Seonwoo Kim

MEDIPOST Biomedical Research Institute, Sŏul, Seoul, South Korea

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Publications (95)337.64 Total impact

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    ABSTRACT: The pathogenesis and clinicopathologic characteristics of Epstein-Barr virus (EBV)-negative lymphoepithelioma-like gastric carcinoma (LELC) are still unclear. In addition, it remains controversial whether EBV infection itself affects the prognosis of LELC. Between 1995 and 2011, 145 LELC patients (124 patients with EBV infection and 21 patients without EBV infection) underwent radical gastrectomy with D2 lymph node dissection. The clinicopathologic features and prognosis of EBV-negative LELC cases were compared with those of EBV-positive LELC cases. The median duration of follow-up after surgery was 55 months. Microsatellite instability (MSI) analysis was performed on 20 EBV-negative LELC cases. EBV-negative LELC accounted for 14.5 % of the total LELC cases. EBV-negative LELC was significantly associated with older age, female sex, advanced T stage, and advanced American Joint Committee on Cancer (AJCC) tumor stage compared with EBV-positive LELC. In univariate analysis, patients with EBV-negative LELC had significantly shorter overall, disease-specific, and recurrence-free survival than those with EBV-positive LELC. The 5-year overall survival rates were 81.0 % for patients with EBV-negative LELC and 96.2 % for patients with EBV-positive LELC. In a Cox proportional hazards model, EBV infection, age, and AJCC tumor stage were identified as independent predictors of overall survival. MSI-high, MSI-low, and microsatellite-stable tumors accounted for 25, 10, and 65 % of EBV-negative LELC cases, respectively. MSI status did not affect the prognosis of EBV-negative LELC cases. EBV infection serves as an independent predictor of survival in patients with LELC. EBV-negative LELC exhibited clinicopathologic features and prognosis distinct from those of EBV-positive LELC.
    Gastric Cancer 08/2015; DOI:10.1007/s10120-015-0524-x · 4.83 Impact Factor
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    ABSTRACT: To investigate clinical effects of equine-assisted activities and therapy (EAA/T) for treating attention-deficit/hyperactivity disorder (ADHD) in children age 6-13 years. This 12-week, prospective, open-label trial included 24 sessions of EAA/T. Twenty participants (19 boys and 1 girl) completed 12 weeks of EAA/T. Various clinical tests were administered at baseline and after EAA/T. Assessments included the investigator-administered ADHD-Rating Scale (ARS-I), Clinical Global Impressions (CGI)-Severity Scale, Clinical Global Impressions-Improvement Scale (CGI-I), Gordon Diagnostic System, Korea-Child Behavior Checklist (K-CBCL), Self-Esteem Scale, second edition of the Bruininks-Oseretsky test of motor proficiency (BOT-2), and quantitative electroencephalography. The primary efficacy measure was the response rate. The response rate was 90% based on a 30% or greater decline in the ARS-I score or 85% based on CGI-I scores of 1 or 2. The mean±standard deviation ARS-I score decreased from 33.65±6.42 at baseline to 16.80±6.86 after 12 weeks of EAA/T (p<0.001, paired t-test). EAA/T also resulted in significant improvement in the social problems subscale of the K-CBCL and in the manual dexterity, bilateral coordination, and total motor composite subscales of the BOT-2. The theta/beta ratio on electroencephalography was decreased significantly at the Pz electrode after 12 weeks of EAA/T. This is the first study demonstrating that EAA/T is effective for improving core ADHD symptoms. On the basis of these results, EAA/T could be a viable treatment strategy as a part of a multimodal therapy for children with ADHD.
    Journal of alternative and complementary medicine (New York, N.Y.) 07/2015; DOI:10.1089/acm.2015.0067 · 1.52 Impact Factor
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    ABSTRACT: Background : Women are subject to a disproportionate burden from Alzheimer’s disease (AD) and sex differences exist in treatment response and prognosis of the disease. Yet gender-specific risk factors have not been widely studied. We aimed to investigate gender-specific risk factors for AD in subjects with mild cognitive impairment (MCI). Methods : Participants (n = 294) with MCI were recruited from a nationwide, prospective cohort study of dementia and were followed for a median (range) of 13.8 (6.0–36.0) months. Sex-stratified associations of progression to AD with baseline characteristics were explored. Results : Seventy-four individuals (25.2%) developed incident dementia (67 AD) during follow-up. Significant risk factors for probable AD differed by sex. In men, the significant risk factors were severe periventricular white matter hyperintensities, and poorer global cognitive function. In women, older age, clinically significant depressive symptoms at baseline, and positive APOE ε4 alleles were the significant risk factors. Conclusions : Risk factors for progression from MCI to probable AD differed in men and women. These results may translate to gender-specific preventative or therapeutic strategies for patients with MCI.
    Comprehensive Psychiatry 07/2015; DOI:10.1016/j.comppsych.2015.07.002 · 2.26 Impact Factor
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    ABSTRACT: We investigated the vitamin D status of Korean women during pregnancy and assessed the effects of vitamin D deficiency on two pregnancy outcomes; preterm births and the births of small for gestational age. We measured the serum 25-hydroxyvitamin D levels in 220 pregnant Korean women who were recruited prospectively and compared these levels with those of 500 healthy non-pregnant women. We analyzed vitamin D status according to patient demographics, season, and obstetrical characteristics; moreover, we also assessed pregnancy outcomes. The overall prevalence of vitamin D deficiency(<20 ng/mL) in pregnant women and healthy non-pregnant women was 77.3% and 79.2%; respectively; and the prevalence of severe vitamin D deficiency (<10 ng/mL) was 28.6% and 7.2%; respectively (p < 0.05). Vitamin D deficiency was more prevalent in the winter (100%) than in the summer (45.5%) in pregnant Korean women. A higher risk of vitamin D deficiency was observed in the first trimester than in the third trimester (adjusted OR 4.3; p < 0.05). No significant association was observed between vitamin D deficiency and any of the pregnancy outcomes examined. Further research focusing on the long-term consequences of vitamin D deficiency during pregnancy in Korean women is warranted.
    Nutrients 05/2015; 7(5):3427-48. DOI:10.3390/nu7053427 · 3.15 Impact Factor
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    ABSTRACT: Growth factor receptors, often carrying tyrosine kinase activities in their cytoplasmic domains, are overexpressed in many cancers. Coactivation of receptor tyrosine kinases (RTKs) plays a critical role in tumor response to targeted therapeutics. We examined concomitant overexpression of EGFR and MET in patients with HER2+ and HER2- gastric cancers (GCs). Tissue microarray samples obtained from 1,589 GC patients who received R0 gastrectomy with extensive node dissection and adjuvant chemoradiationtherapy were analyzed by immunohistochemistry and fluorescence in situ hybridization. HER2+ was observed in 169 patients (11%). Out of 169 HER2+ patients, 15 (9%) were EGFR+ and MET+, 29 (17%) were EGFR+, 37 (22%) were MET+, and the remaining 88 patients (52%) were HER2+ only, without concomitant EGFR or MET overexpression. Greater number of overexpressed RTKs correlated with younger age (p<0.001), larger tumor size (p=0.027), intestinal histology (p<0.001), and shorter overall survival (p=0.002). The mean overall survival was 113 months for HER2-/EGFR-/MET- and 63 months for HER2+/EGFR+/MET+ subgroups. Patients with HER2+/EGFR+/MET+ GCs had a substantial risk of death with a hazard ratio of 3.01 (95% CI, 1.54–5.90), compared to HER2-/EGFR-/MET- GC patients. Using patient-derived tumor cell models isolated from pericardial effusion of HER2+ and MET+ GC cases, we demonstrated that the combination of HER2-inhibitor (lapatinib) and MET-inhibitor offered a more profound inhibition in the ERK/AKT pathway and cell proliferation than lapatinib alone. Co-overexpression of RTKs was demonstrated in small subsets of GC associated with aggressive behavior, and in these cases, combination therapy may be considered as potential treatment options. © 2014 Wiley Periodicals, Inc.
    International Journal of Cancer 04/2015; 136(7). DOI:10.1002/ijc.29159 · 5.01 Impact Factor
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    ABSTRACT: The risk factors for venous thromboembolism (VTE) in diffuse large B-cell lymphoma (DLBCL) are not clear although thrombosis can be associated with host status, tumor burden and inflammatory activity. We assessed the effect of those factors on VTE in a cross-sectional study of patients enrolled in a prospective cohort study. We analyzed the occurrence of VTE in 322 patients with newly diagnosed DLBCL who received R-CHOP (rituximab cyclophosphamide, doxorubicin, vincristine, and prednisone) between 2008 and 2011. Serum levels of inflammatory cytokines were measured from serum samples archived at diagnosis. With a median follow-up duration of 41.9 months, VTE was documented in 34 patients (10.6%). A comparison of baseline characteristics indicated the group with VTE had higher percentage of old age, stage III/IV and extranodal involvements than the group without VTE (P < 0.05). Thus, the International Prognostic Index was significantly associated with VTE, but the Khorana score was not. A univariate competing risk factor analysis for VTE revealed that increased levels of inflammatory cytokines such as interleukin (IL)-6 and IL-10 were also associated with VTE (P < 0.05) in addition to host and tumor burden. However, a multivariate analysis showed that two host factors including age ( 60 years) and poor performance were independent risk factors for VTE. s Among potential risk factors for VTE including tumor burden and inflammatory activity, age and performance status had a strong impact on the occurrence of VTE in patients with DLBCL who received R-CHOP.
    Cancer Research and Treatment 03/2015; DOI:10.4143/crt.2014.266 · 2.98 Impact Factor
  • Sook-young Woo · Seonwoo Kim · Jinheum Kim
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    ABSTRACT: In clinical studies, patients are often classified into high or low risk groups based on prognostic factors related to survival outcomes. Using maximally selected linear rank statistics, several methods have been developed to determine a cutoff value of the prognostic factor. We propose an extension of these methods for the circumstances that competing risks are encountered in conjunction with an event outcome of interest. A simulation study is carried out to demonstrate the performance of the proposed method using some commonly used measures such as bias, precision, and power. We also apply our method to two real datasets involving lung cancer and hepatocellular carcinoma, illustrating optimal determinations of cutoff values for binary decisions on prognosis.
    Computational Statistics 01/2015; DOI:10.1007/s00180-015-0582-x · 0.35 Impact Factor
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    ABSTRACT: This study researched the clinical effects of hippotherapy and medication in attention deficit hyperactivity disorder (ADHD) children.
    01/2015; 54(1):112. DOI:10.4306/jknpa.2015.54.1.112
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    ABSTRACT: The Masaoka-Koga staging system has been known as the strongest prognostic factor for both survival and recurrence of thymic epithelial tumor (TET). The purpose of our study was to find prognostic determinants among computed tomography (CT), histopathologic, and clinical features of TET. Two radiologists reviewed retrospectively CT findings of 437 patients (male 242, female 195; mean age, 51 years) with TET. With medical record review, surgico-histopathologic results were subcategorized into Masaoka-Koga stages I through IV and World Health Organization histopathologic classifications A-B1, B2-B3, and carcinoma. Overall survival and progression-free survival were analyzed. Clinical, histopathologic, and CT features were correlated from each other. In all, 437 tumors were in Masaoka-Koga stage I (n = 147, 33.6%), stage II (n = 121, 27.7%), stage III (n = 76, 17.4%), or stage IV (n = 93, 21.3%); A and B1 (n = 114, 26.1%) and B2 and B3 TET (n = 223, 51.0%); and thymic carcinoma (n = 100, 22.9%). In multivariable analyses, age, Masaoka-Koga stage IV, thymic carcinoma, and CT stages III and IV were significantly correlated with overall survival (p < 0.05), whereas adjuvant treatment, Masaoka-Koga stages III and IV, World Health Organization B2 and B3, thymic carcinoma, R2 resection, CT size, and CT stage IV were significantly associated with progression-free survival (p < 0.05). Computed tomography stages showed moderate association with Masaoka-Koga stages (K = 0.621). For TET, CT staging is effective in distinguishing both overall survival and progression-free survival, and patients with Masaoka-Koga stage IV or thymic carcinoma or CT stage IV have the worst prognosis. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
    The Annals of Thoracic Surgery 12/2014; 99(2). DOI:10.1016/j.athoracsur.2014.09.050 · 3.63 Impact Factor
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    ABSTRACT: Genetic polymorphism contributes to variation in response to drug treatment of depression. We conducted three independent 6-week treatment studies in outpatients with major depressive disorder (MDD) to develop a pharmacogenomic model predicting response and nonresponse. We screened candidate genomic markers for association with response to selective serotonin reuptake inhibitors (SSRIs). No patients had received any antidepressant drug treatment in the current episode of depression. Outcome evaluation was blinded to drug and genotype data. The prediction model derived from a development sample of 239 completer cases treated with SSRIs comprised haplotypes and polymorphisms related to serotonin synthesis, serotonin transport, glutamate receptors, and GABA synthesis. The model was evaluated prospectively for prediction of outcome in a validation sample of 176 new SSRI-treated completer cases. The model gave a prediction in 60% of these cases. Predictive values were 85% for predicted responders and 86% for predicted nonresponders, compared to prior probabilities of 66% for observed response and 34% for observed nonresponse in those cases (both P<0.001). Convergent cross-validation was obtained through failure of the model to predict outcomes in a third independent sample of 189 completer cases who received non-SSRI antidepressants. We suggest proof of principle for genetic guidance to use or avoid SSRIs in a majority of Korean depressed patients.
    PLoS ONE 09/2014; 9(9):e107098. DOI:10.1371/journal.pone.0107098 · 3.23 Impact Factor
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    ABSTRACT: Background The incidence, risk factors and management strategy of paradoxical reaction to midazolam during endoscopy are yet to be clarified. Methods This single center prospective study included 4140 adult patients (2263 males, mean age of 57.7 ± 12.6) undergoing endoscopy under sedation with midazolam and pethidine between September 2011 and December 2011. The characteristics of patients with and without paradoxical reaction were compared. For patients who experienced paradoxical reaction and received flumazenil, their endoscopic images were reviewed to assess whether European Society of Gastrointestinal Endoscopy guidelines were met as quality indicator of endoscopy. Results The incidence of paradoxical reaction was 1.4%. In multivariate analyses, male gender, unsuccessful sedation in previous endoscopy, upper endoscopy, higher dose of midazolam, and lower dose of pethidine were identified as independent risk factors for paradoxical reaction. Despite paradoxical reaction, endoscopic procedures were successfully completed in 93.3% of cases when flumazenil was administered. The rates of meeting quality indicator of endoscopy were 92.3% in patients receiving flumazenil for paradoxical reaction and 97.6% in patients without paradoxical reaction. Conclusions For patients with risk factors for paradoxical reaction, active use of pethidine with a dose reduction of midazolam might be helpful to prevent the occurrence of paradoxical reaction. Administration of flumazenil might be positively considered in cases of paradoxical reaction.
    Digestive and Liver Disease 08/2014; 46(8). DOI:10.1016/j.dld.2014.04.007 · 2.89 Impact Factor
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    ABSTRACT: The aim of this study was to both develop and validate a nomogram based on the Ki-67 index to predict recurrence. We constructed a nomogram using the Cox proportional hazards model with 953 N0 and N1 postoperative hormone receptor (HR)-positive breast cancer patients and validated it in an external cohort of 895 patients. A prognostic model that used classical variables, Adjuvant! Online, St. Gallen risk stratification, and the four immunohistochemistry (IHC) markers (IHC4 score) was created and assessed by the likelihood ratio χ(2) (LR-χ(2)) test using the bootstrapping method. The nomogram showed an area under the receiver operating characteristic curve (AUC) of 0.75 (95% CI 0.72-0.77) in the training set. The validation set showed good discrimination with an AUC of 0.63 (95% CI 0.60-0.66). In the LR-χ(2) test, the nomogram score was found to be more informative than the IHC4 with clinical score (CS) [LR-χ(2) 13.365 (1 d.f.); 95% CI 2.50-24.23 for CS-IHC4 + nomogram score vs. CS-IHC4] on distant recurrence-free survival. This study implies that the amount of prognostic information contained in the nomogram is superior to that in the CS-IHC4 score in HR-positive N0 and N1 breast cancer patients (NCT1273415). © 2014 S. Karger AG, Basel.
    Oncology 06/2014; 86(5-6):279-288. DOI:10.1159/000362281 · 2.61 Impact Factor
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    ABSTRACT: Objective Caregivers for patients with Alzheimer's disease (AD) suffer from psychological and financial burdens. However, the results of the relationship between burden and cognitive function, performance of activities of daily living, and depressive symptoms have remained inconsistent. Therefore, the aim of this study was to examine which factors are more significant predictors of heightened burden, cognitive impairment or functional decline, besides neuropsychiatric symptoms. Methods A cross-sectional study was conducted in a sample comprised of 1,164 pairs of patients with AD and caregivers from the Clinical Research of Dementia of South Korea study cohorts. The cognitive function of each sub-domain, functional impairments, depressive symptoms, and caregiver burden were assessed using the dementia version of Seoul Neuropsychological Screening Battery (SNSB-D), Barthel Index for Daily Living Activities (ADL), Seoul-Instrumental Activities of Daily Living (S-IADL), the Clinical Dementia Rating Sum of Box (CDR-SB), the Global Deterioration Scale (GDS), the Korean version of the Neuropsychiatric Inventory (K-NPI), and the 15-item Geriatric Depression Scale. Results We found that higher severity (higher CDR-SB and GDS scores) and more functional impairment (lower ADL and higher S-IADL scores) were significantly associated with higher caregiver burden. In addition, depressive symptoms of patients (higher Geriatric Depression Scale scores) were associated with higher caregiver burden. Conclusion Therefore, interventions to help maintain activities of daily living in patients with AD may alleviate caregiver burden and improve caregiver well-being.
    Psychiatry investigation 04/2014; 11(2):152-9. DOI:10.4306/pi.2014.11.2.152 · 1.15 Impact Factor
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    ABSTRACT: Endoscopic resection has become standard therapy for selected patients with early gastric carcinoma (EGC). However, the preoperative diagnostic accuracy for excluding submucosal (SM) invasion is not precise. Moreover, histologic features predicting SM invasion in gastric carcinomas (SMiGC) have not been studied extensively. Pre-treatment gastric biopsies from 60 patients with SM invasion who underwent endoscopic resection were reviewed and compared to 58 biopsies of lesions confirmed to be intramucosal carcinomas (IMC). For validation of the results, an independent cohort consisting of 616 gastric biopsies confirmed as EGC were analyzed. For statistical analyses, chi-square test, Fisher's exact test and multiple logistic progression tests were used. In the biopsy specimens of patients with SMiGCs, differentiated histology, poorly differentiated component, wisps of muscularis mucosa, tumor cribriforming, papillary architecture, desmoplasia and intraglandular eosinophilic necrotic debris (IEND) were observed in 96.7%, 36.7%, 16.7%, 16.7%, 23.3%, 40%, and 46.7% of cases, respectively, while the same features were observed in 100%, 5.2%, 0%, 1.7%, 5.2%, 19%, and 22.4% of biopsies with IMC. In multivariate analyses, poorly differentiated component [odds ratio (OR), 9.59, p = 0.002], IEND [OR, 6.23, p = 0.012], tumor cribriforming [OR, 4.66, p = 0.03] and papillary architecture [OR, 5.52, p = 0.018] were significantly associated with the detection of SM invasion. In the validation cohort, poorly differentiated component (p = 0.003) and papillary architecture (p = 0.008) remained significant. Poorly differentiated component and papillary architecture are significant histopathologic predictors of SM invasion in pretreatment gastric biopsies of lesions considered for endoscopic therapy. Additional prospective studies are warranted to confirm our findings.Virtual slide: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1588557731103084.
    Diagnostic Pathology 02/2014; 9(1):34. DOI:10.1186/1746-1596-9-34 · 2.41 Impact Factor
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    ABSTRACT: The impact of pretreatment nutritional status on the treatment outcome of non-Hodgkin lymphoma has never been explored. Among the 953 patients who were registered in a prospective cohort at Samsung Medical Center., we analyzed 262 patients who had been treated with Ruximab-cyclophosphamide, doxorubicin, vincristine, and prednisone for newly diagnosed diffuse large B-cell lymphoma (DLBCL) and for whom data were available regarding pretreatment nutritional status. Nutritional status at diagnosis was assessed by triceps skin fold (TSF), mid-arm muscle circumference (MAMC), body mass index (BMI), serum albumin, prealbumin, and transferrin. For patients aged 60 yr and older, poor performance and higher tumor burden were associated with malnourishment represented by albumin <3.5 g/dL, prealbumin < 17 g/dL, and transferrin <170 mg/L. Lower BMI (<20), serum albumin, prealbumin, and transferrin were identified as risk factors for febrile neutropenia in univariate analysis, but not in multivariate analysis. In the univariate analysis for OS, all nutritional parameters except MAMC showed a significant association with survival. However, BMI was the only parameter that was independently prognostic for OS in the multivariate analysis (P = 0.031; hazards ratio = 3.32). Nutritional insufficiency encountered in DLBCL patients might influence the occurrence of treatment-related toxicity and poor survival outcome of patients.
    Nutrition and Cancer 01/2014; 66(2). DOI:10.1080/01635581.2014.867065 · 2.47 Impact Factor
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    ABSTRACT: Gastric carcinoma is one of the major causes of cancer-related mortality worldwide. Early detection and treatment leads to an excellent prognosis in patients with early gastric cancer (EGC), whereas the prognosis of patients with advanced gastric cancer (AGC) remains poor. It is unclear whether EGCs and AGCs are distinct entities or whether EGCs are the beginning stages of AGCs. We performed whole exome sequencing of four samples from patients with EGC and compared the results with those from AGCs. In both EGCs and AGCs, a total of 268 genes were commonly mutated and independent mutations were additionally found in EGCs (516 genes) and AGCs (3104 genes). A higher frequency of C>G transitions was observed in intestinal-type compared to diffuse-type carcinomas (P = 0.010). The DYRK3, GPR116, MCM10, PCDH17, PCDHB1, RDH5 and UNC5C genes are recurrently mutated in EGCs and may be involved in early carcinogenesis.
    PLoS ONE 12/2013; 8(12):e82770. DOI:10.1371/journal.pone.0082770 · 3.23 Impact Factor
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    ABSTRACT: Paclitaxel and gemcitabine (PG) combination chemotherapy is effective as a maintenance chemotherapeutic regimen in metastatic breast cancer (MBC) patients because it increases progression-free survival (PFS), which increases overall survival (OS). The primary purpose of our study was to investigate the association between genetic polymorphisms in the genes involved in PG pathways and clinical outcomes in MBC patients treated with PG chemotherapy. A total of 324 MBC patients were enrolled in this prospective multicenter trial of PG as the first-line chemotherapy. Eighty-five of the 324 patients from two institutes were available for analysis of single nucleotide polymorphisms (SNPs). Germline DNA was extracted from peripheral blood mononuclear cells. Thirty-eight SNPs in 15 candidate genes selected from pathways that may influence the metabolism and transport of, or sensitivity, to PG were analysed. The median PFS and OS of all 324 patients were 8.7months (95% confidence interval [CI]: 7.5-9.6months) and 26.9months (95% CI: 23.6-30.1months), respectively. An SNP in SLC28A3 (rs7867504, C/T) was associated with OS (CC or CT versus TT: 37 versus 21months, p=0.027, hazard ratio [HR] 2.6, 95% CI: 1.1-6.3). SLC29A1 GA haplotype had a significantly shorter OS (p=0.030, HR 3.391, 95% CI: 1.13-10.19). RRM1 (ribonucleotide reductase large subunit M1) SNP (rs9937), and haplotypes ATAA and ATGA were significantly associated with neurotoxicity. Genetic polymorphisms in SLC28A3, SLC29A1 and RRM1 can influence the clinical outcome of MBC patients treated with PG chemotherapy. Further studies on the functional mechanisms relating to these germline polymorphisms in these genes are warranted.
    European journal of cancer (Oxford, England: 1990) 12/2013; 50(4). DOI:10.1016/j.ejca.2013.11.028 · 4.82 Impact Factor
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    ABSTRACT: PURPOSE We compared the diagnostic accuracy of co-registered whole body (WB) MRI-PET with that of WB PET-CT in determining the preoperative stage of non-small cell lung cancer (NSCLC). METHOD AND MATERIALS From January 2010 through November 2011, we prospectively enrolled 141 NSCLC patients (86 men, 55 women; mean age, 62 years) who had resectable disease on conventional staging using chest CT. They underwent whole body MRI including diffusion weighted MR imaging of the thorax and PET-CT, which were postprocessed for co-registration of MRI and PET. Two independent, blinded readers determined preoperative stage in the review of WB MRI-PET or PET-CT. Reference standards were obtained for T (n = 106) and N (n = 126) stages based on pathologic results, while M stage (n = 141) were obtained based on pathologic or follow-up imaging findings. The accurate staging, over staging, and under staging were compared by using the McNemar test. RESULTS The accuracy of TNM stage grouping were higher with WB MR-PET (95/141, 67%) than with PET-CT (82/141, 58%) (P =.009) and WB MR-PET significantly decreased the number of under stage (27% in PET-CT vs. 16% MR-PET, P <.001), not increasing the number of over stage (15% in PET-CT vs. 17% in MR-PET, P =.439). T stage was more accurate with MR-PET (81%) than PET-CT (72%) (P =.025) and MR-PET significantly decreased the number of under stage (12% in PET-CT vs. 5% in MR-PET, P =.020). The accuracy of N staging was not different between two modalities (71% in PET-CT vs. 70% in MR-PET, P =.782). The number of under stage was decreased with borderline significance (18% in PET-CT vs. 14% in MR-PET, P =.059). M staging was not different in number of accurate staging (87% in PET-CT vs. 90%, in MR-PET, P =.132) and over staging (1% in PET-CT vs. 3% in MR-PET, P =.317), but MR-PET significantly decreased the number of under stage (12% in PET-CT vs. 7% in MR-PET, P =.008). CONCLUSION WB MRI-PET can be a superior diagnostic modality to PET/CT for T and M staging of NSCLC. For N staging, both MRI-PET and PET-CT show comparable results. CLINICAL RELEVANCE/APPLICATION The development and application of simultaneous WB MRI-PET would be advantageous for the tumor evaluation and the detection of metastasis in cancer imaging and staging.
    Radiological Society of North America 2013 Scientific Assembly and Annual Meeting; 12/2013
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    ABSTRACT: Although peripherally-inserted central catheter (PICC) insertion is commonly performed under fluoroscopic guidance, few reports have addressed performance and dosimetry when PICC is inserted under C-arm fluoroscopy. To evaluate the risk factors of radiation dose in performing PICC insertion using flat panel detector-based mobile C-arm fluoroscopy and a conventional angiography machine. Ninety-eight patients underwent the PICC procedure using conventional angiography equipment (n=49) or flat panel detector-based mobile C-arm fluoroscopy (n=49). Data were prospectively analyzed from July to November 2012. Dose-area product (DAP), tube voltage, tube current, fluoroscopy time, and image quality measured on a 5-point scale were estimated and compared using appropriate statistical tests. There were no significant differences in tube voltage, fluoroscopy time, and image quality between conventional angiography and mobile C-arm fluoroscopy. DAP, mean arm tube current, and tube current in chest fluoroscopy were significantly lower in mobile C-arm fluoroscopy than using the conventional angiography machine (P <0.05). Multivariate analysis identified tube current in chest fluoroscopy, arm tube current, and fluoroscopy equipment as significant risk factors for elevated radiation dose in PICC insertion. PICC insertion can be performed using flat panel detector-based mobile C-arm fluoroscopy instead of a conventional angiography machine. Image quality and fluoroscopy time were not different between the two systems and the use of C-arm fluoroscopy significantly reduced radiation dose.
    Acta Radiologica 11/2013; 55(10). DOI:10.1177/0284185113514221 · 1.35 Impact Factor
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    ABSTRACT: Single nucleotide polymorphisms (SNP) are inter-individual genetic variations that could explain inter-individual differences of response/survival to chemotherapy. The present study was performed to build up a risk model for survival in 247 patients with acute myeloid leukaemia (AML) with normal karyotype (AML-NK). Genome-wide Affymetrix SNP array 6.0 was used for genotyping in discovery set (n = 118). After identifying significant SNPs for overall survival (OS) in single SNP analysis, a risk model was constructed. Out of 632 957 autosomal SNPs analysed, finally four SNPs (rs2826063, rs12791420, rs11623492 and rs2575369) were introduced into the risk model. The model could stratify the patients according to their OS in discovery set (P = 1·053656 × 10−4). Replication was performed using Sequenom platform for genotyping in the validation cohort (n = 129). The model incorporated with clinical and four SNP risk score was successfully replicated in a validation set (P = 5·38206 × 10−3). The integration of four SNPs and clinical factors into the risk model showed higher area under the curve (AUC) reults than in the model incorporating only clinical or only four SNPs, suggesting improved prognostic stratification power by combination of four SNPs and clinical factors. In conclusion, a genome-wide SNP-based risk model in 247 patients with AML-NK can identify a group of high risk patients with poor survival.
    British Journal of Haematology 10/2013; 163(1):62-71. DOI:10.1111/bjh.12492 · 4.96 Impact Factor

Publication Stats

2k Citations
337.64 Total Impact Points

Institutions

  • 2005–2015
    • MEDIPOST Biomedical Research Institute
      Sŏul, Seoul, South Korea
  • 2002–2015
    • Sungkyunkwan University
      • • Samsung Medical Center
      • • Department of Psychiatry
      • • School of Medicine
      • • Department of Radiology
      Sŏul, Seoul, South Korea
  • 2002–2014
    • Samsung Medical Center
      • • Department of Hematology and Oncology
      • • Department of Radiology
      Sŏul, Seoul, South Korea
  • 2004–2013
    • The Seoul Institute
      Sŏul, Seoul, South Korea
    • Hallym University
      Sŏul, Seoul, South Korea
  • 2011
    • Dongguk University
      • Department of Internal Medicine
      Seoul, Seoul, South Korea