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Seoul, South Korea

Kim K.,CHA Medical University | Shin D.G.,Seoul Medical Center | Park M.K.,TCM Epigenetics and Genomics Laboratory | Baik S.H.,Yonsei University | And 3 more authors.
Annals of Surgical Treatment and Research | Year: 2014

Purpose: The aim of this study is to determine whether levels of circulating free DNA (cfDNA) increase according to cancer progression, whether they are restored after surgical resection, and to evaluate cfDNA in gastric cancer patients as a useful biomarker. Methods: A case-control study design was used. Thirty gastric cancer patients and 34 healthy subjects were enrolled from two hospitals in South Korea. The plasma cfDNA of patients with gastric cancer were obtained before surgery and 24 hours after surgery, and then analyzed by a quantitative, real-time polymerase chain reaction. Plasma samples were also obtained from the control group. Results: The mean levels of cfDNA in the healthy control group, patients with early gastric cancer, and with advanced gastric cancer were 79.78 ± 8.12 ng/mL, 106.88 ± 12.40 ng/mL, and 120.23 ± 10.08 ng/mL, respectively (P < 0.01). Sensitivity was 96.67% and specificity was 94.11% when the cutoff value was 90 ng/mL. Variables representing the tumor burden such as tumor size, T stage, TNM stage, and curative resection are also associated with the levels of cfDNA. The levels of cfDNA in the 24-hour-after-surgery group decreased significantly (112.17 ± 13.42 ng/mL vs. 77.93 ± 5.94 ng/mL, P < 0.001) compared to the levels of cfDNA in the preoperation group. Conclusion: The changes in the levels of cfDNA can act as reliable biomarkers to detect cancer early, to predict tumor burden, estimate curative resection and even prognosis. Copyright © 2014, the Korean Surgical Society.


Kim J.Y.,Sungkyunkwan University | Kim K.H.,Sungkyunkwan University | Choi J.S.,Hanyang University | Lee J.H.,MizMedi Hospital
Journal of Minimally Invasive Gynecology | Year: 2014

Study Objective: To compare operative and obstetric outcomes of laparoendoscopic single-site myomectomy (LESS-M) vs conventional laparoscopic myomectomy (LM). Design: Prospective matched case-control study. Setting: A university hospital and a tertiary care center. Patients: Forty-five women underwent LESS-M, and 90 women underwent conventional LM. Intervention: LESS-M or conventional LM. Measurements and Main Results: Operative and obstetric outcomes. There were no significant differences between the 2 groups in demographic characteristics, operative time (135 vs 140minutes), change in hemoglobin concentration (1.9 vs 1.95g/dL), return of bowel activity (35 vs 28hours), hospital stay (5 vs 5days), or complication rate (11.1% vs 8.9%). Insofar as obstetric outcomes, no significant differences were observed between the 2 groups for duration of follow-up (24.4 vs 23.2months), pregnancy rate in patients who desired pregnancy (66.7% vs 50.0%), full-term delivery rate (66.7% vs 58.3%), and time to first pregnancy after surgery (7.6 vs 10.1months). Conclusion: LESS-M is feasible and safe and has comparable obstetric outcomes to conventional LM in selected women with symptomatic myomas. However, a large prospective randomized study is needed. © 2014 AAGL.


Yuk J.-S.,Eulji University | Ji H.Y.,MizMedi Hospital | Shin J.-Y.,Eulji University | Kim L.Y.,The Health Insurance Review and Assessment Service of Korea | And 2 more authors.
Annals of Surgical Oncology | Year: 2016

Purpose: The primary objective of our study was to investigate the effect of morcellation on overall survival in women with unsuspected uterine malignancy (UUM) diagnosed after myomectomy by comparing women who underwent laparotomic myomectomy to those who underwent laparoscopic myomectomy. The secondary objective was to estimate the incidence of UUM diagnosed after myomectomy. Methods: We analyzed the mortality and incidence of women with UUM diagnosed after myomectomy using data from the national health insurance database between 2009 and 2013. To extract women with or without UUM diagnosed after myomectomy, we used diagnosis (C54.X) and procedure codes. We used the indicator of suspicion of death to verify deaths. Results: During the study period, among the study population of approximately 23 million women per year, 102144 women underwent myomectomy. Of them, 69955 and 32085 women were enrolled onto the laparotomic and laparoscopic groups, respectively. In each group, the numbers of women with UUM diagnosed after myomectomy were 76 and 50, respectively. The incidences of UUM and UUM excluding endometrial cancer, respectively, were 0.1, 0.15 % (p = 0.046) and 0.05, 0.07 % (p = 0.147) in each group, respectively. The overall 3-year survival rates for patients with UUM and UUM excluding endometrial cancer were 97.6 ± 0.2 % (n = 23), 91.5 ± 0.5 % (n = 12); and 93.8 ± 0.6 % (n = 8), 93.8 ± 0.6 % (n = 5) in each group, respectively. Additionally, there were no statistically significant differences between the groups with respect to overall survival of women with UUM with or without endometrial cancer (log-rank test; p = 0.14) (time-dependent Cox regression model; p = 0.93). Conclusions: There was no difference in the overall survival of women with UUM with or without endometrial cancer between groups. The incidence of UUM with or without endometrial cancer diagnosed after myomectomy was quite low. © 2015, Society of Surgical Oncology.


Yuk J.-S.,MizMedi Hospital | Kim Y.-J.,Korea University | Hur J.-Y.,Korea University | Shin J.-H.,Korea University
International Journal of Gynecology and Obstetrics | Year: 2013

Objective To estimate the incidence of Bartholin duct cysts and abscesses in the Republic of Korea during 2009. Methods A national patient sample (n = 599 186) was obtained from Korean Health Insurance Review and Assessment Service data and analyzed to estimate the incidence of Bartholin duct cysts and abscesses among Korean women in 2009. Results There were 587 Bartholin duct cysts and 757 Bartholin duct abscesses during 2009. The total incidence of Bartholin duct cysts and abscesses was 0.55 per 1000 person-years and 0.95 per 1000 person-years, respectively. In women aged 35-50 years, the incidence was 1.21 per 1000 person-years and 1.87 per 1000 person-years, respectively. In multivariate logistic regression analysis, the incidence of Bartholin duct cysts and abscesses was associated with age (P < 0.01), but not with season or socioeconomic status, among women aged 15-50 years. The main operation performed was marsupialization (45.2%) for Bartholin duct cysts and incision (71.5%) for Bartholin duct abscesses. Conclusion The incidence of Bartholin duct cysts and abscesses increased with age until menopause, decreasing thereafter. © 2013 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics.


Yuk J.-S.,MizMedi Hospital | Kim Y.J.,Korea University | Hur J.-Y.,Korea University | Shin J.-H.,Korea University
International Journal of Gynecology and Obstetrics | Year: 2013

Objective To estimate the ectopic pregnancy rate in the Republic of Korea and to identify whether socioeconomic factors contribute to the incidence of ectopic pregnancy. Methods Korean National Health Insurance data from January to December 2009 were analyzed to calculate the rate of ectopic pregnancy. Results Among the patient sample (n = 599 186), 59 261 had diagnosis codes for ectopic pregnancies, abortions, or deliveries, and 1102 ectopic pregnancies were identified. The frequency of ectopic pregnancy treated by either surgery or methotrexate was 16.60 per 1000 pregnancies. Low socioeconomic status was a risk factor for ectopic pregnancy (odds ratio [OR], 1.718; 95% confidence interval [CI], 1.065-2.772; P = 0.03), as was older age (OR, 1.016; 95% CI, 0.998-1.033, P = 0.07), although the association was not significant. Among women aged 25-44 years, low socioeconomic status and age were associated with a high incidence of ectopic pregnancy (OR, 1.863; 95% CI, 1.074-3.233, P = 0.03; and OR, 1.061; 95% CI, 1.041-1.081, P < 0.01, respectively). Surgical and methotrexate treatment rates were 90.7% and 9.3%, respectively. The methotrexate failure rate was 30.7%. The recorded ectopic pregnancy sites were tubal or ovarian (90.2%), cornual (6.0%), cervical (2.8%), and abdominal (1.0%). Conclusion Older age and low socioeconomic status were risk factors for ectopic pregnancy. © 2013 International Federation of Gynecology and Obstetrics.

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