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Minimally invasive surgery in infants with congenital diaphragmatic hernia
Chihwan Cha,Young Ju Hong,Eun Young Chang,Hye Kyung Chang,Jung-Tak Oh,Seok Joo Han 대한외과학회 2013 Annals of Surgical Treatment and Research(ASRT) Vol.85 No.2
Purpose: The aim of the study was to determine clinical indications for performing minimally invasive surgery (MIS) with acceptable results by reviewing our experience in congenital diaphragmatic hernia (CDH) repair and comparing outcomes of MIS with open surgery. Methods: Medical records of patients who underwent CDH repair were reviewed retrospectively between January 2008 and December 2012, and outcomes were compared between MIS and open repair of CDH. Results: From 2008 to 2012, 35 patients were operated on for CDH. Among these patients, 20 patients underwent open surgery, and 15 patients underwent MIS. Patients with delayed presentations (60.0% [9/15] in the MIS group vs. 20.0% [4/20] in the open surgery group; P = 0.015) and small diaphragmatic defect less than 3 cm (80.0% [12/15] in the MIS group vs. 0.0% [0/20] in the open surgery group; P < 0.001) were more frequently in the MIS group than the open surgery group. All 10 patients who also had other anomalies underwent open surgery (P = 0.002). Moreover, nine patients who needed a patch for repair underwent open surgery (P = 0.003). Patients in the MIS group showed earlier enteral feeding and shorter hospital stays. There was no recurrence in either group. Conclusion: CDH repair with MIS can be suggested as the treatment of choice for patients with a small sized diaphragmatic defect, in neonates with stable hemodynamics and without additional anomalies, or in infants with delayed presen tation of CDH, resulting in excellent outcomes.
Low PR in ER(+)/HER2(−) breast cancer: high rates of <i>TP53</i> mutation and high SUV
Ahn, Sung Gwe,Yoon, Chang Ik,Lee, Jae Hoon,Lee, Hye Sun,Park, So Eun,Cha, Yoon Jin,Cha, Chihwan,Bae, Soong June,Lee, Kyung-A,Jeong, Joon Bioscientifica Ltd 2018 Endocrine-related cancer Vol.26 No.2
<P>On the basis of <I>TP53</I> mutations and standardized uptake values (SUVs) from 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET), we sought to enhance our knowledge of the biology underlying low progesterone receptor (PR) expression in estrogen receptor (ER)-positive/human epidermal growth factor receptor-2 (HER2)-negative tumors. This study included 272 patients surgically treated for ER-positive, HER2-negative breast cancer and who had undergone <I>TP53</I> gene sequencing. Of these, 229 patients also underwent 18F-FDG PET or PET/CT. Mutational analysis of exons 5–9 of the <I>TP53</I> gene was conducted using PCR amplification and direct sequencing. The SUVs were measured using 18F-FDG-PET scan images. Twenty-eight (10.3%) tumors had a somatic <I>TP53</I> mutation. The <I>TP53</I> mutation rate was significantly higher in low-PR tumors than in high-PR tumors (17.1% vs 7.9%, <I>P</I> = 0.039). Low-PR tumors had significantly higher median SUVs than high-PR tumors (<I>P</I> = 0.046). The multivariable analysis revealed that SUV and age remained independent variables associated with low PR expression. An adverse impact of low PR expression on recurrence-free survival was observed in the multivariable Cox regression hazard model. We provide clinical evidence that genetic alteration of the <I>TP53</I> gene and dysregulated glucose metabolism partly involve low PR expression in ER-positive and HER2-negative breast cancer.</P>