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Du J, Chen X, Wang Y, Yang Z, Wu D, Zhang Q, Liu Y, Zhu X, Jiang S, Cao Y, Chen C, Du L, Zhou W, Lee SK, Xia H, Hei M. Regional variations in retinopathy of prematurity incidence for preterm infants <32 weeks' gestation in China. Public Health 2024; 226:91-98. [PMID: 38029699 DOI: 10.1016/j.puhe.2023.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/30/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVES National-level data on the incidence of retinopathy of prematurity (ROP) in different regions of China is insufficient. This study aimed to compare ROP incidences and care practices in different regions of China and their relationship with regional gross domestic product (GDP) per capita. STUDY DESIGN Retrospective cohort study. METHODS All infants born at <32 weeks gestational age (GA) and admitted to 70 neonatal intensive care units (NICUs) from January 1, 2019, to December 31, 2020, were enrolled. Hospitals were categorised into three regional groups according to geographical locations and GDP per capita from high to low: Eastern, Central, and Western China. The incidence of death or ROP, and care practices were compared among the groups. RESULTS A total of 18,579 infants were enrolled. Median GA was 29.9 (interquartile range 28.4-31.0) weeks and birth weight was 1318.1 (317.2) g. The percentage of GA <28 weeks, complete administration of antenatal steroids, and weight gain velocity during NICU stay were highest in Eastern China and lowest in Western China (all P < 0.01). In Eastern, Central, and Western China, the rates of death or any stage of ROP were 33.3%, 38.5%, and 39.2%, respectively (P < 0.01). CONCLUSIONS There were considerable regional disparities in ROP incidence in preterm infants with GA <32 weeks in China. The incidence of death or ROP ranged from high to low in Western, Central, and Eastern China.
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Affiliation(s)
- J Du
- Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China; National Center of Children's Health, Beijing, China
| | - X Chen
- Department of Neonatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Y Wang
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Z Yang
- Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China; National Center of Children's Health, Beijing, China
| | - D Wu
- Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China; National Center of Children's Health, Beijing, China
| | - Q Zhang
- Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China; National Center of Children's Health, Beijing, China
| | - Y Liu
- Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China; National Center of Children's Health, Beijing, China
| | - X Zhu
- Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China; National Center of Children's Health, Beijing, China
| | - S Jiang
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China; Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Y Cao
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China; Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - C Chen
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China; Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - L Du
- Neonatal Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China; National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - W Zhou
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China; Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - S K Lee
- Maternal-Infant Care Research Centre and Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - H Xia
- Department of Neonatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - M Hei
- Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China; National Center of Children's Health, Beijing, China.
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Ma SB, Lee SK, An YS, Choi HG, Choy WS. Is the 'safe zone' identified in preoperative computed tomography helpful for choosing optimal implant for fixation of radial head fracture? Acta Orthop Belg 2023; 89:709-717. [PMID: 38205765 DOI: 10.52628/89.4.11188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
The purpose of this study is to assess the clinical significance of the radiologic safe zone based on computed tomography and to compare the outcomes of three different implants for fixation of isolated radial head fractures. We retrospectively reviewed 367 patients who underwent internal fixation for isolated radial head fractures. We newly defined two subtypes of Mason type II fractures associated with the radiographic safe zone (IIA, two-part fracture allowing for safe fixation of plate; IIB, two-part fracture not allowing for safe fixation). 170 patients (CCS group, n = 82; HCS group, n = 31; plate group, n = 57) were investigated with no significant differences in demographics. The range of pronation and supination at 1 month postoperatively (P = 0.04 and P = 0.04) and the range of supination at 6 and 12 months postoperatively (P = 0.03 and P = 0.03) were significantly smaller in the plate group. In Mason type IIB fractures, the average MEPS was higher in the CCS and HSC groups than in the plate group (P = 0.01 and P = 0.02). And the average DASH score was lower in the CCS and HCS groups (P < 0.01 and P < 0.01). Evaluation of the radiologic safe zone is potentially helpful in selecting better surgical fixation option. For type III fractures, 2.3-mm cortical screws would be a better option than Acutrak screws. Plates would not be suitable for type IIB radial head fractures.
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Cho MS, Lee SK, Kwon JH, Nam SW. Hepatobiliary and Pancreatic: Challenges in the diagnosis of hepatic nodules in patients with alcoholic liver cirrhosis. J Gastroenterol Hepatol 2023; 38:1867. [PMID: 37427538 DOI: 10.1111/jgh.16277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Affiliation(s)
- M S Cho
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - S K Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - J H Kwon
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - S W Nam
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Lim M, Kim JM, Yang J, Kwon J, Kim KD, Jeong ES, Rhu J, Choi GS, Joh JW, Lee SK. Upper thigh skeletal muscle index predicts outcomes in liver transplant recipients. Ann Surg Treat Res 2023; 105:219-227. [PMID: 37908380 PMCID: PMC10613820 DOI: 10.4174/astr.2023.105.4.219] [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: 05/12/2023] [Revised: 07/26/2023] [Accepted: 08/16/2023] [Indexed: 11/02/2023] Open
Abstract
Purpose The skeletal muscle index (SMI) at the L3 level is widely used to diagnose sarcopenia. The upper thigh (UT) also reflects changes in whole-body muscle mass, but no study has examined this using the UT to diagnose sarcopenia in liver transplantation (LT). This study aimed to determine an optimal cut-off value for UT-SMI and investigate how sarcopenia diagnosed by UT-SMI correlates with outcomes in LT recipients. Methods In this retrospective study of 332 LT patients from 2018 to 2020, we investigated the association between sarcopenia diagnosed by UT-SMI and patient outcomes after LT. Results The cut-off values for UT-SMI were 38.3 cm2/m2 for females (area under the curve [AUC], 0.927; P < 0.001) and 46.7 cm2/m2 for males (AUC, 0.898; P < 0.001). The prevalence of sarcopenia diagnosed by UT-SMI was 33.4% in our cohort. Patient and graft survival rates in the UT-SMI sarcopenia group were significantly poorer than those in the UT-SMI non-sarcopenia group (P < 0.001 and P < 0.001). UT-SMI was an independent prognostic factor for patient survival (hazard ratio [HR], 2.182; 95% confidence interval [CI], 1.183-4.025; P = 0.012) and graft survival (HR, 2.227; 95% CI, 1.054-4704; P = 0.036) in our multivariable Cox analysis. Conclusion We confirmed that sarcopenia diagnosed by UT-SMI is associated with outcomes in LT recipients. In addition, UT-SMI was identified as an independent prognostic factor for patient survival and graft survival. Therefore, UT-SMI could be a good option for CT-based evaluations of sarcopenia in LT recipients.
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Affiliation(s)
- Manuel Lim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Surgery, Myongji Hospital, Hanyang University Medical Center, Goyang, Korea
| | - Jong Man Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jaehun Yang
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jieun Kwon
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyeong Deok Kim
- Department of Surgery, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Eun Sung Jeong
- Department of Surgery, Dongguk University Medical Center, Goyang, Korea
| | - Jinsoo Rhu
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gyu-Seong Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Won Joh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Suk-Koo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Surgery, Myongji Hospital, Hanyang University Medical Center, Goyang, Korea
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Lee MO, Lee SK, Song YG. Midline catheters in the operating room. Niger J Clin Pract 2023; 26:1097-1100. [PMID: 37635602 DOI: 10.4103/njcp.njcp_843_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Backgrounds Among various vascular access devices, midline catheters (MCs) are commonly used in emergency departments, but rarely in operating rooms. Aims To evaluate the feasibility and safety of MCs in the operating room. Materials and Methods This was a retrospective study. The medical records of patients who underwent MC placement in the operating room from October 2020 to July 2022 were reviewed. The rates of successful catheter insertion as well as major and minor complications were assessed. Results Successful catheter insertions were achieved in 149 of 161 patients (92.5%). The median dwell time of midlines was eight days (IQR: 6-10 days). A major or minor complication occurred in 6.7% of the midlines. The rates of major complications of occlusion, upper extremity deep vein thrombosis (DVT), and catheter-related bloodstream infection were 1.3%, 0.7%, and 0%, respectively. Conclusions Placement of MCs in the operating room was feasible and safe. Also, the procedure provides an acceptable alternative for replacing central line catheters and peripherally inserted central catheters.
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Affiliation(s)
- M O Lee
- Department of Anesthesia and Pain Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine (SKKU-SOM), Changwon, Republic of Korea
| | - S K Lee
- Department of Anesthesia and Pain Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine (SKKU-SOM), Changwon, Republic of Korea
| | - Y G Song
- Department of Radiology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine (SKKU-SOM), Changwon, Republic of Korea
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Lin C, Ahn JK, Choi JM, Farrington MS, Gonzalez M, Grethen N, Hsiung YB, Inagaki T, Kamiji I, Kim EJ, Kim JL, Kim HM, Kawata K, Kitagawa A, Komatsubara TK, Kotera K, Lee SK, Lee JW, Lim GY, Luo Y, Matsumura T, Nakagiri K, Nanjo H, Nomura T, Ono K, Redeker JC, Sato T, Sasse V, Shibata T, Shimizu N, Shinkawa T, Shinohara S, Shiomi K, Shiraishi R, Suzuki S, Tajima Y, Tung YC, Wah YW, Watanabe H, Wu T, Yamanaka T, Yoshida HY. Search for the Pair Production of Dark Particles X with K_{L}^{0}→XX, X→γγ. Phys Rev Lett 2023; 130:111801. [PMID: 37001070 DOI: 10.1103/physrevlett.130.111801] [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] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 02/08/2023] [Indexed: 06/19/2023]
Abstract
We present the first search for the pair production of dark particles X via K_{L}^{0}→XX with X decaying into two photons using the data collected by the KOTO experiment. No signal was observed in the mass range of 40-110 MeV/c^{2} and 210-240 MeV/c^{2}. This sets upper limits on the branching fractions as B(K_{L}^{0}→XX)<(1-4)×10^{-7} and B(K_{L}^{0}→XX)<(1-2)×10^{-6} at the 90% confidence level for the two mass regions, respectively.
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Affiliation(s)
- C Lin
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - J K Ahn
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - J M Choi
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - M S Farrington
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - M Gonzalez
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - N Grethen
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - Y B Hsiung
- Department of Physics, National Taiwan University, Taipei, Taiwan 10617, Republic of China
| | - T Inagaki
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - I Kamiji
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - E J Kim
- Division of Science Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - J L Kim
- Division of Science Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - H M Kim
- Division of Science Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - K Kawata
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - A Kitagawa
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T K Komatsubara
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - K Kotera
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - S K Lee
- Division of Science Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - J W Lee
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - G Y Lim
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - Y Luo
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - T Matsumura
- Department of Applied Physics, National Defense Academy, Kanagawa 239-8686, Japan
| | - K Nakagiri
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - H Nanjo
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T Nomura
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - K Ono
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - J C Redeker
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - T Sato
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - V Sasse
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - T Shibata
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - N Shimizu
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T Shinkawa
- Department of Applied Physics, National Defense Academy, Kanagawa 239-8686, Japan
| | - S Shinohara
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - K Shiomi
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - R Shiraishi
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - S Suzuki
- Department of Physics, Saga University, Saga 840-8502, Japan
| | - Y Tajima
- Department of Physics, Yamagata University, Yamagata 990-8560, Japan
| | - Y-C Tung
- Department of Physics, National Taiwan University, Taipei, Taiwan 10617, Republic of China
| | - Y W Wah
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - H Watanabe
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - T Wu
- Department of Physics, National Taiwan University, Taipei, Taiwan 10617, Republic of China
| | - T Yamanaka
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - H Y Yoshida
- Department of Physics, Yamagata University, Yamagata 990-8560, Japan
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Lee EH, Lee SK, Cheon JH, Koh H, Lee JA, Kim CH, Kim JN, Lee KH, Lee SJ, Kim JH, Ahn JY, Jeong SJ, Ku NS, Yong DE, Yoon SS, Yeom JS, Choi JY. Comparing the efficacy of different methods of faecal microbiota transplantation via oral capsule, oesophagogastroduodenoscopy, colonoscopy, or gastric tube. J Hosp Infect 2023; 131:234-243. [PMID: 36414164 DOI: 10.1016/j.jhin.2022.11.007] [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: 07/28/2022] [Revised: 11/08/2022] [Accepted: 11/12/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND The increasing prevalence of multidrug-resistant organism (MDRO) carriage poses major challenges to medicine as healthcare costs increase. Recently, faecal microbiota transplantation (FMT) has been discussed as a novel and effective method for decolonizing MDRO. AIM To compare the efficacy of different FMT methods to optimize the success rate of decolonization in patients with MDRO carriage. METHODS This prospective cohort study enrolled patients with MDRO carriages from 2018 to 2021. Patients underwent FMT via one of the following methods: oral capsule, oesophagogastroduodenoscopy (EGD), colonoscopy, or gastric tube. FINDINGS A total of 57 patients underwent FMT for MDRO decolonization. The colonoscopy group required the shortest time for decolonization, whereas the EGD group required the longest (24.9 vs 190.4 days, P = 0.022). The decolonization rate in the oral capsule group was comparable to that in the EGD group (84.6% vs 85.7%, P = 0.730). An important clinical factor associated with decolonization failure was antibiotic use after FMT (odds ratio = 6.810, P = 0.008). All four groups showed reduced proportions of MDRO species in microbiome analysis after FMT. CONCLUSION Compared to other conventional methods, the oral capsule is an effective FMT method for patients who can tolerate an oral diet. The discontinuation of antibiotics after FMT is a key factor in the success of decolonization.
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Affiliation(s)
- E H Lee
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - S K Lee
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - J H Cheon
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - H Koh
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Severance Children's Hospital, Severance Pediatric Liver Disease Research Group, Yonsei University College of Medicine, Seoul, South Korea
| | - J A Lee
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - C H Kim
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - J N Kim
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - K H Lee
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - S J Lee
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - J H Kim
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - J Y Ahn
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - S J Jeong
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - N S Ku
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - D E Yong
- Division of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea
| | - S S Yoon
- Department of Microbiology and Immunology, Yonsei University College of Medicine, Seoul, South Korea
| | - J S Yeom
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - J Y Choi
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
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Yoon KC, Song S, Lee S, Kim OK, Hong SK, Yi NJ, Kim JM, Lee KW, Kim MS, Choi Y, Suh KS, Lee SK. Outcomes of Split Liver Transplantation vs Living Donor Liver Transplantation in Pediatric Patients: A 5-Year Follow-Up Study in Korea. Ann Transplant 2022; 27:e935682. [PMID: 35502129 PMCID: PMC9084422 DOI: 10.12659/aot.935682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background The number of pediatric patients awaiting liver transplantation has decreased. Due to its increased use in Korea, split liver transplantation (SLT) may be a substitute for living donor liver transplantation (LDLT); however, the outcomes of pediatric SLT and LDLT in Korea remain unreported. Material/Methods We reviewed data of Korean patients aged <18 years who received SLT from 2005 to 2014, based on the Korea national database and compared to recipients who underwent LDLTs at Seoul National University Hospital during the same period. Results A total of 63 and 56 patients were included in SLT and LDLT, respectively. The most common indication for LT was biliary atresia (60.3% in SLT vs 67.9% in LDLT). The Pediatric End-Stage Liver Disease score did not differ between the groups (P>0.05). The 1-, 3-, and 5-year overall survival rates were 92.1%, 90.2%, and 86.6% in the SLT and 96.4%, 94.6%, and 94.6% in the LDLT groups, respectively (P=0.21); the corresponding graft survival rates were 88.9%, 87.1%, and 83.6% in the SLT and 92.9%, 91.0%, and 91.0% in the LDLT groups, respectively (P=0.31). Fulminant hepatic failure was a risk factor for graft failure [OR, 8.77 (1.08–70.92); P=0.042], but not overall survival [OR, 11.78 (0.56–247.29); P=0.11]. Conclusions The graft and overall survival rates of SLT and LDLT were not different in pediatric patients in Korea, and fulminant hepatic failure was the only risk factor affecting graft survival outcomes.
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Affiliation(s)
- Kyung Chul Yoon
- Department of Surgery, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Sanghee Song
- Transplantation Cener, Seoul National University Hospital, Seoul, South Korea
| | - Sanghoon Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ok-Kyung Kim
- Transplantation Cener, Seoul National University Hospital, Seoul, South Korea
| | - Suk Kyun Hong
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Nam-Joon Yi
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Jong Man Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kwang-Woong Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Myoung Soo Kim
- Department of Surgery and The Research Institue for Transplantation, Yonsei University College of Medicine, Seoul, South Korea
| | - YoungRok Choi
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyung-Suk Suh
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Suk-Koo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Lee MO, Lee SK, Park JE, Jin SY. The recurrence of phantom limb pain with spinal anesthesia. Niger J Clin Pract 2022; 25:728-730. [DOI: 10.4103/njcp.njcp_1875_21] [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: 11/04/2022]
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Lee JH, Lee S, Park HJ, Kim YA, Lee SK. Human Liver Stem Cell Transplantation Alleviates Liver Fibrosis in a Rat Model of CCl 4-Induced Liver Fibrosis. Int J Stem Cells 2021; 14:475-484. [PMID: 34711695 PMCID: PMC8611308 DOI: 10.15283/ijsc21031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 02/05/2023] Open
Abstract
Background and Objectives Mesenchymal stem cells (MSCs) elicit therapeutic effects against liver fibrosis in animal models. Human liver stem cells (HLSCs) are cells isolated from human liver tissue that have mesenchymal morphology and express MSC markers. HLSCs also possess intrahepatic stem cell properties. We introduce a rat model of liver fibrosis and trans-portal transplantation of HLSC to demonstrate alleviation of liver fibrosis. Methods and Results Liver fibrosis was induced by intraperitoneal injection of Carbon tetrachloride (CCl4). Sprague Dawley rats underwent simultaneous partial hepatectomy of the left hepatic lobe and HLSC transplantation via the portal vein. Gross appearance of the liver observed following CCl4 injection showed cholestasis and surface nodularity. Sirius red staining revealed deposition of collagen fibers in the extracellular matrix (ECM). Following HLSC transplantation, human albumin secreting cells were detected by immunohistochemistry in liver specimens. Quantitative measurements of fibrosis area stained by Sirius red were compared between baseline and post-HLSC transplant (1×107 cells) following 10 weeks of CCl4 treatment liver specimens. Fibrosis area (p<0.05), serum markers of liver inflammation and fibrosis (AST, ALT levels and APRI, p<0.05) significantly decreased from baseline after HLSC transplantation. RNA expression in liver tissues revealed significant decrease in tissue inhibitor of matrix metalloproteinase 1 (TIMP1), TIMP2 expression and increase in hepatocyte growth factor expression following HLSC transplantation (p<0.05). Conclusions HLSC transplantation effectively reduced the area of liver fibrosis with increased expression of factors promoting ECM degradation. These findings suggest the potential therapeutic role of HLSCs in various liver diseases presenting with liver fibrosis.
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Affiliation(s)
- Ji-Hyun Lee
- Stem Cell and Regenerative Medicine Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Sanghoon Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hey-Jung Park
- Stem Cell and Regenerative Medicine Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Young-Ah Kim
- Stem Cell and Regenerative Medicine Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Suk-Koo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lee SK, Kim JH, Kim MS, Lee UH. Risk factors for scabies treatment resistance: a retrospective cohort study. J Eur Acad Dermatol Venereol 2021; 36:126-132. [PMID: 34592030 DOI: 10.1111/jdv.17713] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/24/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND In order to successfully treat scabies and to prevent its spread, it is important to identify the factors that can influence the outcome of scabies treatment. OBJECTIVES This study was designed to evaluate the risk factors associated with treatment resistance scabies during use of an effective topical medication. METHODS A retrospective cohort study was performed in patients with scabies infestations confirmed by potassium hydroxide (KOH) examinations. Patient characteristics, clinical features and treatment history were collected. The treatment resistance group included patients with persistent scabies infestations for more than 28 days after initiation of antiscabies treatment with 5% permethrin cream. RESULTS In total, 138 patients with scabies infestations treated between January 2017 and December 2020 were included in this study. Of these, 100 (72.5%) patients were treated successfully, while 38 (27.5%) patients experienced treatment resistance. In the univariable analysis, risk factors for treatment resistance scabies included impaired cognitive function (OR = 2.66, 95% CI, 1.15-6.14), limited mobility (OR = 2.97, 95% CI, 1.30-6.83), inpatient status (vs. outpatient, OR = 3.3, 95% CI, 1.28-8.54), topical steroid use before diagnosis (OR = 3.52, 95% CI, 1.61-7.81), systemic steroid use before diagnosis (OR = 3.57, 95% CI, 1.26-10.34) and a positive KOH exam after the first treatment (OR = 7.25, 95% CI, 3.24-17.11). In the multivariable analysis, limited mobility (OR = 3.46, 95% CI, 1.02-12.11) and topical steroid use before diagnosis (OR = 3.65, 95% CI, 1.41-9.75) were significant predictive factors for treatment resistance scabies. CONCLUSIONS Scabies patients with limited mobility and topical steroid use before diagnosis are at high risk of treatment resistance. Dermatologists should take these findings into consideration when treating patients with scabies infestations.
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Affiliation(s)
- S K Lee
- Department of Dermatology, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - J H Kim
- Department of Dermatology, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - M S Kim
- Department of Dermatology, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - U H Lee
- Department of Dermatology, Inje University Sanggye Paik Hospital, Seoul, Korea
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Kim MS, Park H, Lee S, Yoo SY, Cho SY, Lee SK, Jin DK. Clinical characteristics, treatment outcomes, and occurrence of diabetes mellitus after pancreatic resection of solid pseudopapillary tumor in children and adolescents: A single institution experience with 51 cases. Pancreatology 2021; 21:509-514. [PMID: 33509684 DOI: 10.1016/j.pan.2021.01.009] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/25/2020] [Accepted: 01/15/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Solid pseudopapillary tumors (SPTs) are rare, but they comprise the majority of pediatric pancreatic neoplasms. However, studies on these conditions in pediatric patients are lacking. The aim of this study was to investigate the clinical characteristics and treatment outcomes in children and adolescents with SPTs. METHODS This retrospective study included 51 patients with SPTs who had undergone pancreatic tumor resection before the age of 19 years at Samsung Medical Center in Korea (from November 1994 to August 2020). We investigated the postoperative outcomes. RESULTS Of the 51 patients with SPTs (female, 88.2%), the median age at diagnosis was 14 years (range, 8-19). The most common symptom was abdominal pain (60.8%), and 14 patients (27.5%) were asymptomatic. The median maximal tumor diameter was 7 cm (range, 1.4-14), and the pancreatic body and/or tail were involved in 68.6% of patients. The short-term complication rate was 21.5%, and the recurrence rate was 5.9%. New-onset diabetes mellitus (NODM) occurred in four patients. CONCLUSIONS The ideal treatment for SPTs is complete resection of the tumor; however, long-term postoperative complications including NODM should be monitored carefully, particularly in children and adolescents.
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Affiliation(s)
- Min-Sun Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyojung Park
- Department of Pediatrics, Seongnam Citizens Medical Center, Gyeonggi-do, Republic of Korea
| | - Sanghoon Lee
- Department of Pediatric Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - So Young Yoo
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sung Yoon Cho
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Suk-Koo Lee
- Department of Pediatric Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong-Kyu Jin
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Ahn JK, Beckford B, Campbell M, Chen SH, Comfort J, Dona K, Farrington MS, Hanai K, Hara N, Haraguchi H, Hsiung YB, Hutcheson M, Inagaki T, Isoe M, Kamiji I, Kato T, Kim EJ, Kim JL, Kim HM, Komatsubara TK, Kotera K, Lee SK, Lee JW, Lim GY, Lin QS, Lin C, Luo Y, Mari T, Masuda T, Matsumura T, Mcfarland D, McNeal N, Miyazaki K, Murayama R, Nakagiri K, Nanjo H, Nishimiya H, Noichi Y, Nomura T, Nunes T, Ohsugi M, Okuno H, Redeker JC, Sanchez J, Sasaki M, Sasao N, Sato T, Sato K, Sato Y, Shimizu N, Shimogawa T, Shinkawa T, Shinohara S, Shiomi K, Shiraishi R, Su S, Sugiyama Y, Suzuki S, Tajima Y, Taylor M, Tecchio M, Togawa M, Toyoda T, Tung YC, Vuong QH, Wah YW, Watanabe H, Yamanaka T, Yoshida HY, Zaidenberg L. Study of the K_{L}→π^{0}νν[over ¯] Decay at the J-PARC KOTO Experiment. Phys Rev Lett 2021; 126:121801. [PMID: 33834796 DOI: 10.1103/physrevlett.126.121801] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
The rare decay K_{L}→π^{0}νν[over ¯] was studied with the dataset taken at the J-PARC KOTO experiment in 2016, 2017, and 2018. With a single event sensitivity of (7.20±0.05_{stat}±0.66_{syst})×10^{-10}, three candidate events were observed in the signal region. After unveiling them, contaminations from K^{±} and scattered K_{L} decays were studied, and the total number of background events was estimated to be 1.22±0.26. We conclude that the number of observed events is statistically consistent with the background expectation. For this dataset, we set an upper limit of 4.9×10^{-9} on the branching fraction of K_{L}→π^{0}νν[over ¯] at the 90% confidence level.
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Affiliation(s)
- J K Ahn
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - B Beckford
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - M Campbell
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - S H Chen
- Department of Physics, National Taiwan University, Taipei, Taiwan 10617, Republic of China
| | - J Comfort
- Department of Physics, Arizona State University, Tempe, Arizona 85287, USA
| | - K Dona
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - M S Farrington
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - K Hanai
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - N Hara
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - H Haraguchi
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - Y B Hsiung
- Department of Physics, National Taiwan University, Taipei, Taiwan 10617, Republic of China
| | - M Hutcheson
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - T Inagaki
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - M Isoe
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - I Kamiji
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - T Kato
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - E J Kim
- Division of Science Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - J L Kim
- Division of Science Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - H M Kim
- Division of Science Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - T K Komatsubara
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - K Kotera
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - S K Lee
- Division of Science Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - J W Lee
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - G Y Lim
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - Q S Lin
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - C Lin
- Department of Physics, National Taiwan University, Taipei, Taiwan 10617, Republic of China
| | - Y Luo
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - T Mari
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T Masuda
- Research Institute for Interdisciplinary Science, Okayama University, Okayama 700-8530, Japan
| | - T Matsumura
- Department of Applied Physics, National Defense Academy, Kanagawa 239-8686, Japan
| | - D Mcfarland
- Department of Physics, Arizona State University, Tempe, Arizona 85287, USA
| | - N McNeal
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - K Miyazaki
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - R Murayama
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - K Nakagiri
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - H Nanjo
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - H Nishimiya
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - Y Noichi
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T Nomura
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - T Nunes
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - M Ohsugi
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - H Okuno
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - J C Redeker
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - J Sanchez
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - M Sasaki
- Department of Physics, Yamagata University, Yamagata 990-8560, Japan
| | - N Sasao
- Research Institute for Interdisciplinary Science, Okayama University, Okayama 700-8530, Japan
| | - T Sato
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - K Sato
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - Y Sato
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - N Shimizu
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T Shimogawa
- Department of Physics, Saga University, Saga 840-8502, Japan
| | - T Shinkawa
- Department of Applied Physics, National Defense Academy, Kanagawa 239-8686, Japan
| | - S Shinohara
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - K Shiomi
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - R Shiraishi
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - S Su
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Y Sugiyama
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - S Suzuki
- Department of Physics, Saga University, Saga 840-8502, Japan
| | - Y Tajima
- Department of Physics, Yamagata University, Yamagata 990-8560, Japan
| | - M Taylor
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - M Tecchio
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - M Togawa
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T Toyoda
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - Y-C Tung
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - Q H Vuong
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - Y W Wah
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - H Watanabe
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - T Yamanaka
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - H Y Yoshida
- Department of Physics, Yamagata University, Yamagata 990-8560, Japan
| | - L Zaidenberg
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, USA
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An SH, Lee S, Rhu J, Kim JM, Choi GS, Joh JW, Lee SK. Safety and efficacy of conversion to once-daily tacrolimus from twice-daily tacrolimus in pediatric liver transplant recipients. Korean Journal of Transplantation 2020. [DOI: 10.4285/atw2020.or-1184] [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: 11/04/2022] Open
Affiliation(s)
- Sung Hyo An
- Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Sanghoon Lee
- Division of Pediatric Surgery, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Jinsoo Rhu
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Jong Man Kim
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Gyu Seong Choi
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Jae-Won Joh
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Suk-Koo Lee
- Division of Transplantation, Department of Surgery, Vinmec Healthcare System, Hanoi, Vietnam
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Ab Halim SA, Lee SK, Mustangin M, Mohd Saleh MF, Shah SA, Md Isa N. Expression of oestrogen-α receptor in papillary thyroid carcinoma and its association with metastasis. Malays J Pathol 2020; 42:415-422. [PMID: 33361723] [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: 06/12/2023]
Abstract
INTRODUCTION Papillary thyroid carcinoma (PTC) is the ninth most common malignancy among women. Although the disease prognosis is good, less favourable outcomes are predicted in those with higher disease stages and nodal metastasis. Oestrogen- α (ER-α) expression has been associated with aggressive presentation and greater disease progression and has been proposed as a predictor for lymph node metastases. The objective of this study was to evaluate the association between ER expression and clinicopathological features i.e. lymph node metastasis, tumour size, extrathyroidal extension, histological variants of PTC , age groups , ethnic and gender. METHODS We studied ER-α expression in 84 cases of PTC obtained within an eight-year period (2011-2018) by immunohistochemical technique (IHC). Associations between ER-α expression and clinicopathological features were evaluated using Fisher's exact test. The statistical significance was set at p < 0.05. RESULTS ER-α was expressed in 13.1% of all the PTC cases examined (n=11/84). There were no associations observed between ER-α expression and lymph node metastasis (p=1.000), tumour size (p=0.970), extrathyroidal extension (p=0.677), variants of PTC (p=1.000), age groups (p=0.188), gender (p=0.725) or race (p=0.920). CONCLUSION There was no evidence in this study to support the application of ER-α as prediction marker for lymph node metastasis or disease aggressiveness in PTC. Given that the scope of this study was limited to the protein expression of ER- α, we also propose the inclusion of molecular analysis of ESR1 gene expression, as well as inclusion of detailed clinical and radiological findings in future research investigating the role of ER-α in prognostication of PTC.
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Affiliation(s)
- S A Ab Halim
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Pathology, kuala Lumpur, Malaysia.
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Altschul DJ, Haranhalli N, Esenwa C, Unda SR, Garza Ramos RDL, Dardick J, Fernandez-Torres J, Toma A, Labovitz D, Cheng N, Lee SK, Brook A, Zampolin R. The Impact of COVID-19 on Emergent Large-Vessel Occlusion: Delayed Presentation Confirmed by ASPECTS. AJNR Am J Neuroradiol 2020; 41:2271-2273. [PMID: 32883669 DOI: 10.3174/ajnr.a6800] [Citation(s) in RCA: 8] [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: 07/02/2020] [Accepted: 07/27/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Our hypothesis is that the COVID-19 pandemic led to delayed presentations for patients with acute ischemic stroke. This study evaluates the impact of the coronavirus disease 2019 pandemic on presentation, treatment, and outcomes of patients with emergent large-vessel occlusion using data from a large health system in the Bronx, New York. MATERIALS AND METHODS We performed a retrospective cohort study of 2 cohorts of consecutive patients with emergent large-vessel occlusion admitted to 3 Montefiore Health System hospitals in the Bronx from January 1 to February 17, 2020, (prepandemic) and March 1 to April 17, 2020 (pandemic). We abstracted data from the electronic health records on presenting biomarker profiles, admission and postprocedural NIHSS scores, time of symptom onset, time of hospital presentation, time of start of the thrombectomy procedure, time of revascularization, presenting ASPECTS, TICI recanalization score, mRS, functional outcomes, and mortality. RESULTS Of 179 patients admitted with ischemic stroke during the study periods, 80 had emergent large-vessel occlusion, of whom 36 were in the pandemic group. Patients in the pandemic group were younger (66 versus 72 years, P < .061) and had lower ASPECTS (7 versus 9, P < .001) and took longer to arrive at the hospital (361 versus 152 minutes, P < .004) with no other major differences. There was a decreased rate of thrombolysis administration (22% versus 43%, P < .049) and a decreased number of patients treated with mechanical thrombectomy (33% versus 61%, P < .013). CONCLUSIONS The pandemic led to delays in patients arriving at hospitals, leading to decreased patients eligible for treatment, while in-hospital evaluation and treatment times remain unchanged.
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Affiliation(s)
- D J Altschul
- Department of Neurosurgery (D.J.A., N.H., S.R.U., R.d.L.G.R., J.R.-T., A.T.)
| | - N Haranhalli
- Department of Neurosurgery (D.J.A., N.H., S.R.U., R.d.L.G.R., J.R.-T., A.T.)
| | | | - S R Unda
- Department of Neurosurgery (D.J.A., N.H., S.R.U., R.d.L.G.R., J.R.-T., A.T.)
| | - R de La Garza Ramos
- Department of Neurosurgery (D.J.A., N.H., S.R.U., R.d.L.G.R., J.R.-T., A.T.)
| | - J Dardick
- Albert Einstein College of Medicine (J.D.),, Bronx, New York
| | - J Fernandez-Torres
- Department of Neurosurgery (D.J.A., N.H., S.R.U., R.d.L.G.R., J.R.-T., A.T.)
| | - A Toma
- Department of Neurosurgery (D.J.A., N.H., S.R.U., R.d.L.G.R., J.R.-T., A.T.)
| | - D Labovitz
- Radiology (D.L., N.C., S.-K.L., A.B., R.Z.), Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - N Cheng
- Radiology (D.L., N.C., S.-K.L., A.B., R.Z.), Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - S K Lee
- Radiology (D.L., N.C., S.-K.L., A.B., R.Z.), Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - A Brook
- Radiology (D.L., N.C., S.-K.L., A.B., R.Z.), Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - R Zampolin
- Radiology (D.L., N.C., S.-K.L., A.B., R.Z.), Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
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Lee K, Jeon J, Kim JM, Kim G, Kim K, Jang HR, Lee JE, Joh JW, Lee SK, Huh W. Perioperative risk factors of progressive chronic kidney disease following liver transplantation: analyses of a 10-year follow-up single-center cohort. Ann Surg Treat Res 2020; 99:52-62. [PMID: 32676482 PMCID: PMC7332318 DOI: 10.4174/astr.2020.99.1.52] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/28/2020] [Accepted: 04/28/2020] [Indexed: 02/08/2023] Open
Abstract
Purpose The incidence of chronic kidney disease (CKD) has been increasing due to improved survival after liver transplantation (LT). Risk factors of kidney injury after LT, especially perioperative management factors, are potentially modifiable. We investigated the risk factors associated with progressive CKD for 10 years after LT. Methods This retrospective cohort study included 292 adult patients who underwent LT at a tertiary referral hospital between 2000 and 2008. Renal function was assessed by the e stimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease formula. The area under the curve of serial eGFR (AUCeGFR) was calculated for each patient to assess the trajectory of eGFR over the 10 years. Low AUCeGFR was considered progressive CKD. Linear regression analyses were performed to examine the associations between the variables and AUCeGFR. Results Multivariable analysis showed that older age (regression coefficient = -0.53, P < 0.001), diabetes mellitus (DM) (regression coefficient = -6.93, P = 0.007), preoperative proteinuria (regression coefficient = -16.11, P < 0.001), preoperative acute kidney injury (AKI) (regression coefficient = -14.35, P < 0.001), postoperative AKI (regression coefficient = -3.86, P = 0.007), and postoperative mean vasopressor score (regression coefficient = -0.45, P = 0.034) were independently associated with progressive CKD. Conclusion More careful renoprotective management is required in elderly LT patients with DM or preexisting proteinuria. Postoperative AKI and vasopressor dose may be potentially modifiable risk factors for progressive CKD.
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Affiliation(s)
- Kyungho Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Junseok Jeon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Man Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gaabsoo Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyunga Kim
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Hye Ryoun Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Won Joh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Suk-Koo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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18
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Son J, Jang Y, Kim W, Lee S, Jeong JS, Lee SK, Seo JM. Thoracoscopic repair of esophageal atresia with distal tracheoesophageal fistula: is it a safe procedure in infants weighing less than 2000 g? Surg Endosc 2020; 35:1597-1601. [PMID: 32323019 PMCID: PMC7222104 DOI: 10.1007/s00464-020-07538-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 03/31/2020] [Indexed: 11/28/2022]
Abstract
Background Since Rothenberg first performed thoracoscopic repair for esophageal atresia with distal tracheoesophageal fistula (EA/TEF) successfully in 2000, thoracoscopic repair has achieved status as a routine procedure worldwide. Previously, an international multicenter study reported that this procedure was not inferior to conventional open surgery. However, thoracoscopic surgery is a highly difficult operation for surgeons and anesthesiologists; as a result, the safety and efficacy of the surgery is still under debate. Considering these circumstances, the purpose of this study was to analyze the results of single-center thoracoscopic surgery and to compare the outcomes relative to the patient’s weight at the time of surgery. Methods We retrospectively analyzed patients with EA/TEF who underwent thoracoscopic surgery in a single center between October 2008 and February 2017. Results In total, 41 cases of thoracoscopic repair of EA/TEF were performed. Upon subgrouping by over and under 2000 g of body weight at the time of operation, 34 were found to be over 2000 g and seven were under 2000 g. Intraoperative factors and events were not significantly different between the two groups. Additionally, most of the postoperative outcomes, including the rate of postoperative leakage and strictures, showed no difference. On the other hand, the under 2000 g group had more gastroesophageal reflux requiring fundoplication than did the heavier group (P = 0.04). Conclusions The results of this center’s thoracoscopic repair of EA/TEF were not inferior to other centers’ outcomes. Additionally, the intraoperative and postoperative outcomes were similar despite differences in weight at operation. Therefore, thoracoscopic repair might be a feasible surgical option for infants weighing less than 2000 g when performed by a surgeon and anesthesiologist team who are experienced in pediatric thoracoscopic surgery.
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Affiliation(s)
- Joonhyuk Son
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Korea
| | - Yerang Jang
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Korea
| | - Wontae Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Korea
| | - Sanghoon Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Korea
| | - Ji Seon Jeong
- Department of Anesthesiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Suk-Koo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Korea
| | - Jeong-Meen Seo
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Korea.
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19
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Kang KY, Jung JY, Lee SK, Min HK, Hong YS, Park SH, Ju JH. Trabecular bone score value is associated with new bone formation independently of fat metaplasia on spinal magnetic resonance imaging in patients with ankylosing spondylitis. Scand J Rheumatol 2020; 49:292-300. [PMID: 32314620 DOI: 10.1080/03009742.2019.1704053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate the association between trabecular bone score (TBS) and new bone formation in ankylosing spondylitis (AS) patients, and to investigate whether TBS is independently associated with new bone formation. METHOD Sixty-eight patients with AS underwent spinal magnetic resonance imaging (MRI) and dual-energy X-ray absorptiometry of the lumbar spine to measure TBS and bone mineral density at baseline. Lateral radiographs of the cervical and lumbar spine (baseline and 2 years) were assessed for new bone formation (syndesmophyte formation and/or growth combined), and spinal MRIs were assessed for the presence or absence of fat metaplasia (FM) at the first to fourth lumbar vertebrae. The factors associated with new bone formation were analysed at the patient level and the vertebral level. RESULTS New bone formation had developed in 17 patients (25%) at 2 year follow-up. Patients with new bone formation had a higher prevalence of FM and lower TBS at baseline than patients without new bone formation (p = 0.013 and p = 0.041). At the patient level, FM on MRI and low TBS (< 1.23) were significantly associated with new bone formation. At the vertebral level, new bone formation had developed in 25 out of 231 vertebrae (11%) after 2 years. Vertebrae with both FM on MRI and low TBS tended to have more new bone formation (p < 0.001). Syndesmophytes and low TBS (< 1.23) independently increased the risk of new bone formation at the level of individual vertebrae. CONCLUSION At both patient and individual vertebral levels, low TBS was associated with new bone formation independently of FM on MRI.
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Affiliation(s)
- K Y Kang
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea.,Division of Rheumatology, Department of Internal Medicine, College of Medicine, Incheon Saint Mary's Hospital, The Catholic University of Korea , Incheon, Republic of Korea
| | - J-Y Jung
- Department of Radiology, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea
| | - S K Lee
- Department of Radiology, Dongguk University Ilsan Hospital , Gyenggi-do, Republic of Korea
| | - H K Min
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea
| | - Y S Hong
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea.,Division of Rheumatology, Department of Internal Medicine, College of Medicine, Incheon Saint Mary's Hospital, The Catholic University of Korea , Incheon, Republic of Korea
| | - S-H Park
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea
| | - J H Ju
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea
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20
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Kim A, Lee SK, Parupudi T, Rahimi R, Song SH, Park MC, Islam S, Zhou J, Majumdar AK, Park JS, Yoo JM, Ziaie B. An Ultrasonically Powered Implantable Microprobe for Electrolytic Ablation. Sci Rep 2020; 10:1510. [PMID: 32001732 PMCID: PMC6992771 DOI: 10.1038/s41598-020-58090-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 01/10/2020] [Indexed: 11/09/2022] Open
Abstract
Electrolytic ablation (EA) is a promising nonthermal tumor ablation technique that destroys malignant cells through induction of a locoregional pH change. EA is typically performed by inserting needle electrodes inside the tumor followed by application of direct current (DC), thus inducing electrolysis and creating localized pH changes around the electrodes. In this paper, we report an ultrasonically powered implantable EA microprobe that may increase the clinical relevance of EA by allowing wireless control over device operation (capability to remotely turn the device on and off) and providing flexibility in treatment options (easier to administer fractionated doses over a longer period). The wireless EA microprobe consists of a millimeter-sized piezoelectric ultrasonic receiver, a rectifier circuit, and a pair of platinum electrodes (overall size is 9 × 3 × 2 mm3). Once implanted through a minimally invasive procedure, the microprobe can stay within a solid tumor and be repeatedly used as needed. Ultrasonic power allows for efficient power delivery to mm-scale devices implanted deep within soft tissues of the body. The microprobe is capable of producing a direct current of 90 µA at a voltage of 5 V across the electrodes under low-intensity ultrasound (~200 mW/cm2). The DC power creates acidic (pH < 2) and alkaline (pH > 12.9) regions around the anode and the cathode, respectively. The pH change, measured using tissue-mimicking agarose gel, extends to 0.8 cm3 in volume within an hour at an expansion rate of 0.5 mm3/min. The microprobe-mediated EA ablative capability is demonstrated in vitro in cancer cells and ex vivo in mouse liver.
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Affiliation(s)
- A Kim
- Department of Electrical and Computer Engineering, Temple University, Philadelphia, PA, 19122, USA.
| | - S K Lee
- Jubilee Biotechnology LLC, Philadelphia, PA, 19122, USA
| | - T Parupudi
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, 47907, USA.,Birck Nanotechnology Center, West Lafayette, IN, 47907, USA
| | - R Rahimi
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, 47907, USA.,Birck Nanotechnology Center, West Lafayette, IN, 47907, USA
| | - S H Song
- Department of Electronic Engineering, Sookmyung Women's University, Seoul, South Korea
| | - M C Park
- Department of Electrical and Computer Engineering, Temple University, Philadelphia, PA, 19122, USA
| | - S Islam
- Department of Electrical and Computer Engineering, Temple University, Philadelphia, PA, 19122, USA
| | - J Zhou
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, 47907, USA.,Birck Nanotechnology Center, West Lafayette, IN, 47907, USA
| | - A K Majumdar
- Department of Electrical and Computer Engineering, Temple University, Philadelphia, PA, 19122, USA
| | - J S Park
- Pancreatobiliary Cancer Clinic, Department of Surgery, College of Medicine, Gangnam Severance Hospital, Yonsei University, Seoul, South Korea
| | - J M Yoo
- Department of Microbiology, School of Medicine, CHA University, Seongnam, South Korea
| | - B Ziaie
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, 47907, USA. .,Birck Nanotechnology Center, West Lafayette, IN, 47907, USA.
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21
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Kim KS, Kim JM, Lee JS, Choi GS, Cho JW, Lee SK. Stent insertion and balloon angioplasty for portal vein stenosis after liver transplantation: long-term follow-up results. ACTA ACUST UNITED AC 2020; 25:231-237. [PMID: 31063137 DOI: 10.5152/dir.2019.18155] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE It is not easy to determine whether balloon angioplasty or stenting should be performed in patients with portal vein stenosis after liver transplantation. We aimed to propose appropriate indication by evaluating long-term outcomes of balloon angioplasty and stent insertion in adult liver transplant patients. METHODS We retrospectively reviewed 31 patients with portal vein stenosis among 1369 patients who underwent adult liver transplantation from January 2001 to December 2015. When stenosis was confirmed by venography, angioplasty was performed first. When there was no flow improvement or pressure gradient was not decreased after angioplasty, stent insertion was performed. We also performed primary stent insertion without angioplasty for diffuse stenosis, kinking, external compression, and near occlusion of portal vein in venography. We assessed patency in patients who underwent percutaneous transluminal angioplasty and stent insertion through regular outpatient follow-up and evaluated technical and clinical success and long-term results. RESULTS Technical success was 85% and 100% in balloon angioplasty and stent insertion, respectively. Clinical success was achieved in 78% of balloon angioplasties and in 100% of stent insertions. At 1, 5, and 10 years after balloon angioplasty, patency rates were 87%, 82%, and 68% respectively, and the rates of stent patency were all 100%. Portal vein size measured during the operation of patients with and without recurrence were 19±4.2 mm and 19±3.0 mm (P = 0.956), respectively. The balloon size of patients with and without recurrence were 11±1.95 mm and 14±1.66 mm, respectively (P = 0.013), when balloon angioplasty was performed after stenosis diagnosis. CONCLUSION Stent insertion can be considered when fibrotic changes are expected due to repeated inflammation and when the balloon size to be used is small. Balloon angioplasty seems less risky for anastomotic ruptures in portal vein stenosis in the early post liver transplantation period.
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Affiliation(s)
- Kyeong Sik Kim
- Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jong Man Kim
- Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji Soo Lee
- Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Gyu Sung Choi
- Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae-Won Cho
- Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Suk-Koo Lee
- Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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22
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Park H, Kim MS, Lee J, Kim JH, Jeong BC, Lee S, Lee SK, Cho SY, Jin DK. Clinical Presentation and Treatment Outcomes of Children and Adolescents With Pheochromocytoma and Paraganglioma in a Single Center in Korea. Front Endocrinol (Lausanne) 2020; 11:610746. [PMID: 33584544 PMCID: PMC7879705 DOI: 10.3389/fendo.2020.610746] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 12/04/2020] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Pheochromocytoma (PCC) and paraganglioma (PGL) (PPGL) are rare neuroendocrine tumors, and data on managing these conditions in children and adolescents are lacking. The objective of this study was to demonstrate the clinical presentation and treatment outcomes in children and adolescents with PPGL in a single tertiary care center in Korea. METHODS This retrospective study included 23 patients diagnosed with PCC (n = 14) and PGL (n = 9) before the age of 21 at Samsung Medical Center (from June 1994 to June 2019). We describe age, gender, family history, clinical characteristics, laboratory findings, pathologic findings, therapeutic approaches, and treatment outcomes. RESULTS Of the 23 patients, 14 had PCC and nine had PGL. The median age at diagnosis was 16.8 years (range, 6.8-20.8 years). The common presenting symptoms were hypertension (n = 10), headache (n = 9), palpitation (n = 4), and sweating (n = 4). The plasma or 24-hour urine catecholamine and/or metabolite concentrations were markedly elevated in 22 patients with PPGL, but were normal in one patient with carotid body PGL. All tumors were visualized on computed tomography. Genetic tests were performed in 15 patients, and seven patients showed mutations in RET (n = 3), SDHB (n = 3), and VHL (n = 1). All patients underwent surgery, and complete excision was performed successfully. Three patients with metastasis underwent postoperative adjuvant therapy. CONCLUSION This study suggests that pediatric PPGL tends to be extra-adrenal and bilateral and shows a higher potential for genetic mutations. Considering the hereditary predisposition of pediatric PPGL, genetic screening tests are strongly recommended, and lifelong follow-up is needed to detect recurrence and metastasis. Further research with a larger sample size and routine genetic screening is needed to better understand the genetic conditions and long-term prognosis of PPGL.
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Affiliation(s)
- Hyojung Park
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Min-Sun Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jiwon Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jung-Han Kim
- Department of Pediatric Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Byong Chang Jeong
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sanghoon Lee
- Department of Pediatric Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Suk-Koo Lee
- Department of Pediatric Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sung Yoon Cho
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- *Correspondence: Sung Yoon Cho, ; orcid.org/0000-0003-2913-059X; Dong-Kyu Jin,
| | - Dong-Kyu Jin
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- *Correspondence: Sung Yoon Cho, ; orcid.org/0000-0003-2913-059X; Dong-Kyu Jin,
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23
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Kim JM, Joh JW, Choi GS, Lee SK. Generic Tacrolimus (Tacrobell ®) Shows Comparable Outcomes to Brand-Name Tacrolimus in the Long-Term Period After Adult Deceased Donor Liver Transplantation. Drug Des Devel Ther 2019; 13:4431-4438. [PMID: 32021085 PMCID: PMC6948198 DOI: 10.2147/dddt.s229114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 12/02/2019] [Indexed: 12/17/2022]
Abstract
Background Generic tacrolimus (Tacrobell®) is commonly used in liver transplant patients in Korea. No previous studies have assessed the long-term efficacy and safety of generic tacrolimus for adult deceased donor liver transplantation (DDLT) patients. The aim of the present study was to evaluate the long-term efficacy and safety of generic tacrolimus compared to brand-name tacrolimus (Prograf®) in adult DDLT recipients. Methods Two hundred sixty-five adult DDLTs were performed in our center between 2003 and 2017. To determine the efficacy and safety of generic tacrolimus, renal function (estimated glomerular filtration rate [eGFR] and creatinine), infectious complications, rejection-free survival rates, and patient survival rates were investigated. Results Of 265 patients, 193 were selected and divided into a generic tacrolimus group (n=147) and a brand-name group (n=46). Mean follow-up duration was 63.2 ± 44.3 months. The 1-year, 3-year, 5-year, and 10-year patient survival rates were 89.1%, 86.9%, 84.5%, and 75.2%, respectively, in the generic tacrolimus group and 95.7%, 88.9%, 86.3%, and 83.7% in the brand-name tacrolimus group. There were no statistically significant differences in the infectious complications, new-onset diabetes, and renal dysfunction included mean serum creatinine level or eGFR after DDLT between the two groups. Increased recipient age, continuous renal replacement therapy (CRRT) in the pre-transplant phase, and acute rejection were predisposing factors for patient death. Conclusion The present study shows that generic tacrolimus is an alternative comparable to brand-name tacrolimus in adult DDLT patients.
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Affiliation(s)
- Jong Man Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae-Won Joh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Gyu-Seong Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Suk-Koo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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24
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Shirreff L, Mathews A, Shapiro J, Cipolla AR, Lee SK, Po L, Murji A. Impact of Minimally Invasive Gynecology Fellowship Training on Patient Outcomes for Hysterectomy Procedures. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Shirreff L, Mathews A, Shapiro J, Cipolla AR, Lee SK, Po L, Murji A. Hysterectomies Completed in General Gynaecology: Can We Predict Likelihood of a Surgical Complication? J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.638] [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: 11/28/2022]
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26
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Park J, Kwon CHD, Choi GS, Lee SK, Kim JM, Oh J, Chung YJ, Kim KS, Lee JS, Lee KW, Kim GS, Gwak MS, Ko JS, Kwon JH, Kim K, Lee SH, Joh JW. One-Year Recipient Morbidity of Liver Transplantation Using Pure Laparoscopic Versus Open Living Donor Right Hepatectomy: Propensity Score Analysis. Liver Transpl 2019; 25:1642-1650. [PMID: 31271699 DOI: 10.1002/lt.25593] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 06/26/2019] [Indexed: 12/31/2022]
Abstract
Donor safety and graft results of pure laparoscopic living donor right hepatectomy (LLDRH) have previously been compared with those of open living donor right hepatectomy (OLDRH). However, the clinical outcomes of recipients at 1-year follow-up have never been accurately compared. We aimed to compare 1-year outcomes of recipients of living donor right liver transplantation (LRLT) using pure LLDRH and OLDRH. From May 2013 to May 2017, 197 consecutive recipients underwent LRLT. Donor hepatectomies were performed either by OLDRH (n = 127) or pure LLDRH (n = 70). After propensity score matching, 53 recipients were included in each group for analysis. The clinical outcomes at 1-year follow-up were compared between the 2 groups. The primary outcome was recipient death or graft failure during the 1-year follow-up period. In the propensity-matched analysis, the incidence of death or graft failure during the 1-year follow-up period was not different between the 2 groups (3.8% versus 5.7%; odds ratio [OR], 1.45; 95% confidence interval [CI], 0.24-8.95; P = 0.69). However, the composite of Clavien-Dindo 3b-5 complications was more frequent in the pure LLDRH group (OR, 2.62; 95% CI, 1.15-5.96; P = 0.02). In conclusion, although pure LLDRH affords a comparable incidence of fatal complications in recipients, operative complications may increase at the beginning of the program. The safety of the recipients should be confirmed to accept pure LLDRH as a feasible option.
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Affiliation(s)
- Jungchan Park
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Choon Hyuck David Kwon
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Gyu-Seong Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Suk-Koo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jong Man Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jongwook Oh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Young Jae Chung
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyeong Sik Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ji Soo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyo Won Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Gaab Soo Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Mi Sook Gwak
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Justin Sangwook Ko
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ji-Hye Kwon
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Keoungah Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seung Hwan Lee
- Department of Surgery, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - Jae Won Joh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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27
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Park J, Kwon DCH, Choi GS, Kim SJ, Lee SK, Kim JM, Lee KW, Chung YJ, Kim KS, Lee JS, Rhu J, Kim GS, Gwak MS, Ko JS, Lee JE, Lee S, Joh JW. Safety and Risk Factors of Pure Laparoscopic Living Donor Right Hepatectomy: Comparison to Open Technique in Propensity Score–matched Analysis. Transplantation 2019; 103:e308-e316. [DOI: 10.1097/tp.0000000000002834] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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28
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Lee SK, Baek J, Roh JY, Kim HJ. Clinical characteristics of pediatric cutaneous lupus erythematosus: experience from a tertiary referral center in Korea. Lupus 2019; 28:888-892. [DOI: 10.1177/0961203319851568] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The clinical characteristics of cutaneous lupus erythematosus (CLE) are well delineated in adults, but pediatric data, particularly in Asian populations, are limited. Therefore, we evaluated the characteristics of pediatric cases by retrospectively reviewing the medical records of children with CLE during a 15-year period in a tertiary care dermatology clinic in South Korea. The study included 21 children (8 males and 13 females), 4 of whom had neonatal lupus erythematosus (NLE). Among 17 patients with CLE, discoid lupus erythematosus (DLE) was most common (47.1%), followed by acute CLE (ACLE, 35.3%). All ACLE cases had systemic lupus erythematosus (SLE). Female predominance was conspicuous in ACLE/SLE (6/11 females versus 0/6 males), as was older age, whereas DLE and NLE showed near-equal sex distributions. The median age at the diagnosis of CLE was significantly higher in females than in males (15 years versus 4.5 years, p = 0.02). All patients with ACLE/SLE simultaneously showed skin and systemic symptoms from onset. The kidney was the most commonly involved organ. This study revealed unique characteristics of pediatric CLE, further warranting a comprehensive review among various ethnicities to understand the wide spectrum of CLE in the pediatric population.
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Affiliation(s)
| | | | | | - H J Kim
- Department of Dermatology, Gachon Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
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29
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Affiliation(s)
- Sanghoon Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Suk-Koo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Ahn HK, Park S, Hyun SH, Park K, Lee E, Kim JY, Nam SJ, Kim SW, Lee JE, Lee SK, Yu JH, Ahn JS, Im YH, Park YH. Abstract P3-08-12: PIK3CA mutations in breast cancer: Mutational landscape and clinical implications in ER+/HER2- subtype. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-08-12] [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
Introduction: PIK3CA mutation is one of the most frequent genomic alterations in breast cancer. We evaluated PIK3CA mutational status including spatial and temporal heterogeneity, clinical characteristics and prognostic impact focused on ER+/HER2- subtype.
Methods: We performed targeted ultra-deep sequencing (CancerSCAN™) of breast cancer tissue in a prospective cohort. Burden of disease was assessed by metabolic tumor volume(MTV) in 18F-FDG-PET scan. Association with clinical characteristics or survival were tested in ER+/HER2- subtype, using Chi square test or Kaplan-Meier method.
Results: PIK3CA analyses were performed in 1274 breast cancer specimens from 1091 patients. 957 patients had early breast cancer. PIK3CA alterations were found in 397 patients(36.3%), and frequency of PIK3CA mutation was significantly lower in triple negative breast cancer(19.0%), compared with 40.4% in ER+/HER2-, 40.9% in ER+/HER2+, and 45.2% in ER-/HER2+ subtype(p<0.0001). 158 patients had more than two biopsies. Among 92 patients with second biopsy within one month, 11%(10/92) had spatial heterogeneity of PIK3CA mutation. After neoadjuvant chemotherapy, 10%(3/30) of patients had change of PIK3CA mutational status. Serial biopsy at time of recurrence revealed loss or gain of PIK3CA mutation in 10 out of 59 patients (17%). In ER+/HER2- subtype, PIK3CA had a trend toward longer distant disease free survival without statistical significance. In patients with stage IV ER+/HER2- disease, PIK3CA hotspot mutations were associated with significant longer overall survival(OS) (71.0 vs. 37.8 months, p=0.048) and better progression free survival(PFS) at 1st line palliative treatment (37.7 vs. 9.4 months, p = 0.0004). Frequency of symptomatic recurrence, recurrence as oligometastases, and specific metastatic sites were not associated with PIK3CA mutational status, except that bone metastases at first distant metastases was less prevalent in patients with PIK3CA hotspot mutations(35.6% vs. 53.8% in PIK3CA wt, p=0.048). Metabolic tumor volume(MTV) at time of first distant metastases was not associated with presence of PIK3CA mutation.
Conclusion: We observed variations in PIK3CA mutational status in more than 10% of patients with >1 repeated biopsy. In stage IV ER+/HER2- disease, PIK3CA hotspot mutation seemed to be associated with longer PFS and OS, however metabolic tumor burden was not associated with PIK3CA alterations.
Citation Format: Ahn HK, Park S, Hyun SH, Park K, Lee E, Kim J-Y, Nam SJ, Kim SW, Lee JE, Lee SK, Yu JH, Ahn JS, Im Y-H, Park YH. PIK3CA mutations in breast cancer: Mutational landscape and clinical implications in ER+/HER2- subtype [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 P3-08-12.
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Affiliation(s)
- HK Ahn
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S Park
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SH Hyun
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - K Park
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - E Lee
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J-Y Kim
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SJ Nam
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SW Kim
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - JE Lee
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SK Lee
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - JH Yu
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - JS Ahn
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y-H Im
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - YH Park
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim JY, Park KH, Park WY, Nam SJ, Kim SW, Lee JE, Lee SK, Yu JH, Ahn JS, Im YH, Park YH. Abstract P1-09-11: Prognostication of genetic alterations of ESR 1 in estrogen receptor positive metastatic breast cancers using targeted ultra-deep sequencing data analysis. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-09-11] [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
Introduction: Genetic alteration of Estrogen Receptor 1(ESR1) gene have been associated with acquired endocrine resistance and occurred in about 20% of endocrine resistant estrogen receptor(ER)-positive metastatic breast cancer(MBC). Mutations in ligand binding domain of ESR1 lead to constitutive activity of the ER without ligand estrogen and stimulated down stream cell growth signal. Therefore, ESR1 ligand binding domain alteration is known resistant mechanism of aromatase inhibitor. Among these ESR1 mutations, Y537S, one of the ligand binding domain mutations, caused ER antagonist, fulvestrant resistance. Therefore, assessment of ESR1 mutation in ER-positive MBC had significant benefit to further precision medicine for MBCs. In this study, we explored to identify the frequency and type of ESR1 genetic alterations of ER-positive MBC.
Methods: We performed targeted ultra-deep sequencing (CancerSCAN™) using BC tissue specimens. This sequencing was covered entire coding area of ESR1 gene and also detected copy number alteration and translocation of ESR1.
Results: Targeted ultra-deep sequencing of ESR1 was performed using 990 BC tissues. Of 990 tissue samples, 341(34.5%) were MBCs. Of MBCs, 112(11.3%) were ER-positive and human epidermal growth factor receptor 2(HER2)-negative BCs. In ER-positive HER2-negative MBCs (N=112), 21 ESR1 genetic alterations were identified in 19 BCs (17.0%). Nineteen were single nucleotide variats (SNVs) and three were copy number (CN) amplification. Most commonly detected single nucleotide variant (SNV) was D538G (6 of 19, 31.6%) followed by Y537N, Y537S, V382I (4, 2 and 2 cases, respectively). Three mutations occurred in non-ligand binding domain (G415V, V392I and P79A). Two BC samples harbored two ESR1 mutations, respectively (Y537S and D538G, L536P and Y537N). In terms of treatment, 11 of 12 patients with ER-positive MBC harboring ESR1 mutation received palliative endocrine therapies. Eight patients received aromatase inhibitor and two patients received tamoxifen. One patient received letrozole plus palbociclib. In 2 MBCs with Y537S mutation, progression free survival (PFS) of endocrine therapy was 1.4 and 5.3 months. MBCs with D538G had 12.3months of PFS (range, 5.3-23.7(months)) and BCs harboring another ligand binding domain mutations (Y537N, L536H and L536P) had 15.7months of PFS of endocrine therapy (range, 8.4-17.3(months)). BC with mutation observed in non-lignand binding domain had short PFS (1.8 (V392I) and 2.7 (P79A) months, respectively). In terms of ESR1 CN amplification, patients could not receive endocrine therapy because their BCs rapidly progressed and extensive distant metastases were occurred within 3 months after curative surgery.
Conclusion: In this exploratory study, ESR1 genetic alterations were detected in about 20% of ER-positive MBC. The type of genetic alterations varied including SNVs, CNAs. Each locus of ESR1 mutation predicted endocrine resistance. In addition, we might suggest that ESR1 CN amplification is prognostic marker of ER-positive BCs.
Citation Format: Kim J-Y, Park KH, Park W-Y, Nam SJ, Kim SW, Lee JE, Lee SK, Yu JH, Ahn JS, Im Y-H, Park YH. Prognostication of genetic alterations of ESR 1 in estrogen receptor positive metastatic breast cancers using targeted ultra-deep sequencing data analysis [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 P1-09-11.
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Affiliation(s)
- J-Y Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - KH Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - W-Y Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SJ Nam
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SW Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - JE Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SK Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - JH Yu
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - JS Ahn
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y-H Im
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - YH Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim JY, Jung HH, Lim JE, Cho EY, Lee SK, Yu JH, Lee JE, Kim SW, Nam SJ, Park YH, Ahn JS, Im YH. Abstract P4-08-30: Prognostication of immune related gene expression in patients with triple negative breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-08-30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: To date, the role of immunotherapy with check point inhibitors and/or vaccines in the treatment of breast cancer (BC) is still debating, and the main focus of immunotherapy in BC is on triple negative subtype as a target population in many ongoing clinical trials. Translational research into identifying predictive and prognostic immune biomarkers is of particular clinical relevance, but, there are currently no definite prognostic and predictive immune biomarkers in BC, especially in triple negative breast cancer(TNBC). We investigated the expression profiles of immune genes in patients with TNBC to identify the prognostic value of immune genes in search of clinical implications.
Methods : We investigated expression profiles of 770 pan-cancer immune related genes using the nCounter mRNA expression assay (NanoString®) from paraffin-embedded tumor tissues in 200 patients diagnosed as TNBC who received curative surgery at Samsung Medical Center from 2000 to 2004. We analyzed the relationship between stage adjusted level of gene expressions and patients' survival outcomes using Cox regression model.
Results: Of 770 genes, 186 genes were selected from univariate analysis with clinical stage adjustment. In multivariate analysis using Cox regression, expressions of CD1B, CD45, CD53, CT45A1, GTF3C1, IL11RA, IL1RN, LRRN3, MAPK1, NEFL, PRKCE, SPACA3 and RANKL were associated with distant recurrence free survival (p<0.05, respectively). Among these 13 genes, expression of MAPK1, NEFL, CD45, SPACA3 and RANKL were correlated with favorable outcome in terms of distant recurrence free survival (p<0.05, respectively). In terms of overall survival, C3, IL1RL1, IL1RN, IL7 and PRKCE were associated with poor prognosis (p<0.05, respectively) and expression of SAA1 CXCL9 and RANKL resulted in favorable outcome (p<0.05, respectively).
Table 1ParameterParameter EstimateStandard Errorp-valueHazard Ratio95% Confidence Interval(a) distant recurrence free survival Stage2.487350.680570.000312.0293.169, 45.661CD1B1.141910.2753<.00013.1331.826, 5.374CD531.531650.34851<.00014.6262.336, 9.159CT45A10.426110.134210.00151.5311.177, 1.992GTF3C11.193110.579720.03963.2971.059, 10.271IL11RA1.671120.461750.00035.3182.151, 13.146IL1RN0.980280.24657<.00012.6651.644, 4.321LRRN31.424170.28742<.00014.1542.365, 7.297MAPK1-0.542740.258240.03560.5810.35, 0.964NEFL-1.12170.335610.00080.3260.169, 0.629PRKCE2.378340.49659<.000110.7874.076, 28.549CD45-2.736780.43154<.00010.0650.028, 0.151SPACA3-0.745930.272270.00610.4740.278, 0.809RANKL-1.288920.2976<.00010.2760.154, 0.494(b) overall survival Stage1.359280.497810.00633.8931.468, 10.329C30.329830.150350.02831.3911.036, 1.867CXCL9-0.379190.100680.00020.6840.562, 0.834IL1RL10.679360.262940.00981.9731.178, 3.303IL1RN0.437130.172370.01121.5481.104, 2.171IL70.507280.206250.01391.6611.109, 2.488PRKCE0.835340.272910.00222.3061.35, 3.936SAA1-0.564250.13449<.00010.5690.437, 0.74RANKL-0.604990.234510.00990.5460.345, 0.865
Conclusion: High expression of IL1RN, PRKCE were associated with short distant recurrence free survival and overall survival in patients with TNBCs who received curative surgery. In contrast, RANKL expression resulted in prolonged distant recurrence free survival and overall survival.
Citation Format: Kim J-Y, Jung HH, Lim JE, Cho EY, Lee SK, Yu JH, Lee JE, Kim SW, Nam SJ, Park YH, Ahn JS, Im Y-H. Prognostication of immune related gene expression in patients with triple negative breast cancer [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 P4-08-30.
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Affiliation(s)
- J-Y Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - HH Jung
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - JE Lim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - EY Cho
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - SK Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - JH Yu
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - JE Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - SW Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - SJ Nam
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - YH Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - JS Ahn
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - Y-H Im
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
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Kim I, Choi HJ, Ryu JM, Lee SK, Yu JH, Kim SW, Nam SJ, Seo SW, Lee JE. Abstract P2-08-52: A predictive model for distant metastasis in breast cancer patients using machine learning. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-08-52] [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
Introduction
Tumor metastasis is a major clinical challenge accounting for the vast majority of cancer related deaths.In previous studies, prediction of distant metastasis was based on subtypes,clinical status and sometimes gene expression were used however clinical application was difficult.
In this study, we develop the easy to use prediction tool for distant metastasis using clinical characteristics and gene profiles which came from CancerSCANTM, Next Generation Sequencing based targeted-sequencing platform designed at Samsung Medical Center(SMC).
Methods
We performed a retrospective chart review of 326 breast cancer patients who underwent surgery and CancerSCAN TM between Jan 2001 and Dec 2014 at SMC. Median follow up period was 83 months (Range 1˜190). Cancer scanTM cover 381 genes but 27 genes and 34 occasions (loss of function, mutation or copy number variation) were selected for analysis through gradient boosting and Wilcoxon Signed rank test. Azure Machine Learning is a cloud service that enables the execution of machine learning processes.This was accomplished using the steps of (1) edit the data, (2) split the data, (3) train the model, (4) score the model, and (5) evaluate the model. We split the modeling data into training and testing sets using a randomized 50–50 split. Two-class Decision Forest method was used. After deploying the Azure ML predictive model as a web service, we used a Representational State Transfer application programming interface to send data and obtained predictions in real-time.
Results
No distant metastasis group and distant metastasis group consisted of 267 and 59 patients, respectively. HR-/HER2+ and 50 years old and over patients were higher in metastasis group (p-value = 0.003 and p-value = 0.000). Nuclear grade 3 and N2,3 were higher in metastasis group (p-value = 0.010 and p-value = 0.000, p-value = 0.001 respectively). Stage III was also higher in metastasis group (p-value = 0.000). Among 59 patients with distantmetastasis, multiple sites metastasis was 21 cases (35.6%) and then lung metastasis was 19 cases (32.2%). In the 21 cases of multiple sites metastasis, triple sites was 6 cases (28.6%) and double sites was 15 cases (71.4%). PIK3CA mutation was the most frequent gene variation in all patients (34.5% of no metastasis group and 27.1% of metastasis group) but there was no difference between two groups(p-value = 0.278). BRCA 1 loss of function and BRCA2 loss of function were more frequent in metastasis group than no metastasis group(p-value = 0.033 and p-value = 0.024, respectively) but total counts was too small. We assessed the area under the curve (AUC) of the receiver operating characteristic (ROC) curve for predictive value. The AUC of ROC curve was 1.000 and also accuracy, precision, recall were 1.000. In addition, we conducted internal validation using 83 patients during 2015. When we applied a 0.5 threshold value with our predictive model, true negative was 81 and true positive was 2 among 83 patients. Finally, the accuracy of validation was 1.000.
Conclusion
Our predicted model could represent a useful and easy-to-access tool for the selection of patients with distant metastasis. After additional evaluation with large data and external validation, worldwide use of our model could be expected.
Citation Format: Kim I, Choi HJ, Ryu JM, Lee SK, Yu JH, Kim SW, Nam SJ, Seo SW, Lee JE. A predictive model for distant metastasis in breast cancer patients using machine learning [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 P2-08-52.
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Affiliation(s)
- I Kim
- Samsung Medical Center, Seoul, Gangnam-Gu, Korea
| | - HJ Choi
- Samsung Medical Center, Seoul, Gangnam-Gu, Korea
| | - JM Ryu
- Samsung Medical Center, Seoul, Gangnam-Gu, Korea
| | - SK Lee
- Samsung Medical Center, Seoul, Gangnam-Gu, Korea
| | - JH Yu
- Samsung Medical Center, Seoul, Gangnam-Gu, Korea
| | - SW Kim
- Samsung Medical Center, Seoul, Gangnam-Gu, Korea
| | - SJ Nam
- Samsung Medical Center, Seoul, Gangnam-Gu, Korea
| | - SW Seo
- Samsung Medical Center, Seoul, Gangnam-Gu, Korea
| | - JE Lee
- Samsung Medical Center, Seoul, Gangnam-Gu, Korea
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Kan Z, Lal S, Ding Y, Lee JE, Lee SH, Lee SK, Yu JH, Choi YL, Kim SW, Nam SJ, Kim JY, Ram S, Powell E, Ching K, Cho SY, Bonato V, Deng S, Park WY, Rejto P, Bienkowska J, Park YH. Abstract PD5-08: Neoadjuvant chemotherapy alters the genomic landscape and immune microenvironment of breast cancers. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd5-08] [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
Understanding how standard-of-care drug treatments affect tumor intrinsic biology and microenvironment is critical for elucidating drug resistance mechanisms and developing better combination therapies as well as new therapies. To characterize the effects of neoadjuvant chemotherapy (NAC) on the genome, transcriptome and tumor infiltrating leukocytes (TILs), we have conducted whole exome and whole transcriptome sequencing of a large longitudinal breast cancer cohort consisting of 146 cases and 281 paired tumor samples. In total, 52 (38%) patients achieved pathologic complete response (pCR) while 85 patients (62%) had residual disease with standard chemotherapy regimen. Tumor biopsies were collected for each patient at three time points – pre-treatment, three weeks after the first cycle of anthracycline and cyclophosphamide (AC) and at the time of surgery after 3 more cycles of AC followed by 4 cycles of taxane or taxane plus Herceptin in case of HER2+ subtype. We detected 5,955 protein-altering somatic mutations affecting 4,414 genes in pretreatment samples and 502 acquired mutations in surgery samples affecting 477 genes including 19recurrently mutated genes such as TP53 and NOTCH1. Across all subtypes, 4,346 genes were differentially expressed (DE) following NAC treatment and significantly enriched in pathways such as cell cycle, ER signaling, PI3K/mTOR, immune and metabolism. Expression-based virtual microdissection analysis indicated that NAC treatment induced an increase in the fractions of stromal and adjacent normal tissue compartment, consistent with observed reduction in tumor cellularity. To assess the NAC induced changes in the molecular landscape of these tumors, we compared molecular features including gene expression signatures, mutation prevalence and copy number alteration between three time points while adjusting for confounding effects of molecular subtype and tumor cellularity. We found that NAC induced dynamic changes in gene expression signatures associated with proliferation and immunomodulatory treatment response. We further validated the observed pattern of change in TILs through histopathology and digital imaging analyses. In pretreatment tumors, 116 genes were DE between patients with pCR vs. those with residual disease with significant enrichment in immune/inflammatory pathways. Further, pre-treatment TIL levels were found to be significantly associated with pCR, echoing previous reports in breast cancers that implicated anti-tumor immunity in mediating the efficacy of chemotherapies. Our analyses also revealed associations between NAC response and baseline genomic attributes such as genomic alterations that affect DNA damage repair pathways. Taken together, these results suggest that NAC induced a multitude of changes on the genomic landscape and immune microenvironment of breast cancers, some of which point to combination strategies with immunomodulatory therapies and therapies that target DNA damage repair.
Citation Format: Kan Z, Lal S, Ding Y, Lee JE, Lee S-H, Lee SK, Yu JH, Choi Y-l, Kim SW, Nam SJ, Kim J-Y, Ram S, Powell E, Ching K, Cho SY, Bonato V, Deng S, Park W-Y, Rejto P, Bienkowska J, Park Y-H. Neoadjuvant chemotherapy alters the genomic landscape and immune microenvironment of breast cancers [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 PD5-08.
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Affiliation(s)
- Z Kan
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - S Lal
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - Y Ding
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - JE Lee
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - S-H Lee
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - SK Lee
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - JH Yu
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - Y-l Choi
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - SW Kim
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - SJ Nam
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - J-Y Kim
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - S Ram
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - E Powell
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - K Ching
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - SY Cho
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - V Bonato
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - S Deng
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - W-Y Park
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - P Rejto
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - J Bienkowska
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - Y-H Park
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
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Choi HJ, Kim SW, Ryu JM, Kim I, Nam SJ, Yu J, Lee SK, Lee JE. Abstract P1-15-18: Not presented. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-15-18] [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
This abstract was not presented at the conference.
Citation Format: Choi HJ, Kim SW, Ryu JM, Kim I, Nam SJ, Yu J, Lee SK, Lee JE. Not presented [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 P1-15-18.
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Affiliation(s)
- HJ Choi
- Samsung Medical Center, Seoul, Korea
| | - SW Kim
- Samsung Medical Center, Seoul, Korea
| | - JM Ryu
- Samsung Medical Center, Seoul, Korea
| | - I Kim
- Samsung Medical Center, Seoul, Korea
| | - SJ Nam
- Samsung Medical Center, Seoul, Korea
| | - J Yu
- Samsung Medical Center, Seoul, Korea
| | - SK Lee
- Samsung Medical Center, Seoul, Korea
| | - JE Lee
- Samsung Medical Center, Seoul, Korea
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Kim JM, Choi HJ, Kim I, Ryu JM, Yu J, Lee JE, Kim SW, Nam SJ, Lee SK. Abstract P2-08-29: The impact of time interval between diagnosis and surgery in each type and stage of breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-08-29] [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
Background: There are many factors that might contribute to the delay of surgery in patients with breast cancer. Previous studies investigate the influence of delay of surgery, but they reported inconsistent results. The purpose of this study was to evaluate the impact of time of surgery on prognosis of breast cancer.
Methods: We performed a retrospective review of the patients with breast cancer, who received surgery between 1992 and 2009, by using data from Korea Breast Cancer Society Registry. Kaplan-Meier survival analysis and Cox regression model were used to evaluate the impact of time to surgery in breast cancer and subgroup analyses were performed for each disease stage and molecular subtype.
Result: A total 14727 patients were included for analysis. Delay of surgery more than 31 days was associated with worse survival for breast cancer [hazard ratio (HR) = 2.16; 95% confidence interval (CI), 1.936-2.408, p<0.001]. Subgroup analyses revealed that over 31 days of surgical delay were significantly associated with worse survival in hormone receptor positive and HER-2 negative (p<0.001), hormone receptor positive and HER-2 positive (p<0.001), hormone receptor negative and HER-2 positive (p<0.001), triple negative (p<0.001) and stage II, III breast cancer patients (p<0.001).
Conclusion: Surgical delay of more than 31 days were independent risk factors for worse outcome of breast cancer in each molecular subtype and breast cancer group except stage 0 and I. Although preoperative evaluation is required, surgical delay should be shortened to enhance survival of breast cancer, especially in patients with tumor size more than 2cm or presence of lymph node metastasis.
Citation Format: Kim J-M, Choi HJ, Kim I, Ryu JM, Yu J, Lee JE, Kim SW, Nam SJ, Lee SK. The impact of time interval between diagnosis and surgery in each type and stage of breast cancer [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 P2-08-29.
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Affiliation(s)
- J-M Kim
- Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - HJ Choi
- Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - I Kim
- Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - JM Ryu
- Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J Yu
- Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - JE Lee
- Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - SW Kim
- Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - SJ Nam
- Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - SK Lee
- Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Kim KS, Lee JS, Choi GS, Kwon CHD, Cho JW, Lee SK, Park KB, Cho SK, Shin SW, Kim JM. Long-term outcomes after stent insertion in patients with early and late hepatic vein outflow obstruction after living donor liver transplantation. Ann Surg Treat Res 2018; 95:333-339. [PMID: 30505825 PMCID: PMC6255746 DOI: 10.4174/astr.2018.95.6.333] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 02/14/2018] [Revised: 05/27/2018] [Accepted: 06/29/2018] [Indexed: 02/07/2023] Open
Abstract
Purpose The purpose of this study was to describe the long-term effects of stenting in patients with hepatic venous outflow obstruction (HVOO), who underwent living donor liver transplantation (LDLT). Methods Between January 2000 and December 2009, 622 adult patients underwent LDLT at our hospital, and of these patients, 21 (3.3%) were diagnosed with HVOO; among these patients, 17 underwent stenting. The patients were divided into early or late groups according to the time of their HVOO diagnoses (cutoff: 60 days after liver transplantation). Results The median follow-up period was 54.2 months (range, 0.5–192.4 months). Stent insertion was successful in 8 of 10 patients in the early group and 6 of 7 in the late group. The 5-year primary patency rates were 46% and 20%, respectively. In both groups, patients with recurrent HVOO at the beginning showed kinking confirmed by venography. Patients who carried their stents for more than 3 years maintained long-term patency. There was no significant difference in spleen size between groups; however, when the groups were compared according to whether they maintained patency, spleens tended to be smaller in the patency-maintained group. Conclusion Unlike stenosis, if kinking is confirmed on venography, stenting is not feasible in the long term for patients with LDLT.
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Affiliation(s)
- Kyeong Sik Kim
- Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Soo Lee
- Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gyu Sung Choi
- Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Choon Hyuck David Kwon
- Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Won Cho
- Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Suk-Koo Lee
- Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kwang Bo Park
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Ki Cho
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Wook Shin
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Man Kim
- Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Park J, Lee SH, Kim J, Park SJ, Park MS, Choi GS, Lee SK, Kim GS. Predictive Value of Intraoperative Pulmonary Vascular Resistance in Liver Transplantation. Liver Transpl 2018; 24:1680-1689. [PMID: 30240130 DOI: 10.1002/lt.25341] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 09/04/2018] [Indexed: 01/13/2023]
Abstract
We aimed to evaluate the association between intraoperative pulmonary vascular resistance (PVR) and clinical outcome of liver transplantation (LT). Cardiovascular involvement of end-stage liver disease is relatively common, and hemodynamic instability during LT can be fatal to recipients. However, the clinical impact of intraoperative PVR in LT remains undetermined. A total of 363 adult recipients with intraoperative right heart catheterization from January 2011 to May 2016 were analyzed. Patients were divided into 2 groups according to PVR. Two separate analyses were performed according to the time point of measurement: at the beginning and at the end of LT. The primary outcome was all-cause death or graft failure during the follow-up period. Increased PVR was observed in 11.8% (43/363) of recipients at the beginning and 12.7% (46/363) of recipients at the end of LT. PVR at the beginning of LT had no significant effect on the rate of death or graft failure in the multivariate analysis (hazard ratio [HR], 1.24; 95% confidence interval [CI], 0.64-2.38; P = 0.52). In contrast, PVR at the end of LT was significantly associated with death or graft failure during the overall follow-up period (HR, 2.00; 95% CI, 1.13-3.54; P = 0.02). In conclusion, PVR at the end of LT, rather than the beginning, is associated with clinical outcome. Larger trials are needed to support this finding.
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Affiliation(s)
- Jungchan Park
- Departments of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seung-Hwa Lee
- Division of Cardiology, Heart, Stroke and Vascular Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jeayoun Kim
- Departments of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Soo Jung Park
- Departments of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Myung Soo Park
- Department of Medicine, Dongtan Sacred Heart Hospital, Hallym University School of Medicine, Seoul, South Korea
| | - Gyu-Seong Choi
- Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Suk-Koo Lee
- Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Gaab Soo Kim
- Department of Medicine, Dongtan Sacred Heart Hospital, Hallym University School of Medicine, Seoul, South Korea
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Lee SH, Park M, Park KM, Gwag HB, Park J, Kim J, Choi GS, Lee SK, Kim GS. Corrected QT interval on the electrocardiogram after liver transplantation: Surrogate marker of poor clinical outcomes? PLoS One 2018; 13:e0206463. [PMID: 30365563 PMCID: PMC6203397 DOI: 10.1371/journal.pone.0206463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 10/13/2018] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Prolongation of corrected QT interval (QTc) on the electrocardiogram is associated with cardiac arrhythmia and sudden death. Changes in the QTc (corrected QT) interval before and after liver transplantation (LT) for the treatment of liver cirrhosis (LC) and its association with clinical outcomes have not been fully evaluated. METHODS From January 2011 to May 2016, consecutive 516 consecutive recipients were enrolled into LT registry and the median follow-up was 31 months (IQR 12-52). Patients with an available electrocardiogram before LT and 1 month after from LT were analyzed. Patients were divided into 2 groups according to prolonged QTc interval. The patient groups were analyzed separately according whether the electrocardiogram was preoperative or postoperative. The primary outcome was all-cause death during the follow-up period. RESULTS A total of 283 patients were enrolled in the study. In the preoperative QTc prolongation group, there was not a significant rate difference in all-cause mortality in multivariate analysis (hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.53-1.66; P = 0.26). However, in the postoperative QTc prolongation group, mortality was significantly increased (HR, 1.78; 95%CI, 1.05-3.03; P = 0.03) in patients who underwent LT. CONCLUSION In patients who underwent LT for LC, postoperative QTc prolongation on ECG, rather than preoperative, is associated with mortality. Larger clinical trials are needed to support this finding.
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Affiliation(s)
- Seung-Hwa Lee
- Department of Medicine, Heart, Stroke and Vascular Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Myungsoo Park
- Department of Medicine, Dongtan Sacred Heart Hospital, Hallym University School of Medicine, Seoul, Republic of Korea
| | - Kyoung-min Park
- Department of Medicine, Heart, Stroke and Vascular Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- * E-mail:
| | - Hye-bin Gwag
- Department of Medicine, Heart, Stroke and Vascular Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jungchan Park
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jeayoun Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Gyu-Seong Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Suk-Koo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Gaab Soo Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Park J, Choi GS, Gwak MS, Ko JS, Han S, Han B, Joh JW, Kim SJ, Lee SK, Kwon CD, Kim J, Cho CW, Kim GS. Intraoperative abortion of adult living donor liver transplantation: 15 cases from 1,179 cases in 20 years of experience in a single center. Ann Surg Treat Res 2018; 95:213-221. [PMID: 30310804 PMCID: PMC6172354 DOI: 10.4174/astr.2018.95.4.213] [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: 01/31/2018] [Revised: 04/10/2018] [Accepted: 05/07/2018] [Indexed: 11/30/2022] Open
Abstract
Purpose This study aimed to report intraoperative abortion of adult living donor liver transplantation (LDLT). Methods From June 1997 to December 2016, 1,179 adult LDLT cases were performed. 15 cases (1.3%) of intraoperative abortions in LDLT were described. Results Among 15 cases, 5 intraoperative abortions were donor-related, and remaining 10 cases were recipient-related. All donor-related abortions were due to unexpected steatohepatitis. Among remaining 10 recipient-related intraoperative abortions, unexpected extension of hepatocellular carcinoma was related in 5 cases. Two cases of intraoperative abortions were related to bowel inflammation, and 2 cases were associated with severe adhesion related to previous treatment. One recipient with severe pulmonary hypertension was also aborted. Conclusion Complete prevention of aborted LDLT is still not feasible. In this regard, further efforts to minimize intraoperative abortion are required.
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Affiliation(s)
- Jungchan Park
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gyu-Seong Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi Sook Gwak
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Justin Sangwook Ko
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sangbin Han
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Bobae Han
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Won Joh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Joo Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Suk-Koo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Choonhyuck David Kwon
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jongman Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chan Woo Cho
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gaab Soo Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Park J, Choi GS, Gwak MS, Ko JS, Han B, Han S, Joh JW, Lee SK, Kim J, Kim GS. A retrospective analysis of re-exploration after living donor right lobe liver transplantation: incidence, causes, outcomes, and risk factors. Transpl Int 2018; 32:141-152. [PMID: 30144356 DOI: 10.1111/tri.13335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 05/24/2018] [Accepted: 08/21/2018] [Indexed: 12/20/2022]
Abstract
Despite technical difficulties, right lobe liver grafting is preferred in living donor liver transplantation because of the graft size. Re-exploration after living donor right lobe liver transplantation (LRLT) has never been separately analyzed. We aimed to analyze the incidence, causes, outcomes, and risk factors of re-exploration after LRLT. We reviewed medical records of 1016 LRLT recipients from October 2003 to July 2017 and identified recipients who underwent re-exploration within hospital stay. Separate analyses were also performed according to cause of re-exploration. The overall incidence of re-exploration was 17.0% (173/1016). The most common cause of re-exploration was bleeding (50%). Overall re-exploration was associated with clinical outcome, but different results were shown on analyses according to cause of re-exploration. Risk factors of re-exploration were underlying hepatocellular carcinoma and operative duration [Odds ratio (OR), 1.49; 95% confidence interval (CI), 1.05-2.12; P = 0.03, and OR, 1.002; 95% CI, 1.001-1.004; P = 0.0023, respectively]. Re-exploration after LRLT is relatively common, and is strongly associated with mortality and graft failure.
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Affiliation(s)
- Jungchan Park
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gyu-Seong Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi Sook Gwak
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Justin Sangwook Ko
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Bobae Han
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sangbin Han
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Won Joh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Suk-Koo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jongman Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gaab Soo Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Chul Yoon K, Song S, Jwa EK, Lee S, Man Kim J, Kim OK, Kyun Hong S, Yi NJ, Lee KW, Soo Kim M, Hwang S, Suh KS, Lee SK. Survival Outcomes in Split Compared With Whole Liver Transplantation. Liver Transpl 2018; 24:1411-1424. [PMID: 29747216 DOI: 10.1002/lt.25196] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 12/20/2017] [Revised: 04/20/2018] [Accepted: 05/03/2018] [Indexed: 12/11/2022]
Abstract
Split-liver transplantation (SLT) should be cautiously considered because the right trisection (RTS) graft can be a marginal graft in adult recipients. Herein, we analyzed the outcomes of RTS-SLT in Korea, where >75% of adult liver transplantations are performed with living donor liver transplantation. Among 2462 patients who underwent deceased donor liver transplantations (DDLTs) from 2005 to 2014, we retrospectively reviewed 86 (3.5%) adult patients who received a RTS graft (RTS-SLT group). The outcomes of the RTS-SLT group were compared with those of 303 recipients of whole liver (WL; WL-DDLT group). Recipient age, laboratory Model for End-Stage-Liver Disease (L-MELD) score, ischemia time, and donor-to-recipient weight ratio (DRWR) were not different between the 2 groups (P > 0.05). However, malignancy was uncommon (4.7% versus 36.3%), and the donor was younger (25.2 versus 42.7 years) in the RST-SLT group than in the WL-DDLT group (P < 0.05). The technical complication rates and the 5-year graft survival rates (89.0% versus 92.8%) were not different between the 2 groups (P > 0.05). The 5-year overall survival (OS) rate (63.1%) and graft-failure-free survival rate (63.1%) of the RTS-SLT group were worse than that of the WL-DDLT group (79.3% and 79.3%; P < 0.05). The factors affecting graft survival rates were not definite. However, the factors affecting OS in the RTS-SLT group were L-MELD score >30 and DRWR ≤1.0. In the subgroup analysis, OS was not different between the 2 groups if the DRWR was >1.0, regardless of the L-MELD score (P > 0.05). In conclusion, a sufficient volume of the graft estimated from DRWR-matching could lead to better outcomes of adult SLTs with a RTS graft, even in patients with high L-MELD scores.
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Affiliation(s)
- Kyung Chul Yoon
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Sanghee Song
- Transplantation Center, Seoul National University Hospital, Seoul, South Korea
| | - Eun-Kyoung Jwa
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sanghoon Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jong Man Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ok-Kyoung Kim
- Transplantation Center, Seoul National University Hospital, Seoul, South Korea
| | - Suk Kyun Hong
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Nam-Joon Yi
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Kwang-Woong Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Myoung Soo Kim
- Department of Surgery and The Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, South Korea
| | - Shin Hwang
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University of Ulsan College of Medicine, Seoul, South Korea
| | - Kyung-Suk Suh
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Suk-Koo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Choi SY, Kang B, Choe JY, Lee Y, Jang HJ, Park HD, Lee SK, Choe YH. A Case of Glycogen Storage Disease IV with Rare Homozygous Mutations in the Glycogen Branching Enzyme Gene. Pediatr Gastroenterol Hepatol Nutr 2018; 21:365-368. [PMID: 30345254 PMCID: PMC6182483 DOI: 10.5223/pghn.2018.21.4.365] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/13/2018] [Accepted: 03/17/2018] [Indexed: 11/14/2022] Open
Abstract
Glycogen storage disease (GSD) IV is a rare autosomal recessive inherited disorder caused by mutations in the gene coding for glycogen branching enzyme leading to progressive liver disease. GSD IV is associated with mutations in GBE1, which encodes the glycogen branching enzyme. We report a case of GSD IV with rare homozygous mutations in the GBE1 gene (c.791G>A (p.Gly264Glu), which was successfully treated by liver transplantation.
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Affiliation(s)
- So Yoon Choi
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Pediatrics, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Ben Kang
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jae Young Choe
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yoon Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Hyo Jeong Jang
- Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
| | - Hyung-Doo Park
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Suk-Koo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yon Ho Choe
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Hwang KW, Choi JH, Jung SM, Kim YS, Lee SY, Chon MK, Lee SH, Kim JS, Park YH, Kim JH, Chun KJ, Je HG, Lee SK, Choi HO. P1520Defining the blanking period after maze procedure for atrial fibrillation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1520] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K W Hwang
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - J H Choi
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - S M Jung
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - Y S Kim
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - S Y Lee
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - M K Chon
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - S H Lee
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - J S Kim
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - Y H Park
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - J H Kim
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - K J Chun
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - H G Je
- Pusan National University Yangsan Hospital, Department of Cardiovascular and Thoracic Surgery, Yansan, Korea Republic of
| | - S K Lee
- Pusan National University Yangsan Hospital, Department of Cardiovascular and Thoracic Surgery, Yansan, Korea Republic of
| | - H O Choi
- Soonchunhyang University Hospital, Cardiology, Bucheon, Korea Republic of
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Kim YS, Hwang KW, Choi HO, Jung SM, Choi JH, Lee SY, Chun MK, Lee SH, Kim JS, Je HG, Park YH, Kim JH, Lee SK, Chun KJ. P4815Incidence of incomplete surgical left atrial appendage closure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4815] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Y S Kim
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - K W Hwang
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - H O Choi
- Soonchunhyang University Hospital, Department of internal medicine, Bucheon, Korea Republic of
| | - S M Jung
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - J H Choi
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - S Y Lee
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - M K Chun
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - S H Lee
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - J S Kim
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - H G Je
- Pusan National University, Department of Cardiovascular and Thoracic Surgery, Yangsan, Korea Republic of
| | - Y H Park
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - J H Kim
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - S K Lee
- Pusan National University, Department of Cardiovascular and Thoracic Surgery, Yangsan, Korea Republic of
| | - K J Chun
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
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Lee NJ, Shin JH, Lee SS, Park DH, Lee SK, Yoon HK. Transcatheter arterial embolization for iatrogenic bleeding after endoscopic ultrasound-guided pancreaticobiliary drainage. Diagn Interv Imaging 2018; 99:717-724. [PMID: 30033142 DOI: 10.1016/j.diii.2018.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 06/26/2018] [Accepted: 06/28/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE The purpose of this study was to report the incidence of massive bleeding after endoscopic ultrasound-guided transmural pancreaticobiliary drainage (EUS-TPBD) and the clinical outcomes in patients with this condition treated with transcatheter arterial embolization (TAE). PATIENTS AND METHODS We performed a 9-year retrospective analysis of 797 EUS-TPBD procedures (excluding gallbladder or pseudocysts) in 729 patients. Among them, twelve (12/729, 1.65%) patients were referred for TAE to manage active bleeding adjacent to the TPBD sites. There were 8 men and 4 women with a mean age of 66.1 years±13.4 (SD) (range: 45-89 years). The clinical and procedure data of these 12 patients were reviewed. RESULTS Thirteen TAE procedures in 12 patients were performed. The bleeding sites were the left hepatic artery (n=7), the right hepatic artery (n=3), the left gastric artery (n=1), the left accessory gastric artery (n=1) and gastroduodenal artery (n=1). TAE was performed with gelatin sponge particles (n=1), coil (n=1) and n-butyl-2 cyanoacrylate with/without coils (n=11), with technical and clinical success rates of 100% (13/13) and 85% (11/13), respectively. Re-bleeding following embolization with gelatin sponge particles occurred in one patient. Procedure-related ischemic hepatitis was observed in another patient with pancreatic cancer with portal vein involvement. CONCLUSION On the basis of our results, TAE using n-butyl-2 cyanoacrylate seems safe and effective for the treatment of bleeding after EUS-TPBD procedures. When the portal vein is compromised, TAE of the hepatic artery can cause ischemic liver damage.
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Affiliation(s)
- N J Lee
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - J H Shin
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea.
| | - S S Lee
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - D H Park
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - S K Lee
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - H-K Yoon
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
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Lee KW, Han S, Lee S, Ahn SH, Gwak M, Kim G, Joh JW, Lee SK, Kim SJ. Higher Risk of Post-Transplant Graft Failurein Male Recipients of Female Donor Grafts is not Due to Anastomosis Mismatch. Transplantation 2018. [DOI: 10.1097/01.tp.0000543978.49310.d2] [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: 11/25/2022]
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Kim HY, Lee JE, Ko JS, Gwak MS, Lee SK, Kim GS. Intraoperative management of liver transplant recipients having severe renal dysfunction: results of 42 cases. Ann Surg Treat Res 2018; 95:45-53. [PMID: 29963539 PMCID: PMC6024087 DOI: 10.4174/astr.2018.95.1.45] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 01/19/2018] [Accepted: 01/30/2018] [Indexed: 12/26/2022] Open
Abstract
Purpose Whereas continuous renal replacement therapy (CRRT) has been utilized during liver transplantation (LT), there was a lack of evidence to support this practice. We investigated the adverse events at the perioperative periods in recipients of LT who received preoperative CRRT without intraoperative CRRT. Methods We retrospectively reviewed medical records of adult patients (age ≥ 18 years) who received LT between December 2009 and May 2015. Perioperative data were collected from the recipients, who received preoperative CRRT until immediately before LT, because of refractory renal dysfunction. Results Of 706 recipients, 42 recipients received preoperative CRRT. The mean (standard deviation) Model for end-stage liver disease score were 49.6 (13.4). Twenty-six point two percent (26.2%) of recipients experienced the serum potassium > 4.5 mEq/L before reperfusion and treated with regular insulin. Thirty-eight point one percent (38.1%) of recipients were managed with sodium bicarbonate because of acidosis (base excess < −10 mEq/L throughout LT). All patients finished their operations without medically uncontrolled complications such as severe hyperkalemia (serum potassium > 5.5 mEq/L), refractory acidosis, or critical arrhythmias. Mortality was 19% at 30 day and 33.3% at 1 year. Conclusion Although intraoperative CRRT was not used in recipients with severe preoperative renal dysfunction, LT was safely performed. Our experience raises a question about the need for intraoperative CRRT.
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Affiliation(s)
- Ha Yeon Kim
- Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Ja Eun Lee
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Justin S Ko
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi Sook Gwak
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Suk-Koo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gaab Soo Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lee JS, Lee SH, Kim KS, Gil EM, Choi GS, Kim JM, Peck KR, Kwon CHD, Joh JW, Lee SK. Bacterial infection monitoring in the early period after liver transplantation. Ann Surg Treat Res 2018. [PMID: 29520350 PMCID: PMC5842088 DOI: 10.4174/astr.2018.94.3.154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose Infection remains the main cause of morbidity and mortality in liver transplantation (LT) recipients; however infection is notoriously difficult to diagnose because its usual signs and symptoms of infection may be masked or absent. This study comprises an analysis of bacterial infections in the early period after LT. Methods This is a study of 129 adults who underwent LT from January 2013 to December 2013, and it includes patients who were followed daily from the day of transplantation to 1-week posttransplantation using bacteriological cultures of blood, urine, sputum, and drained ascites. Results The following factors were significantly different between the positive and negative culture groups: living donor LT vs. deceased donor LT (odds ratio [OR], 3.269; P = 0.003), model for end-stage liver disease score (OR, 4.364; P < 0.001), and Child-Pugh classification (P = 0.007). Neither positive culture nor negative culture was associated with infection within 4 weeks of surgery (P = 0.03), and most events were due to surgical complications (75%). Conclusion Since the full effect of immunosuppression is not yet present during the first month after LT, we suggest that the number of bacterial culture test could be reduced such that they are performed every other day depending on patient's situation.
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Affiliation(s)
- Ji Soo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung Hwan Lee
- Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine,Seoul, Korea
| | - Kyeong Sik Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Mi Gil
- Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gyu-Seoung Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Man Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Choon Hyuck David Kwon
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Won Joh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Suk-Koo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim JY, Park K, Park WY, Nam SJ, Kim SW, Lee JE, Lee SK, Jung HH, Yu JH, Ahn JS, Im YH, Park YH. Abstract P6-09-08: Identification of ESR1 mutation in breast cancers using targeted ultra-deep sequencing data analysis. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-09-08] [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
Introduction: Estrogen Receptor 1 (ESR1) gene encodes an estrogen receptor, which regulates cell proliferation and promotes tumor progression in estrogen receptor(ER)-positive breast cancer (BC). Therefore, endocrine therapy that inhibiting ER downstream signal, is the most effective treatment strategy in ER-positive BC. However, about 25% of patients with primary disease and almost all patients with metastases will present with or eventually develop endocrine resistance. And genetic alteration of ESR1 is now identified as the endocrine resistance mechanism. However, a few data from clinical trials or public data base exists and could not reflect real world clinic. Therefore, we aimed to identify the frequency and type of ESR1 genetic alterations in BCs through this large scaled study.
Methods: We performed targeted ultra-deep sequencing (CancerSCAN™) using BC tissue specimens. This sequencing was covered entire coding area of ESR1 gene and also detected copy number alteration and translocation of ESR1.
Results: Targeted ultra-deep sequencing of ESR1 was performed using 618 BC tissues. Of 618 tissue samples, 253(40.9%) were MBCs, 362(58.6%) were early BCs (EBCs) and 3 were not identified. In terms of subtypes, 220 ER-positive BCs, 122 ER-positive and HER2-positive BCs, 119 HER2-positive and 153 triple-negative BCs (TNBCs) were included. BCs from patients under 40 year-old were 277(44.8%)(Median: 43.0, range: 23.5 -75.6). ESR1 genetic alterations were identified in 21 BCs (5 EBCs and 16 MBCs). In EBCs, 3 cases were observed in TNBCs and 2 cases were in ER-positive BCs (2.6% and 1.2%, respectively). All five EBC were treatment naïve status. Of 16 cases of ESR1 alterations in MBCs, 10 cases of ESR1 alterations were detected in ER-positive BCs (17.6%), 5cases in ER and HER2-positive BCs(6.7%) and 1 in HER2-positive BCs (1.2%). All ER-positive MBCs were treated with more than one line of endocrine therapy. Most commonly detected genetic alteration was single nucleotide variant (SNV) (15 of 21, 71.4%). Thirteen were in ligand binding domain and two cases occurred in activation function-1 (AF-1) domain (P79A and G145S). D538G and V392I were most frequently mutated loci followed by Y537N (3, 3 and 2 cases, respectively) and only metastatic ER-positive BCs harbored ESR1 activating mutation. Four copy number (CN) amplification in 2 ER-positive and 2 ER and HER2-positive BCs, one CN deletion in TNBC and one ESR1 fusion in ER and HER2-positive BC were also detected (19.0%, 4.8% and 4.8%, respectively). In frame ESR1 fusion was occurred between ESR1 and NPHS1 genes.
Conclusion: In this experimental study, ESR1 genetic alterations were frequently detected in ER-positive MBC but ER-negative or EBC also harbored. The type of genetic alterations varied including SNVs, CN alterations and translocation and ESR1-NPHS1 fusion is the novel genetic alteration that has not been reported. To identify the role of ESR1 genetic alteration in ER-negative BCs and novel translocation, further functional validation would be warranted (Clinical trials.gov Number :NCT02591966).
Citation Format: Kim J-Y, Park K, Park W-Y, Nam SJ, Kim SW, Lee JE, Lee SK, Jung HH, Yu JH, Ahn JS, Im Y-H, Park YH. Identification of ESR1 mutation in breast cancers using targeted ultra-deep sequencing data analysis [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-09-08.
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Affiliation(s)
- J-Y Kim
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - K Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - W-Y Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - SJ Nam
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - SW Kim
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - JE Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - SK Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - HH Jung
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - JH Yu
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - JS Ahn
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - Y-H Im
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - YH Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
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