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Jo H, Shin S, Agura T, Jeong S, Ahn H, Lee J, Kim Y, Kang JS. The Role of α-Enolase on the Production of Interleukin (IL)-32 in Con A-Mediated Inflammation and Rheumatoid Arthritis (RA). Pharmaceuticals (Basel) 2024; 17:531. [PMID: 38675491 PMCID: PMC11054489 DOI: 10.3390/ph17040531] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Interleukin (IL)-32 is produced by T lymphocytes, natural killer cells, monocytes, and epithelial cells. IL-32 induces the production of pro-inflammatory cytokines such as tumor necrosis factor (TNF)-α, IL-1β, IL-6, and IL-8, and IL-32 expression is highly increased in rheumatoid arthritis (RA) patients. Enolase-1 (ENO1) is a glycolytic enzyme and the stimulation of ENO1 induces high levels of pro-inflammatory cytokines in concanavalin A (Con A)-activated peripheral blood mononuclear cells (PBMCs) and macrophages in RA patients. In addition, there are many reports that anti-ENO1 antibody is correlated with the disease progression of RA. It implies that ENO1 could regulate IL-32 production during inflammation related to the pathogenesis of RA. Therefore, we investigated the role of ENO1 in IL-32 production using Con A-activated PBMCs and RA PBMCs. IL-32 expression is increased by ENO1 stimulation using real-time PCR and ELISA. In addition, we confirmed that IL-32 production was decreased in Con A-activated PBMCs and RA PBMCs pre-treated with NF-κB or p38 MAPK pathway inhibitors. Taken together, these results suggest that ENO1 plays an important role in inflammation through the induction of IL-32 production by the activation of the NF-κB and p38 MAPK pathways.
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Affiliation(s)
- Hyejung Jo
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; (H.J.); (T.A.); (S.J.); (H.A.); (J.L.); (Y.K.)
| | - Seulgi Shin
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Republic of Korea;
| | - Tomoyo Agura
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; (H.J.); (T.A.); (S.J.); (H.A.); (J.L.); (Y.K.)
| | - Seoyoun Jeong
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; (H.J.); (T.A.); (S.J.); (H.A.); (J.L.); (Y.K.)
| | - Hyovin Ahn
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; (H.J.); (T.A.); (S.J.); (H.A.); (J.L.); (Y.K.)
| | - Junmyung Lee
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; (H.J.); (T.A.); (S.J.); (H.A.); (J.L.); (Y.K.)
| | - Yejin Kim
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; (H.J.); (T.A.); (S.J.); (H.A.); (J.L.); (Y.K.)
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Republic of Korea;
| | - Jae Seung Kang
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; (H.J.); (T.A.); (S.J.); (H.A.); (J.L.); (Y.K.)
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Republic of Korea;
- Artificial Intelligence Institute, Seoul National University, Seoul 08826, Republic of Korea
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul 08826, Republic of Korea
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Lee M, Han Y, Kang JS, Choi YJ, Sohn HJ, Kwon W, Jang JY. CORRIGENDUM: Correction of the ethical statements. Training efficacy of robotic duct-to-mucosa pancreaticojejunostomy simulation using silicone models for surgical fellows. Ann Surg Treat Res 2024; 106:241. [PMID: 38586551 PMCID: PMC10995838 DOI: 10.4174/astr.2024.106.4.241] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024] Open
Abstract
[This corrects the article on p. 45 in vol. 106, PMID: 38205096.].
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Affiliation(s)
- Mirang Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yoo Jin Choi
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hee Ju Sohn
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Department of Surgery, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Lee M, Han Y, Kang JS, Choi YJ, Sohn HJ, Kwon W, Jang JY. Training efficacy of robotic duct-to-mucosa pancreaticojejunostomy simulation using silicone models for surgical fellows. Ann Surg Treat Res 2024; 106:45-50. [PMID: 38205096 PMCID: PMC10774700 DOI: 10.4174/astr.2024.106.1.45] [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: 08/29/2023] [Revised: 10/11/2023] [Accepted: 10/26/2023] [Indexed: 01/12/2024] Open
Abstract
Purpose In the era of minimally invasive surgery (MIS), robotic pancreatoduodenectomy (PD) is actively performed, and clinical fellows need to thoroughly prepare for MIS-PD during the training process. Although pancreaticojejunostomy (PJ) is a difficult anastomosis that requires repeated practice, there are obstacles preventing its practice that concerns patient safety and limited time in the actual operating room. This study evaluated the efficacy of simulation-based training of robotic duct-to-mucosa PJ using pancreatic and intestinal silicone models using a scoring system. Methods Three pancreatobiliary clinical fellows who had never performed a real robotic PJ participated in this study. Each trainee, who was well acquainted with master's video created by a senor surgeon, performed the robotic PJ procedures 9 times, and 3 independent pancreatobiliary surgeons assessed the videos and analyzed the scores using a blind method. Results The mean robotic PJ times for the 3 trainees were 42.8 and 29.1 minutes for the first and 9th videos, respectively. The mean score was 13.8 (range, 6-17) for the first video and 17.7 (range, 15-19) for the 9th video. When comparing earlier and later attempts, the PJ time decreased significantly (2,201.67 seconds vs. 2,045.50 seconds, P = 0.007), whereas test scores increased significantly (total score 14.22 vs. 16.89, P = 0.011). Conclusion This robotic education system will help pancreatobiliary trainees overcome the learning curves efficiently and quickly without raising ethical concerns associated with animal models or direct practice with human subjects. This will be of practical assistance to trainees preparing for MIS-PD.
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Affiliation(s)
- Mirang Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yoo Jin Choi
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hee Ju Sohn
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Department of Surgery, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Abdulameer NJ, Acharya U, Adare A, Aidala C, Ajitanand NN, Akiba Y, Akimoto R, Alfred M, Apadula N, Aramaki Y, Asano H, Atomssa ET, Awes TC, Azmoun B, Babintsev V, Bai M, Bandara NS, Bannier B, Barish KN, Bathe S, Bazilevsky A, Beaumier M, Beckman S, Belmont R, Berdnikov A, Berdnikov Y, Bichon L, Black D, Blankenship B, Bok JS, Borisov V, Boyle K, Brooks ML, Bryslawskyj J, Buesching H, Bumazhnov V, Campbell S, Canoa Roman V, Chen CH, Chiu M, Chi CY, Choi IJ, Choi JB, Chujo T, Citron Z, Connors M, Corliss R, Corrales Morales Y, Csanád M, Csörgő T, Datta A, Daugherity MS, David G, Dean CT, DeBlasio K, Dehmelt K, Denisov A, Deshpande A, Desmond EJ, Ding L, Dion A, Doomra V, Do JH, Drees A, Drees KA, Durham JM, Durum A, En'yo H, Enokizono A, Esha R, Fadem B, Fan W, Feege N, Fields DE, Finger M, Finger M, Firak D, Fitzgerald D, Fokin SL, Frantz JE, Franz A, Frawley AD, Gallus P, Gal C, Garg P, Ge H, Giles M, Giordano F, Glenn A, Goto Y, Grau N, Greene SV, Grosse Perdekamp M, Gunji T, Guragain H, Gu Y, Hachiya T, Haggerty JS, Hahn KI, Hamagaki H, Hanks J, Han SY, Harvey M, Hasegawa S, Hemmick TK, He X, Hill JC, Hodges A, Hollis RS, Homma K, Hong B, Hoshino T, Huang J, Ikeda Y, Imai K, Imazu Y, Inaba M, Iordanova A, Isenhower D, Ivanishchev D, Jacak BV, Jeon SJ, Jezghani M, Jiang X, Ji Z, Johnson BM, Joo E, Joo KS, Jouan D, Jumper DS, Kang JH, Kang JS, Kawall D, Kazantsev AV, Key JA, Khachatryan V, Khanzadeev A, Khatiwada A, Kihara K, Kim C, Kim DH, Kim DJ, Kim EJ, Kim HJ, Kim M, Kim T, Kim YK, Kincses D, Kingan A, Kistenev E, Klatsky J, Kleinjan D, Kline P, Koblesky T, Kofarago M, Koster J, Kotov D, Kovacs L, Kurgyis B, Kurita K, Kurosawa M, Kwon Y, Lajoie JG, Larionova D, Lebedev A, Lee KB, Lee SH, Leitch MJ, Leitgab M, Lewis NA, Lim SH, Liu MX, Li X, Loomis DA, Lynch D, Lökös S, Majoros T, Makdisi YI, Makek M, Manion A, Manko VI, Mannel E, McCumber M, McGaughey PL, McGlinchey D, McKinney C, Meles A, Mendoza M, Meredith B, Miake Y, Mignerey AC, Miller AJ, Milov A, Mishra DK, Mitchell JT, Mitrankova M, Mitrankov I, Miyasaka S, Mizuno S, Mondal MM, Montuenga P, Moon T, Morrison DP, Moukhanova TV, Muhammad A, Mulilo B, Murakami T, Murata J, Mwai A, Nagamiya S, Nagle JL, Nagy MI, Nakagawa I, Nakagomi H, Nakano K, Nattrass C, Nelson S, Netrakanti PK, Nihashi M, Niida T, Nouicer R, Novitzky N, Nukazuka G, Nyanin AS, O'Brien E, Ogilvie CA, Oh J, Orjuela Koop JD, Orosz M, Osborn JD, Oskarsson A, Ozawa K, Pak R, Pantuev V, Papavassiliou V, Park JS, Park S, Patel L, Patel M, Pate SF, Peng JC, Peng W, Perepelitsa DV, Perera GDN, Peressounko DY, PerezLara CE, Perry J, Petti R, Pinkenburg C, Pinson R, Pisani RP, Potekhin M, Pun A, Purschke ML, Radzevich PV, Rak J, Ramasubramanian N, Ravinovich I, Read KF, Reynolds D, Riabov V, Riabov Y, Richford D, Riveli N, Roach D, Rolnick SD, Rosati M, Rowan Z, Rubin JG, Runchey J, Saito N, Sakaguchi T, Sako H, Samsonov V, Sarsour M, Sato S, Sawada S, Schaefer B, Schmoll BK, Sedgwick K, Seele J, Seidl R, Sen A, Seto R, Sett P, Sexton A, Sharma D, Shein I, Shibata M, Shibata TA, Shigaki K, Shimomura M, Shi Z, Shukla P, Sickles A, Silva CL, Silvermyr D, Singh BK, Singh CP, Singh V, Slunečka M, Smith KL, Soltz RA, Sondheim WE, Sorensen SP, Sourikova IV, Stankus PW, Stepanov M, Stoll SP, Sugitate T, Sukhanov A, Sumita T, Sun J, Sun Z, Sziklai J, Takahama R, Takahara A, Taketani A, Tanida K, Tannenbaum MJ, Tarafdar S, Taranenko A, Timilsina A, Todoroki T, Tomášek M, Torii H, Towell M, Towell R, Towell RS, Tserruya I, Ueda Y, Ujvari B, van Hecke HW, Vargyas M, Velkovska J, Virius M, Vrba V, Vznuzdaev E, Wang XR, Wang Z, Watanabe D, Watanabe Y, Watanabe YS, Wei F, Whitaker S, Wolin S, Wong CP, Woody CL, Wysocki M, Xia B, Xue L, Yalcin S, Yamaguchi YL, Yanovich A, Yoon I, Younus I, Yushmanov IE, Zajc WA, Zelenski A, Zou L. Measurement of Direct-Photon Cross Section and Double-Helicity Asymmetry at sqrt[s]=510 GeV in p[over →]+p[over →] Collisions. Phys Rev Lett 2023; 130:251901. [PMID: 37418716 DOI: 10.1103/physrevlett.130.251901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 11/04/2022] [Accepted: 04/28/2023] [Indexed: 07/09/2023]
Abstract
We present measurements of the cross section and double-helicity asymmetry A_{LL} of direct-photon production in p[over →]+p[over →] collisions at sqrt[s]=510 GeV. The measurements have been performed at midrapidity (|η|<0.25) with the PHENIX detector at the Relativistic Heavy Ion Collider. At relativistic energies, direct photons are dominantly produced from the initial quark-gluon hard scattering and do not interact via the strong force at leading order. Therefore, at sqrt[s]=510 GeV, where leading-order-effects dominate, these measurements provide clean and direct access to the gluon helicity in the polarized proton in the gluon-momentum-fraction range 0.02<x<0.08, with direct sensitivity to the sign of the gluon contribution.
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Affiliation(s)
- N J Abdulameer
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - U Acharya
- Georgia State University, Atlanta, Georgia 30303, USA
| | - A Adare
- University of Colorado, Boulder, Colorado 80309, USA
| | - C Aidala
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - N N Ajitanand
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - Y Akiba
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - R Akimoto
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - M Alfred
- Department of Physics and Astronomy, Howard University, Washington, D.C. 20059, USA
| | - N Apadula
- Iowa State University, Ames, Iowa 50011, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - Y Aramaki
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - H Asano
- Kyoto University, Kyoto 606-8502, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - E T Atomssa
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - T C Awes
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - B Azmoun
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - V Babintsev
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - M Bai
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - N S Bandara
- Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003-9337, USA
| | - B Bannier
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - K N Barish
- University of California-Riverside, Riverside, California 92521, USA
| | - S Bathe
- Baruch College, City University of New York, New York, New York 10010, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Bazilevsky
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Beaumier
- University of California-Riverside, Riverside, California 92521, USA
| | - S Beckman
- University of Colorado, Boulder, Colorado 80309, USA
| | - R Belmont
- University of Colorado, Boulder, Colorado 80309, USA
- Physics and Astronomy Department, University of North Carolina at Greensboro, Greensboro, North Carolina 27412, USA
| | - A Berdnikov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - Y Berdnikov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - L Bichon
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - D Black
- University of California-Riverside, Riverside, California 92521, USA
| | - B Blankenship
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - J S Bok
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - V Borisov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - K Boyle
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M L Brooks
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J Bryslawskyj
- Baruch College, City University of New York, New York, New York 10010, USA
- University of California-Riverside, Riverside, California 92521, USA
| | - H Buesching
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - V Bumazhnov
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - S Campbell
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
- Iowa State University, Ames, Iowa 50011, USA
| | - V Canoa Roman
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - C-H Chen
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Chiu
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - C Y Chi
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - I J Choi
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - J B Choi
- Jeonbuk National University, Jeonju, 54896, Korea
| | - T Chujo
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - Z Citron
- Weizmann Institute, Rehovot 76100, Israel
| | - M Connors
- Georgia State University, Atlanta, Georgia 30303, USA
| | - R Corliss
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | | | - M Csanád
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - T Csörgő
- MATE, Laboratory of Femtoscopy, Károly Róbert Campus, H-3200 Gyöngyös, Mátraiút 36, Hungary
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - A Datta
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | | | - G David
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - C T Dean
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - K DeBlasio
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - K Dehmelt
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - A Denisov
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - A Deshpande
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - E J Desmond
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - L Ding
- Iowa State University, Ames, Iowa 50011, USA
| | - A Dion
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - V Doomra
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - J H Do
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - A Drees
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - K A Drees
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - J M Durham
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - A Durum
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - H En'yo
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - A Enokizono
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - R Esha
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - B Fadem
- Muhlenberg College, Allentown, Pennsylvania 18104-5586, USA
| | - W Fan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - N Feege
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - D E Fields
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - M Finger
- Charles University, Faculty of Mathematics and Physics, 180 00 Troja, Prague, Czech Republic
| | - M Finger
- Charles University, Faculty of Mathematics and Physics, 180 00 Troja, Prague, Czech Republic
| | - D Firak
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - D Fitzgerald
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - S L Fokin
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - J E Frantz
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - A Franz
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A D Frawley
- Florida State University, Tallahassee, Florida 32306, USA
| | - P Gallus
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
| | - C Gal
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - P Garg
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - H Ge
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - M Giles
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - F Giordano
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - A Glenn
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - Y Goto
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - N Grau
- Department of Physics, Augustana University, Sioux Falls, South Dakota 57197, USA
| | - S V Greene
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | | | - T Gunji
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - H Guragain
- Georgia State University, Atlanta, Georgia 30303, USA
| | - Y Gu
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - T Hachiya
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - J S Haggerty
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - K I Hahn
- Ewha Womans University, Seoul 120-750, Korea
| | - H Hamagaki
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - J Hanks
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - S Y Han
- Ewha Womans University, Seoul 120-750, Korea
- Korea University, Seoul 02841, Korea
| | - M Harvey
- Texas Southern University, Houston, Texas 77004, USA
| | - S Hasegawa
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - T K Hemmick
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - X He
- Georgia State University, Atlanta, Georgia 30303, USA
| | - J C Hill
- Iowa State University, Ames, Iowa 50011, USA
| | - A Hodges
- Georgia State University, Atlanta, Georgia 30303, USA
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - R S Hollis
- University of California-Riverside, Riverside, California 92521, USA
| | - K Homma
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - B Hong
- Korea University, Seoul 02841, Korea
| | - T Hoshino
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - J Huang
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - Y Ikeda
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - K Imai
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - Y Imazu
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - M Inaba
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - A Iordanova
- University of California-Riverside, Riverside, California 92521, USA
| | - D Isenhower
- Abilene Christian University, Abilene, Texas 79699, USA
| | - D Ivanishchev
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - B V Jacak
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - S J Jeon
- Myongji University, Yongin, Kyonggido 449-728, Korea
| | - M Jezghani
- Georgia State University, Atlanta, Georgia 30303, USA
| | - X Jiang
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - Z Ji
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - B M Johnson
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Georgia State University, Atlanta, Georgia 30303, USA
| | - E Joo
- Korea University, Seoul 02841, Korea
| | - K S Joo
- Myongji University, Yongin, Kyonggido 449-728, Korea
| | - D Jouan
- IPN-Orsay, Univ. Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, BP1, F-91406 Orsay, France
| | - D S Jumper
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - J H Kang
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - J S Kang
- Hanyang University, Seoul 133-792, Korea
| | - D Kawall
- Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003-9337, USA
| | - A V Kazantsev
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - J A Key
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - V Khachatryan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - A Khanzadeev
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - A Khatiwada
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - K Kihara
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - C Kim
- Korea University, Seoul 02841, Korea
| | - D H Kim
- Ewha Womans University, Seoul 120-750, Korea
| | - D J Kim
- Helsinki Institute of Physics and University of Jyväskylä, P.O.Box 35, FI-40014 Jyväskylä, Finland
| | - E-J Kim
- Jeonbuk National University, Jeonju, 54896, Korea
| | - H-J Kim
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - M Kim
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - T Kim
- Ewha Womans University, Seoul 120-750, Korea
| | - Y K Kim
- Hanyang University, Seoul 133-792, Korea
| | - D Kincses
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - A Kingan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - E Kistenev
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - J Klatsky
- Florida State University, Tallahassee, Florida 32306, USA
| | - D Kleinjan
- University of California-Riverside, Riverside, California 92521, USA
| | - P Kline
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - T Koblesky
- University of Colorado, Boulder, Colorado 80309, USA
| | - M Kofarago
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - J Koster
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - D Kotov
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - L Kovacs
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - B Kurgyis
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - K Kurita
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - M Kurosawa
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - Y Kwon
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - J G Lajoie
- Iowa State University, Ames, Iowa 50011, USA
| | - D Larionova
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - A Lebedev
- Iowa State University, Ames, Iowa 50011, USA
| | - K B Lee
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S H Lee
- Iowa State University, Ames, Iowa 50011, USA
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - M J Leitch
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - M Leitgab
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - N A Lewis
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - S H Lim
- Pusan National University, Pusan 46241, Korea
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - M X Liu
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - X Li
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D A Loomis
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - D Lynch
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - S Lökös
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - T Majoros
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - Y I Makdisi
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Makek
- Weizmann Institute, Rehovot 76100, Israel
- Department of Physics, Faculty of Science, University of Zagreb, Bijenička c. 32 HR-10002 Zagreb, Croatia
| | - A Manion
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - V I Manko
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - E Mannel
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M McCumber
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - P L McGaughey
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D McGlinchey
- University of Colorado, Boulder, Colorado 80309, USA
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - C McKinney
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - A Meles
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - M Mendoza
- University of California-Riverside, Riverside, California 92521, USA
| | - B Meredith
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - Y Miake
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - A C Mignerey
- University of Maryland, College Park, Maryland 20742, USA
| | - A J Miller
- Abilene Christian University, Abilene, Texas 79699, USA
| | - A Milov
- Weizmann Institute, Rehovot 76100, Israel
| | - D K Mishra
- Bhabha Atomic Research Centre, Bombay 400 085, India
| | - J T Mitchell
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Mitrankova
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - Iu Mitrankov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - S Miyasaka
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - S Mizuno
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - M M Mondal
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - P Montuenga
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - T Moon
- Korea University, Seoul 02841, Korea
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - D P Morrison
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T V Moukhanova
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - A Muhammad
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - B Mulilo
- Korea University, Seoul 02841, Korea
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, School of Natural Sciences, University of Zambia, Great East Road Campus, Box 32379 Lusaka, Zambia
| | - T Murakami
- Kyoto University, Kyoto 606-8502, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - J Murata
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - A Mwai
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - S Nagamiya
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - J L Nagle
- University of Colorado, Boulder, Colorado 80309, USA
| | - M I Nagy
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - I Nakagawa
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - H Nakagomi
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - K Nakano
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - C Nattrass
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - S Nelson
- Florida A&M University, Tallahassee, Florida 32307, USA
| | | | - M Nihashi
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - T Niida
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - R Nouicer
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - N Novitzky
- Helsinki Institute of Physics and University of Jyväskylä, P.O.Box 35, FI-40014 Jyväskylä, Finland
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - G Nukazuka
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A S Nyanin
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - E O'Brien
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - C A Ogilvie
- Iowa State University, Ames, Iowa 50011, USA
| | - J Oh
- Pusan National University, Pusan 46241, Korea
| | | | - M Orosz
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - J D Osborn
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - A Oskarsson
- Department of Physics, Lund University, Box 118, SE-221 00 Lund, Sweden
| | - K Ozawa
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - R Pak
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - V Pantuev
- Institute for Nuclear Research of the Russian Academy of Sciences, prospekt 60-letiya Oktyabrya 7a, Moscow 117312, Russia
| | - V Papavassiliou
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - J S Park
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - S Park
- Mississippi State University, Mississippi State, Mississippi 39762, USA
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - L Patel
- Georgia State University, Atlanta, Georgia 30303, USA
| | - M Patel
- Iowa State University, Ames, Iowa 50011, USA
| | - S F Pate
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - J-C Peng
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - W Peng
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - D V Perepelitsa
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- University of Colorado, Boulder, Colorado 80309, USA
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - G D N Perera
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - D Yu Peressounko
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - C E PerezLara
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - J Perry
- Iowa State University, Ames, Iowa 50011, USA
| | - R Petti
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - C Pinkenburg
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - R Pinson
- Abilene Christian University, Abilene, Texas 79699, USA
| | - R P Pisani
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Potekhin
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Pun
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - M L Purschke
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - P V Radzevich
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - J Rak
- Helsinki Institute of Physics and University of Jyväskylä, P.O.Box 35, FI-40014 Jyväskylä, Finland
| | - N Ramasubramanian
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | | | - K F Read
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - D Reynolds
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - V Riabov
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - Y Riabov
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - D Richford
- Baruch College, City University of New York, New York, New York 10010, USA
| | - N Riveli
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - D Roach
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - S D Rolnick
- University of California-Riverside, Riverside, California 92521, USA
| | - M Rosati
- Iowa State University, Ames, Iowa 50011, USA
| | - Z Rowan
- Baruch College, City University of New York, New York, New York 10010, USA
| | - J G Rubin
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - J Runchey
- Iowa State University, Ames, Iowa 50011, USA
| | - N Saito
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
| | - T Sakaguchi
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - H Sako
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - V Samsonov
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - M Sarsour
- Georgia State University, Atlanta, Georgia 30303, USA
| | - S Sato
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - S Sawada
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
| | - B Schaefer
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - B K Schmoll
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - K Sedgwick
- University of California-Riverside, Riverside, California 92521, USA
| | - J Seele
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - R Seidl
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Sen
- Iowa State University, Ames, Iowa 50011, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - R Seto
- University of California-Riverside, Riverside, California 92521, USA
| | - P Sett
- Bhabha Atomic Research Centre, Bombay 400 085, India
| | - A Sexton
- University of Maryland, College Park, Maryland 20742, USA
| | - D Sharma
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - I Shein
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - M Shibata
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
| | - T-A Shibata
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - K Shigaki
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - M Shimomura
- Iowa State University, Ames, Iowa 50011, USA
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
| | - Z Shi
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - P Shukla
- Bhabha Atomic Research Centre, Bombay 400 085, India
| | - A Sickles
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - C L Silva
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D Silvermyr
- Department of Physics, Lund University, Box 118, SE-221 00 Lund, Sweden
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - B K Singh
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
| | - C P Singh
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
| | - V Singh
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
| | - M Slunečka
- Charles University, Faculty of Mathematics and Physics, 180 00 Troja, Prague, Czech Republic
| | - K L Smith
- Florida State University, Tallahassee, Florida 32306, USA
| | - R A Soltz
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - W E Sondheim
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S P Sorensen
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - I V Sourikova
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - P W Stankus
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - M Stepanov
- Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003-9337, USA
| | - S P Stoll
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T Sugitate
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - A Sukhanov
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T Sumita
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - J Sun
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - Z Sun
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - J Sziklai
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - R Takahama
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
| | - A Takahara
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - A Taketani
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - K Tanida
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - M J Tannenbaum
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - S Tarafdar
- Vanderbilt University, Nashville, Tennessee 37235, USA
- Weizmann Institute, Rehovot 76100, Israel
| | - A Taranenko
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - A Timilsina
- Iowa State University, Ames, Iowa 50011, USA
| | - T Todoroki
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - M Tomášek
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
| | - H Torii
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - M Towell
- Abilene Christian University, Abilene, Texas 79699, USA
| | - R Towell
- Abilene Christian University, Abilene, Texas 79699, USA
| | - R S Towell
- Abilene Christian University, Abilene, Texas 79699, USA
| | - I Tserruya
- Weizmann Institute, Rehovot 76100, Israel
| | - Y Ueda
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - B Ujvari
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - H W van Hecke
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - M Vargyas
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - J Velkovska
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - M Virius
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
| | - V Vrba
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
- Institute of Physics, Academy of Sciences of the Czech Republic, Na Slovance 2, 182 21 Prague 8, Czech Republic
| | - E Vznuzdaev
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - X R Wang
- New Mexico State University, Las Cruces, New Mexico 88003, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - Z Wang
- Baruch College, City University of New York, New York, New York 10010, USA
| | - D Watanabe
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - Y Watanabe
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - Y S Watanabe
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
| | - F Wei
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - S Whitaker
- Iowa State University, Ames, Iowa 50011, USA
| | - S Wolin
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - C P Wong
- Georgia State University, Atlanta, Georgia 30303, USA
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - C L Woody
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Wysocki
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - B Xia
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - L Xue
- Georgia State University, Atlanta, Georgia 30303, USA
| | - S Yalcin
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - Y L Yamaguchi
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - A Yanovich
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - I Yoon
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - I Younus
- Physics Department, Lahore University of Management Sciences, Lahore 54792, Pakistan
| | - I E Yushmanov
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - W A Zajc
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - A Zelenski
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - L Zou
- University of California-Riverside, Riverside, California 92521, USA
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5
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Kim HS, Lee M, Han Y, Kang JS, Kang YH, Sohn HJ, Kwon W, Lee DH, Jang JY. Role of neoadjuvant treatment in resectable pancreatic cancer according to vessel invasion and increase of CA19-9 levels. J Hepatobiliary Pancreat Sci 2023. [PMID: 36652346 DOI: 10.1002/jhbp.1302] [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: 10/01/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND/PURPOSE The efficacy of neoadjuvant treatment (NAT) for resectable pancreatic cancer remains debatable, particularly in patients with portal vein (PV)/superior mesenteric vein (SMV) contact and elevated serum carbohydrate antigen (CA) 19-9. This study investigated the clinical significance of PV/SMV contact and CA19-9 levels, and the role of NAT in resectable pancreatic cancer. METHODS A total of 775 patients who underwent surgery for resectable pancreatic cancer between 2007 and 2018 were included. Propensity score-matched (PSM) analysis (1:3) was performed based on tumor size, lymph node enlargement, and PV/SMV contact. Subgroup analyses were performed according to PV/SMV contact and CA19-9 level. RESULTS Among the patients, 52 underwent NAT and 723 underwent upfront surgery. After PSM, NAT group showed better survival than upfront surgery group (median 30.0 vs 22.0 months, P = .047). In patients with PV/SMV contact, NAT tended to have better survival (30.0 vs 22.0 months, P = .069). CA19-9 >150 U/mL was a poor prognostic factor, with NAT showing a significant survival difference compared with upfront surgery (34.0 vs 18.0 months, P = .004). CONCLUSIONS Neoadjuvant treatment showed better survival than upfront surgery in resectable pancreatic cancer. In patients with PV/SMV contact or CA19-9 >150 U/mL, NAT showed a survival difference compared to upfront surgery; therefore, NAT could be considered in these patients.
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Affiliation(s)
- Hyeong Seok Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Surgery, Goodjang Hospital, Seoul, Republic of Korea
| | - Mirang Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yoon Hyung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hee Ju Sohn
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Surgery, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Republic of Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dong Ho Lee
- Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
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6
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Moon DK, Kang JS, Byun Y, Choi YJ, Lee HW, Jang JY, Lim CS. Incidence of bactibilia and related factors in patients who undergo cholecystectomy. Ann Surg Treat Res 2023; 104:10-17. [PMID: 36685772 PMCID: PMC9830044 DOI: 10.4174/astr.2023.104.1.10] [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: 07/01/2022] [Revised: 10/13/2022] [Accepted: 10/25/2022] [Indexed: 01/04/2023] Open
Abstract
Purpose In general, bile is normally sterile. However, there are reports bactibilia may occur in certain instances, though the causal factors are unclear. We analyzed possible preoperative predictors of bactibilia upon cholecystectomy. Methods Bile samples were collected during cholecystectomies from November 2018 to November 2019. A total of 428 open or laparoscopic cholecystectomies were performed. Preoperative, intraoperative, and postoperative variables were compared between the culture-positive and culture-negative groups. Results One hundred fifty-seven patients (36.7%) were culture-positive. Gram-negative bacteria (95 [61.0%]) were more common. Escherichia coli (38 [40.0%]) and Enterobacter (22 [23.2%]) were the most common species. In univariate analysis, age of ≥70 years (P < 0.001), male sex (P < 0.001), high American Society of Anesthesiologists physical status grades (P = 0.001), diabetes mellitus (P = 0.002), jaundice (P = 0.007), high Tokyo Guideline grades (P = 0.008), percutaneous transhepatic gallbladder drainage (PTGBD; P < 0.001), endoscopic retrograde cholangiopancreatography (ERCP; P < 0.001) were identified as a risk factors for bactibilia. In multivariate analysis, age of ≥70 years (hazard ratio [HR], 2.874; 95% confidence interval [CI], 1.769-4.670; P = 0.001), ERCP (HR, 9.001; 95% CI, 4.833-16.75; P < 0.001), and PTGBD (HR, 2.866; 95% CI, 1.440-4.901; P = 0.002) were independent risk factors for bactibilia. Conclusion Among patients who underwent cholecystectomy, those who were elderly, symptomatic, and underwent preoperative drainage were more likely to have bactibilia. In such cases, surgeons should take care to prevent bile leakage during surgery and consider administering appropriate antibiotics.
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Affiliation(s)
- Do Kyoon Moon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Division of Hepatobiliary Pancreas Surgery, Department of Surgery, Korea University Medical College, Seoul, Korea
| | - Yoonhyeong Byun
- Department of Surgery, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, Korea
| | - Yoo Jin Choi
- Division of Hepatobiliary Pancreas Surgery, Department of Surgery, Korea University Medical College, Seoul, Korea
| | - Hae Won Lee
- Department of Surgery, Seoul National University Bundang Hospital, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Chang-Sup Lim
- Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
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7
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Lee M, Kang JS, Kim H, Kwon W, Lee SH, Ryu JK, Kim YT, Oh DY, Chie EK, Jang JY. Impact of conversion surgery on survival in locally advanced pancreatic cancer patients treated with FOLFIRINOX chemotherapy. J Hepatobiliary Pancreat Sci 2023; 30:111-121. [PMID: 34581022 DOI: 10.1002/jhbp.1050] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/13/2021] [Accepted: 09/20/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Locally advanced (unresectable) pancreatic cancer (LAPC) is surgically unresectable and often treated with chemotherapy. Most previous studies, that have evaluated conversion surgery after chemotherapy, included heterogeneous patients and chemotherapy regimens, making it challenging to determine the impact of FOLFIRINOX. The present study evaluated the survival benefit of conversion surgery in patients with LAPC who received FOLFIRINOX chemotherapy, and analyzed the prognostic factors. METHODS Patients with LAPC who received FOLFIRINOX as first-line therapy for at least four cycles were included. During chemotherapy, surgical eligibility was determined based on radiologic and metabolic response to the treatment. Clinicopathologic characteristics were compared between the curative-intent surgery and non-resection groups, and the prognostic factors were analyzed. RESULTS A total of 279 patients were included. The rates of partial response (PR) and stable disease (SD) were 34.1% and 51.4%, respectively, and 16.8% patients underwent curative-intent surgery. The median survival was significantly longer in the resection group than in the non-resection group (56 vs 21 months, P < .001). In a multivariate analysis, curative-intent surgery (HR 0.260; P < .001) was the most important factor. CONCLUSIONS Conversion surgery after FOLFIRINOX chemotherapy effectively rescues patients with LAPC. Patients without progression after FOLFIRINOX could be considered as potential candidates for conversion surgery.
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Affiliation(s)
- Mirang Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sang Hyub Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ji Kon Ryu
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yong-Tae Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Do-Youn Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eui Kyu Chie
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
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8
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Lee DH, Yoon W, Lee A, Han Y, Byun Y, Kang JS, Kim H, Kwon W, Suh YA, Choi Y, Namkung J, Han S, Yi SG, Heo JS, Han IW, Park JO, Park JK, Kim SC, Jun E, Kang CM, Lee WJ, Lee HK, Lee H, Lee S, Jeong SY, Lee KE, Han W, Park T, Jang JY. Multi-biomarker panel prediction model for diagnosis of pancreatic cancer. J Hepatobiliary Pancreat Sci 2023; 30:122-132. [PMID: 33991409 DOI: 10.1002/jhbp.986] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/02/2021] [Accepted: 05/02/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND/PURPOSE The current study aimed to develop a prediction model using a multi-marker panel as a diagnostic screening tool for pancreatic ductal adenocarcinoma. METHODS Multi-center cohort of 1991 blood samples were collected from January 2011 to September 2019, of which 609 were normal, 145 were other cancer (colorectal, thyroid, and breast cancer), 314 were pancreatic benign disease, and 923 were pancreatic ductal adenocarcinoma. The automated multi-biomarker Enzyme-Linked Immunosorbent Assay kit was developed using three potential biomarkers: LRG1, TTR, and CA 19-9. Using a logistic regression model on a training data set, the predicted values for pancreatic ductal adenocarcinoma were obtained, and the result was classification into one of the three risk groups: low, intermediate, and high. The five covariates used to create the model were sex, age, and three biomarkers. RESULTS Participants were categorized into four groups as normal (n = 609), other cancer (n = 145), pancreatic benign disease (n = 314), and pancreatic ductal adenocarcinoma (n = 923). The normal, other cancer, and pancreatic benign disease groups were clubbed into the non-pancreatic ductal adenocarcinoma group (n = 1068). The positive and negative predictive value, sensitivity, and specificity were 94.12, 90.40, 93.81, and 90.86, respectively. CONCLUSIONS This study demonstrates a significant diagnostic performance of the multi-marker panel in distinguishing pancreatic ductal adenocarcinoma from normal and benign pancreatic disease states, as well as patients with other cancers.
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Affiliation(s)
- Doo-Ho Lee
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea
- Department of Surgery, Gachon university Gil medical center, Incheon, Korea
| | - Woongchang Yoon
- Bio-MAX/N-Bio Institute, Seoul National University, Seoul, Korea
| | - Areum Lee
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea
| | - Yoonhyeong Byun
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea
| | - Young-Ah Suh
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea
| | - Yonghwan Choi
- Immunodiagnostics R&D Team, IVD Business Unit 5, SK Telecom, Seoul, Korea
| | - Junghyun Namkung
- Immunodiagnostics R&D Team, IVD Business Unit 5, SK Telecom, Seoul, Korea
| | - Sangjo Han
- Immunodiagnostics R&D Team, IVD Business Unit 5, SK Telecom, Seoul, Korea
| | - Sung Gon Yi
- Immunodiagnostics R&D Team, IVD Business Unit 5, SK Telecom, Seoul, Korea
| | - Jin Seok Heo
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - In Woong Han
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joon Oh Park
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joo Kyung Park
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Song Cheol Kim
- Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Eunsung Jun
- Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Chang Moo Kang
- Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Woo Jin Lee
- Center for Liver Cancer, National Cancer Center, Seoul, Korea
| | - Hyeon Kook Lee
- Department of Surgery, Ewha Womans University School of Medicine, Seoul, Korea
| | - Huisong Lee
- Department of Surgery, Ewha Womans University School of Medicine, Seoul, Korea
| | - Seungyeoun Lee
- Department of Mathematics and Statistics, Sejong University, Seoul, Korea
| | - Seung-Yong Jeong
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea
| | - Kyu Eun Lee
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea
| | - Wonshik Han
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea
| | - Taesung Park
- Department of Statistics, Seoul National University, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea
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9
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Kang YH, Kang JS, Lee M, Jung HS, Yun WG, Cho YJ, Han Y, Kwon W, Jang JY. Comparisons of short-term outcomes of anastomotic methods of duct-to-mucosa pancreaticojejunostomy: out-layer continuous suture versus modified Blumgart method. Ann Surg Treat Res 2022; 103:331-339. [PMID: 36601337 PMCID: PMC9763782 DOI: 10.4174/astr.2022.103.6.331] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/12/2022] [Accepted: 09/27/2022] [Indexed: 12/15/2022] Open
Abstract
Purpose Postoperative pancreatic fistula (POPF) is the most troublesome complication after pancreaticojejunostomy (PJ). This study aimed to compare the short-term outcomes of 2 different methods of duct-to-mucosa PJ; out-layer continuous suture anastomosis (OCA) and the modified Blumgart method (mBM). Methods This retrospective cohort study enrolled patients who underwent curative-intent, open PD between 2015 and 2020. In mBM, 2 transpancreatic U-sutures were performed between the pancreatic margin and jejunum, with reinforced sutures in the central region. Patient demographics, diagnosis, intraoperative factors, postoperative complications, and POPF defined by the International Study Group on Pancreatic Fistula were investigated. Clinically relevant POPF (CR-POPF) included grades B and C POPF. Results A total of 184 patients underwent OCA, and 96 patients underwent mBM. The mBM group had more patients who underwent neoadjuvant therapy. The fistula risk scores were comparable between the 2 groups. Both groups showed no significant differences in CR-POPF and overall surgical complication rates. The total operation time was comparable, although the operation time for PJ was shorter in mBM. Conclusion No significant differences were observed in the postoperative outcomes between each group; the operation time for PJ in mBM was shorter. Therefore, mBM may be considered for utilization in duct-to-mucosa PJ.
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Affiliation(s)
- Yoon Hyung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Mirang Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hye-Sol Jung
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Won-Gun Yun
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Young Jae Cho
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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10
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Byun Y, Choi YJ, Han Y, Kang JS, Kim H, Kwon W, Jang JY. Outcomes of 5000 pancreatectomies in Korean single referral center and literature reviews. J Hepatobiliary Pancreat Sci 2022; 29:1327-1335. [PMID: 33636051 DOI: 10.1002/jhbp.933] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/06/2021] [Accepted: 02/14/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Pancreatic resection has higher postoperative mortality and morbidity rates than other abdominal operations. Some centers have reported remarkable postoperative outcomes of minimally invasive surgery. This study investigated the chronological trends of pancreatectomies by analyzing a large-scale database. METHODS The medical records of 5175 patients who underwent pancreatic resection between 1961 and 2019 at a single institution were reviewed. To investigate the chronological change in survival outcomes of periampullary cancer, the survival data of 3,108 patients were analyzed. RESULTS Patient age and the proportion with pancreatic cancer have increased over time. From 2015 to 2019, pancreatic cancer was the most common cause for resection (35.9%), followed by pancreatic cysts (24.8%) and common bile duct cancer (13.4%). The incidence of postoperative complications tended to decrease over time (26.0% from 2000 to 2004; 20.8% from 2015 to 2019). A comparison of survival outcomes of periampullary malignancies by period revealed that patients with pancreatic cancer significantly improved (5-year survival rate: 14.4% before 2000% vs 15.2% from 2000 to 2009% vs 29.0% after 2009, P < .001). CONCLUSIONS Postoperative outcomes of pancreatic resection have improved over the past few decades. To improve outcomes in the future, an active multidisciplinary approach and postoperative management are required.
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Affiliation(s)
- Yoonhyeong Byun
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea
| | - Yoo Jin Choi
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea
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11
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Kang JS, Herrero C, Castañeda P. What is the degree of variability in formal training for pediatric orthopedic surgeons performing scoliosis surgery? Acta Ortop Mex 2022; 36:367-372. [PMID: 37669656] [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] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
INTRODUCTION although pediatric orthopedic surgeons worldwide perform scoliosis surgery, the training received is variable and poorly understood. By surveying the European Pediatric Orthopedic Society (EPOS) and the Sociedad Latinoamericana de Ortopedia (SLAOTI), we aim to characterize this variability. MATERIAL AND METHODS in 2021, we distributed an anonymous online questionnaire to EPOS and SLAOTI. RESULTS 43% EPOS and 22% SLAOTI perform scoliosis procedures (p < 0.05). 18% EPOS and 2% SLAOTI performed > 35 procedures annually (p < 0.05). 70% EPOS and 27% SLAOTI received formal training in spinal deformity surgery (p < 0.005). CONCLUSIONS results show significant differences in training and performance of scoliosis procedures between societies.
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Affiliation(s)
- J S Kang
- Department of Orthopedic Surgery, NYU Langone Health, New York, N.Y. USA
| | - C Herrero
- Department of Orthopedic Surgery, NYU Langone Health, New York, N.Y. USA
| | - P Castañeda
- Department of Orthopedic Surgery, NYU Langone Health, New York, N.Y. USA
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12
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Jo H, Lee D, Go C, Jang Y, Chu N, Bae S, Kang D, Im JP, Kim Y, Kang JS. Preventive Effect of Vitamin C on Dextran Sulfate Sodium (DSS)-Induced Colitis via the Regulation of IL-22 and IL-6 Production in Gulo(−/−) Mice. Int J Mol Sci 2022; 23:ijms231810612. [PMID: 36142515 PMCID: PMC9505994 DOI: 10.3390/ijms231810612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/24/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
Reactive oxygen species (ROS), which are exceptionally high in IBD lesions, are known to cause abnormal immune responses to inflammatory reactions in inflammatory bowel diseases (IBD) through damage to the intestinal mucosal linings. Moreover, they are theorized to be an agent of IBD development. Vitamin C is widely known to be an effective antioxidant for its ability to regulate inflammatory responses through its ROS scavenging effect. Therefore, we examined vitamin C’s influence on the development and progression of IBD in Gulo(−/−) mice, which cannot synthesize vitamin C like humans due to a defect in the expression of L-gulono-γ–lactone oxidase, an essential enzyme for vitamin C production. First, we found extensive oxidative stress and an inflammation increase in the colon of vitamin C-insufficient Gulo(−/−) mice. We also found decreased IL-22 production and NKp46(+) cell recruitment and the impaired activation of the p38MAPK pathway. Additionally, comparing vitamin C-insufficient Gulo(−/−) mice to vitamin C-sufficient Gulo(−/−) mice and wild-type mice, the insufficient group faced a decrease in mucin-1 expression, accompanied by an increase in IL-6 production, followed by the activation of the STAT3 and Akt pathways. The results suggest that vitamin C insufficiency induces severe colitis, meaning vitamin C could also take on a preventative role by regulating the production of cytokines and the induction of inflammation.
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Affiliation(s)
- Hyejung Jo
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Dahae Lee
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Cheolhyeon Go
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Yoojin Jang
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Naghyung Chu
- Department of Biology, College of Arts and Sciences, Emory University, Atlanta, GA 30322, USA
| | - Suhyun Bae
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Dongmin Kang
- Department of Psychological and Brain Sciences, College of Arts and Sciences, Boston University, Boston, MA 02215, USA
| | - Jong Pil Im
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Yejin Kim
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Korea
- Medical Research Center, Institute of Allergy and Clinical Immunology, Seoul National University, Seoul 03080, Korea
- Correspondence: (Y.K.); (J.S.K.)
| | - Jae Seung Kang
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Korea
- Medical Research Center, Institute of Allergy and Clinical Immunology, Seoul National University, Seoul 03080, Korea
- Artificial Intelligence Institute, Seoul National University, Seoul 08826, Korea
- Correspondence: (Y.K.); (J.S.K.)
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Choi YJ, Lee JM, Kang JS, Sohn HJ, Byun Y, Han Y, Kim H, Kwon W, Jang JY. Impact of surgery on survival outcomes for Bismuth type IV Klatskin tumors. J Gastrointest Surg 2022; 26:1890-1898. [PMID: 35680776 DOI: 10.1007/s11605-022-05293-1] [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: 12/12/2021] [Accepted: 02/26/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Bismuth-Corlette type IV Klatskin tumors have conventionally been considered unresectable. This retrospective study aimed to demonstrate the survival improvement of patients with type IV Klatskin tumors when resected and suggest possible radiological features for R0 resectability. METHODS Data on type IV Klatskin tumors diagnosed between 2008 and 2019 were reviewed retrospectively. Patients with distant metastasis, concomitant other cancers at the initial state, extensive vascular invasions, poor liver function, and poor general condition were excluded. The survival outcomes of patients and radiologic parameters of bile duct tumors were compared between the curative resection (R0, 1 resection) and non-resection groups. RESULTS The demographic findings of patients with curative resection (n = 48) and non-resection (n = 111) were comparable. Both were potentially resectable in the initial state. The postoperative morbidity was 22.9% and the 90-day mortality 4.2%. There was a significant difference in the median survival among the curative-intended resection, palliative treatment, and supportive care groups (35, 16, and 12 months, respectively; P < 0.001). DISCUSSION In patients with type IV Klatskin tumor without extensive tumor invasion into adjacent tissues, including major vessels, surgical resection can be considered for better survival. CLINICAL REGISTRATION NUMBER IRB No. 2009-100-1157.
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Affiliation(s)
- Yoo Jin Choi
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, 101 Daehak-ro, Chongro-gu, Seoul, 03080, Korea.,Division of HBP Surgery, Department of Surgery, Korea University Medical Center, Seoul, Korea
| | - Jung Min Lee
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, 101 Daehak-ro, Chongro-gu, Seoul, 03080, Korea.,Pancreatobiliary Cancer Clinic, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, 101 Daehak-ro, Chongro-gu, Seoul, 03080, Korea
| | - Hee-Ju Sohn
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, 101 Daehak-ro, Chongro-gu, Seoul, 03080, Korea
| | - Yoonhyeong Byun
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, 101 Daehak-ro, Chongro-gu, Seoul, 03080, Korea.,Department of Surgery, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, 101 Daehak-ro, Chongro-gu, Seoul, 03080, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, 101 Daehak-ro, Chongro-gu, Seoul, 03080, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, 101 Daehak-ro, Chongro-gu, Seoul, 03080, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, 101 Daehak-ro, Chongro-gu, Seoul, 03080, Korea.
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Jo H, Lee D, Go C, kim Y, Kang JS. The effect of alloferon on chemosensitivity of pancreatic cancer through the regulation of SLC6A14 expression. The Journal of Immunology 2022. [DOI: 10.4049/jimmunol.208.supp.118.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Pancreatic cancer is one of the most malignant solid tumors with a high mortality rate. Although there have been many trials for effective therapies using chemotherapeutic drugs, such as gemcitabine, pancreatic cancer still shows significantly higher mortality than other types of cancer. Therefore, it is needed to examine the effective therapeutic ways to improve conventional therapy for pancreatic cancer. It has been previously reported that cancer cells possess a high rate of glutamine uptake needed for their rapid proliferation. In addition, it has recently been reported that amino acid transporter SLC6A14 is up-regulated in some cancers in close relation to glutamine metabolism. Alloferon is a peptide isolated from the insect immune system and shows anti-viral and anti-inflammatory effects based on its immune modulating function. In addition, its anti-tumor effect was recently discovered, but the related mechanisms are largely unknown. For this reason, I investigated the effect of alloferon on pancreatic cancer cell lines Panc-1 and AsPC-1. When Panc-1 and AsPC-1 were exposed to alloferon for 3 weeks, I found down-regulation of SLC6A14 expression and decreased glutamine uptake. Given that SLC6A14 is involved in tumor progression and survival by promoting glutamine uptake into cancer cells, alloferon could be an effective way with conventional chemotherapeutic drug, gemcitabine. Therefore, alloferon could be a useful adjuvant for an effective therapeutic way with conventional chemotherapeutic drug, gemcitabine.
This study was funded by the NRF of Korea (No.:2017R1A2B2010948, 2017R1A6A3A11032576, 2020R1C1C1009334)
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Affiliation(s)
- HyeJung Jo
- 1Seoul National University College of Medicine, South Korea
| | - DaHae Lee
- 1Seoul National University College of Medicine, South Korea
| | - Cheolhyeon Go
- 1Seoul National University College of Medicine, South Korea
| | - Yejin kim
- 1Seoul National University College of Medicine, South Korea
| | - Jae Seung Kang
- 1Seoul National University College of Medicine, South Korea
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15
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Lee D, Jo H, Go C, kim Y, Kang JS. The roles of IL-22 and its receptor in the regulation of inflammatory responses in the brain. The Journal of Immunology 2022. [DOI: 10.4049/jimmunol.208.supp.46.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Abstract
Interleukin (IL)-22 is a potent mediator of inflammatory responses. The IL-22 receptor consists of the IL-22Rα and IL-10Rβ subunits. Previous studies have shown that IL-22Rα expression is restricted to non-hematopoietic cells in the skin, pancreas, intestine, liver, lung, and kidney. Although IL-22 is involved in the development of inflammatory responses, there have been no re-ports of its role in brain inflammation. Here, we used RT-PCR, western blotting, flow cytometry, immunohistochemical, and microarray analyses to examine the role of IL-22 and expression of IL-22Rα in the brain, using the microglial cell line, hippocampal neuronal cell line, and inflamed mouse brain tissue. Treatment of BV2 and HT22 cells with recombinant IL-22 increased the ex-pression levels of the pro-inflammatory cytokines IL-6 and TNF-α, as well as cyclooxygenase (COX)-2 and prostaglandin E2. We also found that the JNK and STAT3 signaling pathways play an important role in IL-22-mediated increases in inflammatory mediators. Microarray analyses revealed up-regulated expression of inflammation-related genes in IL-22-treated HT22 cells. Finally, we found that IL-22Rα is spontaneously expressed in the brain and is upregulated in in-flamed mouse brain. Overall, our results demonstrate that interaction of IL-22 with IL-22Rα plays a role in the development of inflammatory responses in the brain.
This study was funded by the NRF of Korea (No.: 2017R1A2B2010948, 2017R1A6A3A11032576, 2020R1C1C1009334)
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Affiliation(s)
- DaHae Lee
- 1Seoul National University College of Medicine, South Korea
| | - HyeJung Jo
- 1Seoul National University College of Medicine, South Korea
| | - Cheolhyeon Go
- 1Seoul National University College of Medicine, South Korea
| | - Yejin kim
- 1Seoul National University College of Medicine, South Korea
| | - Jae Seung Kang
- 1Seoul National University College of Medicine, South Korea
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16
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Jung HS, Han Y, Kang JS, Sohn H, Lee M, Lee KB, Kim H, Kwon W, Jang JY. Prediction of malignancy in Main duct or Mixed-type Intraductal Papillary Mucinous Neoplasms of the Pancreas. J Hepatobiliary Pancreat Sci 2022; 29:1014-1024. [PMID: 35451206 DOI: 10.1002/jhbp.1161] [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: 08/26/2021] [Revised: 02/20/2022] [Accepted: 03/27/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/PURPOSE Surgical indications of main-duct involved intraductal papillary mucinous neoplasm (IPMN), especially for main pancreatic duct (MPD) of 5-9mm, remain controversial. We aimed to predict malignancy risk of main-duct involved IPMN. METHODS Total 258 patients with main-duct involved IPMN between 2000 and 2017 in our institute were retrospectively analyzed. Main-duct IPMN was classified into segmental and diffuse type by dilated MPD pattern. Clinicopathologic features and predictive factors for malignancy were analyzed. RESULTS Among 258, 47 and 211 had pure main-duct (segmental:27, diffuse-type:20) and mixed-type. Malignant IPMN presented higher in main-duct type (66.0%) compared to mixed-type (46.9%). The diffuse-type (72.2%) had more invasive carcinoma than the segmental type (40.7%). Invasive IPMN risk increased proportionally to the MPD diameter (5≤MPD <10mm vs. 10≤MPD<15mm vs. MPD≥15mm; 23.4% vs. 40.0% vs. 48.6%). Symptoms, elevated serum carbohydrate antigen, MPD ≥10mm, mural nodule, thickened wall, and distal atrophy were independent predictive factors for malignancy. Patients with MPD of 5-9mm with at least one predictive factor had 35.0% of malignancy risk. CONCLUSIONS The invasive IPMN risk was different according to the dilated main-duct pattern. Patients with main-duct type, diffuse-type, MPD ≥10mm, and MPD 5-9mm with at least one predictive factor should be candidates for immediate surgery.
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Affiliation(s)
- Hye-Sol Jung
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Heeju Sohn
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Mirang Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Bun Lee
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Lee D, Jo H, Go C, Jang Y, Chu N, Bae S, Kang D, Kim Y, Kang JS. The Roles of IL-22 and Its Receptor in the Regulation of Inflammatory Responses in the Brain. Int J Mol Sci 2022; 23:757. [PMID: 35054942 PMCID: PMC8775345 DOI: 10.3390/ijms23020757] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/07/2022] [Accepted: 01/10/2022] [Indexed: 12/17/2022] Open
Abstract
Interleukin (IL)-22 is a potent mediator of inflammatory responses. The IL-22 receptor consists of the IL-22Rα and IL-10Rβ subunits. Previous studies have shown that IL-22Rα expression is restricted to non-hematopoietic cells in the skin, pancreas, intestine, liver, lung, and kidney. Although IL-22 is involved in the development of inflammatory responses, there have been no reports of its role in brain inflammation. Here, we used RT-PCR, Western blotting, flow cytometry, immunohistochemical, and microarray analyses to examine the role of IL-22 and expression of IL-22Rα in the brain, using the microglial cell line, hippocampal neuronal cell line, and inflamed mouse brain tissue. Treatment of BV2 and HT22 cells with recombinant IL-22 increased the expression levels of the pro-inflammatory cytokines IL-6 and TNF-α, as well as cyclooxygenase (COX)-2 and prostaglandin E2. We also found that the JNK and STAT3 signaling pathways play an important role in IL-22-mediated increases in inflammatory mediators. Microarray analyses revealed upregulated expression of inflammation-related genes in IL-22-treated HT22 cells. Finally, we found that IL-22Rα is spontaneously expressed in the brain and is upregulated in inflamed mouse brain. Overall, our results demonstrate that interaction of IL-22 with IL-22Rα plays a role in the development of inflammatory responses in the brain.
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Affiliation(s)
- Dahae Lee
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Korea; (D.L.); (H.J.); (C.G.); (Y.J.); (S.B.)
| | - Hyejung Jo
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Korea; (D.L.); (H.J.); (C.G.); (Y.J.); (S.B.)
| | - Cheolhyeon Go
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Korea; (D.L.); (H.J.); (C.G.); (Y.J.); (S.B.)
| | - Yoojin Jang
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Korea; (D.L.); (H.J.); (C.G.); (Y.J.); (S.B.)
| | - Naghyung Chu
- Department of Biology, College of Arts and Sciences, Emory University, Atlanta, GA 30322, USA;
| | - Suhyun Bae
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Korea; (D.L.); (H.J.); (C.G.); (Y.J.); (S.B.)
| | - Dongmin Kang
- Department of Psychological and Brain Sciences, College of Arts and Sciences, Boston University, Boston, MA 02215, USA;
| | - Yejin Kim
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Korea; (D.L.); (H.J.); (C.G.); (Y.J.); (S.B.)
- Medical Research Center, Institute of Allergy and Clinical Immunology, Seoul National University, Seoul 03080, Korea
| | - Jae Seung Kang
- Laboratory of Vitamin C and Antioxidant Immunology, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Korea; (D.L.); (H.J.); (C.G.); (Y.J.); (S.B.)
- Medical Research Center, Institute of Allergy and Clinical Immunology, Seoul National University, Seoul 03080, Korea
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Lee JM, Kim H, Sohn HJ, Choi YJ, Kang JS, Han Y, Kwon W, Jang JY. Comparison of oncologic outcomes of extrahepatic cholangiocarcinoma according to tumor location: perihilar cholangiocarcinoma versus distal bile duct cancer. Ann Surg Treat Res 2022; 102:100-109. [PMID: 35198513 PMCID: PMC8831089 DOI: 10.4174/astr.2022.102.2.100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/24/2021] [Accepted: 01/10/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose Extrahepatic cholangiocarcinoma is distinguished into perihilar cholangiocarcinoma (PHC) and distal bile duct cancer (DBC). The studies for each subtype have been conducted separately. This study compared oncological outcomes between PHC and DBC. Methods From 2001 to 2017, patients who underwent surgery at Seoul National University Hospital for PHC or DBC were enrolled. T stage was reclassified for tumor extent as ‘confined to’ or ‘beyond’ the bile duct (BD). In survival analysis, stage matching was performed based on tumor extent and lymph node (LN) metastasis. Results There were 680 patients enrolled: 295 with PHC and 385 with DBC. The R0 resection rate was higher in DBC (77.3% vs. 89.9%, P = 0.001). Tumors confined to BD were more common in PHC (61.7% vs. 37.7%, P = 0.001). The 5-year survival rate (5YSR) was higher in DBC patients (30.8% vs. 47.8%, P = 0.001). After stage matching, DBC patients showed better 5YSR for tumors confined to BD/LN(–) (47.1% vs. 64.3%), confined to BD/LN(+) (22.0% vs. 35.0%), beyond BD/LN(–) (21.9% vs. 49.8%), and beyond BD/LN(+) (9.6% vs. 26.9%). The overall recurrence rate was higher in PHC (59.7% vs. 51.9%, P = 0.045), with no difference in the recurrence types between two groups. Radiation therapy was effective for patients with advanced stage disease (5YSR: 35.8% vs. 29.5%, P = 0.022); adjuvant chemotherapy was effective for patients receiving R1 resection (5YSR: 37.3% vs. 13.2%, P = 0.040). Conclusion Differences were identified in oncological outcomes between PHC and DBC, including pathologic findings and survival outcomes.
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Affiliation(s)
- Jung Min Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Ju Sohn
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yoo Jin Choi
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Cho A, Kim H, Sohn HJ, Lee M, Kang YH, Kim HS, Han Y, Kang JS, Kwon W, Jang JY. Risk factors deteriorating severe exocrine pancreatic insufficiency measured by stool elastase after pancreatoduodenectomy and the risk factors for weight loss. Ann Surg Treat Res 2022; 102:20-28. [PMID: 35071116 PMCID: PMC8753381 DOI: 10.4174/astr.2022.102.1.20] [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] [Received: 07/06/2021] [Revised: 10/07/2021] [Accepted: 11/11/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose The measurement of stool elastase (SE) level is useful for evaluating pancreatic exocrine function. This study aimed to determine the risk factors for severe exocrine pancreatic insufficiency (EPI) after pancreatoduodenectomy (PD), and analyze serial changes in nutritional markers and weight based on the SE level. Methods Among patients who underwent PD for periampullary disease, patients whose preoperative and postoperative SE levels were measured were included in the study. The deteriorated (exocrine function) group comprised patients whose SE levels decreased from ≥100 µg/g preoperatively to <100 µg/g postoperatively. Patients whose weight 12 months postoperatively was greater than that 3 months postoperatively were classified into the weight-recovery group. Results Of the 202 included patients, the deteriorated group had a higher incidence of preoperative SE level above 200 µg/g, benign pathology, and the presence of a clinically relevant postoperative pancreatic fistula than the maintained group. Patients who did not undergo weight recovery had a higher rate of history of adjuvant radiotherapy compared to the no-recovery group. Conclusion The evaluation of EPI by measuring SE alone is not sufficient because it does not reflect the nutritional status of patients, and a comprehensive approach that considers other parameters is required for EPI management.
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Affiliation(s)
- Ara Cho
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Ju Sohn
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Mirang Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon Hyung Kang
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyeong Seok Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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Sohn HJ, Kim H, Kim SJ, Lee KB, Han Y, Lee JM, Kang JS, Kwon W, Chie EK, Kim H, Jang JY. Oncologic outcomes according to the location and status of resection margin in pancreas head cancer: role of radiation therapy in R1 resection. Ann Surg Treat Res 2022; 102:10-19. [PMID: 35071115 PMCID: PMC8753382 DOI: 10.4174/astr.2022.102.1.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/13/2021] [Accepted: 12/03/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose The clinical significance of margin status in pancreatic head cancer is still controversial due to the nonstandardized definition of R status and pathologic reporting. This study aims to evaluate the impact of the margin status including location and the role of radiation therapy in pancreatic head cancer. Methods A total of 314 patients who underwent curative-intent surgery for pancreatic head cancer between 2010 and 2017 were analyzed. Demographics, survival, and local recurrences were compared according to 2 definitions: 0-mm R1 as direct involvement and 1-mm R1 as close resection margin less than 1 mm. The specific margins were divided into 4 groups according to the location around the pancreas: pancreas transection, anterior surface, posterior surface, and vessel (superior mesenteric artery/superior mesenteric vein) margin. Results The 0-mm R1-rate was 15.6%, and increased to 36.3% in 1-mm R1. The median overall survival rate of 0-mm R0 vs. R1 was 26 months vs. 16 months (P = 0.052) and that of 1-mm R0 vs. R1 was 27 months vs. 18 months, respectively (P = 0.016). In individual margins, posterior, anterior surface, and pancreas transection margin involvement were associated with poor outcome, and the 1 mm posterior surface involvement was an independent risk factor for disease-free survival (hazard ratio, 1.63). Adjuvant radiation therapy had oncologic benefits, especially in R1 patients (P = 0.011) compared to R0 patients (P = 0.088). Conclusion Margin status, especially 1-mm R1 status is an important predictive factor, and involved posterior surface has a clinical impact. Patients with positive margins should be considered adjuvant radiation therapy.
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Affiliation(s)
- Hee Ju Sohn
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Sun Joo Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung Bun Lee
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Min Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Eui Kyu Chie
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea
| | - Haeryoung Kim
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Kang JS, Sohn HJ, Choi YJ, Byun Y, Lee JM, Lee M, Kang YH, Kim HS, Han Y, Kim H, Kwon W, Jang JY. The development and clinical efficacy of simulation training of open duct-to-mucosa pancreaticojejunostomy using pancreas and intestine silicone models. Ann Surg Treat Res 2022; 102:328-334. [PMID: 35800994 PMCID: PMC9204022 DOI: 10.4174/astr.2022.102.6.328] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/12/2022] [Accepted: 04/28/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose As pancreaticojejunostomy (PJ) is a challenging anastomosis, an education program is needed to train young surgeons to perform PJ. This study evaluated the effects of simulation-based training of open PJ using pancreas and intestine silicone models. Methods Five videos pancreatobiliary clinical fellows who did not perform PJ participated in this study. After watching the master video created by a senior pancreatobiliary surgeon, each trainee performed the PJ using silicone models and recorded them 10 times using a video camera. Of these videos, 5 were randomly duplicated due to the validation of the scoring system. The scoring system developed consisted of 20 scores. Three pancreatobiliary professors scored their performance by watching videos. Results The mean procedure time of the 5 trainees was 25.4 minutes (range, 23.5–27.3 minutes) in the first video and 15.8 minutes (range, 13.8–19.1 minutes) in the 10th video. The mean score was 12.6 (range, 5–19) and 18.3 (range, 15–20) in the first and 10th videos, respectively. The scores were similar among the duplicated videos for each supervisor. Conclusion This education system would help pancreatobiliary trainees to overcome learning curves efficiently without ethical issues related to animal models or direct practice to human patients.
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Affiliation(s)
- Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hee Ju Sohn
- Department of Surgery, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea
| | - Yoo Jin Choi
- Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yoonhyeong Byun
- Department of Surgery, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, Korea
| | - Jung Min Lee
- Department of Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Mirang Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon Hyung Kang
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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22
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Byun Y, Kim EJ, Lee A, Suh YA, Sohn HJ, Lee JM, Kang JS, Choi YJ, Han Y, Kim H, Kwon W, Jang JY. In vivo study for the hemostatic efficacy and foreign body reaction of a new powder-type polysaccharide hemostatic agent. Ann Surg Treat Res 2022; 102:65-72. [PMID: 35198509 PMCID: PMC8831091 DOI: 10.4174/astr.2022.102.2.65] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/09/2021] [Accepted: 01/10/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose Various hemostatic agents have been introduced in therapy as postoperative bleeding is a poor prognostic factor for postoperative outcomes. These products can be divided into those that directly promote the hemostatic cascade and those that physically form a barrier by absorbing blood. The latter, powder-type hemostatic agents have the advantages of being inexpensive and more absorbable with less foreign body reactions (FBRs) and are applicable to a relatively wide area. This study was conducted to verify the safety and efficacy of a newly invented polysaccharide product (OOZFIX, Theracion Biomedical), which improves blood absorption and hemostatic effects. Methods Two separate animal experiments were performed. The first evaluated FBRs histologically at 3 days, 2 weeks, and 4 weeks, after implantation of OOZFIX in rats, and the second compared hemostatic performance of OOZFIX and Arista AH (Bard) in the porcine liver punch biopsy model. Results We found minimal FBRs in the 3-day group and no reactions in both the 2-week and 4-week groups after implantation of hemostatic agents. The time to hemostasis of OOZFIX was not significantly different from that of Arista AH (median [interquartile range]: 9 [6–10] minutes vs. 8 [6–10] minutes, respectively; P = 0.522). When comparing the serial bleeding grade tendency, there was no statistical difference between OOZFIX and Arista AH (P = 0.656). Conclusion OOZFIX caused a minimal FBR that disappeared within 2 weeks in vivo, and its hemostatic performance was comparable with that of an existing agent, Arista AH. Further clinical studies are required in the future.
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Affiliation(s)
- Yoonhyeong Byun
- Department of Surgery, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea
| | - Eun Jin Kim
- Theracion Biomedical Co., Ltd., Seongnam, Korea
| | - Areum Lee
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Young-Ah Suh
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Hee Ju Sohn
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Min Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Yoo Jin Choi
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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23
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Kang JS, Hong SY, Han Y, Sohn HJ, Lee M, Kang YH, Kim HS, Kim H, Kwon W, Jang JY. Limits of serum carcinoembryonic antigen and carbohydrate antigen 19-9 as the diagnosis of gallbladder cancer. Ann Surg Treat Res 2021; 101:266-273. [PMID: 34796142 PMCID: PMC8564080 DOI: 10.4174/astr.2021.101.5.266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/01/2021] [Accepted: 09/24/2021] [Indexed: 12/29/2022] Open
Abstract
Purpose Although serum CEA and CA 19-9 have been widely utilized for the diagnosis of gallbladder cancer (GBC), few studies have examined the diagnostic performance of them. This study aimed to investigate the diagnostic performance of these 2 biomarkers and demonstrate their clinical usefulness in diagnosing GBC. Methods Between January 2000 and March 2020, a total of 751 GBC patients and 2,310 normal controls were included. Serum CEA and CA 19-9 were measured preoperatively. Receiver operating characteristic curves were obtained, and the sensitivity and specificity of each biomarker were evaluated. Results In terms of differentiating GBC from the control, the sensitivity and specificity of serum CEA at 5 ng/mL was 12.1% and 99.1%, respectively, and those of serum CA 19-9 at 37 IU/mL were 28.7% and 94.5%, respectively. The optimal cutoff values of CEA and CA 19-9 were set to 2.1 ng/mL and 26 IU/mL in the receiver operating characteristic curves, respectively. The sensitivities of CEA and CA 19-9 at new cutoff values slightly increased but remained low (CEA, 42.9%; CA 19-9, 38.2%). When differentiating early-stage GBC from advanced tumor, the sensitivity and specificity, were 14.2% and 96.1% for CEA (cutoff value, 5 ng/mL) and 33.6% and 90.1% for CA 19-9 (cutoff value, 37 IU/mL), respectively. Conclusion Serum CEA and CA 19-9 levels are not suitable for screening GBC patients from controls. New promising biomarkers with higher sensitivity should be explored.
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Affiliation(s)
- Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Su Young Hong
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Ju Sohn
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Mirang Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon Hyung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hyeong Seok Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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24
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Kim HS, Han Y, Kang JS, Kang YH, Lee M, Sohn HJ, Kim H, Kwon W, Jang JY. Serum carcinoembryonic antigen and carbohydrate antigen 19-9 as preoperative diagnostic biomarkers of extrahepatic bile duct cancer. BJS Open 2021; 5:6476923. [PMID: 34935900 PMCID: PMC8693162 DOI: 10.1093/bjsopen/zrab127] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/07/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 have been proposed as useful preoperative biomarkers of extrahepatic bile duct cancer (EBDC). This study investigated the accuracy of CEA and CA19-9 for preoperative diagnosis of EBDC. METHODS Patients who underwent surgery for EBDC at a tertiary centre between 1995 and 2018 were studied, and those with concurrent hepatobiliary diseases (including gallbladder cancer, intraductal papillary mucinous neoplasms of pancreas), which could affect CEA or CA19-9 levels, were excluded. The control group included patients who underwent cholecystectomy for benign gallbladder diseases during the same period. Diagnostic accuracy was determined using sensitivity, specificity and area under the receiver operating characteristic curve (AUC). RESULTS After excluding 23 patients, 687 patients (488 men and 199 women, mean age 65.8 years) were compared with the control group of 2310 patients. Median CEA and CA19-9 levels were 1.8 μg/l and 47.0 kU/l in patients with EBDC. CEA (cut-off 5.0 μg/l) showed AUC of 0.541, sensitivity 9.0 per cent and specificity 99.2 per cent, whereas CA19-9 (cut-off 37.0 kU/l) showed AUC of 0.753, sensitivity 56.2 per cent and specificity 94.5 per cent. Sensitivity of CA19-9 was lower in early (T stages 0-II) than advanced (T stages III and IV) cancer (47.0 versus 64.9 per cent), and also lower in N0 stage cancer than lymph node metastasis (50.1 versus 68.8 per cent). CONCLUSION Serum CEA and CA19-9 showed low sensitivity limiting their usefulness as diagnostic biomarkers of EBDC.
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Affiliation(s)
- Hyeong Seok Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Yoon Hyung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Mirang Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Hee Ju Sohn
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
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25
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Kang JS, Choi YJ, Byun Y, Han Y, Kim JH, Lee JM, Sohn HJ, Kim H, Kwon W, Jang JY. Radiological tumour invasion of splenic artery or vein in patients with pancreatic body or tail adenocarcinoma and effect on recurrence and survival. Br J Surg 2021; 109:105-113. [PMID: 34718433 DOI: 10.1093/bjs/znab357] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 09/03/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Major vessel invasion is an important factor for determining the surgical approach and long-term prognosis for patients with pancreatic head cancer. However, clinical implications of vessel invasion have seldom been reported in pancreatic body or tail cancer. This study aimed to evaluate the clinical relevance of splenic vessel invasion with pancreatic body or tail cancer compared with no invasion and investigate prognostic factors. METHODS This study enrolled patients who underwent upfront distal pancreatectomy from 2005 to 2018. The circular degree of splenic vessel invasion was investigated and categorized into three groups (group 1, no invasion; group 2, 0-180°; group 3, 180° or more). Clinicopathological variables and perioperative and survival outcomes were evaluated, and multivariable Cox proportional analysis was performed to evaluate prognostic factors. RESULTS Among 249 enrolled patients, tumour size was larger in patients with splenic vessel invasion (3.9 versus 2.9 cm, P = 0.001), but the number of metastatic lymph nodes was comparable to that in patients with no vessel invasion (1.7 versus 1.4, P = 0.241). The 5-year overall survival rates differed significantly between the three groups (group 1, 38.4 per cent; group 2, 16.8 per cent; group 3, 9.7 per cent, P < 0.001). Patients with both splenic artery and vein invasion had lower 5-year overall survival rates than those with one vessel (7.5 versus 20.2 per cent, P = 0.021). Cox proportional analysis revealed adjuvant treatment, R0 resection and splenic artery invasion as independent prognostic factors for adverse outcomes in pancreatic body or tail cancer. CONCLUSION Splenic vessel invasion was associated with higher recurrence and lower overall survival in pancreatic body or tail cancers suggesting a need for a neoadjuvant approach.
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Affiliation(s)
- Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yoo Jin Choi
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yoonhyeong Byun
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jung Hoon Kim
- Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jung Min Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hee Ju Sohn
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
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26
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Kim HS, Kim H, Han Y, Lee M, Kang YH, Sohn HJ, Kang JS, Kwon W, Jang JY. ROBOT-assisted pancreatoduodenectomy in 300 consecutive cases: Annual trend analysis and propensity score-matched comparison of perioperative and long-term oncologic outcomes with the open method. J Hepatobiliary Pancreat Sci 2021; 29:301-310. [PMID: 34689430 DOI: 10.1002/jhbp.1065] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND/PURPOSE We previously reported perioperative and oncologic outcomes of robot-assisted pancreatoduodenectomy (RAPD); however, the follow-up period in RAPD was relatively short, and disease-matched survival analyses were lacking. Therefore, this study investigated time trends of perioperative and long-term disease-matched outcomes of RAPD. METHODS Annual clinicopathologic outcomes of 328 patients with RAPD between 2015 and 2020 were analyzed and compared with 929 patients with open PD using the propensity score-matched (PSM) analysis based on postoperative pancreatic fistula (POPF) risk and oncologic variables in malignant patients. RESULTS Robot-assisted pancreatoduodenectomy cases increased from 10 (6.3%) in 2015 to 116 (50.2% of total PD) in 2020, with malignancy proportion increasing from 50.0% to 80.2%. POPF risk-based PSM analysis showed that compared with open PD, RAPD had younger patients (63.7 vs 65.6 years, P = .018), longer operation time (339.1 vs 290.0 min, P < .001); however, estimated blood loss (P = .275), complications (17.1% vs 18.3%, P = .702), and clinically relevant POPF (9.8% vs 11.1%, P = .584) were similar with shorter postoperative hospital stay (10.8 vs 15.6 days, P < .001). In disease and stage-matched malignant patients, R0 resection (93.9% vs 91.2%, P = .376), total retrieved lymph node (18.2 vs 19.9, P = .058), and 5-year survival rate (57.3% vs 60.6%, P = .406) were similar between RAPD and open PD, also in pancreatic cancer patients (31.6% vs 26.3%, P = .068). CONCLUSIONS Robot-assisted pancreatoduodenectomy demonstrated similar perioperative outcomes with earlier recovery and equivalent long-term survival with open PD. RAPD is safe and feasible for periampullary lesions, including pancreatic cancers, and its role will expand in the era of minimally invasive surgery.
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Affiliation(s)
- Hyeong Seok Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Mirang Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon Hyung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Ju Sohn
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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27
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Kang YH, Kang JS, Cho YS, Kim HS, Lee M, Han Y, Sohn HJ, Kim H, Kwon W, Jang JY, Lee HK. A retrospective multicentre study on the evaluation of perioperative outcomes of single-port robotic cholecystectomy comparing the Xi and SP versions of the da Vinci robotic surgical system. Int J Med Robot 2021; 18:e2345. [PMID: 34676970 DOI: 10.1002/rcs.2345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 09/26/2021] [Accepted: 10/15/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Single-incision robotic cholecystectomy (SIRC) is widely performed with both the da Vinci Xi system (Xi) and the da Vinci SP system (SP). But there are limited numbers of studies comparing these platforms. METHODS Patients who underwent SIRC between 2019 and 2020 were enrolled. Patient demographics, intraoperative factors, postoperative complications, postoperative pain were compared using a one-to-one propensity score matching (PSM). RESULTS Overall, 258 patients underwent SIRC with Xi and 72 with SP. After PSM, there were significant differences between the Xi and SP in operation time at console and numeric rating scale for postoperative pain, but no difference in total operation time and postoperative complications. The SP group showed more estimated blood loss. CONCLUSIONS Despite the statistical difference, clinical benefit was not significant. Both platforms can be safe and feasible to perform SIRC, but further investigation including the surgeon's workload and ergonomics is needed as a prospective study.
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Affiliation(s)
- Yoon Hyung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yo Seok Cho
- Department of Surgery, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Hyeong Seok Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Mirang Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hee Ju Sohn
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyeon Kook Lee
- Department of Surgery, Ewha Womans University College of Medicine, Seoul, Republic of Korea
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28
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Oh MY, Kim H, Choi YJ, Byun Y, Han Y, Kang JS, Sohn H, Lee JM, Kwon W, Jang JY. Conversion surgery for initially unresectable extrahepatic biliary tract cancer. Ann Hepatobiliary Pancreat Surg 2021; 25:349-357. [PMID: 34402435 PMCID: PMC8382869 DOI: 10.14701/ahbps.2021.25.3.349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/24/2021] [Accepted: 06/20/2021] [Indexed: 12/12/2022] Open
Abstract
Backgrounds/Aims Surgical resection is the only curative treatment for biliary tract cancers; however, most patients undergo palliative chemotherapy because they are contraindicated for surgery. Conversion surgery, a treatment strategy for downsizing chemotherapy and subsequent surgical resection, is feasible for initially unresectable biliary tract cancers following the introduction of effective chemotherapeutic agents. Methods Patients initially diagnosed with unresectable biliary tract cancers, and treated with conversion surgery after palliative chemotherapy between 2013 and 2019, were reviewed retrospectively. Results Twelve patients underwent conversion surgery after palliative chemotherapy for initially unresectable biliary tract cancers. The final pathological diagnosis included six perihilar cholangiocarcinomas, four distal common bile duct cancers, and two gallbladder cancers. Different chemotherapy regimens were used, but all the patients were treated with gemcitabine at some point during their treatment. The median overall survival was 28 months, which was longer than that of patients treated with isolated palliative chemotherapy in previous studies. Conclusions Conversion surgery represents a therapeutic alternative for specific cases of unresectable biliary tract cancers. Palliative chemotherapy for initially unresectable biliary tract cancers is recommended for downsizing the tumor and expanding the indications for surgery. Further studies and clinical trials are required to develop new and effective chemotherapeutic regimens.
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Affiliation(s)
- Moon Young Oh
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Yoo Jin Choi
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Yoonhyeong Byun
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Heeju Sohn
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Min Lee
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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29
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Lee JM, Kim H, Kang JS, Byun Y, Choi YJ, Sohn HJ, Han Y, Kwon W, Jang JY. Comparison of perioperative short-term outcomes and oncologic long-term outcomes between open and laparoscopic distal pancreatectomy in patients with pancreatic ductal adenocarcinoma. Ann Surg Treat Res 2021; 100:320-328. [PMID: 34136428 PMCID: PMC8176202 DOI: 10.4174/astr.2021.100.6.320] [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: 11/02/2020] [Revised: 02/15/2021] [Accepted: 03/09/2021] [Indexed: 12/16/2022] Open
Abstract
Purpose Laparoscopic distal pancreatectomy (LDP) is widely performed but its efficacy and safety are not established for malignant lesions. This study was aimed to compare outcomes of LDP and open distal pancreatectomy (ODP) in pancreatic ductal adenocarcinoma (PDAC). Methods Patients who underwent distal pancreatectomy for PDAC between 2009 and 2017 were enrolled. The preoperative clinical stage was evaluated and propensity score matching (PSM) was performed using age, sex, The American Joint Committee on Cancer 8th clinical T stage, and other organ involvement. Results In 186 patients enrolled, 35 (18.8%) received LDP. The ODP group showed larger tumor size and frequent involvement of other organs in preoperative images. However, after PSM, these differences were balanced. R0 resection (90.5% vs. 94.3%, P = 0.730), harvested lymph nodes (14.3 vs. 12.6, P = 0.380) and pathologic T stage (P = 0.474) were comparable between ODP and LDP groups, respectively. LDP demonstrated shorter operation time, less postoperative pain, and shorter hospitalization (14.4 days vs. 11.1 days, P = 0.026). In terms of long-term oncologic outcomes, median overall survival (32 months vs. 28 months, P = 0.724) and disease-free survival (18 months vs. 19 months, P = 0.926) were comparable. Conclusion LDP demonstrated better short-term outcomes and comparable long-term outcomes compared with ODP. LDP is a safe and feasible procedure for PDAC.
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Affiliation(s)
- Jung Min Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yoonhyeong Byun
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yoo Jin Choi
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Ju Sohn
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Choi YJ, Byun Y, Kang JS, Kim HS, Han Y, Kim H, Kwon W, Oh DY, Paik WH, Lee SH, Ryu JK, Kim YT, Lee K, Kim H, Chie EK, Jang JY. Comparison of Clinical Outcomes of Borderline Resectable Pancreatic Cancer According to the Neoadjuvant Chemo-Regimens: Gemcitabine versus FOLFIRINOX. Gut Liver 2021; 15:466-475. [PMID: 32839360 PMCID: PMC8129663 DOI: 10.5009/gnl20070] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 06/07/2020] [Accepted: 06/30/2020] [Indexed: 12/21/2022] Open
Abstract
Background/Aims Although many studies have reported the promising effect of neoadjuvant treatment for borderline resectable pancreatic cancer (BRPC) to increase resectability, only a few studies have recommended the use of first-line chemotherapeutic agents as neoadjuvant treatment for BRPC. The current study compared clinical outcomes between gemcitabine and FOLFIRINOX (5-fluorouracil, leucovorin, oxaliplatin, and irinotecan) in patients with BRPC. Methods In this single-center retrospective study, 100 BRPC patients treated with neoadjuvant chemotherapy and resection from 2008 to 2018 were reviewed. Clinical outcomes included overall survival, resectability, and recurrence patterns after gemcitabine or FOLFIRINOX treatment. Results For neoadjuvant chemotherapy, gemcitabine was administered to 34 patients and FOLFIRINOX to 66. Neoadjuvant radiotherapy was administered to 27 patients (79.4%) treated with gemcitabine and 19 (28.8%) treated with FOLFIRINOX (p<0.001). The 2- and 5-year survival rates (YSRs) were significantly higher after FOLFIRINOX (2YSR, 72.2%; 5YSR, 46.0%) than after gemcitabine (2YSR, 58.4%; 5YSR, 19.1%; p=0.041). The margin negative rate was comparable (gemcitabine, 94.1%; FOLFIRINOX, 92.4%; p=0.753), and the tumor size change in percentage showed only a marginal difference (gemcitabine, 20.5%; FOLFIRINOX, 29.0%; p=0.069). Notably, the metastatic recurrence rate was significantly lower in the FOLFIRINOX group (n=20, 52.6%) than in the gemcitabine group (n=22, 78.6%; p=0.001). The rate of adverse events after chemotherapy was significantly higher with FOLFIRINOX than with gemcitabine (43.9%, 20.6%, respectively; p=0.037). Conclusions FOLFIRINOX provided more clinical and oncological benefit than gemcitabine, with significantly higher overall survival and lower cumulative recurrence rates in BRPC. However, since FOLFIRINOX causes more adverse effects, the regimen should be individualized based on patient's general condition and clinical status.
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Affiliation(s)
- Yoo Jin Choi
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yoonhyeong Byun
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hyeong Seok Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Do-Youn Oh
- Departments of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Woo Hyun Paik
- Departments of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Hyub Lee
- Departments of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Kon Ryu
- Departments of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yong-Tae Kim
- Departments of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kyungbun Lee
- Departments of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Haeryoung Kim
- Departments of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Eui Kyu Chie
- Departments of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Kang JS, Mok L, Heo JS, Han IW, Shin SH, Yoon YS, Han HS, Hwang DW, Lee JH, Lee WJ, Park SJ, Park JS, Kim Y, Lee H, Yu YD, Yang JD, Lee SE, Park IY, Jeong CY, Roh Y, Kim SR, Moon JI, Lee SK, Kim HJ, Lee S, Kim H, Kwon W, Lim CS, Jang JY, Park T. Development and External Validation of Survival Prediction Model for Pancreatic Cancer Using Two Nationwide Database: Surveillance, Epidemiology and End Results (SEER) and Korea Tumor Registry System-Biliary Pancreas (KOTUS-BP). Gut Liver 2021; 15:912-921. [PMID: 33941710 PMCID: PMC8593502 DOI: 10.5009/gnl20306] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/31/2020] [Accepted: 01/15/2021] [Indexed: 11/04/2022] Open
Abstract
Background/Aims Several prediction models for evaluating the prognosis of nonmetastatic resected pancreatic ductal adenocarcinoma (PDAC) have been developed, and their performances were reported to be superior to that of the 8th edition of the American Joint Committee on Cancer (AJCC) staging system. We developed a prediction model to evaluate the prognosis of resected PDAC and externally validated it with data from a nationwide Korean database. Methods Data from the Surveillance, Epidemiology and End Results (SEER) database were utilized for model development, and data from the Korea Tumor Registry System-Biliary Pancreas (KOTUS-BP) database were used for external validation. Potential candidate variables for model development were age, sex, histologic differentiation, tumor location, adjuvant chemotherapy, and the AJCC 8th staging system T and N stages. For external validation, the concordance index (C-index) and time-dependent area under the receiver operating characteristic curve (AUC) were evaluated. Results Between 2004 and 2016, data from 9,624 patients were utilized for model development, and data from 3,282 patients were used for external validation. In the multivariate Cox proportional hazard model, age, sex, tumor location, T and N stages, histologic differentiation, and adjuvant chemotherapy were independent prognostic factors for resected PDAC. After an exhaustive search and 10-fold cross validation, the best model was finally developed, which included all prognostic variables. The C-index, 1-year, 2-year, 3-year, and 5-year time-dependent AUCs were 0.628, 0.650, 0.665, 0.675, and 0.686, respectively. Conclusions The survival prediction model for resected PDAC could provide quantitative survival probabilities with reliable performance. External validation studies with other nationwide databases are needed to evaluate the performance of this model.
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Affiliation(s)
- Jae Seung Kang
- Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Lydia Mok
- Department of Statistics and Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Korea
| | - Jin Seok Heo
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - In Woong Han
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Hyun Shin
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoo-Seok Yoon
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ho-Seong Han
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Dae Wook Hwang
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Hoon Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Jung Lee
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Jae Park
- Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, Korea
| | - Joon Seong Park
- Pancreatobiliary Cancer Clinic, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yonghoon Kim
- Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Huisong Lee
- Department of Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
| | - Young-Dong Yu
- Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Korea
| | - Jae Do Yang
- Department of Surgery, Jeonbuk National University Medical School, Jeonju, Korea
| | - Seung Eun Lee
- Department of Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Il Young Park
- Department of General Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Chi-Young Jeong
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Younghoon Roh
- Department of Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Seong-Ryong Kim
- Department of Surgery, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
| | - Ju Ik Moon
- Department of Surgery, Konyang University Hospital, Daejeon, Korea
| | - Sang Kuon Lee
- Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Hee Joon Kim
- Department of Surgery, Chonnam National University Hospital, Gwangju, Korea
| | - Seungyeoun Lee
- Department of Mathematics and Statistics, Sejong University, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Chang-Sup Lim
- Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Taesung Park
- Department of Statistics and Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Korea
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Kang JS, Lee KB, Choi YJ, Byun Y, Han Y, Kim H, Kwon W, Jang JY. A comparison of outcomes in patients with intracholecystic papillary neoplasms or conventional adenocarcinomas of the gallbladder. HPB (Oxford) 2021; 23:746-752. [PMID: 33092965 DOI: 10.1016/j.hpb.2020.09.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 06/08/2020] [Revised: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Intracholecystic papillary neoplasm (ICPN) of the gallbladder (GB) is an exophytic intraepithelial neoplasm. This study aimed to investigate clinicopathologic findings, prognosis and recurrence patterns of patients with ICPN as compared to those patients with conventional adenocarcinoma of the gallbladder (GBC). METHODS Patients who underwent surgical resection for suspected GB cancer between 2000 and 2018 were included. ICPN was defined as an exophytic papillary mass within the GB lumen with a size ≥1.0 cm. RESULTS Of 607 patients, 241 patients (40%) were pathologically diagnosed with ICPN. Of the 241 patients with ICPNs, 110 (46%) were T1 or less. Following T stage-matched analysis, the rate of lymph node metastases were comparable (50 [52%] vs. 37 [49%], P = 0.581). The five-year survival rate was higher in ICPN, but after T stage-matching, they were comparable (69.1 vs. 63.2%, P = 0.171). Overall recurrence rates were also comparable, with the exception of lower peritoneal seeding in patients with ICPN. CONCLUSION Patients with ICPN who underwent resection were more likely to have an earlier T stage. There was no significant difference in prognosis and recurrence between ICPN and conventional GBC after stage matching. Therefore, the treatment strategy for ICPN should follow the same protocols used for conventional GBC.
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Affiliation(s)
- Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyoung Bun Lee
- Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yoo Jin Choi
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yoonhyeong Byun
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Kang MK, Kim H, Byun Y, Han Y, Choi YJ, Kang JS, Kwon W, Han IW, Shin SH, Choi DW, You Y, Heo JS, Jang JY. Optimal stapler cartridge selection to reduce post-operative pancreatic fistula according to the pancreatic characteristics in stapler closure distal pancreatectomy. HPB (Oxford) 2021; 23:633-640. [PMID: 33012640 DOI: 10.1016/j.hpb.2020.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/05/2020] [Accepted: 09/07/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Postoperative pancreatic fistula (POPF) is associated with potentially fatal complications, but there is lack of data on relationship between pancreas thickness, and stapler size and the POPF rate. This study aimed to suggest optimal stapler that reduces POPF rate according to the pancreas thickness. METHODS This retrospective cohort study was conducted in two tertiary high-volume pancreas centers. 599 patients who underwent distal pancreatectomy were assessed for stump reinforcement methods, pathology findings, pancreas thickness, and cartridge used. The cartridges were grouped as I, II, III according to the closed height ≤1.5 mm, 1.8 mm, and ≥2.0 mm, respectively. RESULTS The POPF rate increased according to the thickness. The stapler Groups I, II, and III had an overall POPF rate of 66.4% vs. 61.7% vs. 57.8%, but Group II stapler cartridge showed a significant reduction in the POPF rate than other cartridges in pancreas with thickness <13 mm (53.5% vs. 21.7% vs. 36.0%, p = 0.031). There was no significant difference between the POPF rate according to stapler groups when the pancreas was thicker than 13 mm. CONCLUSION Thickness is the strongest risk factor in predicting POPF. Use of Group II stapler cartridge for pancreas with a thickness of <13 mm can help reduce POPF.
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Affiliation(s)
- Min Kyu Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yoonhyeong Byun
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yoo Jin Choi
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - In Woong Han
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sang Hyun Shin
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong Wook Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yunghun You
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jin Seok Heo
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
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Choi YJ, Yoon W, Lee A, Han Y, Byun Y, Kang JS, Kim H, Kwon W, Suh YA, Kim Y, Lee S, Namkung J, Han S, Choi Y, Heo JS, Park JO, Park JK, Kim SC, Kang CM, Lee WJ, Park T, Jang JY. CORRIGENDUM: Addition of data source: Diagnostic model for pancreatic cancer using a multi-biomarker panel. Ann Surg Treat Res 2021; 100:252. [PMID: 33854995 PMCID: PMC8019984 DOI: 10.4174/astr.2021.100.4.252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Yoo Jin Choi
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Woongchang Yoon
- Bio-MAX/N-Bio Institute, Seoul National University, Seoul, Korea
| | - Areum Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yoonhyeong Byun
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Young-Ah Suh
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yongkang Kim
- Department of Statistics, Seoul National University, Seoul, Korea
| | - Seungyeoun Lee
- Department of Applied Mathematics, Sejong University, Seoul, Korea
| | | | - Sangjo Han
- Data Labs, AI Center, SK Telecom, Seoul, Korea
| | | | - Jin Seok Heo
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joon Oh Park
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joo Kyung Park
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Suwon, Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Song Cheol Kim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang Moo Kang
- Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Woo Jin Lee
- Center for Liver Cancer, National Cancer Center, Seoul, Korea
| | - Taesung Park
- Department of Statistics, Seoul National University, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Oh MY, Kim EJ, Kim H, Byun Y, Han Y, Choi YJ, Kang JS, Kwon W, Jang JY. Changes in postoperative long-term nutritional status and quality of life after total pancreatectomy. Ann Surg Treat Res 2021; 100:200-208. [PMID: 33854989 PMCID: PMC8019983 DOI: 10.4174/astr.2021.100.4.200] [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: 09/09/2020] [Revised: 11/14/2020] [Accepted: 12/01/2020] [Indexed: 11/30/2022] Open
Abstract
Purpose Quality of life (QoL) is widely known to be poor after total pancreatectomy (TP) due to the loss of pancreatic function and poor nutritional status, but prospective studies on changes in QoL over time are lacking. The aim of this study was to prospectively evaluate the short- and long-term consequences of pancreatic exocrine insufficiency, changes in nutritional status, and their associated effects on QoL after TP. Methods Prospective data were collected from patients who underwent TP between 2008 and 2018. Validated questionnaires (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire [EORTC QLQ] Core 30, EORTC QLQ-pancreatic cancer module, and the Mini Nutritional Assessment), measured frequency of bowel movement, relative body weight (RBW), triceps skinfold thickness (TSFT), and serum levels of protein, albumin, transferrin, and hemoglobin A1c were collected serially for 1 year. Results Thirty patients who underwent TP were eligible for the study. Bowel movement frequency increased over time, and the RBW and TSFT were lowest by 1 year. The global health status score showed no significant difference over time. At 3 months, physical and role function scores as well as symptoms of fatigue, constipation, and digestive difficulties worsened significantly. Most indices recovered after 1 year, but poorer physical function scores, digestive difficulties, and altered bowel habits persisted. Conclusion Because some symptoms do not recover over time, careful follow-up and supportive postoperative management are needed for TP patients, including nutritional support with pancreatic enzyme replacement and education about medication adherence and diet.
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Affiliation(s)
- Moon Young Oh
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Eun Joo Kim
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Yoonhyeong Byun
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Yoo Jin Choi
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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Byun Y, Lee KB, Jang JY, Han Y, Choi YJ, Kang JS, Kim H, Kwon W. Peritumoral lymph nodes in pancreatic cancer revisited; is it truly equivalent to lymph node metastasis? J Hepatobiliary Pancreat Sci 2021; 28:893-901. [PMID: 33735543 DOI: 10.1002/jhbp.940] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/17/2021] [Accepted: 02/21/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Lymph node (LN) metastasis is a well-known poor prognostic factor of pancreatic cancer. LN metastasis, through direct invasion of tumor cell to peritumoral lymph nodes (PTLN), is treated as the same as those which spread through lymphatic channels. This study aimed to evaluate the impact of PTLN invasion on the oncologic outcome of pancreatic cancer. METHODS Five hundred and six patients who underwent operation for pancreatic ductal adenocarcinoma from 2012 to 2018 were reviewed. PTLN invasion was defined as direct invasion of tumor cells in contact with main tumor. RESULTS Among the 506 patients, 112 patients (22.1%) had PTLN invasion. PTLN invasion group (PTLNI) showed better disease-free survival than regional LN metastasis group (RLNM) and combined LN metastasis group (CLNM) (PTLNI 21 vs RLNM 11 vs CLNM 12 months, P = .003). There was no significant difference between N0 and PTLNI (PTLNI 21 vs N0 23 months, P = .999). In multivariate analysis, conventional LN metastasis was a significant factor compared to N0, but PTLN invasion was not (hazard ratio 0.786 [0.507-1.220], P = .283). CONCLUSION Because PTLN invasion does not adversely affect survival in the same way as LN metastasis does, pancreatic cancer-may be overstaged if PTLN invasion were dealt in the same manner as a metastatic LN. Therefore, PTLN invasion should be disregarded from current nodal staging system.
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Affiliation(s)
- Yoonhyeong Byun
- Division of Pancreatobiliary Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyoung-Bun Lee
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Division of Pancreatobiliary Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Division of Pancreatobiliary Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Yoo Jin Choi
- Division of Pancreatobiliary Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Division of Pancreatobiliary Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Division of Pancreatobiliary Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Division of Pancreatobiliary Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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Choi YJ, Yoon W, Lee A, Han Y, Byun Y, Kang JS, Kim H, Kwon W, Suh YA, Kim Y, Lee S, Namkung J, Han S, Choi Y, Heo JS, Park JO, Park JK, Kim SC, Kang CM, Lee WJ, Park T, Jang JY. Diagnostic model for pancreatic cancer using a multi-biomarker panel. Ann Surg Treat Res 2021; 100:144-153. [PMID: 33748028 PMCID: PMC7943279 DOI: 10.4174/astr.2021.100.3.144] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/06/2020] [Accepted: 12/11/2020] [Indexed: 12/28/2022] Open
Abstract
Purpose Diagnostic biomarkers of pancreatic ductal adenocarcinoma (PDAC) have been used for early detection to reduce its dismal survival rate. However, clinically feasible biomarkers are still rare. Therefore, in this study, we developed an automated multi-marker enzyme-linked immunosorbent assay (ELISA) kit using 3 biomarkers (leucine-rich alpha-2-glycoprotein [LRG1], transthyretin [TTR], and CA 19-9) that were previously discovered and proposed a diagnostic model for PDAC based on this kit for clinical usage. Methods Individual LRG1, TTR, and CA 19-9 panels were combined into a single automated ELISA panel and tested on 728 plasma samples, including PDAC (n = 381) and normal samples (n = 347). The consistency between individual panels of 3 biomarkers and the automated multi-panel ELISA kit were accessed by correlation. The diagnostic model was developed using logistic regression according to the automated ELISA kit to predict the risk of pancreatic cancer (high-, intermediate-, and low-risk groups). Results The Pearson correlation coefficient of predicted values between the triple-marker automated ELISA panel and the former individual ELISA was 0.865. The proposed model provided reliable prediction results with a positive predictive value of 92.05%, negative predictive value of 90.69%, specificity of 90.69%, and sensitivity of 92.05%, which all simultaneously exceed 90% cutoff value. Conclusion This diagnostic model based on the triple ELISA kit showed better diagnostic performance than previous markers for PDAC. In the future, it needs external validation to be used in the clinic.
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Affiliation(s)
- Yoo Jin Choi
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Woongchang Yoon
- Bio-MAX/N-Bio Institute, Seoul National University, Seoul, Korea
| | - Areum Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yoonhyeong Byun
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Young-Ah Suh
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yongkang Kim
- Department of Statistics, Seoul National University, Seoul, Korea
| | - Seungyeoun Lee
- Department of Applied Mathematics, Sejong University, Seoul, Korea
| | | | - Sangjo Han
- Data Labs, AI Center, SK Telecom, Seoul, Korea
| | | | - Jin Seok Heo
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joon Oh Park
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joo Kyung Park
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Suwon, Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Song Cheol Kim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Korea
| | - Chang Moo Kang
- Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Woo Jin Lee
- Center for Liver Cancer, National Cancer Center, Seoul, Korea
| | - Taesung Park
- Department of Statistics, Seoul National University, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Hwang JH, Piao H, Jang JY, Lee SK, Han D, Lee GM, Go C, Kim Y, Oh KI, Kang JS, Yan JJ, Yang J. Suppressive effects of vitamin C-treated induced-regulatory T cells on heart allograft rejection under vitamin C-deficient or -sufficient conditions. PLoS One 2021; 16:e0246967. [PMID: 33577562 PMCID: PMC7880463 DOI: 10.1371/journal.pone.0246967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 01/28/2021] [Indexed: 12/30/2022] Open
Abstract
Foxp3 stability of vitamin C-treated induced-regulatory T cells (V-iTregs) is superior to that of conventional iTregs (C-iTregs). However, the role of V-iTregs in allograft rejection under vitamin C-deficient conditions, such as those seen in humans, remains unclear. We aimed to elucidate the role of vitamin C treatment on generation and maintenance of iTregs from gulo knockout (Gulo-KO) mice as well as wild type (WT) mice, and in vitro and in vivo suppressive effects of V-iTregs on heart allograft rejection in either Gulo-KO or WT recipient mice. Conversion efficiency of iTregs was similar between C- and V-iTregs in both WT and Gulo-KO mice. V-iTregs from WT or Gulo-KO mice showed better in vitro Foxp3 stability than C-iTregs, although there was no difference between WT V-iTregs and Gulo-KO V-iTregs. Furthermore, V-iTregs from WT or Gulo-KO mice suppressed in vitro T cell proliferation better than C-iTregs. Heterotrophic heart transplantation from BALB/c mice to WT or vitamin C-deficient Gulo-KO C57BL/6J mice was performed following adoptive transfer of C- or V-iTregs. V-iTregs as well as C-iTregs prolonged heart allograft survival in WT and Gulo-KO mice. However, there was no difference between the C- and V-iTreg groups. Supplementation of low- or high-dose vitamin C did not induce significant changes in heart allograft survival in Gulo-KO recipients that had received V-iTregs. In conclusion, V-iTregs do not exert better suppressive effects on heart allograft survival than C-iTregs in either WT or vitamin C-deficient recipients.
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Affiliation(s)
- Ju Hee Hwang
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Honglin Piao
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Medicine, Graduate School, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Joon Young Jang
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sun-Kyung Lee
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Medicine, Graduate School, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dongkyu Han
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Gwang-Min Lee
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Cheolhyeon Go
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yejin Kim
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Kwon Ik Oh
- Department of Pathology, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Jae Seung Kang
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Ji-Jing Yan
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jaeseok Yang
- Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea
- Department of surgery, Seoul National University hospital, Seoul, Republic of Korea
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39
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Han Y, Jang JY, Oh MY, Kim HS, Byun Y, Kang JS, Kim SH, Lee KB, Kim H, Kwon W. Natural history and optimal treatment strategy of intraductal papillary mucinous neoplasm of the pancreas: Analysis using a nomogram and Markov decision model. J Hepatobiliary Pancreat Sci 2020; 28:131-142. [PMID: 33283481 DOI: 10.1002/jhbp.878] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND/PURPOSE With the increase in detection of intraductal papillary mucinous neoplasms (IPMN), a tailored approach is needed. This study was aimed at exploring the natural history of IPMN and suggest optimal treatment based on malignancy risk using a nomogram and Markov decision model. METHODS Patients with IPMN who underwent surveillance or surgery were included. Changes in worrisome features/high-risk stigmata and malignancy conversion rate were assessed. Life expectancy and quality-adjusted life year (QALY) were compared using a nomogram predicting malignancy. RESULTS Overall, 2006 patients with histologically confirmed or radiologically typical IPMN were enrolled. Of these, 1773 (88.4%), 81 (4.0%), and 152 (7.6%), respectively, had branch duct (BD)-, main duct-, and mixed-type IPMN at initial diagnosis. The cumulative risk of developing worrisome feature or high-risk stigmata was 19.0% and 35.0% at 5- and 10-year follow-up, respectively. The progression of malignancy rate at 10-year follow-up was 79.9% for main and mixed IPMNs and 5.9% for BD-IPMN. Nomogram-based malignancy risk prediction is well correlated with natural history based on pathologic biopsy and shows good stratification of survival. The decision model recommends surgery to maximize survival and QALY especially in those with >35% malignancy risk. CONCLUSIONS Compared with main duct- and mixed-type IPMN, which have a high risk of malignancy (79.9%), BD-IPMN is very indolent (5.9%). The nomogram-based decision model suggests surgery rather than surveillance for patients with a high malignancy risk. The optimal treatment strategy between surgery and surveillance should consider patients' health status, malignancy risk, and centers' experience.
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Affiliation(s)
- Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Moon Young Oh
- Department of Surgery and Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyeong Seok Kim
- Department of Surgery and Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yoonhyeong Byun
- Department of Surgery and Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Se Hyung Kim
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kyoung-Bun Lee
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Kang RH, Jang JE, Huh E, Kang SJ, Ahn DR, Kang JS, Sailor MJ, Yeo SG, Oh MS, Kim D, Kim HY. A brain tumor-homing tetra-peptide delivers a nano-therapeutic for more effective treatment of a mouse model of glioblastoma. Nanoscale Horiz 2020; 5:1213-1225. [PMID: 32510090 DOI: 10.1039/d0nh00077a] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Organ-specific cell-penetrating peptides (CPPs) are a class of molecules that can be highly effective at delivering therapeutic cargoes, and they are currently of great interest in cancer treatment strategies. Herein, we describe a new CPP (amino acid sequence serine-isoleucine-tyrosine-valine, or SIWV) that homes to glioblastoma multiforme (GBM) brain tumor tissues with remarkable specificity in vitro and in vivo. The SIWV sequence was identified from an isoform of annexin-A3 (AA3H), a membrane-interacting human protein. The mechanism of intracellular permeation is proposed to follow a caveolin-mediated endocytotic pathway, based on in vitro and in vivo receptor inhibition and genetic knockdown studies. Feasibility as a targeting agent for therapeutics is demonstrated in a GBM xenograft mouse model, where porous silicon nanoparticles (pSiNPs) containing the clinically relevant anticancer drug SN-38 are grafted with SIWV via a poly-(ethylene glycol) (PEG) linker. The formulation shows enhanced in vivo targeting ability relative to a formulation employing a scrambled control peptide, and significant (P < 0.05) therapeutic efficacy relative to free SN-38 in the GBM xenograft animal model.
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Affiliation(s)
- Rae Hyung Kang
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea.
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Lee M, Kwon W, Kim H, Byun Y, Han Y, Kang JS, Choi YJ, Jang JY. The Role of Location of Tumor in the Prognosis of the Pancreatic Cancer. Cancers (Basel) 2020; 12:cancers12082036. [PMID: 32722142 PMCID: PMC7465041 DOI: 10.3390/cancers12082036] [Citation(s) in RCA: 14] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/11/2020] [Accepted: 07/22/2020] [Indexed: 02/07/2023] Open
Abstract
Identification of prognostic factors is important to improve treatment outcomes in pancreatic cancer. This study aimed to investigate the effect of the location of pancreatic cancer on survival and to determine whether it was a significant prognostic factor. Altogether, 2483 patients diagnosed with pancreatic cancer were examined. Comparative analysis of clinicopathologic characteristics, survival analysis, and multivariate analysis were performed. Cancers of the pancreatic head or the uncinate process were present in 49.5% of patients. The head/uncinate cancers had more clinical T1/T2 tumors (59.4% vs. 35.5%, p < 0.001) and a significantly higher 5-year survival rate (8.9% vs. 7.3%, p < 0.001) than the body/tail cancers. The 5-year survival rate in patients with head/uncinate cancers was significantly lower in the resectable (p = 0.014) and the locally advanced groups (p = 0.007). In patients who underwent resection with curative intent, the 5-year survival rate was lower in the head/uncinate group (p = 0.046). The overall outcome of the head/uncinate cancers was better than the body/tail cancers, due to the high proportion of resectable cases. In patients who underwent curative resection, the head/uncinate cancers had a higher number of T1/T2 tumors, but worse outcomes. In the multivariate analysis, tumor location was not an independent prognostic factor for pancreatic cancer.
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Affiliation(s)
| | | | | | | | | | | | | | - Jin-Young Jang
- Correspondence: ; Tel.: +822-2072-2194; Fax: +822-766-3975
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Adare A, Afanasiev S, Aidala C, Ajitanand NN, Akiba Y, Akimoto R, Al-Ta'ani H, Alexander J, Angerami A, Aoki K, Apadula N, Aramaki Y, Asano H, Aschenauer EC, Atomssa ET, Awes TC, Azmoun B, Babintsev V, Bai M, Bannier B, Barish KN, Bassalleck B, Bathe S, Baublis V, Baumgart S, Bazilevsky A, Belmont R, Berdnikov A, Berdnikov Y, Bing X, Blau DS, Boyle K, Brooks ML, Buesching H, Bumazhnov V, Butsyk S, Campbell S, Castera P, Chen CH, Chi CY, Chiu M, Choi IJ, Choi JB, Choi S, Choudhury RK, Christiansen P, Chujo T, Chvala O, Cianciolo V, Citron Z, Cole BA, Connors M, Csanád M, Csörgő T, Dairaku S, Datta A, Daugherity MS, David G, Denisov A, Deshpande A, Desmond EJ, Dharmawardane KV, Dietzsch O, Ding L, Dion A, Donadelli M, Drapier O, Drees A, Drees KA, Durham JM, Durum A, D'Orazio L, Edwards S, Efremenko YV, Engelmore T, Enokizono A, Esumi S, Eyser KO, Fadem B, Fields DE, Finger M, Finger M, Fleuret F, Fokin SL, Frantz JE, Franz A, Frawley AD, Fukao Y, Fusayasu T, Gainey K, Gal C, Garishvili A, Garishvili I, Glenn A, Gong X, Gonin M, Goto Y, Granier de Cassagnac R, Grau N, Greene SV, Grosse Perdekamp M, Gunji T, Guo L, Gustafsson HÅ, Hachiya T, Haggerty JS, Hahn KI, Hamagaki H, Hanks J, Hashimoto K, Haslum E, Hayano R, He X, Hemmick TK, Hester T, Hill JC, Hollis RS, Homma K, Hong B, Horaguchi T, Hori Y, Huang S, Ichihara T, Iinuma H, Ikeda Y, Imrek J, Inaba M, Iordanova A, Isenhower D, Issah M, Isupov A, Ivanischev D, Jacak BV, Javani M, Jia J, Jiang X, Johnson BM, Joo KS, Jouan D, Kamin J, Kaneti S, Kang BH, Kang JH, Kang JS, Kapustinsky J, Karatsu K, Kasai M, Kawall D, Kazantsev AV, Kempel T, Khanzadeev A, Kijima KM, Kim BI, Kim C, Kim DJ, Kim EJ, Kim HJ, Kim KB, Kim YJ, Kim YK, Kinney E, Kiss Á, Kistenev E, Klatsky J, Kleinjan D, Kline P, Komatsu Y, Komkov B, Koster J, Kotchetkov D, Kotov D, Král A, Krizek F, Kunde GJ, Kurita K, Kurosawa M, Kwon Y, Kyle GS, Lacey R, Lai YS, Lajoie JG, Lebedev A, Lee B, Lee DM, Lee J, Lee KB, Lee KS, Lee SH, Lee SR, Leitch MJ, Leite MAL, Leitgab M, Lewis B, Lim SH, Linden Levy LA, Litvinenko A, Liu MX, Love B, Maguire CF, Makdisi YI, Makek M, Malakhov A, Manion A, Manko VI, Mannel E, Masumoto S, McCumber M, McGaughey PL, McGlinchey D, McKinney C, Mendoza M, Meredith B, Miake Y, Mibe T, Mignerey AC, Milov A, Mishra DK, Mitchell JT, Miyachi Y, Miyasaka S, Mohanty AK, Moon HJ, Morrison DP, Motschwiller S, Moukhanova TV, Murakami T, Murata J, Nagae T, Nagamiya S, Nagle JL, Nagy MI, Nakagawa I, Nakamiya Y, Nakamura KR, Nakamura T, Nakano K, Nattrass C, Nederlof A, Nihashi M, Nouicer R, Novitzky N, Nyanin AS, O'Brien E, Ogilvie CA, Okada K, Oskarsson A, Ouchida M, Ozawa K, Pak R, Pantuev V, Papavassiliou V, Park BH, Park IH, Park SK, Pate SF, Patel L, Pei H, Peng JC, Pereira H, Peresedov V, Peressounko DY, Petti R, Pinkenburg C, Pisani RP, Proissl M, Purschke ML, Qu H, Rak J, Ravinovich I, Read KF, Reynolds R, Riabov V, Riabov Y, Richardson E, Roach D, Roche G, Rolnick SD, Rosati M, Rukoyatkin P, Sahlmueller B, Saito N, Sakaguchi T, Samsonov V, Sano M, Sarsour M, Sawada S, Sedgwick K, Seidl R, Sen A, Seto R, Sharma D, Shein I, Shibata TA, Shigaki K, Shimomura M, Shoji K, Shukla P, Sickles A, Silva CL, Silvermyr D, Sim KS, Singh BK, Singh CP, Singh V, Slunečka M, Soltz RA, Sondheim WE, Sorensen SP, Soumya M, Sourikova IV, Stankus PW, Stenlund E, Stepanov M, Ster A, Stoll SP, Sugitate T, Sukhanov A, Sun J, Sziklai J, Takagui EM, Takahara A, Taketani A, Tanaka Y, Taneja S, Tanida K, Tannenbaum MJ, Tarafdar S, Taranenko A, Tennant E, Themann H, Todoroki T, Tomášek L, Tomášek M, Torii H, Towell RS, Tserruya I, Tsuchimoto Y, Tsuji T, Vale C, van Hecke HW, Vargyas M, Vazquez-Zambrano E, Veicht A, Velkovska J, Vértesi R, Virius M, Vossen A, Vrba V, Vznuzdaev E, Wang XR, Watanabe D, Watanabe K, Watanabe Y, Watanabe YS, Wei F, Wei R, White SN, Winter D, Wolin S, Woody CL, Wysocki M, Yamaguchi YL, Yang R, Yanovich A, Ying J, Yokkaichi S, You Z, Younus I, Yushmanov IE, Zajc WA, Zelenski A, Zolin L. Erratum: Evolution of π^{0} Suppression in Au+Au Collisions from sqrt[s_{NN}]=39 to 200 GeV [Phys. Rev. Lett. 109, 152301 (2012)]. Phys Rev Lett 2020; 125:049901. [PMID: 32794791 DOI: 10.1103/physrevlett.125.049901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Indexed: 06/11/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.109.152301.
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Lee EM, Lee J, Kim Y, Yi KS, Cho J, Kim J, An JM, Lee D, Kim SJ, An E, Hong YJ, Jo H, Lee SH, Jung Y, Choi CH, Kang JS, Hur J, Kim D. Hybrid Composite of Silver Nanoparticle-Porous Silicon Microparticles as an Image-Guided Localization Agent for Computed Tomography Scan of the Lungs. ACS Biomater Sci Eng 2020; 6:4390-4396. [PMID: 33455188 DOI: 10.1021/acsbiomaterials.0c00611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
A hybrid composite of silver nanoparticles (AgNPs) and porous silicon microparticles (pSiMPs) was developed and applied for the computed tomography (CT) scanning of the lungs as an image-guided localization agent. We confirmed the grafting of AgNPs on oxidized pSiMPs template using various analytical equipment, including a scanning electron microscope (SEM), Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), and energy-dispersive X-ray spectroscopy (EDS). The hybrid composite showed a high CT contrast intensity (>1000 HU) that enabled us to produce and view images of the lungs. In addition, it showed the ability to maintain a strong CT signal at the injected area of the rabbit's lungs, up to an hour, without spreading. The lack of toxicity and immune response indicated that the composite could be fully utilized as a new image-guided localization agent of CT scans for lung cancer surgery.
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Affiliation(s)
| | | | | | - Kyung Sik Yi
- Department of Radiology, Chungbuk National University, Hospital, and Chungbuk National University College of Medicine and Medical Research Institute, Cheongju-si 28644, Republic of Korea
| | - Janggeun Cho
- Department of Radiology, Chungbuk National University, Hospital, and Chungbuk National University College of Medicine and Medical Research Institute, Cheongju-si 28644, Republic of Korea
| | | | | | | | | | | | | | | | | | | | - Chi-Hoon Choi
- Department of Radiology, Chungbuk National University, Hospital, and Chungbuk National University College of Medicine and Medical Research Institute, Cheongju-si 28644, Republic of Korea
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Choi CW, Kim Y, Kim JE, Seo EY, Zouboulis CC, Kang JS, Youn SW, Chung JH. Enhancement of lipid content and inflammatory cytokine secretion in SZ95 sebocytes by palmitic acid suggests a potential link between free fatty acids and acne aggravation. Exp Dermatol 2020; 28:207-210. [PMID: 30506807 DOI: 10.1111/exd.13855] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 10/27/2018] [Accepted: 11/17/2018] [Indexed: 12/24/2022]
Abstract
A relationship between acne and free fatty acids (FFAs) has been suggested recently. However, the effects of FFAs on sebaceous glands are still largely unknown. At the same time, the role of FFAs during chronic inflammation is well established. Considering that FFAs are also a major component of sebum, it is likely that changes in FFA affect both the synthesis of sebum and the inflammatory response in sebaceous glands. In this study, we examined a hypothesis that FFAs increase the production of sebum and induce inflammation in the sebaceous glands. We found that treatment of SZ95 sebocytes with exogenously applied palmitic acid (PA), a major saturated FFA, induced a significant increase in intracellular lipid levels. Moreover, PA treatment also increased the expression and secretion of the proinflammatory cytokines in SZ95 sebocytes. We also found that Toll-like receptors were required for the inflammatory response triggered by PA. The results of our study strengthen the notion about the link between acne and FFAs and suggest the mechanism underlying this relationship. Our results serve as a foundation for future work that will explore the association between FFA and acne and pave way to the development of novel treatment options for acne.
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Affiliation(s)
- Chong Won Choi
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.,Laboratory of Cutaneous Aging Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Yejin Kim
- Department of Anatomy, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Eun Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.,Laboratory of Cutaneous Aging Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Eun Young Seo
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.,Laboratory of Cutaneous Aging Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Christos C Zouboulis
- Department of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany
| | - Jae Seung Kang
- Department of Anatomy, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Woong Youn
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Ho Chung
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.,Laboratory of Cutaneous Aging Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
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An JM, Kang S, Huh E, Kim Y, Lee D, Jo H, Joung JF, Kim VJ, Lee JY, Dho YS, Jung Y, Hur JK, Park C, Jung J, Huh Y, Ku JL, Kim S, Chowdhury T, Park S, Kang JS, Oh MS, Park CK, Kim D. Penta-fluorophenol: a Smiles rearrangement-inspired cysteine-selective fluorescent probe for imaging of human glioblastoma. Chem Sci 2020; 11:5658-5668. [PMID: 32874505 PMCID: PMC7449700 DOI: 10.1039/d0sc01085e] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/08/2020] [Indexed: 01/20/2023] Open
Abstract
Two of the most critical factors for the survival of glioblastoma (GBM) patients are precision diagnosis and the tracking of treatment progress. At the moment, various sophisticated and specific diagnostic procedures are being used, but there are relatively few simple diagnosis methods. This work introduces a sensing probe based on a turn-on type fluorescence response that can measure the cysteine (Cys) level, which is recognized as a new biomarker of GBM, in human-derived cells and within on-site human clinical biopsy samples. The Cys-initiated chemical reactions of the probe cause a significant fluorescence response with high selectivity, high sensitivity, a fast response time, and a two-photon excitable excitation pathway, which allows the imaging of GBM in both mouse models and human tissue samples. The probe can distinguish the GBM cells and disease sites in clinical samples from individual patients. Besides, the probe has no short or long-term toxicity and immune response. The present findings hold promise for application of the probe to a relatively simple and straightforward following of GBM at clinical sites.
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Affiliation(s)
- Jong Min An
- Department of Biomedical Science , Graduate School , Kyung Hee University , Seoul 02447 , Korea .
| | - Sangrim Kang
- Department of Anatomy and Neurobiology , College of Medicine , Kyung Hee University , Seoul 02447 , Korea
- Department of Pathology , College of Medicine , Kyung Hee University , Seoul 02447 , Korea
| | - Eugene Huh
- Department of Medical Science of Meridian , Graduate School , Kyung Hee University , Seoul 02447 , Korea .
- Department of Life and Nanopharmaceutical Sciences , Graduate School , Kyung Hee University , Seoul 02447 , Korea
| | - Yejin Kim
- Laboratory of Vitamin C and Antioxidant Immunology , Department of Anatomy and Cell Biology , Seoul National University , College of Medicine , Seoul 03080 , Korea .
- Institute of Allergy and Clinical Immunology , Seoul National University Medical Research Center , Seoul 03080 , Korea
| | - Dahae Lee
- Laboratory of Vitamin C and Antioxidant Immunology , Department of Anatomy and Cell Biology , Seoul National University , College of Medicine , Seoul 03080 , Korea .
| | - Hyejung Jo
- Laboratory of Vitamin C and Antioxidant Immunology , Department of Anatomy and Cell Biology , Seoul National University , College of Medicine , Seoul 03080 , Korea .
| | | | - Veronica Jihyun Kim
- Neural Development and Anomaly Laboratory , Department of Anatomy and Cell Biology , Seoul National University , College of Medicine , Seoul 03080 , Korea
| | - Ji Yeoun Lee
- Neural Development and Anomaly Laboratory , Department of Anatomy and Cell Biology , Seoul National University , College of Medicine , Seoul 03080 , Korea
- Division of Pediatric Neurosurgery , Seoul National University, Children's Hospital , Seoul 03080 , Korea
| | - Yun Sik Dho
- Department of Neurosurgery , Seoul National University Hospital , Seoul National University , College of Medicine , Seoul 03080 , Korea .
| | - Yuna Jung
- Department of Biomedical Science , Graduate School , Kyung Hee University , Seoul 02447 , Korea .
| | - Junho K Hur
- Department of Biomedical Science , Graduate School , Kyung Hee University , Seoul 02447 , Korea .
- Department of Pathology , College of Medicine , Kyung Hee University , Seoul 02447 , Korea
| | - Chan Park
- Department of Biomedical Science , Graduate School , Kyung Hee University , Seoul 02447 , Korea .
- Department of Anatomy and Neurobiology , College of Medicine , Kyung Hee University , Seoul 02447 , Korea
| | - Junyang Jung
- Department of Biomedical Science , Graduate School , Kyung Hee University , Seoul 02447 , Korea .
- Department of Anatomy and Neurobiology , College of Medicine , Kyung Hee University , Seoul 02447 , Korea
| | - Youngbuhm Huh
- Department of Biomedical Science , Graduate School , Kyung Hee University , Seoul 02447 , Korea .
- Department of Anatomy and Neurobiology , College of Medicine , Kyung Hee University , Seoul 02447 , Korea
| | - Ja-Lok Ku
- Korean Cell Line Bank , Cancer Research Institute , Seoul National University , College of Medicine , Seoul 03080 , Korea
| | - Sojin Kim
- Department of Neurosurgery , Seoul National University Hospital , Seoul National University , College of Medicine , Seoul 03080 , Korea .
| | - Tamrin Chowdhury
- Department of Neurosurgery , Seoul National University Hospital , Seoul National University , College of Medicine , Seoul 03080 , Korea .
| | - Sungnam Park
- Department of Chemistry , Korea University , Seoul 02841 , Korea .
| | - Jae Seung Kang
- Laboratory of Vitamin C and Antioxidant Immunology , Department of Anatomy and Cell Biology , Seoul National University , College of Medicine , Seoul 03080 , Korea .
- Institute of Allergy and Clinical Immunology , Seoul National University Medical Research Center , Seoul 03080 , Korea
| | - Myung Sook Oh
- Department of Medical Science of Meridian , Graduate School , Kyung Hee University , Seoul 02447 , Korea .
- Department of Oriental Pharmaceutical Science , Kyung Hee East-West Pharmaceutical Research Institute , Kyung Hee University , Seoul 02447 , Korea
| | - Chul-Kee Park
- Department of Neurosurgery , Seoul National University Hospital , Seoul National University , College of Medicine , Seoul 03080 , Korea .
| | - Dokyoung Kim
- Department of Biomedical Science , Graduate School , Kyung Hee University , Seoul 02447 , Korea .
- Department of Anatomy and Neurobiology , College of Medicine , Kyung Hee University , Seoul 02447 , Korea
- Center for Converging Humanities , Kyung Hee University , Seoul 02447 , Korea
- Medical Research Center for Bioreaction to Reactive Oxygen Species , Biomedical Science Institute , School of Medicine , Graduate School , Kyung Hee University , Seoul 02447 , Korea
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Kim Y, Lee D, Jo H, Kang JS. Vitamin C insufficiency aggravates dextran sulfate sodium (DSS)-induced colitis and colitis-associated colon cancer by regulating IL-6 and IL-22 production in Gulo(− /− ) mice. The Journal of Immunology 2020. [DOI: 10.4049/jimmunol.204.supp.233.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Mucosal damage in inflammatory bowel diseases (IBDs) involves the dysfunctional immunoregulation of the gut. Among immunoregulatory factors, oxidative stress is abnormally high level in IBDs, and their destructive effects may contribute to the initiation or propagation of the disease. Vitamin C has anti-oxidant, anti-inflammatory and immunomodulatory effects. So, we investigated the effect of vitamin C on dextran sulfate sodium (DSS)-induced colitis in Gulo(−/−) mice which cannot synthesize vitamin C. Vitamin C-insufficient Gulo(−/−) mice showed the increased oxidative stress and inflammation in the colon. The production of interleukin (IL)-22, the recruitment of NKp46(+) cells, and the activation of p38 MAPK were decreased in the vitamin C-insufficient Gulo(−/−) mice accompanied by decreased mucin-1 expression in compared with vitamin C-sufficient Gulo(−/−) mice and wild-type mice. Moreover, the production of IL-6 was increased, and STAT3 and Akt were activated, which involved the decreased expression of E-cadherin and granyhead like-2 (GRHL2). Consequently, vitamin C-insufficient Gulo(−/−) mice eventually go with severe colitis and cancer development. Therefore, our results suggest that vitamin C has a protective effect on DSS-induced colitis, and has a progressive role in the colon cancer by regulating the production of cytokines and the induction of inflammation.
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Affiliation(s)
- Yejin Kim
- 1Seoul National University College of Medicine, South Korea
| | - Dahae Lee
- 1Seoul National University College of Medicine, South Korea
| | - Hyejung Jo
- 1Seoul National University College of Medicine, South Korea
| | - Jae Seung Kang
- 1Seoul National University College of Medicine, South Korea
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Lee D, Kim Y, Jo H, Kang JS. The role of Interleukin-22 and its receptor Interleukin-22Rα on the regulation of inflammatory responses in the brain. The Journal of Immunology 2020. [DOI: 10.4049/jimmunol.204.supp.59.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Interleukin (IL)-22 is a member of IL-10 family, is a potent mediator of inflammatory responses. It is produced by activated CD4+ T cells and natural killer (NK) cells and takes effect on non-hematopoietic cells mainly stromal and epithelial cells. And, IL-22 receptor consists of IL-22Rα and IL-10Rβ. It is known that IL-22Rα expression is restricted to non-hematopoietic cells in the skin, pancreas, intestine, liver, lung and kidney. Even though IL-22 is mainly involved in the development of inflammatory responses, but there is a no report regarding their roles on inflammatory responses in the brain. In the present study, I investigated the role of IL-22 and its receptor on inflammatory responses in the brain using mouse microglia cell line, BV2 and mouse hippocampal neuronal cell line, HT22. When BV2 and HT22 were treated with rIL-22 (20 ng/ml), expression of cyclooxygenase (COX)-2, was increased and its expression is followed by the increased of PGE2 production. Next, I examined whether production of pro-inflammatory cytokines, such as such as IL-6 and TNF-α, and pro-inflammatory chemokines by IL-22 treatment. As a result, I confirmed that IL-6, TNF-α, and MIG/CXCL9 are remarkably increased. Taken together, IL-22α is spontaneously expressed on the cells, especially microglia and neuron and it is closely involved in the development of inflammatory responses in the brain.
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Affiliation(s)
| | - Yejin Kim
- 2Seoul National University College of Medicine, South Korea
- 3Seoul Natl. Univ. Col. of Med., South Korea
| | - Hyejung Jo
- 3Seoul Natl. Univ. Col. of Med., South Korea
| | - Jae Seung Kang
- 2Seoul National University College of Medicine, South Korea
- 3Seoul Natl. Univ. Col. of Med., South Korea
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Choi CW, Kim BR, Yang S, Kim Y, Kang JS, Youn SW. Regulatory T cells suppress skin inflammation in the imiquimod-induced psoriasis-like mouse model. J Dermatol Sci 2020; 98:199-202. [PMID: 32451152 DOI: 10.1016/j.jdermsci.2020.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 04/06/2020] [Accepted: 04/21/2020] [Indexed: 01/01/2023]
Affiliation(s)
- Chong Won Choi
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Bo Ri Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Seoyun Yang
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Yejin Kim
- Department of Anatomy Cell Biology, Seoul National University College of Medicine, 103 Daehak-ro, Chongno-gu Seoul 03080, Republic of Korea; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Jae Seung Kang
- Department of Anatomy Cell Biology, Seoul National University College of Medicine, 103 Daehak-ro, Chongno-gu Seoul 03080, Republic of Korea; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea.
| | - Sang Woong Youn
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
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Kang JS, Kim HJ, Choi YJ, Byun Y, Lee JM, Han Y, Kim H, Kwon W, Jang JY. Clinicoradiological features of resected serous cystic neoplasms according to morphological subtype and preoperative tentative diagnosis: can radiological characteristics distinguish serous cystic neoplasms from other lesions? Ann Surg Treat Res 2020; 98:247-253. [PMID: 32411629 PMCID: PMC7200608 DOI: 10.4174/astr.2020.98.5.247] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 02/12/2020] [Accepted: 03/06/2020] [Indexed: 12/28/2022] Open
Abstract
Purpose Serous cystic neoplasm (SCN) of the pancreas is considered benign in most cases. However, some SCN patients undergo surgical resection because lesions could not be differentiated preoperatively. This study evaluated causes of resection for SCN, investigated clinical and radiological features of surgically resected SCNs, and compared characteristics of SCNs diagnosed accurately and those misdiagnosed. Methods One hundred patients, who underwent surgery for pancreatic cystic tumors with pathological confirmation of SCN between 2000 and 2014 were retrospectively analyzed. Results The mean patient age was 52.9 years, 67 (67%) were female, and most lesions (72%) were located in the pancreatic body or tail. Fifty-one (51%) pathologically confirmed SCNs were preoperatively diagnosed as non-SCNs. Patients underwent surgery due to uncertain diagnosis (58%) or symptomatology (18%). According to radiological examination, most lesions were macrocystic (85%), exhibited septation (58%), or were enhancing lesions (48%). Compared with preoperatively diagnosed non-SCNs, accurately diagnosed SCNs exhibited septation (75.5% vs. 41.2%, P = 0.001) and central scar (36.7% vs. 11.8%, P = 0.003) more frequently in radiological examinations. In terms of macrocystic tumors (n = 85), most parameters did not differentiate preoperative diagnoses, although lesions accurately diagnosed as SCN exhibited septation more frequently than those preoperatively misdiagnosed as mucinous cystic neoplasm or intraductal papillary mucinous neoplasm (70.7% vs. 38.9% vs. 33.3%, respectively, P = 0.009). Conclusion It is difficult to accurately distinguish macrocystic SCNs from other cystic tumors using conventional radiological methods. For more accurate diagnosis, new biomarkers and/or other diagnostic modalities are needed and warrant further investigation.
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Affiliation(s)
- Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hyo Jun Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yoo Jin Choi
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yoonhyeong Byun
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong Min Lee
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Byun Y, Choi YJ, Kang JS, Han Y, Kim H, Kwon W, Jang JY. Robotic extended cholecystectomy in gallbladder cancer. Surg Endosc 2020; 34:3256-3261. [PMID: 32306112 DOI: 10.1007/s00464-020-07554-z] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 04/04/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND The application of minimally invasive surgery (MIS) in advanced gallbladder cancer (GBC) requiring extended cholecystectomy is challenging, in terms of achieving clinically safe and complete oncologic resection. Recently developed robotic systems, however, may provide advantages in overcoming difficulties faced by laparoscopic MIS. The purpose of this study is to investigate the feasibility and advantages of a robotic system to assist with extended cholecystectomy. METHODS Patients diagnosed with clinically suspected stage T2 or above, GBC (as determined by preoperative computed tomography or ultrasonography) underwent robotic extended cholecystectomy (REC) from February 2018 to January 2020. The attached video shows the detailed procedure in the following order: the positioning of the patient and the trocars, Kocher maneuver, lymph node dissection (#8, 9, 12, 13), skeletonization of hepatoduodenal ligament, ligation of the cystic duct and liver resection. RESULTS Of 16 patients who underwent REC, mean operation time was 198.3 min and the median estimated blood loss was 295 ml. 11 patients (68.8%) were pathologically diagnosed as stage T2 or above, and the metastatic lymph node was identified in 3 patients (18.8%). All cases had secured tumor-free resection margins, and 3 patients (18.8%) showed invasion to the hepatic parenchyma. The mean number of retrieved lymph nodes was 7.2. The median duration of hospital stay was 7 days. There were no mortality or recurrence within 90 days after the operation. CONCLUSION This study suggests that robotic systems can be safely utilized in advanced stage GBC, facilitating oncologically sufficient lymph node dissection and rapid recovery.
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Affiliation(s)
- Yoonhyeong Byun
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Yoo Jin Choi
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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