513 for lumbar spine (LS) and R = 0.657 for femoral neck (FN), P < 0.05 for each). The subjects with osteoporosis had significantly lower dietary vitamin C intake than did subjects without osteoporosis (74.4 ± 66.2 vs 94.1 ± 78.6 mg/day for LS and 65.5 ± 56.6 vs 94.3 ± 79.2 mg/day for FN, respectively, P < 0.001). The multiple-adjusted odds ratio for osteoporosis for dietary vitamin C <100 mg/day was 1.790 (95 % CI 1.333-2.405, P < 0.001). However, the significant association between vitamin C intake and BMD was only observed in subjects with vitamin D deficiency and aged 50-59 years or >70 years. CONCLUSION Dietary vitamin C intake was positively associated with BMD in postmenopausal women, and inadequate vitamin C intake could increase the risk of osteoporosis.
Collapse
Affiliation(s)
- Y A Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Moon JH, Lim S, Han JW, Kim KM, Choi SH, Kim KW, Jang HC. Serum 25-hydroxyvitamin D level and the risk of mild cognitive impairment and dementia: the Korean Longitudinal Study on Health and Aging (KLoSHA). Clin Endocrinol (Oxf) 2015; 83:36-42. [PMID: 25641087 DOI: 10.1111/cen.12733] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 01/09/2015] [Accepted: 01/28/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The association of low vitamin D status with mild cognitive impairment (MCI), a preclinical condition that can lead to dementia, has not yet been fully explored. Our aim was to investigate the association between vitamin D status and the future risk of MCI and dementia in older adults. DESIGN, SETTING AND PARTICIPANTS We conducted a population-based prospective study as a part of the Korean Longitudinal Study on Health and Aging. Four hundred and twelve elderly participants who completed evaluations of cognitive function and metabolic parameters in 2005-2006 and 2010-2011 were analysed. MAJOR OUTCOME MEASURE The rate of development of MCI or dementia during the study period was compared according to baseline vitamin D status. Binary logistic regression analysis was performed to investigate any independent association between vitamin D status and the risks of MCI or dementia. RESULTS Among 405 subjects that remained after excluding seven demented subjects at baseline, 338 subjects remained unchanged or improved in their diagnosis for cognitive function during the study period, whereas 67 subjects showed progression to MCI or dementia. When analyzing 236 subjects whose baseline mini-mental state examination (MMSE) scores were <27, severe vitamin D deficiency at baseline, defined as <25 nmol/l, was independently associated with the progression of cognitive impairment. Among 297 subjects who were normal at baseline, 50 acquired MCI and 247 remained normal. Severe vitamin D deficiency was also independently associated with the development of MCI when analyzing 145 subjects whose baseline MMSE scores were <27. CONCLUSION Severe vitamin D deficiency was independently associated with the future risk of MCI as well as dementia, especially in older adults whose baseline MMSE scores had decreased only modestly.
Collapse
Affiliation(s)
- J H Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, Korea
| | - S Lim
- Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, Korea
| | - J W Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, Korea
| | - K M Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, Korea
| | - S H Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, Korea
| | - K W Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, Korea
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Korea
| | - H C Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, Korea
| |
Collapse
|
26
|
Kim IH, Moon JH, Lim SN, Sohn SK, Kim HG, Lee GW, Kim YS, Lee HS, Kwon KY, Kim SH, Park KT, Chung JS, Lee WS, Lee SM, Hyun MS, Kim H, Ryoo HM, Bae SH, Joo YD. Efficacy and safety of deferasirox estimated by serum ferritin and labile plasma iron levels in patients with aplastic anemia, myelodysplastic syndrome, or acute myeloid leukemia with transfusional iron overload. Transfusion 2015; 55:1613-20. [PMID: 25764017 DOI: 10.1111/trf.13036] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Revised: 01/07/2015] [Accepted: 01/07/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Patients receiving red blood cell (RBC) transfusions are at risk of iron overload, which can cause significant organ damage and is an important cause of morbidity and mortality. STUDY DESIGN AND METHODS This study was an open-label, single-arm, prospective clinical study to evaluate the efficacy and safety of deferasirox (DFX) in patients with aplastic anemia (AA), myelodysplastic syndrome (MDS), or acute myeloid leukemia (AML). Patients with serum ferritin levels of at least 1000 ng/mL and ongoing transfusion requirements were enrolled. DFX was administered for up to 1 year. A total of 100 patients were enrolled. RESULTS Serum ferritin levels decreased significantly following treatment (from 2000 to 1650 ng/mL, p = 0.004). The median absolute reduction in serum ferritin levels was -65 ng/mL in AA (p = 0.037), -647 ng/mL in lower-risk MDS (MDS-LR; p = 0.007), and -552 ng/mL in higher-risk MDS (MDS-HR)/AML (p = 0.482). Mean labile plasma iron (LPI) levels decreased from 0.24 μmol/L at baseline to 0.03 μmol/L at 1 year in all patients (p = 0.036). The mean LPI reduction in each group was -0.17 μmol/L in AA, -0.21 μmol/L in MDS-LR, and -0.30 μmol/L in MDS-HR/AML. Gastrointestinal disorders were commonly observed among groups (16.0%). DFX was temporarily skipped for adverse events in seven patients (7.0%) and was permanently discontinued in 11 patients (11.0%). CONCLUSION DFX reduced serum ferritin and LPI levels in patients with transfusional iron overload. Despite the relatively high percentage of gastrointestinal side effects, DFX was tolerable in all subgroups.
Collapse
Affiliation(s)
- Il-Hwan Kim
- Department of Hemato-Oncology, Inje University Haeundae Paik Hospital, Busan
| | - Joon-Ho Moon
- Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu
| | - Sung-Nam Lim
- Department of Hemato-Oncology, Inje University Haeundae Paik Hospital, Busan
| | - Sang-Kyun Sohn
- Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu
| | - Hoon-Gu Kim
- Department of Hematology/Oncology, Gyeongsang National University Hospital, Jinju
| | - Gyeong-Won Lee
- Department of Hematology/Oncology, Gyeongsang National University Hospital, Jinju
| | - Yang-Soo Kim
- Department of Hematology/Oncology, Kosin University College of Medicine, Busan
| | - Ho-Sup Lee
- Department of Hematology/Oncology, Kosin University College of Medicine, Busan
| | - Ki-Young Kwon
- Department of Hematology/Oncology, Dongsan Medical Center, Daegu
| | - Sung-Hyun Kim
- Department of Hematology/Oncology, Dong-a University Hospital, Busan
| | - Kyung-Tae Park
- Department of Hematology/Oncology, Sungkyunkwan University Samsung Changwon Hospital, Changwon
| | - Joo-Seop Chung
- Department of Hematology/Oncology, Pusan National University, Busan
| | - Won-Sik Lee
- Department of Hemato-Oncology, Inje University Busan Paik Hospital, Busan
| | - Sang-Min Lee
- Department of Hemato-Oncology, Inje University Busan Paik Hospital, Busan
| | - Myung-Soo Hyun
- Department of Hematology/Oncology, Yeungnam University Medical Center, Daegu
| | - Hawk Kim
- Division of Hematology, Ulsan University Hospital, Ulsan
| | - Hun-Mo Ryoo
- Department of Hematology/Oncology, Daegu Catholic University Medical Center, Daegu, Korea
| | - Sung-Hwa Bae
- Department of Hematology/Oncology, Daegu Catholic University Medical Center, Daegu, Korea
| | - Young-Don Joo
- Department of Hemato-Oncology, Inje University Haeundae Paik Hospital, Busan
| |
Collapse
|
27
|
Hwang KL, Song MK, Shin HJ, Na HJ, Shin DH, Kim JK, Moon JH, Ahn JS, Song IC, Hong J, Lee GW, Chung JS. Monosomal and complex karyotypes as prognostic parameters in patients with International Prognostic Scoring System higher risk myelodysplastic syndrome treated with azacitidine. Blood Res 2014; 49:234-40. [PMID: 25548756 PMCID: PMC4278004 DOI: 10.5045/br.2014.49.4.234] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [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: 06/12/2014] [Revised: 07/11/2014] [Accepted: 11/06/2014] [Indexed: 12/03/2022] Open
Abstract
Background Azacitidine (AZA) is standard care for patients with myelodysplastic syndrome (MDS) who have not had allogeneic stem cell transplantation. Chromosomal abnormalities (CA) including complex karyotype (CK) or monosomal karyotype (MK) are associated with clinical outcome in patients with MDS. Methods We investigated which prognostic factors including CAs would predict clinical outcomes in patients with International Prognostic Scoring System (IPSS) higher risk MDS treated with AZA, retrospectively. CK was defined as the presence of three or more numerical or structural CAs. MK was defined as the presence of two or more distinct autosomal monosomies or single autosomal monosomy with at least one additional structural CA. Results A total of 243 patients who treated with AZA, were enrolled. CK was present in 124 patients and MK was present in 90 patients. Bone marrow blasts ≥15% and CK were associated with poorer response (P=0.038, P=0.007) and overall survival (OS) (P<0.001, P<0.001) independently. Although MK in CK group was not associated with prognosis, non-MK status in non-CK group reflected favorable OS (P=0.005). The group including >3 CAs was associated with poorer OS (group including <3 CAs vs. only three CAs, P=0.001; group with >3 CAs vs. only three CAs, P=0.001). Conclusion CK was an important prognostic parameter associated with worse outcome. MK may predict poor survival in only non-CK status. The higher number of CAs was associated with poorer survival.
Collapse
Affiliation(s)
- Kyung-Lim Hwang
- Department of Hematology-Oncology, Pusan National University Hospital, Busan, Korea
| | - Moo-Kon Song
- Department of Hematology-Oncology, Pusan National University Hospital, Busan, Korea
| | - Ho-Jin Shin
- Department of Hematology-Oncology, Pusan National University Hospital, Busan, Korea
| | - Hae-Jung Na
- Department of Hematology-Oncology, Pusan National University Hospital, Busan, Korea
| | - Dong-Hun Shin
- Department of Hematology-Oncology, Pusan National University Hospital, Busan, Korea
| | - Joong-Keun Kim
- Department of Hematology-Oncology, Pusan National University Hospital, Busan, Korea
| | - Joon-Ho Moon
- Department of Hematology, Kyungpook National University Hospital, Daegu, Korea
| | - Jae-Sook Ahn
- Department of Hematology, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Ik-Chan Song
- Department of Hematology, Chungnam Nastional Ujnversity Hospital, Daejeon, Korea
| | - Junshik Hong
- Department of Hematology, Gachon University Gil Medical Center, Incheon, Korea
| | - Gyeong-Won Lee
- Department of Hematology, Gyeong-Sang National University Hospital, School of Medicine, Gyeongsang Natioinal University, Jinju, Korea
| | - Joo-Seop Chung
- Department of Hematology-Oncology, Pusan National University Hospital, Busan, Korea
| |
Collapse
|
28
|
Kwon D, Saadeldin IM, Kim SJ, Park SJ, Kang JT, Park HJ, Moon JH, Koo OJ, Jang G, Lee BC. Optimizing electrical activation of porcine oocytes by adjusting pre- and post-activation mannitol exposure times. Reprod Domest Anim 2014; 49:995-9. [PMID: 25256295 DOI: 10.1111/rda.12420] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 08/10/2014] [Indexed: 11/29/2022]
Abstract
Modifying electrical activation conditions have been used to improve in vitro embryo production and development in pigs. However, there is insufficient information about correlations of porcine embryo development with oocyte pre- and post-activation conditions. The purpose of this study was to compare the developmental rates of porcine oocytes subjected to different mannitol exposure times, either pre- or post-electrical activation, and to elucidate the reason for the optimal mannitol exposure time. Mannitol exposure times around activation were adjusted as 0, 1, 2 or 3 min. Blastocyst development were checked on day 7. Exposure of oocytes to mannitol for 1 or 2 min before electrical activation produced significantly higher blastocyst rates than exposure for 0 or 3 min. There was no significant difference in blastocyst rates when activated oocytes were exposed to mannitol for 0, 1, 2 or 3 min after electrical activation. While exposure of oocytes to mannitol for 1 min pre- and 3 min post-activation showed significantly higher blastocyst development than 0 min pre- and 0 min post-activation. It also showed higher maintenance of normal oocyte morphology than exposure for 0 min pre- and 0 min post-activation. In conclusion, exposure of oocytes to mannitol for 1 min pre- and 3 min post-activation seems to be optimal for producing higher in vitro blastocyst development of porcine parthenogenetic embryos. The higher blastocyst development is correlated with higher maintenance of normal morphology in oocytes exposed to mannitol for 1 min pre- and 3 min post-activation.
Collapse
Affiliation(s)
- D Kwon
- Department of Theriogenology and Biotechnology, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, Korea
| | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Koo BS, Lee SH, Kim JM, Huang S, Kim SH, Rho YS, Bae WJ, Kang HJ, Kim YS, Moon JH, Lim YC. Oct4 is a critical regulator of stemness in head and neck squamous carcinoma cells. Oncogene 2014; 34:2317-24. [PMID: 24954502 DOI: 10.1038/onc.2014.174] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 04/01/2014] [Accepted: 05/06/2014] [Indexed: 01/02/2023]
Abstract
Cancer stem cells (CSCs) have been suggested as responsible for the initiation and progression of cancers. Octamer-binding transcription factor 4 (Oct4) is an important regulator of embryonic stem cell fate. Here, we investigated whether Oct4 regulates stemness of head and neck squamous carcinoma (HNSC) CSCs. Our study showed that ectopic expression of Oct4 promotes tumor growth through cyclin E activation, increases chemoresistance through ABCC6 expression and enhances tumor invasion through slug expression. Also, Oct4 dedifferentiates differentiated HNSC cells to CSC-like cells. Furthermore, Oct4(high) HNSC CSCs have more stem cell-like traits compared with Oct4(low) cells, such as self-renewal, stem cell markers' expression, chemoresistance, invasion capacity and xenograft tumorigeneity in vitro and in vivo. In addition, knockdown of Oct4 led to markedly lower HNSC CSC stemness. Finally, there was a significant correlation between Oct4 expression and survival of 119 HNSC patients. Collectively, these data suggest that Oct4 may be a critical regulator of HNSC CSCs and its targeting may be potentially valuable in the treatment of HNSC CSCs.
Collapse
Affiliation(s)
- B S Koo
- Department of Otolaryngology-Head and Neck Surgery, Cancer Research Institute, Daejeon, Korea
| | - S H Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
| | - J M Kim
- Research Institute for Medical Sciences and Pathology, Chungnam National University College of Medicine, Daejeon, Korea
| | - S Huang
- Research Institute for Medical Sciences and Pathology, Chungnam National University College of Medicine, Daejeon, Korea
| | - S H Kim
- Department of Otolaryngology-Head and Neck Surgery, Cancer Research Institute, Daejeon, Korea
| | - Y S Rho
- Department of Otorhinolaryngology-Head and Neck Surgery, Ewha University School of Medicine, Seoul, Korea
| | - W J Bae
- Department of Otolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Seoul, Korea
| | - H J Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - Y S Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - J H Moon
- Department of Otorhinolaryngology-Head and Neck Surgery, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - Y C Lim
- Department of Otorhinolaryngology-Head and Neck Surgery, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| |
Collapse
|
30
|
Lee TH, Lee SJ, Moon JH, Park SH. Technical tips and issues of biliary stenting, focusing on malignant hilar obstruction. MINERVA GASTROENTERO 2014; 60:135-149. [PMID: 24780948] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In patients with inoperable hilar cholangiocarcinoma (HCCA), palliative endoscopic or percutaneous drainage provides benefits in terms of symptomatic improvement and quality of life. Endoscopic biliary stent placement is considered the gold standard, with metal stents preferred over plastic stents in patients with more than three months of life expectancy. However, the endoscopic management of advanced hilar obstruction is often more challenging and complex than distal malignant biliary obstructions. Recently, the Asia-Pacific working group on hepatobiliary cancers produced consensus recommendations on the use of endoscopic vs. percutaneous drainage and unilateral vs. bilateral drainage in the management of HCCA. However, these guidelines must be weighed against context-specific information, such as the volume of liver drainage required, life expectancy of the patient, and the available expertise. In this literature review, we describe the issues commonly encountered during endoscopic biliary stenting for malignant hilar obstruction and provide technical guidance to improve success rates and patient outcomes.
Collapse
Affiliation(s)
- T H Lee
- Division of Gastroenterology Department of Internal Medicine Soonchunhyang University School of Medicine Cheonan Hospital, Cheonan and Bucheon Hospital, Bucheon, Republic of Korea -
| | | | | | | |
Collapse
|
31
|
An HJ, Choi EK, Kim JS, Hong SW, Moon JH, Shin JS, Ha SH, Kim KP, Hong YS, Lee JL, Choi EK, Lee JS, Jin DH, Kim TW. INCB018424 induces apoptotic cell death through the suppression of pJAK1 in human colon cancer cells. Neoplasma 2014; 61:56-62. [PMID: 24195509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Janus kinase (JAK) is one of the main upstream activators of signal transducers and activators of transcription (STAT) that are constitutively activated in various malignancies and are associated with cell growth, survival, and carcinogenesis. Here, we investigated the role of JAKs in colorectal cancer in order to develop effective therapeutic targets for INCB018424, which is the first JAK1/2 inhibitor to be approved by FDA. After examining the basal expression levels of phospho-JAK1 and phospho-JAK2, we measured the effects of INCB018424 on the phosphorylation of JAK1/2 using western blot analysis. Cell viability was determined using the trypan blue exclusion assay. The cell death mechanism was identified by the activation of caspase 3 using western blot and annexin V staining. The basal levels of phospho-JAK1 and phospho-JAK2 were cancer cell type dependent. Colorectal cancer cell lines that phosphorylate both JAK1 and JAK2 include DLD-1 and RKO. INCB018424 inactivates both JAK1 and JAK2 in DLD-1 cells but inactivates only JAK1 in RKO cells. Cell death was proportional to the inactivation of JAK1 but not JAK2. INCB018424 causes caspase-dependent cell death, which is prevented by treatment with z-VAD. The inhibition of JAK1 phosphorylation seemed sufficient to allow INCB018424-mediated apoptosis. JAK1 is a key molecule that is involved in colon cancer cell survival and the inhibition of JAK1 by INCB01424 results in caspase-dependent apoptosis in colorectal cancer cells. The use of selective JAK1 inhibitors could be an attractive therapy against colorectal cancer, but further clinical investigations are needed to test this possibility.
Collapse
|
32
|
Song MK, Chung JS, Lee JJ, Jeong SY, Lee SM, Hong JS, Chong A, Moon JH, Kim JH, Lee SM, Kim SJ, Shin HJ. Metabolic tumor volume by positron emission tomography/computed tomography as a clinical parameter to determine therapeutic modality for early stage Hodgkin's lymphoma. Cancer Sci 2013; 104:1656-61. [PMID: 24033666 DOI: 10.1111/cas.12282] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 08/27/2013] [Accepted: 08/28/2013] [Indexed: 01/22/2023] Open
Abstract
Recent studies have shown that metabolic tumor volume (MTV) by positron emission tomography/computed tomography (PET/CT) is an important prognostic parameter in patients with non-Hodgkin's lymphoma. However, it is unknown whether doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) alone in early stage Hodgkin's lymphoma would lead to similar disease control as combined modality therapy (CMT) using MTV by PET/CT. One hundred and twenty-seven patients with early stage Hodgkin's lymphoma who underwent PET/CT at diagnosis were enrolled. The MTV was delineated on PET/CT by the area ≥SUV(max), 2.5 (standardized uptake value [SUV]). Sixty-six patients received six cycles of ABVD only. The other 61 patients received CMT (involved-field radiotherapy after 4-6 cycles of ABVD). The calculated MTV cut-off value was 198 cm(3) . Clinical outcomes were compared according to several prognostic factors (i.e. age ≥50 years, male, performance status ≥2, stage II, B symptoms, ≥4 involved sites, extranodal site, large mediastinal mass, CMT, elevated erythrocyte sedimentation rate and high MTV). Older age (progression-free survival [PFS], P = 0.003; overall survival [OS], P = 0.007), B symptoms (PFS, P = 0.006; OS, P = 0.036) and high MTV (PFS, P = 0.008; OS, P = 0.007) were significant independent prognostic factors. Survival of two high MTV groups treated with ABVD only and CMT were lower than the low MTV groups (PFS, P < 0.012; OS, P < 0.045). ABVD alone was sufficient to control disease in those with low MTV status. However, survival was poor, even if the CMT was assigned a high MTV status. The MTV would be helpful for deciding the therapeutic modality in patients with early stage Hodgkin's lymphoma.
Collapse
Affiliation(s)
- Moo-Kon Song
- Department of Hematology-Oncology, Pusan National University Hospital Medical Research Institute, Busan, Korea
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Lee TH, Moon JH, Kim JH, Park DH, Lee SS, Choi HJ, Cho YD, Park SH, Kim SJ. Primary and revision efficacy of cross-wired metallic stents for endoscopic bilateral stent-in-stent placement in malignant hilar biliary strictures. Endoscopy 2013; 45:106-13. [PMID: 23212727 DOI: 10.1055/s-0032-1325928] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [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: 02/06/2023]
Abstract
BACKGROUND AND STUDY AIMS Endoscopic bilateral drainage for inoperable malignant hilar biliary strictures (HBS) using metal stents is considered to be technically difficult. Furthermore, endoscopic revision of bilateral stenting after occlusion can be challenging. This study was performed to evaluate the long-term efficacy of endoscopic bilateral stent-in-stent placement of cross-wired metallic stents in high-grade malignant HBS and planned endoscopic bilateral revision. PATIENTS AND METHODS A total of 84 patients with inoperable high-grade malignant HBS were enrolled from three academic tertiary referral centers. Two cross-wired metal stents were inserted using a bilateral stent-in-stent placement method. Bilateral endoscopic revision was also performed during follow-up using either identical metal stents or plastic stents. The main outcome measurements were technical and functional success, complications, stent patency, and endoscopic revision efficacy. RESULTS The technical and clinical success rates of endoscopic bilateral stent-in-stent placement of cross-wired metallic stents were 95.2% (80/84) and 92.9% (78/84), respectively. Median patency (range) and survival were 238 days (10-429) and 256 days (10-1130), respectively. Obstruction of primary bilateral stents occurred in 30.8% (24/78) of patients with functionally successful stent placement. The technical and clinical success rates of planned bilateral endoscopic revision for occluded stents were 83.3% (20/24) and 79.2% (19/24), respectively. For revision, bilateral metallic stents were placed in 11 patients (55.0%); the remaining patients received plastic stents. CONCLUSIONS Palliative endoscopic bilateral stent-in-stent placement of cross-wired metallic stents was effective in patients with inoperable HBS. Revision endoscopic bilateral stenting may be feasible and successful in cases where the primary deployed metal stents are occluded.
Collapse
Affiliation(s)
- T H Lee
- Digestive Disease Center, Department of Internal Medicine, Soon Chun Hyang University School of Medicine, Cheonan, Republic of Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Lee YN, Moon JH, Choi HJ. Reply to Peng & Chow. Endoscopy 2013; 45:155. [PMID: 23364845 DOI: 10.1055/s-0032-1326180] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
|
35
|
Lee HS, Park LC, Lee EM, Shin SH, Kim YS, Moon JH, Lee WS, Shin HJ, Kim MH, Ye BJ, Chung JS. Predictive factors for rapid neutrophil and platelet engraftment after allogenic peripheral blood stem cell transplantation in patients with acute leukemia. Ann Hematol 2013; 92:1685-93. [PMID: 23896629 DOI: 10.1007/s00277-013-1847-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Accepted: 07/09/2013] [Indexed: 10/26/2022]
Abstract
The aim of this study was to investigate predictive factors for rapid engraftment after allogeneic peripheral blood stem cell transplantation (alloPBSCT) in patients with acute leukemia. Two hundred sixty-two patients receiving alloPBSCT were analyzed. Subset analyses of donor stem cells were conducted using a flow cytometric method. The correlation between rapid engraftment of neutrophils, platelets, and donor stem cells doses, as well as other recipient and donor clinical factors, was analyzed. In univariate analysis, factors correlated with neutrophil engraftment (≥0.5 × 10(9)/L) by day 12 were achievement of complete remission (CR) after induction chemotherapy (CR1) before hematopoietic cell transplantation (HCT) and high numbers of CD34+ cells, CD3+ T cells, and CD3+/CD4+ T cells. Factors correlated with platelet engraftment (≥20 × 10(9)/L) by day 12 were achievement of CR1 before HCT, donor and recipient sex mismatch, and high numbers of mononuclear cells, CD34+ cells, CD3+ T cells, CD3+/CD4+ T cells, CD3+/CD8+ T cells, and CD56+ NK cells. In multivariate analysis, independent predictive factors for rapid neutrophil and platelet engraftment were CR1 before HCT (p < 0.001 and p = 0.002, respectively), high number of donor CD34+ cells (p = 0.005 and p < 0.001, respectively), and high number of CD3+ T cells (p = 0.005 and p = 0.001, respectively). In conclusion, achieving CR1 before HCT, as well as larger quantities of donor CD34+ and CD3+ T cells, may predict rapid neutrophil and platelet engraftment after PBSCT.
Collapse
Affiliation(s)
- Ho Sup Lee
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Choi JY, Kang JT, Park SJ, Kim SJ, Moon JH, Saadeldin IM, Jang G, Lee BC. Effect of 7,8-dihydroxyflavone as an antioxidant on in vitro maturation of oocytes and development of parthenogenetic embryos in pigs. J Reprod Dev 2013; 59:450-6. [PMID: 23748647 PMCID: PMC3934122 DOI: 10.1262/jrd.2012-134] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [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] [Indexed: 01/15/2023] Open
Abstract
One of the factors that impairs in vitro produced porcine embryos
is the oxidative stress that is mainly caused by the imbalance between reactive
oxygen species (ROS) generation and antioxidants activity, especially that of
glutathione (GSH). Here, we examined the effect of 7,8-dihydroxyflavone (7,8-DHF), a
kind of flavonoid antioxidant, on porcine oocyte maturation and its developmental
competence. Porcine oocytes were cultured in media supplemented with 0, 1, 5 and 10
μM 7,8-DHF during both in vitro maturation (IVM) and in
vitro culture (IVC) after parthenogenetic activation. Maturation of
oocytes was evaluated based on first polar body (PB) extrusion and intracellular GSH
level, and developmental competence was assessed through observing cleavage and
blastocyst formation. In each step, the levels of intracellular GSH and ROS were
assessed by fluorescence intensity, and the apoptosis-related gene expression was
examined using semiquantitative RT-PCR. The group treated with 1 μM 7,8-DHF during
IVM and IVC showed increased cytoplasmic maturation and reached the blastocysts stage
(36.1%) at a higher rate than the other groups (24.7, 16.0 and 10.3% for 0, 5 and 10
μM, P<0.05). In that group, the intracellular GSH level was significantly
increased while ROS generation was significantly decreased after IVM and IVC
(P<0.05). Moreover, it showed high expression of an anti-apoptotic gene
(BCL2L1) and low expression of a pro-apoptotic gene
(BAK1) (P<0.05). In conclusion, treatment with 1 μM 7,8-DHF
during IVM and IVC showed an anti-apoptotic effect by increasing intracellular GSH
synthesis and scavenging ROS and therefore improved the developmental competence of
porcine embryos.
Collapse
Affiliation(s)
- Ji-Yei Choi
- Department of Theriogenology and Biotechnology, College of Veterinary Medicine, Seoul National University, Seoul 151-742, Korea
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Kang JT, Kwon DK, Park SJ, Kim SJ, Moon JH, Koo OJ, Jang G, Lee BC. Quercetin improves the in vitro development of porcine oocytes by decreasing reactive oxygen species levels. J Vet Sci 2013; 14:15-20. [PMID: 23388446 PMCID: PMC3615227 DOI: 10.4142/jvs.2013.14.1.15] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [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: 03/03/2011] [Accepted: 04/04/2012] [Indexed: 11/22/2022] Open
Abstract
Quercetin is a plant-derived flavonoid found in fruits or vegetables that has antioxidant properties and acts as a free radical scavenger. We investigated the effects of quercetin on porcine oocyte nuclear maturation and embryonic development after parthenogenetic activation. We then evaluated the antioxidant activities of quercetin by measuring reactive oxygen species (ROS) levels in matured oocytes. Immature oocytes were untreated or treated with 1, 10, and 50 µg/mL quercetin during in vitro maturation (IVM). Quercetin treatment did not improve oocyte nuclear maturation, but significantly higher blastocyst rates (p < 0.05) of parthenogenetically activated oocytes were achieved when the IVM medium was supplemented with an adequate concentration of quercetin (1 µg/mL). However, cleavage rates and blastocyst cell numbers were not affected. Oocytes treated with 1 or 10 µg/mL quercetin had significantly lower (p < 0.05) levels of ROS than the control and group treated with the highest concentration of quercetin (50 µg/mL). Moreover, this highest concentration was detrimental to oocyte nuclear maturation and blastocyst formation. Based on our findings, we concluded that exogenous quercetin reduces ROS levels during oocyte maturation and is beneficial for subsequent embryo development.
Collapse
Affiliation(s)
- Jung-Taek Kang
- Department of Theriogenology and Biotechnology, College of Veterinary Medicine, Seoul National University, Seoul 151-742, Korea
| | | | | | | | | | | | | | | |
Collapse
|
38
|
Nakajima K, Moon JH, Tsutsui S, Miyazaki Y, Yamasaki M, Yamada T, Kato M, Yasuda K, Sumiyama K, Yahagi N, Saida Y, Kondo H, Nishida T, Mori M, Doki Y. Esophageal submucosal dissection under steady pressure automatically controlled endoscopy (SPACE): a randomized preclinical trial. Endoscopy 2012; 44:1139-48. [PMID: 22932809 DOI: 10.1055/s-0032-1310093] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [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: 12/27/2022]
Abstract
BACKGROUND AND STUDY AIMS A new overtube system has been developed for steady pressure automatically controlled endoscopy (SPACE) in the gastrointestinal tract. The objectives of this study were to validate the feasibility and safety of SPACE in the esophagus, and to evaluate its potential advantages over conventional (manually insufflating) endoscopy in endoscopic submucosal dissection (ESD). METHODS This was a multicenter preclinical trial using acute porcine models (n = 20). In Experiment 1 (feasibility/safety study), SPACE was attempted in the esophagus with continuous monitoring of cardiopulmonary parameters and intraluminal pressures in the downstream bowel. Different insufflation pressures were tested to optimize the insufflation condition. Each session was video-recorded and scored by blinded reviewers. In Experiment 2 (randomized trial), esophageal ESD was attempted using either SPACE or conventional endoscopy, and results were compared. RESULTS In Experiment 1, SPACE was performed safely without intraluminal pressure elevation in the downstream bowel. According to video review, SPACE provided more stable, reproducible, and rapid visualization than conventional endoscopy. The insufflation pressure was optimized at 14 mmHg for esophageal SPACE. In Experiment 2, ESD was completed in all animals. The ESD time was significantly shorter with SPACE compared with conventional endoscopy (1326 vs. 1616 seconds; P = 0.009). Responses to questionnaires showed that 94 % - 100 % of participants considered SPACE to provide improved exposure and more uniform tissue tension than conventional endoscopy. Other data were comparable. CONCLUSIONS SPACE is feasible, safe, and potentially effective for complicated endoscopic procedures, such as ESD. SPACE improves and standardizes endoscopic exposure and tissue tension. A clinical study is required to further confirm its safety and clinical effectiveness.
Collapse
Affiliation(s)
- K Nakajima
- Department of Gastroenterological Surgery, Osaka University, Osaka, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Moon J, Kim S, Park H, Kang J, Park S, Koo O, da Torre BR, Saadeldin IM, Lee B, Jang G. Production of porcine cloned embryos derived from cells conditionally expressing an exogenous gene using Cre-loxP. ZYGOTE 2012; 20:423-5. [PMID: 22272567 DOI: 10.1017/s0967199411000773] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
It is increasingly evident that conditional gene expression in pigs is necessary to make transgenic models. In this study, we investigated conditional expression in porcine fetal fibroblasts using Cre-loxP recombination, a system that has had limited application in large animals to date. Transformed fibroblasts were reprogrammed in enucleated oocytes to support further early embryonic development. Fetal fibroblasts from miniature pigs were used for transfection with a plasmid that contained a red fluorescent protein marker (pCALNL-DsRed) and a floxed neomycin-resistance gene. Cells were selected with 750 μg/ml neomycin for 2 weeks following transfection but did not express DsRed after visualization under a fluorescence microscope. Expression was achieved only after transient transfection with plasmid DNA that expressed the Cre recombinase enzyme. The cells that expressed DsRed were used for somatic cell nuclear transfer (SCNT). A total of 121 oocytes were used for SCNT and 76 cloned embryos (62.8%) were seen to have cleaved. Six blastocysts developed after SCNT and expressed DsRed. Deletion of the floxed neomycin-resistance gene was confirmed by reverse transcription polymerase chain reaction (RT-PCR) in cloned blastocysts. This study demonstrated that Cre-loxP recombination can be conducted successfully in miniature pig fibroblasts and that the sequentially transformed cells can develop to the pre-implantation embryo stage via SCNT.
Collapse
Affiliation(s)
- JoonHo Moon
- Department of Theriogenology and Biotechnology, College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul, Republic of Korea
| | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Song MK, Chung JS, Shin HJ, Moon JH, Ahn JS, Lee HS, Lee SM, Lee GW, Kim SJ, Lee SM. Clinical value of metabolic tumor volume by PET/CT in extranodal natural killer/T cell lymphoma. Leuk Res 2012; 37:58-63. [PMID: 23040533 DOI: 10.1016/j.leukres.2012.09.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Revised: 08/22/2012] [Accepted: 09/16/2012] [Indexed: 10/27/2022]
Abstract
This study investigated whether metabolic tumor volume (MTV) by PET/CT as indicator of extent of lymphoma burden would be a prognostic factor in stage I(E)/II(E) extranodal natural killer/T cell lymphoma (ENKTCL). Eighty patients with stage I(E)/II(E) ENKTCL in the upper aerodigestive tract underwent PET/CT at diagnosis were enrolled and 32 patients received upfront radiotherapy (RTx). MTV was measured on PET/CT images by the extranodal region above SUV, 2.5. Receiver operating curve analyses indicated that an MTV of 35.2 cm(3) was the ideal cut-off to distinguish between low and high MTV groups. Clinical outcomes were compared according to several prognostic factors (age, stage, high performance status [PS], high International Prognostic Index, elevated lactate dehydrogenase [LDH], local tumor invasiveness [LTI], high MTV and up-front RT). High PS, elevated LDH, LTI, high MTV and upfront RT were associated with survivals. In multivariate analysis, high MTV (PFS, HR=4.170, 95% CI=1.714-10.147, p=0.002; OS, HR=4.102, 95% CI=1.617-10.408, p=0.003) and up-front RT (PFS, HR=0.410, 95%CI=0.178-0.946, p=0.037; OS, HR=0.365, 95% CI=0.152-0.872, p=0.023) were significant independent prognostic factors. Upfront RTx and extent of tumor burden, as measured by the MTV, had significant prognostic value in patients with ENKTCL.
Collapse
Affiliation(s)
- Moo-Kon Song
- Department of Hematology-Oncology, Pusan National University Hospital Medical Research Institute, Busan, Republic of Korea.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Lee YN, Moon JH, Choi HJ, Min SK, Kim HI, Lee TH, Cho YD, Park SH, Kim SJ. Direct peroral cholangioscopy using an ultraslim upper endoscope for management of residual stones after mechanical lithotripsy for retained common bile duct stones. Endoscopy 2012; 44:819-24. [PMID: 22791587 DOI: 10.1055/s-0032-1309880] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [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: 02/08/2023]
Abstract
BACKGROUND AND STUDY AIMS The incidence of residual stones after mechanical lithotripsy for retained common bile duct (CBD) stones is relatively high. Peroral cholangioscopy using a mother-baby system may be useful for confirming complete extraction of stones, but has several limitations regarding routine use. We evaluated the role of direct peroral cholangioscopy (DPOC) using an ultraslim upper endoscope for the evaluation and removal of residual CBD stones after mechanical lithotripsy. PATIENTS AND METHODS From August 2006 to November 2010, 48 patients who had undergone mechanical lithotripsy for retained CBD stones with no evidence of filling defects in balloon cholangiography were recruited. The bile duct was inspected by DPOC after balloon cholangiography. Detected residual CBD stones were directly retrieved with a basket or balloon catheter under DPOC. The incidence of residual stones detected by DPOC, and the success rate of residual stone retrieval under DPOC were investigated. RESULTS DPOC was successfully performed in 46 of the 48 patients (95.8%). Of these, 13 patients (28.3%) had residual CBD stones (mean number 1.4, range 1-3; mean diameter 4.5 mm, range 2.3-9.6). The residual stones were removed directly under DPOC in 11 of these patients (84.6%). There were no complications associated with DPOC or stone removal. CONCLUSION DPOC using an ultraslim upper endoscope is a useful endoscopic procedure for the evaluation and extraction of residual stones after mechanical lithotripsy for retained CBD stones.
Collapse
Affiliation(s)
- Y N Lee
- Digestive Disease Center, Department of Internal Medicine, Soon Chun Hyang University School of Medicine, Bucheon and Seoul, Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Choi JY, Kang JT, Park SJ, Kim SJ, Moon JH, Saadeldin IM, Kim T, Jang G, Lee BC. 7,8-Dihydroxyflavone Improves In Vitro Development of Porcine Oocytes/Embryos by Decreasing Reactive Oxygen Species Levels. Biol Reprod 2012. [DOI: 10.1093/biolreprod/87.s1.217] [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: 11/14/2022] Open
|
43
|
Cheon YK, Moon JH, Choi HJ, Lee JE, Lee YN, Cho YD, Lee TH, Park SH, Kim SJ. Direct peroral pancreatoscopy with an ultraslim endoscope for the evaluation of intraductal papillary mucinous neoplasms. Endoscopy 2012; 43 Suppl 2 UCTN:E390-1. [PMID: 22275014 DOI: 10.1055/s-0030-1256933] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Y K Cheon
- Digestive Disease Center, Department of Internal Medicine, Soon Chun Hyang University School of Medicine, Bucheon and Seoul, Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Song MK, Chung JS, Shin HJ, Moon JH, Lee JO, Lee HS, Lee SM, Lee GW, Lee SE, Kim SJ. Prognostic value of metabolic tumor volume on PET / CT in primary gastrointestinal diffuse large B cell lymphoma. Cancer Sci 2012; 103:477-82. [PMID: 22126515 DOI: 10.1111/j.1349-7006.2011.02164.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Primary gastrointestinal (PGI) diffuse large B cell lymphoma (DLBCL) is a relatively common disease. Recent studies indicate that measurement of maximum standardized uptake value (SUV(max)) on pretreatment for (18)F-fluorodeoxyglucose PET is an important prognostic factor in PGI DLBCL. However, there is still an association between initial tumor burden and prognosis. Thus, in the present study, we investigated whether tumor volume by PET could have a potential prognostic value to predict the outcome. From 2006 to 2009, 165 Stage I E/II E PGI DLBCL patients were enrolled in the study. One hundred and five patients received cyclophosphamide, doxorubicin, vincristine, prednisone, and rituximab (R-CHOP) only, whereas 60 patients underwent surgery plus R-CHOP. Metabolic tumor volume (MTV) was defined initial tumor burden as target GI lesion above SUV, 2.5 by PET as a contouring border. Over a median follow-up period of 36.6 months, receiver operating characteristic (ROC) analysis indicated that the best cut-off values for MTV and SUV(max) were 160.1 cm(3) and 12.0, respectively. The estimated area under the ROC curve was higher for MTV than SUV(max). Thus, MTV was a better predictor for survival than SUV(max). In patients with a low MTV (<160.1 cm(3)), there were no significant differences in survival between patients undergoing R-CHOP alone and surgery plus R-CHOP (P = 0.347 for progression-free survival [PFS]; P = 0.148 for overall survival [OS]). Conversely, in patients with a high MTV (>160.1 cm(3)), survival was longer in those who underwent surgery plus R-CHOP than in those treated with R-CHOP alone (P < 0.001 for PFS; P < 0.001 for OS). Multivariate analysis revealed that high MTV is an independent factor for predicting survival. Even in the era of rituximab, treatment of PGI DLBCL is not easy in patients with a high MTV.
Collapse
Affiliation(s)
- Moo-Kon Song
- Department of Hematology-Oncology, Pusan National University Hospital Medical Research Institute, Busan, Korea
| | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Song MK, Chung JS, Shin HJ, Moon JH, Lee JJ, Yoon SS, Kim JS, Lee JO, Do YR, Lee HS, Park EK. Cyclophosphamide-containing regimen (TCD) is superior to melphalan-containing regimen (MPT) in elderly multiple myeloma patients with renal impairment. Ann Hematol 2012; 91:889-96. [PMID: 22237937 DOI: 10.1007/s00277-011-1401-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Accepted: 12/29/2011] [Indexed: 11/30/2022]
Abstract
Renal impairment (RI) is a frequent complication with higher incidence of infections and an important prognostic factor for survival. Melphalan clearance is renal function dependent whereas cyclophosphamide is renal function independent. We investigated which combination regimen should be selected between melphalan-combining regimen (MPT) or cyclophosphamide-combining regimen (TCD) in elderly multiple myeloma (MM) patients with RI. Between 2005 and 2009, 157 newly diagnosed MM patients with RI were included comparing MPT with TCD therapy as initial treatment. Seventy-four patients were given MPT regimen, and 83 patients were given TCD regimen. Baseline characteristics were similar between the MPT and TCD groups. Analysis of different cutoff levels between 25% and 75% quartiles using log-rank test determined that glomerular filtration rate (GFR), 40 ml/min/1.73 m(2) as the cutoff point, yielded the highest difference in event-free survival (EFS) and overall survival (OS). The MPT subgroup with low GFR (GFR <40 ml/min/1.73 m(2)) had poorer response rates than others. The incidence of neutropenia and infection with febrile neutropenia were higher in the MPT subgroup with low GFR than the others (p = 0.016, p < 0.001). Furthermore, mortality due to the infection was higher in the MPT subgroup with low GFR than the others (p < 0.001). EFS was lower in the MPT subgroup with low GFR than the others (p < 0.001). OS was lower in the MPT subgroup with low GFR than the others (p < 0.001). In newly diagnosed elderly MM patients with RI, TCD regimen would be an effective and tolerable treatment option due to the combination of cyclophosphamide independent to renal function and dexamethasone effective for RI.
Collapse
Affiliation(s)
- Moo-Kon Song
- Department of Hematology-Oncology, School of Medicine, Pusan National University Hospital Medical Research Institute, Seo-gu, Busan, Republic of Korea
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Kang JT, Kwon DK, Park SJ, Kim SJ, Moon JH, Saadeldin IM, Koo OJ, Jang G, Lee BC. Quercetin Improves In Vitro Development of Porcine Oocytes by Decreasing Reactive Oxygen Species Levels. Biol Reprod 2011. [DOI: 10.1093/biolreprod/85.s1.589] [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: 11/13/2022] Open
|
47
|
Yi YS, Chung JS, Song MK, Shin HJ, Seol YM, Choi YJ, Cho GJ, Lee GW, Moon JH, Hwang IH, Ahn KH, Lee HS, Shin KH, Hwang JM. The risk factors for herpes zoster in bortezomib treatment in patients with multiple myeloma. Korean J Hematol 2010; 45:188-92. [PMID: 21120208 PMCID: PMC2983043 DOI: 10.5045/kjh.2010.45.3.188] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 08/16/2010] [Accepted: 09/02/2010] [Indexed: 11/17/2022]
Abstract
Background Bortezomib has significant activity in treating multiple myeloma (MM). The risk of herpes zoster (HZ) has been reported to increase significantly with bortezomib treatment, but the predisposing factors for HZ are not clear. This study is a retrospective analysis of the relevant risk factors for HZ in Korean MM patients treated with bortezomib. Methods Sixty-six patients with refractory or relapsed MM who underwent chemotherapy with bortezomib were included in the study. Prophylactic antiviral drugs were not used for treatment. The following parameters were reviewed: age, gender, stage and type of MM, extent of previous treatment, history of HZ, duration from the time of diagnosis to the time of bortezomib treatment initiation, and absolute lymphocyte counts (ALC) at the time of bortezomib treatment initiation. Results The incidence of HZ was 16.7%. There were no intergroup differences between the HZ-positive and the HZ-negative groups with regard to a history of HZ, number of previous treatments, and exposure to steroids before bortezomib treatment. The median duration from the time of MM diagnosis to the time of bortezomib treatment initiation in the HZ-positive group was significantly shorter than that in the HZ-negative group. The median ALC at the time of bortezomib initiation in the HZ-positive group was significantly lower than that in the HZ-negative group. Conclusion Bortezomib itself might act as a risk factor for HZ by inhibiting cell-mediated immunity, and patients with low ALC at the time of bortezomib treatment initiation were at greater risk of HZ during bortezomib treatment.
Collapse
Affiliation(s)
- Yang-Seon Yi
- Department of Hematology-Oncology, Busan Cancer Center, Pusan National University Hospital Medical Research Institute, Busan, Korea
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Kim MK, Suh C, Lee DH, Min CK, Kim SJ, Kim K, Moon JH, Yoon SS, Lee GW, Kang HJ, Kim SH, Choi CW, Eom HS, Kwak JY, Kim HJ, Mun YC, Bang SM, Lee K, Shin HJ, Lee JH. Immunoglobulin D multiple myeloma: response to therapy, survival, and prognostic factors in 75 patients. Ann Oncol 2010; 22:411-6. [PMID: 20682550 DOI: 10.1093/annonc/mdq393] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND To analyze the clinical features, outcomes including efficacy of treatment, and prognostic factors of patients with immunoglobulin D multiple myeloma (IgD MM). DESIGN AND METHODS Seventy-five patients diagnosed with IgD MM were selected from the Korean Myeloma Registry database (www.myeloma.or.kr). RESULTS Median age was 57 years and the main presenting features were bone pain (77%). Renal function impairment and hypercalcemia were present in 40 (53%) and 20 (27%) patients. Sixty-seven patients (89%) had lambda light chains. Forty-eight patients (64%) were of stage III by International Staging System. Twenty-six patients (53%) had chromosomal abnormalities mostly by conventional cytogenetics. Thirty-nine patients (54%) were treated with vincristine, adriamycin, and dexamethasone chemotherapy; the overall response rate (ORR) of 56%. Sixteen patients (22%) received first-line chemotherapy including new drugs (bortezomib or thalidomide), with an ORR of 81%. At a median follow-up time of 28.6 months, median overall survival (OS) was 18.5 months. Age, extramedullary plasmacytoma, del(13) or hypoploidy, serum β(2) microglobulin level, and platelet count were significant prognostic factors for OS. CONCLUSIONS IgD MM is an aggressive disease that is usually detected at an advanced stage. Despite a positive initial response, survival after relapse was dismal. Intensive treatment strategies before and following stem cell transplantation may improve outcomes in younger patients.
Collapse
Affiliation(s)
- M K Kim
- Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Yang DH, Kim YK, Sohn SK, Chung JS, Joo YD, Lee JH, Lee JL, Ahn JS, Moon JH, Shin HJ, Choi YJ, Lee WS, Kim HJ, Lee JJ. Induction treatment with cyclophosphamide, thalidomide, and dexamethasone in newly diagnosed multiple myeloma: a phase II study. Clin Lymphoma Myeloma Leuk 2010; 10:62-7. [PMID: 20223731 DOI: 10.3816/clml.2010.n.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Thalidomide has alternative mechanisms of action; it can be combined with dexamethasone or alkylating agents for the treatment of multiple myeloma (MM); however, the optimal doses and appropriate intervals of thalidomide continue to be debated. PATIENTS AND METHODS We assessed the clinical efficacy and toxicity of thalidomide in patients with newly diagnosed MM; 68 patients were treated with pulsed cyclophosphamide, thalidomide, and dexamethasone (CTD) chemotherapy for induction treatment. RESULTS After a median of 28 months' follow-up, the overall response rate was 79.4%, with a 42.6% complete response (CR) or very good partial response (VGPR). Patients with cytogenetically high-risk disease had poor CR/VGPR rates (27.3%) at a median of 11.5 months of time to progression (TTP) compared with patients with standard-risk disease who achieved CR/VGPR rates (50%) at a median of 20.3 months of TTP. The major adverse events included peripheral sensory neuropathy (14.3%), infection (10.2%), and thromboembolic complications (5.9%). Thirty-two patients who achieved more than a PR proceeded to peripheral blood stem cell collection with a median number of 5.0 x 106 CD34+ cells/kg collected. CONCLUSION CTD resulted in a favorable response with tolerable toxicity in patients with MM and did not affect the yield of the stem cell collection.
Collapse
Affiliation(s)
- Deok-Hwan Yang
- Chonnam National University Hwasun Hospital, Republic of Korea, Jeollanam-do, Republic of Korea
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Moon JH, Kim SN, Kang BW, Chae YS, Kim JG, Ahn JS, Kim YK, Yang DH, Lee JJ, Kim HJ, Choi YJ, Shin HJ, Chung JS, Cho GJ, Sohn SK. Early onset of acute GVHD indicates worse outcome in terms of severity of chronic GVHD compared with late onset. Bone Marrow Transplant 2010; 45:1540-5. [PMID: 20190848 DOI: 10.1038/bmt.2010.12] [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: 11/09/2022]
Abstract
Acute GVHD (aGVHD) is an important risk factor for predicting the incidence or severity of chronic GVHD (cGVHD). Transplant outcome can be influenced by the onset time of aGVHD in patients who have received allogeneic PBSC transplants (PBSCTs). The medical records of 134 patients who survived more than 3 months after myeloablative allogeneic PBSCT were retrospectively reviewed. In all, 38 patients (28.4%) developed grade II-IV aGVHD before day +28 (early aGVHD) and 25 patients (18.7%) after day +28 (late aGVHD). The 5-year cumulative incidence of cGVHD was 78.9% in the early-aGVHD group and 56.6% in the late-aGVHD group (P=0.034). The 5-year OS was 51.0% for the early-aGVHD and 80.8% for the late-aGVHD group (P=0.406). Infection was the primary cause of death for the early-aGVHD group (51.4 vs 16.7%, P=0.017), whereas relapse of the primary disease was higher among the patients with late aGVHD, although this was statistically insignificant (58.3 vs 25.7%, P=0.309). In a multivariate analysis, early aGVHD was identified as a risk factor for developing cGVHD (hazard ratio (HR) 2.278, P=0.004). The development of aGVHD early after allogeneic PBSCT increased the risk of cGVHD and infection-related death rate when compared with the late onset of aGVHD.
Collapse
Affiliation(s)
- J H Moon
- Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Korea
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|