Detection of <i>MYCN</i> Amplification in Serum DNA Using Conventional Polymerase Chain Reaction

Ma, Youngeun,Lee, Ji Won,Park, Soo Jin,Yi, Eun Sang,Choi, Young Bae,Yoo, Keon Hee,Sung, Ki Woong,Koo, Hong Hoe The Korean Academy of Medical Sciences 2016 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.31 No.9

<P>Neuroblastoma (NB) is the most common extra-cranial solid tumor of childhood and is characterized by a wide range of clinical behaviors. Amplification of <I>MYCN</I> is a well-known poor prognostic factor in NB patients. As the <I>MYCN</I> amplification status is usually tested using tumor specimens, lengthy and invasive procedures are unavoidable. To evaluate the possibility of detecting <I>MYCN</I> amplification without invasive procedure, we performed conventional polymerase chain reaction (PCR) analysis to identify <I>MYCN</I> amplification using the preserved serum DNA. PCR of serum DNA was done in 105 NB patients whose <I>MYCN</I> status had been confirmed by fluorescence in situ hybridization. <I>MYCN</I> amplification was evaluated as the ratio of signal intensities between <I>MYCN</I> and <I>NAGK</I> (M/N ratio). When regarding the tissue FISH results as a reference, 10 patients had <I>MYCN</I>-amplified (MNA) NB, and 95 had non-MNA NB. The M/N ratio of the MNA group (median 2.56, range 1.01-3.58) was significantly higher than that of the non-MNA group (median 0.97, range 0.67-5.18) (<I>P</I> < 0.001). In the receiver operating characteristic curve analysis, the area under the curve was 0.957 (95% confidence interval 0.898–1.000; <I>P</I> < 0.001), and it showed 90.9% sensitivity and 97.9% specificity with the selected cut-off value set as 1.6. The detection of <I>MYCN</I> amplification using conventional PCR analysis of serum samples seems to be a simple and promising method to evaluate the <I>MYCN</I> status of NB patients. Further study with a larger set of patients is needed to confirm the accuracy of this result.</P>

Tandem High-dose Chemotherapy without Craniospinal Irradiation in Treatment of Non-metastatic Malignant Brain Tumors in Very Young Children

Ma Youngeun,임도훈,Cho Heewon,이지원,성기웅,유건희,구홍회,신형진,서연림 대한의학회 2020 Journal of Korean medical science Vol.35 No.48

Background: Infants and very young children with malignant brain tumors have a poorer survival and a higher risk for neurologic deficits. The present study evaluated the feasibility and effectiveness of multimodal treatment including tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/auto-SCT) in minimizing use of radiotherapy (RT) in very young children with non-metastatic malignant brain tumors. Methods: Twenty consecutive patients younger than 3 years were enrolled between 2004 and 2017. Tandem HDCT/auto-SCT was performed after six cycles of induction chemotherapy. Local RT was administered only to patients with post-operative gross residual tumor at older than 3 years. Since September 2015, early post-operative local RT for patients with atypical teratoid/rhabdoid tumor or primitive neuroectodermal tumor was administered. Results: All 20 enrolled patients underwent the first HDCT/auto-SCT, and 18 proceeded to the second. Two patients died from toxicity during the second HDCT/auto-SCT, and four patients experienced relapse/progression (one localized and three metastatic), three of whom remained alive after salvage treatment including RT. A total of 17 patients remained alive at a median 7.8 (range, 2.5−15.7) years from diagnosis. Nine survivors received no RT, six survivors received local RT alone, and two survivors who experienced metastatic relapse after tandem HDCT/auto-SCT received both local and craniospinal RT. The 5-year overall, event- free, and craniospinal RT-free survival rates were 85.0% ± 8.0%, 70.0% ± 10.2%, and 75.0% ± 9.7%, respectively. Neuroendocrine and neurocognitive functions evaluated 5 years after tandem HDCT/auto-SCT were acceptable. Conclusion: Our results suggest that non-metastatic malignant brain tumors in very young children could be treated with multimodal therapy including tandem HDCT/auto-SCT while minimizing RT, particularly craniospinal RT.

Characteristics of Korean Trauma Patients: A Single-center Analysis Using the Korea Trauma Database

( Youngeun Park ),( Min Chung ),( Gil Jae Lee ),( Min A Lee ),( Jae Jeong Park ),( Kang Kook Choi ),( Sung Youl Hyun ),( Yang Bin Jeon ),( Dae Sung Ma ),( Yong-cheol Yoon ),( Jungnam Lee ),( Byungchul 대한외상학회 2016 大韓外傷學會誌 Vol.29 No.4

Purpose: Two years have passed since a level I trauma center was officially opened in the Gacheon Gil Hospital, South Korea. We analyzed 2014 and 2015 registered patient data from the Korean Trauma Data Base (KTDB) to identify trends in trauma patient care and factors that influence the quality of trauma care at the Gacheon Gil trauma center. Methods: Data was extracted from the KTDB included patient age, sex, systolic blood pressure at emergency room arrival, revised trauma score, injury severity score, trauma injury severity score, transfusion amount, and the cause of death was analyzed. Results: A total of 3269 trauma patients were admitted to our trauma center in 2014 and 3225 in 2015. Demographics and mechanism of injury were not significantly different between years. The severity of trauma injury was decreased in 2015 although the mortality rate was slightly increased. This requires further analysis. Conclusion: The aim of this study was to determine the general status and trends in trauma incidence and management outcomes for the Incheon area. We noted no significant changes in trauma status from 2014 to 2015. We need to collect and review trauma patient data over a long period in order to elucidate trauma incidence and management trends in the trauma field. Finally, studies using trauma patient data will indicate appropriate quality control factors for trauma care and help to improve the quality of trauma management. [ J Trauma Inj 2016; 29: 155-160 ]

노인복지시설의 메뉴 및 조리법에 대한 현황 실태 조사

김영은(Kim, Youngeun),문수진(Moon, Soojean),문예나(Moon, Yeana),윤하늘(Yoon, Haneul),마요영(Ma, Yoyoung),최일숙(Choi, Ilsook) 한국생활과학회 2023 한국생활과학회 학술대회 Vol.2023 No.5

Treatment Outcomes in Children and Adolescents with Relapsed or Progressed Solid Tumors: a 20-year, Single-Center Study

Cho, Hee Won,Lee, Ji Won,Ma, Youngeun,Yoo, Keon Hee,Sung, Ki Woong,Koo, Hong Hoe The Korean Academy of Medical Sciences 2018 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.33 No.41

<P><B>Background</B></P><P>By estimating the survival rates and exploring prognostic factors in pediatric patients with relapsed or progressed solid tumors, our purpose was to generate background data for future studies.</P><P><B>Methods</B></P><P>We reviewed the medical records of 258 patients with solid tumors who experienced relapse/progression and received subsequent salvage treatment between 1996 and 2016.</P><P><B>Results</B></P><P>A total of 60 patients remained progression-free during first-line salvage treatment, while the remaining 198 patients experienced relapse/progression again; 149 underwent second-line salvage treatment. A total of 76 patients underwent high-dose chemotherapy and autologous stem cell transplantation (HDCT/auto-SCT), and 44 patients received allogeneic SCT. The 10-year progression-free survival (PFS) and overall survival (OS) from relapse/progression were 18.4% ± 2.7% and 24.5% ± 3.0%, respectively. Survival rates were relatively higher in patients with anaplastic ependymoma, initially non-high-risk neuroblastoma, osteosarcoma, Wilms tumor and retinoblastoma. A multivariate analysis showed that relapse/progression during initial treatment, metastatic relapse/progression, and impossible debulking surgery were independent poor prognostic factors for both PFS and OS. Patients who exhibited a complete response or partial response during conventional salvage treatment showed significantly higher survival after SCT than those with stable disease or progressive disease (10-year OS: 54.8% ± 7.0% vs. 7.0% ± 3.5%, <I>P</I> < 0.001).</P><P><B>Conclusion</B></P><P>The prognosis of relapsed/progressed pediatric solid tumors still remains unsatisfactory. New, effective treatment strategies are needed to overcome limitations of current approaches. Hopefully, the background data generated herein will be used in future clinical trials involving patients with relapsed/progressed solid tumors.</P>

A Case with Multiple Fungal Coinfections in a Patient who Presented with Pancoast Syndrome

( Hyungsuk Jin ),( Dongsub Kim ),( Joon-sik Choi ),( Hee Jae Huh ),( Nam Yong Lee ),( Joungho Han ),( Hee Won Cho ),( Youngeun Ma ),( Tae Yeon Jeon ),( So-young Yoo ),( Keon Hee Yoo ),( Hong Hoe Koo ) 대한소아감염학회 2021 Pediatric Infection and Vaccine Vol.28 No.1

소아암 환자에서 발생하는 침습성 진균 감염은 사망과 후유증에 이르는 중대한 감염이다. 18세 남자 환자가 호중구감소 기간 동안 입원하여 치료받던 중 우측 견관절과 우측 팔에 감각이상과 신경쇠약을 호소하였고, 우측폐상엽의 폐렴이 진단되었다. 기관지의 조직학적 소견과 폐 수술검체에서 시행한 polymerase chain reaction (PCR)로 털곰팡이증을 확진하였으며, 흉수액의 PCR로 페니실리움 디쿰벤스 감염, 갈락토마난 항원법으로 아스페르길루스증을 추정하였다. 환자는 백혈병이 치료되지 못하고 Staphylococcus epidermidis 패혈증이 합병되어 사망하였다. 본 증례에서는 판코스트 증후군의 증상을 보인 환자에서 진단된 다발성 폐진균증을 보고 하는 바이다. Invasive fungal infection (IFI) is a serious threat to pediatric patients with cancer given high morbidity and mortality. We present an 18-year-old male with precursor T-cell lymphoblastic leukemia who developed Pancoast syndrome, presented with paresthesia and numbness in the right shoulder and arm during a neutropenic fever period. He was diagnosed with pneumonia in the right upper lung field. He was later found to have an invasive pulmonary fungal infection caused by multiple fungi species, including Rhizomucor, confirmed by histology and polymerase chain reaction (PCR) (proven infection), Penicillium decumbens diagnosed by PCR, and Aspergillus suspected from galactomannan assay (probable infection). Unfortunately, the patient's condition further worsened owing to the aggravation of leukemia, chemotherapy-induced neutropenia, and bacterial coinfection, leading to multiorgan failure and death. Here, we report a case of IFI caused by multiple fungal species that presented as Pancoast syndrome.