1.Connective tissue disease is associated with the risk of posterior reversible encephalopathy syndrome following lung transplantation in Korea
Tae Jung KIM ; Hyun Joo LEE ; Samina PARK ; Sang-Bae KO ; Soo-Hyun PARK ; Seung Hwan YOON ; Kwon Joong NA ; In Kyu PARK ; Chang Hyun KANG ; Young Tae KIM ; Sun Mi CHOI ; Jimyung PARK ; Joong-Yub KIM ; Hong Yeul LEE
Acute and Critical Care 2025;40(1):79-86
Background:
Posterior reversible encephalopathy syndrome (PRES) is a rare complication of lung transplantation with poorly understood risk factors and clinical characteristics. This study aimed to examine the occurrence, risk factors, and clinical data of patients who developed PRES following lung transplantation.
Methods:
A retrospective analysis was conducted on 147 patients who underwent lung transplantation between February 2013 and December 2023. The patients were diagnosed with PRES based on the clinical symptoms and radiological findings. We compared the baseline characteristics and clinical information, including primary lung diseases and immunosuppressive therapy related to lung transplantation operations, between the PRES and non-PRES groups.
Results:
PRES manifested in 7.5% (n=11) of the patients who underwent lung transplantation, with a median onset of 15 days after operation. Seizures were identified as the predominant clinical manifestation (81.8%, n=9) in the group diagnosed with PRES. All patients diagnosed with PRES recovered fully. Patients with PRES were significantly associated with connective tissue disease-associated interstitial lung disease (45.5% vs. 18.4%, P=0.019, odds ratio=9.808; 95% CI, 1.064–90.386; P=0.044). Nonetheless, no significant variance was observed in the type of immunotherapy, such as the use of calcineurin inhibitors, blood pressure, or acute renal failure subsequent to lung transplantation.
Conclusions
PRES typically manifests shortly after lung transplantation, with seizures being the predominant initial symptom. The presence of preexisting connective tissue disease as the primary lung disease represents a significant risk factor for PRES following lung transplantation.
2.Non-Arteritic Ischemic Optic Neuropathy Following COVID-19 Vaccination in Korea: A Case Series
Yeji MOON ; Jae Ho JUNG ; Hyun Jin SHIN ; Dong Gyu CHOI ; Kyung-Ah PARK ; Hyeshin JEON ; Byung Joo LEE ; Seong-Joon KIM ; Sei Yeul OH ; Hyosook AHN ; Seung Ah CHUNG ; Ungsoo Samuel KIM ; Haeng-Jin LEE ; Joo Yeon LEE ; Youn Joo CHOI ;
Journal of Korean Medical Science 2023;38(12):e95-
Background:
To report the clinical manifestations of non-arteritic anterior ischemic optic neuropathy (NAION) cases after coronavirus disease 2019 (COVID-19) vaccination in Korea.
Methods:
This multicenter retrospective study included patients diagnosed with NAION within 42 days of COVID-19 vaccination. We collected data on vaccinations, demographic features, presence of vascular risk factors, ocular findings, and visual outcomes of patients with NAION.
Results:
The study included 16 eyes of 14 patients (6 men, 8 women) with a mean age of 63.5 ± 9.1 (range, 43–77) years. The most common underlying disease was hypertension, accounting for 28.6% of patients with NAION. Seven patients (50.0%) had no vascular risk factors for NAION. The mean time from vaccination to onset was 13.8 ± 14.2 (range, 1–41) days. All 16 eyes had disc swelling at initial presentation, and 3 of them (18.8%) had peripapillary intraretinal and/or subretinal fluid with severe disc swelling. Peripapillary hemorrhage was found in 50% of the patients, and one (6.3%) patient had peripapillary cotton-wool spots. In eight fellow eyes for which we were able to review the fundus photographs, the horizontal cup/ disc ratio was less than 0.25 in four eyes (50.0%). The mean visual acuity was logMAR 0.6 ± 0.7 at the initial presentation and logMAR 0.7 ± 0.8 at the final visit.
Conclusion
Only 64% of patients with NAION after COVID-19 vaccination have known vascular and ocular risk factors relevant to ischemic optic neuropathy. This suggests that COVID-19 vaccination may increase the risk of NAION. However, overall clinical features and visual outcomes of the NAION patients after COVID-19 vaccination were similar to those of typical NAION.
3.Genomic Signatures from Clinical Tumor Sequencing in Patients with Breast Cancer Having Germline BRCA1/2 Mutation
Ju Won KIM ; Hyo Eun KANG ; Jimi CHOI ; Seung Gyu YUN ; Seung Pil JUNG ; Soo Yeon BAE ; Ji Young YOU ; Yoon-Ji CHOI ; Yeul Hong KIM ; Kyong Hwa PARK
Cancer Research and Treatment 2023;55(1):155-166
Purpose:
BRCA1 and BRCA2 are among the most important genes involved in DNA repair via homologous recombination (HR). Germline BRCA1/2 (gBRCA1/2)-related cancers have specific characteristics and treatment options but conducting gBRCA1/2 testing and interpreting the genetic imprint are sometimes complicated. Here, we describe the concordance of gBRCA1/2 derived from a panel of clinical tumor tissues using next-generation sequencing (NGS) and genetic aspects of tumors harboring gBRCA1/2 pathogenic variants.
Materials and Methods:
Targeted sequencing was performed using available tumor tissue from patients who underwent gBRCA1/2 testing. Comparative genomic analysis was performed according to gBRCA1/2 pathogenicity.
Results:
A total of 321 patients who underwent gBRCA1/2 testing were screened, and 26 patients with gBRCA1/2 pathogenic (gBRCA1/2p) variants, eight patients with gBRCA1/2 variants of uncertain significance (VUS; gBRCA1/2v), and 43 patients with gBRCA1/2 wild-type (gBRCA1/2w) were included in analysis. Mutations in TP53 (49.4%) and PIK3CA (23.4%) were frequently detected in all samples. The number of single-nucleotide variants (SNVs) per tumor tissue was higher in the gBRCA1/2w group than that in the gBRCA1/2p group (14.81 vs. 18.86, p=0.278). Tumor mutation burden (TMB) was significantly higher in the gBRCA1/2w group than in the gBRCA1/2p group (10.21 vs. 13.47, p=0.017). Except for BRCA1/2, other HR-related genes were frequently mutated in patients with gBRCA1/2w.
Conclusion
We demonstrated high sensitivity of gBRCA1/2 in tumors analyzed by NGS using a panel of tumor tissues. TMB value and aberration of non-BRCA1/2 HR-related genes differed significantly according to gBRCA1/2 pathogenicity in patients with breast cancer.
4.Comparison of the Data of a Next-Generation Sequencing Panel from K-MASTER Project with That of Orthogonal Methods for Detecting Targetable Genetic Alterations
Yoon Ji CHOI ; Jung Yoon CHOI ; Ju Won KIM ; Ah Reum LIM ; Youngwoo LEE ; Won Jin CHANG ; Soohyeon LEE ; Jae Sook SUNG ; Hee-Joon CHUNG ; Jong Won LEE ; Eun Joo KANG ; Jung Sun KIM ; Taekyu LIM ; Hye Sook KIM ; Yu Jung KIM ; Mi Sun AHN ; Young Saing KIM ; Ji Hyun PARK ; Seungtaek LIM ; Sung Shim CHO ; Jang Ho CHO ; Sang Won SHIN ; Kyong Hwa PARK ; Yeul Hong KIM
Cancer Research and Treatment 2022;54(1):30-39
Purpose:
K-MASTER project is a Korean national precision medicine platform that screened actionable mutations by analyzing next-generation sequencing (NGS) of solid tumor patients. We compared gene analyses between NGS panel from the K-MASTER project and orthogonal methods.
Materials and Methods:
Colorectal, breast, non–small cell lung, and gastric cancer patients were included. We compared NGS results from K-MASTER projects with those of non-NGS orthogonal methods (KRAS, NRAS, and BRAF mutations in colorectal cancer [CRC]; epidermal growth factor receptor [EGFR], anaplastic lymphoma kinase [ALK] fusion, and reactive oxygen species 1 [ROS1] fusion in non–small cell lung cancer [NSCLC], and Erb-B2 receptor tyrosine kinase 2 (ERBB2) positivity in breast and gastric cancers).
Results:
In the CRC cohort (n=225), the sensitivity and specificity of NGS were 87.4% and 79.3% (KRAS); 88.9% and 98.9% (NRAS); and 77.8% and 100.0% (BRAF), respectively. In the NSCLC cohort (n=109), the sensitivity and specificity of NGS for EGFR were 86.2% and 97.5%, respectively. The concordance rate for ALK fusion was 100%, but ROS1 fusion was positive in only one of three cases that were positive in orthogonal tests. In the breast cancer cohort (n=260), ERBB2 amplification was detected in 45 by NGS. Compared with orthogonal methods that integrated immunohistochemistry and in situ hybridization, sensitivity and specificity were 53.7% and 99.4%, respectively. In the gastric cancer cohort (n=64), ERBB2 amplification was detected in six by NGS. Compared with orthogonal methods, sensitivity and specificity were 62.5% and 98.2%, respectively.
Conclusion
The results of the K-MASTER NGS panel and orthogonal methods showed a different degree of agreement for each genetic alteration, but generally showed a high agreement rate.
5.Clinical practice guideline for endoscopic resection of early gastrointestinal cancer
Chan Hyuk PARK ; Dong-Hoon YANG ; Jong Wook KIM ; Jie-Hyun KIM ; Ji Hyun KIM ; Yang Won MIN ; Si Hyung LEE ; Jung Ho BAE ; Hyunsoo CHUNG ; Kee Don CHOI ; Jun Chul PARK ; Hyuk LEE ; Min-Seob KWAK ; Bun KIM ; Hyun Jung LEE ; Hye Seung LEE ; Miyoung CHOI ; Dong-Ah PARK ; Jong Yeul LEE ; Jeong-Sik BYEON ; Chan Guk PARK ; Joo Young CHO ; Soo Teik LEE ; Hoon Jai CHUN
Intestinal Research 2021;19(2):127-157
Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.
6.Clinical practice guideline for endoscopic resection of early gastrointestinal cancer
Chan Hyuk PARK ; Dong-Hoon YANG ; Jong Wook KIM ; Jie-Hyun KIM ; Ji Hyun KIM ; Yang Won MIN ; Si Hyung LEE ; Jung Ho BAE ; Hyunsoo CHUNG ; Kee Don CHOI ; Jun Chul PARK ; Hyuk LEE ; Min-Seob KWAK ; Bun KIM ; Hyun Jung LEE ; Hye Seung LEE ; Miyoung CHOI ; Dong-Ah PARK ; Jong Yeul LEE ; Jeong-Sik BYEON ; Chan Guk PARK ; Joo Young CHO ; Soo Teik LEE ; Hoon Jai CHUN
Intestinal Research 2021;19(2):127-157
Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.
7.cal Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer
Chan Hyuk PARK ; Dong-Hoon YANG ; Jong Wook KIM ; Jie-Hyun KIM ; Ji Hyun KIM ; Yang Won MIN ; Si Hyung LEE ; Jung Ho BAE ; Hyunsoo CHUNG ; Kee Don CHOI ; Jun Chul PARK ; Hyuk LEE ; Min-Seob KWAK ; Bun KIM ; Hyun Jung LEE ; Hye Seung LEE ; Miyoung CHOI ; Dong-Ah PARK ; Jong Yeul LEE ; Jeong-Sik BYEON ; Chan Guk PARK ; Joo Young CHO ; Soo Teik LEE ; Hoon Jai CHUN
The Korean Journal of Gastroenterology 2020;75(5):264-291
Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.
8.Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer
Chan Hyuk PARK ; Dong-Hoon YANG ; Jong Wook KIM ; Jie-Hyun KIM ; Ji Hyun KIM ; Yang Won MIN ; Si Hyung LEE ; Jung Ho BAE ; Hyunsoo CHUNG ; Kee Don CHOI ; Jun Chul PARK ; Hyuk LEE ; Min-Seob KWAK ; Bun KIM ; Hyun Jung LEE ; Hye Seung LEE ; Miyoung CHOI ; Dong-Ah PARK ; Jong Yeul LEE ; Jeong-Sik BYEON ; Chan Guk PARK ; Joo Young CHO ; Soo Teik LEE ; Hoon Jai CHUN
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2020;20(2):117-145
Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.
9.Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer
Chan Hyuk PARK ; Dong-Hoon YANG ; Jong Wook KIM ; Jie-Hyun KIM ; Ji Hyun KIM ; Yang Won MIN ; Si Hyung LEE ; Jung Ho BAE ; Hyunsoo CHUNG ; Kee Don CHOI ; Jun Chul PARK ; Hyuk LEE ; Min-Seob KWAK ; Bun KIM ; Hyun Jung LEE ; Hye Seung LEE ; Miyoung CHOI ; Dong-Ah PARK ; Jong Yeul LEE ; Jeong-Sik BYEON ; Chan Guk PARK ; Joo Young CHO ; Soo Teik LEE ; Hoon Jai CHUN
Journal of Digestive Cancer Report 2020;8(1):1-50
Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.
10.Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer
Chan Hyuk PARK ; Dong-Hoon YANG ; Jong Wook KIM ; Jie-Hyun KIM ; Ji Hyun KIM ; Yang Won MIN ; Si Hyung LEE ; Jung Ho BAE ; Hyunsoo CHUNG ; Kee Don CHOI ; Jun Chul PARK ; Hyuk LEE ; Min-Seob KWAK ; Bun KIM ; Hyun Jung LEE ; Hye Seung LEE ; Miyoung CHOI ; Dong-Ah PARK ; Jong Yeul LEE ; Jeong-Sik BYEON ; Chan Guk PARK ; Joo Young CHO ; Soo Teik LEE ; Hoon Jai CHUN
Journal of Digestive Cancer Report 2020;8(1):1-50
Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.

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