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Lee O, Yoon SK, Yoon SJ, Kim H, Han IW, Heo JS, Shin SH. Fate of small remnant pancreatic tail in splenic hilum after laparoscopic spleen preserving distal pancreatectomy: a retrospective study. Ann Surg Treat Res 2024; 106:211-217. [PMID: 38586554 PMCID: PMC10995840 DOI: 10.4174/astr.2024.106.4.211] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/04/2024] [Accepted: 01/15/2024] [Indexed: 04/09/2024] Open
Abstract
Purpose When performing laparoscopic spleen-preserving distal pancreatectomy (LSPDP), sometimes, anatomically challenging patients are encountered, where the pancreatic tail is deep in the splenic hilum. The purpose of this study was to discuss the experience with the surgical technique of leaving the deep pancreatic tail of the splenic hilum in these patients. Methods Eleven patients who underwent LSPDP with remnant pancreatic tails between November 2019 and August 2021 at Samsung Medical Center in Seoul, Korea were included in the study. Their short-term postoperative outcomes were analyzed retrospectively. Results The mean operative time was 168.6 ± 26.0 minutes, the estimated blood loss was 172.7 ± 95.8 mL, and the postoperative length of stay was 6.1 ± 1.0 days. All 11 lesions were in the body or tail of the pancreas and included 2 intraductal papillary mucinous neoplasms, 6 neuroendocrine tumors, 2 cystic neoplasms, and 1 patient with chronic pancreatitis. In 10 of the 11 patients, only the pancreatic tail was left inside the distal portion of the splenic hilum of the branching splenic vessel, and there was a collection of intraabdominal fluid, which was naturally resolved. One patient with a remnant pancreatic tail above the hilar vessels was readmitted due to a postoperative pancreatic fistula with fever and underwent internal drainage. Conclusion In spleen preservation, leaving a small pancreatic tail inside the splenic hilum is feasible and more beneficial to the patient than performing splenectomy in anatomically challenging patients.
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Affiliation(s)
- Okjoo Lee
- Division of Hepatobiliary-pancreatic Surgery, Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - So Kyung Yoon
- Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - So Jeong Yoon
- Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - In Woong Han
- Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Seok Heo
- Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Hyun Shin
- Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lee O, Yoon SK, Yoon SJ, Kim H, Han IW, Heo JS, Shin SH. Pancreatic Metastasectomy for Secondary Malignancy of the Pancreas: A Single-institution Experience. Anticancer Res 2024; 44:703-710. [PMID: 38307567 DOI: 10.21873/anticanres.16861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND/AIM Metastasis to the pancreas is rare, and the benefit of resection for secondary pancreatic cancer is poorly defined. Furthermore, there are no guidelines for pancreatic metastasectomy in such patients. The purpose of this study was to discuss our experience with the operative management of secondary pancreatic cancer. PATIENTS AND METHODS This retrospective study included 76 patients who underwent pancreatic metastasectomy for secondary pancreatic cancer between January 2000 and December 2020 at Samsung Medical Center, Seoul, Republic of Korea. RESULTS Among the study subjects, 44 underwent distal pancreatectomy, 21 pancreaticoduodenectomy, 5 total pancreatectomy, and 6 enucleation or wedge resection for metastasis. The overall survival (OS) and recurrence-free survival (RFS) were higher in the patients with RCC than in patients with other malignancies (p=0.004 and p=0.051, respectively). Statistically significant differences were not observed in OS and RFS between patients with right RCC (rRCC) or left RCC (lRCC; p=0.523 and p=0.586, respectively). CONCLUSION Pancreatic metastasectomy may offer promising outcomes regarding curative intent in instances of secondary pancreatic metastasis, particularly in the context of RCC. However, regarding the side of primary RCC, no statistically significant differences were found in OS and RFS between rRCC and lRCC.
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Affiliation(s)
- Okjoo Lee
- Division of Hepatobiliary-pancreatic Surgery, Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
| | - So Kyung Yoon
- Division of Hepatobiliary-pancreatic Surgery, Department of Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - So Jeong Yoon
- Division of Hepatobiliary-pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hongbeom Kim
- Division of Hepatobiliary-pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - In Woong Han
- Division of Hepatobiliary-pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jin Seok Heo
- Division of Hepatobiliary-pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sang Hyun Shin
- Division of Hepatobiliary-pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Lee O, Shin YC, Ryu Y, Yoon SJ, Kim H, Shin SH, Heo JS, Jung W, Lim CS, Han IW. Comparison between percutaneous transhepatic gallbladder drainage and upfront laparoscopic cholecystectomy in patients with moderate-to-severe acute cholecystitis: a propensity score-matched analysis. Ann Surg Treat Res 2023; 105:310-318. [PMID: 38023435 PMCID: PMC10648612 DOI: 10.4174/astr.2023.105.5.310] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/03/2023] [Accepted: 09/01/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose In the Tokyo Guidelines 2018 (TG18), emergency laparoscopic cholecystectomy is recognized as a crucial early treatment option for acute cholecystitis. However, early laparoscopic intervention in patients with moderate-to-severe acute cholecystitis or those with severe comorbidities may increase the risk of complications. Therefore, in the present study, we investigated the association between early laparoscopic cholecystectomy and percutaneous transhepatic gallbladder drainage (PTGBD) in moderate-to-severe acute cholecystitis patients. Methods We retrospectively analyzed 835 TG18 grade II or III acute cholecystitis patients who underwent laparoscopic cholecystectomy at 4 tertiary medical centers in the Republic of Korea. Patients were classified into 2 groups according to whether PTGBD was performed before surgery, and their short-term postoperative outcomes were analyzed retrospectively. Results The patients were divided into 2 groups, and 1:1 propensity score matching was conducted to establish the PTGBD group (n = 201) and the early laparoscopic cholecystectomy group (n = 201). The PTGBD group experienced significantly higher rates of preoperative systemic inflammatory response syndrome (24.9% vs. 6.5%, P < 0.001), pneumonia (7.5% vs. 3.0%, P = 0.045), and cardiac disease (67.2% vs. 57.7%, P = 0.041) than the early operation group. However, there was no difference in biliary complication (hazard ratio, 1.103; 95% confidence interval, 0.519-2.343; P = 0.799) between the PTGBD group and early laparoscopic cholecystectomy group. Conclusion In most cases of moderate-to-severe cholecystitis, early laparoscopic cholecystectomy was relatively feasible. However, PTGBD should be considered if patients have the risk factor of underlying disease when experiencing general anesthesia.
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Affiliation(s)
- Okjoo Lee
- Division of Hepatobiliary-pancreatic Surgery, Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Yong Chan Shin
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Youngju Ryu
- Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - So Jeong Yoon
- Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Hyun Shin
- Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Seok Heo
- Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Woohyun Jung
- Department of Surgery, Ajou University Hospital, Ajou University College of Medicine, Suwon, Korea
| | - Chang-Sup Lim
- Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - In Woong Han
- Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lee O, Kim MJ, Lee JE, Kwon GY, Hwang NY, Kim K, Park JB, Lee KW. Effects of Treating Subclinical Rejection 2 Weeks After Kidney Transplantation, as Determined by Analyzing 1-Year Histologic Outcomes. Transplant Proc 2023:S0041-1345(23)00129-X. [PMID: 37062613 DOI: 10.1016/j.transproceed.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/13/2023] [Indexed: 04/18/2023]
Abstract
Subclinical rejection (SCR) is associated with chronic allograft nephropathy. Therefore, early detection and treatment of SCR through a protocol biopsy (PB) can reduce the incidence of pathologic changes. This study evaluates the impact of early detection and treatment of SCR using a routine PB 2 weeks after kidney transplantation (KT) by examining histologic outcomes 1 year later. We reviewed 624 KT recipients at the Samsung Medical Center between August 2012 and December 2018. Protocol biopsy was planned 2 weeks and 1 year after transplantation. We compared the histologic changes between the 2 biopsies. After a propensity score matching analysis, we divided the patients into 2 groups: the proven normal group (n = 256) and the rejection group (n = 96) at the PB taken 2 weeks post-transplant. The rejection group showed no significant difference from the normal group in the flow of graft function or the Kaplan-Meier curve for graft survival. In the histologic outcomes, the pathologic differences between the groups significantly improved between the 2 time points. Treating SCR through a PB 2 weeks after KT can contribute to the maintenance of graft function and improve histologic changes 1 year after KT.
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Affiliation(s)
- Okjoo Lee
- Department of Surgery, Soonchunhyang University Hospital Bucheon, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
| | - Min Jung Kim
- Department of Surgery, Seoul Medical Center, Seoul, Republic of Korea
| | - Jung Eun Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ghee Young Kwon
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Na Young Hwang
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyunga Kim
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jae Berm Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Kyo Won Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Lee O, Kim MJ, Lee JE, Hwang NY, Kim K, Lee KW, Park JB. The Protective Role of Protocol Biopsy for Allograft Kidney Maintenance in Kidney Transplantation. Transplant Proc 2023:S0041-1345(23)00095-7. [PMID: 36990887 DOI: 10.1016/j.transproceed.2023.01.029] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 01/04/2023] [Indexed: 03/29/2023]
Abstract
Many studies have reported that protocol biopsy (PB) may help preserve kidney function in kidney transplant recipients. Early detection and treatment of subclinical rejection may reduce the incidence of chronic antibody-mediated rejection and graft failure. However, no consensus has been reached regarding PB effectiveness, timing, and policy. This study aimed to evaluate the protective role of routine PB performed 2 weeks and 1 year after kidney transplantation. We reviewed 854 kidney transplant recipients at the Samsung Medical Center between July 2007 and August 2017, with PBs planned at 2 weeks and 1 year after transplantation. We compared the trends in graft function, chronic kidney disease (CKD) progression, new-onset CKD, infection, and patient and graft survival between the 504 patients who underwent PB and 350 who did not undergo PB. The PB group was again divided into 2 groups: the single PB group (n = 207) and the double PB group (n = 297). The PB group was significantly different from the no-PB group in terms of the trends in graft function (estimated glomerular filtration rate). The Kaplan-Meier curve showed that PB did not significantly improve graft or overall patient survival. However, in the multivariate Cox analysis, the double PB group had advantages in graft survival, CKD progression, and new-onset CKD. PB can play a protective role in the maintenance of kidney grafts in kidney transplant recipients.
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Lee O, Lim CS, Yoon SJ, Jung JH, Shin SH, Heo JS, Shin YC, Jung W, Han IW. Comparison of Short-Term Surgical Outcomes According to Immediately Postoperative Serum Glucose Level in Non-Diabetic Pancreatic Resection Patients. Biomedicines 2022; 10:biomedicines10102427. [PMID: 36289689 PMCID: PMC9599123 DOI: 10.3390/biomedicines10102427] [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: 08/22/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 12/03/2022] Open
Abstract
The adequate regulation of postoperative serum glucose level (SGL) is widely accepted; however, the effects for non-diabetic patients who underwent major pancreatic surgery have not yet been established. We discerned the relevance of the immediately postoperative SGL to short-term postoperative outcomes from major pancreatic surgery in non-diabetic patients. Between January 2007 and December 2016, 2259 non-diabetic patients underwent major pancreatic surgery at four tertiary medical centers in Republic of Korea. Based on a SGL of 200 mg/dL, patients were classified into two groups by averaging the results of four SGL tests taken on the first day after surgery, and their short-term postoperative outcomes were analyzed. A 1:1 propensity score matching method was conducted to establish the high SGL group (n = 568) and the normal SGL group (n = 568). The high SGL group experienced a significantly higher rate of level C complications in the Clavien-Dindo classification (CDc) than the normal SGL group (24.1% vs. 16.5%, p = 0.002). Additionally, an SGL of more than 200 mg/dL was associated with a significantly high risk of complications above level C CDc after adjusting for other risk factors (hazard ratio = 1.324, 95% confidence interval = 1.048–1.672, p = 0.019). The regulation of SGL of less than 200 mg/dL in non-diabetic patients early after major pancreatic surgery could be helpful for reducing postoperative complications.
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Affiliation(s)
- Okjoo Lee
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170, Jomaru-ro, Bucheon 14584, Korea
| | - Chang-Sup Lim
- Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea
| | - So Jeong Yoon
- Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
| | - Ji Hye Jung
- Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
| | - Sang Hyun Shin
- Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
| | - Jin Seok Heo
- Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
| | - Yong Chan Shin
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Juhwa-ro 170, Ilsanseo-gu, Goyang 10380, Korea
| | - Woohyun Jung
- Department of Surgery, Ajou University Hospital, Ajou University College of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon 16499, Korea
| | - In Woong Han
- Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
- Correspondence: ; Tel.: +82-2-3410-1089
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Na B, Lee O, Kim Y, Jung Y, Na K, Lee H, Park S, Park I, Kang C, Kim Y. EP16.02-021 The Expression of CEACAMs and Serum CEA Levels as Biomarkers of Postoperative Cancer Recurrence in Non-small Cell Lung Cancer. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.1052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Yoon SJ, Lee O, Jung JH, Shin SH, Heo JS, Han IW. Prophylactic octreotide for postoperative pancreatic fistula in patients with pancreatoduodenectomy: Risk-stratified analysis. Medicine (Baltimore) 2022; 101:e29303. [PMID: 35665731 PMCID: PMC9276315 DOI: 10.1097/md.0000000000029303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 04/27/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Postoperative pancreatic fistula is one of the most critical complications following pancreatic surgery. This study aimed to evaluate the utility of selective prophylactic octreotide for patients at high risk of developing postoperative pancreatic fistula. METHODS From June 2019 to July 2020, 263 patients underwent pancreatoduodenectomy with pancreatojejunostomy at Samsung Medical Center. The individual fistula risk scores were calculated using a previously developed nomogram. The clinicopathological data of the patients were retrospectively reviewed. RESULTS There were 81 patients in the low-risk group and 182 patients in the high-risk group. No statistically significant differences were found in the rates of clinically relevant postoperative pancreatic fistula between octreotide group and the control group in all patients (15.0% vs 14.7%, P = .963) and in the high-risk group (16.1% vs 23.6%, P = .206). In risk factor analysis, postoperative octreotide was not an independent risk factor for clinically relevant pancreatic fistula in all patients and the high-risk group. Drain fluid amylase levels on the first postoperative day were significantly associated with clinically relevant postoperative pancreatic fistula, regardless of the individual risk. CONCLUSIONS The selective use of octreotide, even in high-risk patients, showed no protective effect against pancreatic fistula. Therefore, the routine use of postoperative octreotide is not recommended.
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Lee O, Shin YC, Ryu Y, Shin SH, Heo JS, Lim CS, Han IW. Adverse Effects of Sarcopenic Obesity on Postoperative Complications after Major Hepatectomy in Patients with Hilar Cholangiocarcinoma. J Clin Med 2022; 11:jcm11071860. [PMID: 35407468 PMCID: PMC8999157 DOI: 10.3390/jcm11071860] [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] [Received: 03/15/2022] [Revised: 03/24/2022] [Accepted: 03/24/2022] [Indexed: 02/04/2023] Open
Abstract
Sarcopenic obesity (SO), which is defined as a high ratio of visceral adipose tissue to skeletal muscle, is a well-known risk factor for post-hepatectomy outcomes in patients with hepatocellular carcinoma. However, few studies have evaluated the effect of SO on postoperative outcomes in patients with hilar cholangiocarcinoma (CCC). This retrospective study aimed to evaluate the effect of preoperative SO on postoperative outcomes in patients with hilar CCC following major hepatectomy. Preoperative SO was assessed in 328 patients undergoing hepatectomy for hilar CCC at three institutions between 2006 and 2016. SO was calculated from cross-sectional visceral fat and muscle area displayed on preoperative CT imaging. Preoperative SO was present in 98 patients (29.9%). The major complication rate in patients with SO was higher than in those without SO (54.1% vs. 37.0%, p = 0.004). Additionally, postoperative hospital stays were prolonged in patients with SO (18.5 vs. 16.5 days, p = 0.038). After multivariable analysis, SO was identified as an independent risk factor for major complications after hepatectomy in hilar CCC patients (OR = 0.866, 95% CI: 1.148–3.034, p = 0.012). Careful postoperative management is needed after major hepatectomy in hilar CCC patients with SO.
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Affiliation(s)
- Okjoo Lee
- Samsung Medical Center, Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Sungkyunkwan University School of Medicine, 81, Irwon-Ro, Gangnam-gu, Seoul 06355, Korea; (O.L.); (Y.R.); (S.H.S.); (J.S.H.)
| | - Yong Chan Shin
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang 10380, Korea;
| | - Youngju Ryu
- Samsung Medical Center, Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Sungkyunkwan University School of Medicine, 81, Irwon-Ro, Gangnam-gu, Seoul 06355, Korea; (O.L.); (Y.R.); (S.H.S.); (J.S.H.)
| | - Sang Hyun Shin
- Samsung Medical Center, Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Sungkyunkwan University School of Medicine, 81, Irwon-Ro, Gangnam-gu, Seoul 06355, Korea; (O.L.); (Y.R.); (S.H.S.); (J.S.H.)
| | - Jin Seok Heo
- Samsung Medical Center, Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Sungkyunkwan University School of Medicine, 81, Irwon-Ro, Gangnam-gu, Seoul 06355, Korea; (O.L.); (Y.R.); (S.H.S.); (J.S.H.)
| | - Chang-Sup Lim
- Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul 03088, Korea
- Correspondence: (C.-S.L.); (I.W.H.); Tel.: +82-2-870-3291 (C.-S.L.); +82-2-3410-0772 (I.W.H.); Fax: +82-2-831-2826 (C.-S.L.); +82-2-3410-6980 (I.W.H.)
| | - In Woong Han
- Samsung Medical Center, Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Sungkyunkwan University School of Medicine, 81, Irwon-Ro, Gangnam-gu, Seoul 06355, Korea; (O.L.); (Y.R.); (S.H.S.); (J.S.H.)
- Correspondence: (C.-S.L.); (I.W.H.); Tel.: +82-2-870-3291 (C.-S.L.); +82-2-3410-0772 (I.W.H.); Fax: +82-2-831-2826 (C.-S.L.); +82-2-3410-6980 (I.W.H.)
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Lee O, Kim JM, Kim SJ, Rhu J, Choi GS, Joh JW. Healthy Spouses can be Considered as Living Liver Donors. World J Surg 2022; 46:1474-1484. [PMID: 35316397 DOI: 10.1007/s00268-022-06518-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Spousal donors have gradually been accepted as an alternative living liver donors to alleviate the organ shortage and prevent donations from children. No information is available regarding the effects of spousal donation on donor safety and recipient outcomes. Our purpose in this study was to determine how spousal liver grafts in living donor liver transplantation (LDLT) affect donor safety and recipient outcomes compared with those of LDLT from children. METHODS We retrospectively analyzed 656 patients, including spouses and children, who underwent a right or extended right hepatectomy for living liver donation between January 2009 and December 2018. RESULTS Spouses represented 18.8% (n = 123) of living liver donors. Female donors comprised 78.9% (n = 97) of spousal donors, and the proportion of male donors in the children group was 72.6% (n = 387). The mean donor operation time of the spousal group was shorter than that of the children group (330 min vs. 358 min; P = 0.011), and the complication rate in the spousal group was lower than that in the children group (12.2% vs. 22.9%; P = 0.006). However, there were no differences in severe complication rates, hospitalization, or liver function tests between the 2 groups at 3 months after donor surgery. The overall survival of recipients in the spousal group was not reduced compared to that of recipients in the children group. CONCLUSION The present study suggests that, with careful selection, spousal donation is feasible and safe in LDLT.
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Affiliation(s)
- Okjoo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Jong Man Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea.
| | - Sang Jin Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Jinsoo Rhu
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Gyu-Seong Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Jae-Won Joh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
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Yoon SJ, Kim H, Lee O, Jung JH, Lim CS, Shin YC, Kwon W, Jang JY, Shin SH, Heo JS, Han IW. Development and external validation of a nomogram with inflammatory markers for predicting invasiveness of intraductal papillary mucinous neoplasm of pancreas. Medicine (Baltimore) 2022; 101:e29036. [PMID: 35356913 PMCID: PMC10684245 DOI: 10.1097/md.0000000000029036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 02/19/2022] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Recent studies have reported that inflammatory markers, such as neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and advanced lung cancer inflammation index, are associated with invasiveness of intraductal papillary mucinous neoplasm (IPMN). This study aimed to develop and validate a new nomogram that includes inflammatory markers for predicting the invasiveness of IPMN.The data of 365 patients who underwent surgical resection for IPMN at 4 centers between 1995 and 2016 were retrospectively reviewed to develop a new nomogram. For external validation, a separate patient cohort was used. The predictive ability of the nomogram was evaluated using the area under the receiver operating characteristic curve.The new nomogram was developed using the following variables which were identified as risk factors for invasive IPMN: body mass index, preoperative serum bilirubin level, carbohydrate antigen 19-9, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, advanced lung cancer inflammation index, main duct type, presence of solid portion, and tumor size. After external validation, the area under the curve value was 0.649 (95% CI: 0.578-0.720, P < .001).To the best of our knowledge, this study is the first to predict and externally validate the invasiveness in IPMN using inflammatory markers. Further research is necessary to improve predictability of the model for selecting patients for surgical resection.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - In Woong Han
- Correspondence: In Woong Han, Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School ofMedicine, 81, Irwon-ro, Gangnam-gu, Seoul 06351, South Korea (e-mail: ).
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Lee O, Rhu J, Choi GS, Kim JM, Kim K, Joh JW. Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver Transplantation. Ann Transplant 2022; 27:e935604. [PMID: 35379768 PMCID: PMC8994471 DOI: 10.12659/aot.935604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Liver transplantation (LT) has been validated widely all over the world as the curative treatment for hepatocellular carcinoma (HCC). Statins have been reported to prevent the progression of HCC. There are many factors that affect recurrence of HCC, but the precise role of statins is unknown. Therefore, we examined whether statin therapy is associated with decreased HCC recurrence in patients who underwent living-donor LT (LDLT) for HCC. Material/Methods We retrospectively analyzed 844 HCC patients who underwent primary adult-to-adult LDLT in our center between January 2007 and December 2016. Statin therapy was defined as administration of statins for more than 30 cumulative defined daily doses (cDDDs) after LT. We compared HCC recurrence and patient survival between non-statin (n=334) and statin (n=52) groups. Results The recurrence rate was higher in the non-statin group; however, time-dependent multivariate analysis with Kaplan-Meier curves showed that statin users did not significantly benefit in terms of HCC recurrence-related survival or overall survival. Further, risk factor analysis of HCC recurrence and patient survival confirmed multiple regional treatments (≥3 times), high alpha fetoprotein level (≥100 ng/mL), large tumor size (≥3 cm), and microvascular invasion as risk factors for HCC recurrence, but statin treatment was not associated with a significantly lower recurrence rate of HCC or reduced mortality after adjusting for other risk factors. Conclusions Statin use might be associated with prevention of HCC progression, but no significant decrease in HCC recurrence rates in LDLT patients was recorded in this study.
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Affiliation(s)
- Okjoo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jinsoo Rhu
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Gyu-Seong Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jong Man Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyunga Kim
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, South Korea
| | - Jae-Won Joh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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13
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Perlis N, Finelli A, Lovas M, Lund A, Di Meo A, Lajkosz K, Berlin A, Papadakos J, Ghai S, Deniffel D, Meng E, Wiljer D, Alibhai S, Bakas V, Badzynski A, Lee O, Cafazzo J, Haider M. Exploring the value of using patient-oriented mri reports in clinical practice. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00558-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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14
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Song JY, Lee KW, Kim K, Kim KD, Yang J, Kwon JE, Lee O, Park JB. Recipient efficacy and safety of kidney transplantation from older living donor: consideration for using older kidney as a solution to the shortage of organs. Korean J Transplant 2021; 35:238-246. [PMID: 35769855 PMCID: PMC9235463 DOI: 10.4285/kjt.21.0020] [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: 08/27/2021] [Revised: 09/16/2021] [Accepted: 10/20/2021] [Indexed: 11/30/2022] Open
Abstract
Background As a solution to organ shortages, studies on kidney transplantation (KT) from older donors are being conducted. However, many controversies remain about its safety and efficacy. Methods In Samsung Medical Center, from January 2000 to May 2015, 1,141 patients underwent living KT. Cases of retransplantation, recipient and donor aged younger than 18 years, and multiorgan transplantation were excluded, and a total of 859 cases were selected. Analysis was performed by dividing the patents into two groups a younger donor group (donors <60 years old; n=826) and an older donor group (donors ≥60 years old; n=33). Results There were no significant differences between the two groups in patient death (log-rank P=0.173) or in postoperative complications. The older donor group had a higher acute rejection (P=0.034; hazard ratio [HR], 1.704) and graft failure rate (P=0.029, HR=2.352). There was no significant difference in the trend of estimated glomerular filtration rate over time (P=0.189). Conclusions KT using kidneys from old-aged donors is safe, but there is room for improvement due to problems with higher acute rejection and graft failure rate.
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Affiliation(s)
- Ji Yeon Song
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyo Won Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyunga Kim
- Biomedical Statistics Center, Data Science Research Institute, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
- Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
| | - Kyeong Deok Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jaehun Yang
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Eun Kwon
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Okjoo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Berm Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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15
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Kim KD, Lee JE, Kim JM, Lee O, Hwang NY, Rhu J, Choi GS, Kim K, Joh JW. Cost-effectiveness and long-term outcomes of liver transplantation using hepatitis B core antibody-positive grafts with hepatitis B immunoglobulin prophylaxis in Korea. Clin Mol Hepatol 2021; 27:603-615. [PMID: 34492755 PMCID: PMC8524070 DOI: 10.3350/cmh.2021.0137] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 09/07/2021] [Indexed: 11/30/2022] Open
Abstract
Background/Aims Hepatitis B core antibody (anti-HBc)-positive donors are used as an extended donor pool, and current guidelines recommend the usage of nucleos(t)ide analogues (NAs) as prophylaxis for preventing de novo hepatitis B virus infection (DNH). We analyzed the long-term outcomes of a large cohort of liver transplantation (LT) patients receiving anti-HBc-positive grafts and evaluated the risk of DNH when hepatitis B immunoglobulin (HBIG) monotherapy was used as prophylaxis. We also compared the cost-effectiveness of HBIG and NAs. Methods We retrospectively reviewed 457 patients with anti-HBc-positive grafts and 898 patients with anti-HBc-negative grafts who underwent LT between January 2001 and December 2018. We compared recipient characteristics according to the anti-HBc status of the donor, and compared the costs of using NAs for the rest of the patient’s life and using HBIG to maintain hepatitis B surface antibody titers above 200 IU/L. Results The 1-, 5-, and 10-year patient survival rates were 87.7%, 73.5%, and 67.7%, respectively, in patients with anti-HBc-positive grafts, and 88.5%, 77.4%, and 70.3%, respectively, in patients with anti-HBc-negative grafts (P=0.113). Among 457 recipients with anti-HBc-positive grafts, 117 (25.6%) were non-HBV recipients. The overall incidence of DNH was 0.9%. When using HBIG under insurance coverage, the cumulative cost was lower compared with using NA continuously without insurance coverage in Korea. Conclusions Anti-HBc-positive grafts alone do not affect patient survival or graft survival. HBIG monoprophylaxis has good outcomes for preventing DNH, and the patient’s long-term cost burden is low in Korea because of the national insurance system in this cohort.
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Affiliation(s)
- Kyeong Deok Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Eun Lee
- Department of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Jong Man Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Okjoo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Na Young Hwang
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Jinsoo Rhu
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gyu-Seong Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyunga Kim
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Jae-Won Joh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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16
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Kao T, Lee O. Three dimensional matrix stiffness orchestrates the alteration of viscoelasticity in human mesenchymal stem cells. Cytotherapy 2021. [DOI: 10.1016/s1465324921004692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kim KD, Lee KW, Kim SJ, Lee O, Lim M, Jeong ES, Kwon J, Yang J, Oh J, Park JB. Safety and effectiveness of kidney transplantation using a donation after brain death donor with acute kidney injury: a retrospective cohort study. Sci Rep 2021; 11:5572. [PMID: 33692385 PMCID: PMC7946918 DOI: 10.1038/s41598-021-84977-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/22/2021] [Indexed: 12/29/2022] Open
Abstract
The use of kidneys from donation after brain death (DBD) donors with acute kidney injury (AKI) is a strategy to expand the donor pool. The aim of this study was to evaluate how kidney transplantation (KT) from a donor with AKI affects long-term graft survival in various situations. All patients who underwent KT from DBD donors between June 2003 and April 2016 were retrospectively reviewed. The KDIGO (Kidney Disease: Improving Global Outcomes) criteria were used to classify donor AKI. The cohort included 376 donors (no AKI group, n = 117 [31.1%]; AKI group n = 259 [68.9%]). Death-censored graft survival was similar according to the presence of AKI, AKI severity, and the AKI trend (p = 0.929, p = 0.077, and p = 0.658, respectively). Patients whose donors had AKI who received using low dose (1.5 mg/kg for three days) rabbit anti-thymocyte globulin (r-ATG) as the induction agent had significantly superior death-censored graft survival compared with patients in that group who received basiliximab (p = 0.039). AKI in DBD donors did not affect long-term death-censored graft survival. Low-dose r-ATG may be considered as an induction immunosuppression in recipients receiving kidneys with AKI because it showed better graft survival than basiliximab.
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Affiliation(s)
- Kyeong Deok Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06355, Republic of Korea
| | - Kyo Won Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06355, Republic of Korea.
| | - Sang Jin Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06355, Republic of Korea
| | - Okjoo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06355, Republic of Korea
| | - Manuel Lim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06355, Republic of Korea
| | - Eun Sung Jeong
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06355, Republic of Korea
| | - Jieun Kwon
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06355, Republic of Korea
| | - Jaehun Yang
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06355, Republic of Korea
| | - Jongwook Oh
- Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Jae Berm Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06355, Republic of Korea
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18
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Lim M, Kim JM, Kwon JE, Jeong ES, Yang J, Lee O, Kim KD, Kim SJ, Rhu J, Choi GS, Joh JW. Hepatocellular Carcinoma Arising from Hepatocellular Adenoma in an Elderly Male Patient. J Liver Cancer 2021; 21:87-91. [PMID: 37384277 PMCID: PMC10035722 DOI: 10.17998/jlc.21.1.87] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/02/2021] [Accepted: 03/02/2021] [Indexed: 06/30/2023]
Abstract
Hepatocellular adenoma is a benign tumor of the liver occurring predominantly in young women taking oral contraceptives. The malignant transformation of hepatocellular adenoma into hepatocellular carcinoma has rarely been reported. Herein, we report the case of an elderly male patient with hepatocellular carcinoma that developed from hepatocellular adenoma. The patient's high risk for surgery and conflicting biopsy and imaging results made it difficult to determine the treatment direction. Eventually, the mass was completely removed by laparoscopic left hemi-hepatectomy without complications.
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Affiliation(s)
- Manuel Lim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Man Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Eun Kwon
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Sung Jeong
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jaehun Yang
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Okjoo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyeong Deok Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Jin Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jinsoo Rhu
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gyu-Seong Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Won Joh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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19
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Kim KD, Lee KW, Kim SJ, Lee O, Kwon J, Jeong ES, Yang J, Lim M, Park JB. Clinical outcomes in elderly kidney transplant recipients: emphasis on choice of induction immunosuppressive therapy. Korean Journal of Transplantation 2020. [DOI: 10.4285/atw2020.po-1134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Kyeong Deok Kim
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Kyo Won Lee
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Sang Jin Kim
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Okjoo Lee
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Jieun Kwon
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Eun Sung Jeong
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Jaehun Yang
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Manuel Lim
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Jae Berm Park
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
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20
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Kim KD, Lee KW, Kim SJ, Lee O, Kwon J, Jeong ES, Lim M, Yang J, Park JB. Safety and effectiveness of kidney transplantation using a donation-after-brain-death donor with acute kidney injury: a retrospective cohort study. Korean Journal of Transplantation 2020. [DOI: 10.4285/atw2020.op-1049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Kyeong Deok Kim
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Kyo Won Lee
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Sang Jin Kim
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Okjoo Lee
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Jieun Kwon
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Eun Sung Jeong
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Manuel Lim
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Jaehun Yang
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Jae Berm Park
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
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21
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Lim M, Lee KW, Park BK, Park JB, Kim SJ, Kim KD, Lee O, Yang J, Kwon J, Jung ES. Feasibility and safety of 2-week protocol biopsy after kidney transplantation. Korean Journal of Transplantation 2020. [DOI: 10.4285/atw2020.po-1067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Manuel Lim
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Kyo Won Lee
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Byung Kwan Park
- Department of Radiology, Samsung Medical Center, Seoul, Korea
| | - Jae Berm Park
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Sang Jin Kim
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Kyeong-Deok Kim
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Okjoo Lee
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Jaehun Yang
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Jieun Kwon
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Eun sung Jung
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
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22
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Lee O, Lee KW, Park JB, Lee JE, Hwang NY, Kim K. The protective role of protocol biopsy against chronic kidney disease progression in kidney transplantation. Korean Journal of Transplantation 2020. [DOI: 10.4285/atw2020.op-1100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Okjoo Lee
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Kyo Won Lee
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Jae Berm Park
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Internal Medicine, Samsung Medical Center, Seoul, Korea
| | - Na Young Hwang
- Department of Biostatistics, Samsung Medical Center, Seoul, Korea
| | - Kyunga Kim
- Department of Biostatistics, Samsung Medical Center, Seoul, Korea
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Lee O, Lee KW, Park JB, Lee JE, Hwang NY, Kim K. Impact of treatment of subclinical rejection at 2 weeks after kidney transplantation, compared by analysis of 1-year histologic outcomes. Korean Journal of Transplantation 2020. [DOI: 10.4285/atw2020.op-1102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Okjoo Lee
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Kyo Won Lee
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Jae Berm Park
- Division of Transplantation, Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Internal Medicine, Samsung Medical Center, Seoul, Korea
| | - Na Young Hwang
- Department of Biostatistics, Samsung Medical Center, Seoul, Korea
| | - Kyunga Kim
- Department of Biostatistics, Samsung Medical Center, Seoul, Korea
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Lin H, Wang Y, Lee C, Lee O. A comparison between long non-coding RNA repertoires of exosomes derived from naïve and cytokine-activated human mesenchymal stem cells. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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25
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Lee O, Pilewskie M, Xu Y, Benante K, Blanco L, Helenowski I, Tull MB, Muzzio M, Jovanovic B, Karlan S, Hansen N, Bethke K, Kulkarni S, Perloff M, Dimond EP, Heckman-Stoddard BM, Khan SA. Abstract P6-21-12: Local transdermal therapy (LTT): Drug permeation and distribution of telapristone acetate (TPA) in a pre-surgical window study of women undergoing mastectomy. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-21-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Low uptake and poor adherence to oral drugs for breast cancer prevention and ductal carcinoma in situ has led to an interest in local routes of delivery with the intent of decreasing systemic exposure and reducing toxicity. LTT has emerged as a possible alternative; previous studies have shown selectively higher concentrations in the breast than in the serum with this delivery route. A question related to LTT is whether or not the drug will permeate and distribute throughout the breast, as is expected with oral delivery.
Methods: We conducted a double-blind study of oral versus LTT delivery of the selective progesterone receptor modulator, telapristone acetate (TPA), in a presurgical window setting, enrolling 82 women planning therapeutic or prophylactic mastectomy. We randomized 67 women 1:1, to oral TPA 12 mg daily, or gel TPA applied to both breasts daily (12 mg/breast), for 4 weeks ±1 week. Mastectomy specimens were sampled at 5 non-tumor locations as well as the tumor and lymph node when available. Samples were split in two: drug concentration (conc.) assay using LC-MS/MS and histological evaluation of tissue composition (fat, fibrous stroma, epithelium). The primary endpoint was mean drug conc. across all breast locations (anticipating that the gel would deliver a mean concentration that was >50% of the mean in the oral group). A secondary endpoint was the drug distribution pattern across the breast, expecting that the distribution would be similar. The tumor sample was saved for biomarker assays related to TPA action; these are ongoing, for a pre-planned pooled analysis of data with NCT01800422 (reported in SABCS abstract 851863).
Results: Of 63 evaluable women (33 oral and 30 gel group), 27 had unilateral and 36 had bilateral mastectomy. The mean drug conc. in the oral group was 166.3 ng/G (SE 11.7), and in the gel group was 10.6 ng/G (SE 10.8), (p<.0001). The conc. was variable across the 7 locations tested in both groups. High concentrations were found in the superficial and deep central locations, retroareolar and lateral locations ranked in the middle, and the medial location was discrepant, being high in the oral and low in the gel group. The variation in drug concentration across all locations was not significantly different between groups (Kolmogorov-Smirnov p=0.99). Among women with bilateral mastectomy, drug concentrations were similar between breasts in both oral and gel groups. In the gel group, despite low TPA concentrations, there was evidence of drug metabolism. The major metabolite, CDB 4453 was detectable in 192/193 samples with detectable parent drug. Analysis of drug concentration adjusted for tissue composition is ongoing.
Conclusions: The gel formulation of TPA did not permeate the skin well. However, the drug delivered to the breast was distributed throughout the breast, similar to the oral delivery route, with the highest concentration in the deep central location. These drug distribution data are novel; drug distribution at multiple locations throughout the breast has not previously been shown. Further work is needed to understand breast distribution with formulations known to have good dermal permeation.
Citation Format: Lee O, Pilewskie M, Xu Y, Benante K, Blanco L, Helenowski I, Tull MB, Muzzio M, Jovanovic B, Karlan S, Hansen N, Bethke K, Kulkarni S, Perloff M, Dimond EP, Heckman-Stoddard BM, Khan SA. Local transdermal therapy (LTT): Drug permeation and distribution of telapristone acetate (TPA) in a pre-surgical window study of women undergoing mastectomy [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-21-12.
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Affiliation(s)
- O Lee
- Northwestern University, Chicago, IL; Memorial Sloan Kettering, New York, NY; IIT Research Institute, Chicago, IL; Cedars-Sinai Medical Center, Los Angeles, CA; National Institutes of Health, Bethesda, MD
| | - M Pilewskie
- Northwestern University, Chicago, IL; Memorial Sloan Kettering, New York, NY; IIT Research Institute, Chicago, IL; Cedars-Sinai Medical Center, Los Angeles, CA; National Institutes of Health, Bethesda, MD
| | - Y Xu
- Northwestern University, Chicago, IL; Memorial Sloan Kettering, New York, NY; IIT Research Institute, Chicago, IL; Cedars-Sinai Medical Center, Los Angeles, CA; National Institutes of Health, Bethesda, MD
| | - K Benante
- Northwestern University, Chicago, IL; Memorial Sloan Kettering, New York, NY; IIT Research Institute, Chicago, IL; Cedars-Sinai Medical Center, Los Angeles, CA; National Institutes of Health, Bethesda, MD
| | - L Blanco
- Northwestern University, Chicago, IL; Memorial Sloan Kettering, New York, NY; IIT Research Institute, Chicago, IL; Cedars-Sinai Medical Center, Los Angeles, CA; National Institutes of Health, Bethesda, MD
| | - I Helenowski
- Northwestern University, Chicago, IL; Memorial Sloan Kettering, New York, NY; IIT Research Institute, Chicago, IL; Cedars-Sinai Medical Center, Los Angeles, CA; National Institutes of Health, Bethesda, MD
| | - MB Tull
- Northwestern University, Chicago, IL; Memorial Sloan Kettering, New York, NY; IIT Research Institute, Chicago, IL; Cedars-Sinai Medical Center, Los Angeles, CA; National Institutes of Health, Bethesda, MD
| | - M Muzzio
- Northwestern University, Chicago, IL; Memorial Sloan Kettering, New York, NY; IIT Research Institute, Chicago, IL; Cedars-Sinai Medical Center, Los Angeles, CA; National Institutes of Health, Bethesda, MD
| | - B Jovanovic
- Northwestern University, Chicago, IL; Memorial Sloan Kettering, New York, NY; IIT Research Institute, Chicago, IL; Cedars-Sinai Medical Center, Los Angeles, CA; National Institutes of Health, Bethesda, MD
| | - S Karlan
- Northwestern University, Chicago, IL; Memorial Sloan Kettering, New York, NY; IIT Research Institute, Chicago, IL; Cedars-Sinai Medical Center, Los Angeles, CA; National Institutes of Health, Bethesda, MD
| | - N Hansen
- Northwestern University, Chicago, IL; Memorial Sloan Kettering, New York, NY; IIT Research Institute, Chicago, IL; Cedars-Sinai Medical Center, Los Angeles, CA; National Institutes of Health, Bethesda, MD
| | - K Bethke
- Northwestern University, Chicago, IL; Memorial Sloan Kettering, New York, NY; IIT Research Institute, Chicago, IL; Cedars-Sinai Medical Center, Los Angeles, CA; National Institutes of Health, Bethesda, MD
| | - S Kulkarni
- Northwestern University, Chicago, IL; Memorial Sloan Kettering, New York, NY; IIT Research Institute, Chicago, IL; Cedars-Sinai Medical Center, Los Angeles, CA; National Institutes of Health, Bethesda, MD
| | - M Perloff
- Northwestern University, Chicago, IL; Memorial Sloan Kettering, New York, NY; IIT Research Institute, Chicago, IL; Cedars-Sinai Medical Center, Los Angeles, CA; National Institutes of Health, Bethesda, MD
| | - EP Dimond
- Northwestern University, Chicago, IL; Memorial Sloan Kettering, New York, NY; IIT Research Institute, Chicago, IL; Cedars-Sinai Medical Center, Los Angeles, CA; National Institutes of Health, Bethesda, MD
| | - BM Heckman-Stoddard
- Northwestern University, Chicago, IL; Memorial Sloan Kettering, New York, NY; IIT Research Institute, Chicago, IL; Cedars-Sinai Medical Center, Los Angeles, CA; National Institutes of Health, Bethesda, MD
| | - SA Khan
- Northwestern University, Chicago, IL; Memorial Sloan Kettering, New York, NY; IIT Research Institute, Chicago, IL; Cedars-Sinai Medical Center, Los Angeles, CA; National Institutes of Health, Bethesda, MD
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Lee O, Sullivan ME, Xu Y, Shidfar A, Ivancic D, Zeng Z, Singhal H, Helenowski I, Jovanovic B, Hansen N, Bethke K, Gann P, Gradishar WJ, Clare SE, Khan SA. Abstract P5-04-02: Progesterone receptor (PR) antagonism by telapristone acetate (TPA): A randomized, placebo-controlled phase IIB pre-surgical window trial in women with stage 0-II breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-04-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: In vitro and preclinical data indicate that TPA, a selective PR modulator, has activity against hormone-sensitive early breast cancer. We conducted a pre-surgical window trial of oral TPA in Stage 0-II breast cancer to assess the effect of TPA on suppression of cell proliferation (Ki67), and on differential gene expression in responsive and non-responsive tumors.
Methods: We enrolled 70 pre and postmenopausal women into a 1:1 randomized, double-blind, placebo-controlled trial of oral TPA 12mg (Repros Therapeutics Inc.) for 2-10 weeks. The primary endpoint was Ki67 labelling, comparing diagnostic core needle biopsy to post-therapy surgical specimens. Ki67 changes were quantitated by dual immunohistochemistry (Ki67/pan-cytokeratin) and image analysis (Aperio ImageScope and Definiens Tissue Studio®). RNA-sequencing (using RNA extracted from the paraffin blocks) was performed with Illumina TruSeq RNA Coding Access method. Differential gene expression pre-post therapy was assessed, followed by Gene Set Enrichment Analysis for pathway analysis. Ki67 changes from baseline were tested with Paired signed-rank test. For gene expression analysis, p values were calculated by Wald test and adjusted for multiple comparisons by Benjamini-Hochberg method (adjusted p <0.05 and 2-fold gene expression cut-off).
Results: Among 61 evaluable women, (29 placebo and 32 TPA) 97% of tumors were ER or PR positive and 91% were ER and PR positive (balanced across arms). A significant 6% decrease in mean %Ki67 was seen in the TPA arm (p= 0.003). When stratified by menopause, the significance held in premenopausal women (n= 22, p= 0.03) but not in postmenopausal women (n=10, p= 0.08). However, a Ki67 decrease (4%) was also observed in placebo group (p = 0.04); this was non-significant after pre- postmenopausal stratification. Overall, differential gene expression analysis showed no significant modulation of genes in either group. Using a pre-specified response parameter (50% relative reduction in Ki67), we identified 12/32 (38%) “responders” in the TPA, and 9/29 (31%) in the placebo arm. In sub-group analysis of these responders, we found 103 genes to be significantly modulated by treatment in the TPA “responders”, but saw no significant change in any gene expression in placebo “responders”. Gene set enrichment analysis for the 103 genes showed that TPA blocked the progression of cell cycle genes (PTTG1, PLK1, UBE2C, HIST1H3F, PSMD3, and etc.) and suppressed PGR and ERBB2 expression. In a pre-planned pooled analysis, these results will be combined with NCT02314156, reported in SABCS abstract 851790.
Conclusions: An anti-proliferative (Ki67) signal of TPA was observed in early stage breast cancer patients, but interpretation was limited by placebo group changes. The TPA group demonstrated differential suppression of proliferation-related genes among Ki67 responders, but the placebo group did not. Ongoing analysis will examine signatures related to stemness, metastasis, and immune suppression (potentially better endpoints in trials targeting P signaling). These analyses may help us select the right population and the right biomarkers for future trials.
Citation Format: Lee O, Sullivan ME, Xu Y, Shidfar A, Ivancic D, Zeng Z, Singhal H, Helenowski I, Jovanovic B, Hansen N, Bethke K, Gann P, Gradishar WJ, Clare SE, Khan SA. Progesterone receptor (PR) antagonism by telapristone acetate (TPA): A randomized, placebo-controlled phase IIB pre-surgical window trial in women with stage 0-II breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-04-02.
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Affiliation(s)
- O Lee
- Northwestern University, Chicago, IL; Northshore Hospital, Evanston, IL; University Illinois at Chicago, Chicago, IL
| | - ME Sullivan
- Northwestern University, Chicago, IL; Northshore Hospital, Evanston, IL; University Illinois at Chicago, Chicago, IL
| | - Y Xu
- Northwestern University, Chicago, IL; Northshore Hospital, Evanston, IL; University Illinois at Chicago, Chicago, IL
| | - A Shidfar
- Northwestern University, Chicago, IL; Northshore Hospital, Evanston, IL; University Illinois at Chicago, Chicago, IL
| | - D Ivancic
- Northwestern University, Chicago, IL; Northshore Hospital, Evanston, IL; University Illinois at Chicago, Chicago, IL
| | - Z Zeng
- Northwestern University, Chicago, IL; Northshore Hospital, Evanston, IL; University Illinois at Chicago, Chicago, IL
| | - H Singhal
- Northwestern University, Chicago, IL; Northshore Hospital, Evanston, IL; University Illinois at Chicago, Chicago, IL
| | - I Helenowski
- Northwestern University, Chicago, IL; Northshore Hospital, Evanston, IL; University Illinois at Chicago, Chicago, IL
| | - B Jovanovic
- Northwestern University, Chicago, IL; Northshore Hospital, Evanston, IL; University Illinois at Chicago, Chicago, IL
| | - N Hansen
- Northwestern University, Chicago, IL; Northshore Hospital, Evanston, IL; University Illinois at Chicago, Chicago, IL
| | - K Bethke
- Northwestern University, Chicago, IL; Northshore Hospital, Evanston, IL; University Illinois at Chicago, Chicago, IL
| | - P Gann
- Northwestern University, Chicago, IL; Northshore Hospital, Evanston, IL; University Illinois at Chicago, Chicago, IL
| | - WJ Gradishar
- Northwestern University, Chicago, IL; Northshore Hospital, Evanston, IL; University Illinois at Chicago, Chicago, IL
| | - SE Clare
- Northwestern University, Chicago, IL; Northshore Hospital, Evanston, IL; University Illinois at Chicago, Chicago, IL
| | - SA Khan
- Northwestern University, Chicago, IL; Northshore Hospital, Evanston, IL; University Illinois at Chicago, Chicago, IL
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Zhao H, Wang J, Fang D, Lee O, Chatterton RT, Stearns V, Khan SA, Bulun SE. Adiposity Results in Metabolic and Inflammation Differences in Premenopausal and Postmenopausal Women Consistent with the Difference in Breast Cancer Risk. Horm Cancer 2018; 9:229-239. [PMID: 29546532 PMCID: PMC10355891 DOI: 10.1007/s12672-018-0329-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 11/13/2017] [Accepted: 03/05/2018] [Indexed: 11/28/2022]
Abstract
Obesity is associated with increased risk of breast cancer in postmenopausal but not in premenopausal women. Many factors may be responsible for this difference. The aim of this study was to determine the mechanisms by which the genes related to the AMPK pathway, inflammation, and estrogen actions are affected by adiposity in breast tissue with the objective of identifying differences that may explain the different breast cancer risk in premenopausal and postmenopausal women. Random fine needle aspirates (rFNAs) of breast tissue were collected from 57 premenopausal and 55 postmenopausal women and were classified as normal weight, overweight, or obese. Expression levels of 21 target genes were determined using a TaqMan Low Density Array procedure. Breast tissue estradiol levels were measured by a liquid chromatography-tandem mass spectrometry procedure, and serum estradiol and follicle-stimulating hormone (FSH) were measured by a radioimmunoassay and an enzyme-linked immunosorbent assay, respectively. We found that in postmenopausal women, serum and tissue estradiol levels were increased in those who were overweight, and serum FSH levels were decreased in obese status. Interestingly, RPS6KB1, an AMPK downstream-responsive gene for protein synthesis and cell growth, and estrogen receptor α (encoded by the ESR1 gene) and its target gene GATA3 were significantly decreased in rFNA of premenopausal, obese women. In postmenopausal women, RPS6KB1, ESR1, and GATA3 expression remained unchanged in relation to adiposity. However, prostaglandin-endoperoxide synthase 2 (PTGS2), cyclin D1 (CCND1), and another ESR1 target gene, TFF1, were elevated in rFNA of obese postmenopausal women. Thus, as bodyweight increases, gene expression is indicative of increased proliferation in postmenopausal women but decreased proliferation in premenopausal women. Overall, our data reveal a novel process by which obesity promotes the risk of breast cancer in postmenopausal but not premenopausal women.
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Affiliation(s)
- H Zhao
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
- Division of Reproductive Science in Medicine, Department of Obstetrics and Gynecology, Feinberg School of Medicine at Northwestern University, Robert H. Lurie Comprehensive Cancer Center, 303 E. Superior Street, Suite 4-121, Chicago, IL, 60611, USA.
| | - J Wang
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - D Fang
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - O Lee
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - R T Chatterton
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - V Stearns
- Kimmel Cancer Center, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - S A Khan
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - S E Bulun
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Lee O, Kim K, Kim J, Kim YD, Pak H, Hong G, Chim CY, Uhm J, Cho I, Joung B, Yu C, Lee H, Kang W, Heo J, Jang Y. P3830Favorable neurological outcomes of left atrial appendage occlusion versus non-vitamin K antagonist oral anticoagulants after stroke in atrial fibrillation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- O Lee
- Severance Hospital, Cardiology, Yongin, Korea Republic of
| | - K Kim
- Severance Hospital, Cardiology, Seoul, Korea Republic of
| | - J Kim
- Severance Hospital, Cardiology, Seoul, Korea Republic of
| | - Y D Kim
- Severance Hospital, Neurology, Seoul, Korea Republic of
| | - H Pak
- Severance Hospital, Cardiology, Seoul, Korea Republic of
| | - G Hong
- Severance Hospital, Cardiology, Seoul, Korea Republic of
| | - C Y Chim
- Severance Hospital, Cardiology, Seoul, Korea Republic of
| | - J Uhm
- Severance Hospital, Cardiology, Seoul, Korea Republic of
| | - I Cho
- Severance Hospital, Cardiology, Seoul, Korea Republic of
| | - B Joung
- Severance Hospital, Cardiology, Seoul, Korea Republic of
| | - C Yu
- Korea University Anam Hospital, Cardiology, Seoul, Korea Republic of
| | - H Lee
- Sejong General Hospital, Cardiology, Seoul, Korea Republic of
| | - W Kang
- Gil Hospital, Cardiology, Incheon, Korea Republic of
| | - J Heo
- Severance Hospital, Neurology, Seoul, Korea Republic of
| | - Y Jang
- Severance Hospital, Cardiology, Seoul, Korea Republic of
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Lee C, Lee O. Ginkgo biloba extract treats osteoporosis. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Affiliation(s)
- C.‐I. Moon
- Department of Medical IT EngineeringCollege of Medical SciencesSoonchunhyang University Asan Korea
| | - O. Lee
- Department of Medical IT EngineeringCollege of Medical SciencesSoonchunhyang University Asan Korea
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Ranjan M, Lee O, Sun L, Karavites L, Clare S, Khan SA. Abstract P6-07-09: Attenuation of progesterone driven mammary stem cell expansion by telapristone acetate. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-07-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: The interplay of the ovarian hormones estradiol (E2) and progesterone (P4) contributes to the development of breast cancer, potentially aided by P4-induced expansion in mammary stem cells as observed in diestrous phase in mice, as well as the luteal phase and during pregnancy in women. Telapristone Acetate (TPA), a selective progesterone receptor modulator (SPRM), exhibits a protective effect against mammary carcinogenesis in rodents. TPA has been shown to display a more specific PR blockade and less toxicity when compared to RU486. We have examined the mammary stem cell pool expansion upon exposure to E2+P4 in mice and compared its attenuation by both TPA and RU486.
Methods: 8 week old female ovariectomized FVB mice weighing above 20g, were randomized into 4 treatment groups: sham (skin incision only, no pellets), E2+P4, E2+P4+Telapristone Acetate (TPA), E2P4+ Mifepristone (RU486). Eight experimental replicates were performed. At age 10 weeks, the mice were implanted with subcutaneous 30-day release pellets of E2 and P4 (0.3 mg E2 & 30.0 mg P4), E2P4+TPA (30.0 mg) and E2P4+RU486 (30.3 mg) in either flank. The mice were euthanized at day 15 of treatment. Single cell suspensions of the 4th inguinal mammary gland pair and one thoracic gland were prepared and labeled with cell surface markers. Lineage negative mammary gland cells were sorted into luminal and basal population subsets. The basal cell niche was identified as CD24+CD49fhi, the mammary stem cells (MaSC) within this niche are identified by CD61+CD49fhi. The cells were sorted on BD FACSAria 5-Laser and the data was analyzed using BD FACSDIVA.The D'Agostino-Pearson test was performed to determine the normal distribution and once normal distribution was confirmed one-way ANOVA (repeated measures) was performed to examine differences in percent cell populations with Tukey test for post-hoc analysis.
Results: The mammary stem cells (MaSC, CD61+CD49fhi) within the basal cell (CD24+CD49fhi) niche showed significant expansion at day 15 in mice implanted with Estrogen and Progesterone 30-day release pellet compared to sham (64.2%, 45.07% respectively; p=0.0392). This expansion was significantly attenuated in both TPA (-38.21%, p=0.011) and RU486 (-34.30%, p=0.002) treated mice compared to MaSC in mice treated with E2+P4 alone (+45.07%). Simultaneously, luminal progenitor cells (CD61+CD49flo) show a marked reduction in E2+P4 treated mice compared to sham (17.77%, 45.54%, respectively; p=0.0375). Luminal mature cells (CD61-CD49flo) show an expansion in E2+P4 treated mice compared to sham (82.23%, 54.41% respectively; %, p=0.0371). TPA significantly (58.40 %, p=0.061) suppresses LM cells expansion observed in the E2+P4 group. TPA and RU486 show significant suppression of the MaSC population in mouse mammary gland compared to the EP-treated mice.
Conclusion: TPA and RU486 alter the P4 driven changes in mammary gland cellular composition and in a manner consistent with the hypothesis that they will inhibit hormone-induced tumorigenesis in the mammary gland. To gain a better insight into this phenomenon, a high throughput transcriptomic profiling (RNASeq) of mammary stem cells isolated from the treatment groups is being performed.
Citation Format: Ranjan M, Lee O, Sun L, Karavites L, Clare S, Khan SA. Attenuation of progesterone driven mammary stem cell expansion by telapristone acetate [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-07-09.
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Affiliation(s)
- M Ranjan
- Northwestern University, Chicago, IL
| | - O Lee
- Northwestern University, Chicago, IL
| | - L Sun
- Northwestern University, Chicago, IL
| | | | - S Clare
- Northwestern University, Chicago, IL
| | - SA Khan
- Northwestern University, Chicago, IL
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Lee O, Sun L, Karavites LC, Clare SE, Khan SA. Abstract P5-14-01: Telapristone acetate abrogates PR-dependent paracrine-mediated mammary cell proliferation. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-14-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Blockade of the progesterone (P)-progesterone receptor (PR) axis is a novel but untested strategy for breast cancer prevention. We report preclinical data evaluating telapristone acetate (TPA) compared with mifepristone (MFP), the prototype PR-antagonist. We hypothesize that the progesterone-PR blockade by TPA will inhibit PR-dependent paracrine expression (RANKL, WNT4, ID4, and calcitonin) attenuating cell proliferation and abrogating side branching and alveoli formation of mammary glands induced by hormones similar in extent or superior to MFP.
Methods:Adult virgin FVB mice at 12 weeks of age were randomized to four treatment groups: no treatment control, EP (0.3 mg E + 30 mg P), EP + TPA (30mg), and EP + MFP (30mg). Hormone and drug pellets were subcutaneously implanted in flank area between the neck and shoulder. After 28-day treatments, the mice were euthanized to collect mammary glands, and processed as mammary whole mounts and as formalin-fixed paraffin embedding (FFPE) specimens. We evaluated cell proliferation (Ki67) by immunohistochemistry. Total RNA was extracted from FFPE specimens and the Nanostring nCounter assay was utilized to assess paracrine gene expression. The Mann Whitney test was used to calculate statistical significance (p<0.05).
Results: We observed a considerable increase in side branches and alveoli in EP treatment group compared to the controls. The growth of the mammary gland stimulated by EP treatment was corroborated by a significant increase in Ki67 compared to control mice (median 41% vs 24%, respectively, p < 0.0001). Both TPA and MFP treatment abrogated side branching and alveoli formation and significantly reduced median Ki67 to 1/3 of that of control mice having endogenous estrus cycle hormone levels (24%, 8%, and 9% for control, EP+TPA and EP+MFP groups, respectively).TPA induced greater Ki67 reduction than MFP (7.5 ± 1.9% vs. 9.4 ± 1.9%, p= 0.04). As expected, EP treatment upregulated the RANKL expression compared to the control group while the administration of TPA and MFP significantly inhibited the RANKL expression stimulated by EP treatment. The mRNA expression measurement revealed that Rankl expression was 18 fold increased by EP treatment but completely inhibited by TPA and MFP treatment (p<0.001 for both drugs). Similarly the Rank expression was increased two-fold by EP treatment (p< 0.05) but down-regulated by TPA and MFP treatment (p<0.01 for both drugs). We observed significant upregulation of Wnt4, and Calca expression by EP treatment compared to controls (p<0.01 for both). Id4 expression showed the same trend but the change was non-significant. The addition of TPA completely opposed the hormone-stimulated increase of three paracrine molecules (Wnt4, Calca, and Id4) to a level below control group (p< 0.001 for all).
Conclusions: We have demonstrated that TPA abrogates cell proliferation induced by exogenous EP hormones in an ovary intact mouse model. The blockade of PR-P binding was evident by complete inhibition of paracrine expression (not only RANKL/RANK expression but also WNT4, Calcitonin, and ID4 expression). TPA was efficacious as MFP in opposing paracrine-induced mammary cell proliferation, and warrants further testing in a breast cancer prevention trial.
Citation Format: Lee O, Sun L, Karavites LC, Clare SE, Khan SA. Telapristone acetate abrogates PR-dependent paracrine-mediated mammary cell proliferation [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-14-01.
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Affiliation(s)
- O Lee
- Northwestern Univeristy, Chicago, IL; Mount Sinai Hopsital, Chicago, IL
| | - L Sun
- Northwestern Univeristy, Chicago, IL; Mount Sinai Hopsital, Chicago, IL
| | - LC Karavites
- Northwestern Univeristy, Chicago, IL; Mount Sinai Hopsital, Chicago, IL
| | - SE Clare
- Northwestern Univeristy, Chicago, IL; Mount Sinai Hopsital, Chicago, IL
| | - SA Khan
- Northwestern Univeristy, Chicago, IL; Mount Sinai Hopsital, Chicago, IL
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Lee O. INTERGENERATIONAL FORUM TO ENHANCE STUDENTS’ ENGAGEMENT AND ELDERS’ LEARNING OUTCOMES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- O. Lee
- University of North Carolina Charlotte, Charlotte, North Carolina
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Lee O, Muzzio M, Ivancic D, Rogers C, Allu S, Khan SA. Abstract OT3-02-09: Phase II pre-surgical window trial of telapristone acetate (TPA) in early breast cancer and DCIS patients: Distribution of TPA in plasma, normal breast tissue and tumors. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot3-02-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:In vitro and preclinical data support the notion that anti-progesterone therapy will have activity against both estrogen and progesterone receptors (ER/PR) positive and negative breast cancer, but biomarkers of efficacy may differ in different types of breast cancer. We have conducted a pre-surgical window trial of oral telapristone acetate (TPA, CDB-4124) treatment in early breast cancer patients. This first ever trial of oral TPA for breast cancer and DCIS patients will provide us pilot biologic data that will help select the right population and the right biomarkers for future trials. Here we report distribution of TPA in plasma and breast normal tissue and tumors collected at surgery.
Methods:our trial was a 1:1 randomized, double-blind, and placebo-controlled pre-surgical window trial of oral TPA 12mg (Proellex, CDB-4124, Repros Therapeutics Inc.) treatment for 2-10 weeks. 70 pre and postmenopausal women undergoing surgery for Stage 0-II breast cancer were recruited to the study. The surgical samples of 61 patients were used to determine the concentrations of TPA and its mono-demethylated metabolite (dTPA, CDB-4453) in plasma and matched normal tissue and tumor by Liquid chromatography–tandem mass spectrometry at the Illinois Institute of Technology, while maintaining the blind for the primary endpoint of cell proliferation. Statistical significance and analysis were calculated by Wilcoxon matched-pairs signed rank test and non-parametric Spearman correlation.
Results: We found that 32/61 women displayed detectable plasma concentrations of TPA and dTPA (median with IQR) 109ng/mL (71.3, 216) and 46.5 ng/mL (34.2, 73.7), respectively. TPA concentration was 2.3 times higher than dTPA in plasma (p<0.0001). The normal and tumor tissue samples of these 32 women were further analyzed. In normal tissue samples, the concentrations of TPA and dTPA were 283 ng/g (70.7, 326) and 51.0 ng/g (24.4, 122), respectively. TPA concentration was 5.5 fold higher than dTPA in normal tissue (p<0.0001). In tumors, the TPA and dTPA concentrations were 137 ng/g (31.1, 278) and 36.4 ng/g (17.3, 68.7), respectively. TPA concentration was 3.8 fold higher than dTPA in tumors (p<0.0001).Interestingly, TPA and dTPA were more abundant in normal tissue than in tumors (p=0.0005 for TPA, and p=0.0013 for dTPA). We found that TPA and dTPA was highly correlated in plasma (r=0.492, p=0.0042). Plasma TPA concentration was highly correlated with normal tissue concentration (r=0.61, p=0.0003) but non-significantly correlated with tumor concentration (r=0.32, p=0.147). However, the normal and tumor tissue concentrations of TPA and dTPA were highly correlated (r=0.71, p=0.0002 for TPA and r=0.556, p=0.0072 for dTPA).
Conclusions: Plasma TPA concentrations reflect concentration in normal breast tissue better than in tumors. However, within the breast, TPA concentration in normal and tumor tissue is correlated. Our trial is to be unblended shortly, and we plan to relate these results to the proliferative rates in tumor and normal tissue. The variability observed in plasma and tissue concentrations also suggests that pharmacogenomics studies may be appropriate in the future.
Citation Format: Lee O, Muzzio M, Ivancic D, Rogers C, Allu S, Khan SA. Phase II pre-surgical window trial of telapristone acetate (TPA) in early breast cancer and DCIS patients: Distribution of TPA in plasma, normal breast tissue and tumors [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT3-02-09.
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Affiliation(s)
- O Lee
- Northwestern University, Chicago, IL; Illinois Institute of Technology Research Institute, Chicago, IL
| | - M Muzzio
- Northwestern University, Chicago, IL; Illinois Institute of Technology Research Institute, Chicago, IL
| | - D Ivancic
- Northwestern University, Chicago, IL; Illinois Institute of Technology Research Institute, Chicago, IL
| | - C Rogers
- Northwestern University, Chicago, IL; Illinois Institute of Technology Research Institute, Chicago, IL
| | - S Allu
- Northwestern University, Chicago, IL; Illinois Institute of Technology Research Institute, Chicago, IL
| | - SA Khan
- Northwestern University, Chicago, IL; Illinois Institute of Technology Research Institute, Chicago, IL
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Lee K, Kim M, Lee O, Kim K. Roughness preserving filter design to remove spatial noise from stereoscopic skin images for stable haptic rendering. Skin Res Technol 2017; 23:407-415. [PMID: 28083934 DOI: 10.1111/srt.12351] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND/PURPOSE A problem in skin rendering with haptic feedback is the reconstruction of accurate 3D skin surfaces from stereo skin images to be used for touch interactions. This problem also encompasses the issue of how to accurately remove haptic spatial noise caused by the construction of disparity maps from stereo skin images, while minimizing the loss of the original skin roughness for cloning real tough textures without errors. Since the haptic device is very sensitive to high frequencies, even small amounts of noise can cause serious system errors including mechanical oscillations and unexpected exerting forces. Therefore, there is a need to develop a noise removal algorithm that preserves haptic roughness. METHODS A new algorithm for a roughness preserving filter (RPF) that adaptively removes spatial noise, is proposed. The algorithm uses the disparity control parameter (λ) and noise control parameter (k), obtained from singular value decomposition of a disparity map. The parameter k determines the amount of noise to be removed, and the optimum value of k is automatically chosen based on a threshold of gradient angles of roughness (Ra ). RESULTS The RPF algorithm was implemented and verified with three real skin images. Evaluation criteria include preserved roughness quality and removed noise. Mean squared error (MSE), peak signal to noise ratio (PSNR), and objective roughness measures Ra and Rq were used for evaluation, and the results were compared against a median filter. The results show that the proposed RPF algorithm is a promising technology for removing noise and retaining maximized roughness, which guarantees stable haptic rendering for skin roughness. CONCLUSION The proposed RPF is a promising technology because it allows for any stereo image to be filtered without the risk of losing the original roughness. In addition, the algorithm runs automatically for any given stereo skin image with relation to the disparity parameter λ, and the roughness parameters Ra or Rq are given priority. Although this method has been optimized by graph-cut disparity map building, it can be extended to other disparity map building methods because the parameter k is determined by actual roughness Ra data that can be obtained by simple measurement.
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Affiliation(s)
- K Lee
- 3D Information Processing Laboratory, Department of Electronics and Information Engineering, Korea University, Seoul, Korea
| | - M Kim
- 3D Information Processing Laboratory, Department of Electronics and Information Engineering, Korea University, Seoul, Korea
| | - O Lee
- Department of Medical IT Engineering, Soonchunhyang University, Asan, Korea
| | - K Kim
- Department of Information and Telecommunication, Incheon National University, Incheon, Korea
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Kim J, Ahn JW, Ha S, Kwon SH, Lee O, Oh C. Clinical assessment of rosacea severity: oriental score vs. quantitative assessment method with imaging and biomedical tools. Skin Res Technol 2016; 23:186-193. [PMID: 27514310 DOI: 10.1111/srt.12318] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Rosacea is a common chronic inflammatory disorder affecting facial skin. Currently, no accurate and objective method is available for assessing the severity of rosacea. Most studies use the National Rosacea Society Standard (NRSS) grading method, which lacks objectivity and yields varying results. METHODS Eighteen patients with rosacea were included. Clinical severity was assessed on the basis of the NRSS grade, Investigators' Global Assessment, Patients' Global Assessment, and Dermatology Quality of Life Index. A skin color analysis system was used to measure the facial area showing erythema, and biophysical parameters of facial skin (transepidermal water loss and skin surface hydration) were examined. To find statistical significant in classification severity of the rosacea, statistical analysis was performed with all parameters. RESULTS A significant correlation (P < 0.05) was found between the NRSS grade, facial area showing erythema, and biophysical parameters. The latter two factors differed significantly among patients with rosacea of different levels of severity (mild, moderate, severe; P < 0.05). CONCLUSION Color imaging systems can be useful and reliable for evaluating the severity of rosacea, in addition to biophysical parameter assessment. The combination of these two analytical methods enabled objective and quantitative evaluation of the severity of rosacea.
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Affiliation(s)
- J Kim
- Research Institute for Skin Imaging, Korea University Medical School, Seoul, Korea
| | - J W Ahn
- Research Institute for Skin Imaging, Korea University Medical School, Seoul, Korea
| | - S Ha
- Department of Nursing, School of Health, Chungbuk Health and Science University, Chungbuk, Korea
| | - S H Kwon
- Department of Dermatology, Korea University Medical School, Seoul, Korea
| | - O Lee
- Department of Medical IT Engineering, College of Medical Sciences, Soonchunhyang University, Chungnam, Korea
| | - C Oh
- Research Institute for Skin Imaging, Korea University Medical School, Seoul, Korea.,Department of Dermatology, Korea University Medical School, Seoul, Korea
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Ji A, Chang Y, Fu Y, Lee O, Ho J. Niche-dependent Regulations of Metabolic Balance in High-fat Diet Induced Diabetic Mice by Mesenchymal Stromal Cells. Cytotherapy 2016. [DOI: 10.1016/j.jcyt.2016.03.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lee O, Ho K, Soong B. Intravenous Administration of Allogeneic Mesenchymal Stem Cells in Patients with Cerebellar Ataxias: A Phase I/IIa Clinical Trial. Cytotherapy 2016. [DOI: 10.1016/j.jcyt.2016.03.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rimando M, Wu H, Lee C, Kuo S, Lo Y, Liu Y, Lee O. Bimodal Effects of Dexamethasone on Osteogenic Differentiation of Mesenchymal Stromal Cells. Cytotherapy 2016. [DOI: 10.1016/j.jcyt.2016.03.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Liu Y, Shih Y, Liu Y, Lee O. A Member of Solute Carrier Family SLC41 Regulates the Interaction of Magnesium and Mesenchymal Stromal Cells During Osteogenic Differentiation. Cytotherapy 2016. [DOI: 10.1016/j.jcyt.2016.03.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lee O, Moon JH, Kim SH, Chung YS, Sun GM. Toenail elemental analysis of Korean young adults by instrumental neutron activation analysis. J Radioanal Nucl Chem 2015. [DOI: 10.1007/s10967-015-4638-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lev R, Lee O, Petro S, Lucas J, Castillo E, Vilke G, Coyne C. 329 Specialty-Specific Prescribing Patterns to Patients Who Die From Prescription Drugs: How Do Emergency Physicians Compare? Ann Emerg Med 2015. [DOI: 10.1016/j.annemergmed.2015.07.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Han H, Son S, Yun J, Lee O. Microrna-29A Suppresses Growth, Migration and Invasion of Lung Adenocarcinoma By Targeting Carcinoembryonic Antigen-Related Cell Adhesion Molecule 6. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu326.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Son S, Lee O, Lee Y, Lee H, Song H, Han H, Han J. Diagnostic Performance of Cd66C in Lung Adenocarcinoma-Associated Malignant Pleural Effusion: Comparison with Cea, Ca 19-9, and Cyfra 21-1. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu326.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lee O. Continuous Time Approximations to GARCH(1, 1)-Family Models and Their Limiting Properties. Communications for Statistical Applications and Methods 2014. [DOI: 10.5351/csam.2014.21.4.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Lee O, Kim J, Park G, Kim M, Son S, Ha S, Oh C. Non-invasive assessment of cutaneous wound healing using fluorescent imaging. Skin Res Technol 2014; 21:108-13. [PMID: 25066671 DOI: 10.1111/srt.12165] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND/PURPOSE Optical imaging is a very important technique in the biomedical sciences. The purpose of this study was to develop an in vivo optical system for fluorescent imaging and molecular imaging applications using quantum dots (QDs). METHODS The in vivo optical system was composed of modular parts, including a light source, light guide, excitation filter wheel, excitation filters, emission filter wheel, emission filters, liquid crystal tunable filter (LCTF), macro lens, dark chamber, and a cooled charged-coupled device (CCD) camera for recording images. Filters were selected based on the excitation and absorption spectra of QDs to allow spectral separation and optimization of the acquired image. In contrast with conventional systems, our system allows selection of the emission bandwidth. RESULTS The system was tested in an in vivo study using a wound-healing model in nude mice. The healing process was examined after injection of fibroblasts and keratinocytes labeled with two different sets of QDs. The different QD probes were readily detected and distinguished using our system. CONCLUSION An in vivo optical system is a very useful tool for the detection of genes, proteins, and small-molecule drugs inside living animals, and this imaging modality can also be adopted for real-time visualization of cancer cell metastasis in live animals.
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Affiliation(s)
- O Lee
- Department of Radiological Science, College of Nursing and Health Science, Gimcheon University, Gimcheon, Korea
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Lee O, Jiang W. Fabrication of acellular scaffolds by cryo-chemical decellulaurization of the whole liver for mesenchymal stem cell-based functional hepatic engineering. Cytotherapy 2014. [DOI: 10.1016/j.jcyt.2014.01.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Soong B, Lee O. Treatment of cerebellar ataxia with mesenchymal stem cells: a phase I/II trial. Cytotherapy 2014. [DOI: 10.1016/j.jcyt.2014.01.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lee O, Sullivan M, Ivancic D, Shidfar A, Wiehle R, Khan SA. Abstract P4-11-02: Mammary tumor formation induced by N-methyl-N-nitrosourea (MNU) is accelerated by natural and synthetic progesterone but suppressed by an anti-progesterone CDB4124. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p4-11-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: CDB4124, anti-progesterone suppresses the development of carcinogen-induced ER+/PR+ mammary tumors in rats, and may have implications for prevention and treatment of human breast cancer. We hypothesize that progesterone (P4) and medroxyprogesterone acetate (MPA) will accelerate mammary carcinogenesis induced by MNU, however CDB4124 will efficiently suppress tumor formation stimulated by progesterone.
Methods: ovary intact female Sprague Dawley rats received a single intraperitoneal injection of 50mg/kg MNU at 4-5 weeks of age. 30mg of CDB4124 and 25mg of P4 or MPA (90 release pellets, Innovative research of America, Inc) were implanted in dorsal area at 3 weeks and 4 weeks after MNU injection, respectively. 10-11 rats were used for each treatment group. Tumor incidence, latency, multiplicity, and burden were recorded weekly. 9 weeks after MNU injection all the mice were euthanized and mammary tumors and glands were fixed in 10% (v/v) neutral buffered formalin. Plasma concentrations of CDB4124 and its metabolite CDB4453 were determined by LC-MS/MS.
Results: The first tumor appeared in the control group at 5 weeks, and in the P4 and MPA treated groups at 6 weeks after MNU injection. 7 weeks after MNU injection, mammary tumor incidence of MPA and P4 treated groups were 80% and 50%, respectively compared to 30% in the control group. 9 weeks after MNU injection all MPA treated mice, 80% of P4 treated mice, and 60% of control mice developed tumors. Tumor incidence, latency, multiplicity, and tumor weight were summarized as mean ± SD in Table 1.
[Table 1] Tumor latency, incidence, multiplicity, and burden in mammary tumorsTreatmentsLatency (days)Incidence(%)MultiplicityBurden (g)Control53.7 ± 12.9602.34.25 ± 7.02P453.6 ± 9.6802.64.11 ± 5.32MPA50.8 ± 7.71002.56.02 ± 4.85P4 + CDB412459.3 ± 11.53621.38 ± 0.61MPA + CDB412454.3 ± 10.7732.84.19 ± 4.39
Tumor latency of CDB4124 treated groups was increased; tumor incidence and burden (g) of CDB4124 treated groups were decreased compared to P4 and MPA treated groups. In particular, tumor incidence and burden of CDB4124 + P4 treated group were significantly lower than those of the control group. Plasma CDB4124 and CDB4453 were 11.6 ±5.88 ng/mL and 3.4±1.68 ng/mL, respectively. Histopathology of tumors and mammary glands and immuno-histochemical evaluations of Ki67, activated caspase-3, CD34, ER, and PR are currently underway.
Conclusions: Our results indicated that natural progesterone promotes MNU- induced mammary tumor formation similar to synthetic progesterone, MPA in rats. Under this tumor permissive environment, CDB4124 provided excellent prevention efficacy, suggesting good potential as breast cancer prevention agent.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-11-02.
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Affiliation(s)
- O Lee
- Northwestern University, Chicago, IL; Repros Therapeutics, The Woodlands, TX
| | - M Sullivan
- Northwestern University, Chicago, IL; Repros Therapeutics, The Woodlands, TX
| | - D Ivancic
- Northwestern University, Chicago, IL; Repros Therapeutics, The Woodlands, TX
| | - A Shidfar
- Northwestern University, Chicago, IL; Repros Therapeutics, The Woodlands, TX
| | - R Wiehle
- Northwestern University, Chicago, IL; Repros Therapeutics, The Woodlands, TX
| | - SA Khan
- Northwestern University, Chicago, IL; Repros Therapeutics, The Woodlands, TX
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