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Lee J, Cho S, Chung JH, Yoon SH, Shih BCH, Jung W, Jeon JH, Kim K, Jheon S. Prognosis of spread through air spaces in invasive mucinous lung adenocarcinoma after curative surgery. Eur J Surg Oncol 2024; 50:108053. [PMID: 38412587 DOI: 10.1016/j.ejso.2024.108053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/11/2024] [Accepted: 02/21/2024] [Indexed: 02/29/2024]
Abstract
INTRODUCTION The purpose of this study is to investigate the prognostic impact of spread through air spaces (STAS) in invasive mucinous adenocarcinoma (IMA). MATERIALS AND METHODS From 2015 to 2019, patients who underwent complete resection of IMA were extracted from the prospective database. Multivariable Cox-regression analysis and inverse probability of treatment weight (IPTW) - adjusted log-rank test for 5-year recurrence-free survival (RFS) were performed. RESULTS STAS was observed in 39.1% (53 out of 133). The STAS (+) group shows larger tumor size (2.9 ± 2.4 cm vs 3.8 ± 2.4 cm, p = 0.031) and higher incidence of lympho-vascular invasion (6 [7.5%] vs 18 [34.0%], p < 00.001) compared to the STAS (-) group. The 5-year RFS was 66.1% in the STAS (+) group and 91.8% in the STAS (-) group (p < 00.001), and the incidence of locoregional recurrence was significantly higher in the STAS (+) group than the STAS (-) group (1 [1.2%] vs 12 [22.6%], p < 00.001). Multivariable analysis revealed that STAS was associated with poor prognosis for all-recurrence (hazard ratio 2.81, 95% confidence interval 1.01-7.81, p = 0.048). After IPTW adjustment, 5-year RFS was 66.3% in the STAS (+) group and 92.9% in the STAS (-) group (p = 0.007), and risk for locoregional recurrence was greater in the STAS (+) group than the STAS (-) group (1.1 [0.9%] vs 20.8 [16.6%], p < 00.001). CONCLUSIONS STAS showed negative prognostic impact on all-recurrence, especially due to locoregional recurrence, after curative resection of IMA.
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Affiliation(s)
- Joonseok Lee
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Sukki Cho
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea; Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Jin-Haeng Chung
- Department of Pathology and Translational Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea; Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Seung Hwan Yoon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Beatrice Chia-Hui Shih
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Woohyun Jung
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Jae Hyun Jeon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Kwhanmien Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea; Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sanghoon Jheon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea; Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
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Jeon JH, Kim AW. Brace Yourself… There May Be a Better Option Than Surgery First! Ann Thorac Surg 2024; 117:150-151. [PMID: 36513166 DOI: 10.1016/j.athoracsur.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 12/03/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Jae Hyun Jeon
- Division of Thoracic Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo St, Ste 514, Los Angeles, CA 90033
| | - Anthony W Kim
- Division of Thoracic Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo St, Ste 514, Los Angeles, CA 90033.
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Lee J, Jeon JH, Yoon SH, Shih BCH, Jung W, Hwang Y, Cho S, Kim K, Jheon S. The Optimal Treatment Strategy for Postoperative Anastomotic Leakage After Esophagectomy: a Comparative Analysis Between Endoscopic Vacuum Therapy and Conventional Treatment. J Gastrointest Surg 2023; 27:2899-2906. [PMID: 38040922 DOI: 10.1007/s11605-023-05637-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 02/18/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND We compared the clinical outcomes between endoscopic vacuum therapy (EVT) and conventional treatment (CT) for the management of post-esophagectomy anastomotic leakage. METHODS A retrospective review of the medical records of patients who underwent esophagectomy with esophagogastrostomy from November 2003 to August 2021 was conducted. Thirty-four patients who developed anastomotic leakage were analyzed according to whether they underwent CT (n = 13) or EVT (n = 21). RESULTS The median time to complete healing was significantly shorter in the EVT group than in the CT group (16 [4-142] days vs. 70 [8-604] days; p = 0.011). The rate of clinical success was higher in the EVT group (90.5%) than in the CT group (66.7%, p = 0.159). A subgroup analysis showed more favorable outcomes for EVT in patients with thoracic leakage, including a higher clinical success rate (p = 0.037), more rapid complete healing (p = 0.004), and shorter hospital stays (p = 0.006). However, the results were not significantly different in patients with cervical leakage. Anastomotic strictures occurred in 3 EVT patients (14.3%) and 5 CT patients (50.0%) (p = 0.044), and the EVT group showed a trend towards improved freedom from anastomotic strictures (p = 0.105). CONCLUSIONS EVT could be considered as an adequate treatment option for post-esophagectomy anastomotic leakage. EVT might have better clinical outcomes compared to CT for managing anastomotic leakage after transthoracic esophagogastrostomy, and further studies are needed to evaluate the effectiveness of EVT in patients who undergo cervical esophagogastrostomy.
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Affiliation(s)
- Joonseok Lee
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13620, Republic of Korea
| | - Jae Hyun Jeon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13620, Republic of Korea.
| | - Seung Hwan Yoon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13620, Republic of Korea
| | - Beatrice Chia-Hui Shih
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13620, Republic of Korea
| | - Woohyun Jung
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13620, Republic of Korea
| | - Yoohwa Hwang
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13620, Republic of Korea
| | - Sukki Cho
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13620, Republic of Korea
| | - Kwhanmien Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13620, Republic of Korea
| | - Sanghoon Jheon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13620, Republic of Korea
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Lee J, Cho S, Yoon SH, Shih BCH, Jung W, Jeon JH, Kim K, Jheon S. Surgical outcomes of thoracoscopic thymectomy via the single-port subxiphoid approach versus the unilateral intercostal approach. Interdiscip Cardiovasc Thorac Surg 2023; 37:ivad141. [PMID: 37792493 PMCID: PMC10561956 DOI: 10.1093/icvts/ivad141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/03/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVES The purpose of this study was to explore the safety and feasibility of video-assisted thoracic surgery (VATS) total thymectomy via the single-port subxiphoid approach compared with the intercostal approach. METHODS From January 2018 to May 2022, patients who underwent VATS total thymectomy via the subxiphoid or unilateral intercostal approach and diagnosed with Masaoka-Koga stage I-II, non-myasthenic thymoma were included in this study. Perioperative outcomes, immediate and long-term pain evaluations were compared in a propensity score-matching analysis. RESULTS In total, 95 patients were included and underwent the subxiphoid approach (n = 37) and the intercostal approach (n = 58). Propensity score yielded 2 well-matched cohorts of 30 patients and there was no significant demographical imbalance between the 2 groups. Compared with the intercostal approach, the subxiphoid group demonstrated favourable perioperative outcomes including the intraoperative blood loss (P = 0.025) and the median duration of hospital stay (P = 0.083). The immediate and long-term pain evaluations revealed that the subxiphoid group reported lower visual analogue scales at postoperative 24 h and lower total doses of fentanyl bolus infusions during hospitalization (P = 0.004 and 0.018, respectively), along with lower long-term neuropathic pain scale scores (P = 0.005) than patients in the intercostal group. CONCLUSIONS VATS thymectomy via the single-port subxiphoid approach showed favourable perioperative outcomes compared to the intercostal approach. Moreover, the subxiphoid approach seemed both to cause minimal immediate postoperative pain and to have advantages in reducing long-term neuropathic pain compared with the intercostal approach.
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Affiliation(s)
- Joonseok Lee
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Sukki Cho
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seung Hwan Yoon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Beatrice Chia-Hui Shih
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Woohyun Jung
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Jae Hyun Jeon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Kwhanmien Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sanghoon Jheon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
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Ryu H, Song C, Kim J, Jeon JH, Cho S, Kim K, Jheon S, Kim SH, Kim YJ, Lee JS. Role of prognostic nutritional index in postoperative radiotherapy for non-small cell lung cancer. Thorac Cancer 2023; 14:2859-2868. [PMID: 37594010 PMCID: PMC10542465 DOI: 10.1111/1759-7714.15074] [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: 05/14/2023] [Revised: 07/30/2023] [Accepted: 08/01/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND The prognostic nutritional index (PNI) is known to be correlated with clinical outcomes in non-small cell lung cancer (NSCLC) patients. However, its role has not been studied in patients who have undergone postoperative radiotherapy (PORT). This study aimed to investigate the relationship between PNI and survival and recurrence in NSCLC patients with PORT. METHODS We reviewed 97 stage I-III NSCLC patients who received PORT between January 2006 and December 2016 at our institution. We obtained PNI values for both pre-RT (within 1 month before PORT) and post-RT (within 2 months after PORT) by using serum albumin and lymphocyte count. A cutoff value for PNI was determined by the receiver operating characteristic curve (ROC). The median follow-up period was 52.8 months. RESULTS The ROC curve of post-RT PNI exhibited a higher area under the curve (AUC 0.68, cut-off: 47.1) than that of pre-RT PNI (AUC 0.55, cutoff: 50.3), so the group was divided into high post-RT PNI (> 47.1) and low post-RT PNI ( ≤ 47.1). The five-year overall survival rate (OS) was 66.2% in the high post-RT group, compared with 41.8% in the low post-RT PNI group (p = 0.018). Those with both low pre-RT and low post-RT PNI had the worst five-year OS of 31.1%. Post-RT PNI (HR 0.92, p = 0.003) was an independent risk factor for mortality. CONCLUSIONS PNI after PORT was significantly associated with survival. This finding suggests that PNI can be used as a prognostic marker.
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Affiliation(s)
- Hyejo Ryu
- Department of Radiation OncologySeoul National University HospitalSeoulSouth Korea
| | - Changhoon Song
- Department of Radiation OncologySeoul National University Bundang HospitalSeongnamSouth Korea
| | - Jae‐Sung Kim
- Department of Radiation OncologySeoul National University Bundang HospitalSeongnamSouth Korea
| | - Jae Hyun Jeon
- Department of Thoracic and Cardiovascular SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
| | - Sukki Cho
- Department of Thoracic and Cardiovascular SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
| | - Kwhanmien Kim
- Department of Thoracic and Cardiovascular SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
| | - Sanghoon Jheon
- Department of Thoracic and Cardiovascular SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
| | - Se Hyun Kim
- Department of Internal MedicineSeoul National University Bundang HospitalSeongnamSouth Korea
| | - Yu Jung Kim
- Department of Internal MedicineSeoul National University Bundang HospitalSeongnamSouth Korea
| | - Jong Seok Lee
- Department of Internal MedicineSeoul National University Bundang HospitalSeongnamSouth Korea
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Jeon JH, Harano T, Rodman JCS, Sheth M, Wightman SC, Atay SM, Kim AW. Early outcomes of lung transplantation with lung allografts from coronavirus disease 2019 (COVID-19)-positive donors. J Thorac Cardiovasc Surg 2023:S0022-5223(23)00743-2. [PMID: 37625616 DOI: 10.1016/j.jtcvs.2023.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/24/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023]
Abstract
OBJECTIVE Coronavirus disease 2019 (COVID-19) can be detected for extended periods of time with nucleic acid amplification test even after transmissibility becomes negligible. Lung allografts from COVID-19-positive donors have been used for transplantation in highly selected cases. This study aimed to clarify the early outcomes of lung transplantation with COVID-19-positive donors. METHODS The Organ Procurement and Transplantation Network/United Network for Organ Sharing database between April 2020 and June 2022 was retrospectively analyzed. RESULTS In the study period, 1297 COVID-19-positive donors were identified and the lungs were transplanted from 47 donors (3.6%). Of 47 donors, 44 donors were positive for COVID-19 NAT with nasopharyngeal swabs and the other 3 were positive with bronchoalveolar lavage. The COVID-19-positive lung donors were younger than the COVID-19-negative donors (28.4 ± 11.6 years vs 35.4 ± 13.6 years, P < .001). Recipients of the COVID-19-positive lungs (n = 47) were more likely have a greater lung allocation score (57.1 ± 22.9 vs 50.5 ± 19.7, P = .057) than recipients of COVID-19-negative lungs (n = 5501). The posttransplant length of hospital stay (39.8 ± 43.6 days vs 30.6 ± 34.5 days, P = .181), need for extracorporeal membrane oxygenation support at 72 hours after transplantation (2.6% [1/38] vs 10.4% [541/5184], P = .18), and 1-year overall survival rate (85.6% vs 87.1%, P = .63) were comparable between the 2 groups. CONCLUSIONS Carefully selected lung allografts from COVID-19-positive donors had comparable early posttransplant outcomes to lung allografts from COVID-19-negative donors.
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Affiliation(s)
- Jae Hyun Jeon
- Division of Thoracic Surgery, Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, Calif; Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Takashi Harano
- Division of Thoracic Surgery, Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, Calif.
| | - John C S Rodman
- Biostatistics, Epidemiology, and Research Design, Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, Calif
| | - Megha Sheth
- Keck School of Medicine of the University of Southern California, Los Angeles, Calif
| | - Sean C Wightman
- Division of Thoracic Surgery, Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, Calif
| | - Scott M Atay
- Division of Thoracic Surgery, Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, Calif
| | - Anthony W Kim
- Division of Thoracic Surgery, Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, Calif
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Jeon DS, Kim HC, Kim SH, Kim TJ, Kim HK, Moon MH, Beck KS, Suh YG, Song C, Ahn JS, Lee JE, Lim JU, Jeon JH, Jung KW, Jung CY, Cho JS, Choi YD, Hwang SS, Choi CM. Five-Year Overall Survival and Prognostic Factors in Patients with Lung Cancer: Results from the Korean Association of Lung Cancer Registry (KALC-R) 2015. Cancer Res Treat 2023; 55:103-111. [PMID: 35790197 PMCID: PMC9873320 DOI: 10.4143/crt.2022.264] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/16/2022] [Indexed: 02/04/2023] Open
Abstract
PURPOSE This study aimed to provide the clinical characteristics, prognostic factors, and 5-year relative survival rates of lung cancer diagnosed in 2015. MATERIALS AND METHODS The demographic risk factors of lung cancer were calculated using the KALC-R (Korean Association of Lung Cancer Registry) cohort in 2015, with survival follow-up until December 31, 2020. The 5-year relative survival rates were estimated using Ederer II methods, and the general population data used the death rate adjusted for sex and age published by the Korea Statistical Information Service from 2015 to 2020. RESULTS We enrolled 2,657 patients with lung cancer who were diagnosed in South Korea in 2015. Of all patients, 2,098 (79.0%) were diagnosed with non-small cell lung cancer (NSCLC) and 345 (13.0%) were diagnosed with small cell lung cancer (SCLC), respectively. Old age, poor performance status, and advanced clinical stage were independent risk factors for both NSCLC and SCLC. In addition, the 5-year relative survival rate declined with advanced stage in both NSCLC (82%, 59%, 16%, 10% as the stage progressed) and SCLC (16%, 4% as the stage progressed). In patients with stage IV adenocarcinoma, the 5-year relative survival rate was higher in the presence of epidermal growth factor receptor (EGFR) mutation (19% vs. 11%) or anaplastic lymphoma kinase (ALK) translocation (38% vs. 11%). CONCLUSION In this Korean nationwide survey, the 5-year relative survival rates of NSCLC were 82% at stage I, 59% at stage II, 16% at stage III, and 10% at stage IV, and the 5-year relative survival rates of SCLC were 16% in cases with limited disease, and 4% in cases with extensive disease.
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Affiliation(s)
- Da Som Jeon
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Ho Cheol Kim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Se Hee Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Tae-Jung Kim
- Department of Hospital Pathology, Yeouido St. Mary’s hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Hong Kwan Kim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Mi Hyung Moon
- Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Kyongmin Sarah Beck
- Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Yang-Gun Suh
- Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang,
Korea
| | - Changhoon Song
- Department of Radiation Oncology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam,
Korea
| | - Jin Seok Ahn
- Department of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Jeong Eun Lee
- Division of Pulmonology, Chungnam National University College of Medicine, Daejeon,
Korea
| | - Jeong Uk Lim
- Division of Pulmonary, Allergy and Critical Care Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Jae Hyun Jeon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam,
Korea
| | - Kyu-Won Jung
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang,
Korea
| | - Chi Young Jung
- Department of Pulmonary, Daegu Catholic University Medical Center, Daegu Catholic University School of Medicine, Daegu,
Korea
| | - Jeong Su Cho
- Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Busan,
Korea
| | - Yoo-Duk Choi
- Department of Pathology, Chonnam National University Medical School, Gwangju,
Korea
| | - Seung-Sik Hwang
- Department of Public Health Science, Graduate School of Public Healthy, Seoul National University, Seoul,
Korea
| | - Chang-Min Choi
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea,Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
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Kim TH, Jeon JH, Chung JH, Cho YJ. Pulmonary blastoma that was first diagnosed as dedifferentiated chondrosarcoma using medical thoracoscopy: A case report. Medicine (Baltimore) 2022; 101:e31377. [PMID: 36451398 PMCID: PMC9704978 DOI: 10.1097/md.0000000000031377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
RATIONALE Pulmonary blastoma is an extremely rare and highly aggressive tumor. Only a few hundred cases of pulmonary blastoma have been reported. In other cases, a definitive diagnosis is often made through surgical resection. The use of preoperative histopathological sampling in diagnosing was of limited value because of the variety of pulmonary blastoma histology. And there was no literature that the first biopsy was attempted with medical thoracoscopy for diagnosis. PATIENT CONCERNS A 65-year-old man presented to our hospital with pleural effusion and lung mass. DIAGNOSES The patient was initially diagnosed with dedifferentiated chondrosarcoma by medical thoracoscopic biopsy but the final diagnosis was pulmonary blastoma through bilobectomy. INTERVENTIONS Medical thoracoscopy, and video-assisted thoracoscopic surgery (bilobectomy) followed by adjuvant chemotherapy. OUTCOMES After surgical resection of the tumor, adjuvant chemotherapy has been performed 5 cycles at 3 weeks intervals, and there was no evidence of recurrence on follow-up computed tomography performed 4 months after surgery. LESSONS Medical thoracoscopy is useful for the diagnosis of indeterminate pleural effusion; however, caution is needed when confirming rare malignancies, such as pulmonary blastoma. Although surgical resection is the treatment of choice, appropriate adjuvant chemotherapy to improve the prognosis may be necessary if there is pleural metastasis.
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Affiliation(s)
- Tae Hun Kim
- Divisions of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jae Hyun Jeon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jin-Haeng Chung
- Department of Pathology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Young-Jae Cho
- Divisions of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
- * Correspondence: Young-Jae Cho, Divisions of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Gyeonggi-do 13620, Korea (e-mail: )
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Vishnu R, Jung W, Chia-Hui Shih B, Hwang Y, Jeon JH, Cho S, Kim K, Jheon S. Subcostal robotic-assisted pulmonary resection: Left lingular segmentectomy. JTCVS Tech 2022; 16:149-152. [PMID: 36510517 PMCID: PMC9735356 DOI: 10.1016/j.xjtc.2022.08.018] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/18/2022] [Accepted: 08/04/2022] [Indexed: 12/16/2022] Open
Affiliation(s)
| | - Woohyun Jung
- Address for reprints: Woohyun Jung, MD, Division of Thoracic Surgery, Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, 166, Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Republic of Korea.
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Seong YW, Jeon JH, Jang HJ, Cho S, Jheon S, Kim K. Video-assisted thoracic surgery sleeve resection and bronchoplasty using 3D imaging system: its safety and efficacy. J Cardiothorac Surg 2021; 16:302. [PMID: 34656152 PMCID: PMC8520266 DOI: 10.1186/s13019-021-01685-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 10/07/2021] [Indexed: 11/24/2022] Open
Abstract
Background Video-assisted thoracic surgery sleeve resection with bronchial anastomosis or bronchoplasty is a technically demanding procedure. Three-dimensional endoscopic surgery has been reported to be helpful in decreasing operation time and improving spatial perception with less surgical errors, but there have been rare reports about relatively difficult thoracoscopic procedures utilizing 3D thoracoscope. We performed this study to evaluate early clinical outcomes of thoracoscopic sleeve resection and bronchoplasty utilizing 3D thoracoscope.
Methods Data from a total of 36 patients who underwent thoracoscopic sleeve lobectomy or bronchoplasty at our institution from December 2015 to October 2017 were retrospectively reviewed. Three-port approach with one utility incision was used with a 10 mm, 30° three-dimensional thoracoscope. Twenty-three patients (81%) were male, and mean age was 65.9 ± 9.4 years. Fourteen patients (38.9%) underwent sleeve resection with bronchial anastomosis, 22 (61.1%) underwent wedge or simple bronchoplasty, and one patient received concomitant PA procedure. Bronchial anastomosis sites were not covered with viable tissue flaps.
Results There was no (0%) suture needle injury from spatial misperception during bronchoplasty or sleeve anastomosis. There was no (0%) operative mortality. The pathologic report revealed squamous cell carcinoma (63.9%), adenocarcinoma (19.4%), carcinoid (6.9%), adenosquamous carcinoma (3.4%), and sarcomatoid carcinoma (2.8%). One (2.8%) late mortality was due to systemic recurrence of sarcomatoid carcinoma. There was no (0.0%) anastomotic failure. The mean number of dissected lymph nodes were 27.4 ± 13.2, and mean operation time was 216.8 ± 60.0 min. Median postoperative 24-h drain amount was 315 mL. Median chest tube days and hospital days were 4 and 6, respectively. Two patients (5.6%) had complications greater than Clavien-Dindo grade II—one case of ARDS, and the other case of a delayed bronchopleural fistula. Conclusions Thoracoscopic sleeve resection and bronchoplasty utilizing HD 3D thoracoscope is a safe and effective procedure with excellent early clinical outcomes. Further investigation for long-term outcomes will be needed.
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Affiliation(s)
- Yong Won Seong
- Department of Thoracic and Cardiovascular Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Hyun Jeon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyo-Jun Jang
- Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital, Seoul, Korea
| | - Sukki Cho
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sanghoon Jheon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kwhanmien Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea.
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Jeon JH, Seong YW, Han JE, Cho S, Kim JH, Jheon S, Kim K. Randomized trial of poloxamer 407-based ropivacaine hydrogel after thoracoscopic pulmonary resection. Ann Thorac Surg 2021; 114:1189-1196. [PMID: 34653384 DOI: 10.1016/j.athoracsur.2021.08.077] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/29/2021] [Accepted: 08/30/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND We conducted a comparative study to evaluate the efficacy of poloxamer 407-based ropivacaine hydrogel at the wound site (Gel) and continuous thoracic paravertebral block (On-Q) for postoperative pain following thoracoscopic pulmonary resection. METHODS This prospective, randomized, noninferiority study included 89 patients randomized into the two groups; Gel (poloxamer 407-based 0.75% ropivacaine, 22.5 mg) and On-Q (0.2% ropivacaine, 4 mg/hour for 48 hours). The primary outcome measure was total fentanyl consumption and secondary outcome measures were the need for rescue analgesia and pain intensity using the numeric rating scale (NRS). RESULTS There was no significant difference in total fentanyl consumption between the Gel group and the On-Q group (1504.29 ± 315.72 mcg vs 1560.32 ± 274.81 mcg, p = 0.374). Pain intensity using the NRS between the Gel group and the On-Q group demonstrated no statistical differences (6 hours: 3.56 vs 3.55, p = 0.958; 24 hours: 3.21 vs 3.00, p = 0.250; 48 hours: 2.75 vs 2.49, p = 0.233; and 72 hours: 2.39 vs 2.33, p = 0.811), and there was no significant difference in the frequency of analgesic rescue medication use (3.70 vs 3.33, p = 0.417). CONCLUSIONS We confirm the noninferiority of Gel compared with On-Q for acute postoperative pain following thoracoscopic pulmonary resection. Considering a technical simplicity and low systemic toxicity of the local injection of Gel, this analgesic modality may be worthy of further research and is thus considered to have potential as a viable alternative to On-Q for regional analgesia.
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Affiliation(s)
- Jae Hyun Jeon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Won Seong
- Department of Thoracic and Cardiovascular Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Eun Han
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sukki Cho
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Hee Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sanghoon Jheon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kwhanmien Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea.
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12
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Shih BCH, Jeon JH, Chung JH, Kwon HJ, Lee JH, Jung W, Hwang Y, Cho S, Kim K, Jheon S. Prognostic Significance of the Extranodal Extension of Regional Lymph Nodes in Stage III-N2 Non-Small-Cell Lung Cancer after Curative Resection. J Clin Med 2021; 10:jcm10153324. [PMID: 34362108 PMCID: PMC8347115 DOI: 10.3390/jcm10153324] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/25/2021] [Accepted: 07/26/2021] [Indexed: 11/20/2022] Open
Abstract
The present study investigated the prognostic role of extranodal extension (ENE) in stage III-N2 non-small-cell lung cancer (NSCLC) following curative surgery. From January 2005 to December 2018, pathologic stage III-N2 disease was diagnosed in 371 patients, all of whom underwent anatomic pulmonary resection accompanied by mediastinal lymph node dissection. This study included 282 patients, after excluding 89 patients who received preoperative chemotherapy or incomplete surgical resection. Their lymph nodes were processed; after hematoxylin and eosin staining, histopathologic slides of the metastatic nodes were reviewed by a designated pathologist. Predictors of disease free survival (DFS), including age, sex, operation type, pathologic T stage, nodal status, visceral pleural invasion, perioperative treatment, and the presence of ENE, were investigated. Among the 282 patients, ENE was detected in 85 patients (30.1%). ENE presence was associated with advanced T stage (p = 0.034), N2 subgroups (p < 0.001), lymphatic invasion (p = 0.001), and pneumonectomy (p = 0.002). The multivariable analysis demonstrated that old age (p < 0.001), advanced T stage (p = 0.012), N2 subgroups (p = 0.005), and ENE presence (p = 0.005) were significant independent predictors of DFS. The DFS rate at five years was 21.4% in patients who had ENE and 43.4% in patients who did not have ENE (p < 0.001). The presence of ENE, coupled with tumor-node-metastasis staging, should be recognized as a meaningful prognostic factor in stage III-N2 NSCLC patients.
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Affiliation(s)
- Beatrice Chia-Hui Shih
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si 13620, Korea; (B.C.-H.S.); (W.J.); (Y.H.); (S.C.); (K.K.); (S.J.)
| | - Jae Hyun Jeon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si 13620, Korea; (B.C.-H.S.); (W.J.); (Y.H.); (S.C.); (K.K.); (S.J.)
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul 03080, Korea
- Correspondence: ; Tel.: +82-31-787-7146
| | - Jin-Haeng Chung
- Department of Translational Medicine, Seoul National University Bundang Hospital, Seongnam-si 13620, Korea; (J.-H.C.); (H.J.K.)
- Department of Pathology, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Hyun Jung Kwon
- Department of Translational Medicine, Seoul National University Bundang Hospital, Seongnam-si 13620, Korea; (J.-H.C.); (H.J.K.)
- Department of Pathology, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Jeong Hoon Lee
- Division of Biomedical Informatics, Seoul National University Biomedical Informatics, Seoul National University College of Medicine, Seoul 03080, Korea;
| | - Woohyun Jung
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si 13620, Korea; (B.C.-H.S.); (W.J.); (Y.H.); (S.C.); (K.K.); (S.J.)
| | - Yoohwa Hwang
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si 13620, Korea; (B.C.-H.S.); (W.J.); (Y.H.); (S.C.); (K.K.); (S.J.)
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Sukki Cho
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si 13620, Korea; (B.C.-H.S.); (W.J.); (Y.H.); (S.C.); (K.K.); (S.J.)
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Kwhanmien Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si 13620, Korea; (B.C.-H.S.); (W.J.); (Y.H.); (S.C.); (K.K.); (S.J.)
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Sanghoon Jheon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si 13620, Korea; (B.C.-H.S.); (W.J.); (Y.H.); (S.C.); (K.K.); (S.J.)
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul 03080, Korea
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Han SJ, Jeon JH, Jung W, Seong YW, Cho S, Kim K, Jheon S. Do ground-glass opacity-dominant features have prognostic significance in node-negative adenocarcinomas with invasive components of similar sizes? Eur J Cardiothorac Surg 2021; 57:1189-1194. [PMID: 32047887 DOI: 10.1093/ejcts/ezaa016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 12/11/2019] [Accepted: 12/17/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES The purpose of this study was to analyse the prognostic significance of the dominant features of ground-glass opacities (GGOs) in part-solid node-negative adenocarcinomas with invasive components of similar sizes. METHODS From 2004 to 2017, a total of 544 patients with a diagnosis of part-solid pathological node-negative adenocarcinoma with an invasive component <20 mm in size were selected. The enrolled patients were categorized into 2 groups: a GGO-dominant [50% < GGO (%) < 100%, n = 245] group (group 1) and a solid-dominant [0% < GGO (%) ≤ 50%, n = 299] group (group 2). To analyse the prognostic significance of GGO-dominant features, propensity score matching incorporating variables such as age, sex, preoperative pulmonary function, operation methods and size of the solid component was performed. RESULTS Propensity score matching produced 92 patients in each group for the prognostic analysis. The mean size of the solid part was 8.8 mm in the GGO-dominant group and 9.0 mm in the solid-dominant group (P = 0.34); the mean size of the total lesion was 22.2 mm in the GGO-dominant group and 14.9 mm in the solid-dominant group (P < 0.001). The 5-year overall survival rates were 96.7% in group 1 and 96.2% in group 2 (P = 0.52), and the 5-year disease-free survival rates were 96.7% in group 1 and 94.3% in group 2 (P = 0.48). CONCLUSIONS Although the total sizes of the GGO-dominant lesions were larger than those of the solid-dominant lesions, the prognosis of patients with GGO-dominant lesions was not significantly different from that of patients with solid-dominant lesions in node-negative adenocarcinomas with a similar invasive component size <20 mm.
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Affiliation(s)
- Sung Joon Han
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Hyun Jeon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Woohyun Jung
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Won Seong
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sukki Cho
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kwhanmien Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sanghoon Jheon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
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Lee MK, Moon C, Lee MJ, Kwak YG, Lee E, Jeon JH, Park WB, Jung Y, Kim ES, Lee JH, Chun JY, Park SW. Risk factors for the delayed diagnosis of extrapulmonary TB. Int J Tuberc Lung Dis 2021; 25:191-198. [PMID: 33688807 DOI: 10.5588/ijtld.20.0788] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Extrapulmonary TB (EPTB) is more difficult to diagnose than pulmonary TB. The delayed management of EPTB can lead to complications and increase the socio-economic burden.METHODS: Patients newly diagnosed with EPTB were retrospectively enrolled from 11 general hospitals in South Korea from January 2017 to December 2018. The basic characteristics of patients were described. Univariable and multivariable analyses were performed between early and delayed diagnosis groups to identify risk factors for delayed diagnosis and treatment in EPTB.RESULTS: In total, 594 patients were enrolled. Lymph node TB (28.3%) was the predominant form, followed by abdominal (18.4%) and disseminated TB (14.5%). Concurrent lung involvement was 17.8%. The positivity of diagnostic tests showed no significant difference between the two groups. Acute clinical manifestations in disseminated, pericardial and meningeal TB, and immunosuppression were associated with early diagnosis. Delayed diagnosis was associated with outpatient clinic visits, delayed sample acquisition and diagnostic departments other than infection or pulmonology.CONCLUSION: The delay in diagnosis and treatment of EPTB was not related to differences in microbiological characteristics of Mycobacterium tuberculosis itself; rather, it was due to the indolent clinical manifestations that cause referral to non-TB-specialised departments in the outpatient clinic and delay the suspicion of TB and diagnostic testing.
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Affiliation(s)
- M K Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul
| | - C Moon
- Department of Internal Medicine, Inje University Busan Paik Hospital, Busan
| | - M J Lee
- Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul
| | - Y G Kwak
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang
| | - E Lee
- Department of Internal Medicine, SoonChunHyang University Seoul Hospital, Seoul, Department of Internal Medicine, Boramae Medical Center, Seoul
| | - J H Jeon
- Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Department of Internal Medicine, National Medical Center, Seoul
| | - W B Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul
| | - Y Jung
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang
| | - E S Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam
| | - J H Lee
- Department of Internal Medicine, Wonkwang University College of Medicine, Iksan
| | - J Y Chun
- Department of Internal Medicine, National Cancer Center Hospital, Goyang, South Korea
| | - S W Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Department of Internal Medicine, Boramae Medical Center, Seoul
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Moon DH, Choi JH, Yang HC, Kim MS, Lee JM, Lee GK, Jeon JH. Size and extranodal extension of metastatic lymph nodes in lung adenocarcinoma. J Thorac Dis 2020; 12:6514-6522. [PMID: 33282353 PMCID: PMC7711416 DOI: 10.21037/jtd-20-2039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background This study assessed the prognostic significance of metastatic lymph node size (MLNS) and extranodal extension (EN) in patients with node-positive lung adenocarcinoma (ADC). Methods Prognostic factors influencing survival were analyzed, including age, sex, extent of operation, T- and N-stage, size of tumor, postoperative chemotherapy, presence of EN, and MLNS (>7.0 vs. ≤7.0 mm). Results Three hundred seventy-five patients met the inclusion criteria were enrolled (mean age: 59.8±10.5 years). Increasing MLNS was significantly correlated with large tumor size (P=0.015), advanced N status (P<0.001), and presence of EN (P<0.001). In multivariable analysis, large tumor size [hazard ratio (HR) 1.135, 95% confidence interval (CI): 1.050 to 1.228, P<0.001], adjuvant chemotherapy (HR 0.582, 95% CI: 0.430 to 0.787, P<0.001), EN (HR 1.454, 95% CI: 1.029 to 2.055, P=0.034), and MLNS greater than 7 mm (HR 1.741, 95% CI: 1.238 to 2.447, P<0.001) were significant prognostic factors for survival. Patients were classified into 3 groups: Group A, MLNS ≤7.0 mm/EN (−); Group B, MLNS ≤7.0 mm/EN (+) or MLNS >7.0 mm/EN (−); and Group C, MLNS >7.0 mm/EN (+). The 5-year overall survival (OS) was 72.2%, 59.0%, and 38.5% in Groups A, B and C, respectively (P<0.001). Conclusions The MLNS and presence of EN could provide an important prognostic implication for patients with node-positive lung ADC.
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Affiliation(s)
- Duk Hwan Moon
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea.,Department of Thoracic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin-Ho Choi
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea
| | - Hee Chul Yang
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea
| | - Moon Soo Kim
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea
| | - Jong Mog Lee
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea
| | - Geon-Kook Lee
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea
| | - Jae Hyun Jeon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
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Lim JU, Han S, Kim HC, Choi CM, Jung CY, Cho DG, Jeon JH, Lee JE, Ahn JS, Kim Y, Choi YD, Suh YG, Kim JE, Won YJ, Kim YC, Park CK, Kim SJ. Characteristics of female lung cancer in Korea: analysis of Korean National Lung Cancer Registry. J Thorac Dis 2020; 12:4612-4622. [PMID: 33145034 PMCID: PMC7578488 DOI: 10.21037/jtd-20-1671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Backgrounds The present study evaluated Korean women with lung cancer and compared the clinical characteristics of ever-smoker and never-smoker groups using the National Lung Cancer Registry. Methods In affiliation with the Korean Central Cancer Registry, the Korean Association for Lung Cancer constructed a registry into which 10% of the lung cancer cases in Korea were registered. Female lung cancer patients with valid smoking history were evaluated. Results Among 735 female lung cancer patients, 643 (87.5%) were never-smokers and 92 (12.5%) were smokers. The median survival was significantly longer in the never-smoker group (28 vs. 14 months; P<0.001). Among 683 patients with non-small cell lung cancer (NSCLC), the never-smoker group showed significantly longer median survival (29 vs. 14 months; P=0.002) and a higher proportion of stage I cancer (40.3% vs. 25.7%; P<0.001). Survival analysis of the NSCLC patients showed that smoking status, receiving only supportive care, EGFR mutation status, lung cancer stage, and forced vital capacity (FVC) (%) were significantly associated with mortality in the multivariate analysis (P=0.025, HR 2.39, 95% CI: 1.12–5.11; P=0.017, HR 3.14, 95% CI: 1.22–8.06; P=0.033, HR 0.63, 95% CI: 0.41–0.96; P<0.001, HR 11.88, 95% CI: 5.79–24.38; P=0.002, HR 0.98, 95% CI: 0.96–0.99, respectively). Conclusions In Korean women with NSCLC, smoking status, not receiving active anticancer treatment, EGFR mutation status, lung cancer stage, and pulmonary function were significantly associated with mortality.
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Affiliation(s)
- Jeong Uk Lim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Solji Han
- Department of Applied Statistics, Yonsei University, Seoul, Korea
| | - Ho Cheol Kim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Chang Min Choi
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Chi Young Jung
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Deog Gon Cho
- Department of Thoracic & Cardiovascular Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Jae Hyun Jeon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong Eun Lee
- Division of Pulmonology Department of Internal Medicine, Chungnam National University, Daejeon, Korea
| | - Jin Seok Ahn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea
| | - Yeongdae Kim
- Department of Cardiothoracic Surgery, Pusan National University Hospital, Pusan, Korea
| | - Yoo-Duk Choi
- Department of Pathology, Chonnam National University, Hwasun Hospital, Hwasun, Korea
| | - Yang-Gun Suh
- Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Jung-Eun Kim
- Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Korea
| | - Young-Joo Won
- Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Korea
| | - Young-Chul Kim
- Department of Internal Medicine, Chonnam National University, Hwasun Hospital, Hwasun, Korea
| | - Chan Kwon Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung Joon Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Postech-Catholic Biomedical Engineering Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Nam IC, Shin YS, Jeong WJ, Park MW, Park SY, Song CM, Lee YC, Jeon JH, Lee J, Kang CH, Park IS, Kim K, Sun DI. Guidelines for Tracheostomy From the Korean Bronchoesophagological Society. Clin Exp Otorhinolaryngol 2020; 13:361-375. [PMID: 32717774 PMCID: PMC7669309 DOI: 10.21053/ceo.2020.00353] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/19/2020] [Indexed: 12/17/2022] Open
Abstract
The Korean Bronchoesophagological Society appointed a task force to develop a clinical practice guideline for tracheostomy. The task force conducted a systematic search of the Embase, Medline, Cochrane Library, and KoreaMed databases to identify relevant articles, using search terms selected according to key questions. Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. An external expert review and a Delphi questionnaire were conducted to reach a consensus regarding the recommendations. Accordingly, the committee developed 18 evidence-based recommendations, which are grouped into seven categories. These recommendations are intended to assist clinicians in performing tracheostomy and in the management of tracheostomized patients.
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Affiliation(s)
| | - Inn-Chul Nam
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoo Seob Shin
- Department of Otolaryngology-Head and Neck Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Woo-Jin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Min Woo Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Seoul, Korea
| | - Seong Yong Park
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Chang Myeon Song
- Department of Otolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Young Chan Lee
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jae Hyun Jeon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jongmin Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chang Hyun Kang
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Il-Seok Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Seoul, Korea
| | - Kwhanmien Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Dong Il Sun
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Lee SY, Jeon JH, Jung W, Chae M, Hwang WJ, Hwang Y, Cho S, Chung JH, Kim K, Jheon S. Predictive Factors for Lymph Node Metastasis in Clinical Stage I Part-Solid Lung Adenocarcinoma. Ann Thorac Surg 2020; 111:456-462. [PMID: 32652067 DOI: 10.1016/j.athoracsur.2020.05.083] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 03/25/2020] [Accepted: 05/11/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Accurate clinical staging of tumors with a small solid portion is essential for developing an appropriate treatment plan. This study evaluated predictive factors for lymph node (LN) metastasis in patients with clinical stage I part-solid lung adenocarcinoma. METHODS Medical records of patients with clinical stage I part-solid adenocarcinoma who underwent anatomic pulmonary resection with systematic node evaluation between January 2009 and June 2018 were retrospectively reviewed. To identify predictive factors for LN metastasis, univariate and multivariable logistic regression analyses were performed. RESULTS Among the 593 patients in this study, the overall prevalence of LN metastasis was 3.7% (n = 22), which included 3.0% (n = 18) of patients with N1 LN metastasis and 1.5% (n = 9) of patients with N2 LN metastasis. Combined N1 and N2 nodal involvement was observed in 5 patients. Nodal metastasis was not observed in tumors with a solid portion sized 1.1 cm or smaller. The nodal metastasis rates in cT1b, cT1c, and cT2a tumors were 5.5% (13 of 237), 7.1% (6 of 84), and 13.6% (3 of 22), respectively. According to the multivariable analysis, predictive factors included the size of the solid portion (P = .015) and the high maximum standardized uptake value (SUVmax) of the primary tumor (P = .044). CONCLUSIONS Large solid portion and high SUVmax of the primary tumor were predictive factors of LN metastasis in patients with clinical stage I part-solid lung adenocarcinoma. Systematic LN evaluation should be performed, especially in those who have a large solid portion and high SUVmax of the primary tumor.
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Affiliation(s)
- So Young Lee
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Jae Hyun Jeon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea; Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Woohyun Jung
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Mincheol Chae
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Wan Jin Hwang
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Yoohwa Hwang
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea; Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sukki Cho
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea; Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin-Haeng Chung
- Department of Translational Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea; Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kwhanmien Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea; Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sanghoon Jheon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea; Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
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Han SJ, Jeon JH. Reply to Ma and Zhang. Eur J Cardiothorac Surg 2020; 58:662-663. [DOI: 10.1093/ejcts/ezaa142] [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] [Received: 03/22/2020] [Accepted: 03/26/2020] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sung Joon Han
- Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, Daejeon, Korea
| | - Jae Hyun Jeon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
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Seok H, Song J, Jeon JH, Choi HK, Choi WS, Moon S, Park DW. Timing of antibiotics in septic patients: a prospective cohort study. Clin Microbiol Infect 2020; 26:1495-1500. [PMID: 32062049 DOI: 10.1016/j.cmi.2020.01.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/30/2020] [Accepted: 01/31/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To evaluate the effect of timing and appropriateness of antibiotics administration on mortality in patients diagnosed with sepsis according to the Sepsis-3 definition. METHODS This prospective cohort study was conducted in patients diagnosed with sepsis according to the Sepsis-3 definition at the emergency department of Korea University Ansan Hospital from January 2016 to January 2019. The time to antibiotics was defined as the time in hours from emergency department arrival to the first antibiotic administration. Cox proportional hazards regression analysis was used to estimate the association between time to antibiotics and 7-, 14- and 28-day mortality. RESULTS Of 482 patients enrolled onto this study, 203 (42.1%) of 482 and 312 (64.7%) of 482 were diagnosed with septic shock and high-grade infection respectively. The median time to receipt of antibiotic therapy was 115 minutes. Antibiotics were administered within 3 and 6 hours in 340 (70.4%) of 482 and 450 (93.2%) of 482 patients respectively. Initial appropriate empirical antibiotics were administered in 375 (77.8%) of 482 patients. The time to and appropriateness of the initial antibiotics were not associated with 7-, 14- and 28-day mortality in multivariate analysis. The Sequential Organ Failure Assessment (SOFA) score (adjusted hazard ratio (aHR) 1.229, 95% confidence interval (CI) 1.093-1.381, p 0.001) and initial lactate levels (aHR 1.128, 95% CI 1.034-1.230, p 0.007), Charlson comorbidity index (aHR 1.115, 95% CI 1.027-1.210, p 0.014), 2-hour lactate level (aHR 1.115, 95% CI 1.027-1.210, p 0.009) and SOFA score (aHR 1.077, 95% CI 1.013-1.144, p 0.018) affected 7-, 14- and 28-day mortality respectively. Subgroup analysis with septic shock, bacteraemia and high-grade infection did not affect mortality rates. CONCLUSIONS Time to receipt of antibiotics may not affect the prognosis of patients with sepsis if a rapid and well-trained resuscitation is combined with appropriate antibiotic administration within a reasonable time.
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Affiliation(s)
- H Seok
- Division of Infectious Diseases, Department of Medicine, Republic of Korea
| | - J Song
- Department of Emergency Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - J H Jeon
- Division of Infectious Diseases, Department of Medicine, Republic of Korea
| | - H K Choi
- Division of Infectious Diseases, Department of Medicine, Republic of Korea
| | - W S Choi
- Division of Infectious Diseases, Department of Medicine, Republic of Korea
| | - S Moon
- Department of Emergency Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - D W Park
- Division of Infectious Diseases, Department of Medicine, Republic of Korea.
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Lee Y, Jeon JH, Goh SH, Roh H, Yun JY, Kwon NJ, Choi JH, Yang HC, Kim MS, Lee JM, Lee GK, Han JY. The clinical impact of family history of cancer in female never-smoker lung adenocarcinoma. Lung Cancer 2019; 136:15-22. [DOI: 10.1016/j.lungcan.2019.07.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 07/29/2019] [Accepted: 07/30/2019] [Indexed: 10/26/2022]
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Seong YW, Han SJ, Jung W, Jeon JH, Cho S, Jheon S, Kim K. Perioperative change in neutrophil-to-lymphocyte ratio (NLR) is a prognostic factor in patients with completely resected primary pulmonary sarcomatoid carcinoma. J Thorac Dis 2019; 11:819-826. [PMID: 31019770 DOI: 10.21037/jtd.2019.02.02] [Citation(s) in RCA: 9] [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: 12/21/2022]
Abstract
Background There has been controversy regarding prognostic factors for surgically resected primary pulmonary sarcomatoid carcinoma (PSC). Recently, several studies have shown that neutrophil-to-lymphocyte ratio (NLR) was a prognostic factor for various types of cancers from multiple organs. Therefore, we performed this study to evaluate whether NLR is related to prognosis after complete surgical resection of primary PSC. Methods From Oct. 2003 to Sep. 2015, a total of 50 patients underwent surgical resection for primary PSC. After excluding patients with any history of other malignancy and incompletely resected cases, a total of 37 patients were included, and data were retrospectively collected and analyzed. Change in postoperative NLR and the initial NLR (ΔNLR) was calculated from the perioperative complete blood count (CBC) results. Results Mean age of the cohort was 62.2±1.9 years, and 31 patients (83.8%) were male. Twenty patients (54.1%) were revealed as pN0. Overall 5-year survival rate was 50.3%. Seventeen patients (45.9%) had locoregional or distant metastases. Univariate survival analysis revealed age >70, ΔNLR >17 as risk factors for overall survival (P=0.009, 0.005) and disease-free survival (P=0.036, 0.018). Multivariate Cox-regression analysis revealed age >70 and ΔNLR >17 as independent risk factors for overall survival and ΔNLR >17 as the only independent risk factor for the disease-free survival. Conclusions In patients with completely resected primary PSC, perioperative ΔNLR had a significant effect on the overall survival and disease-free survival. Older age was also an independent risk factor for overall survival.
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Affiliation(s)
- Yong Won Seong
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Joon Han
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Woohyun Jung
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Hyun Jeon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sukki Cho
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sanghoon Jheon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kwhanmien Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
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Choi CM, Kim HC, Jung CY, Cho DG, Jeon JH, Lee JE, Ahn JS, Kim SJ, Kim Y, Choi YD, Suh YG, Kim JE, Lee B, Won YJ, Kim YC. Report of the Korean Association of Lung Cancer Registry (KALC-R), 2014. Cancer Res Treat 2019; 51:1400-1410. [PMID: 30913875 PMCID: PMC6790858 DOI: 10.4143/crt.2018.704] [Citation(s) in RCA: 40] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 02/22/2019] [Indexed: 01/02/2023] Open
Abstract
Purpose The aim of this study was to investigate epidemiology, clinical characteristics and sex differences of patients with lung cancer using nationwide registry in Korea. Materials and Methods The Korean Association for Lung Cancer developed a registry in cooperation with the Korean Central Cancer Registry, and surveyed about 10% of lung cancer cases. For this first survey of cases diagnosed in 2014, cases were selected through a systematic sampling method. Results Total 2,621 lung cancer patients were surveyed, and the median patient age was 70 years. During the study period, adenocarcinoma was the most frequent histologic type, the proportion of female patients was 28.4%, and women had a better prognosis (median survival, not reached vs. 13 months; p<0.001) than did men for non-small cell lung cancer. The proportion of never-smokers was 36.4%, and never-smoking was more prevalent in women than in men (87.5 vs. 16.0%, p<0.001). Epidermal growth factor receptor (EGFR) mutations were found in 36.8% of stage IV adenocarcinoma patients, and higher in female compared to male patients (51.2 vs. 26.6%, p<0.001). In addition, patients with EGFR mutation showed better survival (median survival, 18 vs. 8 months; p<0.001) than patients without EGFR mutation in these patients. Conclusion This is the first survey to gather unbiased nationwide lung cancer statistics in Korea. More than one-third of lung cancer patients had no smoking history. Female had a high proportion of non-smoker, more adenocarcinoma with EGFR mutation and generally better prognosis than male.
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Affiliation(s)
- Chang-Min Choi
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ho Cheol Kim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chi Young Jung
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Deog Gon Cho
- Department of Thoracic & Cardiovascular Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Jae Hyun Jeon
- Center for Lung Cancer, National Cancer Center, Goyang, Korea
| | - Jeong Eun Lee
- Division of Pulmonology, Department of Internal Medicine, Chungnam National University, Daejeon, Korea
| | - Jin Seok Ahn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea
| | - Seung Joon Kim
- Division of Pulmonology, Department of Internal Medicine, The Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yeongdae Kim
- Department of Cardiothoracic Surgery, Pusan National University Hospital, Busan, Korea
| | - Yoo-Duk Choi
- Department of Pathology, Chonnam National University Medical School, Gwangju, Korea
| | - Yang-Gun Suh
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Jung-Eun Kim
- Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Korea
| | - Boram Lee
- Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Korea
| | - Young-Joo Won
- Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Korea
| | - Young-Chul Kim
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea.,Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
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Kim HC, Jung CY, Cho DG, Jeon JH, Lee JE, Ahn JS, Kim SJ, Kim Y, Kim YC, Kim JE, Lee B, Won YJ, Choi CM. Erratum: Clinical Characteristics and Prognostic Factors of Lung Cancer in Korea: A Pilot Study of Data from the Korean Nationwide Lung Cancer Registry. Tuberc Respir Dis (Seoul) 2019; 82:266-267. [PMID: 31267725 PMCID: PMC6609528 DOI: 10.4046/trd.2017.0128.r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This corrects the article on p. 118 in vol. 82, PMID: 29926550.
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Affiliation(s)
- Ho Cheol Kim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chi Young Jung
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Deog Gon Cho
- Department of Thoracic and Cardiovascular Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Jae Hyun Jeon
- Center for Lung Cancer, National Cancer Center, Goyang, Korea
| | - Jeong Eun Lee
- Division of Pulmonology, Department of Internal Medicine, Chungnam National University, Daejeon, Korea
| | - Jin Seok Ahn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea
| | - Seung Joon Kim
- Division of Pulmonology, Department of Internal Medicine, The Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yeongdae Kim
- Department of Cardiothoracic Surgery, Pusan National University Hospital, Busan, Korea
| | - Young Chul Kim
- Department of Pulmonary Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Jung Eun Kim
- Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Korea
| | - Boram Lee
- Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Korea
| | - Young Joo Won
- Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Korea
| | - Chang Min Choi
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kim CJ, Song KH, Park KH, Kim M, Choe PG, Oh MD, Lee SH, Jang HC, Kang SJ, Kim HY, Cheon S, Kwak YG, Choi HJ, Kwon KT, Jeon JH, Kim ES, Kim HB. Impact of antimicrobial treatment duration on outcome of Staphylococcus aureus bacteraemia: a cohort study. Clin Microbiol Infect 2018; 25:723-732. [PMID: 30287412 DOI: 10.1016/j.cmi.2018.09.018] [Citation(s) in RCA: 10] [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] [Received: 02/12/2018] [Revised: 09/24/2018] [Accepted: 09/24/2018] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To assess the outcome of Staphylococcus aureus bacteraemia (SAB) according to factors associated with necessity for longer treatment in conjunction with the duration of treatment. METHODS We prospectively collected the data of patients with SAB consecutively during 12 to 39 months from 11 hospitals. If multiple episodes of SAB occurred in one patient, only the first episode was enrolled. Factors associated with necessity for longer treatment were defined as follows: persistent bacteraemia, metastatic infection, prosthesis and endocarditis. If any of the factors were present, then the case was defined as longer antibiotic treatment warranted (LW) group; those without any factors were defined as shorter antibiotic treatment sufficient (SS) group. Poor outcome was defined as a composite of 90-day mortality or 30-day recurrence. Duration of antibiotic administration was classified as <14 or ≥14 days in the SS group and <28 or ≥28 days in the LW group. RESULTS Among 2098 cases, the outcome was analysed in 1866 cases, of which 591 showed poor outcome. The SS group accounted for 964 cases and the LW group for 852. On multivariate analysis, age over 65 years, pneumonia, higher Sequential Organ Failure Assessment (SOFA) score and chronic liver diseases were risk factors for poor outcome. Administration of antibiotics less than the recommendation was associated with poor outcome, but this significance was observed only in the LW group (adjusted odds ratio = 1.68; 95% confidence interval, 1.00-2.83; p 0.05). CONCLUSIONS Inappropriately short antibiotic treatment was associated with poor outcome in the LW group. Vigilant evaluation for risk factors to determine the duration of treatment may improve the outcome among patients with SAB.
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Affiliation(s)
- C-J Kim
- Department of Internal Medicine, Division of Infectious Diseases, Ewha Womans University School of Medicine, Seoul, South Korea
| | - K-H Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seognnam, South Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - K-H Park
- Department of Infectious Diseases, Chonnam National University Hospital, Gwangju, South Korea.
| | - M Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seognnam, South Korea
| | - P G Choe
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - M-D Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - S H Lee
- Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - H-C Jang
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - S-J Kang
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - H Y Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - S Cheon
- Division of Infectious Diseases, Department of Internal Medicine, Chungnam National University School of Medicine, Daejon, South Korea
| | - Y G Kwak
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - H J Choi
- Department of Internal Medicine, Division of Infectious Diseases, Ewha Womans University School of Medicine, Seoul, South Korea
| | - K T Kwon
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - J H Jeon
- Inje University Haeundae Paik Hospital, Busan, South Korea
| | - E S Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seognnam, South Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
| | - H B Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seognnam, South Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
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Moon DH, Jeon JH, Yang HC, Kim YI, Lee JY, Kim MS, Lee JM, Lee GK. Intramural Metastasis as a Risk Factor for Recurrence in Esophageal Squamous Cell Carcinoma. Ann Thorac Surg 2018. [DOI: 10.1016/j.athoracsur.2018.02.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Kim HC, Jung CY, Cho DG, Jeon JH, Lee JE, Ahn JS, Kim SJ, Kim Y, Kim YC, Kim JE, Lee B, Won YJ, Choi CM. Clinical Characteristics and Prognostic Factors of Lung Cancer in Korea: A Pilot Study of Data from the Korean Nationwide Lung Cancer Registry. Tuberc Respir Dis (Seoul) 2018; 82:118-125. [PMID: 29926550 PMCID: PMC6435924 DOI: 10.4046/trd.2017.0128] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 02/25/2018] [Accepted: 04/12/2018] [Indexed: 02/02/2023] Open
Abstract
Background Lung cancer is a leading cause of morbidity and mortality worldwide, and the incidence continues to rise. Although many prognostic factors have been identified, the clinical characteristics and outcomes in Korean lung cancer patients are not well defined. Methods Of the 23,254 new lung cancer cases registered at the Korea Central Cancer Registry in 2013, total 489 patients from 19 hospitals were abstracted by the Korean Central Cancer Registry. The clinical data retrospectively analyzed, patients were followed up until December 2015. Results The median age was 69 years (interquartile range, 60–74 years); 65.4% were male and 62.1% were ever-smokers. Cough was the most common initial symptom (33.5%); 13.1% of patients were asymptomatic. While squamous cell carcinoma was the most common subtype in male patients (37.2%), adenocarcinoma was the most frequent histological type in all patients (48.7%) and females (76.3%). The majority of patients received treatment (76.5%), which included surgery, radiation therapy, and chemotherapy. Older age (hazard ratio [HR], 1.037), lower body mass index (HR, 0.904), ever-smoker (HR, 2.003), small cell lung cancer (HR, 1.627), and distant metastasis (HR, 3.990) were independent predictors of mortality. Patients without symptoms (HR, 0.387) and without treatment (HR, 0.364) were associated with a favorable outcome in multivariate Cox analysis. Conclusion Lung cancer in Korea occurs predominantly in elderly patients, with adenocarcinoma being the most frequent subtype. The prognosis was poorer in ever-smokers and older, malnourished, and untreated patients with advanced lung cancer.
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Affiliation(s)
- Ho Cheol Kim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chi Young Jung
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Deog Gon Cho
- Department of Thoracic and Cardiovascular Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Jae Hyun Jeon
- Center for Lung Cancer, National Cancer Center, Goyang, Korea
| | - Jeong Eun Lee
- Division of Pulmonology, Department of Internal Medicine, Chungnam National University, Daejeon, Korea
| | - Jin Seok Ahn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea
| | - Seung Joon Kim
- Division of Pulmonology, Department of Internal Medicine, The Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yeongdae Kim
- Department of Cardiothoracic Surgery, Pusan National University Hospital, Busan, Korea
| | - Young Chul Kim
- Department of Pulmonary Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Jung Eun Kim
- Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Korea
| | - Boram Lee
- Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Korea
| | - Young Joo Won
- Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Korea
| | - Chang Min Choi
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Lee JM, Jeon JH, Moon IS, Choi JY. Benefits of active middle ear implants over hearing aids in patients with sloping high tone hearing loss: comparison with hearing aids. Acta Otorhinolaryngol Ital 2018; 37:218-223. [PMID: 28516965 PMCID: PMC5463512 DOI: 10.14639/0392-100x-1146] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 01/15/2017] [Indexed: 11/24/2022]
Abstract
In this retrospective chart review we compared the subjective and objective benefits of active middle ear implants (AMEIs) with conventional hearing aids (HAs) in patients with sloping high tone hearing loss. Thirty-four patients with sensorineural hearing loss were treated with AMEIs. Of these, six had sloping high tone hearing loss and had worn an HA for more than 6 months. Objective assessments, a pure-tone audiogram, as well as a word recognition test, and the Korean version of the Hearing in Noise Test (K-HINT), and a subjective assessment, the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, were performed. Tests were conducted under three circumstances: 1) the unaided state before surgery; 2) the HA-aided state before surgery; and 3) the AMEI-aided state 3 months after surgery. The average high-frequency hearing gain (≥ 2 kHz) was significantly better with AMEIs than with HAs. Although the result had no statistical significance, AMEIs showed a superior word recognition score (WRS) compared to HAs. However, the most comfortable hearing level at which the WRS was tested was significantly decreased with an AMEI compared to an HA. In the K-HINT, patients with an AMEI showed greater recognition than those fitted with an HA under both quiet and noisy conditions. The APAHB scores revealed that patients were more satisfied with an AMEI rather than an HA on all subscales. The use of vibroplasty in patients with sloping high tone loss resulted in positive hearing outcomes when compared to conventional HAs. Based on the data from this study, AMEIs provided better objective and subjective results and could, therefore, be a better alternative for the treatment of sloping hearing loss.
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Affiliation(s)
- J M Lee
- Department of Otorhinolaryngology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - J H Jeon
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - I S Moon
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - J Y Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
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Oh TK, Jeon JH, Lee JM, Kim MS, Kim JH, Lee SJ, Eom W. Chronic Smoking is Not Associated with Increased Postoperative Opioid Use in Patients with Lung Cancer or Esophageal Cancer. Pain Physician 2018; 21:E49-E55. [PMID: 29357340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Chronic smokers show differences in pain sensitivity compared to healthy non-smokers. Yet, no study to date has examined whether smoker status has an effect on postoperative pain. OBJECTIVE We aim to examine a possible correlation between preoperative smoking and postoperative opioid dose based on the hypothesis that smokers would use higher doses of opioids to manage increased postoperative pain. STUDY DESIGN A retrospective observational cohort study. SETTING The National Cancer Center in Korea. METHODS We examined medical record data for patients who had undergone curative resection for either lung or esophageal cancer (lobectomy or bilobectomy for lung cancer or an Ivor Lewis operation for esophageal cancer) between January 1, 2006 and December 31, 2010. We examined the correlation between the total preoperative average number of packs per day multiplied by years of cigarette smoking (pack-years) and morphine equivalent daily doses administered to patients after surgery, considering each type of cancer both individually and together. Partial correlation and regression analyses were performed to determine the causality of a possible relationship between pack-years of cigarette smoking and postoperative opioid dose. RESULTS A total of 1,129 patients (871 patients with lung cancer and 258 patients with esophageal cancer) were included in the final analysis. There was no significant correlation between total pack-years of cigarette smoking and postoperative opioid dose for lung cancer, esophageal cancer, or both cancer types combined (r = 0.042, -0.012, and 0.037, respectively). In the analysis of both cancer types combined, video-assisted thoracic surgery (VATS) was associated with an 11.1% decrease in opioid dose (β = -0.111, P = 0.003) and epidural analgesia was associated with a 7.2% increase in opioid dose (β = 0.072, P = 0.042). LIMITATIONS The retrospective design of this study is a limitation. CONCLUSION Our study did not observe a correlation between preoperative smoking and postoperative opioid dose in patients with lung or esophageal cancer. KEY WORDS Smoking, postoperative pain, opioid, lung cancer, esophageal cancer, analgesia.
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Affiliation(s)
- Tak Kyu Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gumi-ro, Bundang-gu, Seongnam, Korea
| | - Jae Hyun Jeon
- Department of Thoracic Surgery, National Cancer Center, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Jong Mog Lee
- Department of Thoracic Surgery, National Cancer Center, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Moon Soo Kim
- Department of Thoracic Surgery, National Cancer Center, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Jee Hee Kim
- Business School, Business Statistical Analysis and Risk Management, University of Manchester, Manchester, UK
| | - Se Jun Lee
- Business School, Business Statistical Analysis and Risk Management, University of Manchester, Manchester, UK
| | - Woosik Eom
- Business School, Business Statistical Analysis and Risk Management, University of Manchester, Manchester, UK
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Jung SM, Bae JS, Kang SG, Son JS, Jeon JH, Lee HJ, Jeon JY, Sidharthan M, Ryu SH, Shin HW. Acute toxicity of organic antifouling biocides to phytoplankton Nitzschia pungens and zooplankton Artemia larvae. Mar Pollut Bull 2017; 124:811-818. [PMID: 27919420 DOI: 10.1016/j.marpolbul.2016.11.047] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 11/01/2016] [Accepted: 11/19/2016] [Indexed: 06/06/2023]
Abstract
The toxicity of the antifouling biocides Irgarol 1051, Diuron, Chlorothalonil, Dichlofluanid, Sea-nine 211, Copper pyrithione, Zinc pyrithione, Ziram and Zineb were evaluated on Nitzschia pungens and Artemia larvae. Results showed that EC50 for Irgarol 1051 was 0.586μgl-1 was the strongest effect on N. pungens following by Copper pyrithione (4.908μgl-1), Ziram (5.421μgl-1), Zinc pyrithione (5.513μgl-1), Diuron (6.640μgl-1), Zineb (232.249μgl-1), Sea-nine 211(267.368μgl-1), Chlorothalonil (360.963μgl-1) and Dichlofluanid (377.010μgl-1) in 96h. In Artemia larvae, the biocides were evaluated the LC50 for larval survivals at 48h. Sea-nine 211 and Copper pyrithione were 0.318 and 0.319mgl-1. Chlorothalonil, Zinc pyrithione and Ziram were 2.683, 3.147 and 4.778mgl-1. Irgarol 1051, Diuron, Zineb and Dichlofluanid were 9.734, 30.573, 41.170 and 154.944mgl-1. These results provide baseline data concerning the toxicity of antifouling biocides against marine environment.
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Affiliation(s)
- S M Jung
- Department of Biological Science & Biotechnology, Soonchunhyang University, Asan, South Korea
| | - J S Bae
- Department of Biological Science & Biotechnology, Soonchunhyang University, Asan, South Korea
| | - S G Kang
- Department of Biological Science & Biotechnology, Soonchunhyang University, Asan, South Korea
| | - J S Son
- Department of Biological Science & Biotechnology, Soonchunhyang University, Asan, South Korea
| | - J H Jeon
- Department of Biological Science & Biotechnology, Soonchunhyang University, Asan, South Korea
| | - H J Lee
- Department of Biological Science & Biotechnology, Soonchunhyang University, Asan, South Korea
| | - J Y Jeon
- Department of Biological Science & Biotechnology, Soonchunhyang University, Asan, South Korea
| | - M Sidharthan
- Department of Biological Science & Biotechnology, Soonchunhyang University, Asan, South Korea
| | - S H Ryu
- Department of Biological Science & Biotechnology, Soonchunhyang University, Asan, South Korea
| | - H W Shin
- Department of Biological Science & Biotechnology, Soonchunhyang University, Asan, South Korea.
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Jeon JH, Seo Young H, Jeon Won K, Kim MS, Lee D, Ryu Seung M, Jang Dae S, Lee J. Chemical constituents from the groundnuts of Apios americana. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- JH Jeon
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea, Republic of (South)
- 2Convergence Research Center for Diagnosis, Treatment and Care System of Dementia, Korea Institute of Science and Technology, Seoul, Korea, Republic of (South)
| | - H Seo Young
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea, Republic of (South)
- 2Convergence Research Center for Diagnosis, Treatment and Care System of Dementia, Korea Institute of Science and Technology, Seoul, Korea, Republic of (South)
| | - K Jeon Won
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea, Republic of (South)
- 2Convergence Research Center for Diagnosis, Treatment and Care System of Dementia, Korea Institute of Science and Technology, Seoul, Korea, Republic of (South)
| | - MS Kim
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea, Republic of (South)
- 2Convergence Research Center for Diagnosis, Treatment and Care System of Dementia, Korea Institute of Science and Technology, Seoul, Korea, Republic of (South)
| | - D Lee
- Department of Biosystems and Biotechnology, Korea University, Seoul, Korea, Republic of (South)
| | - M Ryu Seung
- Department of Biosystems and Biotechnology, Korea University, Seoul, Korea, Republic of (South)
| | - S Jang Dae
- Department of Pharmaceutical Science, Graduate School, Kyung Hee University, Seoul, Korea, Republic of (South)
| | - J Lee
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea, Republic of (South)
- 2Convergence Research Center for Diagnosis, Treatment and Care System of Dementia, Korea Institute of Science and Technology, Seoul, Korea, Republic of (South)
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Oh TK, Jeon JH, Lee JM, Kim MS, Kim JH, Lim H, Kim SE, Eom W. Association of high-dose postoperative opioids with recurrence risk in esophageal squamous cell carcinoma: reinterpreting ERAS protocols for long-term oncologic surgery outcomes. Dis Esophagus 2017; 30:1-8. [PMID: 28859395 DOI: 10.1093/dote/dox074] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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: 09/07/2016] [Accepted: 05/23/2017] [Indexed: 12/11/2022]
Abstract
Esophageal squamous cell carcinoma (ESCC) is associated with a poor prognosis and high postoperative recurrence rate. Although postoperative opioid use has been associated with cancer recurrence, its relevance in ESCC has not been determined. Therefore, this study investigated whether high-dose postoperative opioid use was associated with recurrence risk in patients with ESCC. For this retrospective analysis, the medical records of patients who were diagnosed with ESCC and who underwent surgery between January 2006 and December 2010 in the National Cancer Center, Korea were evaluated. Total opioid administration over a 10-day period, from during surgery to postoperative day 9, was calculated. A cutoff value was determined using receiver operating characteristic curve analysis, and patients were classified into the high-use and low-use groups. The primary and secondary outcomes of the study were freedom from recurrence and overall survival, respectively. After propensity score matching, the effect of opioid use on freedom from recurrence and overall survival was evaluated using the Kaplan-Meier method. The final analysis set included 258 patients. The cumulative opioid dose cutoff point was 1783.5 mg of oral morphine. High-dose postoperative opioid use was a significant factor affecting recurrence (Hazard ratio [HR], 2.162; 95% confidence interval [CI], 1.583-2.954; P < 0.0001). In contrast, postoperative opioid use was not associated with death (HR, 1.274; 95% CI, 0.922-1.761; P = 0.1422). In patients with ESCC, compared with low-dose opioid use, high-dose intraoperative and postoperative opioid use was significantly associated with an increased risk of recurrence. However, opioid dosage did not affect overall survival.
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Affiliation(s)
- T K Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - J H Jeon
- Thoracic Surgery, National Cancer Center, Goyang
| | - J M Lee
- Thoracic Surgery, National Cancer Center, Goyang
| | - M S Kim
- Thoracic Surgery, National Cancer Center, Goyang
| | - J H Kim
- Departments of Anesthesiology and Pain Medicine
| | - H Lim
- Departments of Anesthesiology and Pain Medicine
| | - S-E Kim
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - W Eom
- Departments of Anesthesiology and Pain Medicine
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Moon DH, Lee JM, Jeon JH, Yang HC, Kim MS. Clinical outcomes of video-assisted thoracoscopic surgery esophagectomy for esophageal cancer: a propensity score-matched analysis. J Thorac Dis 2017; 9:3005-3012. [PMID: 29221273 DOI: 10.21037/jtd.2017.08.71] [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] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Minimally invasive esophagectomy theoretically offers advantages compared with open esophagectomy (OE). The aim of this study was to compare the early- and mid-term outcomes between video-assisted thoracoscopic surgery (VATS) esophagectomy (VE) and OE in patients with esophageal cancer. Methods Between November 2011 and July 2015, a total of 172 patients were divided into two groups depending on the method of esophagectomy: the VE group (n=42) and the OE group (n=130). A propensity analysis that incorporated perioperative variables, such as age, sex, preoperative pulmonary function, Charlson comorbidity index, tumor location, histologic grade of the tumor, pathologic stage and operative procedure (Ivor Lewis or McKeown) was performed, and postoperative outcomes were compared. Results Matching based on propensity scores produced 42 patients in each group for the analysis. After propensity matching, there were only two operative mortalities in the OE group, and both died of postoperative pneumonia. The overall incidence of postoperative complications was 38.1% (16 of 42) and 57.1% (24 of 42) in the VE group and in the OE group, respectively (P=0.088). The incidence of pulmonary complications was lower in the VE group than in the OE group (9.5% vs. 40.5%, P=0.004). The 2-year overall survival and disease-free survival were not different between the two groups (74.4% and 69.5% in the VE group, 69.5% and 69.8% in the OE group, P=0.865 and P=0.513, respectively). Conclusions In select patients, superior short-term surgical results and equal oncological outcomes were achieved with VE compared with OE.
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Affiliation(s)
- Duk Hwan Moon
- Department of Thoracic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong Mog Lee
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, South Korea
| | - Jae Hyun Jeon
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, South Korea
| | - Hee Chul Yang
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, South Korea
| | - Moon Soo Kim
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, South Korea
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Jeon JH, Jeong K, Moon HS. Robot-assisted laparoscopic adenomyomectomy of adenomyotic nodule implanted in the uterine endometrium manifesting as endometrial cancer: a case report and literature review. EUR J GYNAECOL ONCOL 2017; 38:143-146. [PMID: 29767885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Thickened uterine endometrium with abnormal uterine bleeding highly suggests endometrial hyperplasia or endometrial carcinoma. A case of 35-year-old nulliparous woman came to our department with endometrial mass manifesting as endometrial cancer. Transrectal ultrasonography and magnetic resonance imaging (MRI) showed an 8x6 cm multicystic, ill-defined mass compacted at the uterine endometrium, the anterior wall of the uterus, and 3x3 cm heterogenous mass at the left adnexa. The edometrial mass showed multiple septations with enhancement and low-signal intensity on T2-weighted images. After endometrial biopsy was done and simple hyperplasia without atypia was observed at the histopathologic finding, the patient underwent robot-assisted laparoscopy and diagnosed as adenomyoma at the frozen pathology. After adenomyomectomy, permanent pathologic analysis revealed the same result and she recovered without any complications and responded well to gonadotropin-releasing hormone (GnRH) agonist therapy.
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Jeon JH, Kim MS, Moon DH, Yang HC, Hwangbo B, Kim HY, Lee JM, Lee GK. Prognostic Differences in Subgroups of Patients With Surgically Resected T3 Non-Small Cell Lung Cancer. Ann Thorac Surg 2016; 102:1630-1637. [PMID: 27650104 DOI: 10.1016/j.athoracsur.2016.04.096] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 04/26/2016] [Accepted: 04/28/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND This study determined the characteristics and prognosis of each descriptor of T3 non-small cell lung cancer (NSCLC). METHODS A total of 3,241 patients underwent an operation for NSCLC between 2001 and 2013, and this study included 461 patients who received complete anatomic resection of T3 NSCLC. The T3 descriptors were coded as follows: tumor invading main bronchus within 2 cm of the carina (T3-cent), tumor invading beyond visceral pleura (T3-inv), tumor larger than 7 cm (T3-size), separate tumor nodules (T3-sep), or tumor with combined T3 descriptors (T3-comb). RESULTS The T3 distribution was as follows: T3-cent, 75 patients (16.3%); T3-inv, 157 patients (34.1%); T3-size, 132 patients (28.6%); T3-sep, 34 patients (7.4%); and T3-comb, 63 patients (13.7%). Subgroup analyses revealed a significant survival benefit in the T3-cent group compared with the other groups (all p < 0.05). The 5-year disease-free survival (DFS) values were 55.4%, 36.7%, 40.9%, 30.3%, and 32.0% in the T3-cent, T3-inv, T3-size, T3-sep, and T3-comb subgroups, respectively. Multivariable analyses revealed that age (p = 0.019), N status (p = 0.001), adjuvant chemotherapy (p < 0.001), and T3 descriptors (T3-cent versus others, p < 0.001) were the most important independent prognostic factors for DFS. Additional analyses were performed to evaluate prognostic factors for DFS in the T3-cent group. Multivariable analysis revealed that bronchoplastic procedures (p = 0.004) was an independent prognostic factor for DFS. CONCLUSIONS Survival for centrally located T3 NSCLC is better than other types of T3 NSCLC. Lung-preserving operations such as bronchoplastic procedures might result in improved survival of these patients.
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Affiliation(s)
- Jae Hyun Jeon
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Korea
| | - Moon Soo Kim
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Korea.
| | - Duk Hwan Moon
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Korea
| | - Hee Chul Yang
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Korea
| | - Bin Hwangbo
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Korea
| | - Hyae Young Kim
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Korea
| | - Jong Mog Lee
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Korea
| | - Geon-Kook Lee
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Korea
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Jeon JH, Moon D, Yang H, Kim M, Lee J. F-082PROGNOSTIC SIGNIFICANCE OF EXTRANODAL EXTENSION AND SIZE OF METASTATIC LYMPH NODE IN PATIENTS WITH PULMONARY ADENOCARCINOMA. Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hwang Y, Kang CH, Kim HS, Jeon JH, Park IK, Kim YT. Comparison of thoracoscopic segmentectomy and thoracoscopic lobectomy on the patients with non-small cell lung cancer: a propensity score matching study. Eur J Cardiothorac Surg 2014; 48:273-8. [PMID: 25406426 DOI: 10.1093/ejcts/ezu422] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [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: 06/14/2014] [Accepted: 09/30/2014] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Thoracoscopic lobectomy has been widely performed on patients with early-stage lung cancer; meanwhile indications of thoracoscopic segmentectomy have not been clearly defined due to technical difficulties and unclear oncological outcomes. The aim of this study was to compare early and late outcomes between thoracoscopic segmentectomy and thoracoscopic lobectomy. METHODS Between January 2005 and December 2013, 100 thoracoscopic segmentectomies and 1049 thoracoscopic lobectomies were performed on patients with lung cancer in our institute. Preoperative clinical parameters including gender, age, tumour size, pathological stage, histology and forced expiratory volume in 1 s (FEV1) were used for propensity score matching. After propensity score matching, 94 thoracoscopic segmentectomies and 94 lobectomies were selected and compared. RESULTS Thoracoscopic segmentectomies were performed on patients with normal lung function (mean FEV1 = 101.6 ± 24.1%), small-sized tumour (mean diameter 1.7 ± 1.0 cm), early-stage cancer (Stage I 93.7%) and predominant adenocarcinoma (81.9%). The lobectomy group had similar clinical features with the segmentectomy group. Most commonly performed procedures were left upper lobe upper division segmentectomy (19%) and right lower lobe superior segmentectomy (17%). Segmentectomies were performed in all lobes except the right middle lobe. There were no differences between segmentectomy and lobectomy in terms of operation time (166.3 ± 54.7 min vs 181.1 ± 85.2 min, P = 0.47) and hospital stay (6.2 ± 5.2 days vs 7.1 ± 7.1 days, P = 0.31). Incidence of postoperative complications was non-significantly higher in the lobectomy group (17.2 vs 10.6%, P = 0.1), and postoperative mortality rates were also non-significantly higher in the segmentectomy group (1.1 vs 2.1%, P = 0.56). Postoperative FEV1 decrease was non-significantly lower in the segmentectomy group (8.9 ± 10.8 vs 11.0 ± 13.1, P = 0.36). The 3-year overall survival and recurrence-free survival was not different between the two groups (94 and 87% in the segmentectomy group and 96 and 94% in the lobectomy group, P = 0.62 and P = 0.69, respectively). CONCLUSIONS Thoracoscopic segmentectomy could achieve equal short-term surgical results and long-term oncological outcomes compared with thoracoscopic lobectomy.
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Affiliation(s)
- Yoohwa Hwang
- Department of Thoracic and Cardiovascular Surgery, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Chang Hyun Kang
- Department of Thoracic and Cardiovascular Surgery, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hye-Seon Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Korea
| | - Jae Hyun Jeon
- Department of Thoracic and Cardiovascular Surgery, National Cancer Center, Gyeonggi-do, Korea
| | - In Kyu Park
- Department of Thoracic and Cardiovascular Surgery, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Young Tae Kim
- Department of Thoracic and Cardiovascular Surgery, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Kumar S, Ameli-Renani S, Hakim A, Jeon JH, Shrivastava S, Patel U. Ureteral obstruction following renal transplantation: causes, diagnosis and management. Br J Radiol 2014; 87:20140169. [PMID: 25284426 DOI: 10.1259/bjr.20140169] [Citation(s) in RCA: 25] [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] [Indexed: 11/05/2022] Open
Abstract
Renal transplantation, first performed successfully in the 1950s, is the treatment of choice for most patients with end-stage renal failure. It confers longer term survival and a better quality of life than do both haemodialysis and peritoneal dialysis. The success of renal transplantation is dependent on the preservation of renal graft function and despite the many advances in surgical techniques, immunosuppressive regimens and supportive therapies, many challenges remain including post-operative ureteral obstruction. This complication can pose a risk to graft, and, occasionally, to patient survival. In this pictorial review, we describe the causes of ureteral obstruction following renal transplantation and illustrate the pivotal role of radiology in both diagnosing and managing these complications.
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Affiliation(s)
- S Kumar
- 1 Medical School, St George's, University of London, London, UK
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Affiliation(s)
- Woon Heo
- From the Departments of Thoracic and Cardiovascular Surgery (W.H., H.M., D.K.K., H.J.J., Y.-H.H.), Internal Medicine (J.H.J.), and Emergency Medicine (J.Y.L.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Ho-Ki Min
- From the Departments of Thoracic and Cardiovascular Surgery (W.H., H.M., D.K.K., H.J.J., Y.-H.H.), Internal Medicine (J.H.J.), and Emergency Medicine (J.Y.L.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
| | - Do Kyun Kang
- From the Departments of Thoracic and Cardiovascular Surgery (W.H., H.M., D.K.K., H.J.J., Y.-H.H.), Internal Medicine (J.H.J.), and Emergency Medicine (J.Y.L.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Hee Jae Jun
- From the Departments of Thoracic and Cardiovascular Surgery (W.H., H.M., D.K.K., H.J.J., Y.-H.H.), Internal Medicine (J.H.J.), and Emergency Medicine (J.Y.L.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Youn-Ho Hwang
- From the Departments of Thoracic and Cardiovascular Surgery (W.H., H.M., D.K.K., H.J.J., Y.-H.H.), Internal Medicine (J.H.J.), and Emergency Medicine (J.Y.L.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jae Hyun Jeon
- From the Departments of Thoracic and Cardiovascular Surgery (W.H., H.M., D.K.K., H.J.J., Y.-H.H.), Internal Medicine (J.H.J.), and Emergency Medicine (J.Y.L.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jun Yeob Lee
- From the Departments of Thoracic and Cardiovascular Surgery (W.H., H.M., D.K.K., H.J.J., Y.-H.H.), Internal Medicine (J.H.J.), and Emergency Medicine (J.Y.L.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
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Shin YS, Ro KH, Jeon JH, Lee DH. Graft-bending angle and femoral tunnel length after single-bundle anterior cruciate ligament reconstruction: comparison of the transtibial, anteromedial portal and outside-in techniques. Bone Joint J 2014; 96-B:743-51. [PMID: 24891573 DOI: 10.1302/0301-620x.96b6.33201] [Citation(s) in RCA: 27] [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] [Indexed: 01/10/2023]
Abstract
We used immediate post-operative in vivo three-dimensional computed tomography to compare graft bending angles and femoral tunnel lengths in 155 patients who had undergone single-bundle reconstruction of the anterior cruciate ligament using the transtibial (n = 37), anteromedial portal (n = 72) and outside-in (n = 46) techniques. The bending angles in the sagittal and axial planes were significantly greater but the coronal-bending angle was significantly less in the transtibial group than in the anteromedial portal and outside-in groups (p < 0.001 each). The mean length of the femoral tunnel in all three planes was significantly greater in the transtibial group than the anteromedial portal and outside-in groups (p < 0.001 each), but all mean tunnel lengths in the three groups exceeded 30 mm. The only significant difference was the coronal graft- bending angle in the anteromedial portal and outside-in groups (23.5° vs 29.8°, p = 0.012). Compared with the transtibial technique, the anteromedial portal and outside-in techniques may reduce the graft-bending stress at the opening of the femoral tunnel. Despite the femoral tunnel length being shorter in the anteromedial portal and outside-in techniques than in the transtibial technique, a femoral tunnel length of more than 30 mm in the anteromedial portal and outside-in techniques may be sufficient for the graft to heal.
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Affiliation(s)
- Y S Shin
- Seonam Hospital, Department of Orthopaedic Surgery, Seoul, Korea
| | - K H Ro
- Anam Hospital, Department of Orthopaedic Surgery, Korea University, College of Medicine, Seoul, Korea
| | - J H Jeon
- Anam Hospital, Department of Orthopaedic Surgery, Korea University, College of Medicine, Seoul, Korea
| | - D H Lee
- Anam Hospital, Department of Orthopaedic Surgery, Korea University, College of Medicine, Seoul, Korea
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Song JI, Park KH, Jeon JH, Choi HL, Barroga AJ. Dynamics of air temperature, velocity and ammonia emissions in enclosed and conventional pig housing systems. Asian-Australas J Anim Sci 2014; 26:433-42. [PMID: 25049807 PMCID: PMC4093470 DOI: 10.5713/ajas.2011.11515] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Revised: 11/16/2012] [Accepted: 03/24/2012] [Indexed: 11/30/2022]
Abstract
This study aimed to compare the dynamics of air temperature and velocity under two different ventilation and housing systems during summer and winter in Korea. The NH3 concentration of both housing systems was also investigated in relation to the pig’s growth. The ventilation systems used were; negative pressure type for the enclosed pig house (EPH) and natural airflow for the conventional pig house (CPH). Against a highly fluctuating outdoor temperature, the EPH was able to maintain a stable temperature at 24.8 to 29.1°C during summer and 17.9 to 23.1°C during winter whilst the CPH had a wider temperature variance during summer at 24.7 to 32.3°C. However, the temperature fluctuation of the CPH during winter was almost the same with that of EPH at 14.5 to 18.2°C. The NH3 levels in the CPH ranged from 9.31 to 16.9 mg/L during summer and 5.1 to 19.7 mg/L during winter whilst that of the EPH pig house was 7.9 to 16.1 mg/L and 3.7 to 9.6 mg/L during summer and winter, respectively. These values were less than the critical ammonia level for pigs with the EPH maintaining a lower level than the CPH in both winter and summer. The air velocity at pig nose level in the EPH during summer was 0.23 m/s, enough to provide comfort because of the unique design of the inlet feature. However, no air movement was observed in almost all the lower portions of the CPH during winter because of the absence of an inlet feature. There was a significant improvement in weight gain and feed intake of pigs reared in the EPH compared to the CPH (p<0.05). These findings proved that despite the difference in the housing systems, a stable indoor temperature was necessary to minimize the impact of an avoidable and highly fluctuating outdoor temperature. The EPH consistently maintained an effective indoor airspeed irrespective of season; however the CPH had defective and stagnant air at pig nose level during winter. Characteristics of airflow direction and pattern were consistent relative to housing system during both summer and winter but not of airspeed. The ideal air velocity measurement favored the EPH and therefore can be appropriate for the Korean environment. Further emphasis on its cost effectiveness will be the subject of future investigations.
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Affiliation(s)
- J I Song
- National Livestock Research Institute, Rural Development Administration, Suwon, 441-350, Korea
| | - K-H Park
- National Livestock Research Institute, Rural Development Administration, Suwon, 441-350, Korea
| | - J H Jeon
- National Livestock Research Institute, Rural Development Administration, Suwon, 441-350, Korea
| | - H L Choi
- National Livestock Research Institute, Rural Development Administration, Suwon, 441-350, Korea
| | - A J Barroga
- National Livestock Research Institute, Rural Development Administration, Suwon, 441-350, Korea
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Jeon JH, Kang CH, Kim HS, Seong YW, Park IK, Kim YT. Prognostic and predictive role of epidermal growth factor receptor mutation in recurrent pulmonary adenocarcinoma after curative resection. Eur J Cardiothorac Surg 2014; 47:556-62. [PMID: 24760387 DOI: 10.1093/ejcts/ezu177] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [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: 11/14/2022] Open
Abstract
OBJECTIVES Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) treatment prolongs the progression-free survival of patients with advanced non-small-cell lung cancer harbouring EGFR mutations. This study aimed to evaluate the prognostic factors influencing survival after recurrence, and the effectiveness of EGFR-TKIs in patients with recurrent pulmonary adenocarcinoma after curative resection. METHODS EGFR mutations were prospectively evaluated in 594 patients who underwent curative surgical resection for pulmonary adenocarcinoma. Among them, 138 patients who had postoperative recurrent disease were enrolled in the study. Potential prognostic factors for post-recurrence survival (PRS) were evaluated, and predictive factors of responsiveness to EGFR-TKIs were also analysed. RESULTS Among the 138 patients who had postoperative recurrent disease, EGFR mutations were identified in 73 (52.9%) patients. In multivariable analysis, never-smoking status [hazard ratio (HR), 0.522; P = 0.012], adjuvant radiotherapy (HR, 1.995; P = 0.016), disease-free interval of less than 1 year from initial resection to recurrence (HR, 2.382; P = 0.001), surgical treatment for recurrence (HR, 0.346; P = 0.002) and EGFR mutation (HR, 0.552; P = 0.013) were independent prognostic factors for PRS. Among patients treated with EGFR-TKI, EGFR mutation status was the only predictor of response to EGFR-TKI (P < 0.001), and patients with EGFR mutation showed better PRS (3- and 5-year survival rates after recurrence, 68.8 and 41.1%, respectively) than those without EGFR mutations (3- and 5-year survival rates after recurrence, 39.1 and 15.7%, respectively; P = 0.017). CONCLUSIONS Our study demonstrated that EGFR mutation is an independent prognostic factor for PRS. Considering that EGFR mutations were the only independent predictors for response to EGFR-TKIs, selecting patients for EGFR-TKI therapy according to EGFR mutation status may lead to a better prognosis in patients with recurrent pulmonary adenocarcinoma.
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Affiliation(s)
- Jae Hyun Jeon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Chang Hyun Kang
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hye-seon Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Won Seong
- Department of Thoracic and Cardiovascular Surgery, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - In Kyu Park
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Young Tae Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Na KJ, Kang CH, Jeon JH, Seong YW, Park IK, Goo JM, Kim YT. Quantification of emphysema with preoperative computed tomography has stronger association with pulmonary complications than pulmonary function test results after pulmonary lobectomy. J Thorac Cardiovasc Surg 2014; 147:915-20. [DOI: 10.1016/j.jtcvs.2013.11.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 10/05/2013] [Accepted: 11/12/2013] [Indexed: 10/25/2022]
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Seong YW, Kang CH, Choi JW, Kim HS, Jeon JH, Park IK, Kim YT. Early clinical outcomes of robot-assisted surgery for anterior mediastinal mass: its superiority over a conventional sternotomy approach evaluated by propensity score matching†. Eur J Cardiothorac Surg 2014; 45:e68-e73. [DOI: 10.1093/ejcts/ezt557] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Ahn D, Sohn JH, Jeon JH, Jeong JY. Clinical impact of microscopic extrathyroidal extension in patients with papillary thyroid microcarcinoma treated with hemithyroidectomy. J Endocrinol Invest 2014; 37:167-73. [PMID: 24497215 DOI: 10.1007/s40618-013-0025-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [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: 07/29/2013] [Accepted: 11/17/2013] [Indexed: 12/22/2022]
Abstract
BACKGROUND Pathologically confirmed microscopic extrathyroidal extension (ETE) is often identified after hemithyroidectomy in patients with papillary thyroid microcarcinoma (PTMC). Without the presence of microscopic ETE, these patients would be optimal candidates for hemithyroidectomy. AIM The present study aimed at evaluating the clinical impact of microscopic ETE on the recurrence of PTMC treated with hemithyroidectomy. SUBJECTS AND METHODS We compared the clinicopathological characteristics and 5-year outcomes for 262 PTMC patients without ETE and 86 with microscopic ETE who were treated with hemithyroidectomy between January 2004 and December 2010. RESULTS The mean tumour size was larger (0.67 vs. 0.54 cm, p < 0.001) and the proportion of tumours measuring ≥0.5 cm was higher (84.9 vs. 66.8 %, p = 0.001) in patients with microscopic ETE as compared with patients without ETE. Occult multifocal disease was more frequent in patients with microscopic ETE than in those without ETE (14.0 vs. 6.5 %, p = 0.030). However, the recurrence rate was not different between the two groups during the mean 55.8-month follow-up period. In addition, univariate and multivariate analyses revealed no meaningful association between recurrence and microscopic ETE in patients with PTMC treated with hemithyroidectomy. CONCLUSIONS Although microscopic ETE was associated with large tumour size and multifocal disease, its clinical impact on disease recurrence was not significant in PTMC patients treated with hemithyroidectomy. Therefore, microscopic ETE identified after hemithyroidectomy would not be an absolute indication for completion thyroidectomy in patients with PTMC.
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Affiliation(s)
- D Ahn
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
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Kim HS, Lee HJ, Jeon JH, Seong YW, Park IK, Kang CH, Kim KB, Goo JM, Kim YT. Natural History of Ground-Glass Nodules Detected on the Chest Computed Tomography Scan After Major Lung Resection. Ann Thorac Surg 2013; 96:1952-7. [DOI: 10.1016/j.athoracsur.2013.07.071] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 07/09/2013] [Accepted: 07/16/2013] [Indexed: 10/26/2022]
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Jeon JH, Kang CH, Kim HS, Seong YW, Park IK, Kim YT, Kim JH. Video-assisted thoracoscopic lobectomy in non-small-cell lung cancer patients with chronic obstructive pulmonary disease is associated with lower pulmonary complications than open lobectomy: a propensity score-matched analysis. Eur J Cardiothorac Surg 2013; 45:640-5. [PMID: 24052605 DOI: 10.1093/ejcts/ezt460] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES Non-small-cell lung cancer (NSCLC) patients with chronic obstructive pulmonary disease (COPD) are at an increased risk of pulmonary complications after pulmonary resection. This study aimed to identify whether video-assisted thoracoscopic (VATS) lobectomy can reduce postoperative pulmonary complications compared with lobectomy by thoracotomy in NSCLC patients with COPD. METHODS Among a total of 1502 NSCLC patients who underwent lobectomy from April 2005 to June 2012 at the Seoul National University Hospital, 446 (29.7%) were diagnosed with COPD based on the spirometric criteria of the Global Initiative for COPD. Among the 446 patients, 283 presented with stage I NSCLC and were selected for this study. The study patients were divided into two groups: patients undergoing VATS (n = 160) lobectomy and patients undergoing thoracotomy (n = 123) lobectomy. A propensity analysis that incorporated preoperative variables, such as age, sex, Charlson comorbidity index, extent of smoking, preoperative pulmonary function, size of the mass, histological type of the tumour and additional lung resection, was performed, and postoperative outcomes were compared. RESULTS Matching based on propensity scores produced 91 patients in each group for the analysis of postoperative outcomes. There were only three operative mortalities in the thoracotomy group, and all of these patients died of postoperative pneumonia. The overall incidence of postoperative complications was 32.9% (30 of 91) and 22.0% (20 of 91) in the thoracotomy group and in the VATS group, respectively (P = 0.14). Compared with lobectomy by thoracotomy, VATS lobectomy was associated with a lower incidence of pulmonary complications (1.1 vs 12.1%; P < 0.01), shorter operation time (165 vs 201 min; P < 0.01) and shorter length of stay (6.0 vs 9.0 days; P = 0.04). CONCLUSIONS VATS lobectomy is associated with a lower incidence of pulmonary complications compared with lobectomy by thoracotomy in stage I NSCLC patients with COPD. VATS lobectomy may be the preferred strategy for appropriately selected NSCLC patients with COPD.
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Affiliation(s)
- Jae Hyun Jeon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea
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Park IK, Kim YT, Jeon JH, Kim HS, Hwang Y, Seong YW, Kang CH, Kim JH. Importance of Lymph Node Dissection in Thymic Carcinoma. Ann Thorac Surg 2013; 96:1025-32; discussion 1032. [DOI: 10.1016/j.athoracsur.2013.04.057] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 04/10/2013] [Accepted: 04/15/2013] [Indexed: 11/30/2022]
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Lee JH, Ko M, Chae MR, Lee SJ, Kam SC, Park JK, Jeon JH, So I, Lee SW. Radiotelemetric assessment of intracavernosal pressure in apomorphine-induced erection: hypercholesterolemic rats vs normal control. Int J Impot Res 2013; 26:41-4. [DOI: 10.1038/ijir.2013.32] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 04/12/2013] [Accepted: 06/17/2013] [Indexed: 11/09/2022]
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Jeon JH, Kang C, Kim Y, Park I, Kim HS. F-103VIDEO-ASSISTED THORACOSCOPIC LOBECTOMY IN NON-SMALL CELL LUNG CANCER PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE IS ASSOCIATED WITH LOWER PULMONARY COMPLICATIONS THAN OPEN LOBECTOMY: A PROPENSITY SCORE MATCHED ANALYSIS. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt288.103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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