1.The Clinical Outcomes of Cervical Spine Chordoma: A Nationwide Multicenter Retrospective Study
Hangeul PARK ; Yunhee CHOI ; Sungjoon LEE ; Sun-Ho LEE ; Eun-Sang KIM ; Sun Woo JANG ; Jin Hoon PARK ; Yunseong CHO ; Giwuk JANG ; Yoon HA ; Yun-Sik DHO ; Heon YOO ; Sung Uk LEE ; Seung-Ho SEO ; Ki-Jeong KIM ; Seil SOHN ; Chun Kee CHUNG
Neurospine 2024;21(3):942-953
Objective:
Chordoma, a rare malignant tumor originating from embryonal notochord remnants, exhibits high resistance to conventional treatments, making surgical resection imperative. However, the factors influencing prognosis specifically for cervical spine chordoma have not been clearly identified. We investigate the prognosis of cervical spine chordoma with factors influential in a nationwide multicenter retrospective study.
Methods:
This study included all patients diagnosed with cervical spine chordoma at 7 tertiary referral centers from January 1998 to March 2023, excluding those with clivus and thoracic spine chordomas extending into the cervical spine. Local recurrence (LR) was identified through follow-up magnetic resonance imaging, either as reappearance in completely resected tumors or regrowth in residual tumors. The study assessed LR and overall survival, analyzing factors influencing LR and death.
Results:
Forty-five patients with cervical spine chordoma had a mean age of 46.4 years. Over a median follow-up of 52 months, LR and distant metastasis were observed in 21 (46.7%) and 4 patients (8.9%), respectively, and 16 patients (36%) were confirmed dead. The 5-year and 10-year cumulative LR rates were 51.3% and 60%, respectively, while the 5-year and 10-year survival rates were 82% and 53%. Age was the only significant factor affecting mortality (hazard ratio, 1.04; 95% confidence interval, 1.04–1.07; p=0.015). Notably, the degree of resection and adjuvant therapy did not statistically significantly impact local tumor control and mortality.
Conclusion
This study, the largest multicenter retrospective analysis of cervical spine chordoma in Korea, identified age as the only factor significantly affecting patient survival.
2.The Clinical Outcomes of Cervical Spine Chordoma: A Nationwide Multicenter Retrospective Study
Hangeul PARK ; Yunhee CHOI ; Sungjoon LEE ; Sun-Ho LEE ; Eun-Sang KIM ; Sun Woo JANG ; Jin Hoon PARK ; Yunseong CHO ; Giwuk JANG ; Yoon HA ; Yun-Sik DHO ; Heon YOO ; Sung Uk LEE ; Seung-Ho SEO ; Ki-Jeong KIM ; Seil SOHN ; Chun Kee CHUNG
Neurospine 2024;21(3):942-953
Objective:
Chordoma, a rare malignant tumor originating from embryonal notochord remnants, exhibits high resistance to conventional treatments, making surgical resection imperative. However, the factors influencing prognosis specifically for cervical spine chordoma have not been clearly identified. We investigate the prognosis of cervical spine chordoma with factors influential in a nationwide multicenter retrospective study.
Methods:
This study included all patients diagnosed with cervical spine chordoma at 7 tertiary referral centers from January 1998 to March 2023, excluding those with clivus and thoracic spine chordomas extending into the cervical spine. Local recurrence (LR) was identified through follow-up magnetic resonance imaging, either as reappearance in completely resected tumors or regrowth in residual tumors. The study assessed LR and overall survival, analyzing factors influencing LR and death.
Results:
Forty-five patients with cervical spine chordoma had a mean age of 46.4 years. Over a median follow-up of 52 months, LR and distant metastasis were observed in 21 (46.7%) and 4 patients (8.9%), respectively, and 16 patients (36%) were confirmed dead. The 5-year and 10-year cumulative LR rates were 51.3% and 60%, respectively, while the 5-year and 10-year survival rates were 82% and 53%. Age was the only significant factor affecting mortality (hazard ratio, 1.04; 95% confidence interval, 1.04–1.07; p=0.015). Notably, the degree of resection and adjuvant therapy did not statistically significantly impact local tumor control and mortality.
Conclusion
This study, the largest multicenter retrospective analysis of cervical spine chordoma in Korea, identified age as the only factor significantly affecting patient survival.
3.The Clinical Outcomes of Cervical Spine Chordoma: A Nationwide Multicenter Retrospective Study
Hangeul PARK ; Yunhee CHOI ; Sungjoon LEE ; Sun-Ho LEE ; Eun-Sang KIM ; Sun Woo JANG ; Jin Hoon PARK ; Yunseong CHO ; Giwuk JANG ; Yoon HA ; Yun-Sik DHO ; Heon YOO ; Sung Uk LEE ; Seung-Ho SEO ; Ki-Jeong KIM ; Seil SOHN ; Chun Kee CHUNG
Neurospine 2024;21(3):942-953
Objective:
Chordoma, a rare malignant tumor originating from embryonal notochord remnants, exhibits high resistance to conventional treatments, making surgical resection imperative. However, the factors influencing prognosis specifically for cervical spine chordoma have not been clearly identified. We investigate the prognosis of cervical spine chordoma with factors influential in a nationwide multicenter retrospective study.
Methods:
This study included all patients diagnosed with cervical spine chordoma at 7 tertiary referral centers from January 1998 to March 2023, excluding those with clivus and thoracic spine chordomas extending into the cervical spine. Local recurrence (LR) was identified through follow-up magnetic resonance imaging, either as reappearance in completely resected tumors or regrowth in residual tumors. The study assessed LR and overall survival, analyzing factors influencing LR and death.
Results:
Forty-five patients with cervical spine chordoma had a mean age of 46.4 years. Over a median follow-up of 52 months, LR and distant metastasis were observed in 21 (46.7%) and 4 patients (8.9%), respectively, and 16 patients (36%) were confirmed dead. The 5-year and 10-year cumulative LR rates were 51.3% and 60%, respectively, while the 5-year and 10-year survival rates were 82% and 53%. Age was the only significant factor affecting mortality (hazard ratio, 1.04; 95% confidence interval, 1.04–1.07; p=0.015). Notably, the degree of resection and adjuvant therapy did not statistically significantly impact local tumor control and mortality.
Conclusion
This study, the largest multicenter retrospective analysis of cervical spine chordoma in Korea, identified age as the only factor significantly affecting patient survival.
4.The Clinical Outcomes of Cervical Spine Chordoma: A Nationwide Multicenter Retrospective Study
Hangeul PARK ; Yunhee CHOI ; Sungjoon LEE ; Sun-Ho LEE ; Eun-Sang KIM ; Sun Woo JANG ; Jin Hoon PARK ; Yunseong CHO ; Giwuk JANG ; Yoon HA ; Yun-Sik DHO ; Heon YOO ; Sung Uk LEE ; Seung-Ho SEO ; Ki-Jeong KIM ; Seil SOHN ; Chun Kee CHUNG
Neurospine 2024;21(3):942-953
Objective:
Chordoma, a rare malignant tumor originating from embryonal notochord remnants, exhibits high resistance to conventional treatments, making surgical resection imperative. However, the factors influencing prognosis specifically for cervical spine chordoma have not been clearly identified. We investigate the prognosis of cervical spine chordoma with factors influential in a nationwide multicenter retrospective study.
Methods:
This study included all patients diagnosed with cervical spine chordoma at 7 tertiary referral centers from January 1998 to March 2023, excluding those with clivus and thoracic spine chordomas extending into the cervical spine. Local recurrence (LR) was identified through follow-up magnetic resonance imaging, either as reappearance in completely resected tumors or regrowth in residual tumors. The study assessed LR and overall survival, analyzing factors influencing LR and death.
Results:
Forty-five patients with cervical spine chordoma had a mean age of 46.4 years. Over a median follow-up of 52 months, LR and distant metastasis were observed in 21 (46.7%) and 4 patients (8.9%), respectively, and 16 patients (36%) were confirmed dead. The 5-year and 10-year cumulative LR rates were 51.3% and 60%, respectively, while the 5-year and 10-year survival rates were 82% and 53%. Age was the only significant factor affecting mortality (hazard ratio, 1.04; 95% confidence interval, 1.04–1.07; p=0.015). Notably, the degree of resection and adjuvant therapy did not statistically significantly impact local tumor control and mortality.
Conclusion
This study, the largest multicenter retrospective analysis of cervical spine chordoma in Korea, identified age as the only factor significantly affecting patient survival.
5.The Clinical Outcomes of Cervical Spine Chordoma: A Nationwide Multicenter Retrospective Study
Hangeul PARK ; Yunhee CHOI ; Sungjoon LEE ; Sun-Ho LEE ; Eun-Sang KIM ; Sun Woo JANG ; Jin Hoon PARK ; Yunseong CHO ; Giwuk JANG ; Yoon HA ; Yun-Sik DHO ; Heon YOO ; Sung Uk LEE ; Seung-Ho SEO ; Ki-Jeong KIM ; Seil SOHN ; Chun Kee CHUNG
Neurospine 2024;21(3):942-953
Objective:
Chordoma, a rare malignant tumor originating from embryonal notochord remnants, exhibits high resistance to conventional treatments, making surgical resection imperative. However, the factors influencing prognosis specifically for cervical spine chordoma have not been clearly identified. We investigate the prognosis of cervical spine chordoma with factors influential in a nationwide multicenter retrospective study.
Methods:
This study included all patients diagnosed with cervical spine chordoma at 7 tertiary referral centers from January 1998 to March 2023, excluding those with clivus and thoracic spine chordomas extending into the cervical spine. Local recurrence (LR) was identified through follow-up magnetic resonance imaging, either as reappearance in completely resected tumors or regrowth in residual tumors. The study assessed LR and overall survival, analyzing factors influencing LR and death.
Results:
Forty-five patients with cervical spine chordoma had a mean age of 46.4 years. Over a median follow-up of 52 months, LR and distant metastasis were observed in 21 (46.7%) and 4 patients (8.9%), respectively, and 16 patients (36%) were confirmed dead. The 5-year and 10-year cumulative LR rates were 51.3% and 60%, respectively, while the 5-year and 10-year survival rates were 82% and 53%. Age was the only significant factor affecting mortality (hazard ratio, 1.04; 95% confidence interval, 1.04–1.07; p=0.015). Notably, the degree of resection and adjuvant therapy did not statistically significantly impact local tumor control and mortality.
Conclusion
This study, the largest multicenter retrospective analysis of cervical spine chordoma in Korea, identified age as the only factor significantly affecting patient survival.
6.Transient Myocardial Thickening in a 4-year-old Korean Domestic Shorthair Cat
Yunhee JOUNG ; Hyerin AHN ; Jeongbae CHOI ; YoungMin YUN ; Woo-Jin SONG
Journal of Veterinary Clinics 2024;41(2):106-111
A 4-year-old neutered female domestic shorthair cat weighing 5.1 kg was referred to Jeju National University Hospital with acute onset respiratory distress, weakness, and anorexia. The patient had a history of stressful antecedent events that involved bullying by a newly introduced cat. Thoracic radiography and echocardiography revealed a stage C hypertrophic cardiomyopathy phenotype based on the American College of Veterinary Internal Medicine classification system with pulmonary edema, pleural effusion, and pericardial effusion at the same time. The patient was treated with furosemide, pimobendan, and rivaroxaban. Pericardiocentesis was performed because pericardial effusion was identified. Reevaluation after 30 days revealed a normal respiratory rate on physical examination, normal cardiac shape on thoracic radiographs, and normal cardiac measurements on echocardiography. The patient was tentatively diagnosed with transient myocardial thickening (TMT) and all medications were discontinued. Six months after the initial hospitalization, the cat continued to do well without any clinical signs or left ventricular wall thickening. This case is the first report describing feline TMT in Korea. Moreover, it involves a rare case in which pulmonary edema, pleural effusion, and pericardial effusion, which induce cardiac tamponade, occurred simultaneously due to TMT-related congestive heart failure.
7.A Case of Canine Colorectal Carcinoma In Situ with Regulatory T Cell Infiltration
Yunhee JOUNG ; Jiwoong YOON ; Dong Ju LEE ; Woo-Jin SONG ; Jongtae CHEONG ; Hyunjung PARK ; Young-min YUN ; Gee Euhn CHOI ; Myung-Chul KIM
Journal of Veterinary Clinics 2024;41(4):207-214
An adult castrated male dog was presented with persistent hematochezia. Digital rectal examination and endoscopy found multiple colorectal masses. Complete blood count and serum biochemical results were within the reference interval. Fine needle aspirate of the masses indicated a diagnosis of inflamed polyps with a primary differential of malignancy. Histopathologic examination using endoscopy-guided incisional biopsy of the masses revealed an inflamed neoplasm with ossification. A colectomy was performed to remove the tumor. Subsequent histopathologic examination of the surgically resected masses resulted in a diagnosis of colorectal carcinoma in situ (CiS) with immune infiltrates, which were subject to immunohistochemical and flow cytometric immunophenotyping. The immunohistochemistry confirmed intraepithelial CD3 + T cells within CiS. The flow cytometric analysis indicated tumor-infiltrating CD4 + T, CD8 + T, and CD11b + myeloid subsets. The flow cytometric analysis of circulating and tumor-infiltrating leukocytes demonstrated a preferential expansion of CD25 + FOXP3 + regulatory T cells within CiS. To the author’s knowledge, this is the first report to show clinical evidence emphasizing the immunogenicity and immune-suppressive environment of canine colorectal CiS. Our case will be valuable in providing a rationale for basic research that dissects the immune environment for canine colorectal cancers for the future development of cancer immunotherapy.
8.IL-17A and Th17 Cells Contribute to Endometrial Cell Survival by Inhibiting Apoptosis and NK Cell Mediated Cytotoxicity of Endometrial Cells via ERK1/2 Pathway
Young-Ju KANG ; Hee Jun CHO ; Yunhee LEE ; Arum PARK ; Mi Jeong KIM ; In Cheul JEUNG ; Yong-Wook JUNG ; Haiyoung JUNG ; Inpyo CHOI ; Hee Gu LEE ; Suk Ran YOON
Immune Network 2023;23(2):e14-
Immune status including the immune cells and cytokine profiles has been implicated in the development of endometriosis. In this study, we analyzed Th17 cells and IL-17A in peritoneal fluid (PF) and endometrial tissues of patients with (n=10) and without (n=26) endometriosis. Our study has shown increased Th17 cell population and IL-17A level in PF with endometriosis patients. To determine the roles of IL-17A and Th17 cells in the development of endometriosis, the effect of IL-17A, major cytokine of Th17, on endometrial cells isolated from endometriotic tissues was examined. Recombinant IL-17A promoted survival of endometrial cells accompanied by increased expression of anti-apoptotic genes, including Bcl-2 and MCL1, and the activation of ERK1/2 signaling. In addition, treatment of IL-17A to endometrial cells inhibited NK cell mediated cytotoxicity and induced HLA-G expression on endometrial cells. IL-17A also promoted migration of endometrial cells. Our data suggest that Th17 cells and IL-17A play critical roles in the development of endometriosis by promoting endometrial cell survival and conferring a resistance to NK cell cytotoxicity through the activation of ERK1/2 signaling. Targeting IL-17A has potential as a new strategy for the treatment of endometriosis.
9.Re-Identification of Aspergillus Subgenus Circumdati Strains in Korea Led to the Discovery of Three Unrecorded Species
Anbazhagan MAGESWARI ; Yunhee CHOI ; Le Dinh THAO ; Daseul LEE ; Dong-Hyun KIM ; Myung Soo PARK ; Seung-Beom HONG
Mycobiology 2023;51(5):288-299
Aspergillus is one of the largest and diverse genera of fungi with huge economical, biotech nological, and social significance. Taxonomically, Aspergillus is divided into six subgenera comprising 27 sections. In this study, 235 strains of Aspergillus subgenus Circumdati (section: Candidi, Circumdati, Flavi, Flavipedes, Nigri, and Terrei) preserved at the Korean Agricultural Culture Collection (KACC) were analyzed and re-identified using a combined dataset of par tial β-tubulin (BenA), Calmodulin (CaM) gene sequences and morphological data. We con firmed nineteen species to be priorly reported in Korea (A. neotritici, A. terreus, A. floccosus,A. allahabadii, A. steynii, A. westerdijkiae, A. ochraceus, A. ostianus, A. sclerotiorum, A. luchuen sis, A. tubingensis, A. niger, A. welwitschiae, A. japonicus, A. nomius, A. tamarii, A. parasiticus, A.flavi, and A. oryzae). Among the studied strains, three species (A. subalbidus, A. iizukae, and A. uvarum), previously unreported or not officially documented, were discovered in Korea, to the best of our knowledge. We have given a detailed description of the characteristic fea tures of the three species, which remain uncharted in Korea.
10.Latent Tuberculosis Cascade of Care Among Healthcare Workers:A Nationwide Cohort Analysis in Korea Between 2017 and 2018
Jinsoo MIN ; Hyung Woo KIM ; Joon Young CHOI ; Ah Young SHIN ; Ji Young KANG ; Yunhee LEE ; Jun-Pyo MYONG ; Hyunsuk JEONG ; Sanghyuk BAE ; Hyeon-Kyoung KOO ; Sung-Soon LEE ; Jae Seuk PARK ; Hyeon Woo YIM ; Ju Sang KIM
Journal of Korean Medical Science 2022;37(20):e164-
Background:
In 2017, Korea implemented nationwide latent tuberculosis infection (LTBI) project targeting healthcare workers (HCWs). We aimed to assess its performance using the cascade of care model.
Methods:
We included 45,503 employees of medical institutions with positive interferongamma release assay result who participated between March 2017 and December 2018. We described percentages of LTBI participants completing each step in the cascade of care.Poisson regression model was conducted to assess individual characteristics and factors associated with not-visiting clinics for further care, not-initiating LTBI treatment, and notcompleting treatment.
Results:
Proportions of visiting clinics and initiating and completing treatment in HCWs were 54.9%, 38.5%, and 32.0%, respectively. Despite of less likelihood of visiting clinics and initiating LTBI treatment, older age ≥ 65 years were more likely to complete treatment (adjusted relative risk [aRR], 0.80; 95% confidence interval [CI], 0.64–0.99), compared to young age < 35 years. Compared to nurses, doctors were less likely to visit clinic; however, were more likely to initiate treatment (aRR, 0.88; 95% CI, 0.81–0.96). Those who visited public health centers were associated with not-initiating treatment (aRR, 1.34; 95% CI, 1.29–1.40). When treated at private hospitals, 9-month isoniazid monotherapy was less likely to complete treatment, compared to 3-month isoniazid and rifampicin combination therapy (aRR, 1.33; 95% CI, 1.16–1.53).
Conclusion
Among employees of medical institutions with LTBI, only one third completed treatment. Age, occupation, treatment center, and initial regimen were significantly related to LTBI treatment performance indicators. Rifampicin-based short treatment regimens were effective under standard of care.

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