Publications by authors named "Paul Shin"

Introduction: The National Comprehensive Cancer Network (NCCN) recommends excision of the primary tumor using 1-2-cm surgical margins and sentinel lymph node biopsy (SLNB) as the initial management of early-stage Merkel cell carcinoma (MCC). However, there is no clear consensus on the appropriate size of the surgical margins and/or the use of Mohs micrographic surgery (MMS). Our aim was to demonstrate that, independent of the type of surgery, obtaining negative surgical margins is associated with enhanced overall survival (OS).

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Purpose: Intrahepatic cholangiocarcinoma (IHC) is a heterogeneous tumor. The hidden-genome classifier, a supervised machine learning-based algorithm, was used to quantify tumor heterogeneity and improve classification.

Experimental Design: A retrospective review of 1,370 patients with IHC, extrahepatic cholangiocarcinoma (EHC), gallbladder cancer (GBC), hepatocellular carcinoma (HCC), or biphenotypic tumors was conducted.

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Objective: The aim of this study was to describe the surgeon's ability to accurately predict the margin following resection of colorectal liver metastases (CRLMs).

Background: The decision to resect CRLM is based on the surgeon's ability to predict tumor-free resection margins. However, to date, no study has evaluated the accuracy of surgeon margin prediction.

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Objectives: We aimed to determine whether surgeon variation in management of intraductal papillary mucinous neoplasm (IPMN) is driven by differences in risk perception and quantify surgeons' risk threshold for changing their recommendations.

Background: Surgeons vary widely in management of IPMN.

Methods: We conducted a survey of members of the Americas HepatoPancreatoBiliary Association, presented participants with 2 detailed clinical vignettes and asked them to choose between surgical resection and surveillance.

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Aging is a major risk factor for cognitive impairment. Aerobic exercise benefits brain function and may promote cognitive health in older adults. However, underlying biological mechanisms across cerebral gray and white matter are poorly understood.

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The impacts of eutrophication on benthic ecological functions are of increasing concern in recent years. In order to assess the response of macrobenthic fauna to increasing eutrophication, two field sampling surveys were conducted during the summer (July-August 2020) and autumn (October-November 2020) from offshore, nearshore to estuarine sediments in Bohai Bay, northern China. Biological trait analysis was employed for the assessment of macrofaunal samples.

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Blood flow dynamics in microvascular networks are intimately related to the health of tissues and organs. While numerous imaging modalities and techniques have been developed to assess blood flow dynamics for various applications, their utilization has been hampered by limited imaging speed and indirect quantification of blood flow dynamics. Here, direct blood cell flow imaging (DBFI) is demonstrated that provides visualization of individual motions of blood cells over a field of 0.

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Aging is a major risk factor for cognitive impairment. Aerobic exercise benefits brain function and may promote cognitive health in older adults. However, underlying biological mechanisms across cerebral gray and white matter are poorly understood.

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Objective: We aimed to determine whether surgeon variation in management of intraductal papillary mucinous neoplasms (IPMN) is driven by differences in risk perception and quantify surgeons' risk threshold for changing their recommendations.

Background: Surgeons vary widely in management of IPMN.

Methods: We conducted a survey of members of the Americas HepatoPancreatoBiliary Association, presented participants with 2 detailed clinical vignettes and asked them to choose between surgical resection and surveillance.

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Article Synopsis
  • This study investigates cancer patients' understanding of their treatment outcomes, particularly focusing on those with gastrointestinal (GI) cancers across all stages of the disease, not just advanced cases.
  • Out of 135 patients analyzed, only 48% had accurate expectations about their potential for a cure, with lower accuracy observed in more advanced stages of cancer and in patients with unresectable tumors.
  • The findings suggest that improving communication strategies could help enhance patients' understanding of their illness and treatment, especially for those with challenging diagnoses.
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Seasonality has a significant effect on the physiology of fish, especially the effect of water temperature changes. In the present study, the growth, innate immune parameters and liver function indices of two rescued wild adult Chinese sturgeons under captive conditions were monitored for 1 year. The results showed that the total annual weight loss rate of the male was -4.

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Background: Advance care planning, the process through which patient values and goals are explored and documented, is a core quality indicator in cancer care. However, patient values are predominantly elicited at the end of life; patient values earlier in serious illness are not clearly delineated. The objective of this analysis is to assess the content of patient-verified summaries of health-related values among newly diagnosed cancer outpatients in order to develop a theoretical framework to guide future values discussions and optimize person-centered oncologic care.

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Proper regulation and patency of cerebral microcirculation are crucial for maintaining a healthy brain. Capillary stalling, i.e.

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Objective: To determine whether genomic risk groups identified by somatic mutation testing of colorectal liver metastasis (CRLM) can be used for "molecularly-guided" selection for adjuvant systemic chemotherapy and hepatic artery infusion of FUDR (SYS+HAI-FUDR).

Background: Several genomic biomarkers have been associated with clinical phenotype and survival for patients with resectable CRLM. It is unknown whether prognostication afforded by genomic stratification translates into enhanced patient selection for adjuvant hepatic artery infusion therapy.

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Purpose: Lymph node metastasis (LNM) drastically reduces survival after resection of intrahepatic cholangiocarcinoma (IHC). Optimal treatment is ill defined, and it is unclear whether tumor mutational profiling can support treatment decisions.

Experimental Design: Patients with liver-limited IHC with or without LNM treated with resection ( = 237), hepatic arterial infusion chemotherapy (HAIC; = 196), or systemic chemotherapy alone (SYS; = 140) at our institution between 2000 and 2018 were included.

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Article Synopsis
  • The study investigates the genetic alterations in intrahepatic cholangiocarcinoma (iCCA) and their impact on patient outcomes, analyzing 412 cases using targeted next-generation sequencing.
  • Key findings show that certain genetic mutations (TP53, KRAS, and CDKN2A) are linked to poorer overall survival regardless of disease stage, indicating their potential as important prognostic markers.
  • The presence of high-risk genetic or clinical factors significantly affects survival outcomes, with patients having neither showing a median overall survival of 74.2 months, compared to just 18.3 months for those with both high-risk factors.
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Objective: To study the relationship between postwash total motile sperm count (TMSC) and intrauterine insemination (IUI) outcomes.

Design: Retrospective review SETTING: Large fertility clinic PATIENT(S): A total of 92,471 insemination cycles from 37,553 patients were included in this study.

Intervention(s): All stimulated clomiphene citrate, letrozole, and/or injectable gonadotropin IUI cycles performed at a single institution from 2002 through 2018 were reviewed.

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Male infertility is a common disease. Male infertility is also a core competency of urology training and clinical practice. In this white paper from the Society for the Study of Male Reproduction and the Society for Male Reproduction and Urology, we identify and define different physician productivity plans.

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Having a clear understanding of functional hyperemia is crucial for functional brain imaging and neurological disease research. Vasodilation induced by sensory stimulus propagates from the arterioles to the upstream pial arteries in a retrograde fashion. As retrograde vasodilation occurs briefly in the early stage of functional hyperemia, an imaging technique with a high temporal resolution is required for its measurement.

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Purpose: We retrospectively evaluated the utility of sperm cryopreservation at the time of vasectomy reversal.

Materials And Methods: From April 2016 through December 2018 a total of 26 men underwent vasectomy reversal. Sperm cryopreservation is routinely offered at the time of vasectomy reversal at our institution.

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In optical coherence tomography (OCT), high-speed systems based at 1300 nm are among the most broadly used. Here, we present 9.4 MHz A-line rate OCT system at 1300 nm.

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Constructed wetlands (CWs) have been used for wastewater treatment for decades, but research on microorganisms involved, especially long-term changes, is still limited. In this study, we evaluated changes in the substrate microbial community in a pilot-scale horizontal subsurface-flow constructed mangrove wetland during 10-years operation. In the 3rd year of operation, microbial biomass carbon and phospholipid fatty acids (PLFAs) reached peak values in two vegetated belts planted with Aegiceras corniculatum (Ac) and Kandelia obovata (Ko), respectively, then stabilized or declined in the 9th and 10th years of operation.

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