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Kim HW, Kim EH, Roh YH, Joo YS, Eom M, Kim HS, Kang MS, Jeong H, Lim BJ, Han SH, Jung M. Glomerulonephritis following COVID-19 infection or vaccination: a multicenter study in South Korea. Kidney Res Clin Pract 2024; 43:165-176. [PMID: 38600028 PMCID: PMC11016674 DOI: 10.23876/j.krcp.23.219] [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: 08/16/2023] [Revised: 12/16/2023] [Accepted: 01/01/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Despite the widespread impact of the severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019, COVID-19) and vaccination in South Korea, our understanding of kidney diseases following these events remains limited. We aimed to address this gap by investigating the characteristics of glomerular diseases following the COVID-19 infection and vaccination in South Korea. METHODS Data from multiple centers were used to identify de novo glomerulonephritis (GN) cases with suspected onset following COVID-19 infection or vaccination. Retrospective surveys were used to determine the COVID-19-related histories of patients who were initially not implicated. Bayesian structural time series and autoregressive integrated moving average models were used to determine causality. RESULTS Glomerular diseases occurred shortly after the infection or vaccination. The most prevalent postinfection GN was podocytopathy (42.9%), comprising primary focal segmental glomerulosclerosis and minimal change disease, whereas postvaccination GN mainly included immunoglobulin A nephropathy (IgAN; 57.9%) and Henoch-Schönlein purpura nephritis (HSP; 15.8%). No patient progressed to end-stage kidney disease. Among the patients who were initially not implicated, nine patients with IgAN/HSP were recently vaccinated against COVID-19. The proportion of glomerular diseases changed during the pandemic in South Korea, with an increase in acute interstitial nephritis and a decrease in pauci-immune crescentic GN. CONCLUSION This study showed the characteristics of GNs following COVID-19 infection or vaccination in South Korea. Understanding these associations is crucial for developing effective patient management and vaccination strategies. Further investigation is required to fully comprehend COVID-19's impact on GN.
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Affiliation(s)
- Hyung Woo Kim
- Department of Internal Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yun Ho Roh
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Su Joo
- Division of Nephrology, Department of Internal Medicine, Yongin Severance Hospital, Yongin, Republic of Korea
| | - Minseob Eom
- Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Han Seong Kim
- Department of Pathology, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Mi Seon Kang
- Department of Pathology, Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - HoeIn Jeong
- Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Beom Jin Lim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Hyeok Han
- Department of Internal Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minsun Jung
- Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Renal Pathology Study Group of Korean Society of Pathologists
- Department of Internal Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Republic of Korea
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
- Division of Nephrology, Department of Internal Medicine, Yongin Severance Hospital, Yongin, Republic of Korea
- Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
- Department of Pathology, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
- Department of Pathology, Inje University Busan Paik Hospital, Busan, Republic of Korea
- Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea
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Kwon M, Lee M, Kim EH, Choi DW, Jung E, Kim KY, Jung I, Ha J. Risk of depression and anxiety disorders according to long-term glycemic variability. J Affect Disord 2023; 343:50-58. [PMID: 37734626 DOI: 10.1016/j.jad.2023.09.017] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/29/2023] [Accepted: 09/17/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Poor glycemic control has been linked to psychiatric symptoms. However, studies investigating the relationship between glycemic variability (GV) and depression and anxiety disorders are limited. We investigated the association of GV with depression and anxiety disorders. In addition, the relationship between trends in fasting plasma glucose (FPG) levels and these disorders were explored. METHODS We analyzed the National Health Insurance Service-National Sample Cohort database (2002-2013) with 151,814 participants who had at least three health screenings between 2002 and 2010. Visit-to-visit FPG variability was measured as variability independent of the mean (VIM). Depression and anxiety disorders were diagnosed using ICD-10 codes (F41 for anxiety and F32 or F33 for depression) after index date. We analyzed the association between GV and incidences of these disorders using Kaplan-Meier and Cox proportional hazards methods. Trajectory analysis was conducted to explore the relationship between FPG trends and these disorders. RESULTS During follow-up, 7166 and 14,149 patients were newly diagnosed with depression and anxiety disorders, respectively. The highest quartile group of FPG-VIM had a greater incidence of depression and anxiety than the lowest quartile group, with adjusted hazard ratios of 1.09 (95 % confidence interval [CI]: 1.02-1.17) and 1.08 (95 % CI: 1.03-1.14). Group with persistent hyperglycemia, identified through trajectory clustering of FPG levels, had a 1.43-fold increased risk of depression compared to those with consistently low FPG levels. LIMITATIONS Potential selection bias by including participants with at least three health screenings. CONCLUSIONS High GV and persistent hyperglycemia are associated with increased incidence of depression and anxiety disorders.
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Affiliation(s)
- Manjae Kwon
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myeongjee Lee
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong-Woo Choi
- Cancer Big Data Center, National Cancer Control Institute, National Cancer Center, Gyeonggi-do, Republic of Korea
| | - Eunjin Jung
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Keun You Kim
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Junghee Ha
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Koo JH, Lee M, Kim EH, Oh HJ, Lim JS, Hyung WJ, Yoon HI, Jung I, Chung YE. Harmful effect of repetitive intravenous iodinated contrast media administration on the long-term renal function of patients with early gastric cancer. Sci Rep 2023; 13:19448. [PMID: 37945805 PMCID: PMC10636198 DOI: 10.1038/s41598-023-46773-x] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 11/04/2023] [Indexed: 11/12/2023] Open
Abstract
This retrospective study investigated whether repetitive exposure to intravenous iodinated contrast media (ICM) affects long-term renal function in patients who undergo curative surgery for early gastric cancer (EGC) collected from the Korean Health Insurance and Review Assessment (HIRA) database. Patients diagnosed with gastric cancer between January 2010 and December 2013 underwent regular computed tomography (CT) scans to monitor for extragastric recurrence. Patients who already had chronic kidney disease (CKD) before cancer diagnosis or had undergone chemotherapy or repeated surgery were excluded. A nested case-control study design was chosen to analyze the effect of repetitive ICM exposure to long-term renal function by comparing patients who developed CKD 2 years after cancer diagnosis and patients who did not. Among 59,971 patients collected according to inclusion and exclusion criteria, 1021 were diagnosed with CKD 2 years after cancer diagnosis. Using 1:5 matching after adjusting for age, sex and date of cancer diagnosis, 5097 control patients were matched to 1021 CKD patients. Conditional logistic regression showed that the number of CTs taken using ICM slightly increased the odds of CKD (odds ratio, 1.080; 95% confidence interval (CI): 1.059, 1.100; P < 0.0001). Thus, the administration of ICM might contribute to chronic renal function impairment.
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Affiliation(s)
- Ja Ho Koo
- Department of Radiology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Myeongjee Lee
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyung Jung Oh
- Department of Nephrology, Sheikh Khalifa Specialty Hospital, Ras Al-Khaimah, United Arab Emirates
| | - Joon Seok Lim
- Department of Radiology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Woo Jin Hyung
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hong In Yoon
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea.
| | - Yong Eun Chung
- Department of Radiology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
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Kim HW, Kim EH, Lee M, Jung I, Ahn SS. Risk of cancer, tuberculosis and serious infections in patients with ankylosing spondylitis, psoriatic arthritis and psoriasis treated with IL-17 and TNF-α inhibitors: a nationwide nested case-control analysis. Clin Exp Rheumatol 2023; 41:1491-1499. [PMID: 36533975 DOI: 10.55563/clinexprheumatol/qkiorp] [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] [Received: 08/29/2022] [Accepted: 10/27/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Targeting interleukin (IL)-17 and tumour necrosis factor (TNF)-α is recommended for the management of severe/refractory ankylosing spondylitis (AS), psoriatic arthritis (PsA), and psoriasis (PsO); however, safety data comparing these agents, especially in a large Asian population are unavailable. METHODS Patients with AS, PsA and PsO were searched using the Health Insurance Review and Assessment Service database, defined according to the International Classification of Diseases-10 and unique insurance codes for rare diseases. By including patients newly diagnosed with AS, PsA, and PsO between 2010-2020, the outcomes of cancer, tuberculosis (TB) and serious infections following IL-17 and TNF-α inhibitor usage were evaluated. To investigate the association between treatments and outcomes, nested case-control analyses matching patients to controls (maximum of 1:10 ratio) according to index age, sex, index year, and follow-up duration were performed. RESULTS Among 40322, 4953, and 5347 patients with AS, PsA, and PsO, respectively, three different datasets were generated to evaluate incidence of outcomes. Conditional logistic regression analysis revealed that cyclosporine use (odds ratio [OR] 2.286, p=0.0176) increased cancer, and a higher Charlson Comorbidity Index (CCI) score (OR 1.085, p=0.0406) and IL-17 inhibitor use only (OR 0.126, p=0.0457) showed a positive and negative association with TB, respectively. Serious infections increased in patients with high CCI scores (OR 1.117, p<0.0001), cyclosporine users (OR 1.445, p=0.0098), and medical-aided individuals (OR 1.667, p<0.0001). CONCLUSIONS In this nationwide cohort of IL-17 and TNF-α inhibitor users, both treatments conferred comparable risk of cancer and serious infections, while IL-17 inhibitors may be advantageous for TB.
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Affiliation(s)
- Hyung Woo Kim
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myeongjee Lee
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Soo Ahn
- Division of Rheumatology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea.
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Kim KY, Kim EH, Lee M, Ha J, Jung I, Kim E. Restless leg syndrome and risk of all-cause dementia: a nationwide retrospective cohort study. Alzheimers Res Ther 2023; 15:46. [PMID: 36879327 PMCID: PMC9987068 DOI: 10.1186/s13195-023-01191-z] [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: 07/19/2022] [Accepted: 02/13/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Restless leg syndrome (RLS) is associated with poor sleep quality, depression or anxiety, poor dietary patterns, microvasculopathy, and hypoxia, all of which are known risk factors for dementia. However, the relationship between RLS and incident dementia remains unclear. This retrospective cohort study aimed to explore the possibility that RLS could be deemed as a non-cognitive prodromal feature of dementia. METHODS This was a retrospective cohort study using the Korean National Health Insurance Service-Elderly Cohort (aged ≥ 60). The subjects were observed for 12 years, from 2002 to 2013. Identifying patients with RLS and dementia was based on the 10th revised code of the International Classification of Diseases (ICD-10). We compared the risk of all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD) in 2501 subjects with newly diagnosed RLS and 9977 matched controls based on age, sex, and index date. The association between RLS and the risk of dementia was assessed using Cox regression hazard regression models. The effect of dopamine agonists on the risk of dementia among RLS patients was also explored. RESULTS The baseline mean age was 73.4, and the subjects were predominantly females (63.4%). The incidence of all-cause dementia was higher in the RLS group than that in the control group (10.4% vs 6.2%). A baseline diagnosis of RLS was associated with an increased risk of incident all-cause dementia (adjusted hazard ratio [aHR] 1.46, 95% confidence interval [CI] 1.24-1.72). The risk of developing VaD (aHR 1.81, 95% CI 1.30-2.53) was higher than that of AD (aHR 1.38, 95% CI 1.11-1.72). The use of dopamine agonists was not associated with the risk of subsequent dementia among patients with RLS (aHR 1.00, 95% CI 0.76-1.32). CONCLUSIONS This retrospective cohort study suggests that RLS is associated with an increased risk of incident all-cause dementia in older adults, providing some evidence that requires confirmation through prospective studies in the future. Awareness of cognitive decline in patients with RLS may have clinical implications for the early detection of dementia.
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Affiliation(s)
- Keun You Kim
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea.,Department of Neuropsychiatry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, 07061, Seoul, Republic of Korea
| | - Eun Hwa Kim
- Department of Biomedical Systems Informatics, Biostatistics Collaboration Unit, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea
| | - Myeongjee Lee
- Department of Biomedical Systems Informatics, Biostatistics Collaboration Unit, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea
| | - Junghee Ha
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | - Eosu Kim
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea. .,Brain Korea 21 FOUR Project for Medical Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Kang H, Lee B, Jo JH, Lee HS, Park JY, Bang S, Park SW, Song SY, Park J, Shim H, Lee JH, Yang E, Kim EH, Kim KJ, Kim MS, Chung MJ. Machine-Learning Model for the Prediction of Hypoxaemia during Endoscopic Retrograde Cholangiopancreatography under Monitored Anaesthesia Care. Yonsei Med J 2023; 64:25-34. [PMID: 36579376 PMCID: PMC9826962 DOI: 10.3349/ymj.2022.0381] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Hypoxaemia is a significant adverse event during endoscopic retrograde cholangiopancreatography (ERCP) under monitored anaesthesia care (MAC); however, no model has been developed to predict hypoxaemia. We aimed to develop and compare logistic regression (LR) and machine learning (ML) models to predict hypoxaemia during ERCP under MAC. MATERIALS AND METHODS We collected patient data from our institutional ERCP database. The study population was randomly divided into training and test sets (7:3). Models were fit to training data and evaluated on unseen test data. The training set was further split into k-fold (k=5) for tuning hyperparameters, such as feature selection and early stopping. Models were trained over k loops; the i-th fold was set aside as a validation set in the i-th loop. Model performance was measured using area under the curve (AUC). RESULTS We identified 6114 cases of ERCP under MAC, with a total hypoxaemia rate of 5.9%. The LR model was established by combining eight variables and had a test AUC of 0.693. The ML and LR models were evaluated on 30 independent data splits. The average test AUC for LR was 0.7230, which improved to 0.7336 by adding eight more variables with an l1 regularisation-based selection technique and ensembling the LRs and gradient boosting algorithm (GBM). The high-risk group was discriminated using the GBM ensemble model, with a sensitivity and specificity of 63.6% and 72.2%, respectively. CONCLUSION We established GBM ensemble model and LR model for risk prediction, which demonstrated good potential for preventing hypoxaemia during ERCP under MAC.
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Affiliation(s)
- Huapyong Kang
- Division of Gastroenterology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
- Department of Medicine, Yonsei University Graduate School, Seoul, Korea
| | - Bora Lee
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Hyun Jo
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hee Seung Lee
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong Youp Park
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Seungmin Bang
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Woo Park
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Si Young Song
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Joonhyung Park
- Graduate School of AI, Korea Advanced Institute of Science and Technology, Daejeon, Korea
| | - Hajin Shim
- School of Computing, Korea Advanced Institute of Science and Technology, Daejeon, Korea
| | - Jung Hyun Lee
- Graduate School of AI, Korea Advanced Institute of Science and Technology, Daejeon, Korea
| | - Eunho Yang
- Graduate School of AI, Korea Advanced Institute of Science and Technology, Daejeon, Korea
- School of Computing, Korea Advanced Institute of Science and Technology, Daejeon, Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Kwang Joon Kim
- Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Min-Soo Kim
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
| | - Moon Jae Chung
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
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Lee JY, Kim EH, Lee M, Shin JH, Lim SM, Jung IK, Ahn JG, Kang CM, Kang JM. 1315. Dental Discoloration and Enamel dysplasia after Tetracyclines Exposure in Children: A Nationwide Population-Based Study in Korea. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.1146] [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: 12/23/2022] Open
Abstract
Abstract
Background
Tetracycline (TC) is not recommended for pediatric use due to the risk of permanent teeth discoloration and enamel dysplasia. We aimed to assess the incidence of dental abnormality in Korean children and investigate whether the risk was greater in tetracycline-exposed children compared to the general population.
Methods
This nationwide, population-based study using Health Insurance Review and Assessment service database included children (aged 0-12 years) who were prescribed tetracycline for at least a day between January 2008 and December 2020. We evaluated the incidence rate of children who were inserted diagnosis codes for dental discoloration and enamel dysplasia after at least 6 months after prescription as the primary outcome. Standardized incidence ratio was analyzed to determine whether the risk of dental abnormalities was greater in the exposed group compared to the general population in Korea.
Results
A total of 56,990 patients with TCs exposure were included, 3% were under the age of 8 (n=1,735) while the majority of 97% were between ages of 8 and 12 (n=55,255). The incidence rate in 0-7 year old age group was 734 cases per 100,000 person-years, which was about five times higher than the 143 cases per 100,000 person-years of the 8-12 year old group with statistical significance (P< 0.001). The 5-year cumulative incidence rate in the 0-7 years old age group was 4.1 % (95% CI, 3.0-5.7%) and 5.7% (95% CI, 4.1–7.8%) in 10-year period. In the 8-12 year old age group, 5-year cumulative incidence was 0.8% (95% CI, 0.7-0.9%) and 1.3% (95% CI, 1.1-1.4%). The risk of dental abnormalities was not significantly increased in the TC-exposed group of 0-7 year old age group compared to the general population (SIR = 1.08; 95% CI, 0.69-1.60).
Conclusion
The incidence of tooth discoloration and enamel dysplasia was lower than previously suggested, particularly between the ages of 8 and 12 and as low as one-fifth of those under the age of 8, suggesting a reconsideration of limiting use of TCs in children if clinically indicated.
Disclosures
All Authors: No reported disclosures.
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Affiliation(s)
- Ji Young Lee
- Yonsei University College of Medicine , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - Eun Hwa Kim
- Yonsei University College of Medicine , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - Myeongjee Lee
- Yonsei University College of Medicine , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - Je Hee Shin
- Severance Children’s Hospital, Yonsei University College of Medicine , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - Sung Min Lim
- Severance Children’s Hospital, Yonsei University College of Medicine , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - In Kyung Jung
- Yonsei University College of Medicine , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - Jong Gyun Ahn
- Severance Children’s Hospital, Yonsei University College of Medicine , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - Chung-Min Kang
- Yonsei University College of Dentistry , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - Ji-Man Kang
- Severance Children’s Hospital, Yonsei University College of Medicine , Seoul, Seoul-t'ukpyolsi , Republic of Korea
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Kim S, Kim EH, Lee M, Shin JH, Lim SM, Jung IK, Ahn JG, Kang JM, Kang CM, Baek JY, Lee JY. 2149. Risk of dental abnormalities after tetracycline exposure in children: A retrospective, population-based study in Korea, 2003-2015. Open Forum Infect Dis 2022. [PMCID: PMC9752629 DOI: 10.1093/ofid/ofac492.1769] [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: 12/23/2022] Open
Abstract
Background Despite its clinical usefulness, the use of tetracycline antibiotics (TCs) in children has historically been limited because of the risk of permanent tooth discoloration and enamel deformity, although age restrictions have varied across countries (e.g., contraindicated under 8 years of age in Taiwan, USA, and Canada, and under 12 years of age in Korea and UK). We explored whether the incidence of dental abnormalities in Korean children with a history of TCs use differed by age. Furthermore, the relative risk compared to the TCs non-exposed group was calculated. Methods From 2002 to 2015, 1 million standard sample subjects data was provided from National Health Insurance Service in Korea. Children younger than 18 years were included and divided into groups A (0-7 years), B (8-12 years), and C (13-17 years). Subjects in 2002 were excluded for wash-out, as were those diagnosed with dental abnormalities within 6 months after TCs prescription. For comparison, 1:4 matching between the TCs exposure and non-exposure groups was performed according to age and gender. Results Among 14,831 individuals included as study subjects (487 (3%) in group A; 1,695 (11%) in group B; and 12,649 (85%) in group C), 201 (1.4%) were diagnosed with dental abnormalities. The 5-year cumulative incidence of dental abnormalities after exposure to TCs in the group A was 4.7%, which was significantly higher than that of the control group C (0.9%; p< 0.0001), but that of group B was 1.3% and not significantly different from that of group C. In the risk analysis of dental abnormalities according to exposure of TCs, there was no significant difference (adjusted RR=1.03, 95%CI=0.71 to 1.50 in group A; adjusted RR=1.13, 95%CI=0.76 to 1.69 in group B; adjusted RR=1.18, 95%CI=0.97 to 1.43 in group C).
Cumulative incidence rate and relative risk analysis. A. Cumulative incidence rate of dental abnormalities after TCs exposure by age group (p = <.00001). B. Relative risk analysis by TCs exposure and age group.Abbreviation; TCs: tetracycline and its derivatives. Conclusion Korean children aged 0-7 years who were exposed to TCs had a higher cumulative incidence and relative risk of dental deformities compared to the 13-17-year-old group but not the 8-12-year-old group. No significant increase in dental abnormalities was observed with TCs exposure among pediatric age groups. Disclosures All Authors: No reported disclosures.
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Affiliation(s)
- SeoJung Kim
- Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Eun Hwa Kim
- Yonsei University College of Medicine, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Myeongjee Lee
- Yonsei University College of Medicine, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Je Hee Shin
- Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Sung Min Lim
- Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - In Kyung Jung
- Yonsei University College of Medicine, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Jong Gyun Ahn
- Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Ji-Man Kang
- Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Chung-Min Kang
- Yonsei University College of Dentistry, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Jee Yeon Baek
- Yonsei University College of Medicine, Seoul, Seoul-t'ukpyolsi, Republic of Korea
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Kim SJ, Kim EH, Lee M, Baek JY, Lee JY, Shin JH, Lim SM, Kim MY, Jung I, Ahn JG, Kang CM, Kang JM. Risk of Dental Discoloration and Enamel Dysplasia in Children Exposed to Tetracycline and Its Derivatives. Yonsei Med J 2022; 63:1113-1120. [PMID: 36444547 PMCID: PMC9760895 DOI: 10.3349/ymj.2022.0388] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To examine the risk of dental abnormalities after exposure to tetracycline and its derivatives (TCs) in Korean children. MATERIALS AND METHODS Children aged 0-17 years with a claim for prescriptions of TCs between 2002 and 2015 were identified from the Sample Research Database 2.0 of the National Health Insurance Service. Children not exposed to TCs were selected as the control group by matching sex and age (1:4). Cumulative incidence rate and relative risk of dental abnormalities after TCs exposure were investigated. RESULTS The 10-year cumulative incidence rate in the 0-12 years group was 3.1% [95% confidence interval (CI), 2.3-3.9]. The 10-year cumulative incidence rates were 7.0%, 1.9%, and 1.6% in the 0-7, 8-12, and 13-17 years age groups (95% CI: 4.7-9.3, 1.2-2.6, and 1.3-1.9, respectively). There was no significant difference in the risk of dental abnormalities according to TC exposure among the age groups of 0-7 years [adjusted hazard ratio (aHR)=1.0], 8-12 years (aHR=1.1), and 13-17 years (aHR=1.2). CONCLUSION Short-term exposure to TCs does not appear to increase the risk of dental abnormalities in children aged 0-7 and 0-12 years. Restrictions on the use of TCs in children aged 8-12 years, in some countries, may warrant consideration.
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Affiliation(s)
- Seo Jung Kim
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Myeongjee Lee
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Jee Yeon Baek
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Young Lee
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Hee Shin
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Min Lim
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Min Young Kim
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute for Immunology and Immunological Disease, Yonsei University College of Medicine, Seoul, Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Gyun Ahn
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute for Immunology and Immunological Disease, Yonsei University College of Medicine, Seoul, Korea
| | - Chung-Min Kang
- Department of Pediatric Dentistry, Yonsei University College of Dentistry, Seoul, Korea
| | - Ji-Man Kang
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute for Immunology and Immunological Disease, Yonsei University College of Medicine, Seoul, Korea.
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Ihn K, Hahn SM, Lee M, Kim EH, Kang JM, Lim SM, Joo DJ, Jung I. Posttransplant lymphoproliferative disorders after solid organ and hematopoietic stem cell transplantation: a nationwide cohort study in Korea. Korean Journal of Transplantation 2022. [DOI: 10.4285/atw2022.f-2396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Kyong Ihn
- Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Min Hahn
- Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Myeongjee Lee
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ji-Man Kang
- Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Min Lim
- Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Jin Joo
- Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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11
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Kim EH, Nam S, Park CH, Kim Y, Lee M, Ahn JB, Shin SJ, Park YR, Jung HI, Kim BI, Jung I, Kim HS. Periodontal disease and cancer risk: A nationwide population-based cohort study. Front Oncol 2022; 12:901098. [PMID: 36081548 PMCID: PMC9445882 DOI: 10.3389/fonc.2022.901098] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 08/01/2022] [Indexed: 11/24/2022] Open
Abstract
Background Although emerging evidence suggests that periodontitis might increase the risk of cancer, comorbidity and lifestyle behaviors, such as smoking and body mass index (BMI), may have confounded this reported association. This study aimed to investigate whether chronic periodontitis is associated with cancer risk using a large, nationwide database. Methods We conducted a population-based, retrospective cohort study using data from the Korean National Health Insurance Cohort Database obtained between January 2003 and December 2015. We included 713,201 individuals without a history of cancer who were followed up to 10 years. Confounding factors included demographic factors (age, sex, income, and residential area), lifestyle behaviors (smoking history and BMI), and comorbidities, such as hypertension, diabetes, heart failure, and pulmonary disease, using the Charlson Comorbidity Index. Multivariable Cox regression analysis was applied to estimate the adjusted hazard ratio (aHR) for cancer risk. Results Of the 713,201 participants, 53,075 had periodontitis and were placed in the periodontitis group; the remaining 660,126 individuals were included as the control group. Overall, the cumulative incidence of cancer in the periodontitis group was 2.2 times higher than that in the control group. The periodontitis group had an increased risk of total cancer compared to the control group after adjusting for age, sex, comorbidities, BMI, and smoking history (aHR, 1.129; 95% confidence interval [CI], 1.089-1.171; P<0.0001). When examining specific cancer types, significant associations were also observed between periodontitis and stomach cancer (aHR, 1.136; 95% CI, 1.042-1.239; P=0.0037), colon cancer (aHR, 1.129; 95% CI, 1.029-1.239; P=0.0105), lung cancer (aHR, 1.127; 95% CI, 1.008-1.260; P=0.0353), bladder cancer (aHR, 1.307; 95% CI, 1.071-1.595; P=0.0085), thyroid cancer (aHR, 1.191; 95% CI, 1.085-1.308; P=0.0002), and leukemia (aHR, 1.394; 95% CI, 1.039-1.872; P=0.0270). There was no significant association between the development of secondary malignancy and periodontitis in cancer survivors who were alive 5 years after they were diagnosed with the primary malignancy. Conclusions Periodontal disease, including periodontitis, was associated with increased risk of cancer, which persisted after controlling for confounding factors. Further prospective research is warranted to establish a causal relationship.
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Affiliation(s)
- Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Sunghyun Nam
- College of Medicine, Yonsei University, Seoul, South Korea
| | - Chung Hyun Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Yitak Kim
- College of Medicine, Yonsei University, Seoul, South Korea
| | - Myeongjee Lee
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Joong Bae Ahn
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Sang Joon Shin
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Yu Rang Park
- College of Medicine, Yonsei University, Seoul, South Korea
| | - Hoi In Jung
- Department of Preventive Dentistry and Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
| | - Baek-Il Kim
- Department of Preventive Dentistry and Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
- *Correspondence: Han Sang Kim, ; Inkyung Jung,
| | - Han Sang Kim
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
- Graduate School of Medical Science, Brain Korea 21 Project, Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea
- Institute for Innovation in Digital Healthcare (IIDH), Severance Hospital, Seoul, South Korea
- *Correspondence: Han Sang Kim, ; Inkyung Jung,
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Lee W, Cho S, Hwang H, Lee M, Kim EH, Kim KM, Heo K, Chu MK. Crystal‐clear days and unclear days in migraine: A population‐based study. Headache 2022; 62:818-827. [DOI: 10.1111/head.14359] [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] [Received: 11/29/2021] [Revised: 05/01/2022] [Accepted: 06/03/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Wonwoo Lee
- Department of Neurology Yonsei University College of Medicine Seoul South Korea
- Department of Neurology Yongin Severance Hospital, Yonsei University Health System Yongin South Korea
| | - Soo‐Jin Cho
- Department of Neurology Dongtan Sacred Heart Hospital, Hallym University College of Medicine Hwaseong South Korea
| | - Heewon Hwang
- Department of Neurology Yonsei University College of Medicine Seoul South Korea
- Department of Neurology Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine Wonju South Korea
| | - Myeongjee Lee
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics Yonsei University College of Medicine Seoul South Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics Yonsei University College of Medicine Seoul South Korea
| | - Kyung Min Kim
- Department of Neurology Yonsei University College of Medicine Seoul South Korea
| | - Kyoung Heo
- Department of Neurology Yonsei University College of Medicine Seoul South Korea
| | - Min Kyung Chu
- Department of Neurology Yonsei University College of Medicine Seoul South Korea
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Jung SM, Han M, Kim EH, Jung I, Park YB. Comparison of developing tuberculosis following tumor necrosis factor inhibition and interleukin-6 inhibition in patients with rheumatoid arthritis: a nationwide observational study in South Korea, 2013–2018. Arthritis Res Ther 2022; 24:157. [PMID: 35761359 PMCID: PMC9235163 DOI: 10.1186/s13075-022-02842-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 06/15/2022] [Indexed: 11/28/2022] Open
Abstract
Background Tumor necrosis factor (TNF) inhibitors increase the risk of tuberculosis (TB) in patients with rheumatoid arthritis (RA). This study compared the incidence of TB after treatment with TNF inhibitors and tocilizumab in patients with RA, separately in those who were treated for latent tuberculosis infection (LTBI) and those without evidence of LTBI. Methods This study included patients with RA who initiated TNF inhibitors and tocilizumab between December 2013 and August 2018. Patient data were collected from the nationwide database of the Health Insurance Review and Assessment service in South Korea. The incidence of TB was compared among different biologic drugs in patients with or without LTBI treatment. Results Of 4736 patients, 1168 were treated for LTBI and 48 developed TB (554.9 per 100,000 person-years). When compared based on etanercept, infliximab showed a higher risk of TB (adjusted incidence rate ratio 2.71, 95% confidence interval 1.05–7.01), especially in patients without evidence of LTBI. Other TNF inhibitors and tocilizumab showed a comparable incidence of TB, regardless of treatment for LTBI. There was no significant difference in TB incidence after biologic therapy between patients with and without LTBI treatment (627.9/100,000 vs. 529.5/100,000 person-years). In patients treated for LTBI, no differential risk of TB was observed among biologic drugs. Conclusions The incidence of TB was not significantly different among biologic drugs in the current era, except for infliximab in patients who were not treated for LTBI. Treatment of LTBI might alleviate the drug-specific risk of TB in patients with RA. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-022-02842-6.
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Baek JK, Kim HI, Kang MJ, Seon KE, Kim EH, Seo SK. Relationship between the type of hormone replacement therapy and incidence of breast cancer in Korea. Climacteric 2022; 25:516-522. [PMID: 35674251 DOI: 10.1080/13697137.2022.2077096] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 11/03/2022]
Abstract
OBJECTIVE This study aimed to investigate the relationship between hormone replacement therapy (HRT) types and breast cancer (BC) incidence in postmenopausal women in Korea. METHODS The nested case-control study used data from the National Health Insurance Service database. Among the women aged ≥50 years who menopaused between 2004 and 2007, BC incidence up to 2017 was analyzed in 36,446 women using or having used HRT for >1 year and in 36,446 women who did not use any HRT for more than 1 year. HRT types and duration were classified into three categories. RESULTS BC risk (BCR) decreased with tibolone use for all ages. With HRT initiation in women aged ≥50 years, BCR was lower with tibolone and estrogen-progestogen therapy. HRT for <3 years showed lower BCR with tibolone, while higher BCR was observed with estrogen-only therapy. BCR was lower in women of all ages on HRT for >5 years than in the control group. CONCLUSIONS For women in their 50s, tibolone use lowers BCR; for all ages, the use of any HRT for >5 years showed lower BCR in Korea. These divergent results from western countries could be associated with the specific characteristics of BC in Korea.
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Affiliation(s)
- J K Baek
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - H I Kim
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - M J Kang
- Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - K E Seon
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - E H Kim
- Department of Obstetrics and Gynecology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - S K Seo
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Lee SE, Kim GR, Han K, Kim EH, Kim EK, Kim MJ, Yoon JH, Park VY, Moon HJ. US, Mammography, and Histopathologic Evaluation to Identify Low Nuclear Grade Ductal Carcinoma in Situ. Radiology 2022; 303:E42. [PMID: 35604844 DOI: 10.1148/radiol.229011] [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: 11/11/2022]
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Lee SE, Kim GR, Han K, Kim EH, Kim EK, Kim MJ, Yoon JH, Park VY, Moon HJ. US, Mammography, and Histopathologic Evaluation to Identify Low Nuclear Grade Ductal Carcinoma in Situ. Radiology 2022; 303:276-284. [PMID: 35166586 DOI: 10.1148/radiol.211425] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Low nuclear grade ductal carcinoma in situ (DCIS) identified at biopsy can be upgraded to intermediate to high nuclear grade DCIS at surgery. Methods that confirm low nuclear grade are needed to consider nonsurgical approaches for these patients. Purpose To develop a preoperative model to identify low nuclear grade DCIS and to evaluate factors associated with low nuclear grade DCIS at biopsy that was not upgraded to intermediate to high nuclear grade DCIS at surgery. Materials and Methods In this retrospective study, 470 women (median age, 50 years; interquartile range, 44-58 years) with 477 pure DCIS lesions at surgical histopathologic evaluation were included (January 2010 to December 2015). Patients were divided into the training set (n = 330) or validation set (n = 147) to develop a preoperative model to identify low nuclear grade DCIS. Features at US (mass, nonmass) and at mammography (morphologic characteristics, distribution of microcalcification) were reviewed. The upgrade rate of low nuclear grade DCIS was calculated, and multivariable regression was used to evaluate factors for associations with low nuclear grade DCIS that was not upgraded later. Results A preoperative model that included lesions manifesting as a mass at US without microcalcification and no comedonecrosis at biopsy was used to identify low nuclear grade DCIS, with a high area under the receiver operating characteristic curve of 0.97 (95% CI: 0.94, 1.00) in the validation set. The upgrade rate of low nuclear grade DCIS at biopsy was 38.8% (50 of 129). Ki-67 positivity (odds ratio, 0.04; 95% CI: 0.0003, 0.43; P = .005) was inversely associated with constant low nuclear grade DCIS. Conclusion The upgrade rate of low nuclear grade ductal carcinoma in situ (DCIS) at biopsy to intermediate to high nuclear grade DCIS at surgery occurred in more than a third of patients; low nuclear grade DCIS at final histopathologic evaluation could be identified if the mass was viewed at US without microcalcifications and had no comedonecrosis at histopathologic evaluation of biopsy. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Rahbar in this issue.
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Affiliation(s)
- Si Eun Lee
- From the Department of Radiology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea (S.E.L., E.K.K.); Department of Radiology, Research Institute of Radiologic Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (G.R.K., K.H., M.J.K., J.H.Y., V.Y.P.); Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea (E.H.K.); and Department of Radiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 220-701, Korea (H.J.M.)
| | - Ga Ram Kim
- From the Department of Radiology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea (S.E.L., E.K.K.); Department of Radiology, Research Institute of Radiologic Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (G.R.K., K.H., M.J.K., J.H.Y., V.Y.P.); Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea (E.H.K.); and Department of Radiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 220-701, Korea (H.J.M.)
| | - Kyunghwa Han
- From the Department of Radiology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea (S.E.L., E.K.K.); Department of Radiology, Research Institute of Radiologic Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (G.R.K., K.H., M.J.K., J.H.Y., V.Y.P.); Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea (E.H.K.); and Department of Radiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 220-701, Korea (H.J.M.)
| | - Eun Hwa Kim
- From the Department of Radiology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea (S.E.L., E.K.K.); Department of Radiology, Research Institute of Radiologic Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (G.R.K., K.H., M.J.K., J.H.Y., V.Y.P.); Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea (E.H.K.); and Department of Radiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 220-701, Korea (H.J.M.)
| | - Eun-Kyung Kim
- From the Department of Radiology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea (S.E.L., E.K.K.); Department of Radiology, Research Institute of Radiologic Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (G.R.K., K.H., M.J.K., J.H.Y., V.Y.P.); Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea (E.H.K.); and Department of Radiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 220-701, Korea (H.J.M.)
| | - Min Jung Kim
- From the Department of Radiology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea (S.E.L., E.K.K.); Department of Radiology, Research Institute of Radiologic Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (G.R.K., K.H., M.J.K., J.H.Y., V.Y.P.); Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea (E.H.K.); and Department of Radiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 220-701, Korea (H.J.M.)
| | - Jung Hyun Yoon
- From the Department of Radiology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea (S.E.L., E.K.K.); Department of Radiology, Research Institute of Radiologic Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (G.R.K., K.H., M.J.K., J.H.Y., V.Y.P.); Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea (E.H.K.); and Department of Radiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 220-701, Korea (H.J.M.)
| | - Vivian Youngjean Park
- From the Department of Radiology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea (S.E.L., E.K.K.); Department of Radiology, Research Institute of Radiologic Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (G.R.K., K.H., M.J.K., J.H.Y., V.Y.P.); Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea (E.H.K.); and Department of Radiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 220-701, Korea (H.J.M.)
| | - Hee Jung Moon
- From the Department of Radiology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea (S.E.L., E.K.K.); Department of Radiology, Research Institute of Radiologic Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (G.R.K., K.H., M.J.K., J.H.Y., V.Y.P.); Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea (E.H.K.); and Department of Radiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 220-701, Korea (H.J.M.)
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Park CI, Han M, Jung I, Kim EH, Kang JI, Kim SJ. A nationwide nested case-control study of new-onset obsessive-compulsive disorder following antipsychotics use in schizophrenia. Acta Psychiatr Scand 2021; 144:589-598. [PMID: 34564841 DOI: 10.1111/acps.13375] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/31/2021] [Accepted: 09/22/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE A substantial proportion of patients with schizophrenia suffer from comorbid obsessive-compulsive disorder (OCD) possibly associated with antipsychotics. However, little is known about the comparative risks of the antipsychotics. The present study aimed to investigate the risk of new-onset OCD following the initiation of different antipsychotic medications for schizophrenia relative to haloperidol. METHODS Using the Korean national claims data, patients aged 15-60 years newly diagnosed with schizophrenia between 2010 and 2018 were identified. Of the 47,808 patients with schizophrenia treated with nine commonly prescribed antipsychotics, 775 new-onset OCD patients were matched to 3,100 patients without OCD using nested case-control design with 1:4 case-control matching based on the sex, age of index date, date of schizophrenia diagnosis, observation period, locations of medical institutions, and level of medical facilities. Using multivariable conditional logistic regression analysis, odd ratios (ORs) for new-onset OCD comparing each antipsychotic agent relative to haloperidol were computed. RESULTS The risk for new-onset OCD during treatment with clozapine was significantly higher than that with haloperidol (adjusted OR 2.86; 95% confidence interval [1.63-5.03]). The risks for new-onset OCD with other antipsychotics were not significantly different from that with haloperidol. In subgroup analysis, the early and intermediate, but not late-onset schizophrenia group showed significant risk for OCD associated with clozapine use. CONCLUSION The present findings, based on real-world national representative data, provide reliable evidence for the risk of new-onset OCD in patients with schizophrenia receiving clozapine at a population level.
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Affiliation(s)
- Chun Il Park
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Minkyung Han
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Jee In Kang
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
| | - Se Joo Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
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Sung S, Kim EH, Kwon JW, Lee JS, Lee SB, Moon SH, Lee HM, Jung I, Lee BH. Invasive dental procedures as risk factors for postoperative spinal infection and the effect of antibiotic prophylaxis. J Clin Periodontol 2021; 48:1270-1280. [PMID: 34189757 PMCID: PMC8457097 DOI: 10.1111/jcpe.13514] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/19/2021] [Indexed: 11/29/2022]
Abstract
AIM To identify invasive dental procedures as a risk factor for postoperative spinal infection (PSI) and evaluate the effectiveness of antibiotic prophylaxis. MATERIALS AND METHODS We analysed 229,335 patients who underwent spinal surgery with instrumentation from 2010 to 2017, using the nationwide database. The incidence of spinal infection 2 years after surgery was determined. Invasive dental procedures as a risk factor for PSI and the effects of antibiotic prophylaxis during this period were also analysed. RESULTS A total of 15,346 patients (6.69%) were diagnosed with PSI. It was found that advanced age, male sex, and a high Charlson Comorbidity Index were risk factors for PSI. The risk of PSI did not increase following dental procedures (adjusted hazard ratio [HR] 0.850; 95% confidence interval [CI], 0.793-0.912) and was not affected by antibiotics (adjusted HR 1.097; 95% CI, 0.987-1.218). Patients who received dental treatment as early as 3 months after spinal surgery had the lowest risk of postoperative infection (adjusted HR 0.869; 95% CI, 0.795-0.950). CONCLUSIONS Invasive dental procedure does not increase the risk of PSI, and antibiotic prophylaxis before dental procedure was not effective in preventing spinal infection.
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Affiliation(s)
- Sahyun Sung
- Department of Orthopedic Surgery, College of Medicine, Ewha Womans University Seoul Hospital, Seoul, South Korea.,Department of Orthopedic surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Ji-Won Kwon
- Department of Orthopedic surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Soo-Bin Lee
- Department of Orthopedic Surgery, Catholic Kwandong University International Saint Mary's Hospital, Incheon, South Korea
| | - Seong-Hwan Moon
- Department of Orthopedic surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Hwan-Mo Lee
- Department of Orthopedic surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Byung Ho Lee
- Department of Orthopedic surgery, Yonsei University College of Medicine, Seoul, South Korea
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Kang S, Han M, Park CI, Jung I, Kim EH, Boo YJ, Kang JI, Kim SJ. Use of serotonin reuptake inhibitors and risk of subsequent bone loss in a nationwide population-based cohort study. Sci Rep 2021; 11:13461. [PMID: 34188108 PMCID: PMC8241982 DOI: 10.1038/s41598-021-92821-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 06/15/2021] [Indexed: 11/30/2022] Open
Abstract
This study examined whether the use of SRIs is associated with an increased risk of bone loss using a nested case-control design with a nationwide population-based cohort in Korea. Using the Korean National Health Screening Cohort, subjects newly diagnosed with osteoporosis or osteopenia (n = 55,799) were matched with controls (n = 278,995) at a ratio of 1:5. We stratified the participants by their time-dependent use of SRIs and sex and controlled for various confounders, including lifestyle habits, laboratory data, and comorbidities. Conditional logistic regression showed that both recent and former users of SRIs had an increased risk of subsequent bone loss compared with non-users: men [recent users: odds ratio (OR) 1.35, 95% confidential interval (CI) 1.20, 1.53; former-users: OR 1.10, 95% CI 1.01, 1.20]; women (recent users: OR 1.38, 95% CI 1.28-1.48; former-users: OR 1.07, 95% CI 1.02, 1.21). The use of SRIs was associated with an increased risk of bone loss in both men and women. In particular, the association was stronger in recent users. These findings provide population-level evidence for the risk of bone loss associated with SRI exposure and highlight the importance of monitoring the bone health of SRI users.
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Affiliation(s)
- Sunyoung Kang
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minkyung Han
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chun Il Park
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Jun Boo
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jee In Kang
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Department of Psychiatry, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | - Se Joo Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Department of Psychiatry, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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20
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Kim DS, Park SY, Kim BK, Park JY, Kim DY, Han KH, Lee YR, Tak WY, Kweon YO, Jung I, Han M, Kim EH, Ahn SH, Kim SU. Revised Korean Antiviral Guideline Reduces the Hepatitis B-related Hepatocellular Carcinoma Risk in Cirrhotic Patients. J Korean Med Sci 2021; 36:e105. [PMID: 33904261 PMCID: PMC8076846 DOI: 10.3346/jkms.2021.36.e105] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 02/24/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Since September 2015, the initiation of antiviral therapy (AVT) for patients with chronic hepatitis B (CHB)-related cirrhosis has been reimbursed according to the revised Korean Association for the Study of Liver (KASL) guideline, if the patient had hepatitis B virus DNA level ≥ 2,000 IU/L, regardless of aminotransferase or alanine aminotransferase levels. This study investigated whether the KASL guideline implementation reduced the risk of CHB-related hepatocellular carcinoma (HCC) in patients with cirrhosis in South Korea. METHODS A total of 429 patients with CHB-related cirrhosis who initiated AVT between 2014 and 2016 were recruited. The risk of HCC development was compared between patients who initiated AVT before and after September 2015 (pre-guideline [n = 196, 45.7%] vs. post-guideline implementation [n = 233, 54.3%]). RESULTS Univariate analysis showed that AVT initiation before guideline implementation, older age, male gender, and diabetes significantly predicted increased risk of HCC development (all P < 0.05). Subsequent multivariate analysis showed that AVT initiation before guideline implementation (HR = 1.941), older age (HR = 5.762), male gender (HR = 2.555), and diabetes (HR = 1.568) independently predicted increased risk of HCC development (all P < 0.05). Additionally, multivariate analysis showed that AVT initiation before guideline implementation (HR = 2.309), male gender (HR = 3.058), and lower platelet count (HR = 0.989) independently predicted mortality (P < 0.05). The cumulative incidences of HCC and mortality were significantly higher in patients who initiated AVT before guideline implementation than in those who initiated AVT after guideline implementation (all P < 0.05, log-rank test). CONCLUSION The prognosis of patients with CHB-related cirrhosis who initiated AVT improved after guideline implementation according to the revised KASL guideline.
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Affiliation(s)
- David Sooik Kim
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Soo Young Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Beom Kyung Kim
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
- Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - Jun Yong Park
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
- Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - Do Young Kim
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
- Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - Kwang Hyub Han
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
- Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - Yu Rim Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Won Young Tak
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Young Oh Kweon
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Minkyung Han
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hoon Ahn
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
- Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - Seung Up Kim
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
- Yonsei Liver Center, Severance Hospital, Seoul, Korea.
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21
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Kim MJ, Lee JG, Kim EH, Lee SH. A nomogram to predict arterial bleeding in patients with pelvic fractures after blunt trauma: a retrospective cohort study. J Orthop Surg Res 2021; 16:122. [PMID: 33557886 PMCID: PMC7869209 DOI: 10.1186/s13018-021-02247-2] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/18/2021] [Indexed: 12/04/2022] Open
Abstract
Background Pelvic bone fractures are one of the biggest challenges faced by trauma surgeons. Especially, the presence of bleeding and hemodynamic instability features is associated with high morbidity and mortality in patients with pelvic fractures. However, prediction of the occurrence of arterial bleeding causing massive hemorrhage in patients with pelvic fractures is difficult. Therefore, the aim of this study was to develop a nomogram to predict arterial bleeding in patients with pelvic bone fractures after blunt trauma. Methods The medical records of 1404 trauma patients treated between January 2013 and August 2017 were retrospectively reviewed. Patients older than 15 years with a pelvic fracture due to blunt trauma were enrolled (n = 148). The pelvic fracture pattern on anteroposterior radiography was classified according to the Orthopedic Trauma Association/Arbeitsgemeinschaft fur Osteosynthesefragen (OTA/AO) system. Multivariable logistic regression modeling was used to determine the independent risk factors for arterial bleeding. A nomogram was constructed based on the identified risk factors. Results The most common pelvic fracture pattern was type A (58.8%), followed by types B (34.5%) and C (6.7%). Of the 148 patients, 28 (18.9%) showed pelvic arterial bleeding on contrast-enhanced computed tomography or angiography, or in the operative findings. The independent risk factors for arterial bleeding were a type B or C pelvic fracture pattern, body temperature < 36 °C, and serum lactate level > 3.4 mmol/L. A nomogram was developed using these three parameters, along with a systolic blood pressure < 90 mmHg. The area under the receiver operating characteristic curve of the predictive model for discrimination was 0.8579. The maximal Youden index was 0.1527, corresponding to a cutoff value of 68.65 points, which was considered the optimal cutoff value for predicting the occurrence of arterial bleeding in patients with pelvic bone fractures. Conclusions The developed nomogram, which was based on the initial clinical findings identifying risk factors for arterial bleeding, is expected to be helpful in rapidly establishing a treatment plan and improving the prognosis for patients with pelvic bone fractures. Supplementary Information The online version contains supplementary material available at 10.1186/s13018-021-02247-2.
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Affiliation(s)
- Myoung Jun Kim
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Jae Gil Lee
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Hwan Lee
- Department of Trauma Surgery, Gachon University Gil Medical Center, 21, Namdong-daero 774beon-gil, Namdong-gu, Incheon, Republic of Korea.
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22
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Kong Y, Han M, Lee M, Kim EH, Jung I, Park KK. The Association of Calcium and Vitamin D Use With Implant Survival of Total Knee Arthroplasty: A Nationwide Population-Based Cohort Study. J Arthroplasty 2021; 36:542-549.e3. [PMID: 32888752 DOI: 10.1016/j.arth.2020.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/28/2020] [Accepted: 08/02/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Calcium and vitamin D have been regarded as beneficial nutrients for bone metabolism that may affect survival of arthroplasties. However, the relationship between their use and revision rate of knee arthroplasty has not been evaluated. Thus, we investigated an association between calcium and vitamin D use and the revision rate after primary total knee arthroplasty. METHODS A nationwide population-based cohort study was conducted using the Korean National Health Insurance database. We included patients diagnosed with knee osteoarthritis and underwent primary total knee arthroplasty between 2009 and 2018. Risk for arthroplasty revision was estimated using a Cox proportional hazards model with time-dependent covariates. Log-rank test was used to assess survival of knee arthroplasty. RESULTS Out of 142,147 subjects, 28,403 were calcium and vitamin D users and 113,744 were never users. Calcium and vitamin D significantly reduced the revision risk with a 6-month drug use lag period (adjusted hazard ratio [aHR] 0.56, 95% confidence interval [CI] 0.45-0.70). Calcium and vitamin D combination use for more than 1 year was associated with reduced revision risks in both patients with periprosthetic joint infection (aHR 0.63, 95% CI 0.42-0.95) and patients without infection (aHR 0.70, 95% CI 0.54-0.91). Implant survival was significantly improved in calcium and vitamin D combination users for more than 1 year compared with never users (log-rank P < .001). CONCLUSION Combination use of calcium and vitamin D with a dose of 800 IU or greater for more than 1 year was associated with the greatest reduction in the risks for revision surgery after total knee arthroplasty.
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Affiliation(s)
- Youngho Kong
- Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minkyung Han
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minyoung Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kwan Kyu Park
- Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
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23
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Eoh KJ, Han M, Kim EH, Jung I, Kim YT. Markedly increased risk of malignancies in women with endometriosis. Gynecol Oncol 2021; 161:291-296. [PMID: 33514482 DOI: 10.1016/j.ygyno.2021.01.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 09/30/2020] [Accepted: 01/18/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the cancer risk in a cohort of women with newly diagnosed endometriosis. METHODS This retrospective, nationwide, population-based cohort study utilized data from the 10-year claims database of the Korean National Health Insurance from January 2008 to December 2018. Patients diagnosed with endometriosis between 2010 and 2013 were included; those who underwent appendectomy but were not diagnosed with endometriosis during the study period served as controls. No participant was diagnosed with cancer before enrollment. Cancer diagnoses according to the International Classification of Diseases, 10th revision, were compared between the two groups. Cancer occurrence in both groups was identified according to the diagnostic codes for different organ sites. RESULTS Altogether, 179,865 patients with endometriosis and 87,408 controls were analyzed, and the incidence rates of cancer were 644.3 and 543.8 per 100,000 person-years, respectively. Patients with endometriosis had a significantly increased overall cancer risk (hazard ratio [HR], 1.34; 95% confidence interval [CI], 1.28-1.40; p < 0.001) than controls after adjusting for age, insurance type, and comorbidities. They had significantly increased uterine (HR, 4.59; 95% CI, 3.56-5.91; p < 0.001), ovarian (HR, 2.51; 95% CI, 1.99-3.16; p < 0.001), cervical (HR, 1.84; 95% CI, 1.49-2.28; p < 0.001), breast (HR, 1.44; 95% CI, 1.31-1.58; p < 0.001), and thyroid cancer (HR, 1.34; 95% CI, 1.24-1.45; p < 0.001) risk. Median age at diagnosis was <50 years for all cancer types. CONCLUSIONS Endometriosis was associated with an increased cancer risk, specifically uterine, ovarian, cervical, breast, and thyroid cancers, suggesting that effective cancer screening for early detection of malignancies in women should be implemented in those with endometriosis.
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Affiliation(s)
- Kyung Jin Eoh
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Yongin Severance Hospital, Yongin, Republic of Korea
| | - Minkyung Han
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Young Tae Kim
- Institute of Women's Life Medical Science, Women's Cancer Center, Department of Obstetrics and Gynecology, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
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24
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Lee G, Kim HS, Lee SW, Park YR, Kim EH, Lee B, Hu YJ, Kim KA, Kim D, Cho HY, Kang B, Choi HJ. Pre-screening of patient-reported symptoms using the Edmonton Symptom Assessment System in outpatient palliative cancer care. Eur J Cancer Care (Engl) 2020; 29:e13305. [PMID: 33016473 DOI: 10.1111/ecc.13305] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 01/15/2020] [Revised: 06/24/2020] [Accepted: 08/07/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Although early palliative care is associated with a better quality of life and improved outcomes in end-of-life cancer care, the criteria of palliative care referral are still elusive. METHODS We collected patient-reported symptoms using the Edmonton Symptom Assessment System (ESAS) at the baseline, first and second follow-up visits. A total of 71 patients were evaluable, with a median age of 65 years, male (62%) and Eastern Cooperative Oncology Group (ECOG) performance status distribution of 1/2/3 (28%/39%/33%) respectively. RESULTS Twenty (28%) patients had moderate/severe symptom burden with the mean ESAS ≥ 5. Interestingly, most of the patients with moderate/severe symptom burdens (ESAS ≥ 5) had globally elevated symptom expression. While the mean ESAS score was maintained in patients with mild symptom burden (ESAS < 5; 2.7 at the baseline; 3.4 at the first follow-up; 3.0 at the second follow-up; p = .117), there was significant symptom improvement in patients with moderate/severe symptom burden (ESAS ≥ 5; 6.5 at the baseline; 4.5 at the first follow-up; 3.6 at the second follow-up; p < .001). CONCLUSIONS In conclusion, advanced cancer patients with ESAS ≥ 5 may benefit from outpatient palliative cancer care. Pre-screening of patient-reported symptoms using ESAS can be useful for identifying unmet palliative care needs in advanced cancer patients.
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Affiliation(s)
- Garden Lee
- Division of Hematology Oncology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Han Sang Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.,Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Korea
| | - Si Won Lee
- Palliative Care Center, Yonsei Cancer Center, Seoul, South Korea
| | - Yu Rang Park
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Hwa Kim
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Bori Lee
- Palliative Care Center, Yonsei Cancer Center, Seoul, South Korea
| | - Youn Jung Hu
- Palliative Care Center, Yonsei Cancer Center, Seoul, South Korea
| | - Kyung-A Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - DooA Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.,Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Korea
| | - Ho Yeon Cho
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.,Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Korea
| | - Beodeul Kang
- Medical Oncology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Hye Jin Choi
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.,Palliative Care Center, Yonsei Cancer Center, Seoul, South Korea
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Kang JM, Kim EH, Ihn K, Jung I, Han M, Ahn JG. Corrigendum to "Risk of invasive pneumococcal disease in patients with asplenia/hyposplenism: A nationwide population-based study in Korea, 2009-2018" [Int. J. Infect. Dis. 98 September (2020) 486-493]. Int J Infect Dis 2020; 99:514. [PMID: 32950801 DOI: 10.1016/j.ijid.2020.09.013] [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: 10/23/2022] Open
Affiliation(s)
- Ji-Man Kang
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, South Korea; Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, South Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, South Korea
| | - Kyong Ihn
- Department of Pediatric Surgery, Severance Children's Hospital, Yonsei University College of Medicine, South Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Minkyung Han
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, South Korea
| | - Jong Gyun Ahn
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, South Korea.
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26
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Kang JM, Kim EH, Ihn K, Jung I, Han M, Ahn JG. Risk of invasive pneumococcal disease in patients with asplenia/hyposplenism: A nationwide population-based study in Korea, 2009–2018. Int J Infect Dis 2020; 98:486-493. [DOI: 10.1016/j.ijid.2020.07.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 01/28/2023] Open
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Lee JS, Kim EH, Lee SH. Endoscopically assisted malarplasty: L-rotation technique. J Stomatol Oral Maxillofac Surg 2020; 122:229-234. [PMID: 32810601 DOI: 10.1016/j.jormas.2020.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/21/2020] [Accepted: 07/28/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Endoscopically assisted malarplasty with a greenstick fracture is a method for preserving the body eminence and improving arch protrusion. However, this technique is inadequate when malar body reduction is required. To compensate for these limitations, we developed a new surgical technique using the endoscope to reduce body protrusion. MATERIAL AND METHODS We enrolled 261 patients who visited our clinic for zygoma reduction from January 2017 to December 2018. Their mean age was 31 (range 17-63) years. After a scalp incision, an incomplete osteotomy was created from the most prominent portion of the zygoma body to the zygomaticomaxillary suture line. A complete osteotomy was performed on the arch. These osteotomies resulted in an L-shaped zygoma segment after tapping the bone with a mallet. RESULTS Of the 261 patients who underwent our L-rotation technique, 242 also received a corticotomy. Of those patients, 15 underwent a different degree of zygoma reduction on both sides. A floating zygomatic segment occurred in four cases, although no further surgery was required. One patient's zygomatic segment dropped on one side, requiring rigid fixation through the intraoral approach. Most patients were satisfied and there were no specific complications. CONCLUSIONS Endoscopically assisted malarplasty using an L-rotation technique enables the protrusion of both the arch and body to be reduced. The zygoma reduction can be modified based on the location of the incomplete osteotomoy line and the number of corticotomies required.
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Affiliation(s)
- J S Lee
- Youtiful Vom Aesthetic Plastic Clinic, 326 Dosan-daero, Gangnam-gu, Seoul, Republic of Korea
| | - E H Kim
- Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Goyang-si, Gyeonggi-do, Republic of Korea
| | - S H Lee
- Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Goyang-si, Gyeonggi-do, Republic of Korea.
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Salganik MJ, Lundberg I, Kindel AT, Ahearn CE, Al-Ghoneim K, Almaatouq A, Altschul DM, Brand JE, Carnegie NB, Compton RJ, Datta D, Davidson T, Filippova A, Gilroy C, Goode BJ, Jahani E, Kashyap R, Kirchner A, McKay S, Morgan AC, Pentland A, Polimis K, Raes L, Rigobon DE, Roberts CV, Stanescu DM, Suhara Y, Usmani A, Wang EH, Adem M, Alhajri A, AlShebli B, Amin R, Amos RB, Argyle LP, Baer-Bositis L, Büchi M, Chung BR, Eggert W, Faletto G, Fan Z, Freese J, Gadgil T, Gagné J, Gao Y, Halpern-Manners A, Hashim SP, Hausen S, He G, Higuera K, Hogan B, Horwitz IM, Hummel LM, Jain N, Jin K, Jurgens D, Kaminski P, Karapetyan A, Kim EH, Leizman B, Liu N, Möser M, Mack AE, Mahajan M, Mandell N, Marahrens H, Mercado-Garcia D, Mocz V, Mueller-Gastell K, Musse A, Niu Q, Nowak W, Omidvar H, Or A, Ouyang K, Pinto KM, Porter E, Porter KE, Qian C, Rauf T, Sargsyan A, Schaffner T, Schnabel L, Schonfeld B, Sender B, Tang JD, Tsurkov E, van Loon A, Varol O, Wang X, Wang Z, Wang J, Wang F, Weissman S, Whitaker K, Wolters MK, Woon WL, Wu J, Wu C, Yang K, Yin J, Zhao B, Zhu C, Brooks-Gunn J, Engelhardt BE, Hardt M, Knox D, Levy K, Narayanan A, Stewart BM, Watts DJ, McLanahan S. Measuring the predictability of life outcomes with a scientific mass collaboration. Proc Natl Acad Sci U S A 2020; 117:8398-8403. [PMID: 32229555 PMCID: PMC7165437 DOI: 10.1073/pnas.1915006117] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [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] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
How predictable are life trajectories? We investigated this question with a scientific mass collaboration using the common task method; 160 teams built predictive models for six life outcomes using data from the Fragile Families and Child Wellbeing Study, a high-quality birth cohort study. Despite using a rich dataset and applying machine-learning methods optimized for prediction, the best predictions were not very accurate and were only slightly better than those from a simple benchmark model. Within each outcome, prediction error was strongly associated with the family being predicted and weakly associated with the technique used to generate the prediction. Overall, these results suggest practical limits to the predictability of life outcomes in some settings and illustrate the value of mass collaborations in the social sciences.
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Affiliation(s)
| | - Ian Lundberg
- Department of Sociology, Princeton University, Princeton, NJ 08544
| | | | - Caitlin E Ahearn
- Department of Sociology, University of California, Los Angeles, CA 90095
| | | | - Abdullah Almaatouq
- Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA 02142
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA 02139
| | - Drew M Altschul
- Mental Health Data Science Scotland, Department of Psychology, The University of Edinburgh, Edinburgh EH8 9JZ, United Kingdom
| | - Jennie E Brand
- Department of Sociology, University of California, Los Angeles, CA 90095
- Department of Statistics, University of California, Los Angeles, CA 90095
| | | | - Ryan James Compton
- Human Computer Interaction Lab, University of California, Santa Cruz, CA 95064
| | - Debanjan Datta
- Discovery Analytics Center, Virginia Polytechnic Institute and State University, Arlington, VA 22203
| | - Thomas Davidson
- Department of Sociology, Cornell University, Ithaca, NY 14853
| | | | - Connor Gilroy
- Department of Sociology, University of Washington, Seattle, WA 98105
| | - Brian J Goode
- Social and Decision Analytics Laboratory, Fralin Life Sciences Institute, Virginia Polytechnic Institute and State University, Arlington, VA 22203
| | - Eaman Jahani
- Institute for Data, Systems and Society, Massachusetts Institute of Technology, Cambridge, MA 02139
| | - Ridhi Kashyap
- Department of Sociology, University of Oxford, Oxford OX1 1JD, United Kingdom
- Nuffield College, University of Oxford, Oxford OX1 1NF, United Kingdom
- School of Anthropology and Museum Ethnography, University of Oxford, Oxford OX2 6PE, United Kingdom
| | - Antje Kirchner
- Program for Research in Survey Methodology, Survey Research Division, RTI International, Research Triangle Park, NC 27709
| | - Stephen McKay
- School of Social and Political Sciences, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, United Kingdom
| | - Allison C Morgan
- Department of Computer Science, University of Colorado, Boulder, CO 80309
| | - Alex Pentland
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA 02139
| | - Kivan Polimis
- Center for the Study of Demography and Ecology, University of Washington, Seattle, WA 98105
| | - Louis Raes
- Department of Economics, Tilburg School of Economics and Management, Tilburg University, 5037 AB Tilburg, The Netherlands
| | - Daniel E Rigobon
- Department of Operations Research and Financial Engineering, Princeton University, Princeton, NJ 08544
| | - Claudia V Roberts
- Department of Computer Science, Princeton University, Princeton, NJ 08544
| | - Diana M Stanescu
- Department of Politics, Princeton University,Princeton, NJ, 08544
| | - Yoshihiko Suhara
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA 02139
| | - Adaner Usmani
- Department of Sociology, Harvard University, Cambridge, MA 02138
| | - Erik H Wang
- Department of Politics, Princeton University,Princeton, NJ, 08544
| | - Muna Adem
- Department of Sociology, Indiana University, Bloomington, IN 47405
| | - Abdulla Alhajri
- Department of Nuclear Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139
| | - Bedoor AlShebli
- Computational Social Science Lab, Social Science Division, New York University Abu Dhabi, 129188 Abu Dhabi, United Arab Emirates
| | - Redwane Amin
- Bendheim Center for Finance, Princeton University, Princeton, NJ 08544
| | - Ryan B Amos
- Department of Computer Science, Princeton University, Princeton, NJ 08544
| | - Lisa P Argyle
- Department of Political Science, Brigham Young University, Provo, UT 84602
| | | | - Moritz Büchi
- Department of Communication and Media Research, University of Zurich, Zurich, Switzerland, ZH-8050
| | - Bo-Ryehn Chung
- Center for Statistics & Machine Learning, Princeton University, Princeton, NJ 08544
| | - William Eggert
- Department of Mechanical and Aerospace Engineering, Princeton University, Princeton, NJ 08544
| | - Gregory Faletto
- Statistics Group, Department of Data Sciences and Operations, Marshall School of Business, University of Southern California, Los Angeles, CA 90089
| | - Zhilin Fan
- Department of Statistics, Columbia University, New York, NY 10027
| | - Jeremy Freese
- Department of Sociology, Stanford University, Stanford, CA 94305
| | - Tejomay Gadgil
- Center for Data Science, New York University, New York, NY 10011
| | - Josh Gagné
- Department of Sociology, Stanford University, Stanford, CA 94305
| | - Yue Gao
- Department of Industrial Engineering and Operations Research, Columbia University, New York, NY 10027
| | | | - Sonia P Hashim
- Department of Computer Science, Princeton University, Princeton, NJ 08544
| | - Sonia Hausen
- Department of Sociology, Stanford University, Stanford, CA 94305
| | - Guanhua He
- Department of Molecular Biology, Princeton University, Princeton, NJ 08544
| | - Kimberly Higuera
- Department of Sociology, Stanford University, Stanford, CA 94305
| | - Bernie Hogan
- Oxford Internet Institute, University of Oxford, Oxford OX1 3JS, United Kingdom
| | - Ilana M Horwitz
- Graduate School of Education, Stanford University, Stanford, CA, 94305
| | - Lisa M Hummel
- Department of Sociology, Stanford University, Stanford, CA 94305
| | - Naman Jain
- Department of Operations Research and Financial Engineering, Princeton University, Princeton, NJ 08544
| | - Kun Jin
- Department of Computer Science, Ohio State University, Columbus, OH 43210
| | - David Jurgens
- School of Information, University of Michigan, Ann Arbor, MI 48104
| | - Patrick Kaminski
- Department of Sociology, Indiana University, Bloomington, IN 47405
- Center for Complex Networks and Systems Research, Indiana University, Bloomington, IN 47405
| | - Areg Karapetyan
- Department of Computer Science, Masdar Institute, Khalifa University, 127788 Abu Dhabi, United Arab Emirates
- Research Institute for Mathematical Sciences, Kyoto University, Kyoto 606-8502, Japan
| | - E H Kim
- Department of Sociology, Stanford University, Stanford, CA 94305
| | - Ben Leizman
- Department of Computer Science, Princeton University, Princeton, NJ 08544
| | - Naijia Liu
- Department of Politics, Princeton University,Princeton, NJ, 08544
| | - Malte Möser
- Department of Computer Science, Princeton University, Princeton, NJ 08544
| | - Andrew E Mack
- Department of Politics, Princeton University,Princeton, NJ, 08544
| | - Mayank Mahajan
- Department of Computer Science, Princeton University, Princeton, NJ 08544
| | - Noah Mandell
- Department of Astrophysical Sciences, Princeton University, Princeton, NJ 08544
| | - Helge Marahrens
- Department of Sociology, Indiana University, Bloomington, IN 47405
| | | | - Viola Mocz
- Department of Neuroscience, Princeton University, Princeton, NJ 08544
| | | | - Ahmed Musse
- Department of Electrical Engineering, Princeton University, Princeton, NJ, 08544
| | - Qiankun Niu
- Bendheim Center for Finance, Princeton University, Princeton, NJ 08544
| | | | - Hamidreza Omidvar
- Department of Civil and Environmental Engineering, Princeton University, Princeton, NJ 08544
| | - Andrew Or
- Department of Computer Science, Princeton University, Princeton, NJ 08544
| | - Karen Ouyang
- Department of Computer Science, Princeton University, Princeton, NJ 08544
| | - Katy M Pinto
- Department of Sociology, California State University, Dominguez Hills, Carson, CA 90747
| | - Ethan Porter
- School of Media and Public Affairs, George Washington University, Washington, DC 20052
| | | | - Crystal Qian
- Department of Computer Science, Princeton University, Princeton, NJ 08544
| | - Tamkinat Rauf
- Department of Sociology, Stanford University, Stanford, CA 94305
| | - Anahit Sargsyan
- Social Science Division, New York University Abu Dhabi, 129188 Abu Dhabi, United Arab Emirates
| | - Thomas Schaffner
- Department of Computer Science, Princeton University, Princeton, NJ 08544
| | - Landon Schnabel
- Department of Sociology, Stanford University, Stanford, CA 94305
| | - Bryan Schonfeld
- Department of Politics, Princeton University,Princeton, NJ, 08544
| | - Ben Sender
- Department of Economics, Princeton University, Princeton, NJ 08544
| | - Jonathan D Tang
- Department of Computer Science, Princeton University, Princeton, NJ 08544
| | - Emma Tsurkov
- Department of Sociology, Stanford University, Stanford, CA 94305
| | - Austin van Loon
- Department of Sociology, Stanford University, Stanford, CA 94305
| | - Onur Varol
- Center for Complex Network Research, Northeastern University Networks Science Institute, Boston, MA 02115
- Luddy School of Informatics, Computing, & Engineering, Indiana University, Bloomington, IN 47408
| | - Xiafei Wang
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, NY 13244
| | - Zhi Wang
- Luddy School of Informatics, Computing, & Engineering, Indiana University, Bloomington, IN 47408
- School of Public Health, Indiana University, Bloomington, IN 47408
| | - Julia Wang
- Department of Computer Science, Princeton University, Princeton, NJ 08544
| | - Flora Wang
- Department of Economics, Princeton University, Princeton, NJ 08544
| | - Samantha Weissman
- Department of Computer Science, Princeton University, Princeton, NJ 08544
| | - Kirstie Whitaker
- The Alan Turing Institute, London NW1 2DB, United Kingdom
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, United Kingdom
| | - Maria K Wolters
- School of Informatics, University of Edinburgh, Edinburgh EH8 9AB, United Kingdom
| | - Wei Lee Woon
- Department of Marketplaces & Yield Data Science, Expedia Group, Seattle, WA 98119
| | - James Wu
- Department of the Applied Statistics, Social Science, and Humanities, New York University, New York, NY 10003
| | - Catherine Wu
- Department of Computer Science, Princeton University, Princeton, NJ 08544
| | - Kengran Yang
- Department of Civil and Environmental Engineering, Princeton University, Princeton, NJ 08544
| | - Jingwen Yin
- Department of Statistics, Columbia University, New York, NY 10027
| | - Bingyu Zhao
- Department of Engineering, University of Cambridge, Cambridge CB2 1PZ, United Kingdom
| | - Chenyun Zhu
- Department of Statistics, Columbia University, New York, NY 10027
| | - Jeanne Brooks-Gunn
- Department of Human Development, Teachers College, Columbia University, New York, NY 10027
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032
| | - Barbara E Engelhardt
- Department of Computer Science, Princeton University, Princeton, NJ 08544
- Center for Statistics & Machine Learning, Princeton University, Princeton, NJ 08544
| | - Moritz Hardt
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA 94720
| | - Dean Knox
- Department of Politics, Princeton University,Princeton, NJ, 08544
| | - Karen Levy
- Department of Information Science, Cornell University, Ithaca, NY 14853
| | - Arvind Narayanan
- Department of Computer Science, Princeton University, Princeton, NJ 08544
| | | | - Duncan J Watts
- Department of Computer and Information Science, University of Pennsylvania, Philadelphia, PA 19104
- Annenberg School of Communication, University of Pennsylvania, Philadelphia, PA 19104
- Operations, Information and Decisions Department, University of Pennsylvania, Philadelphia, PA 19104
| | - Sara McLanahan
- Department of Sociology, Princeton University, Princeton, NJ 08544;
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Kim SU, Seo YS, Lee HA, Kim MN, Kim EH, Kim HY, Lee YR, Lee HW, Park JY, Kim DY, Ahn SH, Han KH, Hwang SG, Rim KS, Um SH, Tak WY, Kweon YO, Kim BK, Park SY. Validation of the CAMD Score in Patients With Chronic Hepatitis B Virus Infection Receiving Antiviral Therapy. Clin Gastroenterol Hepatol 2020; 18:693-699.e1. [PMID: 31252188 DOI: 10.1016/j.cgh.2019.06.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/29/2019] [Accepted: 06/16/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Researchers previously developed a scoring system to determine the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV) infection, based on the presence of cirrhosis, patient age, male sex, and diabetes (called the CAMD scoring system). We validated the CAMD scoring system and compared its performance with that of other risk assessment models in an independent cohort. METHODS We followed up 3277 patients with chronic HBV infection (mean age, 48.7 y; 62.6% male; 32.4% with cirrhosis) who were treated with entecavir (n = 1725) or tenofovir (n = 1552) as the first-line antiviral agent in 4 academic teaching hospitals in the Republic of Korea. The primary outcome was development of HCC. We evaluated the ability of the CAMD, PAGE-B, and mPAGE-B scoring systems to identify patients who would develop HCC using integrated area under the curve (iAUC) analysis. RESULTS Over a median follow-up period of 58.2 months, 8.9% of the patients developed HCC. Patients who developed HCC were older, more likely to be male, and had higher proportions of cirrhosis and diabetes than patients who did not develop HCC (all P < .05). CAMD scores identified patients who developed HCC with an iAUC of 0.790, mPAGE-B scores with an iAUC of 0.769, and PAGE-B scores with an iAUC of 0.760. The 5-year cumulative risks of HCC were 1.3% in patients with low CAMD scores (<8), 8.0% in patients with intermediate CAMD scores (8-13), and 24.3% in patients with high CAMD scores (>13) (P < .001 for comparison of low- vs intermediate-score groups and between intermediate- vs high-score groups). The predicted and observed probabilities of HCC had excellent agreement. CONCLUSIONS We validated the CAMD scoring system in determining the risk of HCC in patients with chronic HBV treatment receiving entecavir or tenofovir treatment. Validation was performed in a cohort of patients in the Republic of Korea, where most patients have genotype C2 HBV infection.
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Affiliation(s)
- Seung Up Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea; Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea
| | - Yeon Seok Seo
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Han Ah Lee
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Mi Na Kim
- Department of Internal Medicine, CHA Bundang Medical Center, Cha University, Seongnam, Republic of Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ha Yan Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yu Rim Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Hye Won Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea
| | - Jun Yong Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea; Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea
| | - Do Young Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea; Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea
| | - Sang Hoon Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea; Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea
| | - Kwang-Hyub Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea; Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea
| | - Seong Gyu Hwang
- Department of Internal Medicine, CHA Bundang Medical Center, Cha University, Seongnam, Republic of Korea
| | - Kyu Sung Rim
- Department of Internal Medicine, CHA Bundang Medical Center, Cha University, Seongnam, Republic of Korea
| | - Soon Ho Um
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Won Young Tak
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Young Oh Kweon
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Beom Kyung Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea; Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea.
| | - Soo Young Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
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Park YJ, Kong MK, Lee J, Kim EH, Bai SW. Manchester Operation: An Effective Treatment for Uterine Prolapse Caused by True Cervical Elongation. Yonsei Med J 2019; 60:1074-1080. [PMID: 31637890 PMCID: PMC6813150 DOI: 10.3349/ymj.2019.60.11.1074] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 08/11/2019] [Accepted: 08/14/2019] [Indexed: 12/03/2022] Open
Abstract
PURPOSE Descent of the uterus is a major etiology of uterine prolapse. However, true cervical elongation can cause uterine prolapse without uterine descent. The aim of study was to investigate the clinical outcomes of Manchester operation in patients with uterine prolapse caused by "true cervical elongation," compared with vaginal hysterectomy (VH). MATERIALS AND METHODS Medical records of patients who underwent Manchester operation or VH from 2006 to 2015 were reviewed. True cervical elongation was defined on the basis of C point of the Pelvic Organ Prolapse Quantification (POP-Q) system ≥0 and D point ≤-4, as well as estimated cervical length of ≥5 cm. The primary outcome was recurrence of pelvic organ prolapse (POP) evaluated by POP-Q system. The outcomes of two groups were compared after propensity score matching, for age, parity, and preoperative POP-Q stage. RESULTS During the study period, 23 patients underwent Manchester operation and 374 patients underwent VH. The recurrence rate of POP (p=0.317) and complication rate were not statistically significant different between the two study groups. Manchester operation exhibited shorter operation time than VH (p=0.033). In subgroup analysis (POP-Q stage III), body mass index [odds ratio (OR)=1.74; 95% confidence interval (CI), 1.08-2.81] and not having concurrent anterior colporrhaphy (OR for concurrent anterior colporrhaphy, 0.06; 95% CI, 0.01-0.75) were identified as significant risk factors for recurrence of POP. CONCLUSION The Manchester operation technique seems to be an effective and safe alternative procedure for the treatment of uterine prolapse caused by true cervical elongation, compared with VH.
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Affiliation(s)
- Yun Jin Park
- Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Mi Kyung Kong
- Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Jinae Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Wook Bai
- Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
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Kim SJ, Kim N, Kim EH, Roh YH, Song J, Park KH, Choi YS. Use Of Regional Anesthesia For Lower Extremity Amputation May Reduce The Need For Perioperative Vasopressors: A Propensity Score-Matched Observational Study. Ther Clin Risk Manag 2019; 15:1163-1171. [PMID: 31632043 PMCID: PMC6778747 DOI: 10.2147/tcrm.s213443] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 09/14/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose Lower extremity amputation (LEA) is associated with a high risk of postoperative mortality. The effect of type of anesthesia on postoperative mortality has been studied in various surgeries. However, data for guiding the selection of optimal anesthesia for LEA are limited. This study aimed to determine the effect of anesthesia type on perioperative outcomes in patients with diabetes and/or peripheral vascular disease undergoing LEA. Patients and methods We reviewed the medical records of patients who underwent LEA at our center between September 2007 and August 2017, who were grouped according to use of general anesthesia (GA) or regional anesthesia (RA). Primary outcomes were 30-day and 90-day mortality. Secondary outcomes were postoperative morbidity, intraoperative events, postoperative intensive care unit admission, and postoperative length of stay. Propensity score-matched cohort design was used to control for potentially confounding factors, including patient demographics, comorbidities, medications, and type of surgery. Results Five hundred and nineteen patients (75% male, mean age 65 years) were identified to have received GA (n=227) or RA (n=292) for above-knee amputation (1.5%), below-knee amputation (16%), or more minor amputation (82.5%). Before propensity score matching, there was an association of GA with coronary artery disease (44% [GA] vs 34.5% [RA], p=0.028), peripheral arterial disease (73.1% vs 60.2%, p=0.002), and preoperative treatment with aspirin and clopidogrel (68.7% vs 55.1%, p=0.001; 63% vs 41.8%, p<0.001, respectively). Propensity score matching produced a cohort of 342 patients equally divided between GA and RA. There was no significant between-group difference in 30-day (3.5% vs 2.9%, p=0.737) or 90-day (6.4% vs 4.6%, p=0.474) mortality or postoperative morbidity. However, postoperative ICU admission (14.6% vs 7%, p=0.032), intraoperative hypotension (61.4% vs 14.6%, p<0.001), and vasopressor use (52% vs 14%, p<0.001) were more common with GA than with RA. Conclusion Type of anesthesia did not significantly affect mortality or morbidity after LEA. However, intraoperative hypotension, vasopressor use, and postoperative ICU admission rates were lower with RA.
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Affiliation(s)
- Seon Ju Kim
- Department of Anesthesiology and Pain Medicine, National Health Insurance Service Ilsan Hospital, Goyang 10444, Korea
| | - Namo Kim
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 03722, Korea.,Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Yun Ho Roh
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Jeehyun Song
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Kwang Hwan Park
- Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Yong Seon Choi
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 03722, Korea.,Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 03722, Korea
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Yoon SH, Kim EH, Kim HY, Ahn JG. Presepsin as a diagnostic marker of sepsis in children and adolescents: a systemic review and meta-analysis. BMC Infect Dis 2019; 19:760. [PMID: 31470804 PMCID: PMC6717384 DOI: 10.1186/s12879-019-4397-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 08/23/2019] [Indexed: 12/15/2022] Open
Abstract
Background Early diagnosis of sepsis in pediatric patients is vital but remains a major challenge. Previous studies showed that presepsin is potentially a reliable diagnostic biomarker for sepsis in adult and neonates. However, there is no pooled analysis of its efficacy as a diagnostic biomarker for sepsis in children. The aims of the present meta-analysis were to assess the overall diagnostic accuracy of presepsin in pediatric sepsis and compare it to those for C-reactive protein (CRP) and procalcitonin (PCT). Methods A systematic literature search was performed in Medline/Pubmed, Embase, the Cochrane Library, and ISI Web of Science to identify relevant studies reporting the diagnostic accuracy of presepsin in patients with pediatric sepsis. Sensitivities and specificities were pooled by bivariate meta-analysis. Heterogeneity was evaluated by χ2 test. Results We identified 129 studies in total. Most were disqualified on the basis of their titles/abstracts and duplication. Four studies were included in the final analysis. They comprised 308 patients aged between 1 mo and 18 y. The pooled diagnostic sensitivity and specificity of presepsin were 0.94 (95% confidence interval [CI]: 0.74–0.99) and 0.71 (95% CI: 0.35–0.92), respectively. The pooled diagnostic odds ratio, positive likelihood ratio (LR), and negative LR of presepsin were 32.87 (95% CI: 2.12–510.09), 3.24 (95% CI, 1.14–12.38), and 0.08 (95% CI, 0.01–0.74), respectively. Heterogeneity was found in both sensitivity (χ2 = 11.17; P = 0.011) and specificity (χ2 = 65.78; P < 0.001). No threshold effect was identified among the studies (r = − 0.938). The pooled sensitivity of presepsin (0.94) was higher than that of CRP (0.51) and PCT (0.76), whereas the overall specificity of presepsin (0.71) was lower than that of CRP (0.81) and PCT (0.76). The AUC of presepsin (0.925) was higher than that of CRP (0.715) and PCT (0.820). Conclusion Currently available evidence indicates that presepsin has higher sensitivity and diagnostic accuracy, but lower specificity, than PCT or CRP in detecting sepsis in children. However, these results must be carefully interpreted as the number of studies included was small and the studies were statistically heterogeneous. Electronic supplementary material The online version of this article (10.1186/s12879-019-4397-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Seo Hee Yoon
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Ha Yan Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Gyun Ahn
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
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Kim SW, Kim EH, Lee J, Choi YC, Kim SM, Shin HY. Risk of osteoporosis in patients with chronic inflammatory neuropathy- a population-based cohort study. Sci Rep 2019; 9:9131. [PMID: 31235735 PMCID: PMC6591220 DOI: 10.1038/s41598-019-45591-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 05/30/2019] [Indexed: 12/16/2022] Open
Abstract
The risk of osteoporosis in patients with chronic inflammatory neuropathy (CIN) has not been evaluated in detail. We conducted a population-based case-control study nested in a retrospective cohort to analyze osteoporosis risk among patients with CIN using a nationwide database. Patients with CIN based on the Korean Classification of Disease diagnostic code were included and were matched to controls. A Cox proportional hazards regression model was used to evaluate the effect of CIN on osteoporosis. After propensity score matching, 585 CIN patients and 585 controls were selected. Patients with CIN had an increased osteoporosis risk (hazard ratio [HR] = 2.293, 95% confidence interval [CI] 1.460-3.601) compared with controls. The osteoporosis risk was higher among male patients with CIN than among male controls (HR = 5.404, 95% CI 2.252-12.969), while there were no significant differences among women. Among the CIN patients, the average daily dose of corticosteroids was higher in those who developed osteoporosis (19.6 mg [10.8-49.3]) than those who did not (16.2 mg [7.2-29.1], p = 0.001). The osteoporosis risk among CIN patients is higher than among controls. High risk of osteoporosis in male patients may indicate that osteoporosis in CIN patients results from the disease itself or related treatments.
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Affiliation(s)
- Seung Woo Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Jinae Lee
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Young-Chul Choi
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung Min Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Ha Young Shin
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
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Hong SJ, Kim MJ, Kim JS, Kim EH, Lee J, Ahn CM, Kim BK, Ko YG, Choi D, Hong MK, Jang Y. Effect of Perioperative Antiplatelet Therapy on Outcomes in Patients With Drug-Eluting Stents Undergoing Elective Noncardiac Surgery. Am J Cardiol 2019; 123:1414-1421. [PMID: 30770090 DOI: 10.1016/j.amjcard.2019.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 11/05/2018] [Revised: 01/27/2019] [Accepted: 02/05/2019] [Indexed: 12/21/2022]
Abstract
We investigated the association of perioperative antiplatelet therapy (APT) and outcomes in patients with drug-eluting stent (DES) placement for noncardiac surgery (NCS). In consecutive 23,358 patients who underwent percutaneous coronary interventions between 2005 and 2016, total of 2,179 patients that required 2,179 elective NCS after DES placement were retrospectively analyzed. A net adverse clinical event (NACE), composite of death, myocardial infarction, stent thrombosis, and major bleeding, was assessed at 30 days. Of 2,179 patients, 937 patients (43%) underwent NCS with discontinuation of APT. For overall, NACE occurred in 10 patients who discontinued APT (1.1%) and 22 patients who continued APT (1.8%) without significant differences (hazard ratio [HR] 0.60, 95% confidence interval [CI] 0.28 to 1.27, p = 0.182). Also, adjusted NACE event rates were not different between groups for overall NCSs (adjusted HR 0.76, 95% CI 0.38 to 1.52, p = 0.440), for NCSs >1, ≤12 months after DES, and for NCSs >12 months after DES. Our findings persisted (adjusted HR 1.26, 95% CI 0.51 to 3.10, p = 0.618) when those who continued dual-APT were excluded from the continuation of APT group due to a higher tendency of NACE compared with those who continued single-APT (adjusted HR 2.26, 95% CI 0.98 to 5.21, p = 0.055). However, the patients who discontinued APT for >7 days had a significantly higher NACE than those who discontinued for ≤7 days (adjusted HR 6.93, 95% CI 2.16 to 22.24, p = 0.001). In conclusion, discontinuation of APT may not be associated with higher NACEs 30 days postsurgery compared with continuation of APT, when APT was discontinued for ≤7 days in patients undergoing elective NCS after DES implantation.
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Affiliation(s)
- Sung-Jin Hong
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Korea
| | - Min-Ji Kim
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Korea
| | - Jung-Sun Kim
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Korea.
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Korea
| | - Jinae Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Korea
| | - Chul-Min Ahn
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Korea
| | - Byeong-Keuk Kim
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Korea
| | - Young-Guk Ko
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Korea
| | - Donghoon Choi
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Korea
| | - Myeong-Ki Hong
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Korea
| | - Yangsoo Jang
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Korea
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Kim YY, Kim MJ, Kim EH, Roh YH, An C. Hepatocellular Carcinoma versus Other Hepatic Malignancy in Cirrhosis: Performance of LI-RADS Version 2018. Radiology 2019; 291:72-80. [DOI: 10.1148/radiol.2019181995] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Yeun-Yoon Kim
- From the Department of Radiology (Y.Y.K., M.J.K., C.A.) and Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics (E.H.K., Y.H.R.), Severance Hospital, Yonsei University College of Medicine, Seodaemun-gu Yonsei-ro 50-1, Seoul 03722, Republic of Korea
| | - Myeong-Jin Kim
- From the Department of Radiology (Y.Y.K., M.J.K., C.A.) and Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics (E.H.K., Y.H.R.), Severance Hospital, Yonsei University College of Medicine, Seodaemun-gu Yonsei-ro 50-1, Seoul 03722, Republic of Korea
| | - Eun Hwa Kim
- From the Department of Radiology (Y.Y.K., M.J.K., C.A.) and Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics (E.H.K., Y.H.R.), Severance Hospital, Yonsei University College of Medicine, Seodaemun-gu Yonsei-ro 50-1, Seoul 03722, Republic of Korea
| | - Yun Ho Roh
- From the Department of Radiology (Y.Y.K., M.J.K., C.A.) and Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics (E.H.K., Y.H.R.), Severance Hospital, Yonsei University College of Medicine, Seodaemun-gu Yonsei-ro 50-1, Seoul 03722, Republic of Korea
| | - Chansik An
- From the Department of Radiology (Y.Y.K., M.J.K., C.A.) and Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics (E.H.K., Y.H.R.), Severance Hospital, Yonsei University College of Medicine, Seodaemun-gu Yonsei-ro 50-1, Seoul 03722, Republic of Korea
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Kim EH, Reddy DA, Lee H, Jeong S, Kumar DP, Song JK, Lim M, Kim TK. Hollow CoSe2 nanocages derived from metal–organic frameworks as efficient non-precious metal co-catalysts for photocatalytic hydrogen production. Catal Sci Technol 2019. [DOI: 10.1039/c9cy00843h] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Hollow structured CoSe2 nanocages are developed as efficient co-catalysts for photocatalytic hydrogen productions.
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Affiliation(s)
- Eun Hwa Kim
- Department of Chemistry and Chemistry Institute of Functional Materials
- Pusan National University
- Busan 46241
- Republic of Korea
| | | | - Hwan Lee
- Department of Chemistry and Chemistry Institute of Functional Materials
- Pusan National University
- Busan 46241
- Republic of Korea
| | - Seonghyun Jeong
- Department of Chemistry
- Kyung Hee University
- Seoul 02447
- Republic of Korea
| | - D. Praveen Kumar
- Department of Chemistry
- Yonsei University
- Seoul 03722
- Republic of Korea
| | - Jae Kyu Song
- Department of Chemistry
- Kyung Hee University
- Seoul 02447
- Republic of Korea
| | - Manho Lim
- Department of Chemistry and Chemistry Institute of Functional Materials
- Pusan National University
- Busan 46241
- Republic of Korea
| | - Tae Kyu Kim
- Department of Chemistry
- Yonsei University
- Seoul 03722
- Republic of Korea
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Kumar DP, Kim EH, Park H, Chun SY, Gopannagari M, Bhavani P, Reddy DA, Song JK, Kim TK. Tuning Band Alignments and Charge-Transport Properties through MoSe 2 Bridging between MoS 2 and Cadmium Sulfide for Enhanced Hydrogen Production. ACS Appl Mater Interfaces 2018; 10:26153-26161. [PMID: 30004215 DOI: 10.1021/acsami.8b02093] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Transition-metal dichalcogenide materials play a major role in the state-of-the-art innovations for energy conversion because of potential applications resulting from their unique properties. These materials additionally show inordinate potential toward the progress of hygienic power sources to deal with increasing environmental disputes at the time of skyrocketing energy demands. Herein, we report earth-abundant, few-layered, MoSe2-bridged MoS2/cadmium sulfide (CdS) nanocomposites, which reduce photogenerated electron and hole recombination by effectively separating charge carriers to achieve a high photocatalytic efficiency. Accordingly, the MoSe2-bridged MoS2/CdS system produced effective hydrogen (193 μmol·h-1) as that of water using lactic acid as a hole scavenger with the irradiation of solar light. The presence of few-layered MoSe2 bridges in MoS2/CdS successfully separates photogenerated charge carriers, thereby enhancing the shuttling of electrons on the surface to active edge sites. To the best of our knowledge, this few-layered MoSe2-bridged MoS2/CdS system exhibits the most effective concert among altogether-reported MoS2-based CdS composites. Notably, these findings with ample prospective for the development of enormously real photocatalytic systems are due to their economically viable and extraordinary efficiency.
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Affiliation(s)
- D Praveen Kumar
- Department of Chemistry and Chemical Institute for Functional Materials , Pusan National University , Busan 46241 , Republic of Korea
| | - Eun Hwa Kim
- Department of Chemistry and Chemical Institute for Functional Materials , Pusan National University , Busan 46241 , Republic of Korea
| | - Hanbit Park
- Department of Chemistry and Chemical Institute for Functional Materials , Pusan National University , Busan 46241 , Republic of Korea
| | - So Yeon Chun
- Department of Chemistry , Kyung Hee University , Seoul 02447 , Republic of Korea
| | - Madhusudana Gopannagari
- Department of Chemistry and Chemical Institute for Functional Materials , Pusan National University , Busan 46241 , Republic of Korea
| | - P Bhavani
- Department of Chemistry and Chemical Institute for Functional Materials , Pusan National University , Busan 46241 , Republic of Korea
| | - D Amaranatha Reddy
- Department of Chemistry and Chemical Institute for Functional Materials , Pusan National University , Busan 46241 , Republic of Korea
| | - Jae Kyu Song
- Department of Chemistry , Kyung Hee University , Seoul 02447 , Republic of Korea
| | - Tae Kyu Kim
- Department of Chemistry and Chemical Institute for Functional Materials , Pusan National University , Busan 46241 , Republic of Korea
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Park JC, Kim YJ, Kim EH, Lee J, Yang HS, Kim EH, Hahn KY, Shin SK, Lee SK, Lee YC. Effectiveness of the polysaccharide hemostatic powder in non-variceal upper gastrointestinal bleeding: Using propensity score matching. J Gastroenterol Hepatol 2018; 33:1500-1506. [PMID: 29415371 DOI: 10.1111/jgh.14118] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 12/29/2017] [Accepted: 01/25/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIM Recently, the application of hemostatic powder to the bleeding site has been used to treat active upper gastrointestinal bleeding (UGIB). We aimed to assess the effectiveness of the polysaccharide hemostatic powder (PHP) in patients with non-variceal UGIB. METHODS We reviewed prospectively collected 40 patients with UGIB treated with PHP therapy between April 2016 and January 2017 (PHP group) and 303 patients with UGIB treated with conventional therapy between April 2012 and October 2014 (conventional therapy group). We compared the rate of successful hemostasis and the rebleeding between the two groups after as well as before propensity score matching using the Glasgow-Blatchford score and Forrest classification. RESULTS Thirty patients treated with the PHP and 60 patients treated with conventional therapy were included in the matched groups. Baseline patient characteristics including comorbidities, vital signs, and bleeding scores were similar in the matched groups. The rate of immediate hemostasis and 7-day and 30-day rebleeding were also similar in the two groups before and after matching. In the subgroup analysis, no significant differences in immediate hemostasis or rebleeding rate were noted between PHP in monotherapy and PHP combined with a conventional hemostatic method. At 30 days after the therapy, there were no significant PHP-related complications or mortality. CONCLUSIONS Given its safety, the PHP proved feasible for endoscopic treatment of UGIB, having similar effectiveness as that of conventional therapy. The PHP may become a promising hemostatic method for non-variceal UGIB.
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Affiliation(s)
- Jun Chul Park
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Yeong Jin Kim
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Hye Kim
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jinae Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Su Yang
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
| | - Kyu Yeon Hahn
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Kwan Shin
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Kil Lee
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Chan Lee
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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Park YW, Han K, Ahn SS, Choi YS, Chang JH, Kim SH, Kang SG, Kim EH, Lee SK. Whole-Tumor Histogram and Texture Analyses of DTI for Evaluation of IDH1-Mutation and 1p/19q-Codeletion Status in World Health Organization Grade II Gliomas. AJNR Am J Neuroradiol 2018. [PMID: 29519794 DOI: 10.3174/ajnr.a5569] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Prediction of the isocitrate dehydrogenase 1 (IDH1)-mutation and 1p/19q-codeletion status of World Health Organization grade ll gliomas preoperatively may assist in predicting prognosis and planning treatment strategies. Our aim was to characterize the histogram and texture analyses of apparent diffusion coefficient and fractional anisotropy maps to determine IDH1-mutation and 1p/19q-codeletion status in World Health Organization grade II gliomas. MATERIALS AND METHODS Ninety-three patients with World Health Organization grade II gliomas with known IDH1-mutation and 1p/19q-codeletion status (18 IDH1 wild-type, 45 IDH1 mutant and no 1p/19q codeletion, 30 IDH1-mutant and 1p/19q codeleted tumors) underwent DTI. ROIs were drawn on every section of the T2-weighted images and transferred to the ADC and the fractional anisotropy maps to derive volume-based data of the entire tumor. Histogram and texture analyses were correlated with the IDH1-mutation and 1p/19q-codeletion status. The predictive powers of imaging features for IDH1 wild-type tumors and 1p/19q-codeletion status in IDH1-mutant subgroups were evaluated using the least absolute shrinkage and selection operator. RESULTS Various histogram and texture parameters differed significantly according to IDH1-mutation and 1p/19q-codeletion status. The skewness and energy of ADC, 10th and 25th percentiles, and correlation of fractional anisotropy were independent predictors of an IDH1 wild-type in the least absolute shrinkage and selection operator. The area under the receiver operating curve for the prediction model was 0.853. The skewness and cluster shade of ADC, energy, and correlation of fractional anisotropy were independent predictors of a 1p/19q codeletion in IDH1-mutant tumors in the least absolute shrinkage and selection operator. The area under the receiver operating curve was 0.807. CONCLUSIONS Whole-tumor histogram and texture features of the ADC and fractional anisotropy maps are useful for predicting the IDH1-mutation and 1p/19q-codeletion status in World Health Organization grade II gliomas.
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Affiliation(s)
- Y W Park
- From the Department of Radiology (Y.W.P.), Ewha Womans University College of Medicine, Seoul, Korea.,Departments of Radiology and Research Institute of Radiological Science (Y.W.P., K.H., S.S.A., Y.S.C., S.-K.L.)
| | - K Han
- Departments of Radiology and Research Institute of Radiological Science (Y.W.P., K.H., S.S.A., Y.S.C., S.-K.L.)
| | - S S Ahn
- Departments of Radiology and Research Institute of Radiological Science (Y.W.P., K.H., S.S.A., Y.S.C., S.-K.L.)
| | - Y S Choi
- Departments of Radiology and Research Institute of Radiological Science (Y.W.P., K.H., S.S.A., Y.S.C., S.-K.L.)
| | - J H Chang
- Neurosurgery (J.H.C., S.-G.K., E.H.K.)
| | - S H Kim
- Pathology (S.H.K.), Yonsei University College of Medicine, Seoul, Korea
| | - S-G Kang
- Neurosurgery (J.H.C., S.-G.K., E.H.K.)
| | - E H Kim
- Neurosurgery (J.H.C., S.-G.K., E.H.K.)
| | - S-K Lee
- Departments of Radiology and Research Institute of Radiological Science (Y.W.P., K.H., S.S.A., Y.S.C., S.-K.L.)
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Reddy DA, Park H, Gopannagari M, Kim EH, Lee S, Kumar DP, Kim TK. Designing CdS Mesoporous Networks on Co-C@Co 9 S 8 Double-Shelled Nanocages as Redox-Mediator-Free Z-Scheme Photocatalyst. ChemSusChem 2018; 11:245-253. [PMID: 28972688 DOI: 10.1002/cssc.201701643] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 09/30/2017] [Indexed: 06/07/2023]
Abstract
Designing porous nanostructures with unprecedented functionalities and an effective ability to harvest the maximum energy region of the solar spectrum and suppress the charge-carrier recombination rate offers promising potential for sustainable energy production. Although several functional porous nanostructures have been developed, high-efficiency materials are still needed. Herein, we report a new, highly active, noble-metal-free, and redox-mediator-free Z-scheme photocatalyst, CdS/Co-C@Co9 S8 , for H2 production through water splitting under solar irradiation. The designed photocatalytic system contains open 3 D CdS mesopores as a light absorber for wider solar-light harvesting. Metal-organicframework-derived cobalt nanocrystal-embedded few-layered carbon@Co9 S8 double-shelled nanocages were used as a co-semiconductor to hamper the photo charge-carrier recombination by accelerating the photogenerated electrons and holes from the other semiconductor. The optimized catalyst shows a H2 evolution rate of 26.69 mmol g-1 h-1 under simulated solar irradiation, which is 46 times higher than that of the as-synthesized CdS mesoporous nanostructures. The apparent quantum yield reached 7.82 % at λ=425 nm in 5 h. The outstanding photocatalytic activity of CdS/Co-C@Co9S8 reflects the favorable suppression of the charge-carrier recombination rate, as determined by photoluminescence, photocurrent, and impedance analyses. We believe that the findings reported here may inspire the design of new noble-metal-free porous nanohybrids for sustainable H2 production.
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Affiliation(s)
- D Amaranatha Reddy
- Department of Chemistry and Chemical Institute for Functional Materials, Pusan National University, Busan, 46241, Republic of Korea
| | - Hanbit Park
- Department of Chemistry and Chemical Institute for Functional Materials, Pusan National University, Busan, 46241, Republic of Korea
| | - Madhusudana Gopannagari
- Department of Chemistry and Chemical Institute for Functional Materials, Pusan National University, Busan, 46241, Republic of Korea
| | - Eun Hwa Kim
- Department of Chemistry and Chemical Institute for Functional Materials, Pusan National University, Busan, 46241, Republic of Korea
| | - Seunghee Lee
- Department of Chemistry and Chemical Institute for Functional Materials, Pusan National University, Busan, 46241, Republic of Korea
| | - D Praveen Kumar
- Department of Chemistry and Chemical Institute for Functional Materials, Pusan National University, Busan, 46241, Republic of Korea
| | - Tae Kyu Kim
- Department of Chemistry and Chemical Institute for Functional Materials, Pusan National University, Busan, 46241, Republic of Korea
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41
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Bhavani P, Praveen Kumar D, Jeong S, Kim EH, Park H, Hong S, Gopannagari M, Amaranatha Reddy D, Song JK, Kim TK. Multidirectional-charge-transfer urchin-type Mo-doped W18O49 nanostructures on CdS nanorods for enhanced photocatalytic hydrogen evolution. Catal Sci Technol 2018. [DOI: 10.1039/c7cy02162c] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The urchin shaped Mo doped W18O49 greatly enhances the charge transfer and photocatalytic efficiencies.
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Affiliation(s)
- P. Bhavani
- Department of Chemistry and Chemical Institute for Functional Materials
- Pusan National University
- Busan 46241
- Republic of Korea
| | - D. Praveen Kumar
- Department of Chemistry and Chemical Institute for Functional Materials
- Pusan National University
- Busan 46241
- Republic of Korea
| | - Seonghyun Jeong
- Department of Chemistry
- Kyung Hee University
- Seoul 17104
- Republic of Korea
| | - Eun Hwa Kim
- Department of Chemistry and Chemical Institute for Functional Materials
- Pusan National University
- Busan 46241
- Republic of Korea
| | - Hanbit Park
- Department of Chemistry and Chemical Institute for Functional Materials
- Pusan National University
- Busan 46241
- Republic of Korea
| | - Sangyeob Hong
- Department of Chemistry and Chemical Institute for Functional Materials
- Pusan National University
- Busan 46241
- Republic of Korea
| | - Madhusudana Gopannagari
- Department of Chemistry and Chemical Institute for Functional Materials
- Pusan National University
- Busan 46241
- Republic of Korea
| | - D. Amaranatha Reddy
- Department of Chemistry and Chemical Institute for Functional Materials
- Pusan National University
- Busan 46241
- Republic of Korea
| | - Jae Kyu Song
- Department of Chemistry
- Kyung Hee University
- Seoul 17104
- Republic of Korea
| | - Tae Kyu Kim
- Department of Chemistry and Chemical Institute for Functional Materials
- Pusan National University
- Busan 46241
- Republic of Korea
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Jung YS, Kim EH, Park CH. Editorial: replacing standard proton pump inhibitors with vonoprazan may breathe new life into triple therapy for Helicobacter pylori-authors' reply. Aliment Pharmacol Ther 2017; 46:551-552. [PMID: 28776746 DOI: 10.1111/apt.14206] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Y S Jung
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - E H Kim
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - C H Park
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
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Jung YS, Kim EH, Park CH. Systematic review with meta-analysis: the efficacy of vonoprazan-based triple therapy on Helicobacter pylori eradication. Aliment Pharmacol Ther 2017; 46:106-114. [PMID: 28497487 DOI: 10.1111/apt.14130] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 03/05/2017] [Accepted: 04/13/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND In order to increase eradication rates, vonoprazan, a novel potassium-competitive acid blocker, has been used in Helicobacter pylori eradication therapy. AIM To summarise the results of the efficacy of vonoprazan-based triple therapy, helping clinicians to better understand the benefit of vonoprazan in the treatment of H. pylori infection. METHODS We conducted a systematic literature search on MEDLINE, EMBASE, and the Cochrane Library using the primary keywords "vonoprazan," "takecab", "TAK-438," "potassium," "competitive," "potassium-competitive," "Helicobacter," and "pylori." Studies were included if they evaluated the eradication rate between the vonoprazan-based and proton pump inhibitor (PPI)-based triple therapies. RESULTS Ten studies and 10 644 patients were evaluated. The crude H. pylori eradication rate determined by intention-to-treat analysis was 87.9% and 72.8% in the vonoprazan-based triple therapy and PPI-based triple therapy respectively. The eradication rate of the vonoprazan-based triple therapy was superior to that of the PPI-based triple therapy (pooled risk ratio [RR] [95% confidence interval (CI)]=1.19 [1.15-1.24]) In addition, there was no significant difference in dropout rate due to adverse event between the regimens (pooled RR of the vonoprazan-based triple therapy [95% CI]=0.69 [0.23-2.03]). The incidence of any adverse events also did not differ between the regimens (pooled RR [95% CI]=1.02 [0.78-1.34]). CONCLUSIONS The vonoprazan-based triple therapy showed superior efficacy in terms of H. pylori eradication as compared to the PPI-based triple therapy. In addition, the vonoprazan-based triple therapy showed comparable tolerability and incidence of adverse events.
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Affiliation(s)
- Y S Jung
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - E H Kim
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - C H Park
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
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Choi YS, Ahn SS, Lee HJ, Chang JH, Kang SG, Kim EH, Kim SH, Lee SK. The Initial Area Under the Curve Derived from Dynamic Contrast-Enhanced MRI Improves Prognosis Prediction in Glioblastoma with Unmethylated MGMT Promoter. AJNR Am J Neuroradiol 2017. [PMID: 28642265 DOI: 10.3174/ajnr.a5265] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Although perfusion and permeability MR parameters have known to have prognostic value, they have reproducibility issues. Our aim was to evaluate whether the initial area under the time-to-signal intensity curve (IAUC) derived from dynamic contrast-enhanced MR imaging can improve prognosis prediction in patients with glioblastoma with known MGMT status. MATERIALS AND METHODS We retrospectively examined 88 patients with glioblastoma who underwent preoperative dynamic contrast-enhanced MR imaging. The means of IAUC values at 30 and 60 seconds (IAUC30mean and IAUC60mean) were extracted from enhancing tumors. The prognostic values of IAUC parameters for overall survival and progression-free survival were assessed with log-rank tests, according to the MGMT status. Multivariate overall survival and progression-free survival models before and after adding the IAUC parameters as covariates were explored by net reclassification improvement after receiver operating characteristic analysis for 1.5-year overall survival and 1-year progression-free survival and by random survival forest. RESULTS High IAUC parameters were associated with worse overall survival and progression-free survival in the unmethylated MGMT group, but not in the methylated group. In the unmethylated MGMT group, 1.5-year overall survival and 1-year progression-free survival prediction improved significantly after adding IAUC parameters (overall survival area under the receiver operating characteristic curve, 0.86; progression-free survival area under the receiver operating characteristic curve, 0.74-0.76) to the model with other prognostic factors (overall survival area under the receiver operating characteristic curve, 0.81; progression-free survival area under the receiver operating characteristic curve, 0.69; P < .05 for all) except in the case of IAUC60mean for 1-year progression-free survival prediction (P = .059). Random survival forest models indicated that the IAUC parameters were the second or most important predictors in the unmethylated MGMT group, except in the case of the IAUC60mean for progression-free survival. CONCLUSIONS IAUC can be a useful prognostic imaging biomarker in patients with glioblastoma with known MGMT status, improving prediction of glioblastoma prognosis with the unmethylated MGMT promoter status.
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Affiliation(s)
- Y S Choi
- From the Department of Radiology and Research Institute of Radiological Science (Y.S.C., S.S.A., H.-J.L., S.-K.L.)
| | - S S Ahn
- From the Department of Radiology and Research Institute of Radiological Science (Y.S.C., S.S.A., H.-J.L., S.-K.L.)
| | - H-J Lee
- From the Department of Radiology and Research Institute of Radiological Science (Y.S.C., S.S.A., H.-J.L., S.-K.L.)
| | - J H Chang
- Neurosurgery (J.H.C., S.-G.K., E.H.K.), Yonsei University College of Medicine, Seoul, Korea
| | - S-G Kang
- Neurosurgery (J.H.C., S.-G.K., E.H.K.), Yonsei University College of Medicine, Seoul, Korea
| | - E H Kim
- Neurosurgery (J.H.C., S.-G.K., E.H.K.), Yonsei University College of Medicine, Seoul, Korea
| | - S H Kim
- Departments of Pathology (S.H.K.)
| | - S-K Lee
- From the Department of Radiology and Research Institute of Radiological Science (Y.S.C., S.S.A., H.-J.L., S.-K.L.)
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Movafagh S, Raj D, Sanaei-Ardekani M, Bhatia D, Vo K, Mahmoudieh M, Rahman R, Kim EH, Harralson AF. Hypoxia Inducible Factor 1: A Urinary Biomarker of Kidney Disease. Clin Transl Sci 2017; 10:201-207. [PMID: 28181420 PMCID: PMC5421733 DOI: 10.1111/cts.12445] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 01/03/2017] [Indexed: 01/22/2023] Open
Abstract
Identifying noninvasive biomarkers of kidney disease is valuable for diagnostic and therapeutic purposes. Hypoxia inducible factor 1 (HIF-1) expression is known to be elevated in the kidneys in several renal disease pathologies. We hypothesized that the urinary HIF-1a mRNA level may be a suitable biomarker for expression of this protein in chronic kidney disease (CKD). We compared HIF-1a mRNA levels from urine pellets of CKD and healthy subjects. To ensure that urinary HIF-1a mRNA is of kidney origin, we examined colocalization of HIF-1a mRNA with two kidney specific markers in urine cells. We found that HIF-1a mRNA is readily quantifiable in urine pellets and its expression was significantly higher in CKD patients compared with healthy adults. We also showed that the urinary HIF-1a mRNA comes primarily from cells of renal origin. Our data suggest that urinary HIF-1a mRNA is a potential biomarker in CKD and can be noninvasively assessed in patients.
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Affiliation(s)
- S Movafagh
- Department of Pharmacogenomics, Bernard J. Dunn School of Pharmacy, Shenandoah University, Ashburn, Virginia, USA
| | - D Raj
- Department of Nephrology, George Washington University Division of Kidney Diseases and Hypertension, Washington, DC, USA
| | | | - D Bhatia
- Department of Pharmacogenomics, Bernard J. Dunn School of Pharmacy, Shenandoah University, Ashburn, Virginia, USA
| | - K Vo
- Bernard J. Dunn School of Pharmacy, Shenandoah University, Ashburn, Virginia, USA
| | - M Mahmoudieh
- Bernard J. Dunn School of Pharmacy, Shenandoah University, Ashburn, Virginia, USA
| | - R Rahman
- Kidney and Hypertension Specialists, Manassas, Virginia, USA
| | - E H Kim
- Kidney and Hypertension Specialists, Manassas, Virginia, USA
| | - A F Harralson
- Department of Pharmacogenomics, Bernard J. Dunn School of Pharmacy, Shenandoah University, Ashburn, Virginia, USA
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Burk CM, Kulis M, Leung N, Kim EH, Burks AW, Vickery BP. Utility of component analyses in subjects undergoing sublingual immunotherapy for peanut allergy. Clin Exp Allergy 2016; 46:347-53. [PMID: 26362760 DOI: 10.1111/cea.12635] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 04/15/2015] [Revised: 08/07/2015] [Accepted: 08/24/2015] [Indexed: 01/23/2023]
Abstract
BACKGROUND Sublingual immunotherapy (SLIT) with peanut changes clinical and immune responses in most peanut-allergic individuals, but the response is highly variable. OBJECTIVE We sought to examine the component-specific effects of peanut SLIT and determine whether peanut component testing could predict the outcome of a double-blind, placebo-controlled food challenge (DBPCFC) after 12 months of peanut SLIT. METHODS We included 33 subjects who underwent peanut SLIT with a DBPCFC of 2500 mg of peanut protein performed after 12 months of therapy. Plasma samples from baseline and after 12 months of peanut SLIT were assayed using ImmunoCAP for IgE and IgG4 against whole peanut, Ara h 1, Ara h 2, Ara h 3, Ara h 8, and Ara h 9. RESULTS Following 12 months of SLIT, 10 subjects (30%) passed the DBPCFC without symptoms and were considered desensitized. Subjects that failed the DBPCFC tolerated a median of 460 mg peanut protein (range: 10-1710 mg). The desensitized group had significantly lower baseline levels of IgE against peanut (median 40.8 vs. 231 kUA /L, P = 0.0082), Ara h 2 (median 17 vs. 113 kUA /L, P = 0.0082), and Ara h 3 (median 0.3 vs. 8.5 kUA /L, P = 0.0396). ROC curves indicated that baseline IgE against peanut and Ara h 2 were equally effective at discriminating between the two groups (AUC = 0.7957, P = 0.007752 for both). CONCLUSION AND CLINICAL RELEVANCE In this cohort of subjects undergoing SLIT for peanut allergy, lower baseline levels of IgE against Ara h 2, Ara h 3, and peanut were associated with successful desensitization.
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Affiliation(s)
- C M Burk
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M Kulis
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - N Leung
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - E H Kim
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - A W Burks
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - B P Vickery
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Müller H, Haag I, Jessen F, Kim EH, Klaus J, Konkol C, Bechdolf A. [Cognitive Behavioral Therapy and Assertive Community Treatment Reduces Days in Hospital and Delays Hospital Admission in Severe Psychotic Disorders]. Fortschr Neurol Psychiatr 2016; 84:76-82. [PMID: 26953546 DOI: 10.1055/s-0042-102055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The primary aim of this study was to assess the effectiveness of integrated home treatment (IV, i. e. intensive cognitive behavioral therapy and pharmacotherapy provided within a framework of assertive community treatment) in individuals with severe mental disorders (n = 13) within the German healthcare system. A treatment-as-usual group (TAU, n = 13) was identified by propensity score matching. Symptoms (CGI), functioning (GAF) and service engagement (SES) were assessed. Quality of life (MSLQ-R) was rated by the IV patients. A reduction of days spent in hospital [IV: 2.3 (6.1); TAU: 33.6 (53.6); Z = 45; p = 0.044], time to admission (IV: 384 days 95% CI 309 - 459.1; TAU: 234.9 days 95% CI 127.2 - 342.5; log rank: Chi-square = 4.31, p < 0.05), severity of the illness (p < 0.01), positive symptoms (p < 0.001), and cognitive symptoms (p < 0.05), as well as functioning (p < 0.05) and service engagement (p < 0.05) was observed in IV patients. Despite differences on a descriptive level, differences in total admissions (IV: 15.3%; TAU: 53.8%; odds ratio = 0.155, 95% CI 0.0243 - 1.00) were not significant. A methodological limitation is that symptom ratings were not performed by independent and blinded raters.
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Affiliation(s)
- H Müller
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinik Köln
| | - I Haag
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinik Köln
| | - F Jessen
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinik Köln
| | - E H Kim
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinik Köln
| | - J Klaus
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinik Köln
| | - C Konkol
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinik Köln
| | - A Bechdolf
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinik Köln
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Kim EH, Song SH, Kim GS, Ko JS, Gwak MS, Lee SK. Evaluation of "flat-line" thromboelastography after reperfusion during liver transplantation. Transplant Proc 2015; 47:457-9. [PMID: 25769590 DOI: 10.1016/j.transproceed.2014.11.032] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 11/04/2014] [Accepted: 11/19/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND "Flat-line" (no clot formation) thromboelastography (TEG) is frequently observed after graft reperfusion during liver transplantation (LT). We aimed to evaluate the incidence and causes of flat-line TEG after graft reperfusion during LT. METHODS With institutional review board approval, data of 208 consecutive recipients who underwent LT from May 2010 to May 2012 were retrospectively reviewed. We performed 3 different types of TEG measurements at 5 minutes after graft reperfusion: native TEG (nTEG), tranexamic acid-added TEG (tTEG), and protamine-added TEG (pTEG). The flat-line TEG was defined as having no trace at all at 60 minutes of TEG. We examined the incidence and causes of flat-line nTEG. We also compared recipients with flat-line nTEG (F group) and clot-forming nTEG (C group). RESULTS One hundred eighty-two recipients were included in the final analysis. The incidence of flat-line nTEG was 27% (49/182 cases). Among 49 recipients in the F group, 28 recipients showed clot formation in both tTEG and pTEG, 19 recipients in only tTEG, and 1 recipient in only pTEG; 1 recipient showed no clot formation in any TEGs. Graft from the deceased donor was more frequently observed in the F group than in the C group (P = .039). The F group showed decreased platelet count (P = .001), increased prothrombin time (P = .002), and decreased fibrinogen (P = .009) compared with the C group. CONCLUSIONS No clot formation was relatively common after reperfusion during LT, and the main causes were hyperfibrinolysis and heparin effect. Liver graft from deceased donors was associated more frequently with no clot formation after reperfusion during LT.
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Affiliation(s)
- E H Kim
- Department of Anesthesiology and Pain Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S H Song
- Department of Anesthesiology and Pain Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - G S Kim
- Department of Anesthesiology and Pain Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - J S Ko
- Department of Anesthesiology and Pain Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - M S Gwak
- Department of Anesthesiology and Pain Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S K Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Choi YS, Kim DW, Lee SK, Chang JH, Kang SG, Kim EH, Kim SH, Rim TH, Ahn SS. The Added Prognostic Value of Preoperative Dynamic Contrast-Enhanced MRI Histogram Analysis in Patients with Glioblastoma: Analysis of Overall and Progression-Free Survival. AJNR Am J Neuroradiol 2015; 36:2235-41. [PMID: 26338911 DOI: 10.3174/ajnr.a4449] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/20/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE The prognostic value of dynamic contrast-enhanced MR imaging in patients with glioblastoma is controversial. We investigated the added prognostic value of dynamic contrast-enhanced MR imaging to clinical parameters and molecular biomarkers in patients with glioblastoma by using histogram analysis. MATERIALS AND METHODS This retrospective study consisted of 61 patients who underwent preoperative dynamic contrast-enhanced MR imaging for glioblastoma. The histogram parameters of dynamic contrast-enhanced MR imaging, including volume transfer constant, extravascular extracellular volume fraction, and plasma volume fraction, were calculated from entire enhancing tumors. Univariate analyses for overall survival and progression-free survival were performed with preoperative clinical and dynamic contrast-enhanced MR imaging parameters and postoperative molecular biomarkers. Multivariate Cox regression was performed to build pre- and postoperative models for overall survival and progression-free survival. The performance of models was assessed by calculating the Harrell concordance index. RESULTS In univariate analysis, patients with higher volume transfer constant and extravascular extracellular volume fraction values showed worse overall survival and progression-free survival, whereas plasma volume fraction showed no significant correlation. In multivariate analyses for overall survival, the fifth percentile value of volume transfer constant and kurtosis of extravascular extracellular volume fraction were independently prognostic in the preoperative model, and kurtosis of volume transfer constant and extravascular extracellular volume fraction were independently prognostic in the postoperative model. For progression-free survival, independent prognostic factors were minimum and fifth percentile values of volume transfer constant and kurtosis of extravascular extracellular volume fraction in the preoperative model and kurtosis of extravascular extracellular volume fraction in the postoperative model. The performance of preoperative models for progression-free survival was significantly improved when minimum or fifth percentile values of volume transfer constant and kurtosis of extravascular extracellular volume fraction were added. CONCLUSIONS Higher volume transfer constant and extravascular extracellular volume fraction values are associated with worse prognosis, and dynamic contrast-enhanced MR imaging may have added prognostic value in combination with preoperative clinical parameters, especially in predicting progression-free survival.
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Affiliation(s)
- Y S Choi
- From the Departments of Radiology and Research Institute of Radiological Science (Y.S.C., S.-K.L., S.S.A.)
| | - D W Kim
- Department of Policy Research Affairs (D.W.K.), National Health Insurance Service Ilsan Hospital, Goyang, Gyeonggi-do, Korea
| | - S-K Lee
- From the Departments of Radiology and Research Institute of Radiological Science (Y.S.C., S.-K.L., S.S.A.)
| | - J H Chang
- Neurosurgery (J.H.C., S.-G.K., E.H.K.)
| | - S-G Kang
- Neurosurgery (J.H.C., S.-G.K., E.H.K.)
| | - E H Kim
- Neurosurgery (J.H.C., S.-G.K., E.H.K.)
| | | | - T H Rim
- Ophthalmology (T.H.R.), Yonsei University College of Medicine, Seoul, Korea
| | - S S Ahn
- From the Departments of Radiology and Research Institute of Radiological Science (Y.S.C., S.-K.L., S.S.A.)
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Tai DS, Hu C, Lee CCI, Martinez M, Cantero G, Kim EH, Tarantal AF, Lipshutz GS. Development of operational immunologic tolerance with neonatal gene transfer in nonhuman primates: preliminary studies. Gene Ther 2015; 22:923-30. [PMID: 26333349 DOI: 10.1038/gt.2015.65] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 05/22/2015] [Accepted: 06/18/2015] [Indexed: 02/05/2023]
Abstract
Achieving persistent expression is a prerequisite for effective genetic therapies for inherited disorders. These proof-of-concept studies focused on adeno-associated virus (AAV) administration to newborn monkeys. Serotype rh10 AAV expressing ovalbumin and green fluorescent protein (GFP) was administered intravenously at birth and compared with vehicle controls. At 4 months postnatal age, a second injection was administered intramuscularly, followed by vaccination at 1 year of age with ovalbumin and GFP. Ovalbumin was highest 2 weeks post administration in the treated monkey, which declined but remained detectable thereafter; controls demonstrated no expression. Long-term AAV genome copies were present in myocytes. At 4 weeks, neutralizing antibodies to rh10 were present in the experimental animal only. With AAV9 administration at 4 months, controls showed transient ovalbumin expression that disappeared with the development of strong anti-ovalbumin and anti-GFP antibodies. In contrast, increased and maintained ovalbumin expression was noted in the monkey administered AAV at birth, without antibody development. After vaccination, the experimental monkey maintained levels of ovalbumin without antibodies, whereas controls demonstrated high levels of antibodies. These preliminary studies suggest that newborn AAV administration expressing secreted and intracellular xenogenic proteins may result in persistent expression in muscle, and subsequent vector administration can result in augmented expression without humoral immune responses.
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Affiliation(s)
- D S Tai
- Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - C Hu
- Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - C C I Lee
- California National Primate Research Center and Departments of Pediatrics and Cell Biology and Human Anatomy, University of California, Davis, CA, USA
| | - M Martinez
- California National Primate Research Center and Departments of Pediatrics and Cell Biology and Human Anatomy, University of California, Davis, CA, USA
| | - G Cantero
- Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - E H Kim
- Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - A F Tarantal
- California National Primate Research Center and Departments of Pediatrics and Cell Biology and Human Anatomy, University of California, Davis, CA, USA
| | - G S Lipshutz
- Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,Department of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,Intellectual and Developmental Disabilities Research Center, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,Broad Center of Regenerative Medicine and Stem Cell Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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