1.Acute myeloid leukemia and myelodysplastic neoplasms: clinical implications of myelodysplasia‑related genes mutations and TP53 aberrations
Hyunwoo KIM ; Ja Young LEE ; Sinae YU ; Eunkyoung YOO ; Hye Ran KIM ; Sang Min LEE ; Won Sik LEE
Blood Research 2024;59():41-
Purpose:
The fifth World Health Organization (WHO) classification (2022 WHO) and International Consensus Classification (ICC) of myeloid neoplasms have recently been published. In this study, patients were reclassified according to the revised classification and their prognoses were analyzed to confirm the clinical utility of the new classifications.
Methods:
We included 101 adult patients, 77 with acute myeloid leukemia (AML) and 24 with myelodysplastic neoplasms (MDS), who underwent bone marrow aspiration and next-generation sequencing (NGS) between August 2019 and July 2023. We reclassified the patients according to the revised criteria, examined the differences, and analyzed the prognosis using survival analysis.
Results:
According to the 2022 WHO and ICC, 23 (29.9%) patients and 32 (41.6%) patients were reclassified into different groups, respectively, due to the addition of myelodysplasia-related (MR) gene mutations to the diagnostic criteria or the addition of new entities associated with TP53 mutations. The median overall survival (OS) of patients with AML and MR gene mutations was shorter than that of patients in other AML groups; however, the difference was not significant. Patients with AML and TP53 mutation had a significantly shorter OS than the other AML group (p = 0.0014, median OS 2.3 vs 10.3 months). They also had significantly shorter OS than the AML and MR mutation group (p = 0.002, median OS 2.3 vs 9.6 months).
Conclusion
The revised classifications allow for a more detailed categorization based on genetic abnormalities, which may be helpful in predicting prognosis. AML with TP53 mutations is a new ICC category that has shown a high prognostic significance in a small number of cases.
2.Acute myeloid leukemia and myelodysplastic neoplasms: clinical implications of myelodysplasia‑related genes mutations and TP53 aberrations
Hyunwoo KIM ; Ja Young LEE ; Sinae YU ; Eunkyoung YOO ; Hye Ran KIM ; Sang Min LEE ; Won Sik LEE
Blood Research 2024;59():41-
Purpose:
The fifth World Health Organization (WHO) classification (2022 WHO) and International Consensus Classification (ICC) of myeloid neoplasms have recently been published. In this study, patients were reclassified according to the revised classification and their prognoses were analyzed to confirm the clinical utility of the new classifications.
Methods:
We included 101 adult patients, 77 with acute myeloid leukemia (AML) and 24 with myelodysplastic neoplasms (MDS), who underwent bone marrow aspiration and next-generation sequencing (NGS) between August 2019 and July 2023. We reclassified the patients according to the revised criteria, examined the differences, and analyzed the prognosis using survival analysis.
Results:
According to the 2022 WHO and ICC, 23 (29.9%) patients and 32 (41.6%) patients were reclassified into different groups, respectively, due to the addition of myelodysplasia-related (MR) gene mutations to the diagnostic criteria or the addition of new entities associated with TP53 mutations. The median overall survival (OS) of patients with AML and MR gene mutations was shorter than that of patients in other AML groups; however, the difference was not significant. Patients with AML and TP53 mutation had a significantly shorter OS than the other AML group (p = 0.0014, median OS 2.3 vs 10.3 months). They also had significantly shorter OS than the AML and MR mutation group (p = 0.002, median OS 2.3 vs 9.6 months).
Conclusion
The revised classifications allow for a more detailed categorization based on genetic abnormalities, which may be helpful in predicting prognosis. AML with TP53 mutations is a new ICC category that has shown a high prognostic significance in a small number of cases.
3.Acute myeloid leukemia and myelodysplastic neoplasms: clinical implications of myelodysplasia‑related genes mutations and TP53 aberrations
Hyunwoo KIM ; Ja Young LEE ; Sinae YU ; Eunkyoung YOO ; Hye Ran KIM ; Sang Min LEE ; Won Sik LEE
Blood Research 2024;59():41-
Purpose:
The fifth World Health Organization (WHO) classification (2022 WHO) and International Consensus Classification (ICC) of myeloid neoplasms have recently been published. In this study, patients were reclassified according to the revised classification and their prognoses were analyzed to confirm the clinical utility of the new classifications.
Methods:
We included 101 adult patients, 77 with acute myeloid leukemia (AML) and 24 with myelodysplastic neoplasms (MDS), who underwent bone marrow aspiration and next-generation sequencing (NGS) between August 2019 and July 2023. We reclassified the patients according to the revised criteria, examined the differences, and analyzed the prognosis using survival analysis.
Results:
According to the 2022 WHO and ICC, 23 (29.9%) patients and 32 (41.6%) patients were reclassified into different groups, respectively, due to the addition of myelodysplasia-related (MR) gene mutations to the diagnostic criteria or the addition of new entities associated with TP53 mutations. The median overall survival (OS) of patients with AML and MR gene mutations was shorter than that of patients in other AML groups; however, the difference was not significant. Patients with AML and TP53 mutation had a significantly shorter OS than the other AML group (p = 0.0014, median OS 2.3 vs 10.3 months). They also had significantly shorter OS than the AML and MR mutation group (p = 0.002, median OS 2.3 vs 9.6 months).
Conclusion
The revised classifications allow for a more detailed categorization based on genetic abnormalities, which may be helpful in predicting prognosis. AML with TP53 mutations is a new ICC category that has shown a high prognostic significance in a small number of cases.
4.Blood Lymphocytes as a Prognostic Factor for Stage III Non-Small Cell Lung Cancer with Concurrent Chemoradiation
Yong-Hyub KIM ; Yoo-Duk CHOI ; Sung-Ja AHN ; Young-Chul KIM ; In-Jae OH ; Taek-Keun NAM ; Jae-Uk JEONG ; Ju-Young SONG
Chonnam Medical Journal 2024;60(1):40-50
We aimed to identify blood lymphocytes as a prognostic factor for survival in patients with locally advanced stage III non-small cell lung cancer (NSCLC) treated with concurrent chemoradiotherapy (CCRT). This is a secondary study of 196 patients enrolled in the Korean Radiation Oncology Group 0903 phase III clinical trial to evaluate the prognostic significance of circulating blood lymphocyte levels. The median total lymphocyte count (TLC) reduction ratio during CCRT was 0.74 (range: 0.29-0.97). In multivariate analysis, patient age (p=0.014) and gross tumor volume (GTV, p=0.031) were significant factors associated with overall survival, while TLC reduction (p=0.018) and pretreatment neutrophil-to-lymphocyte ratio (NLR; p=0.010) were associated with progression-free survival (PFS). In multivariate logistic regression analysis, pretreatment NLR, GTV, and heart V20 were significantly associated with TLC reduction. Immunohistochemical analysis of programmed death ligand 1 and CD8 expression on T cells was performed on 84 patients. CD8 expression was not significantly associated with the pretreatment lymphocyte count (p=0.673), and PDL1 expression was not significantly associated with OS or PFS. Univariate analysis revealed that high CD8 expression in TILs was associated with favorable OS and was significantly associated with favorable PFS (p=0.032). TLC reduction during CCRT is a significant prognostic factor for PFS, and heart V20 is significantly associated with TLC reduction. Thus, in the era of immunotherapy, constraining the volume of the radiation dose to the whole heart must be prioritized for the better survival outcomes.
5.Treatment Efficacy of Various Maneuvers for Lateral Canal Benign Paroxysmal Positional Vertigo With Apogeotropic Nystagmus: A Randomized Controlled Trial
Hyun Jin LEE ; Eun-Ju JEON ; Sungil NAM ; Seog-Kyun MUN ; Shin-Young YOO ; Seong Hyun BU ; Jin Woong CHOI ; Jae Ho CHUNG ; Seok Min HONG ; Seung-Hwan LEE ; Min-Beom KIM ; Ja-Won KOO ; Hyun Ji KIM ; Jae-Hyun SEO ; Seong-Ki AHN ; Shi Nae PARK ; Minbum KIM ; Won-Ho CHUNG
Clinical and Experimental Otorhinolaryngology 2023;16(3):251-258
Objectives:
The aim of this study was to determine the most effective treatment approach by comparing the impacts of various otolith reduction techniques in patients with apogeotropic lateral semicircular canal benign paroxysmal positional vertigo (LC-BPPV).
Methods:
We performed a multicenter randomized prospective study from January to December 2015, involving 72 consecutive patients with apogeotropic LC-BPPV. The patients were divided into three treatment groups: therapeutic head-shaking (group A), the Gufoni-Appiani maneuver (group B), and the cupulolith repositioning maneuver (CuRM; group C). Each group underwent evaluation and treatment up to the fourth week. Treatment success was defined as the disappearance of positional vertigo and nystagmus.
Results:
This study included 72 patients (49 male and 23 female), with a mean (±standard deviation) age of 55.4±13.5 years. The mean duration of vertigo experienced prior to treatment was 3.9±4.4 days. The mean latency and duration of nystagmus were 2.7±3.0 seconds and 47.9±15.8 seconds, respectively. The overall treatment frequency was 2.0±0.9. The number of treatments differed significantly among the three groups (P<0.05). After 4 weeks, the success rates for groups A, B, and C were 90.5%, 92.3%, and 100%, respectively. No significant difference was observed in the success rate across treatment methods and periods (P>0.05). However, CuRM was the only method with a 100% treatment success rate.
Conclusion
While no clear difference was observed among the three treatments for LC-BPPV, CuRM was found to be superior to the other approaches in the long term.
7.Preventive effect of dentifrice containing 1,450 ppm fluoride and sodium pyrophosphate
Min-Ji PARK ; Ja-Won CHO ; Hyun-Jun YOO ; Mi-Hae YUN ; Kyong-Hoon SHIN ; Young-Hoon PARK
Journal of Korean Academy of Oral Health 2022;46(2):63-69
Objectives:
This study aimed to evaluate the effects of a toothpaste containing sodium pyrophosphate and a high concentration (1,450 ppm) of fluoride on dental plaque, gingivitis index, and calculus index in a clinical trial.
Methods:
This study used an eight-week, randomized, double-blinded, controlled, comparative, parallel design. The participants, who voluntarily signed a consent form, were screened through visit evaluation if they met the selection/exclusion criteria. After a one-week run-in period, the selected participants were randomly assigned to either an experimental or control group in the order of their enrollment. Subsequently, the participants were asked to brush their teeth with the study toothpaste using the rolling method for 3 min, thrice daily, for 8 weeks. Oral examinations were performed at baseline and after 3 weeks, 4 weeks, and 8 weeks. Evaluation of papillary marginal attachment index (PMA index), Talbott’s gingival index, patient hygiene performance index (PHP index), Turesky plaque index, and calculus index were performed during the oral examination.
Results:
After 8 weeks, the PMA indices were 7.12 for the control group and 5.00 for experimental groups. In addition, the PHP index was 2.06 for the control group and 1.66 for the experimental group. Significant differences were observed between the control and experimental groups in all indice (P<0.05).
Conclusions
This study shows that using a toothpaste containing sodium fluoride, sodium pyrophosphate, tocopherol acetate, and dental-type silica improves dental plaque removal, reduces gingivitis, and inhibits calculus formation.
8.A Multicenter, Randomized, Controlled Trial for Assessing the Usefulness of Suppressing Thyroid Stimulating Hormone Target Levels after Thyroid Lobectomy in Low to Intermediate Risk Thyroid Cancer Patients (MASTER): A Study Protocol
Eun Kyung LEE ; Yea Eun KANG ; Young Joo PARK ; Bon Seok KOO ; Ki-Wook CHUNG ; Eu Jeong KU ; Ho-Ryun WON ; Won Sang YOO ; Eonju JEON ; Se Hyun PAEK ; Yong Sang LEE ; Dong Mee LIM ; Yong Joon SUH ; Ha Kyoung PARK ; Hyo-Jeong KIM ; Bo Hyun KIM ; Mijin KIM ; Sun Wook KIM ; Ka Hee YI ; Sue K. PARK ; Eun-Jae JUNG ; June Young CHOI ; Ja Seong BAE ; Joon Hwa HONG ; Kee-Hyun NAM ; Young Ki LEE ; Hyeong Won YU ; Sujeong GO ; Young Mi KANG ;
Endocrinology and Metabolism 2021;36(3):574-581
Background:
Postoperative thyroid stimulating hormone (TSH) suppression therapy is recommended for patients with intermediate- and high-risk differentiated thyroid cancer to prevent the recurrence of thyroid cancer. With the recent increase in small thyroid cancer cases, the extent of resection during surgery has generally decreased. Therefore, questions have been raised about the efficacy and long-term side effects of TSH suppression therapy in patients who have undergone a lobectomy.
Methods:
This is a multicenter, prospective, randomized, controlled clinical trial in which 2,986 patients with papillary thyroid cancer are randomized into a high-TSH group (intervention) and a low-TSH group (control) after having undergone a lobectomy. The principle of treatment includes a TSH-lowering regimen aimed at TSH levels between 0.3 and 1.99 μIU/mL in the low-TSH group. The high-TSH group targets TSH levels between 2.0 and 7.99 μIU/mL. The dose of levothyroxine will be adjusted at each visit to maintain the target TSH level. The primary outcome is recurrence-free survival, as assessed by neck ultrasound every 6 to 12 months. Secondary endpoints include disease-free survival, overall survival, success rate in reaching the TSH target range, the proportion of patients with major cardiovascular diseases or bone metabolic disease, the quality of life, and medical costs. The follow-up period is 5 years.
Conclusion
The results of this trial will contribute to establishing the optimal indication for TSH suppression therapy in low-risk papillary thyroid cancer patients by evaluating the benefit and harm of lowering TSH levels in terms of recurrence, metabolic complications, costs, and quality of life.
9.2019 Laos children’s dental caries experience survey
Chae-Young RHEE ; Ja-Won CHO ; Hyun-Jun YOO ; Nitthasack PHOMMAVONGSA ; Yong-Su AHN ; Hyung-Suk OH
Journal of Korean Academy of Oral Health 2021;45(2):51-56
Objectives:
The aim of this study was to determine the dental caries experience of children in Laos.
Methods:
Oral examinations were performed on a total of 1,540 students in 513 primary school students, 537 middle school students, and 490 high school students and the results analyzed.
Results:
The dft index (decayed-filled primary teeth index) of 6-year-old primary school children was 6.04. The DMFT index (decayed-filled-missing permanent teeth index) was 1.59 in 12-yearold middle school children and 2.04 in 15-year-old middle school children.
Conclusions
Caries experience in most of the age groups was on the high side. It is considered that in Laos, a treatment project to stop the progression of caries is necessary in parallel with a prevention project to lower the caries fatality rate.
10.Deep Learning Algorithm for Simultaneous Noise Reduction and Edge Sharpening in Low-Dose CT Images:A Pilot Study Using Lumbar Spine CT
Hyunjung YEOH ; Sung Hwan HONG ; Chulkyun AHN ; Ja-Young CHOI ; Hee-Dong CHAE ; Hye Jin YOO ; Jong Hyo KIM
Korean Journal of Radiology 2021;22(11):1850-1857
Objective:
The purpose of this study was to assess whether a deep learning (DL) algorithm could enable simultaneous noise reduction and edge sharpening in low-dose lumbar spine CT.
Materials and Methods:
This retrospective study included 52 patients (26 male and 26 female; median age, 60.5 years) who had undergone CT-guided lumbar bone biopsy between October 2015 and April 2020. Initial 100-mAs survey images and 50-mAs intraprocedural images were reconstructed by filtered back projection. Denoising was performed using a vendor-agnostic DL model (ClariCT.AI TM , ClariPI) for the 50-mAS images, and the 50-mAs, denoised 50-mAs, and 100-mAs CT images were compared. Noise, signal-to-noise ratio (SNR), and edge rise distance (ERD) for image sharpness were measured. The data were summarized as the mean ± standard deviation for these parameters. Two musculoskeletal radiologists assessed the visibility of the normal anatomical structures.
Results:
Noise was lower in the denoised 50-mAs images (36.38 ± 7.03 Hounsfield unit [HU]) than the 50-mAs (93.33 ± 25.36 HU) and 100-mAs (63.33 ± 16.09 HU) images (p < 0.001). The SNRs for the images in descending order were as follows: denoised 50-mAs (1.46 ± 0.54), 100-mAs (0.99 ± 0.34), and 50-mAs (0.58 ± 0.18) images (p < 0.001). The denoised 50-mAs images had better edge sharpness than the 100-mAs images at the vertebral body (ERD; 0.94 ± 0.2 mm vs. 1.05 ± 0.24 mm, p = 0.036) and the psoas (ERD; 0.42 ± 0.09 mm vs. 0.50 ± 0.12 mm, p = 0.002). The denoised 50-mAs images significantly improved the visualization of the normal anatomical structures (p < 0.001).
Conclusion
DL-based reconstruction may enable simultaneous noise reduction and improvement in image quality with the preservation of edge sharpness on low-dose lumbar spine CT. Investigations on further radiation dose reduction and the clinical applicability of this technique are warranted.

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