1.In Vitro Analysis of Histology, Mechanics, and Safety of Radiationfree Pre-hydrated Human Acellular Dermal Matrix
Ji Young KIM ; Kyung Min YANG ; Ji Hyun YOUN ; Heejun PARK ; Hyung Min HAHN ; Il Jae LEE
Journal of Breast Cancer 2020;23(6):635-646
Purpose:
Acellular dermal matrix (ADM) supports tissue expanders or implants in implant-based breast reconstruction. The characteristics of ADM tissue are defined by the manufacturing procedure, such as decellularization, preservation, and sterilization, and are directly related to clinical outcomes. This study aimed to compare the properties of a new pre-hydrated-ADM (H-ADM-low) obtained using a decellularization reagent reduction process with a low concentration of detergent with those of radiation-sterilized H-ADM and freeze-dried ADM (FD-ADM).
Methods:
ADMs were evaluated in terms of structure, mechanical quality, and cytotoxicity using histochemical staining, tensile strength testing, and in vitro cell viability analysis.
Results:
The tissue structure of H-ADM-low (CGDERM ONE-STEP) was similar to that of native skin despite complete decellularization. By contrast, in FD-ADM, the tissue structure was damaged by the freeze-drying process, and radiation-sterilized H-ADM showed a compact fibrillar arrangement. Furthermore, matrix components such as collagen and elastin were preserved in H-ADM-low, whereas a loss of elastin fibers with fragmented distribution was observed in radiation-sterilized H-ADMs. H-ADM-low's tensile strength (58.84 MPa) was significantly greater than that of FD-ADM (38.60 MPa) and comparable with that of radiationsterilized H-ADMs. The residual detergent content in H-ADM-low (47.45 mg/L) was 2.67-fold lower than that of H-ADM decellularized with a conventional detergent concentration (126.99 mg/mL), and this finding was consistent with the cell viability results (90.7% and 70.7%, respectively), indicating that H-ADM-low has very low cytotoxicity.
Conclusions
H-ADM-low produced through aseptic processes retains the original tissue structure, demonstrates excellent mechanical properties, and does not affect cell viability.Therefore, this newer H-ADM is suitable for use in implant-based breast reconstruction.
2.Clear Cell Sarcoma of the Soft Tissue in the Distal Phalanx of the Great Toe:A Case Report
Heejun PARK ; Woo Young KANG ; Ok Hee WOO ; Aeree KIM
Journal of the Korean Society of Radiology 2024;85(6):1189-1193
Clear cell sarcoma (CCS) is a rare malignant soft tissue tumor originating from neural crest cells. Histologically resembling malignant melanoma but lacking cutaneous precursor lesions, CCS is characterized by a specific chromosomal translocation (t[12;22][q13;q12]). Primarily affecting young adults, this tumor typically arises in the extremities, especially the knee, foot, and ankle. To our knowledge, distal toe involvement is uncommon. Herein, we present a case initially diagnosed on magnetic resonance imaging as a superficial soft tissue tumor resembling malignant melanoma but subsequently confirmed as CCS of the great toe.
3.Clear Cell Sarcoma of the Soft Tissue in the Distal Phalanx of the Great Toe:A Case Report
Heejun PARK ; Woo Young KANG ; Ok Hee WOO ; Aeree KIM
Journal of the Korean Society of Radiology 2024;85(6):1189-1193
Clear cell sarcoma (CCS) is a rare malignant soft tissue tumor originating from neural crest cells. Histologically resembling malignant melanoma but lacking cutaneous precursor lesions, CCS is characterized by a specific chromosomal translocation (t[12;22][q13;q12]). Primarily affecting young adults, this tumor typically arises in the extremities, especially the knee, foot, and ankle. To our knowledge, distal toe involvement is uncommon. Herein, we present a case initially diagnosed on magnetic resonance imaging as a superficial soft tissue tumor resembling malignant melanoma but subsequently confirmed as CCS of the great toe.
4.Clear Cell Sarcoma of the Soft Tissue in the Distal Phalanx of the Great Toe:A Case Report
Heejun PARK ; Woo Young KANG ; Ok Hee WOO ; Aeree KIM
Journal of the Korean Society of Radiology 2024;85(6):1189-1193
Clear cell sarcoma (CCS) is a rare malignant soft tissue tumor originating from neural crest cells. Histologically resembling malignant melanoma but lacking cutaneous precursor lesions, CCS is characterized by a specific chromosomal translocation (t[12;22][q13;q12]). Primarily affecting young adults, this tumor typically arises in the extremities, especially the knee, foot, and ankle. To our knowledge, distal toe involvement is uncommon. Herein, we present a case initially diagnosed on magnetic resonance imaging as a superficial soft tissue tumor resembling malignant melanoma but subsequently confirmed as CCS of the great toe.
5.Regression of an Enchondroma of the Hand: A Case Report
Heejun PARK ; Woo Young KANG ; Ok Hee WOO ; Wooyoung JANG
Investigative Magnetic Resonance Imaging 2024;28(3):148-152
Enchondromas are common benign bone tumors of the hand and are typically located in the medullary cavity of the metaphysis of the tubular bones. Typical radiological findings reveal cartilage lobules with ring and arc calcifications and entrapped normal medullary fat. The regression of an existing enchondroma, in which the cartilage lobules are replaced by fatty marrow, is considered unusual. Only a few studies have been reported on long tubular bones. Herein, we report an unusual case of a 73-year-old man with an enchondroma in the hand. In this case, a histologic appearance of the enchondroma exhibited loss of matrix mineralization, which corresponded to replacement by marrow fat revealed by magnetic resonance imaging.
6.Risk Factors for Emergency Room Visits Among Patients With Head and Neck Cancer: A Longitudinal Cohort Study Within the Korean Healthcare System
Heejun YI ; Hyojun KIM ; Younghac KIM ; Ye-Jin SUH ; Joo Hyun PARK ; Nayeon CHOI ; Han-Sin JEONG
Clinical and Experimental Otorhinolaryngology 2025;18(1):64-72
Objectives:
. A substantial proportion of patients with head and neck cancer (HNC) require emergency room (ER) visits or unplanned hospitalizations during or after treatment with various modalities. We investigated HNC cases that necessitated ER visitation after cancer treatment, aiming to identify potential risk factors in the context of the Korean healthcare system.
Methods:
. This single-center cohort study examined patients with HNC who received cancer treatments at Samsung Medical Center in 2019 (n=566). Treatment modalities included surgery alone (n=184), surgery and adjuvant therapy (n=138), curative non-surgical treatment such as radiation or chemoradiation (n=209), and palliative treatments (n=35). We followed these cases for up to 3 years, focusing on those who visited the ER during or after cancer treatment, and analyzed the primary reasons and risk factors associated with these visits.
Results:
. The ER visitation rate was 8.0% (n=45) among patients with HNC, with a total of 70 ER visits (12.4%; mean, 1.56; range, 1–4). The rate of treatment-related ER visitation was 4.6%. Common reasons for ER visits included surgical site or wound complications (31.1% of patients visiting the ER, 22.9% of ER visits) and issues with oral intake or feeding (22.2% of patients, 31.4% of visits). Significant risk factors for ER visits included tumor subsite (with hypopharyngeal cancer associated with a 17.9% rate of treatment-related ER visits), tumor stage (T2–4, 8.6%–12.2%; N+ status, 6.7%), and treatment modality (surgery with adjuvant chemoradiation, 19.4%). Patient age and comorbidities did not represent significant factors.
Conclusion
. The most frequent reasons for ER visits among patients with HNC included complications with wounds and feeding. Additionally, tumor characteristics and treatment modality were independent risk factors for ER visits. Adequate planning and management to address these issues could potentially decrease the number of ER visits, lower costs, and improve patient care.
7.Risk Factors for Emergency Room Visits Among Patients With Head and Neck Cancer: A Longitudinal Cohort Study Within the Korean Healthcare System
Heejun YI ; Hyojun KIM ; Younghac KIM ; Ye-Jin SUH ; Joo Hyun PARK ; Nayeon CHOI ; Han-Sin JEONG
Clinical and Experimental Otorhinolaryngology 2025;18(1):64-72
Objectives:
. A substantial proportion of patients with head and neck cancer (HNC) require emergency room (ER) visits or unplanned hospitalizations during or after treatment with various modalities. We investigated HNC cases that necessitated ER visitation after cancer treatment, aiming to identify potential risk factors in the context of the Korean healthcare system.
Methods:
. This single-center cohort study examined patients with HNC who received cancer treatments at Samsung Medical Center in 2019 (n=566). Treatment modalities included surgery alone (n=184), surgery and adjuvant therapy (n=138), curative non-surgical treatment such as radiation or chemoradiation (n=209), and palliative treatments (n=35). We followed these cases for up to 3 years, focusing on those who visited the ER during or after cancer treatment, and analyzed the primary reasons and risk factors associated with these visits.
Results:
. The ER visitation rate was 8.0% (n=45) among patients with HNC, with a total of 70 ER visits (12.4%; mean, 1.56; range, 1–4). The rate of treatment-related ER visitation was 4.6%. Common reasons for ER visits included surgical site or wound complications (31.1% of patients visiting the ER, 22.9% of ER visits) and issues with oral intake or feeding (22.2% of patients, 31.4% of visits). Significant risk factors for ER visits included tumor subsite (with hypopharyngeal cancer associated with a 17.9% rate of treatment-related ER visits), tumor stage (T2–4, 8.6%–12.2%; N+ status, 6.7%), and treatment modality (surgery with adjuvant chemoradiation, 19.4%). Patient age and comorbidities did not represent significant factors.
Conclusion
. The most frequent reasons for ER visits among patients with HNC included complications with wounds and feeding. Additionally, tumor characteristics and treatment modality were independent risk factors for ER visits. Adequate planning and management to address these issues could potentially decrease the number of ER visits, lower costs, and improve patient care.
8.Risk Factors for Emergency Room Visits Among Patients With Head and Neck Cancer: A Longitudinal Cohort Study Within the Korean Healthcare System
Heejun YI ; Hyojun KIM ; Younghac KIM ; Ye-Jin SUH ; Joo Hyun PARK ; Nayeon CHOI ; Han-Sin JEONG
Clinical and Experimental Otorhinolaryngology 2025;18(1):64-72
Objectives:
. A substantial proportion of patients with head and neck cancer (HNC) require emergency room (ER) visits or unplanned hospitalizations during or after treatment with various modalities. We investigated HNC cases that necessitated ER visitation after cancer treatment, aiming to identify potential risk factors in the context of the Korean healthcare system.
Methods:
. This single-center cohort study examined patients with HNC who received cancer treatments at Samsung Medical Center in 2019 (n=566). Treatment modalities included surgery alone (n=184), surgery and adjuvant therapy (n=138), curative non-surgical treatment such as radiation or chemoradiation (n=209), and palliative treatments (n=35). We followed these cases for up to 3 years, focusing on those who visited the ER during or after cancer treatment, and analyzed the primary reasons and risk factors associated with these visits.
Results:
. The ER visitation rate was 8.0% (n=45) among patients with HNC, with a total of 70 ER visits (12.4%; mean, 1.56; range, 1–4). The rate of treatment-related ER visitation was 4.6%. Common reasons for ER visits included surgical site or wound complications (31.1% of patients visiting the ER, 22.9% of ER visits) and issues with oral intake or feeding (22.2% of patients, 31.4% of visits). Significant risk factors for ER visits included tumor subsite (with hypopharyngeal cancer associated with a 17.9% rate of treatment-related ER visits), tumor stage (T2–4, 8.6%–12.2%; N+ status, 6.7%), and treatment modality (surgery with adjuvant chemoradiation, 19.4%). Patient age and comorbidities did not represent significant factors.
Conclusion
. The most frequent reasons for ER visits among patients with HNC included complications with wounds and feeding. Additionally, tumor characteristics and treatment modality were independent risk factors for ER visits. Adequate planning and management to address these issues could potentially decrease the number of ER visits, lower costs, and improve patient care.
9.Small Multi-Gene DNA Panel Can Aid in Reducing the Surgical Resection Rate and Predicting the Malignancy Risk of Thyroid Nodules
Moon Young OH ; Hye-Mi CHOI ; Jinsun JANG ; Heejun SON ; Seung Shin PARK ; Minchul SONG ; Yoo Hyung KIM ; Sun Wook CHO ; Young Jun CHAI ; Woosung CHUNG ; Young Joo PARK
Endocrinology and Metabolism 2024;39(5):777-792
Background:
We explored the utility of a small multi-gene DNA panel for assessing molecular profiles of thyroid nodules and influencing clinical decisions by comparing outcomes between tested and untested nodules.
Methods:
Between April 2022 and May 2023, we prospectively performed fine-needle aspiration (FNA) with gene testing via DNA panel of 11 genes (BRAF, RAS [NRAS, HRAS, KRAS], EZH1, DICER1, EIF1AX, PTEN, TP53, PIK3CA, TERT promoter) in 278 consecutive nodules (panel group). Propensity score-matching (1:1) was performed with 475 nodules that consecutively underwent FNA without gene testing between January 2021 and December 2021 (control group).
Results:
In the panel group, positive call rate for mutations was 41.7% (BRAF 16.2%, RAS 12.6%, others 11.5%, double mutation 1.4%) for all nodules, and 40.0% (BRAF 4.3%, RAS 19.1%, others 15.7%, double mutation 0.9%) for indeterminate nodules. Benign call rate was 69.8% for all nodules, and 75.7% for indeterminate nodules. In four nodules, additional TP53 (in addition to BRAF or EZH1) or PIK3CA (in addition to BRAF or TERT) mutations were co-detected. Sensitivity, specificity, positive predictive value, and negative predictive value were 80.0%, 53.3%, 88.1%, 38.1% for all nodules, and 78.6%, 45.5%, 64.7%, 62.5% for indeterminate nodules, respectively. Panel group exhibited lower surgical resection rates than the control group for all nodules (27.0% vs. 52.5%, P<0.001), and indeterminate nodules (23.5% vs. 68.2%, P<0.001). Malignancy risk was significantly different between the panel and control groups (81.5% vs. 63.9%, P=0.008) for all nodules.
Conclusion
Our panel aids in managing thyroid nodules by providing information on malignancy risk based on mutations, potentially reducing unnecessary surgery in benign nodules or patients with less aggressive malignancies.