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- 검색키워드
- 저자 : ( Joseph J. Noh ) (검색결과 11 건)
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Joseph J. Noh,김민규,최민철,이정원,박현,정상근,주원덕,송승훈,이찬 대한암학회 2022 Cancer Research and Treatment Vol.54 No.4
Purpose This study was to investigate the frequency of mismatch repair deficiency/high microsatellite instability (MMRd/MSI-H) in gynecologic malignancies and the efficacy of immune checkpoint inhibitors (ICIs) in patients with recurrent gynecologic cancers according to MMR/MSI status. Materials and Methods We conducted a multi-center retrospective review on the patients who were diagnosed with gynecologic cancers between 2015 and 2020. Their clinicopathologic information, results of immunohistochemistry staining for MLH1/MSH2/MSH6/PMS2 and MSI analysis, tumor response to treatment with ICIs were investigated. Results Among 1,093 patients included in the analysis, MMRd/MSI-H was most frequent in endometrial/uterine cancers (34.8%, 164/471), followed by ovarian, tubal, and peritoneal cancers (12.8%, 54/422) and cervical cancer (11.3%, 21/186). When assessed by histology without regard for cancer types, the frequency of MMRd/MSI-H was 11.0% (38/345) in high-grade serous adenocarcinoma, 38.6% (117/303) in endometrioid adenocarcinoma, and 30.2% (16/53) in carcinosarcoma. A total of 114 patients were treated with ICIs at least once. The objective response rate (ORR) was 21.6% (8/37) in cervical cancer, 4.7% (2/43) in ovarian cancer, and 25.8% (8/31) in endometrial/uterine cancers. Univariate regression analysis identified MMRd/MSI-H as the only significant factor associated with the ORR (28.9% [11/38] vs. 11.8% [9/76]; odds ratio, 3.033; 95% confidence interval, 1.129 to 8.144; p=0.028). Conclusion The frequency of MMRd/MSI-H is moderate to high in gynecologic cancers in the Korean population. MMRd/MSI-H could be effective predictive biomarkers in gynecologic cancers of any type. PurposeThis study was to investigate the frequency of mismatch repair deficiency/high microsatellite instability (MMRd/MSI-H) in gynecologic malignancies and the efficacy of immune checkpoint inhibitors (ICIs) in patients with recurrent gynecologic cancers according to MMR/MSI status.Materials and MethodsWe conducted a multi-center retrospective review on the patients who were diagnosed with gynecologic cancers between 2015 and 2020. Their clinicopathologic information, results of immunohistochemistry staining for MLH1/MSH2/MSH6/PMS2 and MSI analysis, tumor response to treatment with ICIs were investigated.ResultsAmong 1,093 patients included in the analysis, MMRd/MSI-H was most frequent in endometrial/uterine cancers (34.8%, 164/471), followed by ovarian, tubal, and peritoneal cancers (12.8%, 54/422) and cervical cancer (11.3%, 21/186). When assessed by histology without regard for cancer types, the frequency of MMRd/MSI-H was 11.0% (38/345) in high-grade serous adenocarcinoma, 38.6% (117/303) in endometrioid adenocarcinoma, and 30.2% (16/53) in carcinosarcoma. A total of 114 patients were treated with ICIs at least once. The objective response rate (ORR) was 21.6% (8/37) in cervical cancer, 4.7% (2/43) in ovarian cancer, and 25.8% (8/31) in endometrial/uterine cancers. Univariate regression analysis identified MMRd/MSI-H as the only significant factor associated with the ORR (28.9% [11/38] vs. 11.8% [9/76]; odds ratio, 3.033; 95% confidence interval, 1.129–8.144; p=0.028).ConclusionThe frequency of MMRd/MSI-H is moderate to high in gynecologic cancers in the Korean population. MMRd/MSI-H could be effective predictive biomarkers in gynecologic cancers of any type.
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( Joseph J. Noh ),( Ji-hee Sung ),( Suk-joo Choi ),( Soo-young Oh ),( Cheong-rae Roh ),( Jong-hwa Kim ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-
목적: The present study examined the differences in clinical and laboratory characteristics of the mothers and neonates between Gram-positive and Gram-negative early onset neonatal sepsis (EONS). 방법: Among all singleton births delivered between 24 and 34 weeks of gestation from Sep. 1996 to Jan. 2016 in our institution due to preterm labor (PTL), preterm premature rupture of membrane (PPROM) or incompetent internal os of cervix (IIOC), culture proven neonatal sepsis within 7 days following birth were included in this study. Baseline maternal characteristics and symptoms of clinical chorioamnionitis of the mothers were evaluated while those of neonates were examined for adverse neonatal outcomes and hematologic abnormalities and compared between Gram-positive and Gram-negative EONS. 결과: Among the 62 births examined, there were 27 EONS by Gram-negative and 35 EONS by Gram-positive. The proportion of multiparous women was significantly higher in Gram-negative EONS compared to Gram-positive EONS (70.4% vs. 43%, p=0.031). The reason for admission showed distinct patterns between the two groups; PTL was more common in Gram-positive EONS (57.1% vs. 29.6%, p=0.031) and PPROM tended to be more common in Gram-negative EONS (66.7% vs. 42.9%, p=0.062). There was no difference in gestational age at admission or delivery between the two groups. Among the antepartum parameters of clinical chorioamnionitis, maternal tachycardia (85% vs. 57%, p=0.018) and fever above 37.8 °C (25.9% vs. 8.6%, p=0.068) were more common in Gram-negative EONS compared to Gram-positive EONS. Gram-negative EONS neonates showed significantly higher CRP elevation than Gram-positive EONS neonates (2.21 mg/dL [0.03-24.03] vs. 0.40 mg/dL [0.02-7.27], p=0.003). 결론: Our study demonstrated that the clinical symptoms and characteristics of the mothers who gave births to neonates with EONS may be different according to the types of pathogens by prominent maternal tachycardia and fever in Gram-negative EONS.
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신원교,Joseph J. Noh,서상수,강석범,최철훈,박상윤,김병기,임명철 연세대학교의과대학 2020 Yonsei medical journal Vol.61 No.11
Purpose: Salvage second-line chemotherapy is usually recommended for patients with advanced epithelial ovarian cancer (AEOC)who develop progressive disease (PD) after neoadjuvant chemotherapy (NAC). Herein, we investigated the role of cytoreductivesurgery (CRS) for such patients. Materials and Methods: We retrospectively reviewed the medical records of 36 patients with AEOC who developed PD after receivingNAC at two tertiary academic centers with different treatment strategies between 2001 and 2016. Patients who developedPD after NAC were consistently treated with CRS at one hospital (group A; n=13) and second-line chemotherapy at another (group B;n=23). The clinical characteristics and treatment outcomes were compared between the groups. Results: Overall survival (OS) was longer in group A than in group B (19.4 months vs. 7.9 months; p=0.011). High-grade seroushistology was associated with longer OS than non-high-grade serous types. In group A, optimal surgery resection (<1 cm) wasachieved after CRS in 6 patients (46%). Multivariate analysis showed that the treatment option was the only independent predictivefactor for OS (hazard ratio, 2.30; 95% confidence interval, 1.02–5.17; p=0.044). Conclusion: CRS may result in a survival benefit even in patients with AEOC who develop PD after NAC.
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( Jihee Jung ),( Joseph J. Noh ),( Chel Hun Choi ),( Tae-joong Kim ),( Jeong-won Lee ),( Byoung-gie Kim ),( Yoo-young Lee ) 대한산부인과학회 2022 대한산부인과학회 학술대회 Vol.108 No.-
Objective: The purpose of this study is to compare the oncological outcomes according to adjuvant treatment in patients with high risk endometrial cancer. Methods: A retrospective study was conducted using data between January 1, 2000, and December 31, 2020 at two tertiary centers in Korea (Samsung Medical Center) and Taiwan (National Taiwan University Hospital). Patients with high risk endometrial cancer were eligible. The definition of high risk referred to when final pathology showed grade 3 endometrioid or non-endometrioid with any stages or grade 1-2 endometrioid with stage III or IV. In terms of adjuvant therapy, we categorized it into systemic chemotherapy (CT), radiotherapy (RT), or combination of chemotherapy and radiotherapy (CRT). Propensity score matching was done based on the pathologic stage and cell type after surgery. Results: Total 519 patients with high risk endometrial cancer were eligible in which 176 patients, 200 patients, and 143 patients received RT, CT, and CRT, respectively. In all patient groups, disease free survival and overall survival were statistically significantly higher in the RT group. Advanced stage (stage III-IV) patients who underwent the CRT were improved survival. After propensity score matching, 83 patients in each treatment group were finally analyzed. There was no difference in survival with adjuvant therapy after matching in all patients group, early stage and advanced stage patients. Although statistical significance was not reached after matching, a high survival rate was achieved when CRT was performed in advanced stage patients. CRT was further analyzed by dividing it into concurrent CT and RT, sequential (RT followed by CT, or vice versa), PORTEC3, and Sandwich method, and there was no difference in the survival curve. Conclusion: Although all high-risk endometrial cancer patients were included, survival gains were no different for each stage and treatment group. In stage III and IV groups, it is considered that there is a survival gain in the CRT.
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Role of reactive thrombocytosis after primary cytoreductive surgery in advanced ovarian cancer
( Seung Hun Baek ),( Joseph J. Noh ),( Jung In Shim ),( Jun Hyeok Kang ),( Soo Young Jeong ),( Chel Hun Choi ),( Tae-joong Kim ),( Jeong-won Lee ),( Byoung-gie Kim ),( Duk-soo Bae ),( Yoo-young Lee ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-
Objective: Surgery induced thrombocytosis occurs frequently in various disease. We investigated the incidence of reactive thrombocytosis after maximal cytoreductive surgery in epithelial ovarian cancer and its role on survival. Methods: An electronic chart review was performed of advanced epithelial ovarian cancer patients who had primary cytoreductive surgery from January 1, 2012, and December 31, 2017. Besides from known clinical prognostic factors, serum platelet counts at various time points including before surgery, during peri-operative period, and on each cycle of adjuvant chemotherapy were collected. Results: 474 patients were eligible for the analysis. Median age was 55 years (18 -88) and pretreatment CA 125 was 1519.2 U/mL (5.5-16719). 401 patients (84.6%) were FIGO Stage III and serous histology was most common (405 patients, 85.4%). 79 patients (22.6%) had splenectomy and optimal cytoreduction (residual < 1cm) was achieved at 326 patients (68.8%). Thrombocytosis was observed in 273 patients (57.6%) patients in the entire cohort. Especially, higher platelet counts were observed in patients with splenectomy compared without splenectomy (e.g. on post-operative day 12, p<0.001). Subgroup of patients who still had thrombocytosis during adjuvant chemotherapy showed poorer survivals than the others. In particular, thrombocytosis on 5th cycle of adjuvant chemotherapy showed most significant impact on overall survival (HR; 1.871, 95%CI; 1.034-3.386, p=0.038) among various time points in multivariate analysis. In a logistic regression model, splenectomy (p<0.001) and optimal cytoreduction (p=0.025) significantly attributed to thrombocytosis on 5th cycle. Conclusion: Our findings suggest that reactive thrombocytosis after primary cytoreductive surgery is associated with poor survival in advanced ovarian cancer, particularly when splenectomy was performed and thrombocytosis was observed during adjuvant chemotherapy. New approaches to increase oncological outcomes are needed for this subgroup of patients.
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( Jihee Jung ),( Joonyoung Hong ),( Joseph J. Noh ),( Chel Hun Choi ),( Tae-joong Kim ),( Jeong-won Lee ),( Yoo-young Lee ),( Byoung-gie Kim ) 대한산부인과학회 2022 대한산부인과학회 학술대회 Vol.108 No.-
Objective: The purpose of this study was to determine whether the pretreatment neutrophil-lymphocyte ratio at the time of initiation of immune checkpoint inhibitors (ICIs) in patients with recurrent gynecological cancer has an effect on progression free survival (PFS) and overall survival (OS). Methods: A retrospective, single-center cohort study was conducted using data between March 1, 2002, and February 18, 2021 at Samsung Comprehensive Cancer Center, Seoul. We identified patients who received ICIs for recurrent gynecological cancer (ovarian, endometrial, cervical, and other cancers). The absolute serum neutrophil and lymphocyte ratio (NLR) was calculated from the complete blood count laboratory results performed before the first cycle of ICIs. Based on the median value of the NLR ratio, analysis was performed by dividing into 2 groups as high or low NLR. Results: Among 250 patients, 207 patients were included in the analysis, excluding patients with unknown pre-treatment NLR ratio or follow-up loss. 103 patients were assigned to the group with a low NLR, and 104 patients were assigned to the group with a high NLR ratio. There were statistically significant differences between the two groups in terms of body weight, BMI, prior radiation therapy, ECOG, total number of ICIs, and prior antibiotics use before ICIs (p<0.05). In the univariate analysis according to NLR, the Kaplan-Meier curve showed significantly longer overall survival (OS) in patients with low NLR compared with high NLR (p=0.17). In Cox multivariable analysis, NLR, ECOG, and total number of ICIs were found to affect Especially, low NLR group demonstrated survival gain about 3 times compared to the high group (HR 3.26; 95% CI 1.89 5.62; p<0.001). Conclusion: Pre-treatment high NLR showed significant improved. OS in patients with ICIs for recurrent gynecological cancer. It is thought that pretreatment NLR can be used as a predictive marker to predict survival after ICIs in patients with recurrent gynecological cancer.
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VALIDATION OF NUMERICAL METHODS TO CALCULATE BYPASS FLOW IN A PRISMATIC GAS-COOLED REACTOR CORE
Tak, Nam-Il,Kim, Min-Hwan,Lim, Hong-Sik,Noh, Jae Man,Drzewiecki, Timothy J.,Seker, Volkan,Downar, Thomas J.,Kelly, Joseph Korean Nuclear Society 2013 Nuclear Engineering and Technology Vol.45 No.6
For thermo-fluid and safety analyses of a High Temperature Gas-cooled Reactor (HTGR), intensive efforts are in progress in the developments of the GAMMA+ code of Korea Atomic Energy Research Institute (KAERI) and the AGREE code of the University of Michigan (U of M). One of the important requirements for GAMMA+ and AGREE is an accurate modeling capability of a bypass flow in a prismatic core. Recently, a series of air experiments were performed at Seoul National University (SNU) in order to understand bypass flow behavior and generate an experimental database for the validation of computer codes. The main objective of the present work is to validate the GAMMA+ and AGREE codes using the experimental data published by SNU. The numerical results of the two codes were compared with the measured data. A good agreement was found between the calculations and the measurement. It was concluded that GAMMA+ and AGREE can reliably simulate the bypass flow behavior in a prismatic core.
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