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Park HJ, Kim M, Lee D, Kim HJ, Jung HW. CRISPR-Cas9 and beyond: identifying target genes for developing disease-resistant plants. Plant Biol (Stuttg) 2024; 26:369-377. [PMID: 38363032 DOI: 10.1111/plb.13625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 01/23/2024] [Indexed: 02/17/2024]
Abstract
Throughout the history of crop domestication, desirable traits have been selected in agricultural products. However, such selection often leads to crops and vegetables with weaker vitality and viability than their wild ancestors when exposed to adverse environmental conditions. Considering the increasing human population and climate change challenges, it is crucial to enhance crop quality and quantity. Accordingly, the identification and utilization of diverse genetic resources are imperative for developing disease-resistant plants that can withstand unexpected epidemics of plant diseases. In this review, we provide a brief overview of recent progress in genome-editing technologies, including zinc-finger nucleases (ZFNs), transcription activator-like effector nucleases (TALENs), and clustered regularly interspaced short palindromic repeats (CRISPR)-associated protein 9 (Cas9) technologies. In particular, we classify disease-resistant mutants of Arabidopsis thaliana and several crop plants based on the roles or functions of the mutated genes in plant immunity and suggest potential target genes for molecular breeding of genome-edited disease-resistant plants. Genome-editing technologies are resilient tools for sustainable development and promising solutions for coping with climate change and population increases.
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Affiliation(s)
- H J Park
- Institute of Agricultural Life Science, Dong-A University, Busan, Korea
- Department of Biological Sciences and Research Center of Ecomimetics, Chonnam National University, Gwangju, Korea
| | - M Kim
- Department of Applied Bioscience, Dong-A University, Busan, Korea
| | - D Lee
- Department of Applied Bioscience, Dong-A University, Busan, Korea
| | - H J Kim
- Department of Molecular Genetics, Dong-A University, Busan, Korea
| | - H W Jung
- Institute of Agricultural Life Science, Dong-A University, Busan, Korea
- Department of Applied Bioscience, Dong-A University, Busan, Korea
- Department of Molecular Genetics, Dong-A University, Busan, Korea
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Bowers ME, Wong MK, Ventimiglia J, Nicknam RM, Moster MR, Pro MJ, Dale E, Kolomeyer NN, Lee D, Zheng CX. Effect of bimatoprost sustained-release intracameral implant on intraocular pressure and medication burden in patients with prior glaucoma surgery. J Fr Ophtalmol 2024; 47:103996. [PMID: 37926661 DOI: 10.1016/j.jfo.2023.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/01/2023] [Accepted: 07/03/2023] [Indexed: 11/07/2023]
Abstract
The present retrospective study evaluated intraocular pressure (IOP) and medication burden after bimatoprost sustained-release (bimatoprost SR, Durysta, Allergan) implantation in patients with glaucoma. A secondary objective was to examine an effect of bimatoprost SR in a subset of patients with prior minimally invasive and incisional glaucoma surgery. A retrospective chart review of 122 eyes that received bimatoprost SR by 6 glaucoma specialists at Wills Eye Hospital between March 2020 and September 2021 was performed. One hundred and eighteen eyes from 84 patients had a reduction in IOP (18.5±5.7mmHg vs. 16.0±5.4mmHg, P<0.01) and required fewer glaucoma medications (2.1±1.4 vs. 1.2±1.2, P<0.01) after bimatoprost SR implantation. In 41 eyes from 31 patients who previously underwent glaucoma surgery (including iStent, goniotomy, trabeculectomy, Xen Gel Stent, or tube shunt surgery), medication burden was decreased after bimatoprost SR implantation (1.9±1.3 vs. 1.0±1.0, P<0.001). These data suggest that bimatoprost SR is an efficacious treatment modality for glaucoma, even in post-surgical patients.
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Affiliation(s)
- M E Bowers
- Sidney-Kimmel Medical College, Thomas Jefferson University, 1025, Walnut Street, Suite 100, 19107 Philadelphia, PA, United States.
| | - M K Wong
- Sidney-Kimmel Medical College, Thomas Jefferson University, 1025, Walnut Street, Suite 100, 19107 Philadelphia, PA, United States
| | - J Ventimiglia
- University of Maryland at College Park, 20742 College Park, MD, United States
| | - R M Nicknam
- Sidney-Kimmel Medical College, Thomas Jefferson University, 1025, Walnut Street, Suite 100, 19107 Philadelphia, PA, United States; Glaucoma Service, Wills Eye Hospital, 840, Walnut Street, Suite 1140, 19107 Philadelphia, PA, United States
| | - M R Moster
- Sidney-Kimmel Medical College, Thomas Jefferson University, 1025, Walnut Street, Suite 100, 19107 Philadelphia, PA, United States; Glaucoma Service, Wills Eye Hospital, 840, Walnut Street, Suite 1140, 19107 Philadelphia, PA, United States
| | - M J Pro
- Sidney-Kimmel Medical College, Thomas Jefferson University, 1025, Walnut Street, Suite 100, 19107 Philadelphia, PA, United States; Glaucoma Service, Wills Eye Hospital, 840, Walnut Street, Suite 1140, 19107 Philadelphia, PA, United States
| | - E Dale
- Sidney-Kimmel Medical College, Thomas Jefferson University, 1025, Walnut Street, Suite 100, 19107 Philadelphia, PA, United States; Glaucoma Service, Wills Eye Hospital, 840, Walnut Street, Suite 1140, 19107 Philadelphia, PA, United States
| | - N N Kolomeyer
- Sidney-Kimmel Medical College, Thomas Jefferson University, 1025, Walnut Street, Suite 100, 19107 Philadelphia, PA, United States; Glaucoma Service, Wills Eye Hospital, 840, Walnut Street, Suite 1140, 19107 Philadelphia, PA, United States
| | - D Lee
- Sidney-Kimmel Medical College, Thomas Jefferson University, 1025, Walnut Street, Suite 100, 19107 Philadelphia, PA, United States; Glaucoma Service, Wills Eye Hospital, 840, Walnut Street, Suite 1140, 19107 Philadelphia, PA, United States
| | - C X Zheng
- Sidney-Kimmel Medical College, Thomas Jefferson University, 1025, Walnut Street, Suite 100, 19107 Philadelphia, PA, United States; Glaucoma Service, Wills Eye Hospital, 840, Walnut Street, Suite 1140, 19107 Philadelphia, PA, United States
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Park Y, Lee D, Lee JE, Park HS, Jung SS, Park D, Kang DH, Lee SI, Woo SD, Chung C. The Matrix Stiffness Coordinates the Cell Proliferation and PD-L1 Expression via YAP in Lung Adenocarcinoma. Cancers (Basel) 2024; 16:598. [PMID: 38339350 PMCID: PMC10854616 DOI: 10.3390/cancers16030598] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/05/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
The extracellular matrix (ECM) exerts physiological activity, facilitates cell-to-cell communication, promotes cell proliferation and metastasis, and provides mechanical support for tumor cells. The development of solid tumors is often associated with increased stiffness. A stiff ECM promotes mechanotransduction, and the predominant transcription factors implicated in this phenomenon are YAP/TAZ, β-catenin, and NF-κB. In this study, we aimed to investigate whether YAP is a critical mediator linking matrix stiffness and PD-L1 in lung adenocarcinoma. We confirmed that YAP, PD-L1, and Ki-67, a marker of cell proliferation, increase as the matrix stiffness increases in vitro using the lung adenocarcinoma cell lines PC9 and HCC827 cells. The knockdown of YAP decreased the expression of PD-L1 and Ki-67, and conversely, the overexpression of YAP increased the expression of PD-L1 and K-67 in a stiff-matrix environment (20.0 kPa). Additionally, lung cancer cells were cultured in a 3D environment, which provides a more physiologically relevant setting, and compared to the results obtained from 2D culture. Similar to the findings in 2D culture, it was confirmed that YAP influenced the expression of PD-L1 and K-67 in the 3D culture experiment. Our results suggest that matrix stiffness controls PD-L1 expression via YAP activation, ultimately contributing to cell proliferation.
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Affiliation(s)
- Yeonhee Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 34943, Republic of Korea;
| | - Dahye Lee
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea; (D.L.); (J.E.L.); (H.S.P.); (S.S.J.); (D.P.); (D.H.K.); (S.-I.L.); (S.-D.W.)
| | - Jeong Eun Lee
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea; (D.L.); (J.E.L.); (H.S.P.); (S.S.J.); (D.P.); (D.H.K.); (S.-I.L.); (S.-D.W.)
| | - Hee Sun Park
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea; (D.L.); (J.E.L.); (H.S.P.); (S.S.J.); (D.P.); (D.H.K.); (S.-I.L.); (S.-D.W.)
| | - Sung Soo Jung
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea; (D.L.); (J.E.L.); (H.S.P.); (S.S.J.); (D.P.); (D.H.K.); (S.-I.L.); (S.-D.W.)
| | - Dongil Park
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea; (D.L.); (J.E.L.); (H.S.P.); (S.S.J.); (D.P.); (D.H.K.); (S.-I.L.); (S.-D.W.)
| | - Da Hyun Kang
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea; (D.L.); (J.E.L.); (H.S.P.); (S.S.J.); (D.P.); (D.H.K.); (S.-I.L.); (S.-D.W.)
| | - Song-I Lee
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea; (D.L.); (J.E.L.); (H.S.P.); (S.S.J.); (D.P.); (D.H.K.); (S.-I.L.); (S.-D.W.)
| | - Seong-Dae Woo
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea; (D.L.); (J.E.L.); (H.S.P.); (S.S.J.); (D.P.); (D.H.K.); (S.-I.L.); (S.-D.W.)
| | - Chaeuk Chung
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea; (D.L.); (J.E.L.); (H.S.P.); (S.S.J.); (D.P.); (D.H.K.); (S.-I.L.); (S.-D.W.)
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Kim G, Park C, Yoon YK, Park D, Lee JE, Lee D, Sun P, Park S, Yun C, Kang DH, Chung C. Prediction of lung cancer using novel biomarkers based on microbiome profiling of bronchoalveolar lavage fluid. Sci Rep 2024; 14:1691. [PMID: 38242941 PMCID: PMC10799071 DOI: 10.1038/s41598-024-52296-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 01/16/2024] [Indexed: 01/21/2024] Open
Abstract
There is an unmet need for biomarkers for the diagnosis of lung cancer and decision criteria for lung biopsy. We comparatively investigated the lung microbiomes of patients with lung cancer and benign lung diseases. Patients who underwent bronchoscopy at Chungnam National University Hospital between June 2021 and June 2022 were enrolled. Bronchoalveolar lavage fluid (BALF) was collected from 24 patients each with lung cancer and benign lung diseases. The samples were analyzed using 16S rRNA-based metagenomic sequencing. We found that alpha diversity and the beta diversity distribution (P = 0.001) differed significantly between patients with benign lung diseases and those with lung cancer. Firmicutes was the most abundant phylum in patients with lung cancer (33.39% ± 17.439), whereas Bacteroidota was the most abundant phylum in patients with benign lung disease (31.132% ± 22.505), respectively. In differential abundance analysis, the most differentially abundant microbiota taxon was unclassified_SAR202_clade, belonging to the phylum Chloroflexi. The established prediction model distinguished patients with benign lung disease from those with lung cancer with a high accuracy (micro area under the curve [AUC] = 0.98 and macro AUC = 0.99). The BALF microbiome may be a novel biomarker for the detection of lung cancer.
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Affiliation(s)
- Gihyeon Kim
- Genome and Company, Pangyo-ro 255, Bundang-gu, Seongnam, Korea
| | - Changho Park
- Genome and Company, Pangyo-ro 255, Bundang-gu, Seongnam, Korea
| | | | - Dongil Park
- Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Jeong Eun Lee
- Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Dahye Lee
- Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Pureum Sun
- Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Shinyoung Park
- Genome and Company, Pangyo-ro 255, Bundang-gu, Seongnam, Korea
| | - Changhee Yun
- Genome and Company, Pangyo-ro 255, Bundang-gu, Seongnam, Korea
| | - Da Hyun Kang
- Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon, Korea.
| | - Chaeuk Chung
- Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon, Korea.
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Kim N, Yeo MK, Sun P, Lee D, Kim DK, Lee SI, Chung C, Kang DH, Lee JE. Cathepsin C regulates tumor progression via the Yes-associated protein signaling pathway in non-small cell lung cancer. Am J Cancer Res 2024; 14:97-113. [PMID: 38323275 PMCID: PMC10839315] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/28/2023] [Indexed: 02/08/2024] Open
Abstract
Cathepsin C (CTSC), also known as dipeptidyl peptidase I, is a cathepsin with lysosomal exocysteine protease activity and a central coordinator for the activation of neutrophil-derived serine proteases in the lysosomes of neutrophils. Although the role of CTSC in various cancers, including liver and breast cancers, has recently been reported, its role in non-small cell lung cancer (NSCLC) is largely unknown. This study aimed to investigate the functional role of CTSC in NSCLC and the molecular mechanisms underlying CTSC involvement in disease progression. CTSC overexpression markedly enhanced the growth, motility, and invasiveness of NSCLC cells in vitro and in vivo. CTSC knockdown using shRNA in NSCLC cells reversed the migratory and invasive behavior of NSCLC cells. CTSC also induced epithelial-mesenchymal transition through the Yes-associated protein signaling pathway. In addition, our analyses of clinical samples confirmed that high CTSC expression was associated with lymph node metastasis and recurrence in lung adenocarcinoma. In conclusion, CTSC plays an important role in the progression of NSCLC. Thus, targeting CTSC may be a promising treatment option for patients with NSCLC.
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Affiliation(s)
- Nayoung Kim
- Cancer Research Institute, Chungnam National UniversityDaejeon 35015, Republic of Korea
| | - Min-Kyung Yeo
- Department of Pathology, College of Medicine, Chungnam National UniversityDaejeon 34134, Republic of Korea
| | - Pureum Sun
- Research Institute for Medical Sciences, College of Medicine, Chungnam National UniversityDaejeon 34134, Republic of Korea
| | - Dahye Lee
- Infection Control Convergence Research Center, College of Medicine, Chungnam National UniversityDaejeon 34134, Republic of Korea
| | - Duk Ki Kim
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National UniversityDaejeon 34134, Republic of Korea
| | - Song-I Lee
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National UniversityDaejeon 34134, Republic of Korea
| | - Chaeuk Chung
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National UniversityDaejeon 34134, Republic of Korea
| | - Da Hyun Kang
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National UniversityDaejeon 34134, Republic of Korea
| | - Jeong Eun Lee
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National UniversityDaejeon 34134, Republic of Korea
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Jurado CA, Lee D, Ramirez P, Cortes-Treviño DA, Tsujimoto A. Fracture Resistance of Chairside CAD/CAM Lithium Disilicate-reinforced Ceramic Occlusal Veneers With and Without Margin and Full Coverage Crowns. Oper Dent 2024; 49:84-90. [PMID: 38058016 DOI: 10.2341/23-043-l] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE The aim of this investigation was to compare the fracture resistance of chairside computer-aided design and computer-aided manufacturing (CAD/CAM) lithium disilicate-reinforced ceramic occlusal veneers with and without margin and traditional full coverage premolar crowns. METHODS AND MATERIALS A total of 60 chairside CAD/CAM lithium disilicate-reinforced ceramic (Amber Mill, Hass Bio) restorations were designed and fabricated with a chairside CAD/CAM system (CEREC Dentsply Sirona). The restorations were divided into three groups (n=20): 1) occlusal veneer with 1.0-mm uniform occlusal thickness and with chamfer margin; 2) occlusal veneer with 1.0-mm uniform occlusal thickness and without margin; and 3) full coverage crown with uniform occlusal thickness and gingival margin. Occlusal veneers and crowns were cemented with dual cured resin luting cement (Multilink, Ivoclar Vivadent) to printed resin dies, load cycled (5 million load cycles at 1 Hz with 275 N force), and then loaded until fracture. Load at break (LB) and peak load (PL) until fracture were recorded. Scanning electron microscope images of the tested restorations on the abutments were obtained. RESULTS Fracture strengths were different depending on the design of the restoration. There was no significant difference in fracture strength between the two types of occlusal veneer (LB: 1132.45 N; PL: 1143.30 N for veneers with margin; LB: 1149.25 N; PL: 1219.05 N for veneers without margin). Full coverage crowns showed the lowest fracture resistance (LB: 936.26 N, PL: 976.42 N), which was significantly lower than both designs of occlusal veneer. CONCLUSIONS The fracture resistance of the CAD/CAM lithium disilicate-reinforced ceramic restorations was influenced by the design. Occlusal veneers with and without margin displayed higher fracture resistance than traditional crowns.
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Affiliation(s)
- C A Jurado
- Carlos Alberto Jurado, DDS, MS, clinical associate professor, University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - D Lee
- Damian Lee, DDS, MS, associate professor and chair, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - P Ramirez
- Paulette Ramirez, BS, dental student, Texas Tech University Health Sciences Center El Paso, Woody L. Hunt School of Dental Medicine, El Paso, TX, USA
| | - D A Cortes-Treviño
- Daniel Alberto Cortes-Treviño, DDS, MS, private practice, Dallas, TX, USA
| | - A Tsujimoto
- *Akimasa Tsujimoto, DDS, PhD, professor and chair, Department of Operative Dentistry, Aichi Gakuin University School of Dentistry, Nagoya, Aichi, Japan; adjunct associate professor, Department of Operative Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA; visiting associate professor, Department of General Dentistry, Creighton University School of Dentistry, Omaha, NE, USA
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Lee D, Yun T, Koo Y, Chae Y, Kim H, Yang MP, Lee S, Kang BT. Increased 18 F-fluorodeoxyglucose uptake mimicking malignant lung tumour in a cat with lipid pneumonia. J Small Anim Pract 2023; 64:727. [PMID: 37491743 DOI: 10.1111/jsap.13652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/12/2023] [Accepted: 06/10/2023] [Indexed: 07/27/2023]
Affiliation(s)
- D Lee
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, 28644, Chungbuk, Republic of Korea
| | - T Yun
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, 28644, Chungbuk, Republic of Korea
| | - Y Koo
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, 28644, Chungbuk, Republic of Korea
| | - Y Chae
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, 28644, Chungbuk, Republic of Korea
| | - H Kim
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, 28644, Chungbuk, Republic of Korea
| | - M P Yang
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, 28644, Chungbuk, Republic of Korea
| | - S Lee
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - B T Kang
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, 28644, Chungbuk, Republic of Korea
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Lee D, Kim YN, Cho SH, Yoon HS, Kim YT, Kim S, Kim SW. Comparison of progression-free survival outcome of sentinel node biopsy without ultrastaging versus lymphadenectomy in endometrial cancer: a propensity-matched analysis. J Gynecol Oncol 2023; 34:e79. [PMID: 37477102 PMCID: PMC10627756 DOI: 10.3802/jgo.2023.34.e79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 05/31/2023] [Accepted: 06/24/2023] [Indexed: 07/22/2023] Open
Abstract
OBJECTIVE We aimed to investigate the oncologic outcomes of patients with endometrial cancer who underwent sentinel lymph node (SLN) biopsy without ultrastaging compared with that of those who underwent lymphadenectomy (LND). METHODS Patients with endometrial cancer who underwent staging with SLN biopsy or LND during 2006 - 2021 were analyzed using propensity score matching (PSM). SLN metastasis was examined using hematoxylin and eosin staining, without ultrastaging. Progression-free survival (PFS) was compared between the two groups before and after PSM using age, histology, and stage as covariates. Clinical variables such as recurrence patterns and lymphatic complications, were assessed. RESULTS After excluding 213 patients who underwent validation LND with SLN biopsy, 902 were identified. The demographics of the remaining patients differed according to histology, myometrial invasion depth, and stage. Lymph node metastasis was less frequent in the SLN group than in the LND group (9.4% vs. 3.8%, p=0.004). The recurrence rates within 2 years were lower in the SLN group. The SLN group exhibited significantly superior 2-year and overall PFS than the LND group. Among patients with uterus-confined disease, overall PFS was favorable for SLN biopsy. After matching, differences in PFS were no longer observed, although the lymphocele and lymphedema rates were significantly lower in the SLN group. CONCLUSION In patients with endometrial cancer, SLN biopsy without ultrastaging did not compromise survival outcomes and was associated with significantly reduced lymphatic complication rates compared with LND. Therefore, SLN biopsy can be recommended for patients with endometrial cancer without definitive preoperative evidence of distant metastasis.
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Affiliation(s)
- Dahye Lee
- Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Yoo-Na Kim
- Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hyun Cho
- Department of Obstetrics and Gynecology, Seoul St. Mary's hospital, The Catholic University of Korea, Seoul, Korea
| | - Hye Soo Yoon
- Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Young Tae Kim
- Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Sunghoon Kim
- Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Wun Kim
- Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
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Raman B, McCracken C, Cassar MP, Moss AJ, Finnigan L, Samat AHA, Ogbole G, Tunnicliffe EM, Alfaro-Almagro F, Menke R, Xie C, Gleeson F, Lukaschuk E, Lamlum H, McGlynn K, Popescu IA, Sanders ZB, Saunders LC, Piechnik SK, Ferreira VM, Nikolaidou C, Rahman NM, Ho LP, Harris VC, Shikotra A, Singapuri A, Pfeffer P, Manisty C, Kon OM, Beggs M, O'Regan DP, Fuld J, Weir-McCall JR, Parekh D, Steeds R, Poinasamy K, Cuthbertson DJ, Kemp GJ, Semple MG, Horsley A, Miller CA, O'Brien C, Shah AM, Chiribiri A, Leavy OC, Richardson M, Elneima O, McAuley HJC, Sereno M, Saunders RM, Houchen-Wolloff L, Greening NJ, Bolton CE, Brown JS, Choudhury G, Diar Bakerly N, Easom N, Echevarria C, Marks M, Hurst JR, Jones MG, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Howard LS, Jacob J, Man WDC, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Singh SJ, Thomas DC, Toshner M, Lewis KE, Heaney LG, Harrison EM, Kerr S, Docherty AB, Lone NI, Quint J, Sheikh A, Zheng B, Jenkins RG, Cox E, Francis S, Halling-Brown M, Chalmers JD, Greenwood JP, Plein S, Hughes PJC, Thompson AAR, Rowland-Jones SL, Wild JM, Kelly M, Treibel TA, Bandula S, Aul R, Miller K, Jezzard P, Smith S, Nichols TE, McCann GP, Evans RA, Wain LV, Brightling CE, Neubauer S, Baillie JK, Shaw A, Hairsine B, Kurasz C, Henson H, Armstrong L, Shenton L, Dobson H, Dell A, Lucey A, Price A, Storrie A, Pennington C, Price C, Mallison G, Willis G, Nassa H, Haworth J, Hoare M, Hawkings N, Fairbairn S, Young S, Walker S, Jarrold I, Sanderson A, David C, Chong-James K, Zongo O, James WY, Martineau A, King B, Armour C, McAulay D, Major E, McGinness J, McGarvey L, Magee N, Stone R, Drain S, Craig T, Bolger A, Haggar A, Lloyd A, Subbe C, Menzies D, Southern D, McIvor E, Roberts K, Manley R, Whitehead V, Saxon W, Bularga A, Mills NL, El-Taweel H, Dawson J, Robinson L, Saralaya D, Regan K, Storton K, Brear L, Amoils S, Bermperi A, Elmer A, Ribeiro C, Cruz I, Taylor J, Worsley J, Dempsey K, Watson L, Jose S, Marciniak S, Parkes M, McQueen A, Oliver C, Williams J, Paradowski K, Broad L, Knibbs L, Haynes M, Sabit R, Milligan L, Sampson C, Hancock A, Evenden C, Lynch C, Hancock K, Roche L, Rees M, Stroud N, Thomas-Woods T, Heller S, Robertson E, Young B, Wassall H, Babores M, Holland M, Keenan N, Shashaa S, Price C, Beranova E, Ramos H, Weston H, Deery J, Austin L, Solly R, Turney S, Cosier T, Hazelton T, Ralser M, Wilson A, Pearce L, Pugmire S, Stoker W, McCormick W, Dewar A, Arbane G, Kaltsakas G, Kerslake H, Rossdale J, Bisnauthsing K, Aguilar Jimenez LA, Martinez LM, Ostermann M, Magtoto MM, Hart N, Marino P, Betts S, Solano TS, Arias AM, Prabhu A, Reed A, Wrey Brown C, Griffin D, Bevan E, Martin J, Owen J, Alvarez Corral M, Williams N, Payne S, Storrar W, Layton A, Lawson C, Mills C, Featherstone J, Stephenson L, Burdett T, Ellis Y, Richards A, Wright C, Sykes DL, Brindle K, Drury K, Holdsworth L, Crooks MG, Atkin P, Flockton R, Thackray-Nocera S, Mohamed A, Taylor A, Perkins E, Ross G, McGuinness H, Tench H, Phipps J, Loosley R, Wolf-Roberts R, Coetzee S, Omar Z, Ross A, Card B, Carr C, King C, Wood C, Copeland D, Calvelo E, Chilvers ER, Russell E, Gordon H, Nunag JL, Schronce J, March K, Samuel K, Burden L, Evison L, McLeavey L, Orriss-Dib L, Tarusan L, Mariveles M, Roy M, Mohamed N, Simpson N, Yasmin N, Cullinan P, Daly P, Haq S, Moriera S, Fayzan T, Munawar U, Nwanguma U, Lingford-Hughes A, Altmann D, Johnston D, Mitchell J, Valabhji J, Price L, Molyneaux PL, Thwaites RS, Walsh S, Frankel A, Lightstone L, Wilkins M, Willicombe M, McAdoo S, Touyz R, Guerdette AM, Warwick K, Hewitt M, Reddy R, White S, McMahon A, Hoare A, Knighton A, Ramos A, Te A, Jolley CJ, Speranza F, Assefa-Kebede H, Peralta I, Breeze J, Shevket K, Powell N, Adeyemi O, Dulawan P, Adrego R, Byrne S, Patale S, Hayday A, Malim M, Pariante C, Sharpe C, Whitney J, Bramham K, Ismail K, Wessely S, Nicholson T, Ashworth A, Humphries A, Tan AL, Whittam B, Coupland C, Favager C, Peckham D, Wade E, Saalmink G, Clarke J, Glossop J, Murira J, Rangeley J, Woods J, Hall L, Dalton M, Window N, Beirne P, Hardy T, Coakley G, Turtle L, Berridge A, Cross A, Key AL, Rowe A, Allt AM, Mears C, Malein F, Madzamba G, Hardwick HE, Earley J, Hawkes J, Pratt J, Wyles J, Tripp KA, Hainey K, Allerton L, Lavelle-Langham L, Melling L, Wajero LO, Poll L, Noonan MJ, French N, Lewis-Burke N, Williams-Howard SA, Cooper S, Kaprowska S, Dobson SL, Marsh S, Highett V, Shaw V, Beadsworth M, Defres S, Watson E, Tiongson GF, Papineni P, Gurram S, Diwanji SN, Quaid S, Briggs A, Hastie C, Rogers N, Stensel D, Bishop L, McIvor K, Rivera-Ortega P, Al-Sheklly B, Avram C, Faluyi D, Blaikely J, Piper Hanley K, Radhakrishnan K, Buch M, Hanley NA, Odell N, Osbourne R, Stockdale S, Felton T, Gorsuch T, Hussell T, Kausar Z, Kabir T, McAllister-Williams H, Paddick S, Burn D, Ayoub A, Greenhalgh A, Sayer A, Young A, Price D, Burns G, MacGowan G, Fisher H, Tedd H, Simpson J, Jiwa K, Witham M, Hogarth P, West S, Wright S, McMahon MJ, Neill P, Dougherty A, Morrow A, Anderson D, Grieve D, Bayes H, Fallon K, Mangion K, Gilmour L, Basu N, Sykes R, Berry C, McInnes IB, Donaldson A, Sage EK, Barrett F, Welsh B, Bell M, Quigley J, Leitch K, Macliver L, Patel M, Hamil R, Deans A, Furniss J, Clohisey S, Elliott A, Solstice AR, Deas C, Tee C, Connell D, Sutherland D, George J, Mohammed S, Bunker J, Holmes K, Dipper A, Morley A, Arnold D, Adamali H, Welch H, Morrison L, Stadon L, Maskell N, Barratt S, Dunn S, Waterson S, Jayaraman B, Light T, Selby N, Hosseini A, Shaw K, Almeida P, Needham R, Thomas AK, Matthews L, Gupta A, Nikolaidis A, Dupont C, Bonnington J, Chrystal M, Greenhaff PL, Linford S, Prosper S, Jang W, Alamoudi A, Bloss A, Megson C, Nicoll D, Fraser E, Pacpaco E, Conneh F, Ogg G, McShane H, Koychev I, Chen J, Pimm J, Ainsworth M, Pavlides M, Sharpe M, Havinden-Williams M, Petousi N, Talbot N, Carter P, Kurupati P, Dong T, Peng Y, Burns A, Kanellakis N, Korszun A, Connolly B, Busby J, Peto T, Patel B, Nolan CM, Cristiano D, Walsh JA, Liyanage K, Gummadi M, Dormand N, Polgar O, George P, Barker RE, Patel S, Price L, Gibbons M, Matila D, Jarvis H, Lim L, Olaosebikan O, Ahmad S, Brill S, Mandal S, Laing C, Michael A, Reddy A, Johnson C, Baxendale H, Parfrey H, Mackie J, Newman J, Pack J, Parmar J, Paques K, Garner L, Harvey A, Summersgill C, Holgate D, Hardy E, Oxton J, Pendlebury J, McMorrow L, Mairs N, Majeed N, Dark P, Ugwuoke R, Knight S, Whittaker S, Strong-Sheldrake S, Matimba-Mupaya W, Chowienczyk P, Pattenadk D, Hurditch E, Chan F, Carborn H, Foot H, Bagshaw J, Hockridge J, Sidebottom J, Lee JH, Birchall K, Turner K, Haslam L, Holt L, Milner L, Begum M, Marshall M, Steele N, Tinker N, Ravencroft P, Butcher R, Misra S, Walker S, Coburn Z, Fairman A, Ford A, Holbourn A, Howell A, Lawrie A, Lye A, Mbuyisa A, Zawia A, Holroyd-Hind B, Thamu B, Clark C, Jarman C, Norman C, Roddis C, Foote D, Lee E, Ilyas F, Stephens G, Newell H, Turton H, Macharia I, Wilson I, Cole J, McNeill J, Meiring J, Rodger J, Watson J, Chapman K, Harrington K, Chetham L, Hesselden L, Nwafor L, Dixon M, Plowright M, Wade P, Gregory R, Lenagh R, Stimpson R, Megson S, Newman T, Cheng Y, Goodwin C, Heeley C, Sissons D, Sowter D, Gregory H, Wynter I, Hutchinson J, Kirk J, Bennett K, Slack K, Allsop L, Holloway L, Flynn M, Gill M, Greatorex M, Holmes M, Buckley P, Shelton S, Turner S, Sewell TA, Whitworth V, Lovegrove W, Tomlinson J, Warburton L, Painter S, Vickers C, Redwood D, Tilley J, Palmer S, Wainwright T, Breen G, Hotopf M, Dunleavy A, Teixeira J, Ali M, Mencias M, Msimanga N, Siddique S, Samakomva T, Tavoukjian V, Forton D, Ahmed R, Cook A, Thaivalappil F, Connor L, Rees T, McNarry M, Williams N, McCormick J, McIntosh J, Vere J, Coulding M, Kilroy S, Turner V, Butt AT, Savill H, Fraile E, Ugoji J, Landers G, Lota H, Portukhay S, Nasseri M, Daniels A, Hormis A, Ingham J, Zeidan L, Osborne L, Chablani M, Banerjee A, David A, Pakzad A, Rangelov B, Williams B, Denneny E, Willoughby J, Xu M, Mehta P, Batterham R, Bell R, Aslani S, Lilaonitkul W, Checkley A, Bang D, Basire D, Lomas D, Wall E, Plant H, Roy K, Heightman M, Lipman M, Merida Morillas M, Ahwireng N, Chambers RC, Jastrub R, Logan S, Hillman T, Botkai A, Casey A, Neal A, Newton-Cox A, Cooper B, Atkin C, McGee C, Welch C, Wilson D, Sapey E, Qureshi H, Hazeldine J, Lord JM, Nyaboko J, Short J, Stockley J, Dasgin J, Draxlbauer K, Isaacs K, Mcgee K, Yip KP, Ratcliffe L, Bates M, Ventura M, Ahmad Haider N, Gautam N, Baggott R, Holden S, Madathil S, Walder S, Yasmin S, Hiwot T, Jackson T, Soulsby T, Kamwa V, Peterkin Z, Suleiman Z, Chaudhuri N, Wheeler H, Djukanovic R, Samuel R, Sass T, Wallis T, Marshall B, Childs C, Marouzet E, Harvey M, Fletcher S, Dickens C, Beckett P, Nanda U, Daynes E, Charalambou A, Yousuf AJ, Lea A, Prickett A, Gooptu B, Hargadon B, Bourne C, Christie C, Edwardson C, Lee D, Baldry E, Stringer E, Woodhead F, Mills G, Arnold H, Aung H, Qureshi IN, Finch J, Skeemer J, Hadley K, Khunti K, Carr L, Ingram L, Aljaroof M, Bakali M, Bakau M, Baldwin M, Bourne M, Pareek M, Soares M, Tobin M, Armstrong N, Brunskill N, Goodman N, Cairns P, Haldar P, McCourt P, Dowling R, Russell R, Diver S, Edwards S, Glover S, Parker S, Siddiqui S, Ward TJC, Mcnally T, Thornton T, Yates T, Ibrahim W, Monteiro W, Thickett D, Wilkinson D, Broome M, McArdle P, Upthegrove R, Wraith D, Langenberg C, Summers C, Bullmore E, Heeney JL, Schwaeble W, Sudlow CL, Adeloye D, Newby DE, Rudan I, Shankar-Hari M, Thorpe M, Pius R, Walmsley S, McGovern A, Ballard C, Allan L, Dennis J, Cavanagh J, Petrie J, O'Donnell K, Spears M, Sattar N, MacDonald S, Guthrie E, Henderson M, Guillen Guio B, Zhao B, Lawson C, Overton C, Taylor C, Tong C, Mukaetova-Ladinska E, Turner E, Pearl JE, Sargant J, Wormleighton J, Bingham M, Sharma M, Steiner M, Samani N, Novotny P, Free R, Allen RJ, Finney S, Terry S, Brugha T, Plekhanova T, McArdle A, Vinson B, Spencer LG, Reynolds W, Ashworth M, Deakin B, Chinoy H, Abel K, Harvie M, Stanel S, Rostron A, Coleman C, Baguley D, Hufton E, Khan F, Hall I, Stewart I, Fabbri L, Wright L, Kitterick P, Morriss R, Johnson S, Bates A, Antoniades C, Clark D, Bhui K, Channon KM, Motohashi K, Sigfrid L, Husain M, Webster M, Fu X, Li X, Kingham L, Klenerman P, Miiler K, Carson G, Simons G, Huneke N, Calder PC, Baldwin D, Bain S, Lasserson D, Daines L, Bright E, Stern M, Crisp P, Dharmagunawardena R, Reddington A, Wight A, Bailey L, Ashish A, Robinson E, Cooper J, Broadley A, Turnbull A, Brookes C, Sarginson C, Ionita D, Redfearn H, Elliott K, Barman L, Griffiths L, Guy Z, Gill R, Nathu R, Harris E, Moss P, Finnigan J, Saunders K, Saunders P, Kon S, Kon SS, O'Brien L, Shah K, Shah P, Richardson E, Brown V, Brown M, Brown J, Brown J, Brown A, Brown A, Brown M, Choudhury N, Jones S, Jones H, Jones L, Jones I, Jones G, Jones H, Jones D, Davies F, Davies E, Davies K, Davies G, Davies GA, Howard K, Porter J, Rowland J, Rowland A, Scott K, Singh S, Singh C, Thomas S, Thomas C, Lewis V, Lewis J, Lewis D, Harrison P, Francis C, Francis R, Hughes RA, Hughes J, Hughes AD, Thompson T, Kelly S, Smith D, Smith N, Smith A, Smith J, Smith L, Smith S, Evans T, Evans RI, Evans D, Evans R, Evans H, Evans J. Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study. Lancet Respir Med 2023; 11:1003-1019. [PMID: 37748493 PMCID: PMC7615263 DOI: 10.1016/s2213-2600(23)00262-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/16/2023] [Accepted: 06/30/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. METHODS In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. FINDINGS Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2-6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5-5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4-10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32-4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23-11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. INTERPRETATION After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification. FUNDING UK Research and Innovation and National Institute for Health Research.
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Sourial F, Shamsesfandabadi P, Matani H, Hwang MS, Oh S, Lee D. A Comparison of Treatment Plan Adaptation Methods on PTV Margin Coverage in MR-Linac Prostate SBRT. Int J Radiat Oncol Biol Phys 2023; 117:e439-e440. [PMID: 37785426 DOI: 10.1016/j.ijrobp.2023.06.1615] [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) MRI-Linac guided radiotherapy is a novel treatment modality allowing for daily online adaptation of contours and treatment planning. MRI-Linac prostate SBRT (MRL-SBRT) has recently been shown to provide a tangible benefit in decreasing both acute and late toxicity, due to the ability to evaluate soft tissue contrast, directly monitor organ motion, and anatomical changes during the entire treatment course. Multiple MRI-Linac platforms are available, which provide different advantages with regards to imaging and motion management. We undertook this study to assess coverage of the clinical target volume with use of a standard PTV margin in patients receiving either adapt-to-position (ATP) only treatment or a combination of adapt-to-position and adapt-to-shape (ATP+ATS) on the Elekta Unity MR-Linac. MATERIALS/METHODS Data was collected retrospectively in patients who underwent prostate SBRT using a 1.5 T MR-Linac (Unity, Elekta AB, Stockholm, Sweden). Prior to each fraction, determination of ATP or ATS planning was at the discretion of the treating physician. Prostate and organs at risk (OAR's) were contoured on the reference MRI and daily MR image sets acquired prior to each fraction. The prostate PTV consisted of a 5mm margin, except 3mm posteriorly. Contours were merged to account for target and OAR volumes during all fractions. Target volumes from the reference plan were then compared to the clinical target volume (CTV) on pre-treatment MR-Linac imaging as well as intersection with OAR's. RESULTS Nineteen men, median age 72 years (range 67-75), with prostate cancer underwent treatment from May 2021 to January 2023 with MRL-SBRT. The average time for ATP vs ATP+ATS was 45 minutes (range 35-60) and 60 minutes (range 50-80), respectively. The mean CTV treated was 43.4cc (range 31-60) for ATP and 51.8cc (range 36-67) for ATP+ATS. Prior to plan adaptation, target volumes in 92.6% of fractions were not covered completely by the PTV. In the ATP cohort, 89% of fractions had a portion of the CTV uncovered with an average of 2.9cc. In the ATP+ATS cohort, 96.4% had a portion of the CTV uncovered, with an average of 6.9cc. There was no difference in the amount of PTV intersection for ATP or ATP+ATS plans with the rectum (1.1cc vs. 1.5cc) and bladder (9.2cc vs. 12.6cc), respectively. All patients completed the planned course of treatment. CONCLUSION Adaptive radiation therapy for prostate cancer utilizing an MR-Linac based approach with the Elekta Unity was feasible for patients requiring either ATP only or ATP+ATS plans. As expected, ATS plans required longer treatment time, allowing for improved coverage of the target when deemed clinically necessary. Despite a larger overall volume treated in ATS plans, there was no difference in overlap with OARs between ATP and ATS plans. Adaption for each daily fraction and intrafraction motion monitoring improved CT coverage with our pre-specified PTV margin.
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Affiliation(s)
- F Sourial
- Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
| | - P Shamsesfandabadi
- Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
| | - H Matani
- Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
| | - M S Hwang
- Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
| | - S Oh
- Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
| | - D Lee
- Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
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Hwang MS, Lee D, Oh S, Pavord D, Kirichenko AV, Renz PB. Assessment of Daily Target Motion to Optimize ITV Margins in Online Adaptive Plan for Liver and Pancreatic SBRT on MR-LINAC. Int J Radiat Oncol Biol Phys 2023; 117:e674. [PMID: 37785988 DOI: 10.1016/j.ijrobp.2023.06.2125] [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) Accurate measurement of daily target motion on online plan adaptation is essential for re-optimizing the internal target volume (ITV) margins. In this study, by analyzing 2D cine MR images acquired in a 1.5T MR-Linac, we assessed daily target motion and its inter-fractional variations, which is then used to customize ITV margins for MR-based online adaptive plan of liver and pancreatic stereotactic body radiotherapy (SBRT). MATERIALS/METHODS Twenty-threepatients, enrolled in this study, underwent MR-guided online adaptive SBRT on 1.5 T MR-Linac: liver (n = 12 without compression belt (CB), n = 2 with CB) and pancreas (n = 9 with CB). Target motion in a 2D coronal and sagittal MR images (> 200 cine images to cover multiple breathing cycles), as well as a set of 4D-CT images during the simulation, was analyzed to determine patient specific ITV margins for a reference plan. On every fraction of online adaptive SBRT, the 2D MR images were exported to commercially available software along with a planning MR images: a T1-wighted MR image set for pancreas and or a navigated T2-wighted MR image set for liver. Daily target motion was then measured by overlaying the orthogonal cine image set on the T1- or T2-wighted image set. The ITV margin was adjusted when required prior to online plan optimization RESULTS: Thisstudy successfully assessed the daily target motion and inter-fractional variations in 23 liver or pancreatic cancer patients. We found a discrepancy of daily target motion of orthogonal 2D cine MR images from that of 4D-CT, required to adjust the ITV margin for online plan adaptation. In liver SBRT without CB, 15 out of 45 fractions from 12 patients (33.3 %) went through adjusted ITV margin. The tumor motion was large up to a 2.2 cm along the inferior direction in a patient without CB and thus the patient was treated on a conventional Linac with the active breathing control (ABC) unit for breath-hold. On the other hand, no adjustments were necessary for 2 liver patients with CB. In 9 patients with pancreatic cancers, we found the inter-fractional ITV variations in 3 out of 45 fractions (6.7 %) adjusted the ITV margin. The daily target motion in the pancreatic patients with CB was more stable and relatively smaller than that of the liver patients. CONCLUSION Theorthogonal 2D cine MR images are evidently essential for assessing daily target motion to evaluate the inter-fractional variation and achieve daily ITV-customized liver and pancreatic SBRT in the 1.5 T MR-Linac. The customized ITV approach will improve the treatment outcome of the MR-guided online adaptive therapy.
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Affiliation(s)
- M S Hwang
- Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
| | - D Lee
- Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
| | - S Oh
- Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
| | - D Pavord
- Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
| | - A V Kirichenko
- Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
| | - P B Renz
- Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
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Kim JT, Lee CH, Jung D, Choi S, Jeong SH, Lee D, Lee Y, Chung TD. Virus-templated redox nanowire network for enzyme electrode. Biosens Bioelectron 2023; 237:115518. [PMID: 37442029 DOI: 10.1016/j.bios.2023.115518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/26/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023]
Abstract
Viruses have unique coat proteins that are genetically modifiable. Their surface can serve as a nano-template on which electroactive molecules are immobilized. In this study, we report filamentous bacteriophage as a backbone to which redox mediators are covalently and densely tethered, constructing redox nanowire, i.e. an electron conducting biomaterial. The highly ordered coat proteins of a filamentous bacteriophage provide flexible and biocompatible platform to constitute a biohybrid redox nanowire. Incorporating bacteriophage and redox molecules form an entangled assembly of nanowires enabling facile electron transfer. Electron transfer among the molecular mediators in the entangled assembly originates apparent electron diffusion of which the electron transfer rate is comparable to that observed in conventional redox polymers. Programming peptide terminals suggests further enhancement in electron mediation by increasing redox species mobility. In addition, the redox nanowire film functions as a favorable matrix for enzyme encapsulation. The stability of the enzymes entrapped in this unique matrix is substantially improved.
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Affiliation(s)
- Ji Tae Kim
- Department of Chemistry, Seoul National University, Seoul, 08826, Republic of Korea
| | - Chang Heon Lee
- Department of Chemistry, Seoul National University, Seoul, 08826, Republic of Korea
| | - Dongwook Jung
- Department of Chemistry, Seoul National University, Seoul, 08826, Republic of Korea
| | - Sejong Choi
- Department of Chemistry, Seoul National University, Seoul, 08826, Republic of Korea
| | - Sung Hee Jeong
- Program in Nano Science and Technology, Graduate School of Convergence Science and Technology, Seoul National University, Suwon-Si, Gyeonggi-do, 16229, Republic of Korea
| | - Dahye Lee
- Department of Chemistry, Seoul National University, Seoul, 08826, Republic of Korea
| | - Yan Lee
- Department of Chemistry, Seoul National University, Seoul, 08826, Republic of Korea
| | - Taek Dong Chung
- Department of Chemistry, Seoul National University, Seoul, 08826, Republic of Korea; Program in Nano Science and Technology, Graduate School of Convergence Science and Technology, Seoul National University, Suwon-Si, Gyeonggi-do, 16229, Republic of Korea; Electrochemistry Laboratory, Advanced Institutes of Convergence Technology, Suwon-Si, Gyeonggi-do, 16229, Republic of Korea.
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13
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Pike C, Coakley C, Ahmed N, Lee D, Little F, Padian N, Bekker LG. Goals for girls: a cluster-randomized trial to investigate a school-based sexual health programme amongst female learners in South Africa. Health Educ Res 2023; 38:375-391. [PMID: 37405698 PMCID: PMC10516375 DOI: 10.1093/her/cyad025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/06/2023]
Abstract
The delivery of comprehensive sexuality education to adolescents at school is recognized as a long-term strategy to support adolescent health. Suboptimal sexual and reproductive health (SRH) outcomes among South African adolescents necessitate the ongoing development and optimization of SRH education and promotion models. We conducted a cluster-randomized controlled trial amongst secondary schools (n = 38) in Cape Town, South Africa, to evaluate a sport-based, near-peer-led SRH curriculum, SKILLZ, amongst female learners (n = 2791). Biomedical (sexually transmitted infections [STIs], human immunodeficiency virus [HIV] and pregnancy) and socio-behavioural (social support, gender norms and self-concept) outcomes were assessed pre and post intervention. Attendance at SKILLZ was low and intervention participants did not show an improvement in SRH outcomes, with HIV and pregnancy incidence remaining stable and STI prevalence remaining high and increasing in both control and intervention arms. Although evidence of positive socio-behavioural measures was present at baseline, participants with high attendance showed further improvement in positive gender norms. SKILLZ did not demonstrate the capacity to significantly impact clinical SRH outcomes. Modest improvements in outcomes amongst high attenders suggest that the impact may be possible with improved attendance; however, in the absence of optimal attendance, alternative intervention strategies may be required to improve SRH outcomes amongst adolescents.
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Affiliation(s)
- C Pike
- Desmond Tutu HIV Centre, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
| | - C Coakley
- Desmond Tutu HIV Centre, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
- Centre for Social Science Research, Faculty of Humanities, University of Cape Town, Cape Town 7701, South Africa
| | - N Ahmed
- Desmond Tutu HIV Centre, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
- Mortimer Market Centre, Central North West London NHS Trust, Off Caper Street, London WC1E 6 JB, UK
| | - D Lee
- Grassroot Soccer, 35 Jamieson Street, Cape Town 7784, South Africa
| | - F Little
- Department of Statistical Sciences, University of Cape Town, Private Bag X3, Rhodes Gift, Cape Town 7707, South Africa
| | - N Padian
- Grassroot Soccer, 35 Jamieson Street, Cape Town 7784, South Africa
- School of Medicine University of California San Francisco, San Francisco, CA 94143, USA
| | - L G Bekker
- Desmond Tutu HIV Centre, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
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Jeong J, Lee D, Park BC, Lee TH, Park SW. Establishment of a TNFRSF11B knock-out human induced pluripotent stem cell line (KSCBi002-B-2) via CRISPR/Cas9 system. Stem Cell Res 2023; 71:103167. [PMID: 37481965 DOI: 10.1016/j.scr.2023.103167] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/28/2023] [Accepted: 07/12/2023] [Indexed: 07/25/2023] Open
Abstract
A TNFRSF11B (TNF Receptor Superfamily Member 11b) gene encodes a soluble decoy receptor, osteoprotegerin (OPG), which has a key role in repressing osteoclast differentiation. In this report, we generated a biallelic knock-out hiPSC line for the TNFRSF11B gene via CRISPR/Cas9. When TNFRSF11B Knock-out hiPSCs were differentiated into mesenchymal progenitor cells (MPCs), the expression level of OPG was significantly decreased compared to normal hiPSC-derived MPCs. This knock-out hiPSCs will provide a chance to study Paget disease of bone 5 (juvenile Paget disease).
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Affiliation(s)
- Jujin Jeong
- Department of Oral Biochemistry, School of Dentistry, Chonnam National University, Gwangju 61186, South Korea
| | - Dahye Lee
- Department of Oral Biochemistry, School of Dentistry, Chonnam National University, Gwangju 61186, South Korea
| | - Byeong-Cheol Park
- Department of Oral Biochemistry, School of Dentistry, Chonnam National University, Gwangju 61186, South Korea
| | - Tae-Hoon Lee
- Department of Oral Biochemistry, School of Dentistry, Chonnam National University, Gwangju 61186, South Korea.
| | - Sang-Wook Park
- Department of Oral Biochemistry, School of Dentistry, Chonnam National University, Gwangju 61186, South Korea.
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15
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Hong G, Park HS, Yeo MK, Lee D, Chung C. Dynamic changes in pathology and PD-L1 expression in a patient with metastatic lung adenocarcinoma who received pembrolizumab therapy followed by two salvage surgeries two years later: A case report. Thorac Cancer 2023; 14:2320-2324. [PMID: 37416998 PMCID: PMC10423660 DOI: 10.1111/1759-7714.15023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/08/2023] Open
Abstract
During chemotherapy, certain cancer cells undergo cell death, which alters the properties of remaining cells and leads to numerous changes in the constituent cells of lung cancer. Immunotherapy has been used as neoadjuvant therapy, and several studies have reported changes in lung cancer tissue following treatment with immuno-anticancer drugs in early stage disease. However, no research has currently discussed the pathological and PD-L1 expression changes in metastatic lung cancer. Here, we describe a patient with lung adenocarcinoma and multiple metastases who achieved complete remission after receiving initial carboplatin/pemetrexed followed by pembrolizumab treatment for 2-years. The initial biopsy revealed adenocarcinoma with high PD-L1 expression, and next-generation sequencing (NGS) identified KRAS, RBM10, and STAG2 mutations. After 2-years of treatment with pembrolizumab, the patient achieved complete response (CR). The patient underwent first salvage surgery for the oligo-relapse lesion, and the pathology result showed a large cell neuroendocrine tumor (NET) with adenocarcinoma and no PD-L1 expression. NGS revealed KRAS and TP53 mutations. After one year, a chest computed tomography (CT) scan revealed a small nodule in the right lower lobe, and the patient underwent second salvage surgery. Pathology results showed minimally invasive adenocarcinoma with no PD-L1 expression and no significant genetic mutations. This case report demonstrates the dynamic changes cancer cells undergo following pembrolizumab treatment and salvage surgeries and is the first report to compare pathological changes after immunotherapy and two subsequent salvage surgeries in metastatic lung adenocarcinoma. Clinicians must remain vigilant to these dynamic changes throughout treatment and consider salvage surgery for oligo-relapse lesions. By understanding these changes, new strategies can be developed to improve the long-term efficacy of immunotherapy.
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Affiliation(s)
- Green Hong
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of MedicineChungnam National UniversityDeajeonSouth Korea
| | - Hee Sun Park
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of MedicineChungnam National UniversityDeajeonSouth Korea
| | - Min Kyung Yeo
- Department of Pathology, College of MedicineChungnam National UniversityDeajeonSouth Korea
| | - Dahye Lee
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of MedicineChungnam National UniversityDeajeonSouth Korea
| | - Chaeuk Chung
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of MedicineChungnam National UniversityDeajeonSouth Korea
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16
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McCartney G, Hoggett R, Walsh D, Lee D. How important is it to avoid indices of deprivation that include health variables in analyses of health inequalities? Public Health 2023; 221:175-180. [PMID: 37473649 DOI: 10.1016/j.puhe.2023.06.028] [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: 03/07/2023] [Revised: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVES This study aimed to quantify the difference in mortality inequalities using the Scottish Index of Multiple Deprivation (SIMD) and the Income and Employment Index (IEI; a subindex of SIMD, which excludes health) as ranking measures in Scotland. STUDY DESIGN This ecological study was a cross-sectional analysis of routine administrative data. METHODS Data from the 2020 SIMD and the subindex using data from only the Income and Employment domains, the IEI, were obtained. The correlation between data zones, percentage of data zones that changed deprivation tenth and differences in the Slope Index of Inequality (SII) and Relative Index of Inequality (RII) for Standardised Mortality Ratios (SMRs) across tenths were compared when data zones were ranked by SIMD and IEI. RESULTS There was a close correlation between data zones ranked by SIMD and IEI (R2 = 0.96). When data zones were ranked by IEI, 18.7% of data zones moved to a lower deprivation tenth, and 20.8% of data zones moved to a higher deprivation tenth, compared with SIMD. However, only a negligible number of data zones moved two or more tenths. The SMRs across deprivation tenths were very similar between the SIMD and IEI, as were the summary health inequality measures of SII (87.3 compared with 85.7) and RII (0.88 and 0.86). CONCLUSION Although there is a logical problem in using deprivation indices that include health outcomes to rank areas to calculate the scale of health inequalities, the impact of using an alternative subindex containing only data from the income and employment domains is minimal. For population-wide analyses of health inequalities in Scotland, the SIMD does not introduce a substantial bias in the health inequalities summary measures despite substantial movement of small areas between ranked population tenths. Although not examined here, this is likely to be relevant to other similar indices across the United Kingdom.
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Affiliation(s)
- G McCartney
- College of Social Sciences, University of Glasgow, 40 Bute Gardens, Glasgow, G12 8RT, UK.
| | - R Hoggett
- NHS Education for Scotland, 89 Hydepark St, Glasgow, G3 8BW, UK
| | - D Walsh
- Glasgow Centre for Population Health, Olympia Building, Bridgeton Cross, Glasgow, UK
| | - D Lee
- School of Mathematics and Statistics, Mathematics and Statistics Building, Glasgow, G12 8SQT, UK
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Park D, Lee D, Kim Y, Park Y, Lee YJ, Lee JE, Yeo MK, Kang MW, Chong Y, Han SJ, Choi J, Park JE, Koh Y, Lee J, Park Y, Kim R, Lee JS, Choi J, Lee SH, Ku B, Kang DH, Chung C. Cryobiopsy: A Breakthrough Strategy for Clinical Utilization of Lung Cancer Organoids. Cells 2023; 12:1854. [PMID: 37508518 PMCID: PMC10377875 DOI: 10.3390/cells12141854] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
One major challenge associated with lung cancer organoids (LCOs) is their predominant derivation from surgical specimens of patients with early-stage lung cancer. However, patients with advanced lung cancer, who are in need of chemotherapy, often cannot undergo surgery. Therefore, there is an urgent need to successfully generate LCOs from biopsy specimens. Conventional lung biopsy techniques, such as transthoracic needle biopsy and forceps biopsy, only yield small amounts of lung tissue, resulting in a low success rate for culturing LCOs from biopsy samples. Furthermore, potential complications, like bleeding and pneumothorax, make it difficult to obtain sufficient tissue. Another critical issue is the overgrowth of normal lung cells in later passages of LCO culture, and the optimal culture conditions for LCOs are yet to be determined. To address these limitations, we attempted to create LCOs from cryobiopsy specimens obtained from patients with lung cancer (n = 113). Overall, the initial success rate of establishing LCOs from cryobiopsy samples was 40.7% (n = 46). Transbronchial cryobiopsy enables the retrieval of significantly larger amounts of lung tissue than bronchoscopic forceps biopsy. Additionally, cryobiopsy can be employed for peripheral lesions, and it is aided via radial endobronchial ultrasonography. This study significantly improved the success rate of LCO culture and demonstrated that the LCOs retained characteristics that resembled the primary tumors. Single-cell RNA sequencing confirmed high cancer cell purity in early passages of LCOs derived from patients with advanced lung cancer. Furthermore, the three-dimensional structure and intracellular components of LCOs were characterized using three-dimensional holotomography. Finally, drug screening was performed using a specialized micropillar culture system with cryobiopsy-derived LCOs. LCOs derived from cryobiopsy specimens offer a promising solution to the critical limitations of conventional LCOs. Cryobiopsy can be applied to patients with lung cancer at all stages, including those with peripheral lesions, and can provide sufficient cells for LCO generation. Therefore, we anticipate that cryobiopsy will serve as a breakthrough strategy for the clinical application of LCOs in all stages of lung cancer.
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Affiliation(s)
- Dongil Park
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Dahye Lee
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Yoonjoo Kim
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Yeonhee Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 34943, Republic of Korea
| | - Yeon-Jae Lee
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Jeong Eun Lee
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Min-Kyung Yeo
- Department of Pathology, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Min-Woong Kang
- Thoracic and Cardiovascular Surgery, School of Medicine, Chungnam National University, Munhwa-ro 282, Jung-Gu, Daejeon 35015, Republic of Korea
| | - Yooyoung Chong
- Thoracic and Cardiovascular Surgery, School of Medicine, Chungnam National University, Munhwa-ro 282, Jung-Gu, Daejeon 35015, Republic of Korea
| | - Sung Joon Han
- Thoracic and Cardiovascular Surgery, School of Medicine, Chungnam National University, Munhwa-ro 282, Jung-Gu, Daejeon 35015, Republic of Korea
| | - Jinwook Choi
- School of Life Science, Gwangju Institute of Science and Technology, Gwangju 61005, Republic of Korea
| | - Jong-Eun Park
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Republic of Korea
| | - Yongjun Koh
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Republic of Korea
| | | | - YongKeun Park
- Tomocube Inc., Daejeon 34141, Republic of Korea
- Department of Physics, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Republic of Korea
| | - Ryul Kim
- GENOME INSIGHT Inc., Daejeon 34051, Republic of Korea
| | - Jeong Seok Lee
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Republic of Korea
- GENOME INSIGHT Inc., Daejeon 34051, Republic of Korea
| | - Jimin Choi
- Central R&D Center, Medical & Bio Decision Co., Ltd., Suwon 16229, Republic of Korea
| | - Sang-Hyun Lee
- Central R&D Center, Medical & Bio Decision Co., Ltd., Suwon 16229, Republic of Korea
| | - Bosung Ku
- Central R&D Center, Medical & Bio Decision Co., Ltd., Suwon 16229, Republic of Korea
| | - Da Hyun Kang
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Chaeuk Chung
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea
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Kim HS, Lee D, Kim KN, Kim SM, Park YT. Factors associated with the download and use of mobile personal health record applications in Korean hospitals. Health Informatics J 2023; 29:14604582231196955. [PMID: 37604505 DOI: 10.1177/14604582231196955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
The use of mobile personal health records (m-PHR) has been little studied at the organizational level. This study was to investigate the relationships of various hospital-related factors with m-PHR use in Korean hospitals. Downloads of m-PHR applications for 101 hospitals were examined from May 26 to 30 June 2022. The dependent variable was the number of m-PHR downloads, and the major independent variables included six technological, organizational, and environmental factors. As technological factors, the number of computed tomography and magnetic resonance imagery devices were significantly associated with downloads (RR = 1.119, CI = 1.022-1.226, p = 0.016; and RR = 1.155; 95% CI = 1.024-1.302, p = 0.019, respectively). At the organizational level, the number of physicians, adjusting for the number of beds, and the number of medical information management staff showed significant associations (RR = 1.059, CI = 1.019-1.100, p = 0.004; and RR = 1.026, CI = 1.002-1.050, p = 0.033, respectively). From an environmental standpoint, downloads were positively associated with the proportion of the local population of working age (20-59 years) (RR = 1.102, CI 1.022-1.189, p = 0.012). Healthcare policymakers should pay close attention to these factors to advocate for the widespread use of m-PHR applications.
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Affiliation(s)
- Hyeon Seok Kim
- Biomedical Research Center, Korea University Anam Hospital, Seongbuk-gu, Korea
| | - Dahye Lee
- Department of Business, Hunet Co., Ltd, Guro-gu, Kore
| | - Kee Nyun Kim
- Department of Hospital Administration, Allbarun Seoul HospitalGangdong-gu, Korea
| | - Sang Mi Kim
- Department of Health Management, Jeonju University, Jeonju, Korea
| | - Young-Taek Park
- HIRA Research Institute, Health Insurance Review and Assessment Service, Wonju-si, Korea
- Graduate School of Business Administration, Kyung Hee University, Dongdaemun-gu, Korea
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Park DY, Hwang J, Kim Y, Lee D, Kim YY, Kim HS, Hwang I. Antimicrobial activity of Limosilactobacillus fermentum strains isolated from the human oral cavity against Streptococcus mutans. Sci Rep 2023; 13:7969. [PMID: 37198248 DOI: 10.1038/s41598-023-35168-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 05/13/2023] [Indexed: 05/19/2023] Open
Abstract
Oral probiotics have been recently gaining much attention owing to their potential to inhibit the progression of dental caries by controlling the cariogenic effects of Streptococcus mutans. We isolated and genotypically identified 77 lactic acid bacteria including 12 Limosilactobacillus fermentum probiotic candidates from the oral cavity of healthy volunteers. Among the 12 L. fermentum isolates, nine isolates effectively inhibited the growth of S. mutans via hydrogen peroxide (H2O2) production. The others neither suppressed the growth of S. mutans nor produced H2O2. Eight out of the nine H2O2-producing L. fermentum isolates exhibited strong adherence to oral epithelial KB cells while inhibiting the adherence of S. mutans to KB cells. The eight H2O2-producing isolates were neither haemolytic based on a blood-agar test, cytotoxic according to lactate dehydrogenase assay, nor resistant to eight antibiotics represented by the European Food Safety Authority guideline, indicating that the isolates have potential to suppress the cariogenesis driven by S. mutans while providing general probiotic benefits.
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Affiliation(s)
| | | | - Yunji Kim
- Apple Tree Institute of Biomedical Science, Apple Tree Medical Foundation, Goyang-Si, South Korea
| | - Dahye Lee
- Apple Tree Dental Hospital, Apple Tree Medical Foundation, Goyang-Si, South Korea
| | - Young-Youn Kim
- Apple Tree Institute of Biomedical Science, Apple Tree Medical Foundation, Goyang-Si, South Korea
- Apple Tree Dental Hospital, Apple Tree Medical Foundation, Goyang-Si, South Korea
| | - Hye-Sung Kim
- Apple Tree Institute of Biomedical Science, Apple Tree Medical Foundation, Goyang-Si, South Korea
- Apple Tree Dental Hospital, Apple Tree Medical Foundation, Goyang-Si, South Korea
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20
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Nam K, Lee D, Lee S. A denoising model based on multi-agent reinforcement learning with data transformation for digital tomosynthesis. Phys Med Biol 2023. [PMID: 37192630 DOI: 10.1088/1361-6560/acd615] [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] [Indexed: 05/18/2023]
Abstract
OBJECTIVE Denoising models based on the supervised learning have been proposed for medical imaging. However, its clinical availability in digital tomosynthesis (DT) imaging is limited due to the necessity of a large amount of training data for providing acceptable image quality and the difficulty in minimizing a loss. Reinforcement learning (RL) can provide the optimal pollicy, which maximizes a reward, with a small amount of training data for implementing a task. In this study, we presented a denoising model based on the multi-agent RL for DT imaging in order to improve the performance of the machine learning-based denoising model.
Approach: The proposed multi-agent RL network consisted of shared sub-network, value sub-network with a reward map convolution (RMC) technique and policy sub-network with a convolutional gated recurrent unit (convGRU). Each sub-network was designed for implementing feature extraction, reward calculation and action execution, respectively. The agents of the proposed network were assigned to each image pixel. The wavelet and Anscombe transformations were applied to DT images for delivering precise noise features during network training. The network training was implemented with the DT images obtained from the 3D digital chest phantoms, which were constructed by using clinical CT images. The performance of the proposed denoising model was evaluated in terms of signal-to-noise ratio (SNR), structural similarity (SSIM) and peak signal-to-noise ratio (PSNR).
Main Results: Comparing the supervised learning, the proposed denoising model improved the SNRs of the output DT images by 20.64% while maintaining the similar SSIMs and PSNRs. In addition, the SNRs of the output DT images with the wavelet and Anscombe transformations were 25.88 and 42.95% higher than that for the supervised learning, respectively. 
Significance: The denoising model based on the multi-agent RL can provide high-quality DT images, and the proposed method enables the performance improvement of machine learning-based denoising models.
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Affiliation(s)
- Kibok Nam
- Department of Medical Science, Konyang University, 158 Gwanjeodong-ro, Seo-gu, Daejeon, 35365, Korea (the Republic of)
| | - Dahye Lee
- Department of Medical Science, Konyang University, 158 Gwanjeodong-ro, Seo-gu, Daejeon, 35365, Korea (the Republic of)
| | - Seungwan Lee
- Department of Medical Science, Konyang University , 158 Gwanjeodong-ro, Seo-gu, Daejeon, 35365, Korea (the Republic of)
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21
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Lee D, Usmani A, Wu R, Wicks T, Fernandez J, Huang J, Arroyo L, Rinde-Hoffman D, Kumar S, Feliberti J, Oliveira G, Berman P, Mackie B. Relation Between Individual Blood Gene Expression Profile (GEP) and Tissue GEP in Antibody-Mediated Rejection in Heart Transplant. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Mizrahi I, Shah P, Huang R, Nagamine T, Gozun M, Lee D, Shimabuku L, Khan Z, Lum C, Brodsky M. Echocardiographic Findings in Patients with Methamphetamine Cardiomyopathy. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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23
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Lee D, Usmani A, Wu R, Wicks T, Fernandez J, Huang J, Arroyo L, Rinde-Hoffman D, Kumar S, Feliberti J, Oliveira G, Berman P, Mackie B. Differences in Individual Blood Gene Expression Profile (GEP) Levels in T-Cell Mediated Rejection Assessed by Molecular Microscopy in Heart Transplant. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Li B, Lee C, Cadete M, Lee D, Zhu H, Sherman P, Pierro A. A9 INTESTINAL ORGANOID TRANSPLANTATION REVERSED THE INTESTINAL EPITHELIUM DAMAGE IN EXPERIMENTAL NECROTIZING ENTEROCOLITIS. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991355 DOI: 10.1093/jcag/gwac036.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
NOT PUBLISHED AT AUTHOR’S REQUEST
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Affiliation(s)
- B Li
- The Hospital for Sick Children, Toronto, Canada
| | - C Lee
- The Hospital for Sick Children, Toronto, Canada
| | - M Cadete
- The Hospital for Sick Children, Toronto, Canada
| | - D Lee
- The Hospital for Sick Children, Toronto, Canada
| | - H Zhu
- The Hospital for Sick Children, Toronto, Canada
| | - P Sherman
- The Hospital for Sick Children, Toronto, Canada
| | - A Pierro
- The Hospital for Sick Children, Toronto, Canada
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25
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Talenfeld C, Lansing A, Clarke K, Wright G, Lee D, Ghosh S, Raza S, Zhang Y, McClure T. Abstract No. 542 Microwave Ablation versus Cryoablation for T1a Renal Cell Carcinoma: A Systematic Literature Review and Meta-Analysis. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
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26
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McCartney G, Hoggett R, Walsh D, Lee D. How well do area-based deprivation indices identify income- and employment-deprived individuals across Great Britain today? Public Health 2023; 217:22-25. [PMID: 36841035 DOI: 10.1016/j.puhe.2023.01.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 08/17/2022] [Revised: 11/21/2022] [Accepted: 01/19/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Area-based deprivation indices are used in many countries to target interventions and policies to populations with the greatest needs. Analyses of the Carstairs deprivation index applied to postcode sectors in 2001 identified that less than half of all deprived individuals lived in the most deprived areas. OBJECTIVE This article examines the specificity and sensitivity of deprivation indices across Great Britain in identifying individuals claiming income- and employment-related social security benefits. STUDY DESIGN This was a descriptive analysis of cross-sectional administrative data. METHODS The data sets for the 2020 Scottish Index of Multiple Deprivation, Scottish Income and Employment Index, the 2019 English Index of Multiple Deprivation and the 2019 Welsh Index of Multiple Deprivation were obtained. For each data set, small areas were ranked by increasing overall deprivation, and the cumulative proportions of individuals who were income and employment deprived were calculated. Receiver operating characteristic curves were plotted to show the sensitivity and specificity of each index, and the percentages of income- and employment-deprived individuals captured at different overall deprivation thresholds were calculated. RESULTS Across all indices, the sensitivity and specificity for detecting income- and employment-deprived individuals were low, with less than half living in the most deprived 20% of areas. Between 55% and 62% of income-deprived people and between 56% and 63% of employment-deprived people were missed across the indices at the 20% deprivation threshold. The sensitivity and specificity were slightly higher for income deprivation than employment deprivation across indices and slightly higher for the Scottish Index of Multiple Deprivation and Scottish Income and Employment Index than for the English Index of Multiple Deprivation and Welsh Index of Multiple Deprivation. CONCLUSION Area-based deprivation measures in Great Britain have limited sensitivity and specificity for identifying individuals who are income or employment deprived. Place-based policies and interventions are unlikely to be effective at reducing inequalities as a result. Creation of individually linked data sets and interventions that recognise the social and economic relationships between social groups are likely to be more effective.
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Affiliation(s)
- G McCartney
- College of Social Sciences, University of Glasgow, 40 Bute Gardens, Glasgow G12 8RT, UK.
| | - R Hoggett
- NHS Tayside Directorate of Public Health, King's Cross, Clepington Rd, Dundee DD3 8EA, UK
| | - D Walsh
- Glasgow Centre for Population Health, Olympia Building, Bridgeton Cross, Glasgow, UK
| | - D Lee
- School of Mathematics and Statistics, Mathematics and Statistics Building, Glasgow, G12 8SQ, UK
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Park H, Ma BS, Kim Y, Lee D, Li S, Kim HJ, Kim TS, Kim BJ. Direct Measurement of the Thermomechanical Properties of Poly(3-hexylthiophene) Thin Films on Ionic Liquid Surfaces. Macromolecules 2023. [DOI: 10.1021/acs.macromol.2c02275] [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: 02/17/2023]
Affiliation(s)
| | | | | | | | | | - Hyeong Jun Kim
- Department of Chemical and Biomolecular Engineering, Sogang University, Seoul 04107, Republic of Korea
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Lee JH, Lee D, Lee HL, Lee G. Hysterectomy for uterine fibroids and stress urinary incontinence surgery: A nationwide cohort study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00909-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Shim J, Park J, Shin D, Jung Y, Yeo E, Lee J, Lee D. 189 Integrating single-cell and spatial transcriptomics of human hair follicles to define transcriptional signature of follicular dermal papilla. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Lee D, Choe Y, Lee YJ, Shin CH, Lee YA. LBODP086 An Unusual Infant Case Of Gastric Volvulus Presenting With Dumping Syndrome. J Endocr Soc 2022. [PMCID: PMC9625336 DOI: 10.1210/jendso/bvac150.1234] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
An 18-day female infant, born preterm small for gestational age (SGA), developed fasting hypoglycemia. A critical sample revealed an insulin level of 4.7 μIU/mL at the time of hyloglycemia (39 mg/dL) without ketoacidosis. Diazoxide therapy was started under the impression of transient neonatal hyperinsulinemia related to SGA, however, hypogycemia was developed on the 21st day of life. Targeted next generation sequencing (NGS) was performed for possible congenital hyperinuslinism. During octreotide therapy, postprandial hyperglycemia was incidentally detected at 27 days. Continuous glucose monitoring (CGM; Dexcom G6, San Diego, California) revealed postprandial hyperglycemia and subsequent hypoglycemia suggestive of dumping syndrome, although she had no prior history of surgery. An upper gastrointestinal series revealed the anomalous rotation of the stomach along the mesenteroaxial axis perpendicular to its longitudinal axis, implying gastric volvulus. The possibility of dumping syndrome caused by gastric volvulus was confirmed by stable glucose level in the euglucemic range using CGM after continuous nasojejunal feeding. She received laparoscopic gastropexy to anchor the stomach. Euglycemia was maintained after surgery and octreotide therapy was successfully discontinued. NGS identified no pathogenic variant for congenital hyperinsulinism. At 8 months of age, she exhibited catch-up growth and normal development. This is the first infant case of gastric volvulus presenting with dumping syndrome during diazoxide therapy for transient neonatal hyperinsulinism. Presentation: No date and time listed
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Affiliation(s)
- Dahye Lee
- Seoul National University Hospital , Seoul, Korea , Republic of
| | - Yunsoo Choe
- SEOUL NATIONAL UNIVERSITY HOSPITAL , Seoul, Korea , Republic of
| | - Yun Jeong Lee
- Seoul National University Hospital , Seoul, Korea , Republic of
| | - Choong H Shin
- Seoul Natl University College of Medical , Seoul, Korea , Republic of
| | - Young A Lee
- SEOUL NATIONAL UNIVERSITY HOSPITAL , Seoul, Korea , Republic of
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Chen X, Oh S, Hwang M, Lee D, Fuhrer R, Kirichenko A, Renz P, Sohn J. Dosimetric Assessment for Real-Time Anatomical Motion during MR-Guided Radiation Therapy by MR-LINAC. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Cosper P, Funk L, Lee D, Paracha M, Kimple R, Lambert P, Weaver B. HPV16 E6 Induces Chromosomal Instability due to Misaligned Chromosomes Caused by E6AP-Dependent Degradation of the Mitotic Kinesin CENP-E. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Olesovsky C, Ha A, Austin P, Ross H, Chong A, Porter J, Fang J, Atzema C, Jackevicius C, Lee D. Patterns of anticoagulant prescribing and renal function changes in patients with atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.616] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
The prevalence of atrial fibrillation (AF) is nearly three times higher in patients with chronic kidney disease (CKD) than the general population. These patients have an increased risk of stroke and systemic thromboembolism (SSE) as well as bleeding. The role for direct oral anticoagulants (DOACs) in those with advanced CKD and AF remains controversial. Studies show that patients on DOACs for AF with advanced CKD have similar risk of SSE and bleeding compared to those on warfarin, but these failed to account for changes in renal function over time.
Purpose
We sought to evaluate the pattern of oral anticoagulant prescribing, class switching, discontinuation and renal function trajectory in patients with AF in the last decade, coinciding with the development of DOACs.
Methods
Using linked administrative databases, we assessed patients 66 years of age and older with a new diagnosis of non-valvular AF between April 1, 2012 and March 31, 2020 who were started on oral anticoagulation within 90 days of diagnosis. Participants required a baseline serum creatinine (Cr) measurement in the year preceding AF diagnosis. Cr values were used to calculate the estimated glomerular filtration rate (eGFR) using the CKD Epidemiology Collaboration equation. Kidney function was tracked at baseline and longitudinally among patients prescribed DOACs versus warfarin using the Laboratories Information System. Anticoagulant class switching was tracked and discontinuation was defined if a new prescription for anticoagulation was not filled after 90 days of their last prescription ending.
Results
A total of 57,574 participants were included in the study; 48,662 were started on DOACs and 8,912 were started on warfarin. In April 2012, 83.8% of patients were prescribed warfarin; however, the proportion of first prescriptions significantly evolved over time to DOACs (Figure 1). Of those started on DOACs, 13,383 (27.5%) discontinued therapy, 34,918 (71.8%) remained on therapy and 361 (0.7%) switched to warfarin. The rate of discontinuation among those started on warfarin was higher with 4,144 (46.5%) stopping, 3,172 (35.6%) continuing therapy and 1,596 (17.9%) switching to DOACs. Most patients (75.6%) who switched to DOACs from warfarin remained on DOACs until the occurrence of dialysis, renal transplantation, death, or the last follow-up date (March 31, 2020). At baseline, the mean eGFR in the warfarin group was 56.2 compared with 66.3 mL/min/1.73 m2 in the DOAC group (p<0.01). Over the course of study, more than half of the subjects in both groups had a 20% or more decline in eGFR (Figure 2).
Conclusion
Given the degree of renal function decline and frequency of anticoagulant class switching in our cohort, existing observational studies comparing DOACs to warfarin in patients with AF and CKD may be limited. In order to better compare DOACs to warfarin in this population, time-varying covariates like renal function should be included in modelling.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): CIHR Foundation Grant
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Affiliation(s)
| | - A Ha
- University Health Network , Toronto , Canada
| | - P Austin
- Institute for Clinical Evaluative Sciences , Toronto , Canada
| | - H Ross
- University Health Network , Toronto , Canada
| | - A Chong
- Institute for Clinical Evaluative Sciences , Toronto , Canada
| | - J Porter
- Institute for Clinical Evaluative Sciences , Toronto , Canada
| | - J Fang
- Institute for Clinical Evaluative Sciences , Toronto , Canada
| | - C Atzema
- Institute for Clinical Evaluative Sciences , Toronto , Canada
| | - C Jackevicius
- Institute for Clinical Evaluative Sciences , Toronto , Canada
| | - D Lee
- University Health Network , Toronto , Canada
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Trostel S, Meyers H, McLaren J, Bracey A, Lee D, Lichtenheld A, Li W, Singer D, Dodd K, Smith S. 265 Sinus Tachycardia Is Rare Among Hemodynamically Stable Patients With Occlusion Myocardial Infarction. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Chu Y, Awasthi A, Lee S, Edani D, Yin C, Hochberg J, Shah T, Chung T, Ayello J, van de Ven C, Klein C, Lee D, Cairo M. OBINUTUZUMAB (GA101) VS. RITUXIMAB SIGNIFICANTLY ENHANCES CELL DEATH, ANTIBODY-DEPENDENT CYTOTOXICITY AND IMPROVES OVERALL SURVIVAL AGAINST CD20+ PRIMARY MEDIASTINAL B-CELL LYMPHOMA (PMBL) IN A XENOGRAFT NOD-SCID IL2RGNULL (NSG) MOUSE MODEL: A POTENTIAL TARGETED AGENT IN THE TREATMENT OF PMBL. Leuk Res 2022. [DOI: 10.1016/s0145-2126(22)00211-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Chu Y, Tian M, Marcondes M, Overwijk W, Lee D, Klein C, Cairo M. OPTIMIZING CHIMERIC ANTIGEN RECEPTOR (CAR) ENGINEERED NK CELL-MEDIATED CYTOTOXICITY COMBINED WITH ANTI-CD 20 OR ANTI-CD79 THERAPEUTIC ANTIBODIES AND NKTR-255 IN BURKITT LYMPHOMA (BL). Leuk Res 2022. [DOI: 10.1016/s0145-2126(22)00233-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Hamdy M, El-Beshlawy A, Ebeid FS, Kwiatkowski JL, Kanter J, Inusa B, Williams S, Verissimo M, Lee D, Temin NT, Fradette C, Tricta F, Elalfy MS. RANDOMIZED CONTROLLED TRIAL OF THE EFFICACY AND SAFETY OF DEFERIPRONE: SUBGROUP ANALYSIS OF PEDIATRIC PATIENTS IN IRON-OVERLOADED PATIENTS WITH SICKLE CELL DISEASE AND OTHER ANEMIAS. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Wang C, Lu Z, Simpson C, Lee D, Tranmer J. PREDICTING LONG-TERM SURVIVAL AFTER DE NOVO CARDIOVERTER DEFIBRILLATOR IMPLANTATION FOR PRIMARY PREVENTION. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Lindsay P, Anderson K, Ducharme A, Lee D, McKelvie R, Poon S, Desmarais O, Desbiens M, Virani S. THE STATE OF HEART FAILURE SERVICES IN CANADA: FINDINGS OF THE HEART & STROKE NATIONAL HEART FAILURE RESOURCES AND SERVICES INVENTORY. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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KC P, Acharya M, Maharjan A, Lee D, Kusma S, Adhikari M, Kim S, Kim S, Kim D, Kim D, Choi Y, Kim C, Kim H, Heo Y. P10-05 No apparent cellular immunotoxicity in mice subchronically exposed to polyethylene or polytetrafluorethylene microplastics through gastric intubation. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Acharya M, Lee D, Maharjan A, Yang S, Seo S, Kang H, Sin J, Lee G, Yu Y, Park J, Lee G, Kim C, Kim H, Heo Y. P10-04 Development of alternative test method for immunotoxicity prediction on chemical substances through profiling of cytokines production from THP-1 cell line. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Maharjan A, Acharya M, Lee D, C PK, Kusma S, Adhikari M, Lee J, Kim J, Kim M, Park K, Park H, Hwang S, Kim C, Kim H, Heo Y. P13-06 Comparison of overall immunity levels among workers at grape or pear orchards, rose greenhouse, and open-field onion farms. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Åkesson KE, Ganda K, Deignan C, Oates MK, Volpert A, Brooks K, Lee D, Dirschl DR, Singer AJ. Post-fracture care programs for prevention of subsequent fragility fractures: a literature assessment of current trends. Osteoporos Int 2022; 33:1659-1676. [PMID: 35325260 PMCID: PMC8943355 DOI: 10.1007/s00198-022-06358-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/18/2022] [Indexed: 01/07/2023]
Abstract
Post-fracture care (PFC) programs evaluate and manage patients with a minimal trauma or fragility fracture to prevent subsequent fractures. We conducted a literature review to understand current trends in PFC publications, evaluate key characteristics of PFC programs, and assess their clinical effectiveness, geographic variations, and cost-effectiveness. We performed a search for peer-reviewed articles published between January 2003 and December 2020 listed in PubMed or Google Scholar. We categorized identified articles into 4 non-mutually exclusive PFC subtopics based on keywords and abstract content: PFC Types, PFC Effectiveness/Success, PFC Geography, and PFC Economics. The literature search identified 784 eligible articles. Most articles fit into multiple PFC subtopics (PFC Types, 597; PFC Effectiveness/Success, 579; PFC Geography, 255; and PFC Economics, 98). The number of publications describing how PFC programs can improve osteoporosis treatment rates has markedly increased since 2003; however, publication gaps remain, including low numbers of publications from some countries with reported high rates of osteoporosis and/or hip fractures. Fracture liaison services and geriatric/orthogeriatric services were the most common models of PFC programs, and both were shown to be cost-effective. We identified a need to expand and refine PFC programs and to standardize patient identification and reporting on quality improvement measures. Although there is an increasing awareness of the importance of PFC programs, publication gaps remain in most countries. Improvements in established PFC programs and implementation of new PFC programs are still needed to enhance equitable patient care to prevent occurrence of subsequent fractures.
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Affiliation(s)
- K E Åkesson
- Faculty of Medicine, Lund University, Malmö, Sweden.
- Department of Orthopedics, Skåne University Hospital, Inga Marie Nilssons gata 22, S-205 02, Malmö, Sweden.
| | - K Ganda
- Concord Clinical School, University of Sydney, Sydney, Australia
- Department of Endocrinology, Concord Repatriation General Hospital, Sydney, Australia
| | - C Deignan
- Global Clinical Development, Amgen Inc., CA, Thousand Oaks, USA
| | - M K Oates
- Global Clinical Development, Amgen Inc., CA, Thousand Oaks, USA
| | - A Volpert
- BioScience Communications, New York, NY, USA
| | | | - D Lee
- Global Marketing, Amgen Inc., Thousand Oaks, CA, USA
- Health Collaboration Partners LLC, Thousand Oaks, CA, USA
| | - D R Dirschl
- Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago Medicine, Chicago, IL, USA
| | - A J Singer
- Department of Obstetrics and Gynecology, MedStar Georgetown University Hospital, Washington, DC, USA
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Shin H, Zouboulis C, Kim M, Lee D, Chung J. 750 Minocycline suppresses lipogenesis via inhibition of p300 histone acetyltransferase activity in human SZ95 sebocytes. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kim YN, Lee D, Cha J, Kang WJ, Lee YJ, Lee JY, Nam EJ, Kim S, Kim YT, Kim SW. Usefulness and potential pitfalls of pre-operative PET-CT in patients with endometrial cancer undergoing one- and two-step sentinel lymph node mapping: Do negative findings on PET-CT negativity really indicate node negativity? Gynecol Oncol 2022; 166:438-443. [PMID: 35907682 DOI: 10.1016/j.ygyno.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/08/2022] [Accepted: 07/17/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE We investigated the utility of Positron emission tomography-Computed tomography (PET-CT) in the setting of two different sentinel lymph node (SLN) mapping techniques; the conventional cervical injection method (one-step) and the two-step method, which involves fundal injection followed by cervical injection. METHODS Patients with endometrial cancer undergoing FDG PET-CT followed by laparoscopic or robotic surgical staging with SLN mapping at the Yonsei Cancer Center between July 2014 and April 2021 were stratified into the PET-positive group (with suspected or likely lymph nodes metastasis) and PET-negative group. A chart review was performed for the number of harvested SLNs, patterns of SLN metastases, and recurrence. RESULTS Among 466 patients undergoing one-step (n = 276) and two-step (n = 190) SLN mapping, LN metastasis was identified in 21 of 434 PET-negative and 18 of 32 PET-positive patients. The sensitivity and specificity of PET-CT for diagnosing lymph node metastasis were 46.2% and 96.7%, respectively. Among PET-positive patients with LN metastasis, anatomical distribution was concordant in 14/18 patients (77.8%). Among PET-negative patients, four (2.3%) had metastatic para-aortic SLNs, including three (1.7%) with isolated para-aortic metastases; metastatic para-aortic SLNs were exclusively found in the two-step group. Among PET-positive patients, para-aortic SLN metastasis was identified in 35.7% of two-step and 16.7% of one-step group. Among the 21 PET false-negative patients, recurrence was seen in four patients (19%) after a median follow-up of 34 months (range: 7-70 months). CONCLUSIONS PET-CT served as a useful guide to clinicians with high anatomical concordance rate in patients with LN metastasis. However, despite high specificity, sensitivity was limited. SLN metastasis pattern, especially at the para-aortic level, indicates that the two-step SLN technique might be useful in PET-negative and PET-positive patients.
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Affiliation(s)
- Yoo-Na Kim
- Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dahye Lee
- Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jongtae Cha
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Won Jun Kang
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yong Jae Lee
- Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jung-Yun Lee
- Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Ji Nam
- Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sunghoon Kim
- Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Tae Kim
- Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang Wun Kim
- Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Lee D, Choi S, Chang J, Park YJ, Kim JH, Park SM. Association of antibiotics exposure within the first 2 years after birth with subsequent childhood type 1 diabetes. Endocrine 2022; 77:21-29. [PMID: 35552980 DOI: 10.1007/s12020-022-03042-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/28/2021] [Accepted: 03/12/2022] [Indexed: 12/11/2022]
Abstract
PURPOSE Antibiotics prescription in early life can cause dysbiosis, an imbalance of gut microbiota. We aimed to reveal the relationship between antibiotics exposure during the first 2 years after birth and type 1 diabetes risk in children under 8 years of age using a nationally representative data from South Korea. METHODS The final study population consisted of 63,434 children from the National Health Insurance Service (NHIS) database from 2008 to 2015. The primary exposure of interest was antibiotics prescription in first 2 years after birth. The analysis was conducted with cumulative defined daily dose (cDDD; 0-29, 30-59, ≥ 60 cDDD), the number of antibiotics classes (0-3, 4, ≥5 classes), and age at first antibiotics prescription (0-119, 120-239, ≥ 240 days). Age, sex, household income, and overweight were considered as potential confounding covariates. RESULTS Compared to those within the less than 30 cDDD, other groups that were prescribed more antibiotics did not have a significant difference in diabetes risk (aHR 0.86, 95% CI 0.37-2.02 in ≥ 60 cDDD). The number of antibiotics classes and age at first antibiotics prescriptions were also not associated with the risk of type 1 diabetes. The development of diabetes was not related to the cDDD, the number of antibiotics classes, and age at first antibiotics prescription according to subgroup analysis which was stratified by overweight. CONCLUSIONS Antibiotics exposure within the first 2 years of life was not associated with subsequent diabetes risk. Future studies using a larger number of long-term follow-up data are needed.
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Affiliation(s)
- Dahye Lee
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, South Korea
| | - Seulggie Choi
- Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul, South Korea
| | - Jooyoung Chang
- Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul, South Korea
| | - Young Jun Park
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Jae Hyun Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Sang Min Park
- Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul, South Korea.
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea.
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Ahn S, Jo S, Lee D, Han D, Lee H, Moon D. Postoperative progress of modified grid incision and sealing with collagen fleece for treatment of Peyronie's disease. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kim N, Lee J, Oh E, Jekarl D, Lee D, Im K, Cho S. Immunotherapy: OFF-THE-SHELF PARTIAL HLA MATCHING SARS-COV-2 ANTIGEN SPECIFIC T CELL THERAPY: A NEW POSSIBILITY FOR COVID- 19 TREATMENT. Cytotherapy 2022. [PMCID: PMC9035761 DOI: 10.1016/s1465-3249(22)00303-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Sedler J, Schroeder A, Mathew R, Chen S, Weinberg K, Bernstein D, Lee D, Dykes J, Hollander S. Memory B Cell Deficiency and Disseminated Nocardiosis in a Pediatric Patient with Congenital Single Ventricle Physiology and Heart Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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