Mi Ryung Roh

Harvard Medical School, Boston, Massachusetts, United States

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Publications (81)175.28 Total impact

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    Annals of Dermatology 04/2015; 27(2):218-20. DOI:10.5021/ad.2015.27.2.218 · 0.95 Impact Factor
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    Tae Hyung Kim, Ji Hye Lee, Mi Ryung Roh
    Annals of Dermatology 04/2015; 27(2):237-8. DOI:10.5021/ad.2015.27.2.237 · 0.95 Impact Factor
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    ABSTRACT: Sinonasal mucosal melanoma (SMM) is an aggressive and rare type of melanoma. Although the classic RAS-RAF-MEK pathway is thought to be the main pathway involved in melanoma pathogenesis, genetic alterations in the PI3K-AKT pathway, including PTEN-regulated signaling, are also thought to contribute. So far, data regarding altered PTEN expression and epigenetic mechanism of PTEN silencing in development of SMM is extremely limited. Herein we report on a case of SMM with liver and bone metastases with an epigenetic alteration of PTEN. Results of mutation analysis for BRAF, NRAS, HRAS, KRAS, PIK3CA, C-kit, and PTEN were negative, however, methylation of PTEN CpG islands was observed. Our case not only supports PTEN as a major tumor suppressor involved in melanoma tumorigenesis, but also a potential epigenetic mechanism of PTEN silencing in development of SMM.
    Cancer Research and Treatment 03/2015; DOI:10.4143/crt.2014.356 · 2.98 Impact Factor
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    ABSTRACT: Dermatofibrosarcoma protuberans (DFSP) carries a translocation resulting in the collagen type I alpha 1 (COL1A1)-platelet-derived growth factor beta (PDGFB) fusion gene, which is responsible for PDGFB activation. The purpose of this study is to evaluate the clinicopathological, genetic, and therapeutic features of DFSP in Korean patients. Clinicopathological features of 37 patients with DFSP were reviewed. Multiplex reverse transcriptase-polymerase chain reaction (PCR) was carried out in 16 patients using formalin-fixed, paraffin-embedded tissues and specific primers for COL1A1 and PDGFB. The mean age of 37 patients was 37.4 years old. The most common tumor location was the trunk. All patients were treated primarily with surgery: 34 (91.7%) cases with Mohs micrographic surgery (MMS) and 3 (8.3%) cases with wide local excision. The median follow-up time was 33.7 months. Two patients, one in each treatment group, demonstrated local recurrence during the follow-up period. The COL1A1-PDGFB fusion gene was expressed in 14 (87.5%) cases, demonstrated by reverse transcriptase PCR analysis. No association was found among the different COL1A1-PDGFB fusion transcripts, the various histological subtypes and clinical features. Our results support the effectiveness of MMS in treating DFSP. The COL1A1-PDGFB fusion transcript was observed in 87.5% of patients. Therefore, COL1A1-PDGFB is a useful and accurate tool in diagnosing DFSP in Koreans.
    Yonsei Medical Journal 03/2015; 56(2):440-6. DOI:10.3349/ymj.2015.56.2.440 · 1.26 Impact Factor
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    ABSTRACT: There is no standard second-line regimen for malignant melanoma patients with disease progression after first-line chemotherapy, and platinum-alkylating agents combined with paclitaxel have shown modest efficacy. We conducted a phase II, open-label, single-arm study to test the efficacy of docetaxel combined with carboplatin for malignant melanoma patients who failed previous treatment with dacarbazine. Intravenous docetaxel (35 mg/m2 on days 1 and 8 of each cycle) and carboplatin (area under the curve [AUC] 3 on days 1 and 8 of each cycle) was administered every 21 days. Primary end point was objective response rate (ORR). (ClinicalTrials.gov number NCT02223884). Thirty patients were enrolled in the study, and the median follow-up duration was 19.8 months. Among 25 per-protocol patients, there were three responders (one with complete response [CR] and two with partial response [PR]) and 17 stable disease (SD) patients (ORR = 12.0%). Among the per-protocol population, the median progression free survival (PFS) was 4.3 months and the median overall survival (OS) was 9.6 months. Uveal melanoma patients (n=9) showed the best prognosis compared to other subtypes (median PFS 7.6 months and OS 9.9 months). The most common grade 3 or 4 adverse event was neutropenia (n=15, 50.0%). Docetaxel combined with carboplatin showed association with an acceptable safety profile and overall efficacy for patients with malignant melanoma who had progressed on chemotherapy containing dacarbazine.
    Cancer Research and Treatment 02/2015; DOI:10.4143/crt.2014.261 · 2.98 Impact Factor
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    ABSTRACT: The incidence of cutaneous melanoma (CM) continues to increase in the Caucasian population in the United States. In 2014, women only accounted for 42% of the 76,100 new melanoma cases and only 33% of the 9,710 deaths associated with CM in the US.(1) These trends are consistently observed in populations around the world. Indeed, gender disparity in melanoma outcome is so consistently observed that gender has been suggested as an important prognostic factor in melanoma, despite not being formerly incorporated in staging algorithms.(2) The source of this gender disparity in melanoma remains unclear but likely represents both biological and behavioral etiologies. Herein, we review the current knowledge of how melanoma differs between men and women.
    02/2015; 1(1):21-25. DOI:10.1016/j.ijwd.2015.01.001
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    ABSTRACT: Pigmented mammary Paget disease is a very rare clinicopathologic variant of mammary Paget disease. Diagnosis is often difficult because its clinical and histological features are very similar to those of malignant melanoma. Herein, we report a case of pigmented mammary Paget disease misdiagnosed as malignant melanoma.
    Annals of Dermatology 12/2014; 26(6):747-750. DOI:10.5021/ad.2014.26.6.747 · 0.95 Impact Factor
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    ABSTRACT: Surgical scars are crucial cosmetic problem, especially when in exposed areas such as the anterior neck following thyroidectomy. To evaluate the impact of post-thyroidectomy scars on quality of life (QoL) of thyroid cancer patients and identify the relationship between scar characteristics and QoL. Patients with post-thyroidectomy scars on the neck were recruited. QoL was measured using the Dermatology Life Quality Index (DLQI). Scar characteristics were graded according to Vancouver scar scale (VSS) score. Ninety-seven patients completed a battery of questions at the time of enrollment. Post-thyroidectomy scars were classified according to morphology as linear flat scars, linear bulging scars, hypertrophic scars or adhesive scars. There were 32 patients (33.0%), 9 patients (9.3%), 41 patients (42.3%) and 15 patients (15.5%), respectively, in each group. The mean total DLQI score was 9.02. Domain 2 (daily activities, 2.87 points), which includes questions about clothing, was the most greatly impacted among patients. The total DLQI scores of patients who have experienced scar-related symptoms were significantly higher than those of patients without symptoms (p<0.05). The VSS scores were 3.09 for linear flat scars, 6.89 for linear bulging scars, 6.29 for hypertrophic scars and 5.60 for adhesive scars. However, the DLQI scores did not significantly differ among scar types or VSS scores. Post-thyroidectomy scars on the neck affect the QoL of thyroid cancer patients regardless of scar type. Therefore, clinicians should pay attention to the psychological effects of scars on patients and take care to minimize post-thyroidectomy scar.
    Annals of Dermatology 12/2014; 26(6):693-699. DOI:10.5021/ad.2014.26.6.693 · 0.95 Impact Factor
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    ABSTRACT: Melanoma of unknown primary (MUP) is a condition of metastatic melanoma without a primary lesion. We sought to identify the prognosis of MUP compared with melanoma of known primary (MKP). We searched for observational studies containing at least 10 patients with MUP from MEDLINE and EMBASE from inception to December 22, 2012. The outcomes of interest were overall and disease-free survival; meta-analyses of hazard ratio stratified by stage using a random effects model were performed. In addition, second systematic review identified risk factors influencing the survival of patients with MUP. Eighteen studies including 2084 patients with MUP and 5894 with MKP were included. MUP had a better overall survival compared with MKP in stage III (15 studies; hazard ratio 0.83, 95% confidence interval 0.73-0.96, P = .010) and stage IV (6 studies; hazard ratio 0.85, 95% confidence interval 0.75-0.96, P = .008). Secondly, 22 studies including 3312 patients with MUP were reviewed, and increased stage and old age were the risk factors in patients with MUP. Diverse observational studies were reviewed, and selection and reporting biases are possible. The current meta-analyses suggest better survival outcomes in patients with MUP than those in patients with MKP with the same corresponding tumor stage. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
    Journal of the American Academy of Dermatology 11/2014; 72(1). DOI:10.1016/j.jaad.2014.09.029 · 5.00 Impact Factor
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    ABSTRACT: BackgroundGenetic alterations have been identified in melanomas according to different levels of sun exposure. Whereas the conventional morphology-based classification provides a clue for tumor growth and prognosis, the new classification by genetic alterations offers a basis for targeted therapy.ObjectiveThe purpose of this study is to demonstrate the biological behavior of melanoma subtypes and compare the two classifications in the Korean population.MethodsA retrospective chart review was performed on patients found to have malignant melanoma in Severance Hospital from 2005 to 2012. Age, sex, location of the tumor, histologic subtype, tumor depth, ulceration, lymph node invasion, visceral organ metastasis, and overall survival were evaluated.ResultsOf the 206 cases, the most common type was acral melanoma (n=94, 45.6%), followed by nonchronic sun damage-induced melanoma (n=43, 20.9%), and mucosal melanoma (n=40, 19.4%). Twenty-one patients (10.2%) had the chronic sun-damaged type, whereas eight patients (3.9%) had tumors of unknown primary origin. Lentigo maligna melanoma was newly classified as the chronic sun-damaged type, and acral lentiginous melanoma as the acral type. More than half of the superficial spreading melanomas were newly grouped as nonchronic sun-damaged melanomas, whereas nodular melanoma was rather evenly distributed.ConclusionThe distribution of melanomas was largely similar in both the morphology-based and sun exposure-based classifications, and in both classifications, mucosal melanoma had the worst 5-year survival owing to its tumor thickness and advanced stage at the time of diagnosis.
    Annals of Dermatology 08/2014; 26(4):485-90. DOI:10.5021/ad.2014.26.4.485 · 0.95 Impact Factor
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    ABSTRACT: Background: Matrix metalloproteinase (MMP), tissue inhibitor of metalloproteinase (TIMP), and membrane-type 1 matrix metalloproteinase (MT1-MMP) are thought to be involved in the destruction of basement membrane and stromal invasion by cancer cells. Objective: The aim of this study was to identify and compare MMP and TIMP expression in internal malignancies and paired cutaneous metastatic lesions. Materials and Methods: We compared the expression of MMP-2, MMP-9, MT1-MMP, and TIMP-2 in the internal malignancy and paired cutaneous metastatic lesion using immunohistochemical stains. Results: The cutaneous metastatic lesions expressed significantly more MMP-2, MMP-9, and MT1-MMP and significantly less TIMP-2 than did the paired internal malignancies. In breast cancer, cutaneous metastatic lesions expressed significantly more MMP-9 and significantly less TIMP-2 than did the primary breast cancer lesion. In lung cancer, the cutaneous metastatic lesion expressed significantly more MMP-2 and MT1-MMP than did the primary lesion. In stomach cancer, the cutaneous metastatic lesion expressed significantly less TIMP-2 than did the primary lesion. Conclusions: Our study demonstrates that cutaneous metastatic lesions have different MMPs and TIMP-2 expression patterns compared with their paired internal malignancies. Also, MMPs and TIMP-2 expression differs according to the type of primary cancer.
    American Journal of Dermatopathology 07/2014; 37(5). DOI:10.1097/DAD.0000000000000184 · 1.43 Impact Factor
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    ABSTRACT: Runt-related transcription factor 3 (RUNX3) has recently been reported to be a possible predictor of sensitivity of cancer cells for photodynamic therapy (PDT), a promising therapeutic modality for keloids. In this study, we aimed to elucidate the implications of RUNX3 for keloid pathogenesis and sensitivity to pheophorbide a-based PDT (Pa-PDT). RUNX3 and proliferating cell nuclear antigen (PCNA) expression were examined in 6 normal skin samples and 32 keloid tissue samples by immunohistochemistry. We found that RUNX3 expression was detected more often in keloid tissues than in dermis of normal skin. In keloid tissues, RUNX3 expression was significantly increased in patients presenting with symptoms of pain or pruritus, and was also significantly related to PCNA expression. The therapeutic effect of Pa-PDT was comparatively investigated in keloid fibroblasts (KFs) with and without RUNX3 expression. Significant differences were found after Pa-PDT between KFs with and without RUNX3 expression in cell viability, proliferative ability, type I collagen expression, generation of reactive oxygen species (ROS), and apoptotic cell death. In addition, RUNX3 expression was significantly decreased after Pa-PDT in KFs, and KFs with downregulation of RUNX3 showed significantly increased cell viability after Pa-PDT. Pa-PDT may be a potential therapeutic modality for keloids, and RUNX3, as a possible contributor to keloid pathogenesis, may improve sensitivity to Pa-PDT in KFs.
    Lasers in Medical Science 06/2014; 30(1). DOI:10.1007/s10103-014-1614-4 · 2.42 Impact Factor
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    ABSTRACT: Background: A number of reports have been published regarding the use of imiquimod for the treatment of melanoma in situ and metastatic melanoma. Essential steps in the process of melanoma invasion and metastasis include degradation of basement membranes and remodeling of the extracellular matrix by proteolytic enzymes, including matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). Objective: To evaluate the anti-invasive effect of imiquimod in human malignant melanoma cell lines, SK-MEL-2 and SK-MEL-24, in vitro, and to investigate imiquimod-induced changes in the expression of MMPs and TIMPs. Methods: Invasiveness of melanoma cell lines following imiquimod treatment was evaluated by invasion assays. In order to investigate the mechanism of the anti-invasive effect of imiquimod, m RNA and protein levels of MMP-2, -9, membrane type 1 (MT1)-MMP, TIMP-1, and -2 were assessed by real-time reverse transcription-polymerase chain reaction, gelatin zymography, and western blotting. Results: Imiquimod treatment decreased in vitro viability of melanoma cells in a concentration-dependent manner. Imiquimod also elicited a concentration-dependent suppress- ion of invasion in both melanoma cell lines. A concentration-dependent decrease in MMP-2 and MT1-MMP protein levels and a concentration-dependent increase in TIMP-1 and -2 protein levels by imiquimod was observed in both melanoma cell lines. However, expression of MMP-9 protein was increased in SK-MEL-2 but decreased in SK-MEL-24 with increasing imiquimod concentrations. Imiquimod elicited alterations in MMPs and TIMPs mRNA levels that parallel the observed changes in protein levels. Conclusion: Imiquimod may elicit an anti-invasive effect on human melanoma cells by regulating MMPs and TIMPs.
    Annals of Dermatology 06/2014; 26(3):363-73. DOI:10.5021/ad.2014.26.3.363 · 0.95 Impact Factor
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    ABSTRACT: Glutathione peroxidase 3 (GPX3) is a member of the glutathione peroxidase family of selenoproteins and is one of the key defensive enzymes against oxidative damages to host cells. Downregulation of GPX3 due to its promoter hypermethylation has been documented in several different types of cancer, indicating that GPX3 functions as a possible tumor suppressor. In the present study, we showed that GPX3 is also significantly downregulated in cervical cancer tissues compared to normal cervical tissues by qRT-PCR analyses and immunohistostainings. GPX3 expression was significantly related to lymph node metastasis and prognosis in cervical cancer patients. Treatment of cervical cancer cells with 5-aza-2'-deoxycytidine restored the expression of GPX3 and methylation-specific PCR (MSP) confirmed the CpG methylation of the GPX3 gene. Our results indicate that promoter methylation is one of the major causes of GPX3 downregulation in cervical cancer and GPX3 could serve as a predictive biomarker for lymph node metastasis and prognosis of cervical cancer.
    Oncology Reports 04/2014; 31(6). DOI:10.3892/or.2014.3152 · 2.19 Impact Factor
  • International journal of dermatology 04/2014; 53(4):e240-2. DOI:10.1111/j.1365-4632.2011.04897.x · 1.23 Impact Factor
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    International journal of dermatology 03/2014; 53(7). DOI:10.1111/ijd.12323 · 1.23 Impact Factor
  • The Journal of Dermatology 12/2013; 41(1). DOI:10.1111/1346-8138.12338 · 2.35 Impact Factor
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    ABSTRACT: Background: For periorbital rejuvenation, injection of botulinum toxin A (BoNT/A) is known to improve both static as well as dynamic wrinkles. A microneedle fractional radiofrequency (MFR) device was recently developed and is a novel and promising tool. Objective: This study compares the effects of these two treatment modalities on periorbital static wrinkles and lines. Methods: Twelve healthy women aged 20-59 years with periorbital wrinkles participated in this study. Each patient received one session of intradermal injection of BoNT/A on the left periorbital area and three sessions of MFR on the right. Clinical improvement, skin elasticity and subjective satisfaction were evaluated at every visit (baseline, 3, 6 and 18 weeks). Results: BoNT/A injection showed superior effects at 3 and 6 weeks. However, the MFR device showed better improvement at 18 weeks. In skin biopsies, the expression of procollagen 3 and elastin was increased on the MFR side compared to the untreated skin and the BoNT/A injection side. The patient satisfaction surveys at 3 weeks showed better satisfaction on the BoNT/A treatment side compared to the MFR treatment side. At 18 weeks, there were no significant differences in patient satisfaction between the two sides. Conclusion: BoNT/A injection rapidly improved periorbital wrinkles, but the effect decreased up to week 18. Compared to BoNT/A injection, MFR therapy showed gradual and long-term improvement in periorbital rejuvenation. © 2013 S. Karger AG, Basel.
    Dermatology 11/2013; 227(4). DOI:10.1159/000356162 · 1.69 Impact Factor
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    ABSTRACT: Postoperative adhesive symptoms (swallowing difficulty or pulling sensation during neck extension) are one of the major complications of thyroidectomy. Moreover, adhesive scars are often visible and cause cosmetic concerns. To evaluate the efficacy and safety of combined treatment with surgical subcision and intralesional corticosteroid injection for postoperative adhesive thyroidectomy scars. A retrospective analysis was performed of 16 Korean patients with postoperative adhesive thyroidectomy scars treated with three sessions of surgical subcision and intralesional corticosteroid injection. The Vancouver Scar Scale score decreased significantly after treatment (P < .001). Follow-up revealed that six of the 16 patients (37.5%) had clinical improvement of 51% to 75%, six (37.5%) had moderate clinical improvement of 26% to 50%, and three (18.8%) had improvement of 76% to 100%; one patient (6.3%) demonstrated minimal to no improvement. After three sessions of treatment, the mean clinical improvement grade was 2.68, which means moderate to marked improvement compared to before treatment. Post-treatment erythema was observed in most patients, and notable bruising after treatment observed in five patients resolved spontaneously within 7 days. Combined treatment with surgical subcision and intralesional corticosteroid injection is a cost-effective and minimally invasive treatment for postoperative adhesive thyroidectomy scars.
    Dermatologic Surgery 11/2013; 39(12). DOI:10.1111/dsu.12361 · 1.56 Impact Factor
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    ABSTRACT: Wrinkle formation usually accompanies skin aging. In particular, accentuated nasolabial folds and loss of elasticity are early signs of skin aging. The use of 1,444-nm pulsed neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers has increased in popularity. To evaluate the safety and efficacy of a novel 1,444-nm pulsed Nd:YAG laser in the treatment of NLF and cheek laxity using subdermal laser therapy. Ten Korean patients with moderate to severe NLF were enrolled. Each received a single treatment session with a 1,444-nm Nd:YAG laser. Two blinded physicians evaluated clinical improvement by rating comparative photographs on a 5-point scale. Efficacy was also assessed by measuring elasticity and roughness. Skin biopsies were performed on five volunteers before treatment and 3 months after treatment. The 1,444-nm Nd:YAG laser effectively promoted clinical improvement of NLF and cheek laxity (p < .05). Significant differences in elasticity and roughness were observed (p < .05). Epidermal proliferation was stimulated as demonstrated by increases in epidermal thickness and Ki-67 expression (p < .05). Quantitative image analyses of pre- and post-treatment biopsies revealed that collagen fibers increased from baseline (p > .05). Transforming growth factor beta and heat shock protein-70 messenger RNA levels quantified using real-time reverse transcriptase polymerase chain reaction increased significantly from baseline (p < .05). The 1,444-nm Nd:YAG laser is an effective treatment modality with minimal complications for the treatment of NLF and cheek laxity, but further research with a larger group of patients is needed to confirm these findings.
    Dermatologic Surgery 07/2013; 39(7):1067-78. DOI:10.1111/dsu.12183 · 1.56 Impact Factor

Publication Stats

262 Citations
175.28 Total Impact Points

Institutions

  • 2015
    • Harvard Medical School
      • Department of Dermatology
      Boston, Massachusetts, United States
    • Wonju Severance Christian Hospital
      Genshū, Gangwon-do, South Korea
  • 2005–2015
    • Yonsei University Hospital
      • Department of Internal Medicine
      Sŏul, Seoul, South Korea
  • 2006–2014
    • Yonsei University
      • Cutaneous Biology Research Institute
      Sŏul, Seoul, South Korea