Showing papers by "Young Jin Suh published in 2010"

Multidimensional Analysis of the Learning Curve for Laparoscopic Rectal Cancer Surgery

Abstract: Background: The need for an initial learning experience in laparoscopic colorectal cancer surgery has been well established. However, the inherent differences in the complexity and results of laparoscopic rectal cancer surgery, as compared to colon surgery, warrant a study to analyze the learning curve exclusively for rectal cancer resections. Materials and Methods: four hundred thirty-one patients operated on between April 1994 and March 2006 were analyzed retrospectively for changes in surgical outcomes according to case sequence. A multidimensional analysis was done, based on the following parameters: conversion to laparotomy, intraoperative complications, postoperative complications, reoperations, operative time, and transfusion volumes. Multiple statistical methods were used for evaluation of the learning curve, which included the cumulative sum (CUSUM) method, risk-adjusted CUSUM, moving average method, and analysis of variance (ANOVA). Results: The risk factors for conversion were prior ab...

Real hypersurfaces of type b in complex two-plane grassmannians related to the reeb vector

Abstract: In this paper we give a new characterization of real hyper- surfaces of type B, that is, a tube over a totally geodesicQP n in complex two-plane Grassmannians G2(C m+2 ), where m = 2n, with the Reeb vec- tor » belonging to the distribution D, where D denotes a subdistribution in the tangent space TxM such that TxM = D'D? for any point x 2 M and D? = Span{»1,»2,»3 }.

The Change of Practice Patterns of the Hereditary Breast Cancer Management in Korea after the Korean Hereditary Breast Cancer Study

Abstract: change in the practice patterns for managing hereditary breast and ovarian cancer (HBOC) among Korean physicians after the Korean Hereditary Breast Cancer (KOHBRA) study. Methods: The first survey was performed from July to August 2007, at the initiation of the KOHBRA study, and the followup survey was conducted from July to December 2009. Members of the Korean Breast Cancer Society were invited to participate in the study by e-mail. The 2009 survey was conducted with a self-administered questionnaire concerning HBOC management and was identical to the previous questionnaire. Results: According to the 2009 survey, most physicians (60.0%) tended to draw a pedigree (48.0% in 2007 survey). The rate of genetic test recommendations for patients at risk for HBOC was higher in the 2009 survey (84.0%) than that in the 2007 survey (64.0%). Physicians tended to select a BRCA genetic testing candidate more appropriately than in the previous survey (42.4% answered right in 2007 survey; 74.4% in 2009 survey). Fifteen of 25 participants (60.0%) provided genetic counseling before their patients underwent a genetic test, which was higher than that (40.0%) in the 2007 survey. According to the 2009 survey, half of the genetic counseling was being conducted by KOHBRA study research nurses; whereas most of the genetic counseling was conducted by physicians in 2007. Conclusion: The KOHBRA study The Change of Practice Patterns of the Hereditary Breast Cancer Management in Korea after the Korean Hereditary Breast Cancer Study

Laparoscopic splenectomy: 3 ports are enough.

Abstract: With advanced technologies and accumulating experience, a new consensus concerning the least invasive laparoscopic splenectomy should be addressed. We retrospectively analyzed 41 consecutive patients who underwent laparoscopic splenectomy from 1994 to 2007. We divided our patients into 3 groups acco

On $6$-Dimensional Nearly Kähler Manifolds

Abstract: In this paper we give a sufficient condition for a complete, simply connected, and strict nearly Kahler manifold of dimension 6 to be a homogeneous nearly Kahler manifold. This result was announced in a previous paper by the first author.

Is Central Lymph Node Dissection Mandatory in 2 cm or Less Sized Papillary Thyroid Cancer

Abstract: Purpose: There have been controversies on the scope of central lymph node dissection (CND) in papillary thyroid cancer (PTC). We performed this study to determine the role of CND for patients having PTC measuring 2 cm or less. Methods: 530 cases of PTC less than 2 cm had undergone lobectomy plus isthmectomy (LI) with CND or without CND. Clinicopathologic records and clinical outcome were evaluated, retrospectively. Results: Comparing recurrence rates in LI with CND group (4/174, 2.30%) and LI without CND group (16/356, 4.49%), there was no significant statistical difference in recurrence (P=0.331). We compared 20 patients with recurrences and 510 patients of no recurrence. The size of tumor seemed to influence recurrence (P＜0.001) and the size of tumor developing recurrence was larger than the other (1.11 cm vs. 0.75 cm). When considering division into PTC and papillary thyroid microcarcinoma (PTMC), PTMC showed less recurrence significantly (P=0.006). No other variables such as age, sex, tumor location, extrathyroidal extension seemed to be related to the recurrence. Conclusion: We could not find any relevant role of CND to prevent recurrence either locally or regionally in cases of no lymph node metastasis after CND for patients having PTC measuring 2 cm or less. Moreover, prophylactic CND is not mandatory for all cases of PTC less than 2 cm. (J Korean Surg Soc 2010;79:332-339)

Real hypersurfaces in a complex projective space with pseudo-$$\mathbb{D}$$-parallel structure Jacobi operator

Abstract: We introduce the new notion of pseudo-\( \mathbb{D} \)-parallel real hypersurfaces in a complex projective space as real hypersurfaces satisfying a condition about the covariant derivative of the structure Jacobi operator in any direction of the maximal holomorphic distribution. This condition generalizes parallelness of the structure Jacobi operator. We classify this type of real hypersurfaces.

Predictors of 4 or More Positive Axillary Nodes in Patients with Node-positive T1-2 Breast Carcinoma: The Indications for Adjuvant Irradiation of the Level III Axilla and Supraclavicular Fossa

Abstract: Purpose: We evaluate the predictors of 4 or more involved axillary nodes in patients with node-positive T1-2 breast carcinoma to select a group of patients who are indicated for adjuvant irradiation of the level III axilla and supraclavicular fossa (SCF). Methods: We analyzed 286 patients with positive axillary nodes and who were without distant metastases and who underwent breast conserving surgery and axillary lymph node dissection or modified radical mastectomy. We investigated the relationship between the patients and the tumor factors and 4 or more positive axillary nodes. Results: On the multivariate logistic-regression analysis, an increased tumor size (p=0.002), the presence of lymphovascular space invasion (LVSI) (p<0.001) and a palpable mass p<0.001) were positively associated with involvement of 4 or more axillary lymph nodes. In our study, 86.1% of the patients with all the unfavorable factors had involvement of 4 or more nodal metastases. Conclusion: Our data suggest that for patients with node-positive T1-2 breast cancer, the presence of 4 or more involved nodes is frequently observed for the patients with an increased tumor size, the presence of LVSI and a palpable mass at the time of diagnosis, and we recommend that they undergo irradiation of the high axilla and SCF for adjuvant care, if they do not undergo complete axillary dissection.

In Vitro Enhancement of Radiosensitivity by the Combination of Celecoxib and Ad-mda7 in Human Breast Cancer Cells

Abstract: Purpose: Celecoxib and Ad-mda7 have shown its ability to enhance radiosensitivity in various cancer cells in vitro. We expected to synergistically enhance radiosensitivity by combing celecoxib and Ad-mda7 in breast cancer cells in vitro. Methods: MDA-MB-436 and MDA-MB-468 human breast cancer cells were exposed to different doses (0, 2, 4, and 6 Gy) of radiation with or without pretreatment with either Ad-mda7 or celecoxib alone, or with the combination for three days prior to irradiation. Clonogenic cell survival assay was used to compare the radiosensitizing effect. Fluorescence activated cell sorting analysis was performed to assess cell cycle changes and the subdiploid cell population. We determined the prostaglandin E 2 (PGE2) concentration before and after the irradiation (2 Gy, 24 hours). We performed western blot analysis of Akt, phosphorylated Akt, β -catenin, and cyclooxygenase-2 (COX-2). Results: At the sublethal dose of celecoxib and Ad-mda7, the combination showed significantly enhanced radiosensitivity. The enhancement factor for the combination treatment was 1.44 in MDAMB-468 cells and 1.75 in MDA-MB-436 cells. There were an increased percentage of apoptotic cells in the combination therapy group as compared to the controls, but this was not statistically significant. Cell cycle analysis demonstrated an increase in the G 2/M phase of the cell cycle in the combination group compared with controls. The concentration of PGE2 was significantly decreased after the irradiation in both cell lines compared to the controls. Western blot analysis confirmed that this combination treatment effectively suppress the expression of Akt, phosphorylated Akt, and COX-2 in those cell lines, except β -catenin. Conclusion: Cotreatment of Ad-mda7 plus celecoxib definitely showed radioenhancing effect. We presumed that this effect may be the arrest of the cells at the radiosensitive G2/M phase of the cell cycle.

Painless Posterior Thigh Mass as a Presentation of Metastatic Breast Cancer

Abstract: Soft tissue is usually not the site of distant dissemination of solid tumors. It has been shown that intramuscular soft tissue metastatic nodules are painful, whereas soft tissue sarcomas scarcely produce pain, but grow slowly.(1) Therefore, painless soft tissue nodules, especially remote from the index tumor are usually regarded as being unrelated to the primary carcinoma. Commonly, some solid tumors, such as lung, kidney, and colon carcinomas, have been known to be a prevalent source of soft tissue metastasis.(2) To date, there have been no reports on metastatic breast cancer presenting as a painless soft tissue nodule residing subcutaneously at the posterior thigh, and found to have multiple mediastinal lymph node metastases verified by positron emission tomography-computed tomography (PET-CT). As a result of an intense database search and to our understanding, this is the first report of its kind in Korea. We think it is very crucial to differentiate soft tissue metastasis from the index tumor and de novo soft tissue sarcoma given that the prognosis of each case may vary profoundly, especially after misdiagnosis. The onset of metastases into mediastinal lymph nodes and farther down to the posterior thigh seemed to be fairly rapid in this case, stressing the importance of a thorough followup in younger breast cancer patients who harbor a triplenegative phenotype.