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Kim YN, Jo JY, Park J, Lee J, Kim J, Jeon DY, Han H, Jung YC. Challenge for Trade-Off Relationship between the Mechanical Property and Healing Efficiency of Self-Healable Polyimide. ACS Appl Mater Interfaces 2023; 15:54923-54932. [PMID: 37916291 DOI: 10.1021/acsami.3c12594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
Polyimide is actively applied in various industrial fields because of its strong mechanical properties, owing to the interactions between the polymer chains. Fully aromatic imide structures exhibit high glass-transition temperatures due to the strong interactions between their chains, which hinder chain mobility. Therefore, preparing a material that exhibits self-healing at a low temperature of ≤100 °C and good mechanical properties is challenging. Thus, we prepared imides with four-component semiaromatic structures by adjusting the contents of 4,4'-(hexafluoroisopropylidene)diphthalic anhydride and 4,4'-(4,4'-isopropylidenediphenoxy)bis(phthalic anhydride) to yield four-component self-healable colorless polyimides (f-SH-CPIs) with novel structures, flexibilities, good mechanical properties, and low healing temperatures. The flexibilities and distances between the polymer chains, as the basis of the trade-off relationship between the mechanical properties and healing efficiency, were controlled. These materials may be used as substrates in wearable devices and multilayer insulation that may protect from space dust, cosmic rays, and satellite fragments.
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Affiliation(s)
- Young Nam Kim
- Institute of Advanced Composite Materials, Korea Institute of Science and Technology (KIST), 92 Chudong-ro, Bongdong-eup, Wanju-gun, Jeonbuk 55324, Republic of Korea
| | - Jun Young Jo
- Institute of Advanced Composite Materials, Korea Institute of Science and Technology (KIST), 92 Chudong-ro, Bongdong-eup, Wanju-gun, Jeonbuk 55324, Republic of Korea
- Department of Chemical and Biomolecular Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon 34141, Republic of Korea
| | - Jimin Park
- Institute of Advanced Composite Materials, Korea Institute of Science and Technology (KIST), 92 Chudong-ro, Bongdong-eup, Wanju-gun, Jeonbuk 55324, Republic of Korea
| | - Juheon Lee
- Department of Chemical and Biomolecular Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Jaewoo Kim
- Institute of Advanced Composite Materials, Korea Institute of Science and Technology (KIST), 92 Chudong-ro, Bongdong-eup, Wanju-gun, Jeonbuk 55324, Republic of Korea
| | - Dae-Young Jeon
- Department of Electrical Engineering, Gyeongsang National University, Jinju, Gyeongnam 52828, Republic of Korea
| | - Haksoo Han
- Department of Chemical and Biomolecular Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Yong Chae Jung
- Institute of Advanced Composite Materials, Korea Institute of Science and Technology (KIST), 92 Chudong-ro, Bongdong-eup, Wanju-gun, Jeonbuk 55324, Republic of Korea
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Im DH, Kim YN, Cho EH, Kim DH, Byun JM, Jeong DH. Risk Factors and Pregnancy Outcomes of Antepartum Hemorrhage in Women with Placenta Previa. Reprod Sci 2023; 30:2728-2735. [PMID: 36940086 PMCID: PMC10480293 DOI: 10.1007/s43032-023-01191-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 02/01/2023] [Indexed: 03/21/2023]
Abstract
Placenta previa (PP) is one such complication related to several adverse pregnancy outcomes. Adverse outcomes are likely greater if PP coexists with antepartum hemorrhage (APH). This study aims to evaluate the risk factors and pregnancy outcomes of APH in women with PP. This retrospective case-control study included 125 singleton pregnancies with PP who delivered between 2017 and 2019. Women with PP were divided into two groups: PP without APH (n = 59) and PP with APH (n = 66). We investigated the risk factors associated with APH and compared the differences between both groups in placental histopathology lesions due to APH and the resulting maternal and neonatal outcomes. Women with APH had more frequent antepartum uterine contractions (33.3% vs. 10.2%, P = .002) and short cervical length (< 2.5 cm) at admission (53.0% vs. 27.1%, P = .003). The placentas from the APH group had lower weight (442.9 ± 110.1 vs. 488.3 ± 117.7 g, P = .03) in the gross findings, and a higher rate of villous agglutination lesions (42.4% vs. 22.0%, P = .01) in the histopathologic findings. Women with APH in PP had higher rates of composite adverse pregnancy outcomes (83.3% vs. 49.2%, P = .0001). Neonates born to women with APH in PP had worse neonatal outcomes (59.1% vs. 23.9%, P = .0001). Preterm uterine contractions and short cervical length were the most significant risk factors for APH in PP.
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Affiliation(s)
- Do Hwa Im
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, 75 Bokji-Ro, Busanjin-Gu, Busan, 473920, South Korea
| | - Young Nam Kim
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, 75 Bokji-Ro, Busanjin-Gu, Busan, 473920, South Korea.
- Paik Institute for Clinical Research, Busan Paik Hospital, Inje University, Busan, South Korea.
| | - Eun Hye Cho
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, 75 Bokji-Ro, Busanjin-Gu, Busan, 473920, South Korea
| | - Da Hyun Kim
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, 75 Bokji-Ro, Busanjin-Gu, Busan, 473920, South Korea
| | - Jung Mi Byun
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, 75 Bokji-Ro, Busanjin-Gu, Busan, 473920, South Korea
- Paik Institute for Clinical Research, Busan Paik Hospital, Inje University, Busan, South Korea
| | - Dae Hoon Jeong
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, 75 Bokji-Ro, Busanjin-Gu, Busan, 473920, South Korea
- Paik Institute for Clinical Research, Busan Paik Hospital, Inje University, Busan, South Korea
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Tewari C, Kim YN, Muramatsu H, Endo M, Kim YA, Jung YC. Development and Optimization of Water-Soluble Double-Walled Carbon Nanotubes by Effective Surface Treatment of Inner Walls. Langmuir 2023; 39:6698-6704. [PMID: 37130267 DOI: 10.1021/acs.langmuir.3c00092] [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] [Indexed: 05/04/2023]
Abstract
Carbon nanotubes are a significant class of nanomaterials with distinctive properties that have led to their application in a variety of fields, such as polymer composites, medicine, electronics, and material science. However, their nonpolar nature and insolubility in polar solvents limit their applications. To address this issue, highly functionalized and water-soluble double-walled carbon nanotubes (DWNTs) were developed by selectively oxidizing the inner walls of the DWNTs using oleum and nitric acid. The impact of reaction time on the chemical functionalization of DWNTs was investigated under two different reaction durations of 2 and 24 h. The presence of highly oxygenated functional groups resulted in high water solubility, which was confirmed by high- and low-frequency Raman spectroscopy, high-resolution transmission electron microscopy (TEM), scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), Brunauer-Emmett-Teller (BET) method, and optical spectroscopy. The conductivity of highly water-soluble W-DWNTs (24 h) was 122.65 × 102 S cm-1. After annealing for 12 h at 140 °C, the W-DWNTs retained 72% of their conductivity (88.79 × 102 S cm-1).
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Affiliation(s)
- Chetna Tewari
- Institute of Advanced Composite Materials, Korea Institute of Science and Technology (KIST), 92 Chudong-ro, Bongdong-eup, Wanju-gun, Jeonbuk 55324, Republic of Korea
| | - Young Nam Kim
- Institute of Advanced Composite Materials, Korea Institute of Science and Technology (KIST), 92 Chudong-ro, Bongdong-eup, Wanju-gun, Jeonbuk 55324, Republic of Korea
| | - Hiroyuki Muramatsu
- Faculty of Engineering, Shinshu University, Wakasato, Nagano-shi 380-8553, Japan
| | - Morinobu Endo
- Global Aqua Innovation Center, Shinshu University, Wakasato, Nagano-shi 380-8553, Japan
| | - Yoong Ahm Kim
- School of Polymer Science and Engineering, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Republic of Korea
| | - Yong Chae Jung
- Institute of Advanced Composite Materials, Korea Institute of Science and Technology (KIST), 92 Chudong-ro, Bongdong-eup, Wanju-gun, Jeonbuk 55324, Republic of Korea
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Byun JM, Cho HJ, Lee DS, Yoon HK, Kim YN, Im DH, Kim DH, Lee KB, Sung MS, Jeong DH. Frequency of serous tubal intraepithelial carcinoma (STIC) in patients with high grade serous ovarian cancer. Taiwan J Obstet Gynecol 2023; 62:107-111. [PMID: 36720520 DOI: 10.1016/j.tjog.2022.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE Serous tubal intraepithelial carcinoma (STIC) is a known precursor of high-grade serous ovarian cancer (HGSOC). This study aimed to evaluate the proportion of STIC in patients with HGSOC and analyze the STIC-related prognosis in patients with HGSOC. MATERIALS AND METHODS All pathology reports at our institution that included bilateral salpingectomies of patients with HGSOC from January 2013 to December 2018 were reviewed by two experienced pathologists. The specimens from the ovaries and the salpinx including fimbria were examined. We analyzed the correlation between STIC and HGSOC and compared the clinical characteristics and STIC-related prognostic outcomes in patients with HGSOC. RESULTS Eleven of the 76 cases were STIC. BRCA mutations were found in 16.9% of patients with HGSOC. STIC was observed in 30.0% of patients with BRCA mutations and in 14.3% of patients without BRCA mutations. The incidence of STIC in patients with BRCA mutations was approximately twice that in patients without BRCA mutations; however, the difference was not statistically significant (P = 0.231). Further, the 5-year survival rate of patients without STIC appeared to be high; nevertheless, the difference was not statistically significant (59.7% vs. 47.4%, P = 0.633). Moreover, there was no significant difference in disease-free survival rate according to STIC (36.4% vs. 33.1%, P = 0.956). CONCLUSION STIC was identified in patients with HGSOC, and STIC incidence was prominent in HGSOC related to BRCA mutation. Although low frequency, STIC was detected in patients without BRCA mutation. Therefore, prophylactic salpingectomy may be useful for prevention of HGSOC.
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Affiliation(s)
- Jung Mi Byun
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, South Korea; Paik Institute for Clinical Research, Inje University, College of Medicine, South Korea.
| | - Hwa Jin Cho
- Department of Pathology, Inje University, College of Medicine, South Korea
| | - Dae Sim Lee
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, South Korea; Paik Institute for Clinical Research, Inje University, College of Medicine, South Korea
| | - Hye Kyoung Yoon
- Department of Pathology, Inje University, College of Medicine, South Korea
| | - Young Nam Kim
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, South Korea; Paik Institute for Clinical Research, Inje University, College of Medicine, South Korea
| | - Do Hwa Im
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, South Korea
| | - Da Hyun Kim
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, South Korea
| | - Kyung Bok Lee
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, South Korea; Paik Institute for Clinical Research, Inje University, College of Medicine, South Korea
| | - Moon Su Sung
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, South Korea; Paik Institute for Clinical Research, Inje University, College of Medicine, South Korea
| | - Dae Hoon Jeong
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, South Korea; Paik Institute for Clinical Research, Inje University, College of Medicine, South Korea.
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Jeong H, Ryu S, Kim YN, Ha YM, Tewari C, Kim SY, Kim JK, Jung YC. Easy, Fast Self-Heating Polyurethane Nanocomposite with the Introduction of Thermally Annealed Carbon Nanotubes Using Near-Infrared Lased Irradiation. Materials (Basel) 2022; 15:ma15238463. [PMID: 36499964 PMCID: PMC9740191 DOI: 10.3390/ma15238463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/17/2022] [Accepted: 11/24/2022] [Indexed: 05/20/2023]
Abstract
In this study, high-crystallinity single walled carbon nanotubes (H-SWNTs) were prepared by high-temperature thermal annealing at 1800 °C and a self-heating shape memory polyurethane nanocomposite with excellent self-heating characteristics was developed within a few seconds by irradiation with near-infrared rays. With a simple method (heat treatment), impurities at the surface of H-SWNTs were removed and at the same time the amorphous structure converted into a crystalline structure, improving crystallinity. Therefore, high conductivity (electric, thermal) and interfacial affinity with PU were increased, resulting in improved mechanical, thermal and electric properties. The electrical conductivity of neat polyurethane was enhanced from ~10-11 S/cm to 4.72 × 10-8 S/cm, 1.07 × 10-6 and 4.66 × 10-6 S/cm, while the thermal conductivity was enhanced up to 60% from 0.21 W/mK, 0.265 W/mK and 0.338 W/mK for the composites of 1, 3 and 5 wt%, respectively. Further, to achieve an effective photothermal effect, H-SWNTs were selected as nanofillers to reduce energy loss while increasing light-absorption efficiency. Thereafter, near-infrared rays of 818 nm were directly irradiated onto the nanocomposite film to induce photothermal properties arising from the local surface plasmon resonance effect on the CNT surface. A self-heating shape memory composite material that rapidly heated to 270 °C within 1 min was developed, even when only 3 wt.% of H-SWNTs were added. The results of this study can be used to guide the development of heat-generating coating materials and de-icing materials for the wing and body structures of automobiles or airplanes, depending on the molding method.
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Affiliation(s)
- Hyunsung Jeong
- Institute of Advanced Composite Materials, Korea Institute of Science and Technology (KIST), 92 Chudong-ro, Bongdong-eup, Wanju-gun 55324, Republic of Korea
- School of Chemical Engineering Building, Sungkyunkwan University, II2066 Seobu-ro, Jangan-gu, Suwon 16419, Republic of Korea
| | - Sooyeon Ryu
- Institute of Advanced Composite Materials, Korea Institute of Science and Technology (KIST), 92 Chudong-ro, Bongdong-eup, Wanju-gun 55324, Republic of Korea
- Carbon Materials and Engineering, Jeonbuk National University, Baekje-daero, Deokjin-gu, Jeonju-si 54896, Republic of Korea
| | - Young Nam Kim
- Institute of Advanced Composite Materials, Korea Institute of Science and Technology (KIST), 92 Chudong-ro, Bongdong-eup, Wanju-gun 55324, Republic of Korea
| | - Yu-Mi Ha
- Advanced Materials Division, Korea Research Institute of Chemical Technology (KRICT), 141 Gajeong-Ro, Yuseong-gu, Daejeon 34114, Republic of Korea
| | - Chetna Tewari
- Institute of Advanced Composite Materials, Korea Institute of Science and Technology (KIST), 92 Chudong-ro, Bongdong-eup, Wanju-gun 55324, Republic of Korea
| | - Seong Yun Kim
- Carbon Materials and Engineering, Jeonbuk National University, Baekje-daero, Deokjin-gu, Jeonju-si 54896, Republic of Korea
| | - Jung Kyu Kim
- School of Chemical Engineering Building, Sungkyunkwan University, II2066 Seobu-ro, Jangan-gu, Suwon 16419, Republic of Korea
| | - Yong Chae Jung
- Institute of Advanced Composite Materials, Korea Institute of Science and Technology (KIST), 92 Chudong-ro, Bongdong-eup, Wanju-gun 55324, Republic of Korea
- Correspondence: ; Tel.: +82-63-219-8153
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Im DH, Kim YN, Cho HJ, Kwon MJ, Yoon HK, Kim DH, Min BJ, Byun JM, Jeong DH. Prenatal differential diagnosis of placental mesenchymal dysplasia and molar disease with coexistent live twin fetuses. CLIN EXP OBSTET GYN 2022. [DOI: 10.31083/j.ceog4911254] [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: 11/17/2022]
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Kim YN, Chang YS, Cho KR, Kim BY. A Case of Massive Subcutaneous Emphysema and Pneumomediastinum Due to Dehiscence of Stoma After Emergent Tracheostomy. Ear Nose Throat J 2022; 102:307-311. [PMID: 36124380 DOI: 10.1177/01455613221129435] [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] [Indexed: 11/15/2022] Open
Abstract
Tracheostomy is commonly performed on patients who require long-term ventilator support. As with all other airway managements, tracheostomy comes with risks: tracheal scarring, tracheal rupture, pneumothorax, and tracheoesophageal fistula. Although rare, free air leakage into the surrounding tissues of the tracheostomy site and consequent pneumomediastinum can also occur due to various reasons, such as tracheal rupture and mispositioning of the tracheal tube. Such conditions may require treatments including high flow oxygen, ventilator management, and occasionally surgical intervention. In our case of a 61-year-old female, emergent tracheostomy was performed and subsequent complications of massive pneumomediastinum and subcutaneous emphysema were treated with negative pressure wound therapy. The follow-up radiograph after negative pressure wound therapy showed resolution of pneumomediastinum and subcutaneous emphysema, and there were no additional complications. Negative pressure wound therapy is an effective treatment option for massive pneumomediastinum and subcutaneous emphysema after tracheostomy.
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Affiliation(s)
- Young Nam Kim
- Departments of Otorhinolaryngology--Head and Neck Surgery, 65509Inje University Sanggye Paik Hospital, Nowon-gu, Korea
| | - Young-Soo Chang
- Departments of Otorhinolaryngology--Head and Neck Surgery, 65509Inje University Sanggye Paik Hospital, Nowon-gu, Korea
| | - Kyoung Rai Cho
- Departments of Otorhinolaryngology--Head and Neck Surgery, 65509Inje University Sanggye Paik Hospital, Nowon-gu, Korea
| | - Bo Young Kim
- Departments of Otorhinolaryngology--Head and Neck Surgery, 65509Inje University Sanggye Paik Hospital, Nowon-gu, Korea
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Um S, Her J, Kim SH, Song SA, Kim YN, Shin JH. Performance of BD MAX Group B Streptococcus (GBS) Assay without Enrichment for the Detection of GBS. Ann Lab Med 2022; 42:478-481. [PMID: 35177569 PMCID: PMC8859559 DOI: 10.3343/alm.2022.42.4.478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/29/2021] [Accepted: 12/03/2021] [Indexed: 11/21/2022] Open
Abstract
Group B streptococcus (GBS) is an important pathogen causing neonatal early-onset disease. We evaluated the diagnostic performance of BD Max GBS assay (Becton Dickinson, Franklin Lakes, NJ, USA) without enrichment (direct BDM) for detecting GBS using vaginal and rectal specimens in comparison with culture. In total, 716 specimens collected from 358 pregnant women between June 2018 and May 2020 were included in this study. Bacterial culture was performed using ChromID Strep B agar (bioMérieux, Marcy-l’Étoile, France), and species identification results were confirmed using the VITEK-MS system (bioMérieux). The sensitivity of direct BDM for vaginal and rectal specimens was 75.0% and 100%, respectively. Thirteen specimens showed discrepant results: 10 false-negative results in the vaginal specimens and three false-positive results in the rectal specimens. The overall agreement between direct BDM and culture was 98.9% (354/358). The final sensitivity and specificity of direct BDM were 98.5% and 99.0%, respectively. Discrepant results—one false-negative and three false-positives—were obtained for four specimens. Direct BDM shows a good diagnostic performance and will be useful for GBS screening within a few hours.
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Affiliation(s)
- Sewhan Um
- Inje University College of Medicine, Busan, Korea
| | - Jaeyoung Her
- Inje University College of Medicine, Busan, Korea
| | - Si Hyun Kim
- Department of Clinical Laboratory Science, Semyung University, Jecheon, Korea
| | - Sae Am Song
- Department of Laboratory Medicine, Inje University College of Medicine, Busan, Korea
| | - Young Nam Kim
- Department of Obstetrics and Gynecology, Inje University College of Medicine, Busan, Korea
| | - Jeong Hwan Shin
- Department of Laboratory Medicine, Inje University College of Medicine, Busan, Korea.,Paik Institute for Clinical Research, Inje University College of Medicine, Busan, Korea
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Hwa Im D, Kim YN, Cho HJ, Park YH, Kim DH, Byun JM, Jeong DH, Lee KB, Sung MS. Placental Pathologic Changes Associated with Fetal Growth Restriction and Consequent Neonatal Outcomes. Fetal Pediatr Pathol 2021; 40:430-441. [PMID: 32056478 DOI: 10.1080/15513815.2020.1723147] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
To evaluate the pathological changes of the placenta to determine the mechanism underlying placenta-derived fetal growth restriction (FGR) and investigate its influence on neonatal outcomes. Study design: This retrospective case-control study included 120 singleton pregnancies with FGR as well as 120 gestational age-matched controls. We compared the placental pathological findings and neonatal outcomes according to the presence of placental malperfusion. Results: The FGR group demonstrated lower placental weight (350.8 ± 118.8 vs. 436.1 ± 109.7g, P < .0001), smaller chorionic plate area (157.7 ± 48.0 vs. 201.5 ± 53.4 cm2, P < .0001), and higher rate of villous change lesions (84.2% vs. 52.5%, P < .0001) than the control group. FGR neonates with placental malperfusion had a higher rate of adverse neonatal outcomes (87.1% vs. 63.2%, P = .0175). Conclusion: Small placentas and placental malperfusion reflected in villous changes are associated with FGR. FGR neonates with placental malperfusion are more susceptible to adverse neonatal outcomes.
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Affiliation(s)
- Do Hwa Im
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, Korea (the Republic of)
| | - Young Nam Kim
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, Korea (the Republic of).,Paik Inje Memorial Institute for Clinical Medicine Research, Pusan, Korea (the Republic of)
| | - Hwa Jin Cho
- Department of Pathology, Inje University Busan Paik Hospital, Busan, Korea (the Republic of)
| | - Yong Hee Park
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, Korea (the Republic of)
| | - Da Hyun Kim
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, Korea (the Republic of)
| | - Jung Mi Byun
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, Korea (the Republic of).,Paik Inje Memorial Institute for Clinical Medicine Research, Pusan, Korea (the Republic of)
| | - Dae Hoon Jeong
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, Korea (the Republic of).,Paik Inje Memorial Institute for Clinical Medicine Research, Pusan, Korea (the Republic of)
| | - Kyung Bok Lee
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, Korea (the Republic of).,Paik Inje Memorial Institute for Clinical Medicine Research, Pusan, Korea (the Republic of)
| | - Moon Su Sung
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, Korea (the Republic of)
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Kim TH, Kim NH, Kim JD, Kim YN, Kim YJ, Kim EJ, Yoo KD, Ryu CH, Song HH, Kim H. Transarterial chemoembolization using drug-eluting bead compared with radiofrequency ablation for treatment of single small hepatocellular carcinoma: a pilot non-randomized trial. J Liver Cancer 2021; 21:146-154. [PMID: 37383084 PMCID: PMC10035690 DOI: 10.17998/jlc.2021.05.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/20/2021] [Accepted: 05/27/2021] [Indexed: 06/30/2023]
Abstract
Background/Aims Surgical resection, transplantation, and radiofrequency ablation (RFA) are generally accepted as amenable treatments for small hepatocellular carcinoma (HCC). Recently drug-eluting beads (DEB) which had several treatment advantages were introduced for transarterial chemoembolization (TACE). The aim of this study was to evaluate feasibility and safety of DEB-TACE compared with RFA for the treatment of single small HCC. Methods In this pilot non-randomized trial, we assessed retrospective data of 40 patients who underwent DEB-TACE (n=21) or RFA (n=19) for single small (≤3 centimeter in greatest dimension) HCC. The primary outcomes were tumor response and time to recurrence. The secondary outcome was treatment-related complications. Results Complete response rate to DEB-TACE and RFA after first follow-up assessment was 90.5% and 94.7%, respectively (P=1.000). During mean follow-up of 87.6 months (95% confidence interval, 74.4-102), 7 patients experienced local recurrence. The 6- and 12-month cumulative local recurrence rate was 5.0% and 21.8% in DEB-TACE vs. 11.1% and 17.0% in RFA group (P=0.877). A total 14 distant intrahepatic recurrences were developed and 12- and 24-month cumulative distant intrahepatic recurrence rate was 20.6% and 42.7% in DEB-TACE vs. 17.2% and 36.3% in RFA group (P=0.844). Two patients experienced gangrenous cholecystitis after DEB-TACE requiring cholecystectomy as treatment-related adverse event. Conclusions Tumor response and recurrence rate after single session of DEB-TACE or RFA were similar. DEB-TACE could be applied selectively in patients with a single small HCC if the other therapeutic modality is unfeasible.
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Affiliation(s)
- Tae Hoon Kim
- Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea
| | - Na Hye Kim
- Yonsei University College of Medicine, Seoul, Korea
| | - Jin Dong Kim
- Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea
| | - Young Nam Kim
- Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea
| | - Yu Jin Kim
- Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea
| | - Eun Jung Kim
- Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea
| | - Ki Deok Yoo
- Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea
| | - Choong Heon Ryu
- Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea
| | - Ha Hun Song
- Department of Radiology, Cheju Halla General Hospital, Jeju, Korea
| | - Hyun Kim
- Department of Radiology, Cheju Halla General Hospital, Jeju, Korea
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Kim YN, Jung JH, Park SB. Changes in high-sensitivity C-reactive protein levels and metabolic indices according to grip strength in Korean postmenopausal women. Climacteric 2021; 25:306-310. [PMID: 34423694 DOI: 10.1080/13697137.2021.1965116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE This study aimed to investigate the changes in high-sensitivity C-reactive protein (hs-CRP) level and metabolic indices such as blood pressure, serum lipid level and serum glucose level according to grip strength in postmenopausal women. METHOD Data from participants (postmenopausal women) in the Seventh Korea National Health and Nutrition Examination Survey 2018 were analyzed. Absolute handgrip strength was the sum of the maximal grip strength of both hands, and relative handgrip was calculated as absolute handgrip divided by the body mass index. We performed linear regression analysis after adjusting for confounders to assess the influence of grip strength on hs-CRP level and metabolic indices. RESULTS Linear regression analysis showed that after adjusting for confounders, with an increased absolute grip strength, systolic blood pressure and hs-CRP levels were decreased; however, the changes were not significant for the remaining indices. Relative grip strength was associated with hs-CRP levels and metabolic indices. With a high relative grip strength, hs-CRP, blood pressure, fasting blood glucose, hemoglobin A1c and triglyceride levels were decreased, while the high-density lipoprotein cholesterol level was increased. CONCLUSION Our study evaluated the overall health status using grip strength in postmenopausal women. The grip strength adjusted by body size was suitable in evaluating the overall health status, including inflammatory and metabolic indices. Additionally, increased grip strength was associated with a better health status in postmenopausal women.
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Affiliation(s)
- Y N Kim
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Republic of Korea
| | - J-H Jung
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Republic of Korea
| | - S B Park
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Republic of Korea
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12
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Lee S, Kim YN, Im D, Cho SH, Kim J, Kim JH, Kim K. DNA Methylation and gene expression patterns are widely altered in fetal growth restriction and associated with FGR development. Anim Cells Syst (Seoul) 2021; 25:128-135. [PMID: 34262655 PMCID: PMC8253195 DOI: 10.1080/19768354.2021.1925741] [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] [Indexed: 11/13/2022] Open
Abstract
Fetal growth restriction (FGR) is the failure of the fetus toachieve its genetically determined growth potential, which increasesrisks for a variety of genetic diseases, such as type 2 diabetes mellitus, coronary artery disease, and stroke, during the lifetime. The dysregulation of DNA methylationis known to interact with environmental fluctuations, affect gene expressions comprehensively, and be fatal to fetus development in specific cases. Therefore, we set out to find out epigenetic and transcriptomic alterations associated with FGR development. We found a set of differentially expressed genes associated with differentially methylated regions in placentae and cord blood samples. Using dimensional reduction analysis, the expression and methylation variables of the epigenetically altered genes classified the FGR samples from the controls. These genes were also enriched in the biological pathways such as metabolism and developmental processes related to FGR. Furthermore, three genes of INS, MEG3, and ZFP36L2 are implicated in epigenetic imprinting, which has been associated with FGR. These results strongly suggest that DNA methylation is highly dysregulated during FGR development, and abnormal DNA methylation patterns are likely to alter gene expression.
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Affiliation(s)
- Seoyeong Lee
- Department of Biology, Kyung Hee University, Seoul, Republic of Korea
| | - Young Nam Kim
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, Busan, Republic of Korea
| | - DoHwa Im
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, Busan, Republic of Korea
| | - Su Han Cho
- Department of Life and Nanopharmaceutical Sciences, Kyung Hee University, Seoul, Republic of Korea
| | - Jiyeon Kim
- Department of Life and Nanopharmaceutical Sciences, Kyung Hee University, Seoul, Republic of Korea
| | - Jeong-Hyun Kim
- Department of Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kwoneel Kim
- Department of Biology, Kyung Hee University, Seoul, Republic of Korea.,Department of Life and Nanopharmaceutical Sciences, Kyung Hee University, Seoul, Republic of Korea
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Ha YM, Kim YN, Jung YC. Rapid and Local Self-Healing Ability of Polyurethane Nanocomposites Using Photothermal Polydopamine-Coated Graphene Oxide Triggered by Near-Infrared Laser. Polymers (Basel) 2021; 13:1274. [PMID: 33919935 PMCID: PMC8070893 DOI: 10.3390/polym13081274] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 11/23/2022] Open
Abstract
In this study, we report the self-healing ability of polyurethane (PU) nanocomposites based on the photothermal effect of polydopamine-coated graphene oxide (PDA-rGO). Polydopamine (PDA) was coated on the graphene oxide (GO) surface, while simultaneously reducing GO by the oxidation of dopamine hydrochloride in an alkaline aqueous solution. The PDA-rGO was characterized by Fourier-transform infrared spectroscopy, X-ray diffraction, Raman spectroscopy, thermogravimetric analysis, and scanning electron microscopy-energy-dispersive X-ray analysis. PDA-rGO/PU nanocomposites with nanofiller contents of 0.1, 0.5 and 1 wt% were prepared by ex situ mixing method. The photothermal effect of the PDA-rGO in the PU matrix was investigated at 0.1 W/cm2 using an 808 nm near-infrared (NIR) laser. The photothermal properties of the PDA-rGO/PU nanocomposites were superior to those of the GO/PU nanocomposites, owing to an increase in the local surface plasmon resonance effect by coating with PDA. Subsequently, the self-healing efficiency was confirmed by recovering the tensile stress of the damaged nanocomposites using the thermal energy generated by the NIR laser.
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Affiliation(s)
| | | | - Yong Chae Jung
- Institute of Advanced Composite Materials, Korea Institute of Science and Technology (KIST), 92 Chudong-ro, Bongdong-eup, Wanju-gun, Jeollabuk-Do 55324, Korea; (Y.-M.H.); (Y.N.K.)
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14
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Byun JM, Cho HJ, Park HY, Lee DS, Choi IH, Kim YN, Jeong CH, Kim DH, Hwa Im D, Min BJ, Lee KB, Sung MS, Jeong DH. The clinical significance of HERV-H LTR -associating 2 expression in cervical adenocarcinoma. Medicine (Baltimore) 2021; 100:e23691. [PMID: 33429737 PMCID: PMC7793359 DOI: 10.1097/md.0000000000023691] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 11/15/2020] [Indexed: 01/05/2023] Open
Abstract
HERV-H LTR -associating 2 (HHLA2) is a recently discovered member of the B7-family of immune checkpoint molecules that is overexpressed in several types of cancer. The aim of the present study was to investigate the expression of HHLA2 in cervical adenocarcinoma (AC) and the relationship between its expression and clinicopathological factors to assess its use as a potential marker for AC prognosis.This study included 76 patients diagnosed with cervical AC. Their resected specimens were obtained and a tissue microarray was constructed. Expression of HHLA2 was detected by the immunohistochemistry. Based on the follow-up data, correlation of HHLA2 expression and clinicopathological features, including overall survival (OS) and disease-free survival, was evaluated. Furthermore, we investigated the correlation between the expression of HHLA2 and programmed death ligand 1 (PD-L1).A total of 76 cases of invasive cervical AC were evaluated. High HHLA2 expression was detected in 62 cases (81.6%) and low HHLA2 expression was presented in 14 cases (18.4%). HHLA2 expression showed a significant negative correlation with lymph node metastasis (P = .011). Disease free survival was 75.0% and 49.0% in high-expression and the low expression group, respectively (P = .057). Although there was no statistical significance, an improved OS was observed in the high expression group (83.1% vs 64.9%, P = .479). Further, the expression of HHLA2 and PD-L1 correlated positively (P = .005). Thus, an improved OS was observed in the PD-L1 expression group (90.7% vs 66.2%, P = .037).High expression of HHLA2 is related to tumor progression and prognosis in patients with cervical AC. Therefore, HHLA2 may be a potential biomarker for predicting prognosis of cervical AC.
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Affiliation(s)
- Jung Mi Byun
- Department of Obstetrics and Gynecology, Inje University, College of Medicine, Busan Paik Hospital
- Paik Institute for Clinical Research, Inje University, College of Medicine
| | - Hwa Jin Cho
- Department of Pathology, Inje University, College of Medicine, Busan Paik Hospital
| | - Ha Young Park
- Department of Pathology, Inje University, College of Medicine, Busan Paik Hospital
| | - Dae Sim Lee
- Department of Obstetrics and Gynecology, Inje University, College of Medicine, Busan Paik Hospital
- Paik Institute for Clinical Research, Inje University, College of Medicine
| | - In Hak Choi
- Department of Microbiology and Immunology
- Innovative Therapeutics Research Institute (ITRI)
| | - Young Nam Kim
- Department of Obstetrics and Gynecology, Inje University, College of Medicine, Busan Paik Hospital
- Paik Institute for Clinical Research, Inje University, College of Medicine
| | - Chul Hoi Jeong
- Department of Obstetrics and Gynecology, Inje University, College of Medicine, Haeundae Paik Hospital, South Korea
| | - Da Hyun Kim
- Department of Obstetrics and Gynecology, Inje University, College of Medicine, Busan Paik Hospital
| | - Do Hwa Im
- Department of Obstetrics and Gynecology, Inje University, College of Medicine, Busan Paik Hospital
| | - Byoung Jin Min
- Department of Obstetrics and Gynecology, Inje University, College of Medicine, Busan Paik Hospital
| | - Kyung Bok Lee
- Department of Obstetrics and Gynecology, Inje University, College of Medicine, Busan Paik Hospital
| | - Moon Su Sung
- Department of Obstetrics and Gynecology, Inje University, College of Medicine, Busan Paik Hospital
| | - Dae Hoon Jeong
- Department of Obstetrics and Gynecology, Inje University, College of Medicine, Busan Paik Hospital
- Paik Institute for Clinical Research, Inje University, College of Medicine
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15
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Hu HJ, Lee MY, Cho DY, Oh M, Kwon YJ, Han YJ, Ryu HM, Kim YN, Won HS. Prospective clinical evaluation of Momguard non-invasive prenatal test in 1011 Korean high-risk pregnant women. J OBSTET GYNAECOL 2019; 40:1090-1095. [PMID: 31826681 DOI: 10.1080/01443615.2019.1680617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Clinical performance of the Momguard non-invasive prenatal test (NIPT) was evaluated in a cohort of Korean pregnant women. The foetal trisomies 21, 18 and 13 (T21, T18 and T13) were screened by low-coverage massive parallel sequencing in the maternal blood. Among the 1011 confirmed samples, 32 cases (3.2%) had positive NIPT results. Of these positive cases, 20 cases of T21, all cases of T18 and two cases of T13 had concordant karyotype findings. Only one case out of the remaining 979 negative NIPT samples showed a false negative result. The overall sensitivity and specificity of Momguard to detect the three chromosomal aneuploidies were 96.8% and 99.8%, respectively. Momguard is a clinically useful tool for the detection of T21, T18 and T13 in singleton pregnancy. However, as other NIPT tests, it carries the risk of false positive and false negative results. Hence, the genetic counsellors should provide these limitations to the examinees.Impact StatementWhat is already known on this subject? The NIPT approach using massive parallel sequencing (MPS) showed high sensitivity and specificity in various clinical studies. These results are based on analysis systems using their own bioinformatics algorithms.What the results of this study add? When this NIPT technology was introduced in Korea, the first biological specimens collected in Korea were transported overseas for processing in overseas laboratories and analysed by other country's analysis methods. We needed our own NIPT algorithm and developed Momguard NIPT for the first time in Korea. This study attempted to evaluate this Momguard NIPT protocol prospectively in a large number of samples obtained from three Korean hospitals.What the implications are of these findings for clinical practice and/or further research? The overall sensitivity and specificity to identify T13, T18 and T21 were 96.8% and 99.8%, respectively. These accuracy values were comparable to that of other studies. From this study, we found that Momguard is a clinically useful tool for the detection of three chromosomal aneuploidies. However, as other NIPT tests, it carries the risk of false positive and false negative results. Hence, the genetic counsellors should provide these limitations to the examinees.
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Affiliation(s)
- Hae-Jin Hu
- LabGenomics Clinical Research Institute, LabGenomics, Seongnam, Korea
| | - Mi-Young Lee
- Department of Obstetrics and Gynaecology, University of Ulsan College of Medicine, Asan Medical Centre, Seoul, Korea
| | - Dae-Yeon Cho
- LabGenomics Clinical Research Institute, LabGenomics, Seongnam, Korea
| | - Mijin Oh
- LabGenomics Clinical Research Institute, LabGenomics, Seongnam, Korea
| | - Young-Jun Kwon
- LabGenomics Clinical Research Institute, LabGenomics, Seongnam, Korea
| | - You-Jung Han
- Department of Obstetrics and Gynaecology, CHA Gangnam Medical Centre, CHA University, Seoul, Korea
| | - Hyun Mee Ryu
- Department of Obstetrics and Gynaecology, CHA Bundang Medical Centre, CHA University, Seongnam, Korea
| | - Young Nam Kim
- Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Hye-Sung Won
- Department of Obstetrics and Gynaecology, University of Ulsan College of Medicine, Asan Medical Centre, Seoul, Korea
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16
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Byun JM, Lee DS, Landen CN, Kim DH, Kim YN, Lee KB, Sung MS, Park SG, Jeong DH. Arsenic trioxide and tetraarsenic oxide induce cytotoxicity and have a synergistic effect with cisplatin in paclitaxel-resistant ovarian cancer cells. Acta Oncol 2019; 58:1594-1602. [PMID: 31257975 DOI: 10.1080/0284186x.2019.1630750] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background: Arsenic compounds (As2O3 and As4O6) have demonstrated anticancer effects in various malignancies. In this study, the cytotoxicity of arsenic compounds on ovarian cancer cell lines and the anticancer activity of the combination of arsenic compounds and cisplatin IN chemoresistant ovarian cancer cells were investigated.Methods: We investigated the cytotoxicity of As2O3 and As4O6 and their combinations with cisplatin in the paclitaxel-sensitive ovarian cancer cell lines SKOV3ip1 and HeyA8 and paclitaxel-resistant ovarian cancer cell lines SKOV3TRip2 and HeyA8-MDR. Growth and apoptosis were evaluated by MTT assay and annexin V assay using flow cytometry, respectively. For detection of apoptotic cells, immunofluorescence was performed using a cleaved caspase-3 antibody. Cell-cycle distribution was determined by propidium iodide staining and flow cytometry.Results: Treatment of each cell line with As2O3 or As4O6 led to a marked dose-dependent inhibition of cell growth. As2O3 and As4O6 treatment induced caspase-3-dependent apoptosis in all cell lines compared to the respective control groups (p < .05). As2O3 and As4O6 induced apoptosis of paclitaxel-sensitive and -resistant cancer cell lines following G2/M cell cycle arrest (p < .05). A synergistic effect was achieved by combining cisplatin with As2O3 or As4O6 in the paclitaxel-resistant ovarian cancer cell lines.Conclusions: As2O3 and As4O6 can inhibit cell growth and induce apoptosis in paclitaxel-sensitive and -resistant ovarian cancer cell lines. Their combination with cisplatin resulted in a synergistic effect in paclitaxel-resistant cancer cell lines. These results suggest that arsenic compounds may be given in monotherapy or combination therapy with cisplatin for treating paclitaxel-resistant ovarian cancer.
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Affiliation(s)
- Jung Mi Byun
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, Busan, South Korea
- College of Medicine, Paik Institute for Clinical Research, Inje University, Busan, South Korea
| | - Dae Sim Lee
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, Busan, South Korea
- College of Medicine, Paik Institute for Clinical Research, Inje University, Busan, South Korea
| | - Charles N. Landen
- Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, VA 22908, USA
| | - Da Hyun Kim
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, Busan, South Korea
- College of Medicine, Paik Institute for Clinical Research, Inje University, Busan, South Korea
| | - Young Nam Kim
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, Busan, South Korea
- College of Medicine, Paik Institute for Clinical Research, Inje University, Busan, South Korea
| | - Kyung Bok Lee
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, Busan, South Korea
- College of Medicine, Paik Institute for Clinical Research, Inje University, Busan, South Korea
| | - Moon Su Sung
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, Busan, South Korea
- College of Medicine, Paik Institute for Clinical Research, Inje University, Busan, South Korea
| | - Sae Gwang Park
- College of Medicine, Paik Institute for Clinical Research, Inje University, Busan, South Korea
- Department of Microbiology, Inje University, College of Medicine, Busan, South Korea
| | - Dae Hoon Jeong
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, Busan, South Korea
- College of Medicine, Paik Institute for Clinical Research, Inje University, Busan, South Korea
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Shin SK, Lee JW, Ra H, Kwon OS, Shin JB, Jin YJ, Lee S, Han KJ, Kim YN, Kim TH, Kim YS, Kim JH. Durability of Sustained Virologic Response and Improvement of Fibrosis Markers after Daclatasvir and Asunaprevir Treatment in Genotype 1b Hepatitis C Virus-Infected Patients: a Real Life and Multicenter Study. J Korean Med Sci 2019; 34:e264. [PMID: 31650719 PMCID: PMC6813423 DOI: 10.3346/jkms.2019.34.e264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 09/03/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The long-term data with direct acting antiviral agents were rare. This study investigated the durability of a sustained virologic response (SVR) and the improvement of fibrosis after daclatasvir and asunaprevir (DCV/ASV) treatment in genotype 1b (GT1b) hepatitis C virus (HCV)-infected patients. METHODS A total of 288 HCV GT1b patients without baseline non-structural 5A (NS5A) resistance-associated substitution (RAS) treated with DCV/ASV were enrolled. Virologic response was measured at 12 weeks and 1 year after treatment completion. In cirrhotic patients, liver function, aspartate transaminase to platelet ratio index (APRI), FIB-4 index, fibrosis index (FI), and liver stiffness measurement (LSM) at baseline and 1 year after treatment completion were evaluated. RESULTS SVR12 was obtained in 278 patients (96.5%). Six patients who checked NS5A RAS after treatment failure were RAS positive. Only one patient showed no durability of SVR. In cirrhotic patients who achieved SVR12 (n = 59), the changes of albumin (3.8 [2.2-4.7] to 4.3 [2.4-4.9] g/dL; P < 0.001), platelet count (99 [40-329] to 118 [40-399] × 10³/mm³; P < 0.001), APRI (1.8 [0.1-14.8] to 0.6 [0.1-4.8]; P < 0.001), FIB-4 index (5.45 [0.6-32.8] to 3.3 [0.4-12.2]; P < 0.001), FI (5.5 [0.6-32.8] to 3.3 [0.4-12.2]; P < 0.001), and LSM (17.2 [5.3-48.0] to 11.2 [3.7-28.1] kPa; P = 0.001) between baseline and 1 year after treatment completion were observed. CONCLUSION DCV/ASV treatment for HCV GT1b infected patients without RAS achieved high SVR rates and showed durable SVR. Cirrhotic patients who achieved SVR12 showed the improvement of liver function and fibrosis markers.
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Affiliation(s)
- Seung Kak Shin
- Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Jin Woo Lee
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Hannah Ra
- Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Oh Sang Kwon
- Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
| | - Jong Beom Shin
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Young Joo Jin
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Sangheun Lee
- Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea
| | - Ki Jun Han
- Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea
| | - Young Nam Kim
- Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea
| | - Tae Hun Kim
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Yun Soo Kim
- Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Ju Hyun Kim
- Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
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Park YH, Kim YN, Im DH, Kim DH, Byun JM, Jeong DH, Lee KB, Sung MS. Neonatal outcomes between discordant monochorionic and dichorionic twins. J Matern Fetal Neonatal Med 2019; 34:2080-2088. [PMID: 31416367 DOI: 10.1080/14767058.2019.1657085] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES This study aimed to compare obstetrical complications and neonatal outcomes between monochorionic and dichorionic discordant twin pregnancies. STUDY DESIGN We enrolled 296 patients with twin pregnancy who delivered at Busan Paik Hospital between January 2014 and December 2017. The prevalence of obstetrical complications, neonatal mortality between monochorionic and dichorionic twins was compared. We also investigated whether there is a difference in neonatal outcome and neonatal morbidity between monochorionic discordant twins without monochorionic-specific complications and dichorionic discordant twins. RESULTS The risk of fetal death in utero (13.2 versus 5.2%, p = .025) and inter twin birth weight discordance (35.1 versus 20.8%, p = .031) is increased in monochorionic twins than in dichorionic twins. However, no difference was noted in obstetrical complication and neonatal mortality and morbidity between two groups. Among twin pregnancies with intertwin birth weight discordance, after excluding fetal death in utero and monochorionic specific complication, there was no difference in obstetrical complication and neonatal mortality and morbidity according to chorionicity. There was no difference in neonatal morbidity between monochorionic twins and dichorionic twins when comparing larger neonates and smaller neonates of each group. CONCLUSIONS Risk of birth weight discordance is higher in monochorionic twin but no significant difference was observed in maternal outcomes, neonatal mortality and morbidity between noncomplicated monochorionic and dichorionic discordant twins.
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Affiliation(s)
- Yong Hee Park
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Busan, Republic of Korea
| | - Young Nam Kim
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Busan, Republic of Korea.,Paik Institute for Clinical Research, Busan Paik Hospital, Inje University, Busan, Republic of Korea
| | - Do Hwa Im
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Busan, Republic of Korea
| | - Da Hyun Kim
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Busan, Republic of Korea
| | - Jung Mi Byun
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Busan, Republic of Korea.,Paik Institute for Clinical Research, Busan Paik Hospital, Inje University, Busan, Republic of Korea
| | - Dae Hoon Jeong
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Busan, Republic of Korea.,Paik Institute for Clinical Research, Busan Paik Hospital, Inje University, Busan, Republic of Korea
| | - Kyung Bok Lee
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Busan, Republic of Korea
| | - Moon Su Sung
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Busan, Republic of Korea.,Paik Institute for Clinical Research, Busan Paik Hospital, Inje University, Busan, Republic of Korea
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19
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Cho EH, Byun JM, Park HY, Kang MR, Jung YJ, Jeong CH, Kim YN, Lee KB, Sung MS, Jeong DH. The first case of Anti-N-methyl-d-aspartate receptor encephalitis (Anti-NMDAR encephalitis) associated with ovarian mucinous cystadenoma: A case report. Taiwan J Obstet Gynecol 2019; 58:557-559. [PMID: 31307751 DOI: 10.1016/j.tjog.2019.05.022] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2019] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is a rare autoimmune and paraneoplastic encephalitis caused by the N-methyl-d-aspartate receptor antibody which is related to tumors, such as teratomas of the ovaries. To our knowledge, this is the first reported case of Anti-NMDAR encephalitis associated with ovarian mucinous cystadenoma. CASE REPORT A 23-year-old woman with a flu-like illness, confused mental status, and behavioral changes presented to the hospital. A right-sided ovarian tumor was detected during the work-up and was suspected to be a teratoma that might have caused the encephalitis. A laparoscopic right salpingo-oophorectomy (RSO) was performed. Histopathological examination revealed a mucinous cystadenoma. She recovered gradually and had complete resolution of symptoms after surgical removal of the mucinous cystadenoma and immunotherapy. CONCLUSION Even though anti-NMDAR encephalitis is caused by ovarian teratoma because it contains various types of tissues, ovarian tumors in anti-NMDAR encephalitis may not be limited to ovarian teratomas.
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Affiliation(s)
- Eun Hye Cho
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, South Korea
| | - Jung Mi Byun
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, South Korea; Paik Institute for Clinical Research, Inje University, College of Medicine, South Korea.
| | - Ha Young Park
- Department of Pathology, Busan Paik Hospital, Inje University, College of Medicine, South Korea
| | - Mi Ri Kang
- Department of Neurology, Busan Paik Hospital, Inje University, College of Medicine, South Korea
| | - Yoon Jung Jung
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, South Korea
| | - Chul Hoi Jeong
- Department of Obstetrics and Gynecology, Haeundae Paik Hospital, Inje University, College of Medicine, South Korea
| | - Young Nam Kim
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, South Korea; Paik Institute for Clinical Research, Inje University, College of Medicine, South Korea
| | - Kyung Bok Lee
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, South Korea; Paik Institute for Clinical Research, Inje University, College of Medicine, South Korea
| | - Moon Su Sung
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, South Korea; Paik Institute for Clinical Research, Inje University, College of Medicine, South Korea
| | - Dae Hoon Jeong
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, College of Medicine, South Korea; Paik Institute for Clinical Research, Inje University, College of Medicine, South Korea
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Na SK, Lee SJ, Cho YK, Kim YN, Choi EK, Song BC. Aspartate Aminotransferase-to-Platelet Ratio or Fibros-4 Index Predicts the Development of Hepatocellular Carcinoma in Chronic Hepatitis C Patients with Sustained Virologic Response to Interferon Therapy. J Interferon Cytokine Res 2019; 39:703-710. [PMID: 31216229 DOI: 10.1089/jir.2019.0049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The risk of hepatocellular carcinoma (HCC) is not completely eliminated in chronic hepatitis C (CHC) patients even after viral eradication. There are few studies in predicting the development of HCC using biomarker in CHC patients with sustained virologic response (SVR). We evaluated the role of the aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 index (FIB-4) in predicting HCC development in 295 patients with SVR after interferon therapy. The annual incidence of HCC was 0.55% (95% confidence interval: 0.31-0.96). It was higher in patients with a pretreatment APRI ≥2.0 than in those with an APRI <2.0 (1.82% versus 0.17%; P = 0.0001) and in patients with a FIB-4 ≥ 3.25 compared with those with a FIB-4 < 3.25. (1.50% versus 0.07%; P = 0.0001). The annual incidence of HCC was higher in patients with a post-treatment APRI ≥0.5 than in those with an APRI <0.5 (1.67% versus 0.07%; P < 0.0001) and in patients with a post-treatment FIB-4 ≥ 2.5 compared with those with a FIB-4 < 2.5 (1.49% versus 0.01%; P = 0.0003). Among pretreatment variables, male gender, albumin, APRI, or FIB-4 were independent predictors for HCC. Among post-treatment variables, APRI or FIB-4 was an independent predictor for HCC. HCC surveillance should be performed in these high-risk patients.
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Affiliation(s)
- Seong Kyun Na
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Soon Jae Lee
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Yoo-Kyung Cho
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Young Nam Kim
- Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea
| | - Eun Kwang Choi
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Byung-Cheol Song
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
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Jung EJ, Cho HJ, Byun JM, Jeong DH, Lee KB, Sung MS, Kim KT, Kim YN. Corrigendum to "Placental pathologic changes and perinatal outcomes in placenta previa" [Placenta 63 C (2018) 15-20]. Placenta 2019; 78:54. [PMID: 30772007 DOI: 10.1016/j.placenta.2018.12.011] [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: 10/27/2022]
Affiliation(s)
- Eun Jung Jung
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, South Korea
| | - Hwa Jin Cho
- Department of Pathology, Inje University Busan Paik Hospital, Busan, South Korea
| | - Jung Mi Byun
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, South Korea; Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan, South Korea
| | - Dae Hoon Jeong
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, South Korea; Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan, South Korea
| | - Kyung Bok Lee
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, South Korea; Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan, South Korea
| | - Moon Su Sung
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, South Korea; Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan, South Korea
| | - Ki Tae Kim
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, South Korea; Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan, South Korea
| | - Young Nam Kim
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, South Korea; Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan, South Korea.
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22
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Kim YN, Kim M, Ahn HS, Kim K, Park SY, Kim HI, Jeon MJ, Kim WG, Kim SW, Kim WB, Chung JH, Shong YK, Kim TY, Kim TH. Refining the tumor-node-metastasis staging system for individualized treatment of differentiated thyroid carcinoma. Oral Oncol 2018; 89:8-13. [PMID: 30732964 DOI: 10.1016/j.oraloncology.2018.12.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 12/11/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Patients with differentiated thyroid carcinoma (DTC) are staged according to the single age cut point in addition to anatomic extent. A novel staging system is needed to properly show the character and prognosis of DTC by considering age as a continuous variable. We aimed to refine stage and prognostic groups of the eighth edition tumor-node-metastasis (TNM-8) staging system for DTC and to suggest a possible revision. METHODS We conducted a retrospective data abstraction study of patients with newly diagnosed DTC who were treated at one of two tertiary referral centres in Seoul, Korea between 1994 and 2005. We used recursive partitioning analysis to derive a new staging classification (TNM-RPA) and compared its prediction of cancer-specific survival with that of TNM-8. RESULTS The cohort comprised 6342 patients with DTC who were followed up for a median of 11.4 years. Higher TNM-RPA groups were associated with increased risk of death (10-year cancer-specific survival for stages IA, IB, IIA, IIB, III, and IV: 99.6%, 98.1%, 93.0%, 92.4%, 75.1%, and 56.6%, respectively; P < 0.001). The C-index values were 0.869 (95% CI, 0.833-0.905) for the TNM-RPA and 0.819 (0.789-0.850) for TNM-8. The proportions of variance explained for the ability of the TNM-RPA and TNM-8 stages to predict cancer-specific survival were 7.1% and 5.7%, respectively. CONCLUSION This study presents a RPA-based TNM stage groupings that incorporate multiple age cutoffs and essential anatomic information, which can be conveniently used to facilitate the individual prediction of long-term cancer-specific survival in patients with DTC.
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Affiliation(s)
- Young Nam Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Mijin Kim
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Division of Endocrinology & Metabolism, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Hyeon Seon Ahn
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, South Korea
| | - Kyunga Kim
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, South Korea; Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - So Young Park
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hye In Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Min Ji Jeon
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Won Gu Kim
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sun Wook Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Won Bae Kim
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jae Hoon Chung
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Young Kee Shong
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Tae Yong Kim
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
| | - Tae Hyuk Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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Abstract
High-grade cervical intraepithelial neoplasia (CIN) is a precancerous lesion of cervical cancer. The aims of this study were to evaluate the risk factors for recurrence of high-grade CIN and to determine if the specific genotype of human papillomavirus (HPV) is a predictor of recurrent high-grade CIN. Between January 2010 and December 2014, 172 patients with CIN 2+ underwent cold knife conization or a loop electrosurgical excision. The HPV DNA chip was used to detect HPV. Recurrent lesions were histologically confirmed and considered to be recurrence of CIN2+. We compared the recurrence rate in patients who did and did not have HPV infection after treatment. One hundred forty-eight (86%) patients had HPV infection before treatment. The first follow-up HPV test was performed on average 4.6 months after treatment and the recurrence rate for high-grade CIN was 3.5%. Fifty-eight patients (33.7%) were found to have HPV infection after treatment; of these, 14 (24.1%) had HPV genotype 16 and/or 18. Eleven patients had persistent HPV16 and/or 18 infection and 3 had new HPV 16 infection after treatment (78.6% and 21.4%, P = .001); the HPV 16 genotype was significantly correlated with recurrent disease and persistent infection after treatment (P = .013 and P = .054, respectively, [OR], 19.4; 95% [CI], 1.89-198.79). Recurrence of high-grade CIN was related to HPV infection after treatment, and persistent HPV16 infection was the most important factor for recurrence. Therefore, HPV vaccination for the HPV16 genotype and regular follow-up with HPV testing after treatment may be useful for preventing recurrent high-grade CIN.
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Affiliation(s)
- Jung Mi Byun
- Department of Obstetrics and Gynecology
- Paik Institute for Clinical Research, Busan Paik Hospital, Inje University, Busan, Republic of Korea
| | - Dae Hoon Jeong
- Department of Obstetrics and Gynecology
- Paik Institute for Clinical Research, Busan Paik Hospital, Inje University, Busan, Republic of Korea
| | - Young Nam Kim
- Department of Obstetrics and Gynecology
- Paik Institute for Clinical Research, Busan Paik Hospital, Inje University, Busan, Republic of Korea
| | | | - Kyung Bok Lee
- Department of Obstetrics and Gynecology
- Paik Institute for Clinical Research, Busan Paik Hospital, Inje University, Busan, Republic of Korea
| | - Moon Su Sung
- Department of Obstetrics and Gynecology
- Paik Institute for Clinical Research, Busan Paik Hospital, Inje University, Busan, Republic of Korea
| | - Ki Tae Kim
- Department of Obstetrics and Gynecology
- Paik Institute for Clinical Research, Busan Paik Hospital, Inje University, Busan, Republic of Korea
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Cho HJ, Jung EJ, Byun JM, Jeong DH, Lee KB, Sung MS, Kim YN. Thrombosed Fetal Dural Sinus Malformation: Correlation Between Prenatal Ultrasound and Autopsy Findings. Fetal Pediatr Pathol 2018; 37:287-295. [PMID: 30265815 DOI: 10.1080/15513815.2018.1478473] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Dural sinus malformations, which are characterized by massively dilated dural sinuses, are one of the etiologies of an intracranial fetal cystic mass. Thrombi within these dural sinus malformations can develop while in-utero, and can be visualized by ultrasound in fetal life. Definitive postnatal diagnosis requires an autopsy. CASE REPORT We report two thrombosed fetal dural sinus malformations which are prenatally suspected during the second trimester with ultrasonography and postnatally confirmed with autopsy. CONCLUSION Prenatal ultrasound images and fetal autopsy findings can be useful to establish the prenatal diagnosis of thrombosed dural sinus malformation.
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Affiliation(s)
- Hwa Jin Cho
- a Pathology , Inje University Busan Paik Hospital , Busan , Korea
| | - Eun Jung Jung
- b Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital , Busan , Korea
| | - Jung Mi Byun
- b Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital , Busan , Korea.,c Paik Institute for Clinical Research, Busan Paik Hospital , Busan , Korea
| | - Dae Hoon Jeong
- b Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital , Busan , Korea.,c Paik Institute for Clinical Research, Busan Paik Hospital , Busan , Korea
| | - Kyung Bok Lee
- b Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital , Busan , Korea.,c Paik Institute for Clinical Research, Busan Paik Hospital , Busan , Korea
| | - Moon Su Sung
- b Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital , Busan , Korea.,c Paik Institute for Clinical Research, Busan Paik Hospital , Busan , Korea
| | - Young Nam Kim
- b Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital , Busan , Korea.,c Paik Institute for Clinical Research, Busan Paik Hospital , Busan , Korea
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Choi KJ, Cho MS, Do WJ, Kim YN, Kim J, Nam GB, Kim YH. P2910Thromboembolic risk of imaging-confirmed coronary artery disease without myocardial infarction in patients with non-valvular atrial fibrillation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2910] [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.-J Choi
- Asan Medical Center, Heart institute, Seoul, Korea Republic of
| | - M S Cho
- Asan Medical Center, Heart institute, Seoul, Korea Republic of
| | - W J Do
- Asan Medical Center, Heart institute, Seoul, Korea Republic of
| | - Y N Kim
- Asan Medical Center, Heart institute, Seoul, Korea Republic of
| | - J Kim
- Asan Medical Center, Heart institute, Seoul, Korea Republic of
| | - G B Nam
- Asan Medical Center, Heart institute, Seoul, Korea Republic of
| | - Y H Kim
- Asan Medical Center, Heart institute, Seoul, Korea Republic of
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Kim HI, Kim TH, Choe JH, Kim JH, Kim JS, Kim YN, Kim H, Kim SW, Chung JH. Surgeon volume and prognosis of patients with advanced papillary thyroid cancer and lateral nodal metastasis. Br J Surg 2018; 105:270-278. [DOI: 10.1002/bjs.10655] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 01/25/2017] [Accepted: 06/23/2017] [Indexed: 01/03/2023]
Abstract
Abstract
Background
Surgery is the most important treatment modality for papillary thyroid cancer (PTC). However, the relationship between surgeon volume and long-term oncological outcomes has not been explored.
Methods
Patients diagnosed with N1b PTC after initial thyroid surgery between 1 July 1994 and 31 December 2011 were eligible for inclusion in the study. Surgeons were categorized into high (at least 100 operations per year) and low (fewer than 100 operations per year) volume groups. Kaplan–Meier survival analysis according to surgeon volume was performed, and Cox proportional hazard modelling was used to estimate hazard ratios (HRs) with 95 per cent confidence intervals according to patient, tumour and surgeon factors.
Results
A total of 1103 patients with a median follow-up of 81 (i.q.r. 62–108) months were included in the study. During follow-up, 200 patients (18·1 per cent) developed structural recurrence. A high surgeon volume was associated with low structural recurrence (P = 0·006). After adjustment for age, sex and conventional risk factors for recurrence (histology, tumour size, gross extrathyroidal extension, margin status, more than 5 positive lymph nodes, radioactive iodine therapy), the adjusted HR for structural recurrence for low-volume surgeons was 1·46 (95 per cent c.i. 1·08 to 1·96), compared with high-volume surgeons. Distant metastasis (P = 0·242) and disease-specific mortality (P = 0·288) were not affected by surgeon volume.
Conclusion
Surgeon volume is associated with structural recurrence, but not distant metastasis or cancer-specific death in patients with N1b PTC. Surgeon volume is important in initial surgery for advanced PTC with extensive nodal metastasis in order to ensure curative outcome and reduce treatment-related morbidity.
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Affiliation(s)
- H I Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - T H Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J-H Choe
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J-H Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J S Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y N Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S W Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J H Chung
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
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Jeon MJ, Kim YN, Sung TY, Hong SJ, Cho YY, Kim TY, Shong YK, Kim WB, Kim SW, Chung JH, Kim TH, Kim WG. Practical Initial Risk Stratification Based on Lymph Node Metastases in Pediatric and Adolescent Differentiated Thyroid Cancer. Thyroid 2018; 28:193-200. [PMID: 29179646 DOI: 10.1089/thy.2017.0214] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Data on the risk stratification of pediatric differentiated thyroid cancer (DTC) remain scarce. This study aimed to evaluate the predictors of structural persistent/recurrent disease and revise an initial risk-stratification system in pediatric DTC patients. METHODS This retrospective cohort study included 203 patients (aged <20 years) from two tertiary referral centers in Korea. The extent of cervical lymph node (LN) metastasis was classified based on the location or number of metastatic LNs. RESULTS During a median follow-up duration of 5.5 years, structural persistent/recurrent disease was observed in 51 (25%) patients, including 22 (11%) with distant metastases. The presence of extrathyroidal extension (ETE) and lateral cervical LN metastases or more than five metastatic LNs were independent predictors for structural persistent/recurrent disease. The presence of bilateral lateral cervical LN metastases or >10 metastatic LNs were independent predictors for distant metastasis. A total of 67 (33%), 72 (35%), and 64 (32%) patients were classified into the low-, intermediate-, and high-risk groups, respectively, based on the presence of ETE and the extent of cervical LN metastases. Compared to the low-risk group, the intermediate- and high-risk groups had a significantly greater risk of structural persistent/recurrent disease (hazard ratio = 7.32, p = 0.008, and hazard ratio = 24.28, p < 0.001, respectively). CONCLUSIONS This revised initial risk-stratification system based on the presence of ETE and the extent of cervical LN metastasis is useful for predicting the clinical outcomes of pediatric DTC patients. The findings could facilitate the practical use of a risk-stratification system.
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Affiliation(s)
- Min Ji Jeon
- 1 Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine , Seoul, Korea
| | - Young Nam Kim
- 2 Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
| | - Tae-Yong Sung
- 3 Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine , Seoul, Korea
| | - Suck Joon Hong
- 3 Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine , Seoul, Korea
| | - Yoon Young Cho
- 4 Division of Endocrinology and Metabolism, Department of Medicine, Gyeongsang National University School of Medicine , Jinju, Korea
| | - Tae Yong Kim
- 1 Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine , Seoul, Korea
| | - Young Kee Shong
- 1 Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine , Seoul, Korea
| | - Won Bae Kim
- 1 Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine , Seoul, Korea
| | - Sun Wook Kim
- 2 Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
| | - Jae Hoon Chung
- 2 Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
| | - Tae Hyuk Kim
- 2 Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
| | - Won Gu Kim
- 1 Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine , Seoul, Korea
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Sohn SY, Kim HI, Kim YN, Kim TH, Kim SW, Chung JH. Prognostic indicators of outcomes in patients with lung metastases from differentiated thyroid carcinoma during long-term follow-up. Clin Endocrinol (Oxf) 2018; 88:318-326. [PMID: 28972676 DOI: 10.1111/cen.13489] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 09/22/2017] [Accepted: 09/25/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Distant metastases, although uncommon, represent maximum disease-related mortality in differentiated thyroid carcinoma (DTC). Lungs are the most frequent sites of metastases. We aimed to evaluate long-term outcomes and identify prognostic factors in metastatic DTC limited to the lungs. METHODS This retrospective study included 89 patients with DTC and metastases limited to the lungs, who were treated between 1996 and 2012 at Samsung Medical Center. Progression-free survival (PFS) and cancer-specific survival (CSS) rates were evaluated according to clinicopathologic factors. Cox regression analysis was used to identify independent factors associated with structural progressive disease (PD) and cancer-specific death. RESULTS With a median follow-up of 84 months, the 5- and 10-year CSS rates were 78% and 73%, respectively. Older age at diagnosis (≥55 years), radioactive iodine (RAI) nonavidity, preoperative or late diagnosis of metastasis and macro-nodular metastasis (≥1 cm) were predictive of decreased PFS and CSS. Multivariate analysis identified older age (P = .002), RAI nonavidity (P = .045) and preoperative (P = .030) or late diagnosis (P = .026) as independent predictors of structural PD. RAI avidity was also independent predictor of cancer-specific death (P = .025). CONCLUSION Patients with DTC and metastatic disease limited to the lungs had favourable long-term outcomes. Age, RAI avidity and timing of metastasis were found to be major factors for predicting prognosis.
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Affiliation(s)
- Seo Young Sohn
- Department of Endocrinology and Metabolism, Myongji Hospital, Seonam University, Goyang, Korea
| | - Hye In Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Nam Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Hyuk Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Wook Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hoon Chung
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Byun JM, Kim SS, Kim KT, Kang MS, Jeong DH, Lee DS, Jung EJ, Kim YN, Han J, Song IS, Lee KB, Sung MS. Overexpression of peroxiredoxin-3 and -5 is a potential biomarker for prognosis in endometrial cancer. Oncol Lett 2018. [PMID: 29541251 DOI: 10.3892/ol.2018.7909] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Endometrial cancer is the sixth most common cancer in women worldwide. Peroxiredoxins (PRDXs) are antioxidant enzymes that serve important roles in cell differentiation, proliferation, and apoptosis. In the present study, the potential associations between PRDX expression and endometrial cancer were investigated. The expression levels of various PRDX mRNAs were detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) in endometrial cancer tissues (n=26) and normal endometrial tissues (n=10). Additionally, the expression of PRDX isoforms was immunohistochemically examined in endometrial cancer tissues and adjacent normal endometrial tissues from 42 patients. Finally, the associations between high PRDX expression levels and clinicopathological features were examined in patients with endometrial cancer. Analysis of PRDX expression in endometrial cancer tissues and normal endometrial tissues by semi-quantitative RT-PCR showed that all PRDX isoforms had increased expression in the endometrial cancer tissues compared with that in the normal endometrium, and the differences in the expression levels of PRDX1 and PRDX3 between cancer and normal tissues were statistically significant (P=0.0015 and P=0.0134, respectively). Additionally, analysis of PRDX expression in endometrial cancer and paired normal endometrial tissues by immunohistochemistry showed strong cytoplasmic staining of PRDX3 and PRDX5 in cancer tissues, with high PRDX3 (25/42, 59.5%) and PRDX5 (32/42, 76.2%) appearing more frequently in endometrial cancer than in normal endometrial tissues (P=0.0001 and P=0.0023, respectively). Furthermore, high expression of PRDX5 was associated with advanced-stage endometrial cancer (P=0.0399). Although the 5-year survival rate was marginally higher in patients with low expression of PRDX3 and PRDX5, this result was not statistically significant. In summary, PRDX3 and PRDX5 are highly expressed in endometrial cancer and could be associated with advanced stage and poor prognosis. Therefore, these proteins may potentially be used as prognostic markers for endometrial cancer.
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Affiliation(s)
- Jung Mi Byun
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan 614-735, Republic of Korea.,Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan 614-735, Republic of Korea
| | - Su Sun Kim
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan 614-735, Republic of Korea
| | - Ki Tae Kim
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan 614-735, Republic of Korea.,Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan 614-735, Republic of Korea
| | - Mi Seon Kang
- Department of Pathology, Inje University Busan Paik Hospital, Busan 614-735, Republic of Korea
| | - Dae Hoon Jeong
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan 614-735, Republic of Korea.,Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan 614-735, Republic of Korea
| | - Dae Sim Lee
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan 614-735, Republic of Korea.,Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan 614-735, Republic of Korea
| | - Eun Jung Jung
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan 614-735, Republic of Korea
| | - Young Nam Kim
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan 614-735, Republic of Korea.,Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan 614-735, Republic of Korea
| | - Jin Han
- Department of Physiology, Inje University Busan Paik Hospital, Busan 614-735, Republic of Korea
| | - In Sung Song
- Department of Physiology, Inje University Busan Paik Hospital, Busan 614-735, Republic of Korea
| | - Kyoun Bok Lee
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan 614-735, Republic of Korea.,Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan 614-735, Republic of Korea
| | - Moon Su Sung
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan 614-735, Republic of Korea.,Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan 614-735, Republic of Korea
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Jung EJ, Cho HJ, Byun JM, Jeong DH, Lee KB, Sung MS, Kim KT, Kim YN. Placental pathologic changes and perinatal outcomes in placenta previa. Placenta 2017; 63:15-20. [PMID: 29486851 DOI: 10.1016/j.placenta.2017.12.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 11/29/2017] [Accepted: 12/19/2017] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Placenta previa is a condition in which the placenta implants in the poorly vascularized lower uterine segment, which may result in inadequate uteroplacental perfusion, in turn, adversely affect the neonatal outcome. Abnormal placentation may also lead to severe postpartum hemorrhage as placenta separation proceeds. We aimed to evaluate the differences in placental histopathology and perinatal outcomes in pregnancies complicated with placenta previa and controls. METHOD We undertook a retrospective case-control study of 93 pregnancies with placenta previa and 81 controls between 2011 and 2017. RESULTS Gross findings of the placenta showed that the placentas in placenta previa had significantly higher mean large chorionic plate diameters (18.5 ± 3.2 vs 17.5 ± 2.6 cm, P = .0298), chorionic plate areas (218.4 ± 62.9 cm2 vs 198.7 ± 56.0 cm2, P = .0344), and marginal cord insertion (19.8% vs 8.6%, P = .0411) than control groups. Placental histopathological findings showed that placentas in placenta previa was significantly associated with maternal underperfusion, including villous infarction (50.5% vs 25.9%, P = .0009) and increased intervillous fibrin deposition (38.7% vs 7.4%, P < .0001). Also, women in the placenta previa group had a higher rate of abnormally invasive placenta and severe postpartum hemorrhage. However, placenta previa was not associated with the increased risk of neonatal mortality and morbidity. DISCUSSION Abnormal placentation into the poorly vascularized lower uterine segment induces compensatory placental growth and increased surface area in response to reduced placental perfusion, which was consistent with the histopathological findings of coagulative necrosis of chorionic villi and fibrin deposition in the intervillous space. The morphological changes occurring in placenta previa may have important roles in maintaining adequate uteroplacental-fetal perfusion, which may prevent adverse neonatal outcomes.
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Affiliation(s)
- Eun Jung Jung
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, South Korea
| | - Hwa Jin Cho
- Department of Pathology, Inje University Busan Paik Hospital, Busan, South Korea
| | - Jung Mi Byun
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, South Korea; Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan, South Korea
| | - Dae Hoon Jeong
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, South Korea; Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan, South Korea
| | - Kyung Bok Lee
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, South Korea; Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan, South Korea
| | - Moon Su Sung
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, South Korea; Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan, South Korea
| | - Ki Tae Kim
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, South Korea; Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan, South Korea
| | - Young Nam Kim
- Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, South Korea; Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan, South Korea.
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Kim H, Kim YN, Kim HI, Park SY, Choe JH, Kim JH, Kim JS, Chung JH, Kim TH, Kim SW. Preoperative serum thyroglobulin predicts initial distant metastasis in patients with differentiated thyroid cancer. Sci Rep 2017; 7:16955. [PMID: 29209067 PMCID: PMC5717168 DOI: 10.1038/s41598-017-17176-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 11/22/2017] [Indexed: 12/13/2022] Open
Abstract
Differentiated thyroid cancer (DTC) generally has a favorable prognosis. However, a small percentage of patients suffer from initial distant metastasis (DM). To date, there is no effective predictor for the presence of initial DM. The aim of this study was to determine if preoperative serum thyroglobulin (Tg) level could predict initial DM in DTC. We reviewed an institutional thyroid cancer database from October 1994 to February 2016. To determine the Tg cutoff for predicting initial DM, 4,735 patients who were diagnosed with DTC were included in this study. Fifty-seven patients (1.2%) were identified as having DTC with initial DM. Median preoperative Tg level was 328.4 ng/ml in the initial DM group and 10.0 ng/ml in the non-DM group. Initial DM was the most important factor affecting serum Tg level (β = 2,049.32 ± 103.40; P < 0.001). The Tg cutoff level that distinguished overall DM with the greatest accuracy was 63.4 ng/ml [area under the ROC curve 0.914, sensitivity 84.2%, specificity 90.6%, negative likelihood ratio (LR) 0.17, and positive LR 8.97]. Preoperative Tg levels were useful for predicting initial DM of DTC. Measurement of serum Tg in patients with DTC may guide preoperative staging evaluation and initial treatment.
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Affiliation(s)
- Hosu Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Division of Endocrinology, Department of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Young Nam Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye In Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - So Young Park
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jun-Ho Choe
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung-Han Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jee Soo Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hoon Chung
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Hyuk Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Sun Wook Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Jeon MJ, Kim WG, Kim TH, Kim HK, Kim BH, Yi HS, Kim ES, Kim H, Kim YN, Kim EH, Kim TY, Kim SW, Kang HC, Chung JH, Shong YK, Kim WB. Disease-Specific Mortality of Differentiated Thyroid Cancer Patients in Korea: A Multicenter Cohort Study. Endocrinol Metab (Seoul) 2017; 32:434-441. [PMID: 29199400 PMCID: PMC5744729 DOI: 10.3803/enm.2017.32.4.434] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 08/19/2017] [Accepted: 09/15/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Little is known regarding disease-specific mortality of differentiated thyroid cancer (DTC) patients and its risk factors in Korea. METHODS We retrospectively reviewed a large multi-center cohort of thyroid cancer from six Korean hospitals and included 8,058 DTC patients who underwent initial surgery between 1996 and 2005. RESULTS Mean age of patients at diagnosis was 46.2±12.3 years; 87% were females. Most patients had papillary thyroid cancer (PTC; 97%) and underwent total thyroidectomy (85%). Mean size of the primary tumor was 1.6±1.0 cm. Approximately 40% of patients had cervical lymph node (LN) metastases and 1.3% had synchronous distant metastases. During 11.3 years of follow-up, 150 disease-specific mortalities (1.9%) occurred; the 10-year disease-specific survival (DSS) rate was 98%. According to the year of diagnosis, the number of disease-specific mortality was not different. However, the rate of disease-specific mortality decreased during the study period (from 7.7% to 0.7%). Older age (≥45 years) at diagnosis, male, follicular thyroid cancer (FTC) versus PTC, larger tumor size (>2 cm), presence of extrathyroidal extension (ETE), lateral cervical LN metastasis, distant metastasis and tumor node metastasis (TNM) stage were independent risk factors of disease-specific mortality of DTC patients. CONCLUSION The rate of disease-specific mortality of Korean DTC patients was 1.9%; the 10-year DSS rate was 98% during 1996 to 2005. Older age at diagnosis, male, FTC, larger tumor size, presence of ETE, lateral cervical LN metastasis, distant metastasis, and TNM stages were significant risk factors of disease-specific mortality of Korean DTC patients.
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Affiliation(s)
- Min Ji Jeon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Gu Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Hyuk Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Kyung Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Bo Hyun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Hyon Seung Yi
- Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Eun Sook Kim
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Hosu Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Division of Endocrinology, Department of Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Young Nam Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Heui Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Tae Yong Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sun Wook Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ho Cheol Kang
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jae Hoon Chung
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Kee Shong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Bae Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Sohn SY, Kim YN, Kim HI, Kim TH, Kim SW, Chung JH. Validation of dynamic risk stratification in pediatric differentiated thyroid cancer. Endocrine 2017; 58:167-175. [PMID: 28822062 DOI: 10.1007/s12020-017-1381-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 07/21/2017] [Indexed: 01/12/2023]
Abstract
PURPOSE There has been increasing interest in a risk-adopted management strategy known as dynamic risk stratification following the revised American Thyroid Association guidelines for differentiated thyroid cancer. We aimed to evaluate the usefulness of dynamic risk stratification for predicting structural disease in pediatric differentiated thyroid cancer patients. METHODS We retrospectively reviewed 130 pediatric differentiated thyroid cancer patients (≤19 years) who were treated between 1996 and 2015 at Samsung Medical Center. Patients were stratified according to three American Thyroid Association initial risk group (low, intermediate, or high risk) and four dynamic risk stratification group (excellent, indeterminate, biochemical incomplete, or structural incomplete). RESULTS Based on dynamic risk stratification strategy, structural disease was identified 3.9% in the excellent group, 9.7% in the indeterminate group, 76.9% in the biochemical incomplete group, and 100% in the structural incomplete group. The hazard ratios of the structural disease were 18.10 (P < 0.001) in the biochemical incomplete group, and 19.583 (P < 0.001) in the structural incomplete group compared to the excellent group. The prevalence of structural disease also increased as American Thyroid Association initial risk classification increased (5.9% in the low-risk group, 13.6% in the intermediate-risk group, and 45% in the high-risk group). The hazard ratios of structural disease in the high-risk group was 10.296 (P < 0.001) in compared to the low-risk group. CONCLUSION Dynamic risk stratification based on patient responses to initial therapy was able to effectively predict the risk of structural disease in a pediatric population, and as a follow-up strategy, may work as well in pediatric differentiated thyroid cancer patients as it does in adult differentiated thyroid cancer patients.
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Affiliation(s)
- Seo Young Sohn
- Department of Endocrinology and Metabolism, Seonam University, Myongji Hospital, Goyang, Korea
| | - Young Nam Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye In Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Hyuk Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Wook Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hoon Chung
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Kim HI, Kim M, Lee SH, Park SY, Kim YN, Kim H, Jeon MJ, Kim TY, Kim SW, Kim WB, Kim SW, Lee DH, Park K, Ahn MJ, Chung JH, Shong YK, Kim WG, Kim TH. Development of thyroid dysfunction is associated with clinical response to PD-1 blockade treatment in patients with advanced non-small cell lung cancer. Oncoimmunology 2017; 7:e1375642. [PMID: 29296533 DOI: 10.1080/2162402x.2017.1375642] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [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: 05/01/2017] [Revised: 08/30/2017] [Accepted: 08/30/2017] [Indexed: 12/25/2022] Open
Abstract
Purpose: Drugs that blockade interaction between programmed cell-death protein 1 (PD-1) and its ligand (PD-L1) are promising. Immune-related adverse events (irAEs) might be associated with favorable clinical outcomes, and thyroid dysfunction is one of the most common irAE. We evaluated the association of thyroid dysfunction during PD-1 blockade with the treatment efficacy in patients with non-small cell lung cancer (NSCLC). Experimental Design: A total 58 patients with stage IV NSCLC treated with PD-1 blockade were enrolled. Patients were categorized into thyroid dysfunction and euthyroid groups. Overall survival (OS) and progression-free survival (PFS) of the two groups were compared. Patients, tumor, and medication factors were adjusted using Cox proportional hazard modeling. Objective response rate (RR) and durable control rate were assessed according to the severity of thyroid dysfunction. Results: OS [median 118.0 (73.0-267.0) vs. 71.0 (28.0-160.0) days, log-rank P = 0.025] and PFS [118.0 (73.0-267.0) vs. 61.0 (28.0-130.0), log-rank P = 0.014] were longer in the thyroid dysfunction group. After adjustment, thyroid dysfunction was an independent predictive factor for favorable outcome [adjusted HR = 0.11 (95% CI) 0.01-0.92 for overall death; 0.38 (0.17-0.85) for disease progression]. The severity of thyroid dysfunction was associated with durable control rate (P for trend = 0.008). Conclusions: Thyroid dysfunction during PD-1 blockade is associated with treatment response and could provide supplementary information for immune monitoring in patients with advanced NSCLC.
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Affiliation(s)
- Hye In Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mijin Kim
- Division of Endocrinology & Metabolism, Departments of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Se-Hoon Lee
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - So Young Park
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Nam Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hosu Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Min Ji Jeon
- Division of Endocrinology & Metabolism, Departments of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Yong Kim
- Division of Endocrinology & Metabolism, Departments of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sun Wook Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Bae Kim
- Division of Endocrinology & Metabolism, Departments of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang-We Kim
- Division of Oncology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dae Ho Lee
- Division of Oncology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Keunchil Park
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myung-Ju Ahn
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hoon Chung
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Kee Shong
- Division of Endocrinology & Metabolism, Departments of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Gu Kim
- Division of Endocrinology & Metabolism, Departments of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Hyuk Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Jung EJ, Cho HJ, Park HY, Byun JM, Jeong DH, Lee KB, Sung MS, Kim KT, An HJ, Kim YN. Placental pathology and neonatal outcomes in placenta previa. Placenta 2017. [DOI: 10.1016/j.placenta.2017.07.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kim HI, Kim TH, Kim H, Kim YN, Jang HW, Kim JH, Hur KY, Chung JH, Kim SW. Delayed TSH recovery after dose adjustment during TSH-suppressive levothyroxine therapy of thyroid cancer. Clin Endocrinol (Oxf) 2017; 87:286-291. [PMID: 28375573 DOI: 10.1111/cen.13344] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 03/09/2017] [Accepted: 03/30/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Delayed thyroid-stimulating hormone (TSH) recovery during treatment of Graves' disease is caused by long-term excessive thyroid hormone, which results in downregulation of pituitary thyrotrophs. However, it is unknown whether delayed TSH recovery exists after levothyroxine (LT4) dose reduction in patients with differentiated thyroid cancer (DTC) after long-term TSH suppression. METHODS We retrospectively reviewed 97 DTC patients with LT4 dose reduction after long-term TSH suppression. TSH levels at baseline (point 1), 6 months (point 2) and 12-18 months (point 3) after LT4 dose reduction were compared. A delayed TSH recovery group whose TSH levels changed to upper target TSH category (2015 revised ATA guidelines) from point 2 to point 3 was identified, and risk factors were analysed. RESULTS The median TSH level at point 3 was significantly higher than that of point 2 (0.17 vs 0.09 mIU/L; P<.001). The delayed TSH recovery group (44.3%) showed increased body weight (60.84 vs 62.73 kg; P=.01), while normal response group did not. Greater reduction (%) in the LT4 dose per weight [HR 1.10, 95% CI (1.00-1.22), P=.04] and higher BMI before thyroid surgery [1.19, 1.03-1.38, P=.01] predicted the occurrence of delayed TSH recovery, while higher dose of LT4 per weight after reduction showed preventive effect [HR 0.01, 95% CI (0.00-0.54); P=.02]. CONCLUSIONS Delayed TSH recovery was common during LT4 dose reduction after long-term TSH suppression for DTC management. Six months may not be enough for TSH recovery and to evaluate thyroid hormone status by serum TSH.
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Affiliation(s)
- Hye In Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Hyuk Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hosu Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Nam Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Won Jang
- Department of Medical Education, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung-Han Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyu Yeon Hur
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hoon Chung
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Wook Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim HI, Kim TH, Choe JH, Kim JH, Kim JS, Oh YL, Hahn SY, Shin JH, Jang HW, Kim YN, Kim H, Ahn HS, Kim K, Kim SW, Chung JH. Restratification of survival prognosis of N1b papillary thyroid cancer by lateral lymph node ratio and largest lymph node size. Cancer Med 2017; 6:2244-2251. [PMID: 28857489 PMCID: PMC5633551 DOI: 10.1002/cam4.1160] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 06/22/2017] [Accepted: 07/16/2017] [Indexed: 12/18/2022] Open
Abstract
The current 7th TNM staging stratifies N1b papillary thyroid cancer (PTC) patients without distant metastasis into either stage I or stage IV merely by an age threshold (45 years). To date, no studies have adequately quantified the mortality risk of PTC patients with N1b disease. We hypothesized that incorporating lymph node (LN) factors into the staging system would better predict cancer-specific mortality (CSM). A total of 745 nonmetastatic PTC patients with N1b disease were enrolled. We identified factors related to LNs and cut-points using Cox regression and time-dependent ROC analysis. New prognostic groupings were derived based on minimal hazard differences for CSM among the groups stratified by LN risk and age, and prediction of CSM was assessed. Lateral lymph node ratio (LNR) and largest LN size were significant prognostic LN factors at cut-points of 0.3 and 3 cm. Without LN risk (lateral LNR >0.3 or largest LN size >3 cm), stage IV patients had prognosis [adjusted HR 1.10 (98% CI 0.19-6.20); P = 0.906] similar to stage I patients with LN risk. Patients were restratified into three prognostic groups: Group 1, <45 years without LN risk; Group 2, <45 years with LN risk or ≥45 years without LN risk; and Group 3, ≥45 with LN risk. This system had a lower log-rank P-value (<0.001 vs. 0.002) and higher C-statistics (0.80 vs. 0.71) than the 7th TNM. New prognostic grouping using lateral LNR and largest LN size predicts CSM accurately and distinguishes N1b patients with different prognosis.
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Affiliation(s)
- Hye In Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Hyuk Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jun-Ho Choe
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung-Han Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jee Soo Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Lyun Oh
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo Yeon Hahn
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Hee Shin
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Won Jang
- Department of Medical Education, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Nam Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hosu Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyeon Seon Ahn
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Kyunga Kim
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Sun Wook Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hoon Chung
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim H, Kim TH, Kim HI, Park SY, Kim YN, Kim S, Kim MJ, Jin SM, Hur KY, Kim JH, Lee MK, Min YK, Chung JH, Kang M, Kim SW. Subclinical thyroid dysfunction and risk of carotid atherosclerosis. PLoS One 2017; 12:e0182090. [PMID: 28750042 PMCID: PMC5531563 DOI: 10.1371/journal.pone.0182090] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 07/12/2017] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The effect of subclinical thyroid dysfunction on vascular atherosclerosis remains uncertain. The objective of this study was to elucidate the association between sustained subclinical thyroid dysfunction and carotid plaques, which are an early surrogate marker of systemic atherosclerosis. METHODS The study included 21,342 adults with consistent thyroid hormonal status on serial thyroid function tests (TFTs) and carotid artery duplex ultrasonography at a health screening center between 2007 and 2014. The effect of subclinical thyroid dysfunction on baseline carotid plaques and newly developed carotid plaques during 5-year follow-up was determined by logistic regression analyses and GEE (Generalized Estimating Equations), respectively. RESULTS Carotid plaques were more common in the subclinical hypothyroidism (55.6%) than the euthyroidism (47.8%) at baseline. However, in multivariable analysis, thyroid status was not a significant risk for the carotid plaques at baseline. Instead, traditional cardiovascular risk factors, such as age (P <0.001), systolic blood pressure (P = 0.023), fasting blood glucose (P = 0.030), and creatinine (P = 0.012) were associated with baseline carotid plaques in subclinical hypothyroidism. In longitudinal analyses of subjects who were followed up for more than 5 years, there was no significant difference in the cumulative incidence of new carotid plaques according to time between subjects with subclinical hypothyroidism and those with euthyroidism (P = 0.392). CONCLUSIONS Sustained subclinical thyroid dysfunction did not affect the baseline or development of carotid plaques in healthy individuals.
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Affiliation(s)
- Hosu Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Division of Endocrinology, Department of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Tae Hyuk Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye In Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - So Young Park
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Nam Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seonwoo Kim
- Statistics and Data Center, Samsung Biomedical Research Institute, Seoul, Korea
| | - Min-Ji Kim
- Statistics and Data Center, Samsung Biomedical Research Institute, Seoul, Korea
| | - Sang-Man Jin
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyu Yeon Hur
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hyeon Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Moon-Kyu Lee
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong-Ki Min
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hoon Chung
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mira Kang
- Center for Health Promotion, Samsung Medical Center, Seoul, Korea
- * E-mail: (SWK); (MK)
| | - Sun Wook Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- * E-mail: (SWK); (MK)
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Kim H, Kim TH, Choe JH, Kim JH, Kim JS, Oh YL, Hahn SY, Shin JH, Chi SA, Jung SH, Kim YN, Kim HI, Kim SW, Chung JH. Patterns of Initial Recurrence in Completely Resected Papillary Thyroid Carcinoma. Thyroid 2017; 27:908-914. [PMID: 28446060 DOI: 10.1089/thy.2016.0648] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Despite improvements in the surgical and medical treatment of papillary thyroid carcinoma (PTC), subsets of patients suffer from structural recurrence after initial treatment. This study evaluated the timing and patterns of recurrence in completely resected PTC patients. METHODS A retrospective review of a prospectively maintained thyroid cancer database was performed. The timing and patterns of recurrence were reviewed in 2250 patients with PTC >1 cm who achieved complete remission after total thyroidectomy and/or radioactive iodine treatment. Univariate and multivariate analyses were performed to identify factors predictive of recurrence patterns. RESULTS During 8.1 years of mean follow-up, 68 (3.0%) patients developed structural recurrences: 53 lymph node recurrences (LNR), 11 local soft tissue recurrences (LR), and four distant recurrences (DR). Two patients died of DR. Younger patients had a higher proportion of LNR, and older patients had a tendency toward LR/DR. LNR showed a peak incidence between one and three years after remission, but LR/DR showed a delayed peak incidence between two and four years. The factors that significantly increased the risk of LNR were multifocal tumor and lymph node metastasis (central/lateral). The factors that increased the risk of LR/DR were old age, large tumor size (>2 cm), and lateral lymph node metastasis. In addition, central neck dissection significantly reduced subsequent LR/DR. CONCLUSION Patterns of recurrence after complete PTC resection are variable and associated with specific clinicopathologic factors. Understanding the timing and patterns of recurrence may lead to more effective adjuvant treatment and improved long-term follow-up strategies.
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Affiliation(s)
- Hosu Kim
- 1 Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
- 2 Division of Endocrinology, Department of Medicine, Gyeongsang National University Changwon Hospital , Changwon. Korea
| | - Tae Hyuk Kim
- 1 Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
| | - Jun-Ho Choe
- 3 Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
| | - Jung-Han Kim
- 3 Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
| | - Jee Soo Kim
- 3 Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
| | - Young Lyun Oh
- 4 Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
| | - Soo Yeon Hahn
- 5 Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
| | - Jung Hee Shin
- 5 Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
| | - Sang Ah Chi
- 6 Department of Statics and Data Center, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
| | - Sin-Ho Jung
- 7 Department of Biostatistics and Bioinformatics, Duke University , Durham, North Carolina
| | - Young Nam Kim
- 1 Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
| | - Hye In Kim
- 1 Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
| | - Sun Wook Kim
- 1 Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
| | - Jae Hoon Chung
- 1 Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
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Jung EJ, Byun JM, Kim YN, Lee KB, Sung MS, Kim KT, Jeong DH. Cervical Adenocarcinoma Has a Poorer Prognosis and a Higher Propensity for Distant Recurrence Than Squamous Cell Carcinoma. Int J Gynecol Cancer 2017; 27:1228-1236. [DOI: 10.1097/igc.0000000000001009] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
ObjectiveWe aimed to analyze the differences in prognosis and the pattern of recurrence between squamous cell carcinoma (SCC) and adenocarcinoma (ADC) in patients with cervical cancer.MethodsWe retrospectively reviewed the medical records of 969 patients with SCC and 144 patients with ADC who underwent radical hysterectomy and pelvic lymph node dissection at the Busan Paik Hospital between January 1988 and December 2010.ResultsAdenocarcinoma was associated with poorer disease-free survival (P = 0.0515) and overall survival (OS) (P = 0.0156) compared with SCC, and that this was more apparent for patients with International Federation of Gynecology and Obstetrics stages IIA to IIB disease. Subgroup analysis by prognostic factors for recurrence showed significant differences in the OS in the intermediate-risk subgroup (P = 0.0266), but not in the high-risk subgroup (P = 0.1674). Based on the metastatic pattern in patients with recurrence, ADC was associated with an increased risk for distant recurrence resulting from hematogenous spread compared with SCC (P < 0.0001), and patients with distant recurrence showed a worse OS (P = 0.0481) and survival after recurrence (P = 0.0016) than patients with locoregional or lymphatic recurrence. Multivariate analysis showed that ADC was a significant independent factor for poor disease-free survival (P = 0.0034) and OS (P = 0.0001).ConclusionsAdenocarcinoma is associated with a poorer prognosis and a greater probability of distanat recurrence compared with SCC. Different therapeutic strategies for ADC need to be developed, and when considering the greater tendency for distant recurrence in patients with ADC, systemic chemotherapy may have a role in reducing the risk of hematogenous spread.
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Kim TH, Kim YN, Kim HI, Park SY, Choe JH, Kim JH, Kim JS, Oh YL, Hahn SY, Shin JH, Kim K, Jeong JG, Kim SW, Chung JH. Prognostic value of the eighth edition AJCC TNM classification for differentiated thyroid carcinoma. Oral Oncol 2017; 71:81-86. [PMID: 28688696 DOI: 10.1016/j.oraloncology.2017.06.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [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: 04/25/2017] [Accepted: 06/05/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND The prognostic value of the proposed eighth edition of the American Joint Committee on Cancer (AJCC) tumor, node, and metastasis (TNM) classification is currently unclear. The aim of the study was to evaluate the prognostic value of the eighth edition of the AJCC TNM classification. METHODS We retrospectively assessed 3176 patients with differentiated thyroid carcinoma (DTC) who underwent thyroidectomy at a tertiary Korean hospital from 1996 to 2005. Cancer-specific survival (CSS) was analyzed using the Kaplan-Meier method and compared using the log-rank test. Performance of the eighth edition TNM with respect to prediction of CSS was assessed against the current seventh edition. RESULTS Upon reclassification according to the eighth edition, 37.6% of patients were down-staged. The proportions of stage I and II tumors increased from 61.9% to 81.1% and from 1.7% to 16.0%, respectively, whereas those of stage III and IVB (formerly IVC in the seventh edition) decreased from 27.6% to 2.3% and 0.8% to 0.5%, respectively. The proportions of variance explained (PVEs) for the ability of the eighth and the seventh edition to predict CSS were 3.9% and 2.9%, respectively. The C-index values were 0.765 (95% confidence interval 0.764-0.766) for the eighth edition and 0.736 (0.735-0.737) for the seventh edition. CONCLUSION Our results demonstrate that the eighth edition TNM more accurately predicts CSS for patients with DTC than does the seventh edition.
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Affiliation(s)
- Tae Hyuk Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
| | - Young Nam Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
| | - Hye In Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
| | - So Young Park
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
| | - Jun-Ho Choe
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung-Han Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jee Soo Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young Lyun Oh
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Soo Yeon Hahn
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung Hee Shin
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyunga Kim
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jong Gill Jeong
- Department of Surgery, Yeosu Chonnam Hospital, Yeosu, Republic of Korea
| | - Sun Wook Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea.
| | - Jae Hoon Chung
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea.
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Jung EJ, Byun JM, Kim YN, Lee KB, Sung MS, Kim KT, Shin JB, Jeong DH. Antenatal magnesium sulfate for both tocolysis and fetal neuroprotection in premature rupture of the membranes before 32 weeks’ gestation. J Matern Fetal Neonatal Med 2017; 31:1431-1441. [DOI: 10.1080/14767058.2017.1317743] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Eun Jung Jung
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, Busan, South Korea
| | - Jung Mi Byun
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, Busan, South Korea
- Paik Institute for Clinical Research, Busan Paik Hospital, Inje University, Busan, South Korea
| | - Young Nam Kim
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, Busan, South Korea
- Paik Institute for Clinical Research, Busan Paik Hospital, Inje University, Busan, South Korea
| | - Kyung Bok Lee
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, Busan, South Korea
- Paik Institute for Clinical Research, Busan Paik Hospital, Inje University, Busan, South Korea
| | - Moon Su Sung
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, Busan, South Korea
- Paik Institute for Clinical Research, Busan Paik Hospital, Inje University, Busan, South Korea
| | - Ki Tae Kim
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, Busan, South Korea
- Paik Institute for Clinical Research, Busan Paik Hospital, Inje University, Busan, South Korea
| | - Jong Beom Shin
- Department of Pediatrics, Busan Paik Hospital, Inje University, Busan, South Korea
| | - Dae Hoon Jeong
- Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, Busan, South Korea
- Paik Institute for Clinical Research, Busan Paik Hospital, Inje University, Busan, South Korea
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Abstract
Kaposiform hemangioendothelioma (KHE) is a locally aggressive vascular tumor that usually occurs in soft tissues of the extremity and rarely in the retroperitoneum. We report a unique case of isolated massive fetal ascites attributed to KHE, involving the retroperitoneum and multiple visceral organs, along with the Kasabach-Merritt phenomenon. We suspect that retroperitoneal KHE might have caused massive fetal ascites because of its high potential to invade the lymphatic vessels aggressively in the retroperitoneal space, which possibly permits intestinal lymph leakage into the peritoneal cavities.
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Affiliation(s)
- Hyo Jung An
- a Department of Pathology , College of Medicine, Inje University Busan Paik Hospital , Busan , Republic of Korea
| | - Eun Jung Jung
- b Department of Obstetrics and Gynecology , College of Medicine, Inje University Busan Paik Hospital , Busan , Republic of Korea
| | - Mi Seon Kang
- a Department of Pathology , College of Medicine, Inje University Busan Paik Hospital , Busan , Republic of Korea
| | - Hwa Jin Cho
- a Department of Pathology , College of Medicine, Inje University Busan Paik Hospital , Busan , Republic of Korea
| | - Kyung Han Nam
- c Department of Pathology , College of Medicine, Inje University, Haeundae Paik Hospital , Busan , Republic of Korea
| | - Jung Mi Byun
- b Department of Obstetrics and Gynecology , College of Medicine, Inje University Busan Paik Hospital , Busan , Republic of Korea.,d Paik Institute for Clinical Research, College of Medicine, Busan Paik Hospital , Busan , Republic of Korea
| | - Dae Hoon Jeong
- b Department of Obstetrics and Gynecology , College of Medicine, Inje University Busan Paik Hospital , Busan , Republic of Korea.,d Paik Institute for Clinical Research, College of Medicine, Busan Paik Hospital , Busan , Republic of Korea
| | - Young Nam Kim
- b Department of Obstetrics and Gynecology , College of Medicine, Inje University Busan Paik Hospital , Busan , Republic of Korea.,d Paik Institute for Clinical Research, College of Medicine, Busan Paik Hospital , Busan , Republic of Korea
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Kim M, Kim YN, Kim WG, Park S, Kwon H, Jeon MJ, Ahn HS, Jung SH, Kim SW, Kim WB, Chung JH, Shong YK, Kim TH, Kim TY. Optimal cut-off age in the TNM Staging system of differentiated thyroid cancer: is 55 years better than 45 years? Clin Endocrinol (Oxf) 2017; 86:438-443. [PMID: 27731521 DOI: 10.1111/cen.13254] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 10/05/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Age >45 years is included as a variable in the tumor, node, metastases (TNM) staging of differentiated thyroid cancer (DTC), but a higher cut-off value has been suggested to be more clinically relevant and prevent over-staging. We evaluated the optimal age cut-off to predict disease-specific survival (DSS) in patients with DTC. DESIGN AND PATIENTS This cohort study included 6333 patients with DTC who underwent thyroid surgery at two tertiary referral centres between 1996 and 2005. The optimal age cut-off value between 45 and 65 years for prediction of DSS was assessed. The proportion of variation explained (PVE) and Harrell's c-index was calculated to compare the predictability of each model. RESULTS The median age of patients was 46·0 years (IQR 37·8-54·6), and 5498 (87%) were female. Median follow-up period was 10·0 years, and 10-year DSS rate was 98%. Using TNM staging with 45 years as the cut-off (TNM45), 10-year DSS rates of stage I-IV were 99·4%, 96·1%, 97·7% and 85·9%, respectively (PVE = 3·0%, Harrell's c-index = 0·693); and using 55 years as the cut-off (TNM55), 99·4%, 92·2%, 95·3% and 79·7%, respectively (PVE = 4·3%, Harrell's c-index = 0·776). On receiver operating characteristic curve analysis, the optimal age cut-off for prediction of DSS was 55·4 years (area under the curve = 0·837, P < 0·001). About 20% of patients were down-staged to stage I using TNM55 compared to that using TNM45. CONCLUSIONS The cut-off age of 55 years was more appropriate for TNM staging to achieve better predictability for DSS in patients with DTC. This change would prevent over-staging in low-risk patients and prevent over-aggressive treatment.
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Affiliation(s)
- Mijin Kim
- Departments of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Nam Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Gu Kim
- Departments of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Suyeon Park
- Departments of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyemi Kwon
- Departments of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Ji Jeon
- Departments of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyeon Seon Ahn
- Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Seoul, Korea
| | - Sin-Ho Jung
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Sun Wook Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Bae Kim
- Departments of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Hoon Chung
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Kee Shong
- Departments of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Hyuk Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Yong Kim
- Departments of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Cho YY, Song JS, Park HD, Kim YN, Kim HI, Kim TH, Chung JH, Ki CS, Kim SW. First Report of Familial Dysalbuminemic Hyperthyroxinemia With an ALB Variant. Ann Lab Med 2017; 37:63-65. [PMID: 27834068 PMCID: PMC5107620 DOI: 10.3343/alm.2017.37.1.63] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 05/20/2016] [Accepted: 10/19/2016] [Indexed: 11/29/2022] Open
Abstract
Familial dysalbuminemic hyperthyroxinemia (FDH) is an inherited disease characterized by increased circulating total thyroxine (T4) levels and normal physiological thyroid function. Heterozygous albumin gene (ALB) variants have been reported to be the underlying cause of FDH. To our knowledge, there have been no confirmed FDH cases in Korea. We recently observed a female patient with mild T4 elevation (1.2 to 1.4-fold) and variable levels of free T4 according to different assay methods. Upon Sanger sequencing of her ALB, a heterozygous c.725G>A (p.Arg242His) variant was identified. The patient's father and eldest son had similar thyroid function test results and were confirmed to have the same variant. Although the prevalence of FDH might be very low in the Korean population, clinical suspicion is important to avoid unnecessary evaluation and treatment.
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Affiliation(s)
- Yoon Young Cho
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Division of Endocrinology and Metabolism, Department of Medicine, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Ju Sun Song
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyung Doo Park
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Nam Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye In Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Hyuk Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hoon Chung
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang Seok Ki
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Sun Wook Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Ma W, St-Jacques B, Rudakou U, Kim YN. Stimulating TRPV1 externalization and synthesis in dorsal root ganglion neurons contributes to PGE2 potentiation of TRPV1 activity and nociceptor sensitization. Eur J Pain 2016; 21:575-593. [PMID: 27739618 DOI: 10.1002/ejp.959] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Persistent peripheral sensitization contributes to chronic pain. Plasticity of nociceptive dorsal root ganglion (DRG) neurons (nociceptors) induced by pro-inflammatory mediators contributes to sensitization. Prostaglandin E2 (PGE2) enriched in injured tissues is known not only directly to sensitize DRG neurons, but also to potentiate sensitizing effects of other pain mediators such as capsaicin and its receptor transient receptor potential vanilloid-1 (TRPV1). It remains unknown whether PGE2 potentiates TRPV1 activity by stimulating its synthesis, cell surface and axonal trafficking in DRG neurons. METHODS Combined biochemical, morphological, pharmacological and behavioral approaches have been used to address this issue in both in vitro and in vivo models. RESULTS PGE2 increased TRPV1 externalization in cultured rat DRG neurons in a time- and concentration-dependent manner, an event blocked by an inhibitor of protein synthesis or anterograde export. EP1 and EP4, but not EP2 and EP3, mediated this event. EP1 agonist-induced TRPV1 externalization was suppressed by inhibitors of CaMKII, PLC, PKC and PKCε, while EP4 agonist-induced TRPV1 externalization by inhibitors of cAMP/PKA and ERK/MAPK. Pre-exposure to PGE2 potentiated release of calcitonin gene-related peptide from cultured DRG neurons evoked by subsequent capsaicin stimulation. This event was blocked by an inhibitor of protein synthesis or export, suggesting that PGE2-induced TRPV1 synthesis and externalization is coupled to enhanced TRPV1 activity. Pre-exposure to PGE2 not only prolonged tactile allodynia evoked by subsequent capsaicin challenge, but also increased TRPV1 levels in L4-6 DRG, sciatic nerves and plantar skin. CONCLUSIONS Our data indicate that facilitating TRPV1 synthesis, cell surface and axonal trafficking is a novel mechanism underlying PGE2 potentiation of TRPV1 activity.
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Affiliation(s)
- W Ma
- Douglas Mental Health University Institute, McGill University, Montréal, QC, Canada.,Department of Psychiatry, McGill University, Montréal, QC, Canada
| | - B St-Jacques
- Douglas Mental Health University Institute, McGill University, Montréal, QC, Canada
| | - U Rudakou
- Douglas Mental Health University Institute, McGill University, Montréal, QC, Canada
| | - Y N Kim
- Douglas Mental Health University Institute, McGill University, Montréal, QC, Canada
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Cho YY, Song KH, Kim YN, Ahn SH, Kim H, Park S, Suh S, Kim BJ, Lee SY, Chun S, Koh JM, Lee SH, Kim JH. Symptom-dependent cut-offs of urine metanephrines improve diagnostic accuracy for detecting pheochromocytomas in two separate cohorts, compared to symptom-independent cut-offs. Endocrine 2016; 54:206-216. [PMID: 27481364 DOI: 10.1007/s12020-016-1049-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 07/04/2016] [Indexed: 12/30/2022]
Abstract
The development of advanced imaging techniques has increased the detection of subclinical pheochromocytomas. Because of the substantial proportions of subclinical pheochromocytomas, measurement of urine metanephrine concentrations is crucial due to detect or exclude pheochromocytoma. Although urine metanephrines are elevated in symptomatic subjects, diagnostic cut-offs according to the presence of adrenergic symptoms have not been studied. Pheochromocytomas patients who underwent adrenalectomy at Samsung Medical Center and a control group were compared to determine cut-off concentrations of urine metanephrines. An independent population was analyzed for urine metanephrines with different kits to validate the improvement in diagnostic accuracy using adjusted cut-offs. Symptom-dependent cut-offs of urine metanephrines were higher for symptomatic patients (307 μg/day in males, 235 μg/day in females for urine metanephrine, and 1,045 μg/day in males and 457 μg/day in females for urine normetanephrine) than for asymptomatic patients (206 μg/day in males, 199 μg/day in females for urine metanephrine, and 489 μg/day in males and 442 μg/day in females for urine normetanephrine). Symptom-dependent cut-offs of urine metanephrines improved a specificity from 92.7 % to 96.3 % and a high sensitivity of 97.8 % was maintained. Using the Symptom-dependent cut-offs raised diagnostic accuracy by 5.5 % (p <0.001). Similar trend was also observed in an independent population using different hormone kits. Using symptom-dependent cut-offs of urine metanephrines in symptomatic patients for pheochromocytomas resulted in a significant improvement in diagnostic accuracy in two separate cohorts.
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Affiliation(s)
- Yoon Young Cho
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Medicine, Gyeongsang National University School of Medicine, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Kee-Ho Song
- Division of Endocrinology and Metabolism, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Young Nam Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seong Hee Ahn
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Endocrinology, Inha University School of Medicine, Incheon, Korea
| | - Hyeonmok Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sooyoun Park
- Division of Endocrinology and Metabolism, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Sunghwan Suh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, Korea
| | - Beom-Jun Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Soo-Youn Lee
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sail Chun
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung-Min Koh
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung Hun Lee
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- Samsung Biomedical Research Institute, Seoul, Korea.
- Department of Health Sciences & Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.
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Kim YN, Kim JY, Kim JW, Kim JH, Kim HI, Yune S, Choi DC, Lee BJ. The Hidden Culprit: A Case of Repeated Anaphylaxis to Cremophor. Allergy Asthma Immunol Res 2016; 8:174-7. [PMID: 26739412 PMCID: PMC4713882 DOI: 10.4168/aair.2016.8.2.174] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 07/07/2015] [Indexed: 01/19/2023]
Abstract
Drug-induced anaphylaxis is a big pitfall in patients receiving antineoplastic chemotherapy. We report a case of lung cancer patient who experienced two near-fatal anaphylactic reactions that resulted from paclitaxel and multivitamin, seperately. Recurrent severe reactions to different agents led to further investigation to which material the patient was hypersensitive. The skin prick test revealed sensitization to cremophor, which is a commonly used emulsifying agent. This case emphasizes the importance of correctly identifying the culprit drug of anaphylaxis to avoid potentially fatal reaction.
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Affiliation(s)
- Young Nam Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jun Young Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Won Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Hae Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye In Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sehyo Yune
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Chull Choi
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byung Jae Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Zeb G, Gaskell P, Kim YN, Jalani G, Xiao X, Szkopek T, Cerruti M. The importance of covalent coupling in the synthesis of high performance composite anodes for lithium ion batteries. RSC Adv 2016. [DOI: 10.1039/c6ra01571a] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We present a direct comparison between identical electrostatically and covalently assembled Si–graphene composites for lithium ion battery anodes.
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Affiliation(s)
- Gul Zeb
- Mining & Materials Engineering
- McGill University
- Montreal
- Canada
| | - Peter Gaskell
- Electrical & Computer Engineering
- McGill University
- Montreal
- Canada
| | | | - Ghulam Jalani
- Mining & Materials Engineering
- McGill University
- Montreal
- Canada
| | | | - Thomas Szkopek
- Electrical & Computer Engineering
- McGill University
- Montreal
- Canada
| | - Marta Cerruti
- Mining & Materials Engineering
- McGill University
- Montreal
- Canada
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Byun JM, Jeong DH, Kim YN, Lee KB, Sung MS, Kim KT. Labial adhesions caused by Stevens–Johnson syndrome. DERMATOL SIN 2015. [DOI: 10.1016/j.dsi.2015.02.004] [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: 11/27/2022] Open
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