1
|
Kim S, Kim MJ, Myong JP, Lee YH, Kim BY, Hwang A, Kim GO, Jeong SH, Yoon HK, An TJ, Lim JU. Prior pneumococcal vaccination improves in-hospital mortality among elderly population hospitalized due to community-acquired pneumonia. BMC Pulm Med 2024; 24:168. [PMID: 38589839 PMCID: PMC11000283 DOI: 10.1186/s12890-024-02928-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/22/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Pneumococcal vaccination is a preventive method to reduce pneumonia related mortality. However, real-world data on efficacy of the pneumococcal vaccine in reducing mortality is lacking, especially in elderly patients. This study was conducted to assess the effects of prior pneumococcal vaccination in elderly pneumonia patients. METHODS The data was procured from the Health Insurance Review and Assessment and Quality Assessment database. Hospitalized patients who met the criteria of community-acquired pneumonia (CAP) were included and they were grouped according to vaccination state. Patients were aged ≥ 65 years and treated with beta-lactam, quinolone, or macrolide. Patients were excluded when treatment outcomes were unknown. RESULTS A total of 4515 patients were evaluated, and 1609 (35.6%) of them were vaccinated prior to hospitalization. Mean age was 77.0 [71.0;82.0], 54.2% of them were male, and mean Charlson comorbidity index (CCI) was 3.0. The patients in the vaccinated group were younger than those in the unvaccinated group (76.0 vs. 78.0 years; P < 0.001), and showed higher in-hospital improvement (97.6 vs. 95.0%; P < 0.001) and lower 30-day mortality (2.6 vs. 5.3%; P < 0.001). After adjusting confounding factors such as age, gender, CURB score and CCI score, the vaccinated group demonstrated a significant reduction in 30-day mortality (hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.41-0.81; P < 0.01) and in-hospital mortality (HR 0.53, 95% CI0.37-0.78; P < 0.001) compared to the unvaccinated group in multivariate analysis. Vaccinated group showed better 30-day survival than those in non-vaccinated group (log-rank test < 0.05). CONCLUSIONS Among elderly hospitalized CAP patients, prior pneumococcal vaccination was associated with improved in-hospital mortality and 30-day mortality.
Collapse
Affiliation(s)
- Seohyun Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal medicine, Yeouido St. Mary`s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Moon Jin Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal medicine, Yeouido St. Mary`s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jun-Pyo Myong
- Department of Occupational and Environmental Medicine, Seoul St. Mary`s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yun-Hee Lee
- Department of Urology, Seoul St. Mary`s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bo Yeon Kim
- Healthcare Review and Assessment Committee, Health Insurance Review and Assessment Service , Wonju, Korea
| | - Ahyoung Hwang
- Quality Assessment Department, Health Insurance Review and Assessment Service , Wonju, Korea
| | - Gui Ok Kim
- Quality Assessment Administration Department, Health Insurance Review and Assessment Service , Wonju, Korea
| | - Sung Hwan Jeong
- Healthcare Review and Assessment Committee, Health Insurance Review and Assessment Service , Wonju, Korea
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Gil Medical Center, Gachon University, Incheon, Korea
| | - Hyoung Kyu Yoon
- Division of Pulmonary and Critical Care Medicine, Department of Internal medicine, Yeouido St. Mary`s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Tai Joon An
- Division of Pulmonary and Critical Care Medicine, Department of Internal medicine, Yeouido St. Mary`s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| | - Jeong Uk Lim
- Division of Pulmonary and Critical Care Medicine, Department of Internal medicine, Yeouido St. Mary`s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| |
Collapse
|
2
|
Reimer-Taschenbrecker A, Hess M, Davidovic M, Hwang A, Hübner S, Hofsaess M, Gewert S, Eyerich K, Has C. IL-6 levels dominate the serum cytokine signature of severe epidermolysis bullosa: A prospective cohort study. J Eur Acad Dermatol Venereol 2024. [PMID: 38376135 DOI: 10.1111/jdv.19898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/22/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Systemic inflammation is considered a major player in the pathogenesis of epidermolysis bullosa (EB), but its pattern has only been described in small heterogeneous cohorts. There is controversy if and how systemic inflammation should be therapeutically targeted. METHODS We examined serum proinflammatory, anti-inflammatory, and itch related cytokines in a paediatric cohort of 29 patients with junctional and dystrophic EB. The cytokine that emerged as the most relevant was measured in a validation cohort of 42 patients during follow-up visits over 2 years. RESULTS IL-6 showed the most consistent and highest aberration dominating systemic inflammation. IL-6 correlated with wound body surface area (BSA) in both, finding and validation cohorts. Patients with less than 3% wound BSA had normal IL-6, while IL-6 levels significantly increased at more than 5% and 10% of wound BSA. TGF-β was only marginally elevated in patients with severe recessive dystrophic EB, while TNF-α, IFN-γ and IL-1β varied inconsistently. Patients reporting itch showed elevations in type 2 immunity (IgE, TSLP, IL4 and/or IL-31, respectively). CONCLUSIONS Our data suggest a dominant skin barrier and wound healing inflammatory pattern in junctional and dystrophic EB that depends on the wound area and not on the EB type. In EB, itch mediators may be similar to other pruritic disorders.
Collapse
Affiliation(s)
- A Reimer-Taschenbrecker
- Department of Dermatology, Medical Faculty and Medical Center, University of Freiburg, Freiburg, Germany
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - M Hess
- Institute of Medical Biometry and Statistics, Medical Faculty and Medical Center, University of Freiburg, Freiburg, Germany
| | - M Davidovic
- Department of Dermatology, Medical Faculty and Medical Center, University of Freiburg, Freiburg, Germany
| | - A Hwang
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - S Hübner
- Department of Dermatology, Medical Faculty and Medical Center, University of Freiburg, Freiburg, Germany
| | - M Hofsaess
- Department of Dermatology, Medical Faculty and Medical Center, University of Freiburg, Freiburg, Germany
| | - S Gewert
- Department of Dermatology, Medical Faculty and Medical Center, University of Freiburg, Freiburg, Germany
| | - K Eyerich
- Department of Dermatology, Medical Faculty and Medical Center, University of Freiburg, Freiburg, Germany
| | - C Has
- Department of Dermatology, Medical Faculty and Medical Center, University of Freiburg, Freiburg, Germany
| |
Collapse
|
3
|
Hamrouni M, Hwang A, Jankowski M, Mishra J, Stokowski HS, McKenna TP, Jornod N, Langrock C, Südmeyer T, Safavi-Naeini AH, Fejer MM. Efficient and Broadband Generation of Mid-Infrared Pulses by Optical Parametric Amplification in Dispersion-Engineered Thin Film Lithium Niobate. EPJ Web Conf 2022. [DOI: 10.1051/epjconf/202226702017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
4
|
Burke A, Prins P, Khan A, Hwang A, Marshall J, Unger K. Comprehensive Genetic Profiling and Clinical Outcomes in Gastrointestinal Cancers Treated with Radiotherapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
5
|
Pickerell ATW, Hwang A, Axcell BC. Impact of Yeast-Handling Procedures on Beer Flavor Development during Fermentation. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-49-0087] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- A. T. W. Pickerell
- The South African Breweries Ltd., Department of Research and Development, Box 782178, Sandton, 2146, Republic of South Africa
| | - A. Hwang
- The South African Breweries Ltd., Department of Research and Development, Box 782178, Sandton, 2146, Republic of South Africa
| | - B. C. Axcell
- The South African Breweries Ltd., Department of Research and Development, Box 782178, Sandton, 2146, Republic of South Africa
| |
Collapse
|
6
|
Reid GC, Hwang A, Meisel RH, Allcock ER. The Sterile Filtration and Packaging of Beer into Polyethylene Terephthalate Containers. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-48-0085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- G. C. Reid
- The South African Breweries Ltd., P.O. Box 782178, Sandton 2146
| | - A. Hwang
- The South African Breweries Ltd., P.O. Box 782178, Sandton 2146
| | - R. H. Meisel
- The South African Breweries Ltd., P.O. Box 782178, Sandton 2146
| | - E. R. Allcock
- Microsep (Pty) Ltd., Bramley, Republic of South Africa
| |
Collapse
|
7
|
Audet C, Poffenbarger B, Hwang A. SU-E-T-224: Considerations for the Proper Treatment of Multiple Cranial Metastases with Single Isocenter Volumetric Modulated Arc Therapy. Med Phys 2015. [DOI: 10.1118/1.4924585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
8
|
Shanmugasegaram S, Khan S, Hwang A, Thomas S, Oh P. 201 Examining the Relationships Between Cardiac Rehabilitation (CR) Components and Long-term Physical Activity (PA) Maintenance Post-CR. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
9
|
Nie K, Pouliot J, Hwang A, Sneed P, McDermott M, Ma L. SU-D-211-04: Sector Intensity Modulated (SIM) Gamma Knife Stereotactic Radiosurgery. Med Phys 2012; 39:3610. [PMID: 28517415 DOI: 10.1118/1.4734658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE The latest Gamma Knife (GK) system, Perfexion, consists of 192 Co-60 sources divided into eight sectors. Treatment delivery includes multiple shots placed at different positions. For every shot, each sector can be either blocked or open with four different aperture sizes. However, the beam-on time is designed to be fixed. We proposed an innovative concept, Sector Intensity Modulated (SIM) Gamma Knife by dynamically varying the beam-on time for each individual sector to improve stereotactic radiosurgery planning quality. METHODS The anatomic structures and dose matrices from each sector for every shot were obtained from the GK workstation. The beam-on time for each sector was decomposed with various discrete levels and brute-force algorithm was used to get the optimal solution. The resulting SIM plan was then re-entered into the GK workstation. Six indices were used to benchmark the plan quality: Coverage, Conformality, Gradient, Maximum Dose(s) to critical structure(s), Volume receiving over 8 and 12 Gy. All the SIM plans in comparison with the original plans were further reviewed by an experienced oncologist. RESULTS The simulations were tested on various pituitary adenoma cases. Results consistently showed that SIM yielded better plans with all quantitative indices improved compared to original plan. It provides better conformality, quicker drop off of the isodose line outside the tumor, lower doses to the critical structures as optical- nerve/chiasm while maintaining at least 99% coverage of the tumor. Results were more favorable according to oncologist's view. In particular, up to 20% or 0.6 cc volume decrease in healthy tissue receiving 8 Gy was observed. This may translate into clinically observable reduction in acute/late toxicities. CONCLUSIONS Our preliminary results show that Sector Intensity Modulated Gamma Knife offers superior treatment plans compared to the originally delivered plans. Further works as adding dynamic shot location and dynamic shot shaping will be discussed.
Collapse
Affiliation(s)
- K Nie
- University of California San Francisco, San Francisco, CA
| | - J Pouliot
- University of California San Francisco, San Francisco, CA
| | - A Hwang
- University of California San Francisco, San Francisco, CA
| | - P Sneed
- University of California San Francisco, San Francisco, CA
| | - M McDermott
- University of California San Francisco, San Francisco, CA
| | - L Ma
- University of California San Francisco, San Francisco, CA
| |
Collapse
|
10
|
Soto A, Hwang A, Stansbury J. Probing photopolymerization reactions with real-time UV/vis/near-IR spectroscopy. Dent Mater 2012. [DOI: 10.1016/j.dental.2012.07.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
11
|
Ma L, Sahgal A, Hwang A, Hu W, Descovich M, Chuang C, Barani I, Sneed PK, McDermott M, Larson DA. A Two-Step Optimization Method for Improving Multiple Brain Lesion Treatments with Robotic Radiosurgery. Technol Cancer Res Treat 2011; 10:331-8. [DOI: 10.7785/tcrt.2012.500210] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Planning robotic radiosurgery treatments for multiple (n > 3) metastatic brain lesions is challenging due to the need of satisfying a large number of dose-volume constraints and the requirement of prescribing different dose levels to individual targets. In this study, we developed a sequential two-step optimization technique to improve the planning quality of such treatments. In contrast to the conventional approach of where all targets are simultaneously planned, we have developed a two-step optimization method. In this method, the first step was to create treatment plans for individual targets. In the second step, the 3D dose matrices associated with each plan were exported to Dicom-RT digital files and subsequently optimized. For the optimization, a singular-value-decomposition (SVD) algorithm was implemented to minimize the dose interferences among different targets. Finally, we compared the optimized treatment plans with the treatment plans created using the conventional method to determine the effectiveness of the new method. Large improvements in target dose distributions as well as normal brain sparing were found for the two-step optimization treatment plans as compared with the conventional treatment plans. The two-step optimization significantly lowered the volume of normal brain receiving relatively low doses. For example, the normal brain volume receiving 12-Gy was reduced by averaged 42% (range 34%–47%) with the two-step optimization. Such improvements generally enlarged with increasing number of targets being treated regardless of target sizes. Of note, normal brain dose was found to increase non-linearly with increasing number of targets. In summary, a two-step optimization technique is demonstrated to significantly improve the treatment plan quality as well as reduce the planning effort for multi-target robotic radiosurgery.
Collapse
Affiliation(s)
- L. Ma
- University of California San Francisco, Department of Radiation Oncology & Neurosurgery, UCSF Medical Center 505 Parnassus Avenue, Room L08 San Francisco, CA 94143, USA
| | - A. Sahgal
- Department of Radiation Oncology, Princess Margaret Hospital, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - A. Hwang
- University of California San Francisco, Department of Radiation Oncology & Neurosurgery, UCSF Medical Center 505 Parnassus Avenue, Room L08 San Francisco, CA 94143, USA
| | - W. Hu
- Department of Radiation Oncology, Fudan University Cancer Hospital, Shanghai, China
| | - M. Descovich
- University of California San Francisco, Department of Radiation Oncology & Neurosurgery, UCSF Medical Center 505 Parnassus Avenue, Room L08 San Francisco, CA 94143, USA
| | - C. Chuang
- University of California San Francisco, Department of Radiation Oncology & Neurosurgery, UCSF Medical Center 505 Parnassus Avenue, Room L08 San Francisco, CA 94143, USA
| | - I. Barani
- University of California San Francisco, Department of Radiation Oncology & Neurosurgery, UCSF Medical Center 505 Parnassus Avenue, Room L08 San Francisco, CA 94143, USA
| | - P. K. Sneed
- University of California San Francisco, Department of Radiation Oncology & Neurosurgery, UCSF Medical Center 505 Parnassus Avenue, Room L08 San Francisco, CA 94143, USA
| | - M. McDermott
- University of California San Francisco, Department of Radiation Oncology & Neurosurgery, UCSF Medical Center 505 Parnassus Avenue, Room L08 San Francisco, CA 94143, USA
| | - D. A. Larson
- University of California San Francisco, Department of Radiation Oncology & Neurosurgery, UCSF Medical Center 505 Parnassus Avenue, Room L08 San Francisco, CA 94143, USA
| |
Collapse
|
12
|
Ma L, Li K, Hwang A, Sahgal A, McDermott M, Sneed P, Larson D. SU-C-BRB-06: High-Precision Volume-Staged Treatments with Stereotactic Radiosurgery. Med Phys 2011. [DOI: 10.1118/1.3611472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
13
|
Pomplun M, Hwang A. The Dynamics of Top-Down and Bottom-Up Control of Visual Attention during Search in Complex Scenes. J Vis 2010. [DOI: 10.1167/10.7.1275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
14
|
Ahmed F, Hwang A, Walsh E, Pomplun M. Conspicuity of Object Features Determines Local versus Global Mental Rotation Strategies. J Vis 2010. [DOI: 10.1167/10.7.1005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
15
|
Hwang A, Nguyen TB, Hu W, Roach M, Gottschalk A, Pouliot J, Aubin M, Chen J. SU-GG-T-22: An Adaptive Strategy for Simultaneous Treatment of the Prostate and Pelvic Lymph Nodes. Med Phys 2010. [DOI: 10.1118/1.3468408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
16
|
Kirby N, Chuang C, Pouliot J, Hwang A, Barani I. SU-GG-T-129: Sparing of Neural Stem Cells during Whole-Brain Radiation Treatments. Med Phys 2010. [DOI: 10.1118/1.3468518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
17
|
Hwang A, Sneed P, Barani I, Nakamura JL, Barbaro NM, Ma L. SU-GG-T-519: Improving Gamma Knife Plans Using Independent Sector Weighting. Med Phys 2010. [DOI: 10.1118/1.3468915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
18
|
Ma L, Sahgal A, Hwang A, Hu W, Chuang C, Descovich M, Larson DA. SU-GG-T-510: A Two-Step Optimization Technique for Planning Multi-Target Treatments with Robotic Radiotherapy. Med Phys 2010. [DOI: 10.1118/1.3468906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
19
|
|
20
|
Chen C, Xia P, Bui T, Kramer M, Hwang A, Schechter N, Fowble B. Atlas-based Cardiac Contours in Breast Cancer Patients Offer Efficiency, Standardization, and Comparable Spatial and Dosimetric Accuracy when Compared to Manually Generated Contours. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.1414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
21
|
|
22
|
Tsuji S, Hwang A, Weinberg V, Yom S, Quivey J, Xia P. Adaptive IMRT for Head and Neck Cancer Based on Automatically Generated Contours using Deformable Image Registration. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
23
|
Xia P, Hwang A, Ludlum E, Aubin M, Pouliot J, Roach M. TU-D-AUD B-08: Clinical Validation of a Novel Adaptive Approach for Patients Concurrently Treated with the Prostate and Pelvic Lymph Nodes. Med Phys 2008. [DOI: 10.1118/1.2962580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
24
|
Hwang A, Mu G, Xia P. SU-GG-T-91: Decreasing IMRT Delivery Time by Accounting for Secondary Jaw Movement. Med Phys 2008. [DOI: 10.1118/1.2961843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
25
|
Gillis A, Hwang A, Teo K, Bacharach S, Bucci M, Millender L, Schechter N, Quivey J, Franc B, Xia P. PET-CT for Head and Neck IMRT Planning: Target Delineation and Dose Escalation. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
26
|
Xia P, Hwang A, Mu G, Ludlum E, Aubin M, Pouliot J, Roach III M. Multi-Adaptive-Plan (MAP) IMRT to Accommodate the Independent Movement of the Prostate and Pelvic Lymph Nodes: A Proof of Principle Study Driven by Clinical Necessity. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.2118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
27
|
Sharma S, Vogelzang N, Beck J, Patnaik A, Mita M, Dugan M, Hwang A, Culver K, Atadja P, Prince H. 702 POSTER Phase I pharmacokinetic and pharmacodynamic study of once-weekly IV LBH589. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70501-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
28
|
Sharma S, Vogelzang NJ, Beck J, Patnaik A, Mita M, Dugan M, Hwang A, Masson E, Culver KW, Prince H. Phase I pharmacokinetic (PK) and pharmacodynamic (PD) study of LBH589, a novel deacetylase (DAC) inhibitor given intravenously on a new once weekly schedule. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.14019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
14019 Background: LBH589 is a novel deacetylase inhibitor that inhibits proliferation of tumor cells at nanomolar levels. This phase I study tested the safety and tolerability of IV LBH589 once each week for 3 of 4 wks in pts with advanced solid tumors or lymphoma. Methods: LBH589 was administered IV over 30 min. on days 1, 8 and 15 of a 28-day cycle. Western blots on peripheral blood lymphocytes were used to study histone acetylation (HA). Plasma PK profiles were analyzed on Days 1 and 8. Results: Thirty five pts (median age: 70 yrs; 23M, 12F) have been treated on 3 dose levels [10 mg/m2 (8pts), 15 mg/m2 (8 pts), 20 mg/m2 (19 pts)] with the following tumor types: Cutaneous and peripheral T cell lymphoma (7 pts), prostate (6 pts), mesothelioma (4 pts), colon (3 pts) and other (15 pts). There was one dose-limiting toxicity (transient grade 4 thrombocytopenia) at 20 mg/m2, none at the lower doses. Other G3/G4 toxicities (all cycles) include: transient thrombocytopenia (G4–5 pts, G3–5 pts), neutropenia (G3–2 pts), anemia (G3–5 pts), G3 hypophosphatemia (1 pt), G3 hypokalemia (1 pt), G3 nausea (1 pt) and G3 pruritus (1 pt). Thrombocytopenia was transient. Of 2,042 ECGs, 1 pt had an increase in QTcF from baseline of > 60 msec another with a QTcF >500 msec, both at 20 mg/m2. There was a dose-dependent increase in HA 7 days after one dose with 43% (10 mg/m2), 50% (15 mg/m2) and 60% (20 mg/m2) of pts with increased acetylation. The LBH589 plasma conc. peaked at the end of the 0.5 hr infusion with a mean terminal half-life of 16 hr. Median Cmax achieved with 20 mg/m2 was 1,000 ng/mL (2.86 μM). The AUC0-inf increased linearly with IV doses of 10–20 mg/m2. One pt with CTCL achieved a complete response (CR) on cycle 3, Day 1; this pt had previously received oral LBH589 at 20 mg MWF, achieving a CR on cycle 6, Day 28 that lasted for 7 months. One peripheral T-Cell lymphoma pt achieved a partial response that has persisted for >7 months. One pt with prostate cancer has had a 26% reduction in nodal disease and > 50% drop in PSA in the first 2 cycles. Conclusions: The maximum tolerated dose of LBH589 given IV wkly on a 3 of 4 wk schedule is 20 mg/m2. This dose produced sustained PD effects and higher systemic exposure compared to oral LBH589. Preliminary evidence of antitumor activity has been observed. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- S. Sharma
- Nevada Cancer Inst, Las Vegas, NV; Klinikum der Johannes Gutenberg-Universitat Mainz, Mainz, Germany; Institute for Drug Development,, San Antonio, TX; Novartis Pharmaceuticals Corp., East Hanover, NJ; Peter MacCallum Cancer Centre, Melbourne, Australia
| | - N. J. Vogelzang
- Nevada Cancer Inst, Las Vegas, NV; Klinikum der Johannes Gutenberg-Universitat Mainz, Mainz, Germany; Institute for Drug Development,, San Antonio, TX; Novartis Pharmaceuticals Corp., East Hanover, NJ; Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J. Beck
- Nevada Cancer Inst, Las Vegas, NV; Klinikum der Johannes Gutenberg-Universitat Mainz, Mainz, Germany; Institute for Drug Development,, San Antonio, TX; Novartis Pharmaceuticals Corp., East Hanover, NJ; Peter MacCallum Cancer Centre, Melbourne, Australia
| | - A. Patnaik
- Nevada Cancer Inst, Las Vegas, NV; Klinikum der Johannes Gutenberg-Universitat Mainz, Mainz, Germany; Institute for Drug Development,, San Antonio, TX; Novartis Pharmaceuticals Corp., East Hanover, NJ; Peter MacCallum Cancer Centre, Melbourne, Australia
| | - M. Mita
- Nevada Cancer Inst, Las Vegas, NV; Klinikum der Johannes Gutenberg-Universitat Mainz, Mainz, Germany; Institute for Drug Development,, San Antonio, TX; Novartis Pharmaceuticals Corp., East Hanover, NJ; Peter MacCallum Cancer Centre, Melbourne, Australia
| | - M. Dugan
- Nevada Cancer Inst, Las Vegas, NV; Klinikum der Johannes Gutenberg-Universitat Mainz, Mainz, Germany; Institute for Drug Development,, San Antonio, TX; Novartis Pharmaceuticals Corp., East Hanover, NJ; Peter MacCallum Cancer Centre, Melbourne, Australia
| | - A. Hwang
- Nevada Cancer Inst, Las Vegas, NV; Klinikum der Johannes Gutenberg-Universitat Mainz, Mainz, Germany; Institute for Drug Development,, San Antonio, TX; Novartis Pharmaceuticals Corp., East Hanover, NJ; Peter MacCallum Cancer Centre, Melbourne, Australia
| | - E. Masson
- Nevada Cancer Inst, Las Vegas, NV; Klinikum der Johannes Gutenberg-Universitat Mainz, Mainz, Germany; Institute for Drug Development,, San Antonio, TX; Novartis Pharmaceuticals Corp., East Hanover, NJ; Peter MacCallum Cancer Centre, Melbourne, Australia
| | - K. W. Culver
- Nevada Cancer Inst, Las Vegas, NV; Klinikum der Johannes Gutenberg-Universitat Mainz, Mainz, Germany; Institute for Drug Development,, San Antonio, TX; Novartis Pharmaceuticals Corp., East Hanover, NJ; Peter MacCallum Cancer Centre, Melbourne, Australia
| | - H. Prince
- Nevada Cancer Inst, Las Vegas, NV; Klinikum der Johannes Gutenberg-Universitat Mainz, Mainz, Germany; Institute for Drug Development,, San Antonio, TX; Novartis Pharmaceuticals Corp., East Hanover, NJ; Peter MacCallum Cancer Centre, Melbourne, Australia
| |
Collapse
|
29
|
|
30
|
Hwang A, Taylor C, Seo Y, Iwata K, Li J, Patt B, Hasegawa B. WE-D-I-609-03: Improving the Quantitative Accuracy of a Dedicated Small Animal SPECT/CT Scanner. Med Phys 2005. [DOI: 10.1118/1.1998548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
31
|
Affiliation(s)
- M L Bushey
- Department of Chemistry, Columbia University New York, New York 10027, USA
| | | | | | | |
Collapse
|
32
|
Abstract
Cyclin B1 mRNA is expressed temporally throughout the cell cycle with peak expression in G2 and M phase. Both transcriptional and posttranscriptional controls are important for this cell cycle-dependent regulation of cyclin B1 mRNA. In this study, we observed that cyclin B1 has two major transcripts: (a) a constitutively expressed transcript, and (b) a cell cycle-regulated transcript expressed predominantly during G2-M phase. These different transcripts are due to alternative start sites. The constitutively expressed transcript starts 65 bases upstream from the cell cycle-regulated message. Changes in mRNA stability did not appear to control the expression of the cell cycle-specific transcript, but we were able to identify a 24-base pair region of the cyclin B1 promoter spanning the start site of the cell cycle-regulated transcript that was critical for its cell cycle-regulated promoter activity. This suggests that transcriptional regulation is responsible for controlling the presence of each message. The 24-base pair sequence required for cell cycle regulation was notable for containing the nucleotides GGCT repeated three times. The possibility that these two transcripts might be physiologically distinct was raised when the cell cycle-specific transcript was found to be translated more efficiently in vitro than the constitutively expressed transcript. These results characterize a novel mechanism for the regulation of cyclin B1 throughout the cell cycle that is dependent upon the use of different transcriptional start sites.
Collapse
Affiliation(s)
- A Hwang
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA
| | | | | |
Collapse
|
33
|
Hwang A, Muschel RJ. Radiation and the G2 phase of the cell cycle. Radiat Res 1998; 150:S52-9. [PMID: 9806609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Exposure of mammalian cells to X rays results in prolongation of the cell cycle, including delays or arrests in G1, S and G2 phase. While G1-phase arrest occurs only in cells with wild-type p53 function, a G2-phase delay occurs in all cells regardless of p53 status. In this review, we summarize what is known about cell cycle progression through G2 and M phase and discuss the experimental findings that implicate different mechanisms in the G2-phase delay. Finally, we consider the possibility that G2-phase arrest plays a role in cell survival after irradiation.
Collapse
Affiliation(s)
- A Hwang
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia 19104, USA
| | | |
Collapse
|
34
|
Maity A, Hwang A, Janss A, Phillips P, McKenna WG, Muschel RJ. Delayed cyclin B1 expression during the G2 arrest following DNA damage. Oncogene 1996; 13:1647-57. [PMID: 8895510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Exposure of cells to DNA damaging agents results in a G2 arrest. Exposure of HeLa cells to camptothecin, etoposide or nitrogen mustard for 1 h in S phase resulted in delayed expression of cyclin B1 mRNA during the G2 arrest. Initially the levels of cyclin B1 protein were low as well; however, with extended time the cells blocked in G2 regained higher levels of cyclin B1 protein. In the case of cells treated with nitrogen mustard the higher levels coincided with cells exiting the G2 block into G1. However, with camptothecin or etoposide treatment, while the accumulation of cyclin B1 protein was delayed, its levels eventually surpassed peak levels seen in control cells, in spite of the fact that cells were still blocked in G2. These cells did not continue to progress through the cell cycle indicating further complexity to the mechanisms underlying the G2 block. Decreased transcription and stability of cyclin B1 mRNA were shown to occur after treatment with these DNA damaging agents. These results indicate that suppression of cyclin B1 mRNA expression is one consequence of DNA damage in HeLa cells.
Collapse
Affiliation(s)
- A Maity
- Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, USA
| | | | | | | | | | | |
Collapse
|
35
|
Abstract
Cyclin B1 mRNA expression varies through the cell cycle with its peak in G2/M. In cycling mammalian cells, its lowest level is in G1 with a steady increase in S until a level 50-fold greater than that in G1 is reached. In order to characterize the transcriptional component to this variation in expression, we cloned the upstream region 872 base pairs upstream from the start site of the cyclin B1 gene and have demonstrated that it confers cell cycle-dependent regulation onto two reporter genes, both chloramphenicol acetyltransferase and luciferase. Its activity was 25-fold greater in G2/M than in G1 in HeLa cells with intermediate activity in S. This cyclical activity could be seen with sequences encompassing only 90 base pairs upstream from the start site. Protein binding to this region was demonstrated using electrophoretic mobility shift assays, and the binding profiles appeared to vary depending upon the phase of the cycle in which the extracts are made. Thus, transcriptional control plays an important role in determining cyclin B1 mRNA levels, and cell cycle-dependent activity is regulated through interactions with the region 90 bases upstream from the start site.
Collapse
Affiliation(s)
- A Hwang
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia 19104, USA
| | | | | | | |
Collapse
|
36
|
Williams RE, Kass DA, Kawagoe Y, Pak P, Tunin RS, Shah R, Hwang A, Feldman AM. Endomyocardial gene expression during development of pacing tachycardia-induced heart failure in the dog. Circ Res 1994; 75:615-23. [PMID: 7923607 DOI: 10.1161/01.res.75.4.615] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Selective and specific changes in gene expression characterize the end-stage failing heart. However, the pattern and relation of these changes to evolving systolic and diastolic dysfunction during development of heart failure remains undefined. In the present study, we assessed steady-state levels of mRNAs encoding a group of cardiac proteins during the early development of left ventricular dysfunction in dogs with pacing-induced cardiomyopathy. Corresponding hemodynamic assessments were made in the conscious state in the same animals and at the same time points at baseline, after 1 week of ventricular pacing, and at the onset of clinical heart failure. Systolic dysfunction dominated after 1 week of pacing, whereas diastolic dysfunction was far more pronounced with the onset of heart failure. Atrial natriuretic factor mRNA was undetectable in 7 of 12 hearts at baseline but was expressed in all hearts at 1 week (P < .01 by chi 2 test), and it increased markedly with progression to failure (P = .05). Creatine kinase-B mRNA also rose markedly with heart failure (P < .01). Levels of mRNA encoding beta-myosin heavy chain, mitochondrial creatine kinase, phospholamban, and sarcoplasmic reticulum Ca(2+)-ATPase did not significantly change from baseline, despite development of heart failure. Additional analysis to determine if these mRNA changes were related to the severity of diastolic or systolic dysfunction revealed that phospholamban mRNA decreased in hearts with larger net increases in end-diastolic pressure (+19.2 +/- 1.9 mm Hg) compared with those hearts in which it did not change (+4.0 +/- 4.9, P < .02).(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
Affiliation(s)
- R E Williams
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Md
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Hikima T, Ikeda K, Lin SB, Hwang A, Takano K. [A case report of the chronic desquamative gingivitis (author's transl)]. Nihon Shishubyo Gakkai Kaishi 1976; 18:423-8. [PMID: 1075081 DOI: 10.2329/perio.18.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
38
|
Hikima T, Ikeda K, Hwang A, Lin S. [A long-term observation following tooth hemisection for patients with periodontal disease (author's transl)]. Nihon Shishubyo Gakkai Kaishi 1975; 17:315-21. [PMID: 1075055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
39
|
Ikeda K, Hikima T, Lin S, Hwang A. [A physical property of pulsating water pressure. I. (author's transl)]. Nihon Shishubyo Gakkai Kaishi 1974; 16:173-8. [PMID: 4549391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
40
|
Smith SR, Petillo J, Hwang A. Further studies with the potentiated reagin response to egg albumin. Int Arch Allergy Appl Immunol 1972; 43:145-57. [PMID: 4120033 DOI: 10.1159/000230830] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
High titers of reagins were obtained in rats by initial immunization with egg albumin and <i>B. pertussis </i>and subsequent infection with larvae of <i>N. brasiliensis. </i>These antibodies have physicochemical properties and biological activities identical to those of rat immunoglobulin E (IgE). IgE type antibodies against <i>N. brasiliensis </i>are also produced in these same animals but not until the titers of IgE against egg albumin have decreased.
Collapse
|