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Abdallah LE, Abusubha A, Lee BH, Badami A, Abood G, Knab LM, Jr WS, Refaat T. Treatment Outcomes and Toxicity Profile of MRI-Guided Gated-Real Time Online Adaptive Stereotactic Body Radiotherapy to Patients with Pancreatic Tumors. Int J Radiat Oncol Biol Phys 2023; 117:e281. [PMID: 37785052 DOI: 10.1016/j.ijrobp.2023.06.1263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Stereotactic body radiation therapy (SBRT) to patients with inoperable pancreas cancer has shown promising outcomes. Dose escalation is challenging given the associated risks to nearby organs at risk and requires treatment plan adaptation and motion management. This study reports the treatment related adverse events and treatment outcomes of MRI-guided SBRT utilizing gated-real time online adaptive radiotherapy to patients with pancreatic tumors. MATERIALS/METHODS This is a single institution retrospective IRB approved study and included patients with pancreatic tumors who were treated with MRI-guided SBRT utilizing gated-real time online adaptive radiotherapy, consecutively between 2019 and 2022. All patients were treated with 0.35T MRI linear accelerator. All patients' charts and radiation plans were reviewed for this study. RESULTS The study included 25 patients treated consecutively to 125 radiation fractions with MRI-guided SBRT. The study included 15 females and 10 males, 19 white, 2 Asians, 1 Latin American and 2 African Americans. The median age was 74, and all patients had pancreatic adenocarcinoma (92%) except two patients who had biopsy proven renal cell carcinoma metastatic to the pancreas without evidence of disease elsewhere. Most patients (68%) received chemotherapy (FOLFIRINOX or Gemcitabine / Protein-bound paclitaxel) prior to SBRT. The median dose to gross target volume (GTV) was 50 Gy, and to planning target volume (PTV) was 35 Gy. All patients were treated in 5 radiation fractions. Thirteen patients (52%) received elective nodal irradiation (ENI). All patients had at least a single real-time online adaptive replanning (median 3 fractions, range 1-5 fractions). All treatment fractions were gated (100%) with MRI guidance. The 1-, 2-, & 3- year local-regional control (LRC) were 81%, 57%, & 57% respectively (Median 16 months). The 1-, 2-, & 3- year Distant Control (DC) were 81%, 74%, & 56% respectively (Median 14 months). The 1-, 2-, 3-year overall survival (OS) were 77%, 35%, & 24% (Median 21 months). Planning Target Volume (PTV) dose ≥40Gy was significantly associated with improved local-regional control (p = 0.02). Gross Target Volume (GTV) dose <50Gy was significantly associated with lower DC (p = 0.03). ENI showed a trend towards improved local-regional control but was not statistically significant (p = 0.1). None of the patients experienced ≥ grade 3 toxicities. Most common adverse event were grades 1 or 2 fatigue (24%), nausea (16%), and abdominal discomfort (12%). CONCLUSION In this cohort, MRI-guided SBRT utilizing gated-real time online adaptive radiotherapy was a safe and effective approach for patients with pancreatic tumors who are not surgical candidates. In this study, dose escalation was significantly associated with improved local-regional (PTV ≥40 Gy) and distant control (GTV ≥50Gy). None of the patients experienced grade ≥3 radiation induced adverse events.
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Affiliation(s)
- L E Abdallah
- Loyola University Medical Center, Department of Radiation Oncology, Maywood, IL
| | - A Abusubha
- Loyola University Medical Center, Department of Radiation Oncology, Maywood, IL
| | - B H Lee
- Loyola University Chicago, Stritch School of Medicine, Department of Radiation Oncology, Cardinal Bernardin Cancer Center, Maywood, IL
| | - A Badami
- Department of Hematology Oncology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL
| | - G Abood
- Department of Surgical Oncology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL
| | - L M Knab
- Loyola University Chicago, Stritch School of Medicine, Department of Surgery, Cardinal Bernardin Cancer Center, Maywood, IL
| | - W Small Jr
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL
| | - T Refaat
- Loyola University Chicago, Stritch School of Medicine, Department of Radiation Oncology, Cardinal Bernardin Cancer Center, Maywood, IL
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Wang X, Leng S, Lu Z, Huang S, Lee BH, Baskaran L, Yew MS, Teo L, Chan MY, Ngiam KY, Lee HK, Zhong L, Huang W. Context-aware deep network for coronary artery stenosis classification in coronary CT angiography. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-4. [PMID: 38083399 DOI: 10.1109/embc40787.2023.10340650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Automatic coronary artery stenosis grading plays an important role in the diagnosis of coronary artery disease. Due to the difficulty of learning the informative features from varying grades of stenosis, it is still a challenging task to identify coronary artery stenosis from coronary CT angiography (CCTA). In this paper, we propose a context-aware deep network (CADN) for coronary artery stenosis classification. The proposed method integrates 3D CNN with Transformer to improve the feature representation of coronary artery stenosis in CCTA. We evaluate the proposed method on a multicenter dataset (APOLLO study with NCT05509010). Experimental results show that our proposed method can achieve the accuracy of 0.84, 0.83, and 0.86 for stenosis diagnosis on the lesion, artery, and patient levels, respectively.
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Lee SB, Park Y, Kim DW, Kwon JW, Ha JW, Yang JH, Lee BH, Suk KS, Moon SH, Kim HS, Lee HM. Association between mortality risk and the number, location, and sequence of subsequent fractures in the elderly. Osteoporos Int 2021; 32:233-241. [PMID: 32820370 DOI: 10.1007/s00198-020-05602-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 08/13/2020] [Indexed: 12/16/2022]
Abstract
UNLABELLED The mortality risk showed a positive correlation as the number of subsequent fractures increased. Hip fracture showed the greatest association with mortality risk, followed by vertebral fracture. For the combination of hip and vertebral fracture, a hip fracture after a vertebral fracture showed the highest mortality risk. INTRODUCTION It is unclear whether subsequent fractures or a certain location and sequence of subsequent fractures are associated with mortality risk in the elderly. We aimed to investigate the relationship between subsequent fractures and mortality risk. METHODS Using the Korean National Health Insurance Research Database, we analyzed the cohort data of 24,756 patients aged > 60 years who sustained fractures between 2002 and 2013. Cox regression was used to assess the mortality risk associated with the number, locations, and sequences of subsequent fractures. RESULTS Mortality hazard ratios (HRs) for women and men were shown to be associated with the number of subsequent fractures (one, 1.63 (95% confidence interval [CI], 1.48-1.80) and 1.42 (95% CI, 1.28-1.58); two, 1.75 (95% CI, 1.47-2.08) and 2.03 (95% CI, 1.69-2.43); three or more, 2.46(95% CI, 1.92-3.15) and 1.92 (95% CI, 1.34-2.74), respectively). For women, the mortality risk was high when hip (HR, 2.49; 95% CI, 1.80-3.44) or vertebral (HR, 1.40; 95% CI, 1.03-1.90) fracture occurred as a second fracture. Compared with a single hip fracture, there was a high mortality risk in the group with hip fracture after the first vertebral fracture (HR, 2.90; 95% CI, 1.86-4.54), followed by vertebral fracture after the first hip fracture (HR, 1.90; 95% CI, 1.12-3.22). CONCLUSION The mortality risk showed a positive correlation as the number of subsequent fractures increased. Hip fracture showed the greatest association with mortality risk, followed by vertebral fracture. For the combination of hip and vertebral fracture, a hip fracture after a vertebral fracture showed the highest mortality risk.
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Affiliation(s)
- S-B Lee
- Department of Orthopedic Surgery, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Republic of Korea
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Y Park
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Goyang, 10444, Republic of Korea.
| | - D-W Kim
- Research Analysis Team, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - J-W Kwon
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Goyang, 10444, Republic of Korea
| | - J-W Ha
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Goyang, 10444, Republic of Korea
| | - J-H Yang
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - B H Lee
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - K-S Suk
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - S-H Moon
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - H-S Kim
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - H-M Lee
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
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Jayaram P, Liu C, Dawson B, Ketkar S, Patel SJ, Lee BH, Grol MW. Leukocyte-dependent effects of platelet-rich plasma on cartilage loss and thermal hyperalgesia in a mouse model of post-traumatic osteoarthritis. Osteoarthritis Cartilage 2020; 28:1385-1393. [PMID: 32629163 PMCID: PMC7787501 DOI: 10.1016/j.joca.2020.06.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 06/14/2020] [Accepted: 06/22/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Platelet-rich plasma (PRP) is an emerging therapeutic strategy for treatment of osteoarthritis (OA); however, there is a lack of preclinical and clinical evidence for its efficacy and its mechanism of action is unclear. In the current study, we utilized leukocyte poor-PRP (LP-PRP) and leukocyte rich-PRP (LR-PRP) to mimic clinical point of care formulations and assessed their potential to alter disease progression in a mouse model of post-traumatic OA. METHOD Three-month-old wild-type male FVB/N mice received destabilization of the medial meniscus (DMM) surgery to induce OA. To assess the efficacy of LP-PRP and LR-PRP, mice were given intraarticular injections at 2-, 7- and 28-days post-surgery. Mice were then assessed at 5-, 9-, and 13-weeks post-surgery for changes in chronic pain using the hot plate nociceptive assay. At 14-weeks, OA pathogenesis was evaluated using histology and phase-contrast μCT. RESULTS Treatment with LP-PRP and to a lesser extent LR-PRP preserved cartilage volume and surface area compared to phosphate-buffered saline (PBS) as measured by phase-contrast μCT. However, both treatments had higher Osteoarthritis Research Society International (OARSI) and synovitis scores compared to sham, and neither substantially improved scores compared to PBS controls. With respect to thermal hyperalgesia, PBS-treated mice displayed reduced latency to response compared to sham, and LR-PRP but not LP-PRP improved latency to response at 5-, 9- and 13-weeks post-surgery compared to PBS. CONCLUSION The results of this study suggest that effects of PRP therapy on OA progression and disease-induced hyperalgesia may be leukocyte-dependent. And while LP-PRP and to a lesser extent LR-PRP protect from volume and surface loss, significant pathology is still seen within OA joints. Future work is needed to understand how the different components of PRP effect OA pathogenesis and pain, and how these could be modified to achieve greater therapeutic efficacy.
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Affiliation(s)
- P Jayaram
- H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, TX, USA; Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX, USA
| | - C Liu
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - B Dawson
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - S Ketkar
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - S J Patel
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - B H Lee
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.
| | - M W Grol
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.
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Lee BH, Massa AT, Taylor KR. Accessory Tragus: A Rare Congenital Anomaly in a Dog. J Comp Pathol 2020; 179:79-82. [PMID: 32958153 DOI: 10.1016/j.jcpa.2020.07.009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/20/2020] [Indexed: 10/23/2022]
Abstract
Accessory tragus is a congenital malformation of part of the external ear, commonly reported in humans. Clinically, it is a benign, cutaneous mass located anywhere between the tragus of the ear and the angle of the mouth, along the migratory path of the first branchial arch. An accessory tragus was diagnosed in an otherwise healthy six-month-old male castrated American pit bull terrier that had a haired, pedunculated cutaneous mass on the left maxillary region from birth. Histologically, the mass was a polypoid extension of histologically normal haired skin with a central core of subcutaneous adipose tissue and well-differentiated elastic cartilage. To the authors' knowledge, this is the first report of this lesion in a non-human species. Retrospective examination of records from 2008 to 2018 at the Washington Animal Disease Diagnostic Laboratory failed to identify any other case. As accessory tragus in humans is commonly linked with other congenital anomalies and syndromes, recognition of this lesion in animals may aid in early discovery of other congenital defects and inform adequate excision of the lesion to prevent chondrodermatitis.
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Affiliation(s)
- B H Lee
- Washington Animal Disease Diagnostic Laboratory and Department of Veterinary Microbiology and Pathology, Washington State University College of Veterinary Medicine, Pullman, Washington, USA.
| | - A T Massa
- Washington Animal Disease Diagnostic Laboratory and Department of Veterinary Microbiology and Pathology, Washington State University College of Veterinary Medicine, Pullman, Washington, USA
| | - K R Taylor
- Washington Animal Disease Diagnostic Laboratory and Department of Veterinary Microbiology and Pathology, Washington State University College of Veterinary Medicine, Pullman, Washington, USA
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Kim JO, Lee J, Lee BH. Effect of Scapular Stabilization Exercise during Standing on Upper Limb Function and Gait Ability of Stroke Patients. J Neurosci Rural Pract 2019; 8:540-544. [PMID: 29204011 PMCID: PMC5709874 DOI: 10.4103/jnrp.jnrp_464_16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background The purpose of this study was to determine the effect of scapular stabilization exercise during standing on a paretic side on upper limb function and gait ability of stroke patients. Methods This study was a hospital-based, randomized controlled trial with a blinded assessor. A total of 17 patients with hemiplegic diagnosis after stroke were divided into two groups (9 patients in a study group and 8 patients in a control group). The study group received physical therapy and scapular stabilization exercise on a paretic side. Participants were subjected to initial evaluation before the treatment. Subjects were subsequently re-evaluated 4 and 8 weeks later to compare the changes. Measurements of hand function and gait ability were performed. Results Based on multivariate analysis of variance for repeated-measures, there was a significant time effect for Timed Up and Go test (TUG) (F = 13.816, P = 0.000), Functional Gait Assessment (FGA) (F = 18.613, P = 0.000), and manual function test (MFT) (F = 16.777, P = 0.000). The group × time interaction effect was also significant for FGA (F = 4.966, P = 0.024) and MFT (F = 6.946, P = 0.003), but not for TUG test (F = 3.343, P = 0.069). Conclusion Results of the present study indicated that scapular stabilization exercise during standing on a paretic side for 8 weeks had an effect on hand function and gait ability of hemiplegic patients after stroke. Further studies are needed to find the most proper exercise for stroke patients who have gait disability and upper limb dysfunction.
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Affiliation(s)
- J O Kim
- Department of Physical Therapy, Graduate School of Physical Therapy, Sahmyook University, Seoul, Republic of Korea
| | - J Lee
- Department of Physical Therapy, Graduate School of Physical Therapy, Sahmyook University, Seoul, Republic of Korea
| | - B H Lee
- Department of Physical Therapy, Sahmyook University, Seoul, Republic of Korea
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Abstract
Surgical fixation of hip fractures in patients with below knee amputation is challenging due to the difficulty in obtaining optimal traction for reduction of the fracture. Surgeons may face difficulty in positioning such patients on the traction table due to the absence of the foot and distal lower limb. There are several techniques described to overcome this technical difficulty. In this case report, we present a case of a 64-year old gentleman with bilateral below knee amputation presenting with a comminuted right intertrochanteric fracture. We highlight a simple and effective method of applying skin traction to obtain adequate reduction for hip fracture fixation.
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Affiliation(s)
- B H Lee
- Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore
| | - S W Ho
- Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore
| | - C Y Kau
- Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore
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Ghassemi Nejad J, Sung KI, Lee BH, Peng JL, Kim JY, Chemere B, Oh SM, Kim MJ, Kim SC, Kim BW. 3 Comparison of hair cortisol levels and body temperature response prior to and post heat stress and water deprivation in Holstein dairy cows. J Anim Sci 2018. [DOI: 10.1093/jas/sky073.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- J Ghassemi Nejad
- Institute of Animal Resources, Kangwon National University, Chuncheon, Korea, Republic of (South)
| | - K I Sung
- College of Animal Life Sciences, Kangwon National University, Chuncheon, Korea, Republic of (South)
| | - B H Lee
- College of Animal Life Sciences, Kangwon National University, Chuncheon, Korea, Republic of (South)
| | - J L Peng
- College of Animal Life Sciences, Kangwon National University, Chuncheon, Korea, Republic of (South)
| | - J Y Kim
- College of Animal Life Sciences, Kangwon National University, Chuncheon, Korea, Republic of (South)
| | - B Chemere
- College of Animal Life Sciences, Kangwon National University, Chuncheon, Korea, Republic of (South)
| | - S M Oh
- College of Animal Life Sciences, Kangwon National University, Chuncheon, Korea, Republic of (South)
| | - M J Kim
- Institute of Animal Resources, Kangwon National University, Chuncheon, Korea, Republic of (South)
| | - S C Kim
- College of Animal Life Sciences, Kangwon National University, Chuncheon, Korea, Republic of (South)
| | - B W Kim
- College of Animal Life Sciences, Kangwon National University, Chuncheon, Korea, Republic of (South)
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Park HC, Kim MJ, Lee BH. Randomized clinical trial of antibiotic therapy for uncomplicated appendicitis. Br J Surg 2017; 104:1785-1790. [DOI: 10.1002/bjs.10660] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 06/19/2017] [Accepted: 06/30/2017] [Indexed: 11/05/2022]
Abstract
Abstract
Background
Uncomplicated appendicitis may resolve spontaneously or require treatment with antibiotics or appendicectomy. The aim of this randomized trial was to compare the outcome of a non-antibiotic management strategy with that of antibiotic therapy in uncomplicated appendicitis.
Methods
Patients presenting to a university teaching hospital with CT-verified uncomplicated simple appendicitis (appendiceal diameter no larger than 11 mm and without any signs of perforation) were randomized to management with a no-antibiotic regimen with supportive care (intravenous fluids, analgesia and antipyretics as necessary) or a 4-day course of antibiotics with supportive care. The primary endpoint was rate of total treatment failure, defined as initial treatment failure within 1 month and recurrence of appendicitis during the follow-up period.
Results
Some 245 patients were randomized within the trial, and followed up for a median of 19 months. The duration of hospital stay was shorter (mean 3·1 versus 3·7 days; P < 0·001) and the medical costs lower (€1181 versus 1348; P < 0·001) among those randomized to therapy without antibiotics. There was no difference in total treatment failure rate between the groups: 29 of 124 (23·4 per cent) in the no-antibiotic group and 25 of 121 (20·7 per cent) in the antibiotic group (P = 0·609). Eighteen patients (9 in each group) had initial treatment failure, 15 of whom underwent appendicectomy and three received additional antibiotics. Thirty-six patients (20 in the no-antibiotic group, 16 in the antibiotic group) experienced recurrence, of whom 30 underwent appendicectomy and six received further antibiotics.
Conclusion
Treatment failure rates in patients presenting with CT-confirmed uncomplicated appendicitis appeared similar among those receiving supportive care with either a no-antibiotic regimen or a 4-day course of antibiotics. Registration number: KCT0000124 (http://cris.nih.go.kr).
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Affiliation(s)
- H C Park
- Department of Surgery, Hallym University College of Medicine 170beon-gil 22, Gwanpyeongro, Dong An-Gu, Anyang, 14068, South Korea
| | - M J Kim
- Department of Surgery, Hallym University College of Medicine 170beon-gil 22, Gwanpyeongro, Dong An-Gu, Anyang, 14068, South Korea
| | - B H Lee
- Department of Surgery, Hallym University College of Medicine 170beon-gil 22, Gwanpyeongro, Dong An-Gu, Anyang, 14068, South Korea
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Elf S, Lin R, Xia S, Pan Y, Shan C, Wu S, Lonial S, Gaddh M, Arellano ML, Khoury HJ, Khuri FR, Lee BH, Boggon TJ, Fan J, Chen J. Targeting 6-phosphogluconate dehydrogenase in the oxidative PPP sensitizes leukemia cells to antimalarial agent dihydroartemisinin. Oncogene 2016; 36:254-262. [PMID: 27270429 PMCID: PMC5464402 DOI: 10.1038/onc.2016.196] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 04/19/2016] [Accepted: 04/24/2016] [Indexed: 12/13/2022]
Abstract
The oxidative pentose phosphate pathway (PPP) is crucial for cancer cell metabolism and tumor growth. We recently reported that targeting a key oxidative PPP enzyme, 6-phosphogluconate dehydrogenase (6PGD), using our novel small molecule 6PGD inhibitors Physcion and its derivative S3, shows anti-cancer effects. Notably, humans with genetic deficiency of either 6PGD or another oxidative PPP enzyme, glucose-6-phosphate dehydrogenase (G6PD), exhibit non-immune hemolytic anemia upon exposure to aspirin and various anti-malarial drugs. Inspired by these clinical observations, we examined the anti-cancer potential of combined treatment with 6PGD inhibitors and anti-malarial drugs. We found that stable knockdown of 6PGD sensitizes leukemia cells to anti-malarial agent dihydroartemisinin (DHA). Combined treatment with DHA and Physcion activates AMP-activated protein kinase, leading to synergistic inhibition of human leukemia cell viability. Moreover, our combined therapy synergistically attenuates tumor growth in xenograft nude mice injected with human K562 leukemia cells and cell viability of primary leukemia cells from human patients, but shows minimal toxicity to normal hematopoietic cells in mice as well as red blood cells and mononucleocytes from healthy human donors. Our findings reveal the potential for combined therapy using optimized doses of Physcion and DHA as a novel anti-leukemia treatment without inducing hemolysis.
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Affiliation(s)
- S Elf
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory, Emory University School of Medicine, Atlanta, GA, USA
| | - R Lin
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory, Emory University School of Medicine, Atlanta, GA, USA
| | - S Xia
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory, Emory University School of Medicine, Atlanta, GA, USA
| | - Y Pan
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory, Emory University School of Medicine, Atlanta, GA, USA
| | - C Shan
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory, Emory University School of Medicine, Atlanta, GA, USA
| | - S Wu
- Department of Chemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - S Lonial
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory, Emory University School of Medicine, Atlanta, GA, USA
| | - M Gaddh
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory, Emory University School of Medicine, Atlanta, GA, USA
| | - M L Arellano
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory, Emory University School of Medicine, Atlanta, GA, USA
| | - H J Khoury
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory, Emory University School of Medicine, Atlanta, GA, USA
| | - F R Khuri
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory, Emory University School of Medicine, Atlanta, GA, USA
| | - B H Lee
- Novartis Institutes for BioMedical Research, Cambridge, MA, USA
| | - T J Boggon
- Department of Pharmacology, Yale University School of Medicine, New Haven, CT, USA
| | - J Fan
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory, Emory University School of Medicine, Atlanta, GA, USA
| | - J Chen
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory, Emory University School of Medicine, Atlanta, GA, USA
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Lee BH, Kim N, Nam RH, Lee JY, Lee HS, Lee CH, Park JH, Lee DH. Difficult establishment of a chronic nonsteroidal anti-inflammatory drugs induced gastric inflammation rat model due to gastric adaptation and small bowel damage. Korean J Gastroenterol 2016; 63:341-7. [PMID: 24953610 DOI: 10.4166/kjg.2014.63.6.341] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND/AIMS The prevalence of peptic ulcer disease has not decreased mainly due to an increase in the use of NSAIDs. This study was conducted in order to determine whether a chronic NSAID-induced gastric inflammation model could be established by repeated administration of NSAID. METHODS Indomethacin (10 mg/kg) was administered once per week for six weeks in 8- and 26-week rats and animals were sacrificed every week after administration. Gross ulcer index, histologic damage index, myeloperoxidase (MPO) activity, and mucus (glucosamine) levels were measured. Small bowel damage was also evaluated. RESULTS Gross gastric damage index showed a peak level at three weeks and then decreased slowly in the 26-week indomethacin group. Gastric mucosal glucosamine level increased in both the 8-week (p=0.038) and 26-week groups (p=0.007). In addition, gastric mucosal MPO level decreased in the 8-week group (p=0.018) but did not show a decrease in the 26-week group. Small bowel damage began to occur at three weeks during the schedule and eight of 36 rats (22.2%) died due to perforation or peritonitis of the small bowel in the 8- and 26-week indomethacin groups, respectively. CONCLUSIONS Due to gastric adaptation and small bowel damage, repeated administration of NSAID to experimental animals may not be an adequate method for establishment of the chronic gastric inflammation model.
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Affiliation(s)
- Byoung Hwan Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 463-707, Korea
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Lopez-Hilfiker FD, Mohr C, D'Ambro EL, Lutz A, Riedel TP, Gaston CJ, Iyer S, Zhang Z, Gold A, Surratt JD, Lee BH, Kurten T, Hu WW, Jimenez J, Hallquist M, Thornton JA. Molecular Composition and Volatility of Organic Aerosol in the Southeastern U.S.: Implications for IEPOX Derived SOA. Environ Sci Technol 2016; 50:2200-9. [PMID: 26811969 DOI: 10.1021/acs.est.5b04769] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
We present measurements as part of the Southern Oxidant and Aerosol Study (SOAS) during which atmospheric aerosol particles were comprehensively characterized. We present results utilizing a Filter Inlet for Gases and AEROsol coupled to a chemical ionization mass spectrometer (CIMS). We focus on the volatility and composition of isoprene derived organic aerosol tracers and of the bulk organic aerosol. By utilizing the online volatility and molecular composition information provided by the FIGAERO-CIMS, we show that the vast majority of commonly reported molecular tracers of isoprene epoxydiol (IEPOX) derived secondary organic aerosol (SOA) is derived from thermal decomposition of accretion products or other low volatility organics having effective saturation vapor concentrations <10(-3) μg m(-3). In addition, while accounting for up to 30% of total submicrometer organic aerosol mass, the IEPOX-derived SOA has a higher volatility than the remaining bulk. That IEPOX-SOA, and more generally bulk organic aerosol in the Southeastern U.S. is comprised of effectively nonvolatile material has important implications for modeling SOA derived from isoprene, and for mechanistic interpretations of molecular tracer measurements. Our results show that partitioning theory performs well for 2-methyltetrols, once accretion product decomposition is taken into account. No significant partitioning delays due to aerosol phase or viscosity are observed, and no partitioning to particle-phase water or other unexplained mechanisms are needed to explain our results.
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Affiliation(s)
- F D Lopez-Hilfiker
- Department of Atmospheric Sciences, University of Washington , Seattle, Washington 98195, United States
| | - C Mohr
- Department of Atmospheric Sciences, University of Washington , Seattle, Washington 98195, United States
| | - E L D'Ambro
- Department of Chemistry, University of Washington , Seattle, Washington 98195, United States
| | - A Lutz
- Department of Chemistry and Molecular Biology, University of Gothenburg , 41296 Gothenburg, Sweden
| | - T P Riedel
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill , Chapel Hill, North Carolina 27516, United States
| | - C J Gaston
- Department of Atmospheric Sciences, University of Washington , Seattle, Washington 98195, United States
| | - S Iyer
- Department of Chemistry, University of Helsinki , Helsinki, Finland
| | - Z Zhang
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill , Chapel Hill, North Carolina 27516, United States
| | - A Gold
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill , Chapel Hill, North Carolina 27516, United States
| | - J D Surratt
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill , Chapel Hill, North Carolina 27516, United States
| | - B H Lee
- Department of Atmospheric Sciences, University of Washington , Seattle, Washington 98195, United States
| | - T Kurten
- Department of Chemistry, University of Helsinki , Helsinki, Finland
| | - W W Hu
- Department of Chemistry and Biochemistry, University of Colorado , Boulder, Colorado 80309, United States
- Cooperative Institute for Research in Environmental Sciences, University of Colorado , Boulder, Colorado 80309, United States
| | - J Jimenez
- Department of Chemistry and Biochemistry, University of Colorado , Boulder, Colorado 80309, United States
- Cooperative Institute for Research in Environmental Sciences, University of Colorado , Boulder, Colorado 80309, United States
| | - M Hallquist
- Department of Chemistry and Molecular Biology, University of Gothenburg , 41296 Gothenburg, Sweden
| | - J A Thornton
- Department of Atmospheric Sciences, University of Washington , Seattle, Washington 98195, United States
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13
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Wolfe GM, Kaiser J, Hanisco TF, Keutsch FN, de Gouw JA, Gilman JB, Graus M, Hatch CD, Holloway J, Horowitz LW, Lee BH, Lerner BM, Lopez-Hilifiker F, Mao J, Marvin MR, Peischl J, Pollack IB, Roberts JM, Ryerson TB, Thornton JA, Veres PR, Warneke C. Formaldehyde production from isoprene oxidation across NO x regimes. Atmos Chem Phys 2016. [PMID: 29619046 DOI: 10.5194/acp-16-2597-] [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] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The chemical link between isoprene and formaldehyde (HCHO) is a strong, non-linear function of NOx (= NO + NO2). This relationship is a linchpin for top-down isoprene emission inventory verification from orbital HCHO column observations. It is also a benchmark for overall photochemical mechanism performance with regard to VOC oxidation. Using a comprehensive suite of airborne in situ observations over the Southeast U.S., we quantify HCHO production across the urban-rural spectrum. Analysis of isoprene and its major first-generation oxidation products allows us to define both a "prompt" yield of HCHO (molecules of HCHO produced per molecule of freshly-emitted isoprene) and the background HCHO mixing ratio (from oxidation of longer-lived hydrocarbons). Over the range of observed NOx values (roughly 0.1 - 2 ppbv), the prompt yield increases by a factor of 3 (from 0.3 to 0.9 ppbv ppbv-1), while background HCHO increases by a factor of 2 (from 1.6 to 3.3 ppbv). We apply the same method to evaluate the performance of both a global chemical transport model (AM3) and a measurement-constrained 0-D steady state box model. Both models reproduce the NOx dependence of the prompt HCHO yield, illustrating that models with updated isoprene oxidation mechanisms can adequately capture the link between HCHO and recent isoprene emissions. On the other hand, both models under-estimate background HCHO mixing ratios, suggesting missing HCHO precursors, inadequate representation of later-generation isoprene degradation and/or under-estimated hydroxyl radical concentrations. Detailed process rates from the box model simulation demonstrate a 3-fold increase in HCHO production across the range of observed NOx values, driven by a 100% increase in OH and a 40% increase in branching of organic peroxy radical reactions to produce HCHO.
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Affiliation(s)
- G M Wolfe
- Joint Center for Earth Systems Technology, University of Maryland Baltimore County, Baltimore, MD, USA
- Atmospheric Chemistry and Dynamics Laboratory, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - J Kaiser
- Department of Chemistry, University of Wisconsin-Madison, Madison, WI, USA
| | - T F Hanisco
- Atmospheric Chemistry and Dynamics Laboratory, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - F N Keutsch
- School of Engineering and Applied Sciences and Department of Chemistry and Chemical Biology, Harvard University, Cambridge, MA, USA
| | - J A de Gouw
- Cooperative Institute for Research in Environmental Sciences, University of Colorado Boulder, Boulder, CO, USA
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO, USA
| | - J B Gilman
- Cooperative Institute for Research in Environmental Sciences, University of Colorado Boulder, Boulder, CO, USA
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO, USA
| | - M Graus
- Cooperative Institute for Research in Environmental Sciences, University of Colorado Boulder, Boulder, CO, USA
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO, USA
| | - C D Hatch
- Department of Chemistry, Hendrix College, Conway, AR, USA
| | - J Holloway
- Cooperative Institute for Research in Environmental Sciences, University of Colorado Boulder, Boulder, CO, USA
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO, USA
| | - L W Horowitz
- NOAA Geophysical Fluid Dynamics Laboratory, Princeton, NJ, USA
| | - B H Lee
- Department of Atmospheric Sciences, University of Washington, Seattle, WA, USA
| | - B M Lerner
- Cooperative Institute for Research in Environmental Sciences, University of Colorado Boulder, Boulder, CO, USA
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO, USA
| | - F Lopez-Hilifiker
- Department of Atmospheric Sciences, University of Washington, Seattle, WA, USA
| | - J Mao
- NOAA Geophysical Fluid Dynamics Laboratory, Princeton, NJ, USA
- Program in Atmospheric and Oceanic Sciences, Princeton University, Princeton, NJ
| | - M R Marvin
- Department of Chemistry, University of Maryland, College Park, MD, USA
| | - J Peischl
- Cooperative Institute for Research in Environmental Sciences, University of Colorado Boulder, Boulder, CO, USA
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO, USA
| | - I B Pollack
- Cooperative Institute for Research in Environmental Sciences, University of Colorado Boulder, Boulder, CO, USA
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO, USA
| | - J M Roberts
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO, USA
| | - T B Ryerson
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO, USA
| | - J A Thornton
- Department of Atmospheric Sciences, University of Washington, Seattle, WA, USA
| | - P R Veres
- Cooperative Institute for Research in Environmental Sciences, University of Colorado Boulder, Boulder, CO, USA
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO, USA
| | - C Warneke
- Cooperative Institute for Research in Environmental Sciences, University of Colorado Boulder, Boulder, CO, USA
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO, USA
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14
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Warneke C, Trainer M, de Gouw JA, Parrish DD, Fahey DW, Ravishankara AR, Middlebrook AM, Brock CA, Roberts JM, Brown SS, Neuman JA, Lerner BM, Lack D, Law D, Hübler G, Pollack I, Sjostedt S, Ryerson TB, Gilman JB, Liao J, Holloway J, Peischl J, Nowak JB, Aikin K, Min KE, Washenfelder RA, Graus MG, Richardson M, Markovic MZ, Wagner NL, Welti A, Veres PR, Edwards P, Schwarz JP, Gordon T, Dube WP, McKeen S, Brioude J, Ahmadov R, Bougiatioti A, Lin JJ, Nenes A, Wolfe GM, Hanisco TF, Lee BH, Lopez-Hilfiker FD, Thornton JA, Keutsch FN, Kaiser J, Mao J, Hatch C. Instrumentation and Measurement Strategy for the NOAA SENEX Aircraft Campaign as Part of the Southeast Atmosphere Study 2013. Atmos Meas Tech 2016. [PMID: 29619117 DOI: 10.5194/amt-2015-388] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Natural emissions of ozone-and-aerosol-precursor gases such as isoprene and monoterpenes are high in the southeast of the US. In addition, anthropogenic emissions are significant in the Southeast US and summertime photochemistry is rapid. The NOAA-led SENEX (Southeast Nexus) aircraft campaign was one of the major components of the Southeast Atmosphere Study (SAS) and was focused on studying the interactions between biogenic and anthropogenic emissions to form secondary pollutants. During SENEX, the NOAA WP-3D aircraft conducted 20 research flights between 27 May and 10 July 2013 based out of Smyrna, TN. Here we describe the experimental approach, the science goals and early results of the NOAA SENEX campaign. The aircraft, its capabilities and standard measurements are described. The instrument payload is summarized including detection limits, accuracy, precision and time resolutions for all gas-and-aerosol phase instruments. The inter-comparisons of compounds measured with multiple instruments on the NOAA WP-3D are presented and were all within the stated uncertainties, except two of the three NO2 measurements. The SENEX flights included day- and nighttime flights in the Southeast as well as flights over areas with intense shale gas extraction (Marcellus, Fayetteville and Haynesville shale). We present one example flight on 16 June 2013, which was a daytime flight over the Atlanta region, where several crosswind transects of plumes from the city and nearby point sources, such as power plants, paper mills and landfills, were flown. The area around Atlanta has large biogenic isoprene emissions, which provided an excellent case for studying the interactions between biogenic and anthropogenic emissions. In this example flight, chemistry in and outside the Atlanta plumes was observed for several hours after emission. The analysis of this flight showcases the strategies implemented to answer some of the main SENEX science questions.
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Affiliation(s)
- C Warneke
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - M Trainer
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J A de Gouw
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - D D Parrish
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - D W Fahey
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - A R Ravishankara
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - A M Middlebrook
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - C A Brock
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J M Roberts
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - S S Brown
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J A Neuman
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - B M Lerner
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - D Lack
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - D Law
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - G Hübler
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - I Pollack
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - S Sjostedt
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - T B Ryerson
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J B Gilman
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J Liao
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J Holloway
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J Peischl
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J B Nowak
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - K Aikin
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - K-E Min
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - R A Washenfelder
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - M G Graus
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - M Richardson
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - M Z Markovic
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - N L Wagner
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - A Welti
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - P R Veres
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - P Edwards
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J P Schwarz
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - T Gordon
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - W P Dube
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - S McKeen
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J Brioude
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - R Ahmadov
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | | | - J J Lin
- Georgia Institute of Technology, Atlanta, GA
| | - A Nenes
- Georgia Institute of Technology, Atlanta, GA
- Foundation for Research and Technology Hellas, Greece
- National Observatory of Athens, Greece
| | - G M Wolfe
- NASA Goddard Space Flight Center, Greenbelt, MD
- University of Maryland Baltimore County
| | - T F Hanisco
- NASA Goddard Space Flight Center, Greenbelt, MD
| | - B H Lee
- University of Washington, Madison, WI
| | | | | | - F N Keutsch
- University of Wisconsin-Madison, Madison, WI
| | - J Kaiser
- University of Wisconsin-Madison, Madison, WI
| | - J Mao
- Geophysical Fluid Dynamics Laboratory, NOAA, Princeton, NJ
- Princeton University
| | - C Hatch
- Department of Chemistry, Hendrix College, 1600 Washington Ave., Conway, AR, USA
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15
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Warneke C, Trainer M, de Gouw JA, Parrish DD, Fahey DW, Ravishankara AR, Middlebrook AM, Brock CA, Roberts JM, Brown SS, Neuman JA, Lerner BM, Lack D, Law D, Hübler G, Pollack I, Sjostedt S, Ryerson TB, Gilman JB, Liao J, Holloway J, Peischl J, Nowak JB, Aikin K, Min KE, Washenfelder RA, Graus MG, Richardson M, Markovic MZ, Wagner NL, Welti A, Veres PR, Edwards P, Schwarz JP, Gordon T, Dube WP, McKeen S, Brioude J, Ahmadov R, Bougiatioti A, Lin JJ, Nenes A, Wolfe GM, Hanisco TF, Lee BH, Lopez-Hilfiker FD, Thornton JA, Keutsch FN, Kaiser J, Mao J, Hatch C. Instrumentation and Measurement Strategy for the NOAA SENEX Aircraft Campaign as Part of the Southeast Atmosphere Study 2013. Atmos Meas Tech 2016; 9:3063-3093. [PMID: 29619117 PMCID: PMC5880326 DOI: 10.5194/amt-9-3063-2016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Natural emissions of ozone-and-aerosol-precursor gases such as isoprene and monoterpenes are high in the southeast of the US. In addition, anthropogenic emissions are significant in the Southeast US and summertime photochemistry is rapid. The NOAA-led SENEX (Southeast Nexus) aircraft campaign was one of the major components of the Southeast Atmosphere Study (SAS) and was focused on studying the interactions between biogenic and anthropogenic emissions to form secondary pollutants. During SENEX, the NOAA WP-3D aircraft conducted 20 research flights between 27 May and 10 July 2013 based out of Smyrna, TN. Here we describe the experimental approach, the science goals and early results of the NOAA SENEX campaign. The aircraft, its capabilities and standard measurements are described. The instrument payload is summarized including detection limits, accuracy, precision and time resolutions for all gas-and-aerosol phase instruments. The inter-comparisons of compounds measured with multiple instruments on the NOAA WP-3D are presented and were all within the stated uncertainties, except two of the three NO2 measurements. The SENEX flights included day- and nighttime flights in the Southeast as well as flights over areas with intense shale gas extraction (Marcellus, Fayetteville and Haynesville shale). We present one example flight on 16 June 2013, which was a daytime flight over the Atlanta region, where several crosswind transects of plumes from the city and nearby point sources, such as power plants, paper mills and landfills, were flown. The area around Atlanta has large biogenic isoprene emissions, which provided an excellent case for studying the interactions between biogenic and anthropogenic emissions. In this example flight, chemistry in and outside the Atlanta plumes was observed for several hours after emission. The analysis of this flight showcases the strategies implemented to answer some of the main SENEX science questions.
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Affiliation(s)
- C Warneke
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - M Trainer
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J A de Gouw
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - D D Parrish
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - D W Fahey
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - A R Ravishankara
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - A M Middlebrook
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - C A Brock
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J M Roberts
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - S S Brown
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J A Neuman
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - B M Lerner
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - D Lack
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - D Law
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - G Hübler
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - I Pollack
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - S Sjostedt
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - T B Ryerson
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J B Gilman
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J Liao
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J Holloway
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J Peischl
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J B Nowak
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - K Aikin
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - K-E Min
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - R A Washenfelder
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - M G Graus
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - M Richardson
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - M Z Markovic
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - N L Wagner
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - A Welti
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - P R Veres
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - P Edwards
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J P Schwarz
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - T Gordon
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - W P Dube
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - S McKeen
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - J Brioude
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | - R Ahmadov
- Cooperative Institute for Research in Environmental Sciences, Univ. of Colorado, Boulder
- Chemical Sciences Division, NOAA Earth System Research Laboratory, Boulder, CO
| | | | - J J Lin
- Georgia Institute of Technology, Atlanta, GA
| | - A Nenes
- Georgia Institute of Technology, Atlanta, GA
- Foundation for Research and Technology Hellas, Greece
- National Observatory of Athens, Greece
| | - G M Wolfe
- NASA Goddard Space Flight Center, Greenbelt, MD
- University of Maryland Baltimore County
| | - T F Hanisco
- NASA Goddard Space Flight Center, Greenbelt, MD
| | - B H Lee
- University of Washington, Madison, WI
| | | | | | - F N Keutsch
- University of Wisconsin-Madison, Madison, WI
| | - J Kaiser
- University of Wisconsin-Madison, Madison, WI
| | - J Mao
- Geophysical Fluid Dynamics Laboratory, NOAA, Princeton, NJ
- Princeton University
| | - C Hatch
- Department of Chemistry, Hendrix College, 1600 Washington Ave., Conway, AR, USA
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16
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Oh KS, Lee JH, Yi KY, Lim CJ, Lee S, Park CH, Seo HW, Lee BH. The orally active urotensin receptor antagonist, KR36676, attenuates cellular and cardiac hypertrophy. Br J Pharmacol 2015; 172:2618-33. [PMID: 25597918 DOI: 10.1111/bph.13082] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 12/11/2014] [Accepted: 01/13/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND AND PURPOSE Blockade of the actions of urotensin-II (U-II) mediated by the urotensin (UT) receptor should improve cardiac function and prevent cardiac remodelling in cardiovascular disease. Here, we have evaluated the pharmacological properties of the recently identified UT receptor antagonist, 2-(6,7-dichloro-3-oxo-2H-benzo[b][1,4]oxazin-4(3H)-yl)-N-methyl-N-(2-(pyrrolidin-1-yl)-1-(4-(thiophen-3-yl)phenyl) ethyl)acetamide (KR36676). EXPERIMENTAL APPROACH Pharmacological properties of KR36676 were studied in a range of in vitro assays (receptor binding, calcium mobilization, stress fibre formation, cellular hypertrophy) and in vivo animal models such as cardiac hypertrophy induced by transverse aortic constriction (TAC) or myocardial infarction (MI). KEY RESULTS KR36676 displayed high binding affinity for the UT receptor (Ki : 0.7 nM), similar to that of U-II (0.4 nM), and was a potent antagonist at that receptor (IC50 : 4.0 nM). U-II-induced stress fibre formation and cellular hypertrophy were significantly inhibited with low concentrations of KR36676 (≥0.01 μM). Oral administration of KR36676 (30 mg·kg(-1) ) in a TAC model in mice attenuated cardiac hypertrophy and myocardial fibrosis. Moreover, KR36676 restored cardiac function and myocyte size in rats with MI-induced cardiac hypertrophy. CONCLUSIONS AND IMPLICATIONS A highly potent UT receptor antagonist exerted anti-hypertrophic effects not only in infarcted rat hearts but also in pressure-overloaded mouse hearts. KR36676 could be a valuable pharmacological tool in elucidating the complicated physiological role of U-II and UT receptors in cardiac hypertrophy.
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Affiliation(s)
- K S Oh
- Research Center for Drug Discovery Technology, Korea Research Institute of Chemical Technology, Daejeon, Korea; Department of Medicinal and Pharmaceutical Chemistry, University of Science and Technology, Daejeon, Korea
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17
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Halder D, Mandal C, Lee BH, Lee JS, Choi MR, Chai JC, Lee YS, Jung KH, Chai YG. PCDHB14- and GABRB1-like nervous system developmental genes are altered during early neuronal differentiation of NCCIT cells treated with ethanol. Hum Exp Toxicol 2015; 34:1017-27. [PMID: 25566775 DOI: 10.1177/0960327114566827] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [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: 01/08/2023]
Abstract
Ethanol (EtOH) exposure during embryonic development causes dysfunction of the central nervous system (CNS). Here, we examined the effects of chronic EtOH on gene expression during early stages of neuronal differentiation. Human embryonic carcinoma (NCCIT) cells were differentiated into neuronal precursors/lineages in the presence or absence of EtOH and folic acid. Gene expression profiling and pathway analysis demonstrated that EtOH deregulates many genes and pathways that are involved in early brain development. EtOH exposure downregulated several important genes, such as PCDHB14, GABRB1, CTNND2, NAV3, RALDH1, and OPN5, which are involved in CNS development, synapse assembly, synaptic transmission, and neurotransmitter receptor activity. GeneGo pathway analysis revealed that the deregulated genes mapped to disease pathways that were relevant to fetal alcohol spectrum disorders (FASD, such as neurotic disorders, epilepsy, and alcohol-related disorders). In conclusion, these findings suggest that the impairment of the neurological system or suboptimal synapse formation resulting from EtOH exposure could underlie the neurodevelopmental disorders in individuals with FASD.
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Affiliation(s)
- D Halder
- Department of Molecular and Life Sciences, Hanyang University, Ansan, Republic of Korea
| | - C Mandal
- Department of Molecular and Life Sciences, Hanyang University, Ansan, Republic of Korea
| | - B H Lee
- Department of Psychiatry, Gangnam Eulji Hospital, Eulji University, Seoul, Republic of Korea KARF Hospital, the Korean Alcohol Research Foundation, Goyang, Republic of Korea
| | - J S Lee
- KARF Hospital, the Korean Alcohol Research Foundation, Goyang, Republic of Korea
| | - M R Choi
- Department of Molecular and Life Sciences, Hanyang University, Ansan, Republic of Korea
| | - J C Chai
- Department of Molecular and Life Sciences, Hanyang University, Ansan, Republic of Korea
| | - Y S Lee
- Department of Molecular and Life Sciences, Hanyang University, Ansan, Republic of Korea
| | - K H Jung
- Institute of Natural Science and Technology, Hanyang University, Ansan, Republic of Korea
| | - Y G Chai
- Department of Molecular and Life Sciences, Hanyang University, Ansan, Republic of Korea Department of Nanobiotechnology, Hanyang University, Seoul, Republic of Korea
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18
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Abstract
BACKGROUND The biomechanical interaction between the median nerve and the flexor tendons is an important consideration in Carpal tunnel syndrome (CTS). We aim to quantify the displacement and compressive deformation pattern of the median nerve in various stages of finger flexion in the normal population at the inlet of the carpal tunnel. METHODS Transverse ultrasounds images were taken at the carpal tunnel inlet during full-extension, mid-flexion and full flexion. The displacement, distance, Feret's diameter, and perimeter of the median nerve were calculated and compared between each position. RESULTS Biphasic median nerve motion was observed, with a displacement of 2.84 ± 3.49 mm in the ulnar direction from full-extension to mid-flexion (Phase I) and a further 0.93 ± 3.04 mm from mid-flexion to full flexion (Phase II). Of 49 hands, 37 (75.5%) exhibited ulnar displacement in Phase I while 12 (24.5%) exhibited radial displacement. Feret's diameter (5.95 ± 1.08 mm) and perimeter (13.28 ± 2.09) of the median nerve were greatest in the mid-flexed position. CONCLUSION In a healthy Asian population, the median nerve has a biphasic motion during finger flexion, with maximal deformation in the mid-flexed position.
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Affiliation(s)
- C H Goh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 523230, Singapore
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Nejad JG, Hosseindoust A, Shoae A, Ghorbani B, Lee BH, Oskoueian E, Hajilari D, Amouzmehr A, Lohakare JD, Sung KI. Effects of feeding levels of starter on weaning age, performance, nutrient digestibility and health parameters in holstein dairy calves. Asian-Australas J Anim Sci 2014; 26:827-30. [PMID: 25049856 PMCID: PMC4093240 DOI: 10.5713/ajas.2012.12704] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 03/15/2013] [Accepted: 02/24/2013] [Indexed: 11/27/2022]
Abstract
To evaluate the effects of feeding four different levels of starter in male Holstein dairy calves, a completely randomized study was conducted, using 28 calves with initial body weight of 40.5±2.4 kg. The animals were fed iso-nitrogenous starter and were weaned when they consumed 350, 500, 650 and 800 g/d of starter for 3 d consecutively. Starter and water were available ad-libitum throughout the experiment. Body weight at pre-weaning (less than 5 wk) and post-weaning (8 wk) was lower in calves that received 350 g/d of starter than in the other treatments (p<0.05). Feed conversion ratio (FCR) was the highest among all treatments in pre-weaning period (p<0.05). Dry matter intake (DMI) at weaning and total DMI was higher in that calves received 800 g/d of starter compared with other treatments (p<0.05). Calves fed 350 and 500 g/d of starter were weaned earlier (p<0.05) and showed lower milk consumption (kg, DM) compared with other treatments whereas no significant difference was observed between calves fed 350 and 500 g/d of starter (p>0.05). Dry matter, organic matter and crude protein digestibilities were lower in calves that received 350 g/d of starter compared with other treatments (p<0.05). No differences were observed in acid detergent and neutral detergent fiber digestibility among all treatments (p>0.05).Treatments had no significant effect on time of starting rumination, respiratory score, and days of drug administration for pneumonia. There were no meaningful differences in feces, fecal odor scores, body temperature, and days of drug administration for diarrhea among all treatments (p>0.05). Total dry matter intake at the end of experiment showed no significant difference among calves fed 600 and 800 g/d of starter, but calves fed 350 and 500 g/d of starter showed more dry matter (DM) intake than calves in the 600 and 800 g/d groups (p<0.05).
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Affiliation(s)
- J Ghassemi Nejad
- College of Animal Life Sciences, Kangwon National University, Chuncheon, 200-701, Korea
| | - A Hosseindoust
- College of Animal Life Sciences, Kangwon National University, Chuncheon, 200-701, Korea
| | - A Shoae
- College of Animal Life Sciences, Kangwon National University, Chuncheon, 200-701, Korea
| | - B Ghorbani
- College of Animal Life Sciences, Kangwon National University, Chuncheon, 200-701, Korea
| | - B H Lee
- College of Animal Life Sciences, Kangwon National University, Chuncheon, 200-701, Korea
| | - E Oskoueian
- College of Animal Life Sciences, Kangwon National University, Chuncheon, 200-701, Korea
| | - D Hajilari
- College of Animal Life Sciences, Kangwon National University, Chuncheon, 200-701, Korea
| | - A Amouzmehr
- College of Animal Life Sciences, Kangwon National University, Chuncheon, 200-701, Korea
| | - J D Lohakare
- College of Animal Life Sciences, Kangwon National University, Chuncheon, 200-701, Korea
| | - K I Sung
- College of Animal Life Sciences, Kangwon National University, Chuncheon, 200-701, Korea
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Patel RM, Nagamani SCS, Cuthbertson D, Campeau PM, Krischer JP, Shapiro JR, Steiner RD, Smith PA, Bober MB, Byers PH, Pepin M, Durigova M, Glorieux FH, Rauch F, Lee BH, Hart T, Sutton VR. A cross-sectional multicenter study of osteogenesis imperfecta in North America - results from the linked clinical research centers. Clin Genet 2014; 87:133-40. [PMID: 24754836 DOI: 10.1111/cge.12409] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 04/08/2014] [Accepted: 04/19/2014] [Indexed: 02/06/2023]
Abstract
Osteogenesis imperfecta (OI) is the most common skeletal dysplasia that predisposes to recurrent fractures and bone deformities. In spite of significant advances in understanding the genetic basis of OI, there have been no large-scale natural history studies. To better understand the natural history and improve the care of patients, a network of Linked Clinical Research Centers (LCRC) was established. Subjects with OI were enrolled in a longitudinal study, and in this report, we present cross-sectional data on the largest cohort of OI subjects (n = 544). OI type III subjects had higher prevalence of dentinogenesis imperfecta, severe scoliosis, and long bone deformities as compared to those with OI types I and IV. Whereas the mean lumbar spine area bone mineral density (LS aBMD) was low across all OI subtypes, those with more severe forms had lower bone mass. Molecular testing may help predict the subtype in type I collagen-related OI. Analysis of such well-collected and unbiased data in OI can not only help answering questions that are relevant to patient care but also foster hypothesis-driven research, especially in the context of 'phenotypic expansion' driven by next-generation sequencing.
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Affiliation(s)
- R M Patel
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
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Rosen MA, Sampson JB, Jackson EV, Koka R, Chima AM, Ogbuagu OU, Marx MK, Koroma M, Lee BH. Failure mode and effects analysis of the universal anaesthesia machine in two tertiary care hospitals in Sierra Leone. Br J Anaesth 2014; 113:410-5. [PMID: 24833727 PMCID: PMC4136424 DOI: 10.1093/bja/aeu096] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Anaesthesia care in developed countries involves sophisticated technology and experienced providers. However, advanced machines may be inoperable or fail frequently when placed into the austere medical environment of a developing country. Failure mode and effects analysis (FMEA) is a method for engaging local staff in identifying real or potential breakdowns in processes or work systems and to develop strategies to mitigate risks. Methods Nurse anaesthetists from the two tertiary care hospitals in Freetown, Sierra Leone, participated in three sessions moderated by a human factors specialist and an anaesthesiologist. Sessions were audio recorded, and group discussion graphically mapped by the session facilitator for analysis and commentary. These sessions sought to identify potential barriers to implementing an anaesthesia machine designed for austere medical environments—the universal anaesthesia machine (UAM)—and also engaging local nurse anaesthetists in identifying potential solutions to these barriers. Results Participating Sierra Leonean clinicians identified five main categories of failure modes (resource availability, environmental issues, staff knowledge and attitudes, and workload and staffing issues) and four categories of mitigation strategies (resource management plans, engaging and educating stakeholders, peer support for new machine use, and collectively advocating for needed resources). Conclusions We identified factors that may limit the impact of a UAM and devised likely effective strategies for mitigating those risks.
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Affiliation(s)
- M A Rosen
- Armstrong Institute of Patient Safety and Quality, JHUSOM, Baltimore, MD, USA Anaesthesia and Critical Care Medicine, Johns Hopkins School of Medicine (JHUSOM), Baltimore, MD, USA
| | - J B Sampson
- Anaesthesia and Critical Care Medicine, Johns Hopkins School of Medicine (JHUSOM), Baltimore, MD, USA
| | - E V Jackson
- Anaesthesia and Critical Care Medicine, Johns Hopkins School of Medicine (JHUSOM), Baltimore, MD, USA Value Institute, Christiana Care Health System, Newark, DE, USA
| | - R Koka
- Anaesthesia and Critical Care Medicine, Johns Hopkins School of Medicine (JHUSOM), Baltimore, MD, USA
| | - A M Chima
- Anaesthesia and Critical Care Medicine, Johns Hopkins School of Medicine (JHUSOM), Baltimore, MD, USA
| | - O U Ogbuagu
- Anaesthesia and Critical Care Medicine, Johns Hopkins School of Medicine (JHUSOM), Baltimore, MD, USA
| | - M K Marx
- Anaesthesia and Critical Care Medicine, Johns Hopkins School of Medicine (JHUSOM), Baltimore, MD, USA
| | - M Koroma
- Department of Surgery, Connaught Hospital, Freetown, Sierra Leone
| | - B H Lee
- Anaesthesia and Critical Care Medicine, Johns Hopkins School of Medicine (JHUSOM), Baltimore, MD, USA
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22
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Cho SY, Yoon YA, Ki CS, Huh HJ, Yoo HW, Lee BH, Kim GH, Yoo JH, Kim SY, Kim SJ, Sohn YB, Park SW, Huh R, Chang MS, Lee J, Kwun Y, Maeng SH, Jin DK. Clinical characterization and molecular classification of 12 Korean patients with pseudohypoparathyroidism and pseudopseudohypoparathyroidism. Exp Clin Endocrinol Diabetes 2013; 121:539-45. [PMID: 24127307 DOI: 10.1055/s-0033-1349867] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
CONTEXT Pseudohypoparathyroidism (PHP) is defined as resistance toward parathyroid hormones. PHP and pseudopseudohypoparathyroidism (PPHP) are rare disorders resulting from genetic and epigenetic aberrations within or upstream of the GNAS locus. This study investigated the clinical characteristics and performed a molecular analysis of PHP and PPHP. METHODS A total of 12 patients with (P)PHP from 11 unrelated families (4 with PHP-Ia, 6 with PHP-Ib, and 2 with PPHP) were characterized using both clinical and molecular methods. Clinical features included the presenting symptoms, Albright hereditary osteodystrophy features, and resistance to hormones. Comprehensive analysis of the GNAS and STX16 loci was undertaken to investigate the molecular defects underlying (P)PHP. RESULTS All PHP-Ib patients displayed hypocalcemic symptoms. All PHP-Ia patients showed resistance toward TSH, in addition to PTH. In most patients with PHP, when the diagnosis of PHP was first established, hypocalcemia and hyperphosphatemia were associated with a significant increase in serum PTH levels. One patient with PHP-Ia was diagnosed with growth hormone deficiency and showed a good response to human recombinant growth hormone therapy. 6 patients with PHP-Ia and PPHP showed 5 different mutations in the GNAS gene. 5 patients with PHP-Ib displayed a loss of differentially methylated region (DMR) imprints of the maternal GNAS. One PHP-Ib patient showed a de novo microdeletion in STX16 and a loss of methylation of exon A/B on the maternal allele. No patients revealed paternal disomy among 4 patients with PHP-Ib. CONCLUSIONS Identification of the molecular causes of PHP and PPHP explains their distinctive clinical features and enables confirmation of the diagnosis and exact genetic counseling.
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Affiliation(s)
- S Y Cho
- Department of Pediatrics, Hanyang University Guri Hopistal, Hanyang University College of Medicine, Guri, Republic of Korea
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Kim MT, Rhee KY, Lee BH, Kim CJ. Effect of carbon nanotube addition on the wear behavior of basalt/epoxy woven composites. J Nanosci Nanotechnol 2013; 13:5631-5635. [PMID: 23882807 DOI: 10.1166/jnn.2013.7037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The effect of acid-treated carbon nanotube (CNT) addition on the wear and dynamic mechanical thermal properties of basalt/epoxy woven composites was investigated in this study. Basalt/CNT/epoxy composites were fabricated by impregnating woven basalt fibers into epoxy resin mixed with 1 wt% CNTs which were acid-treated. Wear and DMA (dynamic mechanical analyzer) tests were performed on basalt/epoxy composites and basalt/CNT/epoxy composites. The results showed that the addition of the acid-treated CNTs improved the wear properties of basalt/epoxy woven composites. Specifically, the friction coefficient of the basalt/epoxy composite was stabilized in the range of 0.5-0.6 while it fell in the range of 0.3-0.4 for basalt/CNT/epoxy composites. The wear volume loss of the basalt/CNT/epoxy composites was approximately 68% lower than that of the basalt/epoxy composites. The results also showed that the glass transition temperature of basalt/CNT/epoxy composites was higher than that of basalt/epoxy composites. The improvement of wear properties of basalt/epoxy composites by the addition of acid-treated CNTs was caused by the homogeneous load transfer between basalt fibers and epoxy matrix due to the reinforcement of CNTs.
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Affiliation(s)
- M T Kim
- Department of R&D, Gumi Electronics and Information Technology Research Institute, Gumi 730-853, Korea
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24
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Sule G, Campeau PM, Zhang VW, Nagamani SCS, Dawson BC, Grover M, Bacino CA, Sutton VR, Brunetti-Pierri N, Lu JT, Lemire E, Gibbs RA, Cohn DH, Cui H, Wong LJ, Lee BH. Next-generation sequencing for disorders of low and high bone mineral density. Osteoporos Int 2013; 24:2253-9. [PMID: 23443412 PMCID: PMC3709009 DOI: 10.1007/s00198-013-2290-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [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] [Received: 09/04/2012] [Accepted: 01/03/2013] [Indexed: 10/27/2022]
Abstract
UNLABELLED To achieve an efficient molecular diagnosis of osteogenesis imperfecta (OI), Ehlers-Danlos syndrome (EDS), and osteopetrosis (OPT), we designed a next-generation sequencing (NGS) platform to sequence 34 genes. We validated this platform on known cases and have successfully identified the causative mutation in most patients without a prior molecular diagnosis. INTRODUCTION Osteogenesis imperfecta, Ehlers-Danlos syndrome, and osteopetrosis are collectively common inherited skeletal diseases. Evaluation of subjects with these conditions often includes molecular testing which has important counseling and therapeutic and sometimes legal implications. Since several different genes have been implicated in these conditions, Sanger sequencing of each gene can be a prohibitively expensive and time-consuming way to reach a molecular diagnosis. METHODS In order to circumvent these problems, we have designed and tested a NGS platform that would allow simultaneous sequencing on a single diagnostic platform of different genes implicated in OI, OPT, EDS, and other inherited conditions, leading to low or high bone mineral density. We used a liquid-phase probe library that captures 602 exons (~100 kb) of 34 selected genes and have applied it to test clinical samples from patients with bone disorders. RESULTS NGS of the captured exons by Illumina HiSeq 2000 resulted in an average coverage of over 900X. The platform was successfully validated by identifying mutations in six patients with known mutations. Moreover, in four patients with OI or OPT without a prior molecular diagnosis, the assay was able to detect the causative mutations. CONCLUSIONS In conclusion, our NGS panel provides a fast and accurate method to arrive at a molecular diagnosis in most patients with inherited high or low bone mineral density disorders.
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Affiliation(s)
- G Sule
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, R814, MS225, Houston, TX 77030, USA
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Shin YS, Song SJ, Kang SU, Hwang HS, Choi JW, Lee BH, Jung YS, Kim CH. A novel synthetic compound, 3-amino-3-(4-fluoro-phenyl)-1H-quinoline-2,4-dione, inhibits cisplatin-induced hearing loss by the suppression of reactive oxygen species: in vitro and in vivo study. Neuroscience 2012; 232:1-12. [PMID: 23246618 DOI: 10.1016/j.neuroscience.2012.12.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 12/05/2012] [Accepted: 12/06/2012] [Indexed: 12/20/2022]
Abstract
Cisplatin, a chemotherapeutic agent for treating various solid tumors, produces hearing loss in approximately half a million cancer patients annually in the United States. In the course of developing a new protective agent against cisplatin-induced ototoxicity, we have been interested in a novel synthetic compound, 3-amino-3-(4-fluoro-phenyl)-1H-quinoline-2,4-dione (KR-22332). The effect of KR-22332 on cisplatin-induced cytotoxicity was analyzed in vitro in an organ of Corti-derived cell line (HEI-OC1), and in vivo in a zebrafish and rat model. Cisplatin-induced apoptosis, reactive oxygen species (ROS) generation and altered mitochondrial membrane potential (MMP) in HEI-OC1 cells were observed. KR-22332 significantly inhibited cisplatin-induced apoptosis, change of MMP, and intracellular ROS generation. KR-22332 markedly attenuated the cisplatin-induced loss and changes of auditory neuromasts in the zebrafish. Transtympanic administration of KR-22332 in a rat model was protective against cisplatin-induced hearing loss, as determined by click-evoked auditory brainstem response (p<0.01). Tissue terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling of rat cochlea demonstrated that KR-22332 blocked cisplatin-induced apoptosis. In addition, transtympanic administration of KR-22332 inhibited cisplatin-induced nicotinamide adenine dinucleotide phosphate-oxidase 3 (NOX3) overexpression in the rat cochlea. KR-22332 significantly reduced the expression of p-53, mitogen-activated protein kinases, caspase 3, and tumor necrosis factor-α compared to their significant increase after cisplatin treatment. The results of this study suggest that KR-22332 may prevent ototoxicity caused by the administration of cisplatin through the inhibition of mitochondrial dysfunction and the suppression of ROS generation. These novel findings implicate KR-22332 as a potential candidate for protective agent against cisplatin-induced ototoxicity.
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Affiliation(s)
- Y S Shin
- Department of Otolaryngology, School of Medicine, Ajou University, Suwon, Republic of Korea; Center for Cell Death Regulating Biodrug, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - S J Song
- Bio-organic Science Division, Korea Research Institute of Chemical Technology, Yuseong, Daejeon, Republic of Korea
| | - S U Kang
- Department of Otolaryngology, School of Medicine, Ajou University, Suwon, Republic of Korea; Center for Cell Death Regulating Biodrug, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - H S Hwang
- Department of Otolaryngology, School of Medicine, Ajou University, Suwon, Republic of Korea; Center for Cell Death Regulating Biodrug, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - J W Choi
- Department of Molecular Science & Technology, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - B H Lee
- Department of Otolaryngology, School of Medicine, Ajou University, Suwon, Republic of Korea; Center for Cell Death Regulating Biodrug, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - Y-S Jung
- Bio-organic Science Division, Korea Research Institute of Chemical Technology, Yuseong, Daejeon, Republic of Korea
| | - C-H Kim
- Department of Otolaryngology, School of Medicine, Ajou University, Suwon, Republic of Korea; Center for Cell Death Regulating Biodrug, School of Medicine, Ajou University, Suwon, Republic of Korea.
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Kim JH, Choi JS, Lee BH. PI3K/Akt and MAPK pathways evoke activation of FoxO transcription factor to undergo neuronal apoptosis in brain of the silkworm Bombyx mori (Lepidoptera: Bombycidae). Cell Mol Biol (Noisy-le-grand) 2012; Suppl.58:OL1780-OL1785. [PMID: 23046871] [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] [Received: 07/27/2012] [Accepted: 09/27/2012] [Indexed: 06/01/2023]
Abstract
The Forkhead box O (FoxO) transcription factors, including FoxO1, FoxO3a, FoxO4, and FoxO6, are implicated in the regulation of cell apoptosis and survival. Here, we examined the role of FoxO transcription factors and the involvement of the PI3K/Akt and mitogen-activated protein kinase (MAPK) pathways in neuronal apoptosis in the brain of the silkworm Bombyx mori following starvation. Starvation inhibited cell proliferation and induced apoptosis through caspase-3 activation. The level of phosphorylated kinase Akt increased when the animals ceased feeding. Starvation conditions reduced extracellular-signal-regulated kinase phosphorylation but increased both c-Jun N-terminal kinase and p38 (MAPK) phosphorylation. FoxO1 and FoxO3a were simultaneously localized in the nuclei. These results provide new insights into the process of apoptosis of brain neurons through the involvement of FoxO transcription factors following starvation of insect species.
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Affiliation(s)
- J H Kim
- School of Life Sciences and Biotechnology, Korea University, Seoul 136-701, Korea
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Seo PJ, Kim N, Kim JH, Lee BH, Nam RH, Lee HS, Park JH, Lee MK, Chang H, Jung HC, Song IS. Comparison of Indomethacin, Diclofenac and Aspirin-Induced Gastric Damage according to Age in Rats. Gut Liver 2012; 6:210-7. [PMID: 22570750 PMCID: PMC3343159 DOI: 10.5009/gnl.2012.6.2.210] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Revised: 09/17/2011] [Accepted: 10/10/2011] [Indexed: 12/26/2022] Open
Abstract
Background/Aims Aging gastric mucosa is known to have decreased mucosal defenses and increased susceptibility to injury by nonsteroidal anti-inflammatory drugs. Depending on the type of nonsteroidal anti-inflammatory drug (NSAID), the underlying mechanisms and the extent of damage to the stomach or intestine may differ. This study was performed to evaluate the acute gastric damage caused by different doses of indomethacin, diclofenac and aspirin in rats of various ages. Methods For the acute models, indomethacin (10, 20 or 40 mg/kg), diclofenac (40 or 80 mg/kg) or aspirin (100 mg/kg) was given to 7- and 25-week-old and 1-year-old Sprague-Dawley rats by intragastric gavage. The gross ulcer index, damage area as assessed by imaging, histological index, myeloperoxidase (MPO) activity, and cytosolic phospholipase A2 (cPLA2) levels were measured after 24 hours. Results The gross ulcer index and damage area increased with age in the presence of three NSAIDs (p<0.05). The increases in MPO levels induced by diclofenac and aspirin were significantly higher in 1-year-old than 7-week-old rats (p<0.05). cPLA2 expression induced by indomethacin (10 and 40 mg/kg) was greater in the 1-year-old rats, compared with 7-week-old rats (p<0.05). Conclusions NSAID-induced acute gastric damage increased in a dose- and age-dependent manner.
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Affiliation(s)
- Pyoung Ju Seo
- Department of Internal Medicine Seoul National University Bundang Hospital, Seongnam, Korea
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Jeon K, Choi WI, An JS, Lim SY, Kim WJ, Park GM, Park SS, Choi HS, Lee BH, Choi JC, Na MJ, Park J, Kim JY. Paradoxical response in HIV-negative patients with pleural tuberculosis: a retrospective multicentre study. Int J Tuberc Lung Dis 2012; 16:846-51. [PMID: 22507441 DOI: 10.5588/ijtld.11.0642] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To evaluate the incidence, clinical characteristics and predicting factors for the development of paradoxical response in human immunodeficiency virus negative patients with isolated pleural tuberculosis (TB). DESIGN A multicentre, retrospective cohort study including 458 patients who were diagnosed and treated with isolated pleural TB between March 2005 and February 2010. RESULTS Paradoxical response developed in 72 patients (16%) with isolated pleural TB. The mean time to development of paradoxical response was 8.8 ± 6.4 weeks after initiation of anti-tuberculosis treatment. The main presentation of paradoxical response was aggravation of pre-existing pleural effusion in 58 patients (81%). However, the majority of the patients who developed paradoxical response had no associated symptoms (n = 49, 68%). In multiple logistic regression analysis, development of paradoxical response was independently associated with the proportion of eosinophils (adjusted OR 1.293, 95%CI 1.077-1.553) and protein concentrations (adjusted OR 0.590, 95%CI 0.397-0.878) in the pleural fluid at the time of diagnosis. CONCLUSION Paradoxical response developed in 16% of the patients approximately 2 months after initiation of anti-tuberculosis treatment, presenting with aggravation of pre-existing pleural effusion. Development of paradoxical response was associated with the proportion of eosinophils and protein concentrations in the pleural fluid at the time of diagnosis.
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Affiliation(s)
- K Jeon
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Lee BH, Kim N, Lee HS, Kang JM, Park HK, Jo HJ, Shin CM, Lee SH, Park YS, Hwang JH, Kim JW, Jeong SH, Lee DH, Jung HC, Song IS. The Role of CDX2 in Intestinal Metaplasia Evaluated Using Immunohistochemistry. Gut Liver 2012; 6:71-7. [PMID: 22375174 PMCID: PMC3286742 DOI: 10.5009/gnl.2012.6.1.71] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Accepted: 09/13/2011] [Indexed: 12/31/2022] Open
Abstract
Background/Aims Intestinal metaplasia (IM) has been regarded as a premalignant condition. This study evaluated the role of the transforming factor CDX2 according to the severity and type of IM. Methods This analysis was performed on 383 subjects with IM in the antrum and/or body, with diagnoses that were categorized as controls, dysplasias, and gastric cancers. The IM grades were classified into four groups as negative, mild, moderate or severe using the updated Sydney scoring system. The IM subtypes were categorized as type I, type II, and type III using high iron diamine and alcian blue (pH 2.5) staining. The CDX2 expression in the IM foci was evaluated using immunohistochemistry in specimens from the antrum and/or body. Results CDX2 expression increased according to IM severity (p=0.001) but was not associated with the IM subtype (p=0.881) in the antrum specimens. Similarly, CDX2 expression increased according to the IM grade (p=0.001) but was not associated with the IM subtype (p=0.755) in the body specimens. CDX2 expression was also increased according to baseline disease in the antrum, especially dysplastic and GC group (p=0.003), but not in the body (p=0.582). However, status of Helicobacter pylori infection was not associated with CDX2 expression in the antrum (p=0.692) and body (p=0.271). Conclusions These results show that CDX2 expression is associated with the IM grade regardless of the IM subtype and that it was more frequent in the dysplasia group. These results suggest that CDX2 expression might play an important role in the progression of IM in various environments that can affect neoplastic change.
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Affiliation(s)
- Byoung Hwan Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Kang JM, Seo PJ, Kim N, Lee BH, Kwon J, Lee DH, Jung HC. Analysis of direct medical care costs of peptic ulcer disease in a Korean tertiary medical center. Scand J Gastroenterol 2012; 47:36-42. [PMID: 22126650 DOI: 10.3109/00365521.2011.639083] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES There have been no reported data on the medical care cost of idiopathic peptic ulcer disease (PUD) compared with H. pylori (+) and/or NSAID (+) cases although H. pylori-negative idiopathic ulcers are increasing. The aim of this study was to investigate the direct medical care costs of PUD based on whether it was H. pylori infection/from NSAIDs or idiopathic. MATERIAL AND METHODS One hundred and seventy three patients with PUD comprising H. pylori and/or NSAID use-associated PUD (n = 145) and idiopathic PUD (n = 28) were prospectively enrolled in this study. The direct medical care costs were analyzed retrospectively for the patients with PUD during a one-year follow-up period. RESULTS The recurrence rate within one year was significantly higher in idiopathic PUD than H. pylori and/or NSAID-associated PUD (p = 0.002). Direct medical care costs of idiopathic PUD ($2483.8) were higher than in patients with H. pylori and/or NSAID-associated PUD ($1751.8) resulting from longer duration of medication and higher proportion of endoscopic hemostasis and hospitalization. CONCLUSIONS More clinical research is needed to improve outcome and reduce recurrence rate and medical care costs of idiopathic PUD.
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Affiliation(s)
- Jung Mook Kang
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Kang JM, Kim N, Lee BH, Park HK, Jo HJ, Shin CM, Lee SH, Park YS, Hwang JH, Kim JW, Jeong SH, Lee DH, Jung HC, Song IS. Risk factors for peptic ulcer bleeding in terms of Helicobacter pylori, NSAIDs, and antiplatelet agents. Scand J Gastroenterol 2011; 46:1295-301. [PMID: 21815866 DOI: 10.3109/00365521.2011.605468] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The role of the Helicobacter pylori, nonsteroidal anti-inflammatory drugs (NSAIDs), and antiplatelet agents in the risk of peptic ulcer bleeding has not yet been established. This study was performed to identify the risk factors for peptic ulcer bleeding compared with non-bleeding peptic ulcer disease (PUD). MATERIAL AND METHODS A total of 475 patients, 265 with bleeding PUD and 210 with non-bleeding PUD were consecutively recruited. H. pylori status was determined by histology, rapid urease test, and culture. Exposure to NSAIDs, aspirin, and antiplatelet agents (clopidogrel and ticlopidine) within 4 weeks was obtained. RESULTS Compared with non-bleeding PUD, bleeding PUD had a higher proportion of male gender and current smoking, alcohol drinking, history of aspirin/antiplatelet use, and history of PUD. Whereas the proportion of H. pylori infection and history of H. pylori eradication in bleeding PUD were significantly lower than that in non-bleeding PUD. In multivariate analysis, male gender (OR 1.78, 95% CI 1.10-2.89), drinking alcohol (OR 2.08, 95% CI 1.29-3.14), aspirin/antiplatelet use (OR 2.35, 95% CI 1.45-3.82), and history of PUD (OR 2.46, 95% CI 1.36-4.46) remained independent risk factors for bleeding PUD. When H. pylori status and aspirin/antiplatelet agent use were combined, highest risk of bleeding peptic ulcers was found among H. pylori-negative patients with a history of aspirin/antiplatelet agent use (OR 3.03 95% CI 1.48-6.18) compared with H. pylori-positive patients with no history of aspirin/antiplatelet agent use. CONCLUSIONS Patients with H. pylori-negative peptic ulcers who continuously took aspirin or antiplatelet agents had the highest peptic ulcer bleeding risk.
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Affiliation(s)
- Jung Mook Kang
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Hwang YJ, Sohn MJ, Lee BH, Kim SY, Seo JW, Han YH, Lee JY, Cha SJ, Kim YH. Radiosurgery for metastatic spinal tumors: follow-up MR findings. AJNR Am J Neuroradiol 2011; 33:382-7. [PMID: 22033723 DOI: 10.3174/ajnr.a2760] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE MR imaging is the primary tool for evaluation and monitoring of spinal tumors. We retrospectively analyzed the MR imaging findings before and after SRS for metastatic spinal tumors. MATERIALS AND METHODS We reviewed MR imaging findings on 79 metastatic spinal tumor lesions in 44 patients (29 male and 15 female)who had undergone radiosurgery between November 2003 and April 2008. Posttreatment MR imaging was evaluated retrospectively for 3 aspects: 1) changes in tumor volume; 2) changes in T2 signal intensity;and 3) changes in contrast enhancement patterns. RESULTS With regard to tumor volume on MR images, 32 lesions(40.5%) decreased in volume (group 1), 39 (49.4%) showed no change (group 2), and 8 (10.1%) increased in volume (group 3). T2 signal intensities were unchanged in 4 lesions (type 1), homogeneously increased in 3 (type 2), and changed to a homogeneously dark signal in 4 (type 4). The T2 signal intensity was increased and inter mixed with dark signal intensity (type 3) in 68 lesions. A decrease in contrast enhancement with or without non-enhancing foci was seen in 73 lesions. A persistent homogeneous enhancement pattern was seen in all 4 of the type 1 lesions, in 1 of the 3 type 2 lesions, and in 1 of the 68 type 3 lesions. CONCLUSIONS Main MR imaging features of locally controlled metastatic spinal tumors included no increase in tumor volume, increased T2 signal intensity with intermixed T2 dark signal intensity,and decreased contrast enhancement. Follow-up MR imaging also provided several patterns of tumor recurrence [corrected].
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Affiliation(s)
- Y J Hwang
- Department of Radiology, Inje University Ilsan Paik Hospital, College of Medicine, Goyang-si, Gyenggi-do, Republic of Korea.
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Kang JM, Lee BH, Kim N, Lee HS, Lee HE, Park JH, Kim JS, Jung HC, Song IS. CDX1 and CDX2 expression in intestinal metaplasia, dysplasia and gastric cancer. J Korean Med Sci 2011; 26:647-53. [PMID: 21532856 PMCID: PMC3082117 DOI: 10.3346/jkms.2011.26.5.647] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 03/15/2011] [Indexed: 12/16/2022] Open
Abstract
Intestinal metaplasia (IM) has been regarded as a premalignant condition. However, the pathogenesis of IM is not fully understood. The aim of this study was to evaluate the role of CDX1 and CDX2 in the formation of IM and the progression to dysplasia and gastric cancer (GC). A total of 270 subjects included 90 with GC, dysplasia and age- and sex-matched controls. Real-time PCR (RT-PCR) was performed with body specimens for CDX1 and CDX2. The expression of CDX2 was significantly higher in H. pylori positive group than H. pylori negative group (P = 0.045). CDX1 and CDX2 expression increased proportional to the IM grade of the body (P < 0.001). CDX2 expression was significantly higher in incomplete type of IM than in complete type (P = 0.045). The expression of CDX1 in dysplasia group was significantly higher than in the control group (P = 0.001); in addition, CDX1 and CDX2 in cancer group was significantly higher than control group (P < 0.001, and P < 0.001, respectively). Aberrant expression of CDX1 and CDX2 correlated with H. pylori infection and grade of IM in the body. Furthermore, the results suggest that CDX1 and CDX2 play a role in the progression to GC and dysplasia.
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Affiliation(s)
- Jung Mook Kang
- Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
| | - Byoung Hwan Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Nayoung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hye Seung Lee
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hee Eun Lee
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ji Hyun Park
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Joo Sung Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun Chae Jung
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - In Sung Song
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Affiliation(s)
- Byoung Hwan Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Gyeonggi-do, Korea
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Lee BH, Hwang HJ, Cho CH, Lim SK, Lee SY, Hwang H. Nano-electromechanical switch-CMOS hybrid technology and its applications. J Nanosci Nanotechnol 2011; 11:256-261. [PMID: 21446436 DOI: 10.1166/jnn.2011.3154] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Si-based CMOS technology is facing a serious challenge in terms of power consumption and variability. The increasing costs associated with physical scaling have motivated a search for alternative approaches. Hybridization of nano-electromechanical (NEM)-switch and Si-based CMOS devices has shown a theoretical feasibility for power management, but a huge technical gap must be bridged before a nanoscale NEM switch can be realized due to insufficient material development and the limited understanding of its reliability characteristics. These authors propose the use of a multilayer graphene as a nanoscale cantilever material for a nanoscale NEM switchwith dimensions comparable to those of the state-of-the-art Si-based CMOS devices. The optimal thickness for the multilayer graphene (about five layers) is suggested based on an analytical model. Multilayer graphene can provide the highest Young's modulus among the known electrode materials and a yielding strength that allows more than 15% bending. Further research on material screening and device integration is needed, however, to realize the promises of the hybridization of NEM-switch and Si-based CMOS devices.
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Affiliation(s)
- B H Lee
- Department of Nanobio Materials and Electronics, Gwangju Institute of Science and Technology, Oryong-dong 1, Buk-gu, Gwangju, Korea 500-712
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Wong DK, Liu J, Tan NM, Yin F, Lee BH, Wong TY. Learning-based approach for the automatic detection of the optic disc in digital retinal fundus photographs. Annu Int Conf IEEE Eng Med Biol Soc 2010; 2010:5355-8. [PMID: 21096259 DOI: 10.1109/iembs.2010.5626466] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The optic disc is an important feature in the retina. We propose a method for the detection of the optic disc based on a supervised learning scheme. The method employs pixel and local neighbourhood features extracted from the ROI of a digital retinal fundus photograph. A support vector machine based classification mechanism is used to classify each image point as belonging to the cup and retina. The proposed method is evaluated on a sample image set of 68 retinal fundus images. The results show a high correlation (r>0.9) with the ground truth segmentation, with an overlap error of 6.02%, and found to be comparable to the inter-observer variability based on an independent second observer segmentation of the same data set.
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Affiliation(s)
- D K Wong
- Institute for Infocomm Research, A*STAR, Singapore.
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Kim JJ, Kim N, Lee BH, Kang JM, Seo P, Lim MK, Kwon JH, Song BJ, Lee JW, Lee SH, Park YS, Hwang JH, Kim JW, Jeong SH, Lee DH, Jung HC, Song IS. [Risk factors for development and recurrence of peptic ulcer disease]. Korean J Gastroenterol 2010; 56:220-8. [PMID: 20962557 DOI: 10.4166/kjg.2010.56.4.220] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND/AIMS Peptic ulcer disease (PUD) is one of the common gastrointestinal diseases, and its medical management has been developed so much that the incidence of its serious complications, such as bleeding and perforation, are declining significantly. Its prevalence in Korea is not definitely decreased, probably due to increasing proportion of elderly patients and their rising usage of non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin. This study was conducted to identify the risk factors for development and recurrence of peptic ulcer disease in Korea. METHODS From 2003 to 2008, upper gastrointestinal endoscopy and detailed personal questionnaires were performed for patients who visited Department of Gastroenterology at Seoul National University Bundang Hospital. In total, 475 PUD patients and 335 non-ulcer dyspepsia patients were included. The results of questionnaires and repeated upper gastrointestinal endoscopy at initial diagnosis time and follow-up periods were analyzed. RESULTS Multivariable analysis showed that male, H. pylori infection, NSAIDs use and smoking were risk factors for the development of PUD. The use of proton pump inhibitors (PPIs) and H2 receptor antagonists has significantly reduced the risk of PUD in patients who had taken NSAIDs and/or aspirin. H. pylori infection was found as the only risk factor for the recurrence of PUD. CONCLUSIONS For the old patients who are taking drugs, such as NSAIDs and aspirin, concomitant use of PPIs or H2 receptor antagonists should be considered to protect from the development of PUD. H. pylori eradication has been confirmed again to be essential for the treatment of PUD patients infected with H. pylori.
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Affiliation(s)
- Jin Joo Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Kang JM, Kim N, Kim JH, Oh E, Lee BY, Lee BH, Shin CM, Park JH, Lee MK, Nam RH, Lee HE, Lee HS, Kim JS, Jung HC, Song IS. Effect of aging on gastric mucosal defense mechanisms: ROS, apoptosis, angiogenesis, and sensory neurons. Am J Physiol Gastrointest Liver Physiol 2010; 299:G1147-53. [PMID: 20724528 DOI: 10.1152/ajpgi.00218.2010] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Aging changes in the stomach lead to a decreased capacity for tissue repair in response to gastric acid. The aim of this study was to determine the mechanism associated with the increased susceptibility to injury of aging mucosa including reactive oxygen species (5), apoptosis, angiogenesis, and sensory neuron activity. Fischer 344 rats at four different ages (6, 31, 74 wk, and 2 yr of age) were studied. The connective tissue indicators [salt-soluble collagen and sulfated glycosaminoglycan (sGAG)], lipid hydroperoxide (LPO), myeloperoxidase (MPO), and hexosamine were assessed. We also evaluated the expression of early growth response-1 (Egr-1), phosphatase and tension homologue deleted on chromosome 10 (PTEN), caspase-9 (index of apoptosis), VEGF (index of angiogenesis), calcitonin gene-related peptide (CGRP, index of sensory neurons), and neuronal nitric oxide synthase (nNOS). The histological connective tissue area in the lower part of rat gastric mucosa increased with aging, with increase of salt-soluble collagen and sGAG. LPO and MPO in old rats were significantly greater than in the young rats, whereas hexosamine was significantly reduced. The old gastric mucosa had increased expression of Egr-1, PTEN, and caspase-9, whereas the VEGF, CGRP, and nNOS expression were significantly reduced. These results indicate that the lower part of rat gastric mucosa was found to be replaced by connective tissue with accumulation of oxidative products with aging. In addition, impairment of apoptosis, angiogenesis, and sensory neuron activity via the activation of Egr-1 and PTEN might increase the susceptibility of gastric mucosa to injury during aging.
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Affiliation(s)
- Jung Mook Kang
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Seo PJ, Kim N, Oh JC, Lee BH, Shin CM, Suh S, Park H, Nam RH, Cha JA, Park YS, Lee DH. Comparison of Direct Medical Care Costs Between Erosive Reflux Disease and Non-erosive Reflux Disease in Korean Tertiary Medical Center. J Neurogastroenterol Motil 2010; 16:291-8. [PMID: 20680168 PMCID: PMC2912122 DOI: 10.5056/jnm.2010.16.3.291] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Revised: 07/11/2010] [Accepted: 07/12/2010] [Indexed: 12/13/2022] Open
Abstract
Background/Aims Gastroesophageal reflux disease is one of the most common and frequent chronic disease requiring considerable cost. We investigated the medical care costs in the erosive reflux disease (ERD) and non-erosive reflux disease (NERD). Methods The risk factors and the direct medical care costs were analyzed retrospectively in the ERD (178 patients) and NERD (183 patients) groups for a follow up period of 2 years. Results Logistic regression analysis showed that the ERD was more frequent in the groups of male gender, alcohol consumption, higher body mass index (≥25 kg/m2), hiatal hernia, and higher triglyceride levels (≥150 mg/dL). The direct medical care costs per person for 2 years were found to be $384.8 (ERD) and $412.9 (NERD) without statistically significant differences (p = 0.364). However, 9.3% (17/183) of the NERD patients had visited the emergency room compared to 3.4% (6/178) of the ERD patients (p = 0.029). In addition, more NERD patients were hospitalized than ERD patients (p = 0.006), and because of the longer hospitalization period, the medical costs in NERD patients were higher than ERD patients (p = 0.038). Conclusions In spite of the different risk factors for ERD and NERD, total direct medical care costs were similar between the ERD and NERD group. However, more visits to emergency room and longer hospitalization period with more hospitalization costs in NERD patients account for the differences in medical service and usage distribution between the 2 groups.
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Affiliation(s)
- Pyoung Ju Seo
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea
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Abstract
Strain M7, a thermophilic, anaerobic, terminally sporing bacterium (0.6 by 4.0 mum) was isolated from manure. It degraded filter paper in 1 to 2 days at 60 C in a minimal cellulose medium but was stimulated by yeast extract. It fermented a wide variety of sugars but produced cellulase only in cellulose or carboxymethyl-cellulose media. Cellulase synthesis not only was probably repressed by 0.4% glucose and 0.3% cellobiose, but also cellulase activity appeared to be inhibited by these sugars at these concentrations. Both C(1) cellulase (degrades native cellulose) and C(x) cellulase (beta-1,4-glucanase) activities in strain M7 cultures were assayed by measuring the liberation of reducing sugars with dinitrosalicylic acid. Both activities had optima at pH 6.5 and 67 C. One milliliter of a 48-h culture of strain M7 hydrolyzed 0.044-meq of glucose per min from cotton fibers. The cellulase(s) from strain M7 was extracellular, produced during exponential growth, but was not free in the growth medium until approximately 30% of the cellulose was hydrolyzed. Glucose and cellobiose were the major soluble products liberated from cellulose by the cellulase. ZnCl(2) precipitation appeared initially to be a good method for the concentration of cellulase activity, but subsequent purification was not successful. Isoelectric focusing indicated the presence of four C(x) cellulases (pI 4.5, 6.3, 6.8, and 8.7). The rapid production and high activity of cellulases from this organism strongly support the basic premise that increased hydrolysis of native cellulose is possible at elevated temperature.
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Affiliation(s)
- B H Lee
- Department of Microbiology, The University of British Columbia, Vancouver, British Columbia, Canada
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Eshmuratov A, Nah JC, Kim N, Lee HS, Lee HE, Lee BH, Uhm MS, Park YS, Lee DH, Jung HC, Song IS. The correlation of endoscopic and histological diagnosis of gastric atrophy. Dig Dis Sci 2010; 55:1364-75. [PMID: 19629687 DOI: 10.1007/s10620-009-0891-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Accepted: 06/19/2009] [Indexed: 02/06/2023]
Abstract
PURPOSE Gastric atrophy is a premalignant condition. The aim of this study was to evaluate the correlation between histological and endoscopic findings of atrophy, and to analyze the affecting factors. METHODS Atrophy was graded by endoscopy, and biopsy was performed in the antrum and body for the diagnosis of atrophy according to the Sydney system in the 1,330 subjects. RESULTS Both endoscopic and histological atrophy increased in proportion to age (P < 0.001). The prevalence of endoscopic atrophy was significantly lower than that of histological atrophy especially below 50 years of age. The sensitivity and specificity of endoscopy for the diagnosis of atrophy based on histological diagnosis of atrophy were 61.5 and 57.7% in the antrum, and were 46.8 and 76.4% in the body of the stomach. Multivariate analysis showed that an age <50 (OR 0.38, 95% CI 0.25-0.61) and a PG I/II ratio >3 (OR 0.50, 95% CI 0.35-0.71) in the antrum, and an age < 50 (OR 0.43, 95% CI 0.19-1.00) and a CRP > 5 mg/dl (OR 0.53, 95% CI 0.30-0.94) decreased the sensitivity of the endoscopic diagnosis of atrophy in the body. CONCLUSIONS A high index of suspicion of gastric atrophy is important in the young age group, and confirmation of the diagnosis by histology is necessary.
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Affiliation(s)
- Alisher Eshmuratov
- Department of Internal Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, Gyeonggi-do 463-707, South Korea
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Lee BH, Kim N, Kang SB, Kim SY, Lee KH, Im BY, Jee JH, Oh JC, Park YS, Lee DH. The Long-term Clinical Efficacy of Biofeedback Therapy for Patients With Constipation or Fecal Incontinence. J Neurogastroenterol Motil 2010; 16:177-85. [PMID: 20535349 PMCID: PMC2879852 DOI: 10.5056/jnm.2010.16.2.177] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Accepted: 01/08/2010] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND/AIMS There has been a controversy regarding the usefulness of biofeedback therapy for functional constipation or fecal incontinence. This study was performed to investigate the long-term clinical efficacy of biofeedback therapy. METHODS Sixty-four patients with constipation or fecal incontinence received biofeedback therapy for 4 weeks. Symptom improvements were evaluated immediately after the completion of biofeedback therapy and during the follow-up period of about 12 to 64 months. RESULTS Twenty-five patients in the constipation group [mean age of 52.1 years, 16 men (64.0%)] received 6.2 sessions of biofeedback therapy. Improvement of constipation after the completion of biofeedback therapy was as follows: major response (or improvement) in 3 patients (12.0%), fair in 6 (24.0%), minor in 11 (44.0%) and none in 5 (20.0%). Among 9 patients who showed major or fair improvement, 8 patients (88.9%) maintained the symptom improvement through the long term follow-up periods. Thirty-nine patients in the fecal incontinence group [59.7 years old, 15 men (38.5%)] received 6.8 sessions of biofeedback therapy. Improvement of incontinence after the completion of biofeedback therapy was as follows: major improvement in 6 patients (15.4%), fair in 14 (35.9%), minor in 14 (35.9%), and none in 5 (12.8%). All 11 patients with major or fair improvement maintained the symptom improvement to the end of follow-up periods. CONCLUSIONS Symptom improvements after biofeedback therapy were disappointing in both the constipation and incontinence group. However, when the symptom improvements were classified as major or fair, the improvements continued for at least a year.
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Affiliation(s)
- Byoung Hwan Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea
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Kang HG, Paik KH, Cho HY, Lee BH, Ha IS, Choi Y, Cheong HI. Transcriptome analysis of the response of cultured murine podocytes to puromycin aminonucleoside. Nephron Clin Pract 2010; 115:e1-8. [PMID: 20185935 DOI: 10.1159/000286518] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2009] [Accepted: 08/20/2009] [Indexed: 11/19/2022] Open
Abstract
AIMS Idiopathic nephrotic syndrome is known as a disease of the renal glomerular epithelial cells (podocytes). Recent advances in podocyte biology showed that podocytopathy is the culprit of nephrotic syndrome. To obtain comprehensive information about the response of podocytes to injury, we investigated the gene expression profile of podocytes in response to puromycin aminonucleoside (PAN)-induced injury. METHODS Differentiated mouse podocyte cell line (MPC5) cells were treated with 25 microg/ml PAN for 24, 48, or 72 h. Gene expression profiles of these cells were analyzed. Real time PCR analysis was used to confirm the findings of microarray. RESULTS Expression levels of 23 genes (differentially expressed genes, DEGs), including laminin alpha(1) and MMP3, were significantly different between PAN-treated podocytes and untreated cells. Gene ontology of DEGs indicated that their functional categories were cell adhesion, extracellular matrix (ECM) formation, and ECM degradation. Real-time PCR and indirect immunohistochemistry of PAN-treated and untreated podocytes confirmed the differential expression of DEGs. CONCLUSION Using unbiased global gene expression profiling, we found that podocytes respond to PAN-induced injury by down-regulating the expression of genes involved in cell adhesion and extracellular matrix.
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Affiliation(s)
- H G Kang
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
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Lee BH, Kim N, Hwang TJ, Lee SH, Park YS, Hwang JH, Kim JW, Jeong SH, Lee DH, Jung HC, Song IS. Bismuth-containing quadruple therapy as second-line treatment for Helicobacter pylori infection: effect of treatment duration and antibiotic resistance on the eradication rate in Korea. Helicobacter 2010; 15:38-45. [PMID: 20302588 DOI: 10.1111/j.1523-5378.2009.00735.x] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The eradication rate of first-line Helicobacter pylori treatment is only 70-85% and has been decreasing due to the increase in antibiotic resistance. The aim of this study was to evaluate the efficacy of bismuth-containing quadruple therapy as second-line treatment for H. pylori infection based on treatment duration. METHODS We prospectively enrolled 227 patients that were found to have persistent H. pylori infection after first-line proton-pump inhibitor-clarithromycin-amoxicillin triple therapy. Patients were randomized to 1-week (112 patients) and 2-week (115 patients) quadruple therapy with tripotassium dicitrate bismuthate 300 mg q.i.d., metronidazole 500 mg t.i.d., and tetracycline 500 mg q.i.d. and esomeprazole 20 mg b.i.d. The eradication rate, drug compliance, and adverse events were compared based on treatment duration. RESULTS The eradication rates were 72/112 (64.3%, 95% CI: 0.504-0.830) and 71/92 (77.2%, 0.440-0.749) with 1-week group, and 95/115 (82.6%, 1.165-2.449) an 88/94 (93.6%, 1.213-5.113) with 2-week group by intention-to-treat therapy (p = .002) and per-protocol analysis (p = .001), respectively. The adverse events increased as the treatment durations increased from 7 to 14 days (20.0 and 42.5%, respectively, p < .001). However, there was no significant difference in the patient compliance or the rate of major adverse events between the 1- and 2-week groups (6.3 and 12.5%, respectively, p = .133). CONCLUSION Two-week bismuth-containing quadruple therapy was more effective than the 1-week treatment, and should be considered for second-line treatment in Korea.
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Affiliation(s)
- Byoung Hwan Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
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Abstract
Callosal disconnection signs are closely related to asymmetric hemispheric specialization of cognitive functions. Although extinction is more commonly associated with the right parietotemporal lesion, it may occur following lesions of the corpus callosum. After an infarction involving the left splenium, a 58-year-old right-handed man had no disconnection symptoms that had been reported earlier, but showed visual extinction with left or right visual hemifield dominant stimuli. Our results suggest that dominance specific visual extinction might be another disconnection sign associated with splenial lesion.
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Affiliation(s)
- J I Lee
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangnam-gu, Seoul, South Korea
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Abstract
OBJECTIVE Although a few reviews have been conducted, nonoperative management may be the mainstay of therapy for uncomplicated right colonic diverticulitis. With increasing use of radiological evaluation for diverticulitis, the status of the disease is becoming more accessible. In this study, clinical outcomes of nonoperative management for right colonic diverticulitis were assessed according to disease status using radiological evaluation. METHOD From April 2000 to March 2007, 296 patients were admitted for acute right colonic diverticulitis upon first attack and were treated with nonoperative management. The status of diverticulitis was classified using ultrasonography and/or computed tomography as inflamed diverticulum or phlegmon in 276 patients or pericolic abscess in 20 patients. Uncomplicated diverticulitis was defined as inflamed diverticulum or phlegmon. Length of hospital stay, antibiotic use, failure of initial therapy and the incidence of recurrence after nonoperative management were assessed. RESULTS The mean length of hospital stay and antibiotic use were 6 and 4.7 days respectively. All patients were successfully treated with the initial medical therapy and their hospital stays were uneventful. Of the 276 patients with an uncomplicated diverticulitis, two patients (1%) had a recurrence during follow-up that could be managed nonoperatively. Of the 20 patients with pericolic abscesses, four patients (20%) had a recurrence. One patient underwent laparoscopic ileocolic resection and the other patients were treated nonoperatively. CONCLUSION Nonoperative management may be the treatment of choice for right colonic diverticulitis with inflamed diverticulum or phlegmon. Diverticulitis with pericolic abscess should be treated with additional care.
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Affiliation(s)
- H-C Park
- Department of Surgery, Hallym University College of Medicine, Anyang, Korea
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Lee BH, Kim N, Hwang TJ, Lee SH, Park YS, Hwang JH, Kim JW, Jeong SH, Lee DH, Jung HC, Song IS. Bismuth-containing quadruple therapy as second-line treatment for Helicobacter pylori infection: effect of treatment duration and antibiotic resistance on the eradication rate in Korea. Helicobacter 2010. [PMID: 20302588 DOI: 10.1111/j.1523] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The eradication rate of first-line Helicobacter pylori treatment is only 70-85% and has been decreasing due to the increase in antibiotic resistance. The aim of this study was to evaluate the efficacy of bismuth-containing quadruple therapy as second-line treatment for H. pylori infection based on treatment duration. METHODS We prospectively enrolled 227 patients that were found to have persistent H. pylori infection after first-line proton-pump inhibitor-clarithromycin-amoxicillin triple therapy. Patients were randomized to 1-week (112 patients) and 2-week (115 patients) quadruple therapy with tripotassium dicitrate bismuthate 300 mg q.i.d., metronidazole 500 mg t.i.d., and tetracycline 500 mg q.i.d. and esomeprazole 20 mg b.i.d. The eradication rate, drug compliance, and adverse events were compared based on treatment duration. RESULTS The eradication rates were 72/112 (64.3%, 95% CI: 0.504-0.830) and 71/92 (77.2%, 0.440-0.749) with 1-week group, and 95/115 (82.6%, 1.165-2.449) an 88/94 (93.6%, 1.213-5.113) with 2-week group by intention-to-treat therapy (p = .002) and per-protocol analysis (p = .001), respectively. The adverse events increased as the treatment durations increased from 7 to 14 days (20.0 and 42.5%, respectively, p < .001). However, there was no significant difference in the patient compliance or the rate of major adverse events between the 1- and 2-week groups (6.3 and 12.5%, respectively, p = .133). CONCLUSION Two-week bismuth-containing quadruple therapy was more effective than the 1-week treatment, and should be considered for second-line treatment in Korea.
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Affiliation(s)
- Byoung Hwan Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
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Lee BH, Kim N, Kang SB, Lee KH, Oh JC, Kim SM, Park YS, Lee DH. Two Cases of Chronic Idiopathic Intestinal Pseudo-obstruction with Different Clinical Features. J Neurogastroenterol Motil 2010; 16:83-9. [PMID: 20535331 PMCID: PMC2879827 DOI: 10.5056/jnm.2010.16.1.83] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Accepted: 12/30/2009] [Indexed: 01/27/2023] Open
Abstract
Chronic intestinal pseudo-obstruction (CIPO) is a rare disorder characterized by a severe impairment of gastrointestinal propulsion in the absence of mechanical obstruction. We experienced a case of chronic pseudo-obstruction in the initial phase mimicking acute pseudo-obstruction, which was treated medically. This ongoing case was compared to another recurrent and intractable case successfully treated with surgery and diagnosed as hypoganglionosis. These two cases showed different clinical features and therapeutic approaches for CIPO; one with the first episode of CIPO mimicking Ogilvie's syndrome; the other with recurrent episodes of CIPO with typical features. In conclusion, CIPO is a difficult disorder with various clinical manifestations and different treatment modalities, therefore individualized diagnostic and therapeutic approaches are needed.
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Affiliation(s)
- Byoung Hwan Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea
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Lee JW, Kim N, Cha BH, Lee BH, Hwang TJ, Jeong YJ, Choi TH, Kim HS, Myung HJ, Kim J, Jang JH, Kim YM, Kim JY, Park SW, Park HK, Suh S, Seo PJ, Song JC, Shin CM, Eum YO, Kwon JH, Kim JJ, Song BJ, Park YS, Lee DH. Comparison between Conventional 4 L Polyethylene Glycol and Combination of 2 L Polyethylene Glycol and Sodium Phosphate Solution as Colonoscopy Preparation. Korean J Gastroenterol 2010; 56:299-306. [DOI: 10.4166/kjg.2010.56.5.299] [Citation(s) in RCA: 7] [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: 12/17/2022]
Affiliation(s)
- Jung Won Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine and Liver Research Institute, Seoul, Korea
| | - Nayoung Kim
- Department of Internal Medicine and, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine and Liver Research Institute, Seoul, Korea
| | - Byung Hyo Cha
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Byoung Hwan Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae Jun Hwang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yu Jeong Jeong
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae Hyuck Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hee-Sup Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyung-Joon Myung
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jangeon Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Je-Hyuck Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yeo Myeong Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jong Yeop Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sang Wook Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyun Kyung Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seungchul Suh
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Pyoung Ju Seo
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Joon Chang Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Cheol Min Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine and Liver Research Institute, Seoul, Korea
| | - Young Ook Eum
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jung Hee Kwon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine and Liver Research Institute, Seoul, Korea
| | - Jin Joo Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine and Liver Research Institute, Seoul, Korea
| | - Byeong Jun Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine and Liver Research Institute, Seoul, Korea
| | - Young Soo Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine and Liver Research Institute, Seoul, Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine and Liver Research Institute, Seoul, Korea
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Yoon H, Kim N, Lee BH, Hwang TJ, Lee DH, Park YS, Nam RH, Jung HC, Song IS. Moxifloxacin-containing triple therapy as second-line treatment for Helicobacter pylori infection: effect of treatment duration and antibiotic resistance on the eradication rate. Helicobacter 2009; 14:77-85. [PMID: 19751431 DOI: 10.1111/j.1523-5378.2009.00709.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM The aim of this study was to evaluate the efficacy of a moxifloxacin-containing triple therapy as second-line treatment for Helicobacter pylori infection. We also investigated the effect of treatment duration and antibiotic resistance on the eradication rate of this therapy. METHODS We prospectively enrolled patients found to have persistent H. pylori infections after failure of first-line proton-pump inhibitor-based triple therapy. Patients took moxifloxacin (400 mg q.d.), amoxicillin (1000 mg b.i.d.), and esomeprazole (20 mg b.i.d.). The eradication rate, drug compliance, and adverse event rates were evaluated. Minimal inhibitory tests were performed for moxifloxacin and amoxicillin by the agar dilution method. RESULTS In 2004, 41 patients were treated for 7 days. The intention-to-treat and per-protocol eradication rates (ITT/PP) were 75.6/83.8%. Moxifloxacin resistance was 5.6%. Therapy was extended to 10 days during 2005-2006 and 139 patients were treated. The ITT/PP eradication rates were 71.9/82.6%; moxifloxacin resistance had increased to 12%. The final group of 181 patients in 2007-2008 who were treated for 14 days also had low eradication rates (68/79.9%), but there was no statistical significance in the efficacy among the treatment periods. Moxifloxacin resistance in 2007-2008 was 28.2%. Side-effect increased with treatment duration (i.e., 9.8, 12.2, and 25.4% at 7, 10, and 14 days, respectively, p = .001). CONCLUSION The 7-day moxifloxacin-containing triple therapy produced an unacceptably low eradication rate. Increasing the duration of therapy was expected to increase the eradication rate, but the expected increased did not materialize, most likely because of coincident marked increase in the prevalence of resistance to moxifloxacin. Tailored treatment based on antibiotic susceptibility testing might be more effective in the achievement of high eradication rate when rapid antibiotic resistance such as moxifloxacin is occurring.
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Affiliation(s)
- Hyuk Yoon
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
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