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Ala Aiob,Yeo Rae Kim,Kidong Kim,Hyojin Kim,Yong Beom Kim,Duck Woo Kim,Jae Hong No,Soo Hyun Seo,Dong Hoon Suh,Kyoung Un Park 대한산부인과학회 2023 Obstetrics & Gynecology Science Vol.66 No.6
Objective To examine the efficacy of MSH6 and PMS2 immunohistochemistry (IHC) as a screening method for Lynch syndrome in endometrial cancer patients. Methods Through multidisciplinary discussions, an institutional MSH6 and PMS2 IHC-initiated cascade test (MSH6, PMS2 IHC→microsatellite instability [MSI] assay→germline mismatch repair [MMR] gene sequencing) was developed to screen for Lynch syndrome in endometrial cancer patients. Testing was performed on a consecutive cohort of 218 newly diagnosed endometrial cancer patients who underwent surgery at a tertiary hospital in the Republic of Korea between August 2018 and December 2020. The number of MMR deficiencies (MSH6 or PMS2 loss in IHC) and results of subsequent tests (MSI assay and germline MMR gene sequencing) were examined. Results MMR deficiency was detected in 52 of the 218 patients (24.0%). Among these 52 patients, 34 (65.0%) underwent MSI testing, of which 31 (91.0%) exhibited high MSI. Of the 31 patients with MSI-high status, 15 (48.0%) underwent germline MMR gene sequencing. Subsequently, Lynch syndrome was diagnosed in five patients (33.0%). Conclusion Lynch syndrome screening using MSH6 and PMS2 IHC-initiated cascade testing is a viable strategy in the management of endometrial cancer. A simplified strategy (MSH6 and PMS2 IHC→germline MMR gene sequencing) was proposed because most women with MMR deficiencies exhibited high MSI.
( Kangjoon Kim ),( Ala Woo ),( Youngmok Park ),( Seung Hyun Yong ),( Su Hwan Lee ),( Sang Hoon Lee ),( Ah Young Leem ),( Song Yee Kim ),( Kyungsoo Chung ),( Eun Young Kim ),( Ji Ye Jung ),( Young Ae K 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-
Purpose Studies on risk and protective factors for lung function decline and mortality in rheumatoid arthritis-related interstitial lung disease (RA-ILD) are limited. Therefore, we aimed to investigate clinical factors and medication uses associated with lung function decline and mortality in patients with RA-ILD. Methods This retrospective cohort study examined patients with RA-ILD who visited Severance Hospital, a university-affiliated tertiary referral hospital in South Korea, between January 2006 and December 2019. From 3,946 consecutive RA patients, we selected 170 participants with RA-ILD with at least one spirometry (Figure 1). Absolute FVC decline ≥10% was defined as significant decline of pulmonary function. Valid medical treatment was defined as continuation of medication for at least 12 weeks in the period between diagnosis date of RA and the last follow-up. Data were retrieved from electronic medical records. Results Ninety patients (52.9%) were female; mean ± SD age was 64.0 ± 10.2 years. Multivariate logistic regression showed that high ESR at RA diagnosis (≥81.5 mm/hr) (OR 3.056; 95% CI 1.183-7.890) and history of methotrexate (MTX) use (OR 0.269; 95% CI 0.094-0.769) were identified as risk and protective factors for lung function decline, respectively. Multivariate cox regression analysis showed that age 65 years or older (OR 2.723; 95% CI 1.142-6.491), radiologic pattern of usual interstitial pneumonia (UIP) or probable UIP (OR 3.948; 95% CI 1.522-10.242, p=0.005), baseline FVC % predicted (OR 0.971; 95% CI 0.948-0.994), and history of MTX use (OR 0.284; 95% CI 0.091-0.880) predicted mortality in the cohort. Conclusions MTX use was associated with favorable outcome in terms of lung function and mortality in our cohort. A largersized, prospective study may be warranted to investigate beneficial effect of MTX on RA-ILD.
Incidence and Risk Factors for Brain Metastasis in Patients with Presumed Early-stage Lung Cancer
( Kangjoon Kim ),( Ala Woo ),( Youngmok Park ),( Seung Hyun Yong ),( Su Hwan Lee ),( Ah Young Leem ),( Song Yee Kim ),( Kyungsoo Chung ),( Eun Young Kim ),( Ji Ye Jung ),( Young Ae Kang ),( Young Sam 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-
Purpose Regarding whether brain magnetic resonance imaging (MRI) should be routine in patients with presumed early-stage lung cancer, guideline recommendations are inconsistent. In this regard, we performed the study to evaluate the incidence and risk factors for brain metastasis (BM) in patients with presumed early-stage non-small cell lung cancer (NSCLC). Method A review of the medical charts of consecutive NSCLC patients diagnosed between January 2006 and May 2020 was performed. We identified 1,382 patients who were diagnosed with NSCLC with clinical stage of T1/2aN0M0 apart from brain MRI result (Figure 1). Firth’s bias-reduced logistic regression were used to assess predictors of BM. Fisher’s exact test with the minimum p-value approach was used to determine the optimal cut-off value in tumor size predicting BM. Result Six hundred fifty-one patients (47.1%) were female; mean ± SD age was 64.3 ± 10.4 years. Nine hundred forty-nine patients (68.7%) underwent brain MRI during staging, and 34 patients (3.6%) were shown to have BM. Firth’s bias-reduced logistic regression model showed that tumor size in millimeters (OR 1.056; 95% CI 1.009-1.106) was a single predictor for presence of BM. A cut-off value of 3.5 cm in tumor size was predictive for BM in our cohort (OR 4.538; CI 95% 1.977-9.650). The median overall survival of the participants with BM was 5.5 year and 5-year survival rate was 59.8%. Conclusions Given the incidence and favorable outcome of BM in patients with presumed early-stage NSCLC, routine screening of brain MRI might be considered, especially in patients with tumor size of ≥3.5 cm.
Interstitial Lung Disease Positive for Myositis Specific Antibodies
( Seong Hwan Youn ),( Ala Woo ),( Young Sam Kim ),( Moo Suk Park ),( Young Ae Kang ),( Eun Young Kim ),( Ji Ye Jung ),( Kyung Soo Chung ),( Su Hwan Lee ),( Sang Hoon Lee ),( Young Mok Park ),( Seung H 대한결핵 및 호흡기학회 2023 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.136 No.0
Hong Hye Young,Park Youngmok,Yong Seung Hyun,Woo Ala,Leem Ah Young,Lee Su Hwan,Chung Kyung Soo,Lee Sang Hoon,Kim Song Yee,Kim Eun Young,Jung Ji Ye,Park Moo Suk,Kim Young Sam,Shin Sung Jae,Kang Young A 대한의학회 2024 Journal of Korean medical science Vol.39 No.2
Background: The treatment success rate for tuberculosis (TB) has stagnated at 80–81% in South Korea, indicating unsatisfactory outcomes. Enhancing treatment success rate necessitates the development of individualized treatment approaches for each patient. This study aimed to identify the risk factors associated with unfavorable treatment outcomes to facilitate tailored TB care. Methods: We retrospectively analyzed the data of patients with active TB between January 2019 and December 2020 at a single tertiary referral center. We classified unfavorable treatment outcomes according to the 2021 World Health Organization guidelines as follows: “lost to follow-up” (LTFU), “not evaluated” (NE), “death,” and “treatment failure” (TF). Moreover, we analyzed risk factors for each unfavorable outcome using Cox proportional hazard regression analysis. Results: A total of 659 patients (median age 62 years; male 54.3%) were included in the study. The total unfavorable outcomes were 28.1%: 4.6% LTFU, 9.6% NE, 9.1% deaths, and 4.9% TF. Multivariate analysis showed that a culture-confirmed diagnosis of TB was associated with a lower risk of LTFU (adjusted hazard ratio [aHR], 0.25; 95% confidence interval [CI], 0.10–0.63), whereas the occurrence of adverse drug reactions (ADRs) significantly increased the risk of LTFU (aHR, 6.63; 95% CI, 2.63–16.69). Patients living far from the hospital (aHR, 4.47; 95% CI, 2.50–7.97) and those with chronic kidney disease (aHR, 3.21; 95% CI, 1.33–7.75) were at higher risk of being transferred out to other health institutions (NE). Higher mortality was associated with older age (aHR, 1.06; 95% CI, 1.04–1.09) and comorbidities. The ADRs that occurred during TB treatment were a risk factor for TF (aHR, 6.88; 95% CI, 2.24–21.13). Conclusion: Unfavorable outcomes of patients with TB were substantial at a tertiary referral center, and the risk factors for each unfavorable outcome varied. To improve treatment outcomes, close monitoring and the provision of tailored care for patients with TB are necessary.