Long-term Outcomes of Percutaneous Radiofrequency Ablation as First-Line Therapy of Hepatocellular Carcinoma in Milan Criteria

( Se Young Jang ),( Won Young Tak ),( Soo Young Park ),( Young Oh Kweon ),( Yu Rim Lee ),( Won Kee Lee ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: Radiofrequency ablation (RFA) has been performed for treatment of early stage hepatocellular carcinoma (HCC). Many studies have confirmed the safety and efficacy of RFA for HCC with excellent long-term prognosis. The aim of this study is to analyze long-term outcomes of RFA for early stage HCC as an initial therapy at a single center. Methods: Percutaneous RFA as first-line therapy was applied to 1,097 patients (male: 821, median age: 61 years) diagnosed with HCC within the Milan criteria from January 2001 to December 2019 (Fig.1). Overall and recurrence-free survivals were estimated by Kaplan-meier method and prognostic factors affecting those survivals were analyzed using Cox proportional hazards model. Fig.1. Flowchart of study inclusion. Flowchart summarizing the included patients who were treated by radifrequency ablation (RFA) as a first-line treatment in this study. Results: Liver function of the patients was either Child-Pugh class A (n=982), B (n=108), or C (n=7). Cumulative overall survival rates at 1-, 5-, 10-, and 15-years were 96.1%, 65.8%, 41.6%, and 30.8%, respectively. Cumulative recurrence- free survival rates at 1-, 5-, 10-, and 15-years were 79.7%, 36.4%, 24.9%, and 18.5%, respectively. Prognostic factors for overall survival were age (> 61 years, Hazard ratio, HR=2.025; 95% Confidence interval, CI=1.662-2.468), cirrhosis (HR=1.422; 95% CI=1.145-1.766), tumor size (HR=1.358; 95% CI=1.122-1.642), and Child-Pugh class (HR=2.893; 95% CI=2.281-3.669). Prognostic factors for recurrence-free survival were age (> 61 years, HR=1.561; 95% CI=1.336-1.825), a-fetoprotein (>20 ng/mL, HR=1.407; 95% CI=1.200-1.650), tumor size (HR=1.329; 95% CI=1.140-1.550), Child-Pugh class (HR=1.935; 95% CI=1.556-2.408), and tumor location (surface location, HR=0.817; 95% CI=0.700-0.953). Conclusions: The long-term outcomes of RFA showed good results in treating HCC within the Milan criteria as first-line treatment. RFA was an effective and safe method treating early stage HCC.

The Diagnostic Efficacy of M2BPGi for Liver Fibrosis in HCC and NAFLD Patients

( Se Young Jang ),( Won Young Tak ),( Soo Young Park ),( Young-oh Kweon ),( Yu Rim Lee ),( Bina Jeong ),( Sangkyung Seo ),( Gyoun-eun Kang ),( Gyeonghwa Kim ),( Keun Hur ),( Heon Tak Ha ),( Jae Min Ch 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: Mac-2 binding protein glycan isomer (M2BPGi) is recently identified as a useful non-invasive biomarker for the diagnosis of liver fibrosis. This study aimed to evaluate the diagnostic efficacy of serum M2BPGi for liver fibrosis in hepatocellular carcinoma (HCC) and non-alcoholic fatty liver disease (NAFLD) patients. Methods: M2BPGi levels were analyzed in serum samples collected from biopsy-proven HCC (n=135) and NAFLD (n=113) patients. Fibrosis was graded histopathologically in non-tumorous portion of HCC and NAFLD. Serum M2BPGi levels were determined with an automated immunoassay analyzer. Spearman’s correlation and Kruskal-Wallis test were used to evaluate the correlation and comparison among groups. Diagnostic efficacy for fibrosis was evaluated by the area under the receiver operating characteristic curve (AUC). Results: Median levels (range) of M2BPGi in HCC and NAFLD patients were 1.21 (0.12-14.33) cut-off index (COI) and 0.59 (0.13-5.90) COI, respectively. In HCC patients, fibrosis stages were 0 (n=22), 1 (n=10), 2 (n=11), 3 (n=16), and 4 (n=76). The M2BPGi levels showed a significant positive correlation (r= 0.436, P<0.001) with fibrosis grade in HCC patients and yielded the lower AUC value, 0.787 (P< 0.001) than transient elastography (TE), AUC value, 0.806 (P=0.030) to predict advanced fibrosis (F >2). In NAFLD patients, fibrosis stages were 0 (n=22), 1 (n=34), 2 (n=28), 3 (n=19), and 4 (n=10). The M2BPGi levels showed a significant positive correlation (r=0.578, P<0.001) with fibrosis grade in NAFLD patients and yielded the higher AUC value, 0.824(P< 0.001) than TE, AUC value, 0.637(P=0.035) to predict advanced fibrosis (F >2). Conclusions: Serum M2BPGi can be a useful non-invasive biomarker for predicting fibrosis in HCC and especially in NAFLD patients.

Preparation of Solvent Soluble Dyes Derived from Diketo-pyrrolo-pyrrole Pigment by Introducing an N-Alkyl group

Se-Hwa Choi,Oh-Tak Kwon,Na-rim Kim,Chun Yoon,Jae-Pil Kim,최재홍 대한화학회 2010 Bulletin of the Korean Chemical Society Vol.31 No.4

Diagnostic Efficacy of Mac-2 Binding Protein Glyco-sylation Isomer for Predicting Liver Fibrosis in Patients with Metabolic Associated Fatty Liver Disease: Multi-center Cohort Study

( Se Young Jang ),( Dae Won Jun ),( Ki Tae Yoon ),( Young Youn Cho ),( Hoon Gil Jo ),( Yang Hyun Baek ),( Sang Yi Moon ),( Jo Ae Jeong ),( Young-oh Kweon ),( Soo Young Park ),( Yu Rim Lee ),( Won Youn 대한간학회 2023 춘·추계 학술대회 (The Liver Week) Vol.2023 No.1

Thirteen-Year Outcomes of Radiofrequency Ablation as a First-Line Treatment for Early-Stage Hepatocellular Carcinoma

( Se Young Jang ),( Won Young Tak ),( Soo Young Park ),( Young-oh Kweon ),( Yu Rim Lee ),( Jun Sik Yoon ),( Jung Gil Park ),( Won Gee Lee ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Radiofrequency ablation (RFA) has been widely applied for the treatment of early-stage hepatocellular carcinoma (HCC) and has advantages of minimal invasiveness and safety. Many studies have confirmed that the efficacy of RFA is comparable to that of hepatic resection in the treatment of early-stage HCC. This study analyzed the outcomes of RFA as an initial therapy for HCC within the Milan criteria over a 13-year period. Methods: From November 2001 to December 2013, 804 patients diagnosed as early-stage HCC within the Milan criteria were treated with percutaneous RFA as first-line therapy. The mean follow-up period was 54.5 months. Overall and recurrence-free survival rates, and risk factors affecting survival and recurrence were analyzed. Results: The study included 608 males and 196 females aged 60.3±9.9 years (mean±standard deviation). The patients exhibit liver function at either Child-Pugh class A (n=710) or B (n=94). The cumulative overall survival rates at 1, 5, 10, and 13 years were 92.2%, 58.4%, 35.9%, and 25.3%, respectively; the corresponding cumulative recurrence- free survival rates were 75.2%, 24.4%, 9.8%, and 4.6%. In multivariate analysis, the risk factors for tumor recurrence were age >60 years (hazard ratio [HR]=1.330, 95% confidence interval [CI]=1.130-1.566, p=0.0006), Child-Pugh class B (HR=1.775, 95% CI=1.409-2.237, p< 0.0001), tumor size >3 cm (HR=1.393, 95% CI=1.094-1.775, p=0.0072), peripheral tumor location (HR=0.829, 95% CI=0.701-0.979, p=0.0273), and α-fetoprotein level >200 ng/mL (HR=1.322, 95% CI=1.048-1.668, p=0.0184). Conclusions: The 13-year results of RFA for treating early HCC showed good outcomes with high overall and recurrence-free survival rates and low complication rates. RFA is useful as a first-line treatment for early-stage HCC within the Milan criteria.

Altered White Matter Integrity in Human Immunodeficiency Virus-Associated Neurocognitive Disorder: A Tract-Based Spatial Statistics Study

Oh, Se Won,Shin, Na-Young,Choi, Jun Yong,Lee, Seung-Koo,Bang, Mi Rim unknown 2018 KOREAN JOURNAL OF RADIOLOGY Vol.19 No.3

<P><B>Objective</B></P><P>Human immunodeficiency virus (HIV) infection has been known to damage the microstructural integrity of white matter (WM). However, only a few studies have assessed the brain regions in HIV-associated neurocognitive disorders (HAND) with diffusion tensor imaging (DTI). Therefore, we sought to compare the DTI data between HIV patients with and without HAND using tract-based spatial statistics (TBSS).</P><P><B>Materials and Methods</B></P><P>Twenty-two HIV-infected patients (10 with HAND and 12 without HAND) and 11 healthy controls (HC) were enrolled in this study. A whole-brain analysis of fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity was performed with TBSS and a subsequent 20 tract-specific region-of-interest (ROI)-based analysis to localize and compare altered WM integrity in all group contrasts.</P><P><B>Results</B></P><P>Compared with HC, patients with HAND showed decreased FA in the right frontoparietal WM including the upper corticospinal tract (CST) and increased MD and RD in the bilateral frontoparietal WM, corpus callosum, bilateral CSTs and bilateral cerebellar peduncles. The DTI values did not significantly differ between HIV patients with and without HAND or between HIV patients without HAND and HC. In the ROI-based analysis, decreased FA was observed in the right superior longitudinal fasciculus and was significantly correlated with decreased information processing speed, memory, executive function, and fine motor function in HIV patients.</P><P><B>Conclusion</B></P><P>These results suggest that altered integrity of the frontoparietal WM contributes to cognitive dysfunction in HIV patients.</P>

Temporal Trends and Long-Term Outcomes of Radiofrequency Ablation for Hepatocellular Carcinoma within the Milan Criteria

( Se Young Jang ),( Soo Young Park ),( Young Oh Kweon ),( Yu Rim Lee ),( Hun Kyu Ryeom ),( Jung Guen Cha ),( Sungmin Kim ),( Won Kee Lee ),( Won Young Tak ) 대한간학회 2024 춘·추계 학술대회 (The Liver Week) Vol.2024 No.1

Ultrasonographic ovarian mass scoring system for predicting malignancy in pregnant women with ovarian mass

( Se Jin Lee ),( Hye Rim Oh ),( Sunghun Na ),( Han Sung Hwang ),( Seung Mi Lee ) 대한산부인과학회 2022 Obstetrics & Gynecology Science Vol.65 No.1

During routine antenatal ultrasound examinations, an ovarian mass can be found incidentally. In clinical practice, the differential diagnosis between benign and malignant ovarian masses is essential for planning further management. Ultrasound imaging has become the most popular diagnostic tool during pregnancy, with the recent development of ultrasonography. In non-pregnant women, several methods have been used to predict malignant ovarian masses before surgery. The International Ovarian Tumor Analysis (IOTA) group reported several scoring systems, such as the IOTA simple rules, IOTA logistic regression models, and IOTA assessment of different NEoplasias in the adneXa. Other researchers have also evaluated the malignancy of ovarian masses before surgery using scoring systems such as the Sassone score, pelvic mass score, DePriest score, Lerner score, and Ovarian-Adnexal Reporting and Data System. These researchers suggested specific features of ovarian masses that can be used for differential diagnosis, including size, proportion of solid tissue, papillary projections, inner wall structure, locules, wall thickness, septa, echogenicity, acoustic shadows, and presence of ascites. Although these factors can also be measured in pregnant women using ultrasound, only a few studies have applied ovarian scoring systems in pregnant women. In this article, we reviewed various scoring systems for predicting malignant tumors of the ovary and determined whether they can be applied to pregnant women.

Clinical outcomes of coronavirus disease 2019 in patients with pre-existing liver diseases: A multicenter study in South Korea

Yu Rim Lee,Min Kyu Kang,Jeong Eun Song,Hyun Jung Kim,Young Oh Kweon,Won Young Tak,Se Young Jang,Jung Gil Park,Chang Hyeong Lee,Jae Seok Hwang,Byoung Kuk Jang,Jeong Ill Suh,Woo Jin Chung,Byung Seok Kim 대한간학회 2020 Clinical and Molecular Hepatology(대한간학회지) Vol.26 No.4

Background/Aims: Although coronavirus disease 2019 (COVID-19) has spread rapidly worldwide, the implication of pre-existing liver disease on the outcome of COVID-19 remains unresolved. Methods: A total of 1,005 patients who were admitted to five tertiary hospitals in South Korea with laboratory-confirmed COVID-19 were included in this study. Clinical outcomes in COVID-19 patients with coexisting liver disease as well as the predictors of disease severity and mortality of COVID-19 were assessed. Results: Of the 47 patients (4.7%) who had liver-related comorbidities, 14 patients (1.4%) had liver cirrhosis. Liver cirrhosis was more common in COVID-19 patients with severe pneumonia than in those with non-severe pneumonia (4.5% vs. 0.9%, P=0.006). Compared to patients without liver cirrhosis, a higher proportion of patients with liver cirrhosis required oxygen therapy; were admitted to the intensive care unit; had septic shock, acute respiratory distress syndrome, or acute kidney injury; and died (P<0.05). The overall survival rate was significantly lower in patients with liver cirrhosis than in those without liver cirrhosis (log-rank test, P=0.003). Along with old age and diabetes, the presence of liver cirrhosis was found to be an independent predictor of severe disease (odds ratio, 4.52; 95% confidence interval [CI], 1.20–17.02; P=0.026) and death (hazard ratio, 2.86; 95% CI, 1.04–9.30; P=0.042) in COVID-19 patients. Conclusions: This study suggests liver cirrhosis is a significant risk factor for COVID-19. Stronger personal protection and more intensive treatment for COVID-19 are recommended in these patients.

고혈압 환자에서 만성 신질환의 유병율과 신기능 감소의 예측인자

김세중 ( Se Joong Kim ),송영림 ( Young Rim Song ),진호준 ( Ho Jun Chin ),오윤규 ( Yoon Kyu Oh ),오국환 ( Kook Hwan Oh ),나기영 ( Ki Young Na ),주권욱 ( Kwon Wook Joo ),임춘수,김연수 ( Yon Su Kim ),안규리 ( Cu Rie Ahn ),한진석 ( Jin S 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.1

목적: 고혈압은 만성 신질환의 진행에 중요한 역할을 하는 것으로 알려져 있으나 한국인을 대상으로 한 연구는 미미하다. 이에 저자들은 고혈압 환자에서 만성 신질환의 유병률과 신기능 감소의 예측인자에 대하여 조사하였다. 방법: 서울대학교 분당병원 외래에서 고혈압으로 진단되고 혈청 크레아티닌과 요 검사를 시행 받은 환자 중 1년 이상 추적 관찰된 환자들의 의무기록을 후향적으로 분석하였다. 신기능 감소는 기준시점의 추정된 사구체 여과율 (eGFR)보다 연간 GFR 감소율이 7%이상인 경우로 정의하였다. 결과: 총 981명의 대상 환자에서 만성 신질환의 유병율은 51%이었다. 만성 신질환이 없는 고혈압 환자에서, 신기능 감소의 발생율은 46.2%이었으나, 다중요인 분석에서 신기능 감소의 예측인자는 연령 이외에는 발견되지 않았다. 만성 신질환이 있는 고혈압 환자에서, 신기능 감소는 40.8%에서 발생하였다. 다중요인 분석에서 당뇨의 병력 (위험비 [OR], 2.99; 95% 신뢰구간 [CI], 1.88±4.78), 헤모글로빈 수치 (OR, 0.86; 95% CI, 0.76±0.98), 단백뇨 (OR, 1.86; 95% CI, 1.16±2.98), 및 혈뇨 (OR, 1.62; 95% CI, 1.02±2.58)가 신기능 감소의 위험을 높였다. 결론: 본 연구의 고혈압 환자에서 만성 신질환의 유병률은 높았다. 신기능 감소는 신질환의 유무와 상관없이 높았으나. 신기능 감소의 위험인자는 신질환의 동반여부에 따라 다른 양상을 보였다. 특히 만성 신질환을 동반한 고혈압 환자에서 당뇨의 병력, 빈혈, 단백뇨 및 혈뇨가 신기능 감소와 유의한 연관성을 보였다. Purpose: Hypertension (HT) has been known to play an important role in progression of chronic kidney disease (CKD). However, limited data are available in Korean HT patients. We evaluated the prevalence of CKD and the predictors of decrease in kidney function (DKF) in HT patients. Methods: We retrospectively analyzed the medical records of outpatients with HT in Bundang Seoul National University hospital. DKF was defined as annual loss of estimated glomerular filtration rate (eGFR) more than 7% of baseline eGFR. Results: The prevalence of CKD was 51% in 981 total participants. In HT patients without CKD (NCKD-HT), the incidence of DKF was 46.2%. The incidence of DKF in HT patients with CKD (CKDHT) was 40.8%. Age was only baseline risk factor of DKF in NCKD-HT group. In multifactorial analysis, history of diabetes mellitus (odds ratio [OR], 2.99; 95% Confidence Interval [CI], 1.88±4.78), hemoglobin levels (OR, 0.86; 95% CI, 0.76±0.98), proteinuria (OR, 1.86; 95% CI, 1.16±2.98), and hematuria (OR, 1.62; 95% CI, 1.02±2.58) were related to DKF in CKD-HT group. Conclusion: We suggest that the prevalence of CKD in HT patients is high and DKF is frequent in both NCKD-HT and CKD-HT groups. The pattern of the predictors of DKF shows the difference between the two groups. Especially diabetes, abnormal urinalysis, and anemia are strongly associated with DKF in CKD-HT group.