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Shin D.-Y.,Korea Cancer Center Hospital | Na I.I.,Korea Cancer Center Hospital | Baek H.,Korea Institute of Radiological and Medical Sciences | Yang S.H.,Korea Cancer Center Hospital
Journal of Thoracic Oncology | Year: 2014

BACKGROUND:: This study aimed to explore the potential association of mutation in the epidermal growth factor receptor (EGFR) with brain metastases in patients with pulmonary adenocarcinoma. METHODS:: We analyzed clinical data on 314 patients who were tested for EGFR mutation and underwent brain magnetic resonance imaging at diagnosis. The relationship between EGFR mutation status and brain metastases at the initial presentation was analyzed. In addition, prognostic significance of EGFR mutational status on the risk of brain metastasis was evaluated in subgroups of surgically treated patients. RESULTS:: Of the 314 patients, 138 patients (43.9%) had EGFR mutations. The frequency of EGFR mutation was statistically higher for patients with brain metastases (64.7%, brain metastases; 39.8%, no metastases; 40.2%, extracranial metastases; p = 0.005). A strong association between EGFR mutation status and brain metastasis was observed (adjusted odds ratio = 3.83, p = 0.001), whereas no association was observed between EGFR mutation status and extracranial metastases (adjusted odds ratio = 1.73, p = 0.079). In addition, the number of brain metastases was significantly correlated with the EGFR mutation status (p = 0.029). Further analysis of 133 patients treated with surgical resection showed that EGFR mutation status was a poor prognostic factor for the risk of brain metastasis (hazard ratio = 4.49, p = 0.026) after adjustment for pathologic N stage. CONCLUSIONS:: We found a significant association between EGFR mutation and risk of brain metastases at the time of diagnosis and follow-up after curative resection for pulmonary adenocarcinoma. This result indicates the distinct clinical features of EGFR-mutated tumors in terms of brain metastases. © 2013 by the International Association for the Study of Lung Cancer.


Lim J.S.,Korea Cancer Center Hospital | Lee D.H.,Soonchunhyang University
Osteoporosis International | Year: 2013

Homocystinuria due to cystathionine β-synthase (CBS) deficiency is an inherited disorder of the metabolism of methionine. Clinical manifestations include mental retardation, dislocation of the optic lens, vascular lesions, arterial and venous thromboembolism, skeletal abnormalities, and osteoporosis. Most homocystinuria patients diagnosed in adulthood have severe osteoporosis, and homocystinuria is frequently mentioned as a cause of osteoporosis. Good control of plasma homocysteine may prevent or delay some of these complications. However, the effectiveness of bone mineral density (BMD) gain or fracture prevention has not been addressed. Here, we describe changes in BMD and body composition in 5 CBS deficiency patients who were diagnosed at young age and were managed with good metabolic control. We found that the BMD of each region was within the normal range. BMD gain was adequate and the patients had no significant change in skeletal morphology. © 2013 International Osteoporosis Foundation and National Osteoporosis Foundation.


Shin D.,Jangseong Public Health Center | Kim S.,Korea Cancer Center Hospital | Kim K.H.,Seoul National University | Lee K.,Seoul National University | Park S.M.,Seoul National University
Journal of Clinical Endocrinology and Metabolism | Year: 2014

Context: The association between insulin resistance and bone mass is still not clear. Objective: The purpose of this study was to evaluate the association between insulin resistance and bone mass. Design and Setting: This was a cross-sectional survey of the nationally representative population. Participants: A total of 3113 men (aged ≥20 years) from the fourth Korean National Health and Nutrition Examination Survey of 2008-2009 were included. Main Outcome Measures: Bone mineral density (BMD) was measured using dual-energy x-ray absorptiometry. Osteopenia and osteoporosis were defined using the World Health Organization T score criteria. Fasting plasma insulin and glucose levels were measured, and insulin resistance was evaluated using the homeostasis model assessment-estimated insulin resistance (HOMA-IR) index. Results: Age-, height-, and weight-adjusted mean BMD values significantly decreased as quartiles of HOMA-IR and the fasting plasma insulin level increased (P for trends <.001). In multivariable logistic regression analyses, participants who had a higher HOMA-IR or fasting plasma insulin level had a higher odds ratio for osteoporosis/osteopenia. Interestingly, the association between fasting plasma insulin level and whole-body BMD differed by the degree of insulin resistance. In the lowest quartile of HOMA-IR, the fasting insulin level was positively associated with BMD. As insulin resistance increased, however, the fasting insulin level was inversely associated with BMD, and this relationship became more significant as the degree of insulin resistance increased. Conclusions: In a nationally representative sample of Korean men, insulin resistance and the fasting plasma insulin level were inversely associated with bone mass. Further studies are required to confirm this association and reveal the underlying mechanisms. Copyright © 2014 by the Endocrine Society.


Kang M.J.,Seoul National University | Lim J.S.,Korea Cancer Center Hospital
Korean Journal of Pediatrics | Year: 2013

As chemotherapy and other sophisticated treatment strategies evolve and the number of survivors of long-term childhood cancer grows, the long-term complications of treatment and the cancer itself are becoming ever more important. One of the most important but often neglected complications is osteoporosis and increased risk of fracture during and after cancer treatment. Acquisition of optimal peak bone mass and strength during childhood and adolescence is critical to preventing osteoporosis later in life. However, most childhood cancer patients have multiple risk factors for bone mineral loss. Cancer itself, malnutrition, decreased physical activity during treatment, chemotherapeutic agents such as steroids, and radiotherapy cause bone mineral deficit. Furthermore, complications such as growth hormone deficiency and musculoskeletal deformity have negative effects on bone metabolism. Low bone mineral density is associated with fractures, skeletal deformity, pain, and substantial financial burden not only for childhood cancer survivors but also for public health care systems. Thus, it is important to monitor bone health in these patients and minimize their risk of developing osteoporosis and fragility fractures later in life. © 2013 by The Korean Pediatric Society.


Choi N.,Konkuk University | Ko E.S.,Korea Cancer Center Hospital
Korean Journal of Radiology | Year: 2010

Mammary hamartomas are typically a benign condition and rarely develop into malignant lesions. Only 14 cases of carcinomas associated with a hamartoma have been documented in the literature. In this case report, we describe a case of invasive ductal carcinoma within a hamartoma in a 72-year-old woman. Mammography, ultrasonography, and magnetic resonance imaging showed the features of a typical hamartoma with a suspicious mass arising in it. This case illustrates the importance of identification of unusual findings in a typical mammary hamartoma on radiologic examinations.


Jeon D.-G.,Korea Cancer Center Hospital
Asia-Pacific Journal of Oncology and Hematology | Year: 2010

Osteosarcoma is a rare disease, and osteosarcoma complicated by a pathologic fracture is even rarer, and thus, the prognostic effect of fracture in osteosarcoma on survival is not well understood. In the past, a pathologic fracture per se was considered as an absolute indication for amputation. However, after the introduction of neoadjuvant chemotherapy and limb salvage, the major issue is the possibility of limb salvage in this condition. Today, the concept that a pathologic fracture is not a contraindication to limb salvage is largely accepted. Nevertheless, it remains to be determined whether the presence of a fracture jeopardizes survival or whether it is merely a manifestation of an aggressive tumor biology. Clinic pathologic variables of major concern regarding the prognosis of pathological fractures caused by osteosarcoma are location, histologic subtype, tumor size, histologic response, and local recurrence. However, confounding correlations between variables overlaid with the heterogeneous effects of study design differences are likely to cause contradictory results. In this review article, the author discusses the prognostic effects of pathological fractures, especially in terms of relations with other clinic pathologic variables.


Kim C.H.,Korea Cancer Center Hospital
Tuberculosis and Respiratory Diseases | Year: 2013

Knowledge of molecular pathogenesis of non-small cell lung cancer has increased remarkably and changed the principles of treatment, especially during the past decade. These advancements have been limited mainly to adenocarcinoma of the lung. Recently, genetic alterations in squamous cell lung cancer (SQCLC) have been detailed and positive results of clinical trials using agents targeting these changes have indicated the potential for improved treatment outcomes for SQCLC. © 2013 The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.


Jeon D.-G.,Korea Cancer Center Hospital | Song W.S.,Korea Cancer Center Hospital
Expert Review of Anticancer Therapy | Year: 2010

Despite numerous chemotherapy trials and the introduction of novel agents, survival in localized osteosarcoma, which plateaued in the mid-1980s, has been recalcitrant to our best efforts. The authors considered that a review of previous and current strategies that target survival might provide a direction for research efforts. Here, the focus is placed mainly on the reappraisal of previous mass chemotherapy trials and prognostic factors, in the hope of contriving a strategy to overcome the current stasis. © 2010 Expert Reviews Ltd.


Lee B.J.,Korea Cancer Center Hospital
Clinical nuclear medicine | Year: 2011

A 62-year-old woman was admitted for evaluation of a recently increased lung mass which had been regarded as benign for several years. Interestingly, hypermetabolism was noted in only half of the mass while standardized uptake value of the other half was very low on 1FDG PET/CT suggesting the difference in their nature. Finally, squamous cell carcinoma with hamartoma was found by pathologic examination of surgically removed tumor specimen. As a few reports have suggested that malignant transformation of hamartoma into adenocarcinoma or sarcoma could be possible, this is the first reported case showing that squamous cell carcinoma could also develop from hamartoma. Physicians should be aware of the malignant potential of pulmonary hamartoma.


Lee J.A.,Korea Cancer Center Hospital
Korean Journal of Pediatrics | Year: 2015

Osteosarcoma is the most frequent primary bone tumor. Advances in combination chemotherapy and surgical technique have greatly improved the survival of patients with osteosarcoma. In Korea, improvements in osteosarcoma treatment have been made over the past two decades. The 5-year event-free survival rate of Korean children and adolescents with localized disease is 64.6%, comparable to that of American or European patients. This article provides an overview of current therapies for osteosarcoma in Korea. © 2015 by The Korean Pediatric Society.

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