1.Current Status of Flow Cytometric Immunophenotyping of Hematolymphoid Neoplasms in Korea
Mikyoung PARK ; Jihyang LIM ; Ari AHN ; Eun-Jee OH ; Jaewoo SONG ; Kyeong-Hee KIM ; Jin-Yeong HAN ; Hyun-Woo CHOI ; Joo-Heon PARK ; Kyung-Hwa SHIN ; Hyerim KIM ; Miyoung KIM ; Sang-Hyun HWANG ; Hyun-Young KIM ; Duck CHO ; Eun-Suk KANG
Annals of Laboratory Medicine 2024;44(3):222-234
Background:
Flow cytometric immunophenotyping of hematolymphoid neoplasms (FCIHLN) is essential for diagnosis, classification, and minimal residual disease (MRD) monitoring. FCI-HLN is typically performed using in-house protocols, raising the need for standardization. Therefore, we surveyed the current status of FCI-HLN in Korea to obtain fundamental data for quality improvement and standardization.
Methods:
Eight university hospitals actively conducting FCI-HLN participated in our survey.We analyzed responses to a questionnaire that included inquiries regarding test items, reagent antibodies (RAs), fluorophores, sample amounts (SAs), reagent antibody amounts (RAAs), acquisition cell number (ACN), isotype control (IC) usage, positiveegative criteria, and reporting.
Results:
Most hospitals used acute HLN, chronic HLN, plasma cell neoplasm (PCN), and MRD panels. The numbers of RAs were heterogeneous, with a maximum of 32, 26, 12, 14, and 10 antibodies used for acute HLN, chronic HLN, PCN, ALL-MRD, and multiple myeloma-MRD, respectively. The number of fluorophores ranged from 4 to 10. RAs, SAs, RAAs, and ACN were diverse. Most hospitals used a positive criterion of 20%, whereas one used 10% for acute and chronic HLN panels. Five hospitals used ICs for the negative criterion. Positiveegative assignments, percentages, and general opinions were commonly reported. In MRD reporting, the limit of detection and lower limit of quantification were included.
Conclusions
This is the first comprehensive study on the current status of FCI-HLN in Korea, confirming the high heterogeneity and complexity of FCI-HLN practices. Standardization of FCI-HLN is urgently needed. The findings provide a reference for establishing standard FCI-HLN guidelines.
2.The impact of severe depression on the survival of older patients with end-stage kidney disease
You Hyun JEON ; Jeong-Hoon LIM ; Yena JEON ; Yu-Kyung CHUNG ; Yon Su KIM ; Shin-Wook KANG ; Chul Woo YANG ; Nam-Ho KIM ; Hee-Yeon JUNG ; Ji-Young CHOI ; Sun-Hee PARK ; Chan-Duck KIM ; Yong-Lim KIM ; Jang-Hee CHO
Kidney Research and Clinical Practice 2024;43(6):818-828
Incidence of depression increases in patients with end-stage kidney disease (ESKD). We evaluated the association between depression and mortality among older patients with ESKD, which has not been studied previously. Methods: This nationwide prospective cohort study included 487 patients with ESKD aged >65 years, who were categorized into minimal, mild-to-moderate, and severe depression groups based on their Beck Depression Inventory-II (BDI-II) scores. Predisposing factors for high BDI-II scores and the association between the scores and survival were analyzed. Results: The severe depression group showed a higher modified Charlson comorbidity index value and lower serum albumin, phosphate, and uric acid levels than the other depression groups. The Kaplan-Meier curve revealed a significantly lower survival in the severe depression group than in the minimal and mild-to-moderate depression groups (p = 0.011). Multivariate Cox regression analysis confirmed that severe depression was an independent risk factor for mortality in the study cohort (hazard ratio, 1.39; 95% confidence interval, 1.01–1.91; p = 0.041). Additionally, BDI-II scores were associated with modified Charlson comorbidity index (p = 0.009) and serum albumin level (p = 0.004) in multivariate linear regression. Among the three depressive symptoms, higher somatic symptom scores were associated with increased mortality. Conclusion: Severe depression among older patients with ESKD increases mortality compared with minimal or mild-to-moderate depression, and patients with concomitant somatic symptoms require careful management of their comorbidities and nutritional status.
3.The impact of severe depression on the survival of older patients with end-stage kidney disease
You Hyun JEON ; Jeong-Hoon LIM ; Yena JEON ; Yu-Kyung CHUNG ; Yon Su KIM ; Shin-Wook KANG ; Chul Woo YANG ; Nam-Ho KIM ; Hee-Yeon JUNG ; Ji-Young CHOI ; Sun-Hee PARK ; Chan-Duck KIM ; Yong-Lim KIM ; Jang-Hee CHO
Kidney Research and Clinical Practice 2024;43(6):818-828
Incidence of depression increases in patients with end-stage kidney disease (ESKD). We evaluated the association between depression and mortality among older patients with ESKD, which has not been studied previously. Methods: This nationwide prospective cohort study included 487 patients with ESKD aged >65 years, who were categorized into minimal, mild-to-moderate, and severe depression groups based on their Beck Depression Inventory-II (BDI-II) scores. Predisposing factors for high BDI-II scores and the association between the scores and survival were analyzed. Results: The severe depression group showed a higher modified Charlson comorbidity index value and lower serum albumin, phosphate, and uric acid levels than the other depression groups. The Kaplan-Meier curve revealed a significantly lower survival in the severe depression group than in the minimal and mild-to-moderate depression groups (p = 0.011). Multivariate Cox regression analysis confirmed that severe depression was an independent risk factor for mortality in the study cohort (hazard ratio, 1.39; 95% confidence interval, 1.01–1.91; p = 0.041). Additionally, BDI-II scores were associated with modified Charlson comorbidity index (p = 0.009) and serum albumin level (p = 0.004) in multivariate linear regression. Among the three depressive symptoms, higher somatic symptom scores were associated with increased mortality. Conclusion: Severe depression among older patients with ESKD increases mortality compared with minimal or mild-to-moderate depression, and patients with concomitant somatic symptoms require careful management of their comorbidities and nutritional status.
4.The impact of severe depression on the survival of older patients with end-stage kidney disease
You Hyun JEON ; Jeong-Hoon LIM ; Yena JEON ; Yu-Kyung CHUNG ; Yon Su KIM ; Shin-Wook KANG ; Chul Woo YANG ; Nam-Ho KIM ; Hee-Yeon JUNG ; Ji-Young CHOI ; Sun-Hee PARK ; Chan-Duck KIM ; Yong-Lim KIM ; Jang-Hee CHO
Kidney Research and Clinical Practice 2024;43(6):818-828
Incidence of depression increases in patients with end-stage kidney disease (ESKD). We evaluated the association between depression and mortality among older patients with ESKD, which has not been studied previously. Methods: This nationwide prospective cohort study included 487 patients with ESKD aged >65 years, who were categorized into minimal, mild-to-moderate, and severe depression groups based on their Beck Depression Inventory-II (BDI-II) scores. Predisposing factors for high BDI-II scores and the association between the scores and survival were analyzed. Results: The severe depression group showed a higher modified Charlson comorbidity index value and lower serum albumin, phosphate, and uric acid levels than the other depression groups. The Kaplan-Meier curve revealed a significantly lower survival in the severe depression group than in the minimal and mild-to-moderate depression groups (p = 0.011). Multivariate Cox regression analysis confirmed that severe depression was an independent risk factor for mortality in the study cohort (hazard ratio, 1.39; 95% confidence interval, 1.01–1.91; p = 0.041). Additionally, BDI-II scores were associated with modified Charlson comorbidity index (p = 0.009) and serum albumin level (p = 0.004) in multivariate linear regression. Among the three depressive symptoms, higher somatic symptom scores were associated with increased mortality. Conclusion: Severe depression among older patients with ESKD increases mortality compared with minimal or mild-to-moderate depression, and patients with concomitant somatic symptoms require careful management of their comorbidities and nutritional status.
5.The impact of severe depression on the survival of older patients with end-stage kidney disease
You Hyun JEON ; Jeong-Hoon LIM ; Yena JEON ; Yu-Kyung CHUNG ; Yon Su KIM ; Shin-Wook KANG ; Chul Woo YANG ; Nam-Ho KIM ; Hee-Yeon JUNG ; Ji-Young CHOI ; Sun-Hee PARK ; Chan-Duck KIM ; Yong-Lim KIM ; Jang-Hee CHO
Kidney Research and Clinical Practice 2024;43(6):818-828
Incidence of depression increases in patients with end-stage kidney disease (ESKD). We evaluated the association between depression and mortality among older patients with ESKD, which has not been studied previously. Methods: This nationwide prospective cohort study included 487 patients with ESKD aged >65 years, who were categorized into minimal, mild-to-moderate, and severe depression groups based on their Beck Depression Inventory-II (BDI-II) scores. Predisposing factors for high BDI-II scores and the association between the scores and survival were analyzed. Results: The severe depression group showed a higher modified Charlson comorbidity index value and lower serum albumin, phosphate, and uric acid levels than the other depression groups. The Kaplan-Meier curve revealed a significantly lower survival in the severe depression group than in the minimal and mild-to-moderate depression groups (p = 0.011). Multivariate Cox regression analysis confirmed that severe depression was an independent risk factor for mortality in the study cohort (hazard ratio, 1.39; 95% confidence interval, 1.01–1.91; p = 0.041). Additionally, BDI-II scores were associated with modified Charlson comorbidity index (p = 0.009) and serum albumin level (p = 0.004) in multivariate linear regression. Among the three depressive symptoms, higher somatic symptom scores were associated with increased mortality. Conclusion: Severe depression among older patients with ESKD increases mortality compared with minimal or mild-to-moderate depression, and patients with concomitant somatic symptoms require careful management of their comorbidities and nutritional status.
6.Effect of prophylactic abdominal drainage on postoperative pain in laparoscopic hemicolectomy for colon cancer: a single-center observational study in Korea
Sung Seo HWANG ; Heung-Kwon OH ; Hye-Rim SHIN ; Tae-Gyun LEE ; Mi Jeong CHOI ; Min Hyeong JO ; Hong-min AHN ; Hyeonjeong PARK ; Hyun Hee SIM ; Eunjeong JI ; Anuj Naresh SINGHI ; Duck-Woo KIM ; Sung-Bum KANG
Journal of Minimally Invasive Surgery 2024;27(2):76-84
Purpose:
This study aimed to evaluate the effect of prophylactic abdominal drainage (AD) in laparoscopic hemicolectomy, focusing on assessing postoperative pain outcomes.
Methods:
Patients were categorized into two groups: those with and without AD (AD group vs.no-AD group). A numerical rating scale (NRS) was used to assess postoperative pain on each postoperative day (POD). Further, the inverse probability of treatment weighting (IPTW) method was used to reduce intergroup bias.
Results:
In total, 204 patients who underwent laparoscopic hemicolectomies by a single surgeon between June 2013 and September 2022 at a single institution were retrospectively reviewed. After adjusting for IPTW, NRS scores on POD 2 were significantly lower in the no-AD group (3.2 ± 0.8 vs. 3.4 ± 0.8, p = 0.043). Further examination of postoperative outcomes showed no statistically significant differences in complications between the AD (17.3%) and no-AD (12.4%) groups (p = 0.170). The postoperative length of hospital stay was 7.3 ± 2.8 days in the AD group and 6.9 ± 3.0 days in the no-AD group, with no significant difference (p = 0.298). Time to first flatus was 3.0 ± 0.9 days in the AD group and 2.7 ± 0.9 days in the no-AD group, with no significant difference (p = 0.078). Regarding readmission within 1 month, there were four cases each in the AD (2.3%) and no-AD (1.7%) groups, with no significant difference (p = 0.733).
Conclusion
Laparoscopic hemicolectomy without AD resulted in no significant differences in postoperative clinical outcomes, except for postoperative pain. This finding suggests that prophylactic AD may exacerbate postoperative pain.
7.Fabrication of definitive complete-arch implant-supported fixed prosthesis in upper and lower completely edentulous patient using temporary prosthesis scan: a case report
Seung-Mi JEONG ; Hyun-Lak SON ; Kang-Duck CHOI ; Byung-Ho CHOI
The Journal of Korean Academy of Prosthodontics 2024;62(3):243-252
When fabricating definitive implant-supported fixed prostheses in upper and lower completely edentulous patients, it is crucial to get information about the vertical dimension, jaw relationship, implants, abutments and gingival contour.In this case, temporary prostheses were used to take the information. The temporary prosthesis was scanned outside of the mouth so that it increased the efficiency of scanning it. During the scan of the prosthesis, a scan zig which connected both posterior parts of the prosthesis was used to minimize the scan errors. We report this case because we obtained satisfactory functional and esthetic results by using the digital technology.
8.Treatment Results of Treatment-naïve Neovascular Age-related Macular Degeneration in Patients Over 85 Years of Age
Ji Min KWON ; Sung Soo HWANG ; Jong Wook BANG ; Hyun Woong KIM ; Jae Wan LIM ; Sang Joon LEE ; Dong Geun KIM ; Hyun Duck KWAK ; Kang Yeun PAK
Journal of the Korean Ophthalmological Society 2023;64(9):777-783
Purpose:
To investigate the characteristics and treatment results of patients aged ≥ 85 years who were diagnosed with treatment-naïve neovascular age-related macular degeneration (nAMD).
Methods:
The medical records of patients diagnosed with treatment-naïve nAMD who were ≥ 85 years old at the time of diagnosis with at least 12 months follow-up were retrospectively reviewed. The number of intravitreal injections of anti-vascular endothelial growth factor (VEGF) and agents used during the entire period were investigated. Best-corrected visual acuity and optical coherence tomography results before and after treatment were analyzed. Visual acuity of the fellow eye was also collected.
Results:
A total of 40 eyes of 40 patients with mean age of 87.5 ± 2.4 were included in the study. The mean logarithm of the minimal angle of resolution visual acuity was 0.85 ± 0.57, and the mean of the fellow eye was 0.93 ± 0.99. Compared to before the treatment, there was no significant difference after intravitreal injection in terms of visual acuity. Central retinal thickness showed significant reduction at all time points after treatment.
Conclusions
In patients aged ≥ 85 years at the time of diagnosis, intravitreal injections of anti-VEGF prevented deterioration of visual acuity and showed successful anatomical outcomes. Especially, many had poor visual acuity in the fellow eye, suggesting the importance of maintaining visual acuity. Therefore, active treatment is necessary in the elderly.
9.Universal Screening for Lynch Syndrome Compared with Pedigree-Based Screening: 10-Year Experience in a Tertiary Hospital
Min Hyun KIM ; Duck-Woo KIM ; Hye Seung LEE ; Su Kyung BANG ; Soo Hyun SEO ; Kyung Un PARK ; Heung-Kwon OH ; Sung-Bum KANG
Cancer Research and Treatment 2023;55(1):179-188
Purpose:
Universal screening for Lynch syndrome (LS) refers to routine tumor testing for microsatellite instability (MSI) among all patients with colorectal cancer (CRC). Despite its widespread adoption, real-world data on the yield is lacking in Korean population. We studied the yield of adopting universal screening for LS in comparison with pedigree-based screening in a tertiary center.
Materials and Methods:
CRC patients from 2007-2018 were reviewed. Family histories were obtained and were evaluated for hereditary nonpolyposis colorectal cancer (HNPCC) using Amsterdam II criteria. Tumor testing for MSI began in 2007 and genetic testing was offered using all available clinicopathologic data. Yield of genetic testing for LS was compared for each approach and step.
Results:
Of the 5,520 patients, tumor testing was performed in 4,701 patients (85.2%) and family histories were obtained from 4,241 patients (76.8%). Hereditary CRC (LS or HNPCC) was present in 69 patients (1.3%). MSI-high was present in 6.9%, and 25 patients had confirmed LS. Genetic testing was performed in 41.2% (47/114) of MSI-high patients, out of which 40.4% (19/47) were diagnosed with LS. There were six additional LS patients found outside of tumor testing. For pedigree-based screening, Amsterdam II criteria diagnosed 55 patients with HNPCC. Fifteen of these patients underwent genetic testing, and 11 (73.3%) were diagnosed with LS. Two patients without prior family history were diagnosed with LS and relied solely on tumor testing results.
Conclusion
Despite widespread adoption of routine tumor testing for MSI, this is not a fail-safe approach to screen all LS patients. Obtaining a thorough family history in combination with universal screening provides a more comprehensive ‘universal’ screening method for LS.
10.Association between microsatellite instability and tumor response to neoadjuvant chemoradiotherapy for rectal cancer
Soo Young LEE ; Duck-Woo KIM ; Jaram LEE ; Hyeong-min PARK ; Chang Hyun KIM ; Kyung-Hwa LEE ; Heung-Kwon OH ; Sung-Bum KANG ; Hyeong Rok KIM
Annals of Surgical Treatment and Research 2022;103(3):176-182
Purpose:
The relationship between microsatellite instability (MSI) and tumor response after neoadjuvant chemoradiotherapy (nCRT) in rectal cancer remains unclear. The present study aimed to evaluate the association between MSI and tumor response to nCRT in rectal cancer treatment.
Methods:
Patients with rectal cancer from 2 tertiary hospitals who underwent nCRT, followed by radical surgery, were included. The microsatellite status was determined using a PCR-based Bethesda panel. Tumors with a Dworak’s tumor regression grade of 3 or 4 were considered to have a good response. Predictive factors for a good response to nCRT were analyzed.
Results:
Of the 1,401 patients included, 910 (65.0%) had MSI results and 1.5% (14 of 910) showed MSI-H. Among all the patients, 519 (37.0%) showed a good response to nCRT. A univariate analysis showed that MSI-H tended to be negatively associated with a good response to nCRT, but no statistical significance was observed (7.1% vs. 24.1%, P = 0.208).Multivariate analysis showed that well-differentiated tumors were the only predictive factor for good response to nCRT (odds ratio [OR], 2.241; 95% confidence interval [CI], 1.492–3.364; P < 0.001). MSI status tended to be associated with the response to nCRT (OR, 0.215; 95% CI, 0.027–1.681; P = 0.143).
Conclusion
MSI-H was not associated with response to nCRT in patients with rectal cancer.

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