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Son M, Kim HR, Choe SA, Song SY, Lim KH, Ki M, Heo YJ, Choi M, Go SH, Paek D. Social Inequities in the Survival of Liver Cancer: A Nationwide Cohort Study in Korea, 2007-2017. J Korean Med Sci 2024; 39:e130. [PMID: 38565179 PMCID: PMC10985499 DOI: 10.3346/jkms.2024.39.e130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/25/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND To analyze the effects of socioeconomic status (type of insurance and income level) and cancer stage on the survival of patients with liver cancer in Korea. METHODS A retrospective cohort study was constructed using data from the Healthcare Big Data Platform project in Korea between January 1, 2007, and December 31, 2017. A total of 143,511 patients in Korea diagnosed with liver cancer (International Classification of Diseases, 10th Revision [ICD-10] codes C22, C220, and C221) were followed for an average of 11 years. Of these, 110,443 died. The patient's insurance type and income level were used as indicators of socioeconomic status. Unadjusted and adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using a Cox proportional hazards regression model to analyze the relationship between the effects of sex, age, and cancer stage at first diagnosis (Surveillance, Epidemiology, and the End Results; SEER), type of insurance, and income level on the survival of patients with liver cancer. The interactive effects of the type of insurance, income level, and cancer stage on liver cancer death were also analyzed. RESULTS The lowest income group (medical aid) showed a higher risk for mortality (HR (95% CI); 1.37 (1.27-1.47) for all patients, 1.44 (1.32-1.57) for men, and 1.16 (1.01-1.34) for women) compared to the highest income group (1-6) among liver cancer (ICD-10 code C22) patients. The risk of liver cancer death was also higher in the lowest income group with a distant cancer stage (SEER = 7) diagnosis than for any other group. CONCLUSION Liver cancer patients with lower socioeconomic status and more severe cancer stages were at greater risk of death. Reducing social inequalities is needed to improve mortality rates among patients in lower social class groups who present with advanced cancer.
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Affiliation(s)
- Mia Son
- Department of Preventive Medicine, College of Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Hye-Ri Kim
- Department of Preventive Medicine, College of Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea.
| | - Seung-Ah Choe
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Seo-Young Song
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Kyu-Hyoung Lim
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Myung Ki
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
- BK21FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Korea
| | - Yeon Jeong Heo
- Department of Nursing, College of Nursing, Kangwon National University, Chuncheon, Korea
| | - Minseo Choi
- Department of Preventive Medicine, College of Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Seok-Ho Go
- Department of Preventive Medicine, College of Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Domyung Paek
- Wonjin Institute for Occupational & Environmental Health, Seoul, Korea
- National Cancer Center, Goyang, Korea
- Graduate School of Public Health, Seoul National University, Seoul, Korea.
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Wen ZW, Song SY, Xu JK, Gong YW, Huang YX, Ran JL, Tang XQ, Chen ZQ, Li Y, Luo P. DEVELOPMENT OF AN EXTENDED-RANGE BONNER SPHERE SPECTROMETER FOR CHINA INITIATIVE ACCELERATOR-DRIVEN SYSTEM. Radiat Prot Dosimetry 2023; 199:152-163. [PMID: 36484699 DOI: 10.1093/rpd/ncac251] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 09/20/2022] [Accepted: 11/04/2022] [Indexed: 06/17/2023]
Abstract
To measure the extended-range neutron spectra and calibrate the extended-range neutron dosemeters of the China initiative Accelerator-Driven System (CiADS), an Extended-range Bonner Sphere Spectrometer (EBSS) has been developed. The EBSS was designed based on the PHITS codes, investigating various combinations of materials and diameters of the neutron moderators and the neutron multipliers for extended-range neutrons. Finally, seven polyethylene-only spheres and seven extended-range spheres were selected and subsequently built. The neutron multipliers of the extended-range spheres embedded concentric shells of lead, copper and tungsten. The response functions of the EBSS were analyzed and experimentally validated. It was subsequently tested with 252Cf neutron source and cosmic ray neutron source. The results demonstrate that the EBSS is capable of accurately measuring neutron spectra.
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Affiliation(s)
- Z W Wen
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - S Y Song
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - J K Xu
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- Department of Nuclear Science and Engineering, School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Y W Gong
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- Department of Nuclear Science and Engineering, School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Y X Huang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - J L Ran
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - X Q Tang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- Department of Nuclear Science and Engineering, School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Z Q Chen
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- Department of Nuclear Science and Engineering, School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Y Li
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - P Luo
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- Department of Nuclear Science and Engineering, School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
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Vasella M, Gousopoulos E, Guidi M, Storti G, Song SY, Grieb G, Pauli C, Lindenblatt N, Giovanoli P, Kim BS. Targeted therapies and checkpoint inhibitors in sarcoma. QJM 2022; 115:793-805. [PMID: 33486519 DOI: 10.1093/qjmed/hcab014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 01/10/2021] [Accepted: 01/11/2021] [Indexed: 12/15/2022] Open
Abstract
Sarcomas are defined as a group of mesenchymal malignancies with over 100 heterogeneous subtypes. As a rare and difficult to diagnose entity, micrometastasis is already present at the time of diagnosis in many cases. Current treatment practice of sarcomas consists mainly of surgery, (neo)adjuvant chemo- and/or radiotherapy. Although the past decade has shown that particular genetic abnormalities can promote the development of sarcomas, such as translocations, gain-of-function mutations, amplifications or tumor suppressor gene losses, these insights have not led to established alternative treatment strategies so far. Novel therapeutic concepts with immunotherapy at its forefront have experienced some remarkable success in different solid tumors while their impact in sarcoma remains limited. In this review, the most common immunotherapy strategies in sarcomas, such as immune checkpoint inhibitors, targeted therapy and cytokine therapy are concisely discussed. The programmed cell death (PD)-1/PD-1L axis and apoptosis-inducing cytokines, such as TNF-related apoptosis-inducing ligand (TRAIL), have not yielded the same success like in other solid tumors. However, in certain sarcoma subtypes, e.g. liposarcoma or undifferentiated pleomorphic sarcoma, encouraging results in some cases when employing immune checkpoint inhibitors in combination with other treatment options were found. Moreover, newer strategies such as the targeted therapy against the ancient cytokine macrophage migration inhibitory factor (MIF) may represent an interesting approach worth investigation in the future.
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Affiliation(s)
- M Vasella
- From the Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
| | - E Gousopoulos
- From the Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
| | - M Guidi
- From the Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
| | - G Storti
- Department of Surgical Sciences, Plastic and Reconstructive Surgery, University of Rome-'Tor Vergata', Via Montepellier, 1, 00133 Rome, Italy
| | - S Y Song
- Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, Korea
| | - G Grieb
- Department of Plastic Surgery and Hand Surgery, Gemeinschaftskrankenhaus Havelhoehe, Kladower Damm 221, 14089 Berlin, Germany
- Department of Plastic Surgery, Hand Surgery and Burn Center, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany
| | - C Pauli
- Institute of Pathology and Molecular Pathology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
| | - N Lindenblatt
- From the Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
| | - P Giovanoli
- From the Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
| | - B-S Kim
- From the Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
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Jang HR, Lee HY, Song SY, Lim KH. Clinical outcomes of targeted therapies in elderly patients aged ≥ 80 years with metastatic colorectal cancer. World J Clin Cases 2022; 10:10066-10076. [PMID: 36246797 PMCID: PMC9561573 DOI: 10.12998/wjcc.v10.i28.10066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/26/2022] [Accepted: 08/17/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The 5-fluorouracil-based chemotherapy combined with oxaliplatin or irinotecan is usually used in colorectal cancer (CRC). The addition of a targeted agent (TA) to this combination chemotherapy is currently the standard treatment for metastatic CRC. However, the efficacy and safety of combination chemotherapy for metastatic CRC in patients aged above 80 years has yet to be established.
AIM To assess the clinical outcomes and feasibility of combination chemotherapy using a TA in extremely elderly patients with CRC.
METHODS Eligibility criteria were: (1) Age above 80 years; (2) Metastatic colorectal cancer; (3) Palliative chemotherapy naïve; (4) Eastern Cooperative Oncology Group performance status 0-1; and (5) Adequate organ function. Patients received at least one dose of combination chemotherapy with or without TA. Response was evaluated every 8 wk.
RESULTS Of 30 patients, the median age of 15 patients treated with TA was 83.0 years and that of those without TA was 81.3 years. The median progression-free survival (PFS) and overall survival (OS) in patients treated with TA were 7.4 mo and 15.4 mo, respectively, compared with 4.4 mo and 15.6 mo, respectively, in patients treated without TA. There was no significant difference in PFS (P: 0.193) and OS (P: 0.748) between patients treated with and without TA. Common grade 3/4 hematologic toxicities were anemia (16.7%) and neutropenia (10.0%). After disease progression, the median OS of patients who were treated with and without salvage chemotherapy were 23.5 mo and 7.0 mo, respectively, suggesting significant difference in OS (P = 0.001).
CONCLUSION Combination chemotherapy with TA for metastatic CRC may be considered feasible in patients aged above 80 years, when with careful caution. Salvage chemotherapy can help improve OS in some selected of these elderly patients.
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Affiliation(s)
- Hee Ryeong Jang
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon-si, Gangwon-do 24289, South Korea
| | - Hui-Young Lee
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon-si, Gangwon-do 24289, South Korea
| | - Seo-Young Song
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon-si, Gangwon-do 24289, South Korea
| | - Kyu-Hyoung Lim
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon-si, Gangwon-do 24289, South Korea
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Hong J, Lee YJ, Bae SH, Yi JH, Park S, Chang MH, Park YH, Hyun SY, Chung JS, Jang JE, Jung JY, Jeon SY, Song SY, Kim H, Kim DS, Kim SH, Kim MK, Han SH, Park S, Kim YJ, Lee JH. Lenalidomide for anemia correction in lower-risk del(5q) myelodysplastic syndrome patients of Asian ethnicity. Blood Res 2021; 56:102-108. [PMID: 34187943 PMCID: PMC8246035 DOI: 10.5045/br.2021.2021086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/02/2021] [Indexed: 11/17/2022] Open
Abstract
Background To estimate real-world outcomes in East Asian populations, we conducted a nationwide retrospective analysis of the efficacy and safety of lenalidomide for del(5q) myelodysplastic syndrome (MDS) patients with transfusion-dependent anemia in Korea. Methods Patients aged ≥19 years who had received lenalidomide for the treatment of lower-risk, red blood cell (RBC) transfusion-dependent del(5q) MDS were selected. A filled case report form (CRF) with information from electronic medical records was requested from members of the acute myeloid leukemia (AML)/MDS Working Party of the Korean Society of Hematology. All the CRFs were gathered and analyzed. Results A total of 31 patients were included in this study. Of 28 evaluable patients, 19 (67.9%) achieved RBC transfusion independence (RBC-TI). Female sex and the development of thrombocytopenia during treatment were associated with achieving RBC-TI. The most common non-hematologic toxicities were pruritus, fatigue, and rashes. All non-hematologic toxicities of grades ≥3 were limited to rash (12.9%) and pruritus (6.5%). Dose reduction was required in 15 of the 19 responders (78.9%). The most common final stable dosing schedule for the responders was 5 mg once every other day (31.6%). Conclusion Lenalidomide efficacy and tolerability were similar in the Asian del(5q) MDS patients and western patients. Dose reduction during treatment was common, but it was not associated with inferior outcomes.
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Affiliation(s)
- Junshik Hong
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Yoo Jin Lee
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Sung Hwa Bae
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu Catholic University Hospital, Daegu, Korea
| | - Jun Ho Yi
- Division of Hematology-Oncology, Chung-Ang University Hospital, Seoul, Department of Internal Medicine, Jinju, Korea
| | - Sungwoo Park
- Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Myung Hee Chang
- National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Young Hoon Park
- Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | | | - Joo-Seop Chung
- Pusan National University College of Medicine, Pusan National University Hospital, Busan, Korea
| | - Ji Eun Jang
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Joo Young Jung
- Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - So-Yeon Jeon
- Division of Oncology and Hematology, Department of Internal Medicine, Jeonbuk National University Hospital-Jeonbuk National University Medical School, Jeonju, Korea
| | - Seo-Young Song
- Department of Internal Medicine, Kangwon National University College of Medicine, Kangwon National University Hospital, Chuncheon, Korea
| | - Hawk Kim
- Division of Hematology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Division of Hematology-Oncology, Department of Internal Medicine, Seoul, Korea
| | - Dae Sik Kim
- Korea University Guro Hospital, Seoul, Korea
| | - Sung-Hyun Kim
- Dong-A University College of Medicine, Dong-A University Hospital, Busan, Korea
| | - Min Kyoung Kim
- Yeungnam University College of Medicine, Daegu, Department of Internal Medicine, Jeju, Korea
| | - Sang Hoon Han
- Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Seonyang Park
- Inje University Haeundae Paik Hospital, Busan, Korea
| | - Yoo-Jin Kim
- Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Je-Hwan Lee
- University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Kim YD, Choi YS, Na HG, Song SY, Bae CH. Ginsenoside Rb1 attenuates LPS-induced MUC5AC expression via the TLR4-mediated ERK1/2 and NF-κB pathway in human airway epithelial NCI-H292 cells. J BIOL REG HOMEOS AG 2020; 34:613-618. [PMID: 32512990 DOI: 10.23812/19-420-l-23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Y D Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Yeungnam University, Daegu, Republic of Korea.,Regional Center for Respiratory Diseases, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - Y S Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - H G Na
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - S Y Song
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - C H Bae
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Yeungnam University, Daegu, Republic of Korea
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Lee J, Park HS, Kim JH, Lee DW, Song SY, Lew DH, Kim JY, Kim SI, Cho YU, Lee H, Lee KB, Yoon KH. Abstract OT2-01-03: A prospective pilot study of simultaneous robotic assisted nipple sparing mastectomy and immediate reconstruction. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot2-01-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Endoscopic breast surgery was expected to be an adequate technique to complete cancer clearance and preservation of the patient's body image. However, this technique has limitations including incomplete internal movements and unstable vision of a two dimensional camera due to inflexible endoscopic instruments especially during the skin flap formation. High resolution, ten-fold image magnification, and three-dimensional optics of robotic surgery help overcome the limitations of endoscopic surgery, and thus robotic surgery has been adopted in a wide range of intracorporeal procedures including breast surgery. However, few studies have evaluated feasibility and safety of robotic assisted nipple sparing mastectomy (RANSM) and immediate breast reconstruction (IBR) for the treatment of breast cancer. There were not any investigation to assess patients' satisfaction of cosmetic effect after performing RANSM and IBR. This study is aim to verify the feasibility and the safety of RANSM and IBR and to analyze cosmetic effect of the procedure and satisfaction of patients. The target number of enrollments is 15 patients. Patients who are diagnosed with early breast cancer or BRCA 1/2 mutation carriers are enrolled. Female patients over 20 years old who are candidates to preserve nipple areolar complex and considered to perform reconstruction with implants are prospectively collected. Written informed consents are mandatory. Patients who are considered the high possibility of postoperative radiation therapy according to preoperative stage are not included in this study. We exclude patients who want to undergo other methods of breast reconstruction than breast reconstruction with implants. Patients will undergo RANSM and IBR through a single axillary skin incision simultaneously. Regular follow-up at 1 month and 6 months after RANSM and IBR is scheduled to record recovery of a patient, amount of a drain, date of drain removal, and postoperative complications. Patient satisfaction questionnaire will be completed on the last follow-up day. To evaluate the safety of robotic assisted surgery, the oncologic safety (margin status of nipple areolar complex), postoperative recovery of a patient, and postoperative complications are investigated. We compare preoperative and postoperative 6 month photographs of patients and estimate the surgical outcome by objective indicators to evaluate the cosmetic grading by plastic surgeons. Patients' satisfaction are assessed by questionnaire (BREAST-Q) at the 6-month visit.
Citation Format: Lee J, Park HS, Kim JH, Lee DW, Song SY, Lew DH, Kim JY, Kim SI, Cho YU, Lee H, Lee KB, Yoon KH. A prospective pilot study of simultaneous robotic assisted nipple sparing mastectomy and immediate reconstruction [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT2-01-03.
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Affiliation(s)
- J Lee
- Yonsei University College of Medicine, Seoul, Korea
| | - HS Park
- Yonsei University College of Medicine, Seoul, Korea
| | - JH Kim
- Yonsei University College of Medicine, Seoul, Korea
| | - DW Lee
- Yonsei University College of Medicine, Seoul, Korea
| | - SY Song
- Yonsei University College of Medicine, Seoul, Korea
| | - DH Lew
- Yonsei University College of Medicine, Seoul, Korea
| | - JY Kim
- Yonsei University College of Medicine, Seoul, Korea
| | - SI Kim
- Yonsei University College of Medicine, Seoul, Korea
| | - YU Cho
- Yonsei University College of Medicine, Seoul, Korea
| | - H Lee
- Yonsei University College of Medicine, Seoul, Korea
| | - KB Lee
- Yonsei University College of Medicine, Seoul, Korea
| | - KH Yoon
- Yonsei University College of Medicine, Seoul, Korea
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Kim JH, Lee SC, Oh SY, Song SY, Lee N, Nam EM, Lee S, Hwang IG, Lee HR, Lee KT, Bae SB, Kim HJ, Jang JS, Lim DH, Lee HW, Kang SY, Kang JH. Attenuated FOLFIRINOX in the salvage treatment of gemcitabine-refractory advanced pancreatic cancer: a phase II study. Cancer Commun (Lond) 2018; 38:32. [PMID: 29866170 PMCID: PMC5993129 DOI: 10.1186/s40880-018-0304-1] [Citation(s) in RCA: 20] [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: 08/05/2017] [Accepted: 01/05/2018] [Indexed: 12/18/2022] Open
Abstract
Background Combination therapy with oxaliplatin, irinotecan, fluorouracil, and leucovorin (FOLFIRINOX) chemotherapy drastically improves survival of advanced pancreatic cancer patients. However, the efficacy of FOLFIRINOX as a second-line treatment after gemcitabine failure has not been tested prospectively. We investigated the feasibility and safety of attenuated FOLFIRINOX in patients with gemcitabine-refractory advanced pancreatic cancer. Methods A multicenter phase II prospective open-label, single-arm study was conducted at 14 hospitals. Patients with histologically proven invasive ductal pancreatic adenocarcinoma, a measurable or evaluable lesion, Eastern Cooperative Oncology Group performance status 0 or 1, adequate organ function, and aged 19 years or older were eligible. Attenuated FOLFIRINOX consisted of oxaliplatin 65 mg/m2, irinotecan 135 mg/m2, and leucovorin 400 mg/m2 injected intravenously on day 1 and 5-fluorouracil 2000 mg/m2 continuously infused intravenously over 46 h on days 1–2, repeated every 2 weeks. The primary endpoint was progression-free survival from the initiation of FOLFIRINOX. Secondary endpoints were the objective response rate, disease control rate, overall survival, safety, and tolerability. We estimated overall survival and progression-free survival using the Kaplan–Meier methods. Results We enrolled 39 patients from 14 institutions. The objective response rate was 10.3%, while the disease control rate was 64.1%. The 6-month and 1-year overall survival rates were 59.0% and 15.4%, respectively. Median progression-free survival and overall survival were 3.8 months (95% confidence interval [CI] 1.5–6.0 months) and 8.5 months (95% CI 5.6–11.4 months), respectively. Grade 3 or 4 adverse events were neutropenia (41.0%), nausea (10.3%), anorexia (10.3%), anemia (7.7%), mucositis (7.7%), pneumonia/pleural effusion (5.1%), and fatigue (5.1%). One treatment-related death attributable to septic shock occurred. Conclusion Attenuated FOLFIRINOX may be promising as a second-line therapy for gemcitabine-refractory pancreatic cancer.
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Affiliation(s)
- Jung Hoon Kim
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University, 15 Jinju-daero 816beon-gil, Jinju, 52727, Republic of Korea
| | - Sang-Cheol Lee
- Divsion of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University Hospital Cheonan, Cheonan, 31151, Republic of Korea
| | - Sung Yong Oh
- Department of Internal Medicine, Dong-A University Hospital, Busan, 49201, Republic of Korea
| | - Seo-Young Song
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, 24289, Republic of Korea
| | - Namsu Lee
- Divsion of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University Hospital Seoul, Seoul, 04401, Republic of Korea
| | - Eun Mi Nam
- Department of Internal Medicine, Ewha Womans University, College of Medicine, Seoul, 07985, Republic of Korea
| | - Soonil Lee
- Department of Internal Medicine, Dankook University Hospital, Cheonan, 31116, Republic of Korea
| | - In Gyu Hwang
- Department of Internal Medicine, Chung-Ang University, College of Medicine, Seoul, 06973, Republic of Korea
| | - Hyo Rak Lee
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Korea Cancer Hospital, Seoul, 01812, Republic of Korea
| | - Kyu Taek Lee
- Divsion of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University Hospital Cheonan, Cheonan, 31151, Republic of Korea
| | - Sang-Byung Bae
- Divsion of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University Hospital Cheonan, Cheonan, 31151, Republic of Korea
| | - Han Jo Kim
- Divsion of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University Hospital Cheonan, Cheonan, 31151, Republic of Korea
| | - Joung Soon Jang
- Department of Internal Medicine, Chung-Ang University, College of Medicine, Seoul, 06973, Republic of Korea
| | - Do Hyoung Lim
- Department of Internal Medicine, Dankook University Hospital, Cheonan, 31116, Republic of Korea
| | - Hyun Woo Lee
- Department of Hematology-Oncology, Ajou University Hospital, Suwon, 16499, Republic of Korea
| | - Seok Yun Kang
- Department of Hematology-Oncology, Ajou University Hospital, Suwon, 16499, Republic of Korea
| | - Jung Hun Kang
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University, 15 Jinju-daero 816beon-gil, Jinju, 52727, Republic of Korea.
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Park JW, Lee SW, Kim JS, Song SY. Prediction of local control in early glottic carcinoma using the maximum standardised uptake value. Cancer Radiother 2017; 21:205-209. [PMID: 28495481 DOI: 10.1016/j.canrad.2017.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 01/11/2017] [Accepted: 01/16/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE This retrospective study aimed to determine whether the maximum standardised uptake value (SUVmax) can predict local tumour control in early glottic cancer (Tis, T1, and T2). PATIENTS AND METHODS Fifty-nine patients treated with definitive radiotherapy for early glottic cancer between 2003 and 2011 were enrolled. We evaluated the SUVmax in the region of interest around the original tumour site. Local tumour control and survival were estimated using Kaplan-Meier curves. Receiver operating characteristic curves were used to assess the optimal SUVmax cut-off for predicting local control. RESULTS As determined by laryngoscopy, all patients achieved a complete response. Eleven patients experienced local recurrence, while no distant metastasis occurred. One patient died due to local recurrence, while five lost their larynxes. The median follow-up was 61.5 (range: 6.2-123.4) months. The five-year local progression-free survival was 84.7%, and larynx preservation was possible in 89.6% of cases. The median SUVmax was 2.2. The optimal SUVmax for predicting local tumour control was identified as 3.4. Patients with glottic cancers with an SUVmax>3.4 showed a significantly lower local progression-free survival rate than those with tumours with an SUVmax<3.4 (five-year local progression-free survival rate: 53.4% vs. 95.4%, P<0.01). Multivariate analysis confirmed that a high SUVmax was an independent predictive factor for local progression-free survival (P=0.006). CONCLUSION The use of (18F)-fluorodeoxyglucose-positron emission tomography for evaluation of the SUVmax is useful to predict local progression-free survival in patients with early glottic cancer treated by radiation. Early glottic cancer with a high SUVmax may require aggressive local treatment and careful surveillance.
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Affiliation(s)
- J W Park
- Department of Radiation Oncology, Yeungnam University College of Medicine, 170, Hyeonchung-ro, Nam-gu, 42415 Daegu, South Korea
| | - S W Lee
- Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan, 86 Asanbyeongwon-gil, Songpa-gu, 138-736 Seoul, Republic of Korea.
| | - J S Kim
- Department of Nuclear Medicine, Asan Medical Center, College of Medicine, University of Ulsan, 86 Asanbyeongwon-gil, Songpa-gu, 138-736 Seoul, Republic of Korea
| | - S Y Song
- Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan, 86 Asanbyeongwon-gil, Songpa-gu, 138-736 Seoul, Republic of Korea
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Lim KH, Lee HY, Park SB, Song SY. Feasibility of Modified FOLFOX in Elderly Patients Aged ≥80 Years with Metastatic Gastric Cancer or Colorectal Cancer. Oncology 2017; 93:115-121. [DOI: 10.1159/000471767] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 03/15/2017] [Indexed: 11/19/2022]
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Kim JH, Jeong JH, Park SH, Jeong JS, Ryu YJ, Song SY. Recurrent renal cell carcinoma manifesting as a large intrathoracic fibrotic mass: A case report. Oncol Lett 2016; 11:3835-3838. [PMID: 27313703 DOI: 10.3892/ol.2016.4460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 04/04/2016] [Indexed: 11/05/2022] Open
Abstract
Renal cell carcinomas (RCCs) have a strong tendency to metastasize, and the most common sites are the lungs, bones and liver. Late recurrence is another feature of the RCC, with lesions appearing ≥10 years after surgical treatment. However, fibrosis has rarely been associated with the disease. The present study reports a case of recurrent RCC that manifested as a fibrotic mass within the thorax. A 48-year-old man presented with dyspnea that had persisted for 3 days. The patient had undergone a right radical nephrectomy for stage II clear cell carcinoma of the kidney 6 years previously. The patient was a current smoker, with a smoking history of 20 pack-years. Chest radiography showed pleural effusion in the right thorax with an egg-sized mass shadow within the right upper lung (RUL) field. Computed tomography (CT) showed a main mass, 7 cm in diameter, within the RUL, with heterogeneous enhancement and multiple nodules of various sizes in the lungs, suggestive of primary lung cancer or metastatic RCC. A CT-guided percutaneous needle aspiration biopsy was obtained from the main mass, but histology revealed dense fibrous tissue without any malignant cells. Positron emission tomography-CT demonstrated an irregular hypermetabolic RUL mass, with a standardized uptake value (SUV) of 5.0, along the right pleura, and small pulmonary nodules (SUV, 2.0). Ultrasound-guided biopsy was attempted for a smaller hypermetabolic pleural nodule and the result was clear cell adenocarcinoma, consistent with the previous renal histology. The present study describes the case, along with a review of the relevant literature.
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Affiliation(s)
- Ji Hyun Kim
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University, School of Medicine, Chuncheon, Gangwon 200-947, Republic of Korea
| | - Jae Hoon Jeong
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University, School of Medicine, Chuncheon, Gangwon 200-947, Republic of Korea
| | - Sung-Hyun Park
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University, School of Medicine, Chuncheon, Gangwon 200-947, Republic of Korea
| | - Jin Seon Jeong
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University, School of Medicine, Chuncheon, Gangwon 200-947, Republic of Korea
| | - Young-Joon Ryu
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University, School of Medicine, Chuncheon, Gangwon 200-947, Republic of Korea
| | - Seo-Young Song
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University, School of Medicine, Chuncheon, Gangwon 200-947, Republic of Korea
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Lee SC, Kim JH, Oh SY, Kim K, Song SY, Lee N, Nam EM, Lee S, Hwang IG, Lee HR, Won JH, Lee KT, Bae SB, Kim H, Kim HJ, Jang J, Lim DH, Lee HW, Kang JH. Attenuated FOLFIRINOX (5-FU/LV, irinotecan and oxaliplatin) as second-line chemotherapy for the Koreans (Asian population) with gemcitabine-resistant or –refractory advanced pancreatic cancer. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e15731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Sang-Cheol Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Soonchunhyang University Hospital Seoul, Soonchunhyang University College of Medicine, Seoul, South Korea
| | - Jung Hoon Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, South Korea
| | - Sung Yong Oh
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, South Korea
| | - Kyoungha Kim
- Soonchunhyang University Hospital Seoul, Seoul, South Korea
| | - Seo-Young Song
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea
| | - Namsu Lee
- Soonchunhyang University Hospital Seoul, Seoul, South Korea
| | | | - Soonil Lee
- Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, South Korea
| | - In Gyu Hwang
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Hyo Rak Lee
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, South Korea
| | - Jong-Ho Won
- Soonchunhyang University Seoul Hospital, Seoul, South Korea
| | - Kyu Taek Lee
- Soonchunhyang University Cheonan Hospital, Cheonan, South Korea
| | - Sang-Byung Bae
- Soonchunhyang University Hospital Cheonan, Cheonan, South Korea
| | - Hanjo Kim
- Soonchunhyang University Hospital Cheonan, Cheonan, South Korea
| | - Hyun Jung Kim
- Soonchunhayng University College of Medicine, Bucheon Hospital, Bucheon, South Korea
| | | | | | | | - Jung Hun Kang
- Division of Hematology/Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, South Korea
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Lee SH, Lim KH, Song SY, Lee HY, Park SC, Kang CD, Lee SJ, Choi DW, Park SB, Ryu YJ. Occult gastric cancer with distant metastasis proven by random gastric biopsy. World J Gastroenterol 2016; 22:4270-4274. [PMID: 27122678 PMCID: PMC4837445 DOI: 10.3748/wjg.v22.i16.4270] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Revised: 12/10/2015] [Accepted: 01/18/2016] [Indexed: 02/06/2023] Open
Abstract
Krukenberg tumor, a rare metastatic ovarian tumor arising from gastrointestinal adenocarcinoma mainly, tends to occur in premenopausal females. Finding the origin of a Krukenberg tumor is crucial for determining prognosis. In Eastern countries, the most common origin of Krukenberg tumor is stomach cancer, which is generally diagnosed via endoscopic biopsy to investigate an abnormal mucosal lesion. Here, we describe a case of huge adnexal mass in a 33-year-old woman who presented with abdominal distension. Two independent endoscopic examinations performed by experts in two tertiary university hospitals revealed no abnormal mucosal lesion. The patient was diagnosed with a Krukenberg tumor according to findings from random endoscopic biopsies taken from normal-looking gastric mucosa in our hospital. It is very rare to be diagnosed via a random biopsy in cases where three well-trained endoscopists had not found any mucosal lesion previously. Thus, in this case, random biopsy was helpful in finding the origin of a Krukenberg tumor.
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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.
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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
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15
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Lim KH, Lee HY, Park SB, Song SY. Feasibility of the combination chemotherapy with 5-fluorouracil and oxaliplatin in metastatic gastric or colorectal cancer patients more than age of 80. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.4_suppl.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
136 Background: The combination chemotherapy of 5-fluorouracil (5-FU) and Oxaliplatin is usually used in gastric cancer (GC) and colorectal cancer (CRC). The safety and efficacy of the combination chemotherapy in patients over 80-years old has not been established yet. The purpose of this study was to assess the clinical outcomes and tolerability in the combination with 5-FU, leucovorin and oxaliplatin as first-line treatment in extremely elderly patients with GC or CRC. Methods: Eligibility included: 1) more than 80-years old, 2) metastatic gastric or colorectal cancer 3) chemotherapy-naive, 4) ECOG PS 0-1, 5) adequate organ function. Patients received the combination chemotherapy of 5-FU, leucovorin and oxaliplatin. Response evaluation was done every 8 weeks with RECIST criteria and toxicity was evaluated with NCI-CTCAE. Results: Between Sep 2008 and Nov 2014, 28 patients were reviewed and composed of equal numbers of GC and CRC. The median age was 82.2 years (80.0-85.6yrs) in GC and 81.1 years (80.0-89.3) in CRC, respectively. Total administrated cycles were 89 with median cycles of 5 in GC and 112 with median cycles of 11 in CRC. The median progression-free survival (PFS) and overall survival (OS) in GC were 5.4 months and 6.6 months, as compared with 7.3 months and 8.1 months, respectively. There were no significant difference in PFS (p = 0.94) and OS (p = 0.28) between GC and CRC. Overall survival rates at 1 year were 35.7% and 42.9%, respectively. After disease progression, salvage chemotherapy in GC and CRC was administrated in 1 and 7 patients, respectively. Common grade 3/4 hematology toxicities in both group were neutropenia, anemia. Frequent non-hematological toxicities were anorexia (60%), neuropathy (40%) and mucositis (25%), which were grade 1/2. Conclusions: The combination chemotherapy of 5-fluorouracil (5-FU) and Oxaliplatin has limited effect on improvement of OS in metastatic gastric or colorectal cancer patients more than age of 80. Further studies on the role of chemotherapy in these extremely elderly patients are needed.
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Affiliation(s)
- Kyu-Hyoung Lim
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea
| | - Hui-Young Lee
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea
| | - Sung Bae Park
- Department of Surgery, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea
| | - Seo-Young Song
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea
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Han SS, Kim HJ, Lee SJ, Kim WJ, Hong Y, Lee HY, Song SY, Jung HH, Ahn HS, Ahn IM, Baek H. Effects of Renal Replacement Therapy in Patients Receiving Extracorporeal Membrane Oxygenation: A Meta-Analysis. Ann Thorac Surg 2015; 100:1485-95. [PMID: 26341602 DOI: 10.1016/j.athoracsur.2015.06.018] [Citation(s) in RCA: 27] [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] [Received: 02/17/2015] [Revised: 05/29/2015] [Accepted: 06/01/2015] [Indexed: 11/26/2022]
Abstract
The use of renal replacement therapy (RRT) in patients receiving extracorporeal membrane oxygenation (ECMO) is increasing, but the effect of RRT on ECMO is controversial. We performed a meta-analysis to determine whether RRT is related to higher mortality in patients receiving ECMO. We searched MEDLINE, EMBASE, the Cochrane Library, and KoreaMed and found 43 observational studies with 21,624 patients receiving ECMO and then compared inpatient mortality rates of patients receiving ECMO both with and without RRT. The risk ratio (RR) of mortality between patients receiving RRT and those not receiving RRT tended to decrease as the mortality of the group not receiving RRT increased. Among patients with RRT use rates of 30% and higher, the overall mortality rates for all patients receiving ECMO tended to decrease. We found that the increase in the RR for RRT tended to be greater the longer the initiation of RRT was delayed. We suggest that in patients receiving ECMO who have high RRT use rates, RRT may decrease mortality rates.
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Affiliation(s)
- Seon-Sook Han
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea; Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea
| | - Hyun Jung Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seung Joon Lee
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea; Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea
| | - Woo Jin Kim
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea; Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea
| | - Youngi Hong
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea; Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea
| | - Hui-Young Lee
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea
| | - Seo-Young Song
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea
| | - Hae Hyuk Jung
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea; Division of Nephrology, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea
| | - Hyeong Sik Ahn
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Il Min Ahn
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Department of Literary Arts, Brown University, Providence, Rhode Island
| | - Hyunjeong Baek
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea; Division of Nephrology, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea.
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Kang JH, Oh SY, Song SY, Lee HY, Kim JH, Lee KE, Lee HR, Hwang IG, Park SH, Kim WS, Park YS, Park K. The efficacy of low-dose transdermal fentanyl in opioid-naïve cancer patients with moderate-to-severe pain. Korean J Intern Med 2015; 30:88-95. [PMID: 25589840 PMCID: PMC4293569 DOI: 10.3904/kjim.2015.30.1.88] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 01/15/2014] [Accepted: 04/07/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Little is known about the efficacy of low-dose transdermal fentanyl (TDF) patches in opioid-naïve patients with moderate-to-severe cancer pain. METHODS This study had an open-label, prospective design, and was conducted between April 2007 and February 2009 in seven tertiary cancer hospitals; 98 patients were enrolled. TDF was started using a low-dose formulation (12.5 µg/hr), and the dose was adjusted according to the clinical situation of individual patients. Pain intensity, the TDF doses used, and adverse events (AEs) were monitored over 4 weeks. Data were analyzed using the intent-to-treat and per-protocol principles. RESULTS Of the 98 patients enrolled, 64 (65%) completed the study. The median pain intensity decreased from 6.0 to 3.0 (p < 0.001) at the follow-up visit. The efficacy of low-dose TDF on pain relief was consistent across groups separated according to gender (p < 0.001), age (p < 0.001), metastasis (p < 0.001), previous treatment (p < 0.001), and baseline pain intensity (p < 0.001). The decrease in pain intensity was significantly greater in the severe group compared with the moderate group (mean ± SD, 5.10 ± 2.48 vs. 2.48 ± 1.56; p < 0.001). TDF dose (27.8 µg/hr vs. 24.8 µg/hr, p = 0.423) and the mean treatment time (7.5 days vs. 7.9 days, p = 0.740) required for pain control were not different between the two pain-intensity groups. Patients had AEs of only mild or moderate intensity; among these, nausea (38%) was the most common, followed by vomiting (22%) and somnolence (22%). CONCLUSIONS Low-dose TDF was an effective treatment for patients with cancer pain of moderate-to-severe intensity. Further randomized trials assessing the efficacy of TDF for severe pain and/or optimal starting doses are warranted.
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Affiliation(s)
- Jung Hun Kang
- Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Sung Yong Oh
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Seo-Young Song
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Hui-Young Lee
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jung Han Kim
- Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea
| | - Kyoung Eun Lee
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hye Ran Lee
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - In Gyu Hwang
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Se Hoon Park
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Seok Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Suk Park
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Keunchil Park
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lee HY, Lim KH, Ryu Y, Song SY. Bleomycin-induced flagellate erythema: A case report and review of the literature. Oncol Lett 2014; 8:933-935. [PMID: 25009666 PMCID: PMC4081419 DOI: 10.3892/ol.2014.2179] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [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: 11/04/2013] [Accepted: 05/15/2014] [Indexed: 11/08/2022] Open
Abstract
Bleomycin has been used most commonly in the treatment of Hodgkin’s lymphoma, certain germ cell tumors (GCT) and for the sclerosis of recurrent pleural effusions. Bleomycin toxicity predominantly affects the skin and lungs. Skin toxicity includes Raynaud’s phenomenon, hyperkeratosis, nail-bed changes and palmoplantar desquamation. Flagellate erythema is an unusual rash occurring specifically during bleomycin use. In the present study, we report a case of bleomycin-induced flagellate erythema in a patient with GCT. A 42-year-old male was diagnosed with stage IIIB testicular cancer and treated with bleomycin, etoposide and cisplatin chemotherapy. After 10 days from the initiation of treatment, the patient subsequently developed a generalized pruritus and erythematous linear rash that was most prominent on the trunk, and upper and lower extremities. The patient was commenced on a short course of low-dose oral prednisolone, 20 mg daily, and antihistamine. Consequently, bleomycin was withheld from the patient’s treatment regimen. The present study describes the case, along with a review of the associated literature.
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Affiliation(s)
- Hui-Young Lee
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon-si, Gangwon-do 200-947, Republic of Korea
| | - Kyu-Hyoung Lim
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon-si, Gangwon-do 200-947, Republic of Korea
| | - Youngjoon Ryu
- Department of Pathology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon-si, Gangwon-do 200-947, Republic of Korea
| | - Seo-Young Song
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon-si, Gangwon-do 200-947, Republic of Korea
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Song SY, DAS AK, Minna JD. Comparison between concurrent and sequential chemoradiation for non-small cell lung cancer in vitro.. Oncol Lett 2013; 7:307-310. [PMID: 24396437 PMCID: PMC3881197 DOI: 10.3892/ol.2013.1707] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 11/21/2013] [Indexed: 11/06/2022] Open
Abstract
Current practice guidelines recommend the combination of chemotherapy and thoracic radiation for locally advanced non-small cell lung cancer (NSCLC). Previous meta-analyses have shown that concurrent chemoradiation (CCRT) may be superior to sequential chemoradiation (SCRT). However, few previous in vitro studies have analyzed these two treatment schedules. In the current study, four lung cancer cell lines harboring wild-type epidermal growth factor receptor, comprising two squamous and two non-squamous cell lines, were used. The IC10 concentrations of three platinum-based regimens were combined with radiation treatment. Cells were irradiated at 0, 2, 4, 6 and 8 Gy using a 137Cs irradiator concurrently or sequentially. Surviving fractions (SFs) were plotted as a function of the radiation dose. In A549 cells, only the docetaxel (Doc) and carboplatin (Carbo) combination showed a significant radiosensitizing effect with CCRT treatment. For the other three cell lines, no difference was identified in the SFs between CCRT and SCRT. An in vitro method of comparing CCRT with SCRT was established using lung cancer cell lines. Overall, no significant difference was detected in the radiosensitizing effect of the two treatment schedules, with the exception of the A549 cell lines treated with Doc/Carbo.
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Affiliation(s)
- Seo-Young Song
- Department of Internal Medicine, Kangwon National University Hospital, Chuncheon-si, Gangwon-do 200-722, Republic of Korea
| | - Amit K DAS
- Hamon Cancer Center for Therapeutic Oncology and Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - John D Minna
- Hamon Cancer Center for Therapeutic Oncology and Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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Hong JY, Nam EM, Lee J, Park JO, Lee SC, Song SY, Choi SH, Heo JS, Park SH, Lim HY, Kang WK, Park YS. Randomized double-blinded, placebo-controlled phase II trial of simvastatin and gemcitabine in advanced pancreatic cancer patients. Cancer Chemother Pharmacol 2013; 73:125-30. [PMID: 24162380 DOI: 10.1007/s00280-013-2328-1] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 10/15/2013] [Indexed: 12/21/2022]
Abstract
BACKGROUND Statins have potential antineoplastic properties via arrest of cell-cycle progression and induction of apoptosis. A previous study demonstrated in vitro and in vivo antineoplastic synergism between statins and gemcitabine. The present randomized, double-blinded, phase II trial compared the efficacy and safety of gemcitabine plus simvastatin (GS) with those of gemcitabine plus placebo (GP) in patients with locally advanced and metastatic pancreatic cancer. METHODS Patients were randomly assigned to receive a 3-week regimen with GS (gemcitabine 1,000 mg/m(2) on days 1, 8, and 15 plus simvastatin 40 mg once daily) or GP (gemcitabine 1,000 mg/m(2) on days 1, 8, and 15 plus placebo). The primary end point was time to progression (TTP). RESULTS Between December 2008 and April 2012, 114 patients were enrolled. The median TTP was not significantly different between the two arms, being 2.4 months (95 % CI 0.7-4.1 months) and 3.6 months (95 % CI 3.1-4.1 months) in the GS and GP arms, respectively (P = 0.903). The overall disease control rate was 39.7 % (95 % CI 12.2-33.8 %) and 57.1 % (95 % CI 19.8-44.2 %) in the GS and GP arms, respectively (P = 0.09). The 1-year expected survival rates were similar (27.7 and 31.7 % in the GS and GP arms, respectively; P = 0.654). Occurrence of grade 3 or 4 adverse events was similar in both arms, and no patients had rhabdomyolysis. CONCLUSIONS Adding low-dose simvastatin to gemcitabine in advanced pancreatic cancer does not provide clinical benefit, although it also does not result in increased toxicity. Given the emerging role of statins in overcoming resistance to anti-EGFR treatment, further studies are justified to evaluate the efficacy and safety of combined simvastatin and anti-EGFR agents, such as erlotinib or cetuximab, plus gemcitabine for treating advanced pancreatic cancer.
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Affiliation(s)
- Jung Yong Hong
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong Gangnam-gu, Seoul, 135-710, Korea
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Lim KH, Lee SH, Lee HY, Park SB, Song SY. Efficacy and Feasibility of Modified Folfox as First-Line Chemotherapy in Elderly Patients with Metastatic or Recurrent Gastric Cancer. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt203.84] [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
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Sun JM, Ahn YC, Choi EK, Ahn MJ, Ahn JS, Lee SH, Lee DH, Pyo H, Song SY, Jung SH, Jo JS, Jo J, Sohn HJ, Suh C, Lee JS, Kim SW, Park K. Phase III trial of concurrent thoracic radiotherapy with either first- or third-cycle chemotherapy for limited-disease small-cell lung cancer. Ann Oncol 2013; 24:2088-92. [PMID: 23592701 DOI: 10.1093/annonc/mdt140] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND We compared late thoracic radiotherapy (TRT) with early TRT in the treatment of limited-disease small-cell lung cancer (LD-SCLC). PATIENTS AND METHODS Patients with LD-SCLC received four cycles of etoposide plus cisplatin every 21 days. Patients were randomly assigned to receive either TRT administered concurrently with the first cycle (early TRT) or the third cycle (late TRT) of chemotherapy. The primary end point was complete response rate. RESULTS Two hundred twenty-two patients were randomly assigned.Late TRT was not inferior to early TRT in terms of the complete response rate (early v late; 36.0% v 38.0%). Other efficacy measures including overall survival [median, 24.1 v 26.8 months;hazard ratio (HR) 0.93; 95% CI = 0.67–1.29] and progression free survival (median, 12.4 v 11.2 months; HR 1.09; 95%CI = 0.80–1.48) were not different between two arms. No statistical difference was noted in the pattern of treatment failures.However, neutropenic fever occurred more commonly in the early TRT arm than the late TRT arm (21.6% v 10.2%; P = 0.02) [corrected]. CONCLUSION In LD-SCLC treatment, TRT starting in the third cycle of chemotherapy seemed to be noninferior to early TRT, and had a more favorable profile with regard to neutropenic fever.
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Affiliation(s)
- J-M Sun
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim KH, Song SY, Lim KH, Han SS, Kim SH, Cho JH, Park CW, Lee S, Lee HY. Interstitial Pneumonitis after Treatment with Pemetrexed for Non-small Cell Lung Cancer. Cancer Res Treat 2013; 45:74-7. [PMID: 23613674 PMCID: PMC3629367 DOI: 10.4143/crt.2013.45.1.74] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 08/03/2011] [Indexed: 11/21/2022] Open
Abstract
Pemetrexed is approved as a first-line treatment for advanced non-squamous non-small cell lung cancer (NSCLC) with cisplatin and as a single agent for second-line treatment or for patients who show no disease progression after four cycles of platinum-based doublet induction chemotherapy as maintenance therapy. Pemetrexed has a modest toxicity profile and has not traditionally been regarded as a cause of interstitial pneumonitis. Here, we report on a rare case of pemetrexed-induced pneumonitis in a patient with NSCLC.
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Affiliation(s)
- Kyeong-Hyun Kim
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea
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Kim JY, Lee SW, Lee JH, Suh C, Yoon DH, Lee BJ, Huh J, Choi EK, Kim JH, Song SY, Yoon SM, Kim YS, Kim SS, Park JH, Shin HS, Chang SK, Ahn SD. Stage IE/IIE extranodal NK/T-cell lymphoma arising in the nasal cavity: analysis of CT findings and their prognostic value. Clin Radiol 2013; 68:e384-90. [PMID: 23535315 DOI: 10.1016/j.crad.2012.11.023] [Citation(s) in RCA: 10] [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] [Received: 09/10/2012] [Revised: 11/08/2012] [Accepted: 11/12/2012] [Indexed: 10/27/2022]
Abstract
AIM To investigate the computed tomography (CT) findings in patients with stage IE/IIE extranodal natural killer/T-cell lymphoma (ENKTL) arising in the nasal cavity and to evaluate whether imaging findings revealed by CT have prognostic value. MATERIALS AND METHODS The CT findings of 62 patients diagnosed with IE/IIE ENKTL arising in the nasal cavity were retrospectively reviewed. Imaging findings were investigated, and evaluated imaging findings were analysed for the prognostic value of overall survival (OS) and disease-free survival (DFS). RESULTS Of the 62 patients, 21 (34%) presented with a superficial infiltrative, 38 (61%) with a mass forming, and three (5%) with a combined pattern. Of all imaging findings, local invasiveness (n = 26, 42%), including bony destruction, erosion, or soft-tissue involvement, was the only independent prognostic factor for OS [p = 0.008; hazard ratio (HR): 3.85; 95% confidence intervals (CI): 1.42-10.44] and DFS (p = 0.001; HR: 4.25; 95% CI: 1.72-10.47). In a subgroup analysis of 36 cases with no local invasiveness, a superficial infiltrative pattern in one nasal cavity was a positive prognostic factor for OS (p = 0.028) and DFS (p = 0.008). CONCLUSION Imaging findings at CT provided clinically useful predictions for treatment outcomes. Local invasiveness revealed by CT findings was a strong prognostic factor for poor OS and DFS. In addition, in patients with no local invasiveness, a superficial infiltrative pattern in one nasal cavity predicted favourable OS and DFS.
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Affiliation(s)
- J Y Kim
- Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea
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Lim KH, Lee HY, Song SY. Efficacy and feasibility of gemcitabine and carboplatin as first-line chemotherapy in elderly patients with advanced non-small cell lung cancer. Chin Med J (Engl) 2013; 126:4644-4648. [PMID: 24342304] [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] Open
Abstract
BACKGROUND Although platinum-based chemotherapy is a standard first-line treatment in advanced non-small cell lung cancer (NSCLC), further research for the safety and efficacy of combination chemotherapy in elderly patients has been required. The purpose of this study was to evaluate the efficacy and safety of gemcitabine and carboplatin as first-line treatment in elderly patients with advanced NSCLC and to evaluate the prognostic factors. METHODS Eligibility included: (1) age of 70 years or more, (2) histologically confirmed NSCLC, (3) chemotherapy-naïve, (4) advanced disease with stage IIIB or IV, (5) Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-2, (6) adequate organ function. Patients received intravenous carboplatin (area under curve (AUC) = 5) on day 1 and gemcitabine (1000 mg/m2) on days 1 and 8, every 3 weeks. RESULTS The medical records of forty patients were reviewed retrospectively. Median age was 73.9 years (range, 70-84.6), and there were 27 men (67.5%). Thirty-seven patients (92.5%) had ECOG PS 0-1. Adenocarcinoma was found in 57.5%. Median cycles were administrated with 4.5 per person (range: 1-6). Best responses were partial response in 22 (55.0%) patients and stable disease (SD) in 13 (32.5%). The median progression free survival (PFS) and overall survival (OS) were 5.9 months (95% CI: 4.5-7.3 months) and 9.6 months (95% CI: 8.2-11.0 months), respectively. Grade 4 hematologic toxicities for neutropenia (7.5%), thrombocytopenia (7.5%) and anemia (5.0%) were observed. Histology was significant prognostic factor for PFS (P = 0.024). CONCLUSION Gemcitabine and carboplatin combination chemotherapy is an effective and manageable treatment option in elderly advanced NSCLC patients with good performance status.
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Affiliation(s)
- Kyu-Hyoung Lim
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, 17-1 Hyoja 3-dong, Chuncheonsi, Gangwon-do 200-947, South Korea
| | - Hui-Young Lee
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, 17-1 Hyoja 3-dong, Chuncheonsi, Gangwon-do 200-947, South Korea
| | - Seo-Young Song
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, 17-1 Hyoja 3-dong, Chuncheonsi, Gangwon-do 200-947, South Korea.
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Choi CM, Yang SC, Jo HJ, Song SY, Jeon YJ, Jang TW, Kim DJ, Jang SH, Yang SH, Kim YD, Lee KH, Jang SJ, Kim YT, Kim DK, Chung DH, Kim L, Nam HS, Cho JH, Kim HJ, Ryu JS. Proteins involved in DNA damage response pathways and survival of stage I non-small-cell lung cancer patients. Ann Oncol 2012; 23:2088-2093. [PMID: 22317771 DOI: 10.1093/annonc/mdr606] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Biological complexity leads to significant variation in the survival of patients with stage I non-small-cell lung cancer (NSCLC). DNA damage response (DDR) pathways play a critical role in maintaining genomic stability and in the progression of NSCLC. Therefore, the development of a prognostic biomarker focusing on DDR pathways is an intriguing issue. PATIENTS AND METHODS Expression of several proteins (ATM, ATMpS1981, γH2AX, 53BP1, 53BP1pS25, Chk2, Chk2pT68, MDC1, MDC1pS964, BRCA1pS1423, and ERCC1) and overall survival were investigated in 889 pathological stage I NSCLC patients. RESULTS Low expression of BRCA1pS1423 or ERCC1 was significantly associated with worse survival in the whole cohort of patients. Analysis performed based on histology revealed that low expression of γH2AX, Chk2pT68, or ERCC1 was a poor prognostic factor in squamous cell carcinoma patients [adjusted hazard ratio (aHR), Cox P: 1.544, 0.012 for γH2AX; 1.624, 0.010 for Chk2pT68; 1.569, 0.011 for ERCC1]. The analysis of the interaction between two proteins showed that this effect was more pronounced in squamous cell carcinoma patients. However, these effects were not detected in adenocarcinoma patients. CONCLUSIONS The proteins involved in DDR pathways exhibited differential expression between squamous cell carcinoma and adenocarcinoma and were important determinants of survival in stage I squamous cell carcinoma patients.
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Affiliation(s)
- C M Choi
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul
| | - S C Yang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul
| | - H J Jo
- Department of Pathology, College of Medicine, Wonkwang University, Iksan
| | - S Y Song
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hwasun Hospital, Hwasun-gun
| | - Y J Jeon
- Department of Internal Medicine, School of Medicine, Keimyung University, Daegu
| | - T W Jang
- Department of Internal Medicine, College of Medicine, Kosin University, Busan
| | - D J Kim
- Division of Respiratory and Allergy Medicine, Soonchunhyang University Hospital, College of Medicine, Bucheon
| | - S H Jang
- Division of Pulmonary, Allergy & Critical Care Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang
| | - S H Yang
- Department of Internal Medicine, Wonkwang University Hospital, Iksan
| | - Y D Kim
- Department of Thoracic Surgery, School of Medicine, Pusan National University, Busan
| | - K H Lee
- Department of Internal Medicine, Yeungnam University School of Medicine, Daegu
| | - S J Jang
- Department of Pathology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul
| | - Y T Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul
| | - D K Kim
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul
| | - D H Chung
- Department of Pathology, Seoul National University College of Medicine, Seoul
| | | | - H S Nam
- Pulmonary Division, Department of Internal Medicine, Inha University Hospital, Incheon, Korea
| | - J H Cho
- Pulmonary Division, Department of Internal Medicine, Inha University Hospital, Incheon, Korea
| | - H J Kim
- Pulmonary Division, Department of Internal Medicine, Inha University Hospital, Incheon, Korea
| | - J S Ryu
- Pulmonary Division, Department of Internal Medicine, Inha University Hospital, Incheon, Korea.
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Kim JY, Lee S, Cho KJ, Kim SY, Nam SY, Choi SH, Roh JL, Choi EK, Kim JH, Song SY, Shin HS, Chang SK, Ahn SD. Treatment results of post-operative radiotherapy in patients with salivary duct carcinoma of the major salivary glands. Br J Radiol 2012; 85:e947-52. [PMID: 22573301 DOI: 10.1259/bjr/21574486] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Salivary duct carcinoma (SDC) is a rare malignancy of high-grade pathological type. We evaluated clinical outcomes and prognostic factors in 35 patients with SDC treated post-operatively with adjuvant radiation. METHODS We retrospectively assessed overall survival, locoregional control and disease-free survival in 35 patients with SDC of the major salivary glands who underwent surgery and were subsequently treated with radiotherapy. The evaluated prognostic factors included gender, age, symptom duration, tumour site, tumour size, TNM classification, and the following pathological features: perineural invasion, lymphovascular invasion, extraparenchymal invasion and resection-margin status. RESULTS Of the 35 patients, 30 (85.7%) were male. Median age at initial diagnosis was 62 years (range 38-75 years). The parotid gland was the main site affected in 22 patients (62.9%). 18 patients (51.5%) had pathological T3/T4 tumours, and 26 (74.3%) showed pathological nodal involvement. Actuarial 5-year locoregional control, disease-free survival and overall survival rates were 63.3%, 47.4% and 55.1%, respectively. The cause-specific death rate was 31.4% (n=11). Pathological nodal involvement was correlated with distant metastasis (p=0.011). Lymphovascular invasion was significantly prognostic for distant metastasis-free survival (p=0.049), locoregional control (p=0.012) and overall survival (p=0.003) in a Cox proportional hazard model, whereas perineural invasion was only significantly prognostic for overall survival (p=0.005). CONCLUSIONS Surgery and post-operative radiotherapy were effective for locoregional control. Lymphovascular invasion and perineural invasion were significant prognostic factors in patients with SDC.
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Affiliation(s)
- J Y Kim
- Department of Radiation Oncology, Bundang CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
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Jeon WK, Hong HY, Seo WC, Lim KH, Lee HY, Kim WJ, Song SY, Kim BC. Smad7 sensitizes A549 lung cancer cells to cisplatin-induced apoptosis through heme oxygenase-1 inhibition. Biochem Biophys Res Commun 2012; 420:288-92. [PMID: 22421218 DOI: 10.1016/j.bbrc.2012.02.151] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Accepted: 02/28/2012] [Indexed: 01/10/2023]
Abstract
Smad7, an inhibitory Smad, acts as a key regulator forming autoinhibitory feedback loop in transforming growth factor-beta (TGF-β) signaling. However, a growing body of evidences suggests that Smad7 is capable of apoptotic function. In the present study, we have demonstrated a proapoptotic function of Smad7 as a negative regulator of survival protein heme oxygenase-1 (HO-1). The HO-1 protein level was elevated in cisplatin-resistant A549 human lung cancer cells and blockade of HO-1 activation sensitized the cells to apoptosis. Interestingly, overexpression of Smad7 decreased HO-1 gene expression and its enzymatic activity. Notably, Smad7 reduced Akt activity and infection with adenovirus expressing a constitutively active form of the Akt reversed the inhibitory effects of Smad7 to HO-1, indicating a negative action mechanism of Smad7 to Akt-HO-1-linked survival pathway. Consistently, Smad7 sensitized A549 cells to cisplatin-induced apoptosis and these effects were dependent on HO-1 and Akt inhibition. Based on these findings, we suggest that targeting Smad7 may be an efficient strategy for overcoming drug-resistance in cancer therapy.
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Affiliation(s)
- Woo-Kwang Jeon
- Department of Biochemistry, College of Natural Sciences, Kangwon National University, Chuncheon 200-701, Republic of Korea
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Chung JW, Park S, Chung MJ, Park JY, Park SW, Chung JB, Song SY. A novel disposable, transnasal esophagoscope: a pilot trial of feasibility, safety, and tolerance. Endoscopy 2012; 44:206-9. [PMID: 22271030 DOI: 10.1055/s-0031-1291483] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A novel disposable transnasal esophagoscope, the E.G. Scan (IntroMedic Co. Ltd., Seoul, Korea), was developed for the evaluation of esophageal diseases while eliminating the inconvenience associated with sterilization, portability, patient monitoring, complications, and the economic burden of sedation. The feasibility, safety, and tolerability of the first version of the E.G. Scan was evaluated in this pilot study. Nasal esophagoscopy was performed successfully in 46 patients with known or suspected esophageal diseases. At least 50% of the Z-line was visualized by the E.G. Scan in 38 (82.6%) of 46 patients. Abnormalities were identified in 27 patients: erosive esophagitis (n=18), Barrett's esophagus (n=1), esophageal varices (n=7), and esophageal candidiasis (n=1). Nasal pain was absent or mild in most patients, and adverse events were not observed. Further technical improvement of the E.G. Scan would increase the diagnostic usefulness in future clinical practice.
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Affiliation(s)
- J W Chung
- Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea
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Lee HY, Lee DG, Chun K, Lee S, Song SY. Clear cell carcinoma of the pancreas--a case report and review of the literature. Cancer Res Treat 2009; 41:175-81. [PMID: 19809568 DOI: 10.4143/crt.2009.41.3.175] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Accepted: 04/27/2009] [Indexed: 11/21/2022] Open
Abstract
Most of the malignant neoplasms of the pancreas demonstrate features that are consistent with adenocarcinoma. According to the WHO classification, primary clear cell carcinoma of the pancreas is rare and it is classified as a "miscellaneous" carcinoma. In addition, there is not an adequate systematic overview that can demonstrate its true existence as a definable entity. We report here on an unusual case of primary pancreatic clear cell carcinoma, which is the first such reported case in Korea. A 66 year old woman presented with abdominal pain and significant weight loss over the previous three weeks. On the abdominal computed tomography (CT), we detected an abdominal mass involving the pancreas tail and liver, and clear cell carcinoma with rhabdoid feature was seen on the histologic evaluation. The tumor cells showed well defined cell membranes, clear cytoplasm and prominent cell boundaries. The immunohistochemical stains showed positive reactions to antibodies against pan-cytokeratin, cytokeratin 7, carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA). On the other hand, there was a negative reaction for cytokeratin 20, chromogranin, synaptophysin, smooth muscle actin and HMB-45. She was diagnosed with a primary pancreatic clear cell carcinoma with hepatic metastasis and she received palliative gemcitabine chemotherapy. The patient died one month later of pancreatic cancer progression.
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Affiliation(s)
- Hui-Young Lee
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea
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Li KG, Chen JT, Bai SS, Wen X, Song SY, Yu Q, Li J, Wang YQ. Intracellular oxidative stress and cadmium ions release induce cytotoxicity of unmodified cadmium sulfide quantum dots. Toxicol In Vitro 2009; 23:1007-13. [PMID: 19540911 DOI: 10.1016/j.tiv.2009.06.020] [Citation(s) in RCA: 152] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2008] [Revised: 05/22/2009] [Accepted: 06/16/2009] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To fully understand the cytotoxicity of after-degradation QDs, we synthesized CdS QDs and investigated its toxicity mechanism. METHODS Biomimetic method was proposed to synthesize cadmium sulfide (CdS) QDs. Thereafter MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide) assay was conducted to evaluate their cytotoxicity. To investigate the toxicity mechanism, we subsequently conducted intracellular reactive oxygen species (ROS) measurement with DCFH-DA, glutathione (GSH) measurement with DTNB, and cellular cadmium assay using atomic absorption spectrometer. Microsized CdS were simultaneously tested as a comparison. RESULTS MTT assay results indicated that CdS QDs are more toxic than microsized CdS especially at concentrations below 40 microg/ml. While microsized CdS did not trigger ROS elevation, CdS QDs increase ROS by 20-30% over control levels. However, they both deplete cellular GSH significantly at the medium concentration of 20 microg/ml. In the presence of NAC, cells are partially protected from CdS QDs, but not from microsized particles. Additionally, nearly 20% of cadmium was released from CdS nanoparticles within 24h, which also accounts for QDs' toxicity. CONCLUSION Intracellular ROS production, GSH depletion, and cadmium ions (Cd(2+)) release are possible mechanisms for CdS QDs' cytotoxicity. We also suggested that with QD concentration increasing, the principal toxicity mechanism changes from intracellular oxidative stress to Cd(2+) release.
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Affiliation(s)
- K G Li
- College of Environmental Science and Engineering, Tianjin Key Laboratory of Environmental Remediation and Pollution Control, Nankai University, Tianjin 300071, PR China
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Hong JP, Lee SW, Song SY, Ahn SD, Shin SS, Choi EK, Kim JH. Recombinant human epidermal growth factor treatment of radiation-induced severe oral mucositis in patients with head and neck malignancies. Eur J Cancer Care (Engl) 2009; 18:636-41. [PMID: 19456848 PMCID: PMC2776929 DOI: 10.1111/j.1365-2354.2008.00971.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [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: 02/03/2023]
Abstract
Mucositis of the oral cavity and pharynx is a major dose-limiting factor in the application of radiotherapy (RT) to patients with head and neck cancer. Therefore, we evaluated the wound healing effect of human recombinant epidermal growth factor (rhEGF) in head and neck cancer and lymphoma patients with irradiation (with or without combined chemotherapy-induced oral mucositis). Patients at Asan Medical Center who had undergone definitive RT of the head and neck region with or without combined chemotherapy and who had developed severe oral mucositis (higher than the Radiation Therapy Oncology Group grade 3) were treated with topical rhEGF twice daily for 7 days. The evaluation of response with regard to oral mucositis was performed 1 week later. Of the 11 treated patients, three had nasopharyngeal carcinoma, three had carcinoma of the oropharynx, two had carcinoma of the oral cavity, one had carcinoma of the hypopharynx and two had lymphoma of the head and neck. Six patients received RT only, and five patients received concurrent chemoradiotherapy. All patients showed improvements in their oral mucositis after topical treatment with rhEGF in that the Radiation Therapy Oncology Group grade was significantly decreased (P = 0.0000). This finding suggests that rhEGF is effective and safe for the treatment of radiation-induced mucositis. Further studies are needed to determine the optimal dosage and fractionation schedule.
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Affiliation(s)
- J P Hong
- Department of Plastic and Reconstructive Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Kim YH, Yang JH, Ahn SY, Song SY, Roh H. Communication skills improvement of medial students according to length and methods of preclinical training. Korean J Med Educ 2009; 21:3-16. [PMID: 25812952 DOI: 10.3946/kjme.2009.21.1.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2008] [Accepted: 01/28/2009] [Indexed: 06/04/2023]
Abstract
PURPOSE The purpose of this study is to evaluate the changing pattern of communication skills of medical students according to length and methods of training. METHODS We evaluated a 1-week communications training course in 2003, a 1-year course in 2004, and a 1-semester course in 2005 during development of our curriculum. We have conducted the 10-minute CPX on abdominal pain annually since 2002 to assess the clinical performance of medical students who have completed the 3rd year clerkship. We selected CPX videos that were appropriate for assessment. One hundred sixty-four videos were available (1-week didactics: 42 cases, 1-week training: 28 cases, 1-semester training: 50 cases, 1-year training: 44 cases). We developed a 10-item global rating checklist to assess communication skills. A 5-point Likert scale was used to evaluate each item (4-very likely, 0-least likely). Two expert standardized patient (SP) raters evaluated the communication skills of students independently. We analyzed the outcomes based on the training length and methods. The reliability (G coefficient) was 0.825 with 2 SPs and 1 station. RESULTS The communication skills of students improved with practice and longer training, especially with regard to opening the interview, expressing empathy, understanding the patient's perspective, and preparing for the physical examination. Rapport-building, organization of the interview, understandable explanation, nonverbal communication, active listening and consideration during the physical examination was unchanged between durations of training. The scores for empathetic expression, active listening and understanding the patient's perspective were low across all groups. CONCLUSION We should concentrate our efforts to improve students' skills in empathetic expression, active listening and understanding the patient's perspective.
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Affiliation(s)
- Yang Hee Kim
- Department of Surgery, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Jeong Hee Yang
- Department of Family Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Sung Yeon Ahn
- Department of Pediatrics, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Seo-Young Song
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - HyeRin Roh
- Department of Surgery, School of Medicine, Kangwon National University, Chuncheon, Korea
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Lee HY, Jeong DJ, Lee DG, Chun K, Ryu SW, Song SY. A Case of Immune Thrombocytopenic Purpura Developing after Treatment for Non-Hodgkin's Lymphoma. Korean J Hematol 2009. [DOI: 10.5045/kjh.2009.44.2.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Hui-Young Lee
- Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon, Korea
| | - Dae Joon Jeong
- Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon, Korea
| | - Dong-Gyu Lee
- Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon, Korea
| | - Kwangjin Chun
- Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon, Korea
| | - Sook Won Ryu
- Department of Laboratory Medicine, College of Medicine, Kangwon National University, Chuncheon, Korea
| | - Seo-Young Song
- Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon, Korea
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Son HJ, Song SY, Lee WY, Yang SS, Park SH, Yang MH, Yoon SH, Chun HK. Characteristics of early colorectal carcinoma with lymph node metastatic disease. Hepatogastroenterology 2008; 55:1293-1297. [PMID: 18795675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND/AIMS Endoscopic resection may safely and effectively remove early colorectal cancers. However, additional surgical treatment is needed in cases with metastatic lymph nodes for curative treatment. The purpose of this study was to investigate the correlation between lymph node metastasis and various pathological parameters in early colorectal cancers. METHODOLOGY The clinicopathological records of 3,557 colorectal adenocarcinoma patients who underwent surgical resection at the Samsung Medical Center from August 1995 to June 2005 were reviewed. One hundred forty seven tissue samples with early colorectal cancer were used in this study. Various parameters were studied including gender, location, macroscopic appearance, differentiation, lymphatic tumor emboli, and the depth of tumor invasion. RESULTS Twenty five patients (17.0%) had lymph node metastasis. Male gender, left colon, macroscopically depressed lesions, moderately or poorly differentiated carcinoma, depth of tumor invasion (Sm2 or Sm3), and presence of lymphatic tumor emboli were the risk factors for lymph node metastasis. CONCLUSIONS Early colorectal cancers with male gender, location in the left colon, macroscopically depressed lesion, moderate or poor differentiation, depth in Sm2 or Sm3, and the presence of lymphatic tumor emboli have higher risk of lymph node metastasis than those without. The early colorectal cancers with these risk factors should have surgical resection.
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Affiliation(s)
- H J Son
- Department of Medicine, Samsung Medical Center, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea
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Bae TW, Vanjildorj E, Song SY, Nishiguchi S, Yang SS, Song IJ, Chandrasekhar T, Kang TW, Kim JI, Koh YJ, Park SY, Lee J, Lee YE, Ryu KH, Riu KZ, Song PS, Lee HY. Environmental risk assessment of genetically engineered herbicide-tolerant Zoysia japonica. J Environ Qual 2008; 37:207-218. [PMID: 18178894 DOI: 10.2134/jeq2007.0128] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Herbicide-tolerant Zoysia grass (Zoysia japonica Steud.) has been generated previously through Agrobacterium tumefaciens-mediated transformation. The genetically modified (GM) Zoysia grass survived Basta spraying and grew to maturity normally while the wild-type (WT) grass stopped growing and died. GM Zoysia grass will permit more efficient weed control for various turf grass plantings such as home lawns, golf courses, and parks. We examined the environmental/biodiversity risks of herbicide-tolerant GM Zoysia before applying to regulatory agencies for approval for commercial release. The GM and WT Zoysia grass' substantial trait equivalence, ability to cross-pollinate, and gene flow in confined and unconfined test fields were selectively analyzed for environmental/biodiversity effects. No difference between GM and WT Zoysia grass in substantial traits was found. To assess the potential for cross-pollination and gene flow, a non-selective herbicide, Basta, was used. Results showed that unintended cross-pollination with and gene flow from GM Zoysia grass were not detected in neighboring weed species examined, but were observed in WT Zoysia grass (on average, 6% at proximity, 1.2% at a distance of 0.5 m and 0.12% at a radius of 3 m, and 0% at distances over 3 m). On the basis of these initial studies, we conclude that the GM Zoysia grass generated in our laboratory and tested in the Nam Jeju County field does not appear to pose a significant risk when cultivated outside of test fields.
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Affiliation(s)
- T W Bae
- Faculty of Biotechnology, Cheju National University, Jeju 690-756, Korea
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Son HJ, Son H, Myung W, Yoo HS, Park SH, Song SY, Kwon YD, Song S, Rhee JC. Prognostic indicators of gastric carcinoma confined to the muscularis propria. Histopathology 2007; 51:105-10. [PMID: 17593085 DOI: 10.1111/j.1365-2559.2007.02725.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
AIMS Gastric carcinoma confined to the muscularis propria (MPGC) is considered an intermediate-stage carcinoma. A method of discriminating between more favourable and less favourable prognostic groups of this entity is critically needed in dealing with this heterogeneous disease. The aim of this study was to examine the correlation between survival of patients with MPGC and its various clinicopathological parameters. METHODS AND RESULTS Various clinicopathological parameters were studied in 171 tissue samples including: macroscopic appearance, size, age, sex, stage, invasion depth, Lauren and Ming classifications, extent, lymphatic emboli and nodal metastasis. Tumours macroscopically resembling early gastric cancers, younger patient age, absence of lymphatic tumour emboli and lower stage were significantly associated with better prognosis of MPGC by univariate analysis. Tumours macroscopically resembling early gastric cancers, younger patient age and Lauren's diffuse type were significantly associated with a better prognosis of MPGC by multivariate analysis. CONCLUSIONS These indicators are practical parameters for predicting patient prognosis in clinical practice. The description of these parameters should be carefully noted in the final report and pathologists should evaluate the macroscopic appearance of MPGC.
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Affiliation(s)
- H J Son
- Department of Medicine, Samsung Medical Centre [corrected] Sungkyukwan University School of Medicine [corrected] Seoul, Korea.
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Abstract
This study was designed to determine the accuracy and agreement of a self-collection method using pad for human papillomavirus (HPV) DNA. One hundred and thirty-four patients at university hospitals voluntarily participated in the accuracy study, and 314 volunteers participated in the agreement study at local clinics. DNA was extracted and amplified using HPV L1 consensus primers designed for the direct sequencing. In the accuracy study, all samples were probed via histological examinations. With regard to the detection of squamous intraepithelial lesion (SIL), self-collection pad sampling displays sensitivity, of 76.9%, and specificity, of 93.3%. Three hundred and fourteen self-collection pad samples and the concurrent physicians' samples showed a 97.8% agreement, with a Kappa value of 0.9200. A new self-collection pad for the detection of HPV DNA appears to constitute an easy, rapid, and convenient alternative method for the cervical cancer screening of many women with the virtue of being incredible readily accessible.
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Affiliation(s)
- S R Kim
- Medplan Pathology Laboratory Center, Seoul, Republic of Korea
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Abstract
Early esophageal cancer (EEC) has an excellent prognosis compared to advanced esophageal cancer. Nowadays, endoscopic mucosal resection (EMR) may offer another alternative to cure early cancers of the gastrointestinal tract. We aimed to evaluate the clinical outcomes of EEC in Korea after curative treatments; EMR or surgery. We retrospectively reviewed the medical records of patients diagnosed as EEC from January 1994 to August 2005 at Yonsei University Medical Center, Seoul, Korea. Among 888 patients diagnosed with esophageal cancer, 70 (7.9%) were included as EEC. Among them, 10 patients (14.3%) were treated by EMR, and 50 (71.4%) by operation. The treatment outcomes of EEC in relation to various clinicopathologic factors along with survival rates were analyzed. There were 18 cases (30%) of mucosal lesions and 42 cases (70%) of submucosal lesions. Overall 5-year survival rate was 84.3%. When comparing treatment outcomes between EMR-treated and operated groups, there were no significant differences in complete remission (80%vs. 84%), recurrence (20%vs. 16%) and 5-year survival rate (100%vs. 78.3%). EEC is a potentially curable entity with a good clinical prognosis. EMR can be considered as another treatment arm for EEC, along with surgical resection.
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Affiliation(s)
- J-H Kim
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-Ku, Seoul 120-752, Korea
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Kim WY, Lee JW, Choi JJ, Choi CH, Kim TJ, Kim BG, Song SY, Bae DS. Increased expression of Toll-like receptor 5 during progression of cervical neoplasia. Int J Gynecol Cancer 2007; 18:300-5. [PMID: 17587322 DOI: 10.1111/j.1525-1438.2007.01008.x] [Citation(s) in RCA: 67] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The purpose of this study was to determine whether Toll-like receptor 5 (TLR5) expression was associated with disease progression in cervical neoplasia. TLR5 expression was evaluated by immunohistochemistry (IHC) in 55 formalin-fixed paraffin-embedded cervical tissues; 10 normal cervical specimens, 9 low-grade cervical intraepithelial neoplasias (CINs), 12 high-grade CINs, and 24 invasive squamous cell carcinomas (ISCCs). TLR5 expression was also evaluated at the RNA level, in fresh, frozen cervical carcinoma tissues by real-time quantitative RT-PCR. TLR5 expression, which was mainly observed as cytoplasmic staining, gradually increased in accordance with the histopathologic grade in the following order: low-grade CIN less than high-grade CIN less than ISCC (P < 0.001). Immunohistochemical staining showed that TLR5 expression was undetectable (80%) or weak (20%) in normal cervical squamous epithelial tissues. However, moderate expression was detected in 33.3% of low-grade CIN (3/9), 41.7% of high-grade CIN (5/12), and 45.8% of ISCC (11/24). Strong expression was detected in as much as 33.3% of high-grade CIN (4/12) and 50% of ISCC (12/24). Contrary to IHC results, real-time quantitative RT-PCR revealed that TLR5 expression in tumors was not statistically different compared to normal cervical tissues (P = 0.1452). The IHC result suggests that TLR5 may play a significant role in tumor progression of cervical neoplasia and may represent a useful marker for malignant transformation of cervical squamous cells.
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Affiliation(s)
- W Y Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Park SY, Rhee Y, Youn JC, Park YN, Lee S, Kim DM, Song SY, Lim SK. Ectopic Cushing's syndrome due to concurrent corticotropin-releasing hormone (CRH) and adrenocorticotropic hormone (ACTH) secreted by malignant gastrinoma. Exp Clin Endocrinol Diabetes 2007; 115:13-6. [PMID: 17286228 DOI: 10.1055/s-2007-948212] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [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] [Indexed: 10/23/2022]
Abstract
Ectopic Cushing's syndrome due to various malignancies is not uncommon. However, a few cases of ectopic Cushing's syndrome caused by corticotropin-releasing hormone (CRH), or CRH with adrenocorticotropic hormone (ACTH) have been reported. A 28-year-old woman presented with acute upper gastrointestinal bleeding caused by an active ulcer, located atypically in the 2nd portion of duodenum. Further work-up revealed high gastrin levels and abdominal computed tomography (CT) scans showed a large pancreatic head mass with multiple liver metastases. The serum cortisol and ACTH levels were checked due to hypokalemia with metabolic alkalosis and recent amenorrhea. Cortisol and ACTH were both highly elevated with pituitary hyperplasia and elevated CRH. The existence of ectopic ACTH and CRH in the liver biopsy was also demonstrated immunohistochemically. Since an operation was not feasible, chemotherapy was conducted using paclitaxel and etoposide. These two drugs were chosen according to the IN VITRO chemotherapy response assay to maximize the treatment. This report demonstrates concurrent ACTH- and CRH-related ectopic Cushing's syndrome caused by malignant gastrinoma with multiple liver metastases that was treated with marginal success using a multidisciplinary medical approach.
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Affiliation(s)
- S Y Park
- Department of Internal Medicine and Endocrine Research Institute, College of Medicine, Yonsei University, Seoul, Korea
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Lee SJ, Jung KL, Lee JW, Song SY, Kim BG, Lee JH, Park CS, Bae DS. Analyses of atypical squamous cells refined by the 2001 Bethesda System: the distribution and clinical significance of follow-up management. Int J Gynecol Cancer 2006; 16:664-9. [PMID: 16681744 DOI: 10.1111/j.1525-1438.2006.00403.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [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: 11/28/2022] Open
Abstract
This study was conducted to analyze the clinical significance of follow-up diagnostic methods of atypical squamous cells (ASC) (the 2001 Bethesda System) cases according to age. A computerized search of the cytology database was performed to retrieve all cases diagnosed as ASC from 2001 to 2003. The pathologic reports for all follow-up diagnoses were reviewed. We divided the patients into two groups according to their age, younger than 50 years of age and 50 years and older, and follow-up diagnoses were compared between the two groups. ASC was identified in 1035 (2.0%) of 49,882 women screened, and a total of 914 patients were eligible. In atypical squamous cells of undetermined significance (ASC-US) cases, colposcopically directed biopsy showed CIN I (CIN is cervical intraepithelial neoplasia) or higher grade lesions in 34.9% of cases younger than 50 years of age and in 17.4% of cases 50 years and older (P= 0.000). However, repeat Pap smears and human papillomavirus DNA testing showed no differences between the two groups. In contrast, the three methods did not exhibit significant difference between the two groups in patients with atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) (P= 0.743). Colposcopically directed biopsy for the ASC-US was more useful in patients younger than 50 years of age than in those who were 50 years and older. It is suggested that age should be considered in deciding follow-up diagnostic methods in patients with ASC-US.
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Affiliation(s)
- S-J Lee
- Department of Obstetrics and Gynecology, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea
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Abstract
Phosphorylated AKT (pAKT) is a major contributor to radioresistance in human cancers. The aim of this study was to investigate the association of pAKT expression and radiation resistance in cervical cancer. A retrospective review was made of the records of 27 women who received primary radiation therapy due to locally advanced cervical cancer (LACC) with FIGO stage IIB–IVA. Nine patients regarded as radiation resistant developed local recurrences with a median progression free interval of 9 months. Eighteen patients did not show local recurrences, and were regarded as a radiation-sensitive group. Using pretreatment paraffin-embedded tissues, we evaluated pAKT expression by immunohistochemistry. A significant association was found between the level of pAKT expression and local recurrence. Immunohistochemical staining for pAKT was significantly more frequent in the radiation-resistant than in the radiation-sensitive group (P=0.004). The mean progression-free survival was 86 months for patients with pAKT-negative staining (19 cases) and 44 months for patients with pAKT-positive expression (eight cases) (P=0.008). These results suggest that signalling from phosphatidylinositide 3-kinase/pAKT can lead to radiation resistance, and that evaluation of pAKT may be a prognostic marker for response to radiotherapy in LACC.
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Affiliation(s)
- T-J Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Gangnam-gu, Seoul 135-710, Korea
| | - J-W Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Gangnam-gu, Seoul 135-710, Korea
| | - S Y Song
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Gangnam-gu, Seoul 135-710, Korea
| | - J-J Choi
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Gangnam-gu, Seoul 135-710, Korea
| | - C H Choi
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Gangnam-gu, Seoul 135-710, Korea
| | - B-G Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Gangnam-gu, Seoul 135-710, Korea
| | - J-H Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Gangnam-gu, Seoul 135-710, Korea
| | - D-S Bae
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Gangnam-gu, Seoul 135-710, Korea
- E-mail:
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Park JH, Rhee PL, Kim G, Lee JH, Kim YH, Kim JJ, Rhee JC, Song SY. Enteroendocrine cell counts correlate with visceral hypersensitivity in patients with diarrhoea-predominant irritable bowel syndrome. Neurogastroenterol Motil 2006. [PMID: 16771769 DOI: 10.1111/j.1365-2982.2006.00771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The objective of this study was to determine whether or not the number of enteroendocrine cells (ECs) in the gut is related to visceral hypersensitivity in patients with diarrhoea-predominant irritable bowel syndrome (D-IBS). Twenty-five subjects with D-IBS (mean, 43.1 years; 16 women, nine men) were recruited into our study, along with 13 healthy controls (mean, 40.7 years; nine women, four men). Maximally tolerable pressures were evaluated via barostat testing, and the levels of ECs were immunohistochemically identified and quantified via image analysis. The numbers of ECs between the D-IBS subjects and the controls were not significantly different in the terminal ileum, ascending colon and rectum. However, the maximally tolerable pressures determined in the D-IBS subjects were significantly lower than those of the control subjects (P < 0.01), and we detected a significant relationship between the maximally tolerable pressures and the numbers of ECs in the rectum (r = -0.37, P < 0.01). Rectal sensitivity was enhanced to a greater degree in D-IBS patients exhibiting an elevated level of rectal ECs. This study provides some evidence to suggest that ECs play an important role in visceral hypersensitivity.
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Affiliation(s)
- J H Park
- Division of Gastroenterology, Department of Medicine, Sungkyunkwan University School of Medicine, Kangnam-Gu, Seoul, Korea
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Park JH, Rhee PL, Kim G, Lee JH, Kim YH, Kim JJ, Rhee JC, Song SY. Enteroendocrine cell counts correlate with visceral hypersensitivity in patients with diarrhoea-predominant irritable bowel syndrome. Neurogastroenterol Motil 2006; 18:539-46. [PMID: 16771769 DOI: 10.1111/j.1365-2982.2006.00771.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [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] [Indexed: 12/15/2022]
Abstract
The objective of this study was to determine whether or not the number of enteroendocrine cells (ECs) in the gut is related to visceral hypersensitivity in patients with diarrhoea-predominant irritable bowel syndrome (D-IBS). Twenty-five subjects with D-IBS (mean, 43.1 years; 16 women, nine men) were recruited into our study, along with 13 healthy controls (mean, 40.7 years; nine women, four men). Maximally tolerable pressures were evaluated via barostat testing, and the levels of ECs were immunohistochemically identified and quantified via image analysis. The numbers of ECs between the D-IBS subjects and the controls were not significantly different in the terminal ileum, ascending colon and rectum. However, the maximally tolerable pressures determined in the D-IBS subjects were significantly lower than those of the control subjects (P < 0.01), and we detected a significant relationship between the maximally tolerable pressures and the numbers of ECs in the rectum (r = -0.37, P < 0.01). Rectal sensitivity was enhanced to a greater degree in D-IBS patients exhibiting an elevated level of rectal ECs. This study provides some evidence to suggest that ECs play an important role in visceral hypersensitivity.
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Affiliation(s)
- J H Park
- Division of Gastroenterology, Department of Medicine, Sungkyunkwan University School of Medicine, Kangnam-Gu, Seoul, Korea
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Kim JJ, Chung SW, Kim JH, Kim JW, Oh JS, Kim S, Song SY, Park J, Kim DH. Promoter methylation of helicase-like transcription factor is associated with the early stages of gastric cancer with family history. Ann Oncol 2006; 17:657-62. [PMID: 16497821 DOI: 10.1093/annonc/mdl018] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND To investigate the clinicopathological significance of promoter methylation of the helicase-like transcription factor (HLTF) in primary gastric cancer. PATIENTS AND METHODS Two-hundred fifty six patients participated in this study. Methylation status of HLTF gene was evaluated in fresh-frozen tissues by the methylation-specific polymerase chain reaction. All statistical analyses were two-sided, with a 5% type I error rate. RESULTS Aberrant methylation of HLTF was found in 98 (38%) of 256 gastric cancer patients. HLTF methylation was significantly associated with a family history in the early stages of gastric cancer, regardless of histologic types. In intestinal-type cases, HLTF methylation occurred in 15 (56%) of 27 patients with family histories, and in 26 (31%) of 85 patients without family histories (P = 0.02). In diffuse-type cases, patients with family histories were also found to exhibit a higher prevalence of HLTF methylation than those without family histories (61% vs. 34%; P = 0.009). HLTF methylation in both of the histologic types occurred in about 70-90% of the early stage cases in which the patient had a family history and in 15-30% of cases in which the patient did not have a family history. In our multivariate logistic regression analysis, the stage 1-2 cases with family histories were determined to carry a higher risk of HLTF methylation than did the stage 3-4 cases without family histories in both the intestinal-type (OR = 6.01, 95% CI = 1.20-30.01, P = 0.02) and the diffuse-type cancers (OR = 8.25, 95% CI = 1.67-40.86, P = 0.009). CONCLUSIONS These results suggest that HLTF methylation may play a crucial role in the early stages of gastric carcinogenesis in patients with family histories and may be a valuable susceptible marker for the risk of gastric cancer in individuals with family histories.
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Affiliation(s)
- J J Kim
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Suwon, Korea
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Bravou V, Nishitani H, Song SY, Taraviras S, Varakis J. Expression of the licensing factors, Cdt1 and Geminin, in human colon cancer. Int J Oncol 2005; 27:1511-8. [PMID: 16273206] [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: 05/05/2023] Open
Abstract
Licensing of chromatin for replication is an evolu-tionarily conserved step in the control of cell division and genomic integrity. Proteins that participate in licensing have been recently documented to denote the proliferative state of cells and they have been proposed as diagnostic and prognostic markers in human cancer. Cdt1 was recently discovered as an important licensing factor, that is inhibited by Geminin. In the present study we analyzed Cdt1 and Geminin expression in human colon cancer. We showed that Cdt1 protein is highly expressed in human neoplastic lesions of the colon while its cell-cycle phase-specific expression profile appears preserved during human carcinogenesis. Similarly, Geminin, Cdt1's inhibitor, is also overexpressed in colon carcinomas and its expression correlates with significant clinicopathological parameters of the disease. Moreover, both Cdt1 and Geminin expression are severely downregulated upon differentiation of Caco-2 cells, an in vitro model of intestinal epithelial differentiation.
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Affiliation(s)
- V Bravou
- Department of Anatomy and Histology-Embryology, School of Medicine, University of Patras, 26500 Rio, Patras, Greece
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Song SY, Lee I, Park C, Lee H, Hahm JC, Kang WK. Neolignans from Saururus chinensis inhibit PC-3 prostate cancer cell growth via apoptosis and senescence-like mechanisms. Int J Mol Med 2005; 16:517-23. [PMID: 16142381] [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: 05/04/2023] Open
Abstract
This study investigated the anticancer activity and related mechanisms of neolignans, especially threo, erythro-manassantin A (compound 2), which are isolated from Saururus chinensis, in PC-3 cells. Compound 2 strongly inhibited the proliferation of PC-3 cells in a dose-dependent manner. Different cell morphologies were observed depending on the concentration of compound 2, which suggested different growth inhibitory mechanisms. DNA flow cytometry indicated that both low and high concentrations of compound 2 induced the arrest of PC-3 cells in G1 phase. Western blot analyses showed that hyperphosphorylated Rb and E2F-1 were decreased, whereas hypophosphorylated Rb was increased. The cells treated with compound 2 at 200 ng/ml showed shrinkage morphologically, and the staining of annexin V-FITC revealed apoptotic cell death of these cells. The induction of apoptosis was accompanied by the cleavage of caspase-3, -8, and -9, as well as the downregulation of the Bcl-2 and the upregulation of Bax. By contrast, at low compound 2 concentration (1 ng/ml), the cells arrested in G1 showed characteristic changes in morphology, such as an enlarged, flattened cell shape; the majority strongly expressed SA-beta-galactosidase activity. The number of cells undergoing apoptosis was negligible, and no poly(ADP-ribose) polymerase (PARP) cleavage was observed. The increase of p21 was noticed. However, it appeared to be transient rather than sustained. The protein p27 may be important for maintaining the senescence machinery induced by compound 2 because p27 expression was increased at low concentration compared with that at high concentration. In conclusion, compound 2 showed a significant growth inhibitory effect in PC-3 cells via two different mechanisms, i.e., apoptosis at high concentration and senescence at low concentration.
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Affiliation(s)
- Seo-Young Song
- Department of Medicine, College of Medicine, Kangwon National University, 17-1 Hyo-ja dong, Chuncheon, Kangwon-do 200-722, Korea
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Kim TS, Song SY, Han J, Shim YM, Jeong HS. Giant fibrovascular polyp of the esophagus: CT findings. ACTA ACUST UNITED AC 2005; 30:653-5. [PMID: 16132431 DOI: 10.1007/s00261-005-0339-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2004] [Accepted: 02/16/2005] [Indexed: 11/28/2022]
Abstract
Giant fibrovascular polyp of the esophagus is a rare intraluminal benign tumor that is covered with normal esophageal mucosa, which consists of fibrous tissue, adipose tissue, and vascular structures. We report a case of a giant fibrovascular polyp of the esophagus in which feeding vessels were well visualized within the stalk of the mass at contrast-enhanced helical computed tomography.
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Affiliation(s)
- T S Kim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea.
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