1
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Won Y, Lee GW, Shin JO, Roh D, Kim Y, Won SH, Lee J, Shin K, Kim H, Ko H, Kim B, Kim MB. Nail apparatus changes following upper limb casting or splinting. J Eur Acad Dermatol Venereol 2024; 38:e407-e409. [PMID: 38058239 DOI: 10.1111/jdv.19634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/09/2023] [Indexed: 12/08/2023]
Affiliation(s)
- Yumi Won
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Gi-Wook Lee
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jun-Oh Shin
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Dongyoung Roh
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Yeona Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Sang-Hyeon Won
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jungsoo Lee
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Kihyuk Shin
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hoonsoo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hyunchang Ko
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Byungsoo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Moon-Bum Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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Kim TR, Bae KN, Son JH, Shin K, Kim H, Ko H, Kim B, Kim MB. A Case of Cavernous Sinus Syndrome Due to Extranodal Diffuse Large B-Cell Lymphoma. Ann Dermatol 2023; 35:S300-S303. [PMID: 38061726 PMCID: PMC10727854 DOI: 10.5021/ad.22.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 11/07/2022] [Accepted: 01/02/2023] [Indexed: 12/20/2023] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin's lymphoma accounting for approximately one-third of all cases. DLBCL can present as a lymph node or extranodal tumor. Cavernous sinus (CS) is a small but complex structure in which various arteries, sympathetic plexuses, and cranial nerves are passing through. Cavernous sinus syndrome (CSS) results from any disease process that affects CS including tumor, vascular disease, infection, or inflammation. Herein, we report a case of extranodal DLBCL diagnosed by skin biopsy presenting as CSS. A 58-year-old male presented with a 3-week-old, gradually growing subcutaneous nodule on the left upper lip. He also suffered from ptosis, ophthalmoplegia, diplopia, and headache confined to the right side for 3 months. Histopathologic examination of the left upper lip showed dense dermal infiltration of atypical large tumor cells resembling centroblasts and immunoblasts. Immunohistochemistry studies revealed that the tumor cells were positive for CD20, BCL2, BCL6, MUM1, and MYC. After additional radiologic evaluation with positron emission tomography-computed tomography (PET-CT), brain magnetic resonance imaging, and orbital CT, he was finally diagnosed with extranodal DLBCL involving the right CS, oculomotor muscles, and left upper lip.
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Affiliation(s)
- Tae-Rim Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Kyung-Nam Bae
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Jin-Hwa Son
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Kihyuk Shin
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Hoonsoo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Hyunchang Ko
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Byungsoo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Moon-Bum Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
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3
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Kim TR, Won Y, Kim Y, Won SH, Bae KN, Lee J, Shin K, Kim H, Ko H, Kim MB, Kim B. Predictors of Psoriasis Area and Severity Index 100 response in Korean patients with moderate-to-severe plaque psoriasis receiving biologics. Eur J Dermatol 2023; 33:518-523. [PMID: 38297928 DOI: 10.1684/ejd.2023.4555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
The Psoriasis Area and Severity Index (PASI) 100 response rate after treatment with biologics is reportedly lower in Asians than non-Asians. Large-scale studies evaluating predictors of PASI 100 response in Korean patients with psoriasis are yet to be conducted. To identify predictors of patients achieving PASI 100 response after 48-52 weeks of treatment with a biological agent. We retrospectively reviewed the medical records of 145 patients with psoriasis treated with a single biological agent for over one year. Clinical features were compared between super-responders (defined as achieving PASI 100 at 48-52 weeks) and non-super-responders. Among the patients included in the study, 61 (42.1%) were super-responders. No statistical difference in demographics and face, scalp, or nail involvement was observed. However, the mean body mass index (BMI) and baseline PASI were lower in super-responders (24.3 kg/m2, 14.3) than in non-super-responders (26.1 kg/m2, 16.2). There were more biologically naïve patients among the super-responders (85.2%) than the non-super-responders (67.9%). In Korean patients with moderate-to-severe psoriasis, a better PASI 100 response is expected for patients who are biologically naïve with a relatively lower baseline BMI and PASI.
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Affiliation(s)
- Tae-Rim Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Yumi Won
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Yeona Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Sang-Hyeon Won
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Kyung-Nam Bae
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Jungsoo Lee
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Kihyuk Shin
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Hoonsoo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Hyunchang Ko
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Moon-Bum Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Byungsoo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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Yang TY, Li WC, Chen PKT, Olisova K, Ko H, Chang TY. Novel approach to distinguish submucous cleft palate from isolated cleft palate by ultrasound visualization of fetal swallowing. Ultrasound Obstet Gynecol 2023; 62:603-605. [PMID: 37058361 DOI: 10.1002/uog.26217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/27/2023] [Accepted: 03/31/2023] [Indexed: 06/19/2023]
Affiliation(s)
- T-Y Yang
- Department of Fetal Medicine, Taiji Clinic, Taipei, Taiwan
| | - W-C Li
- Department of Obstetrics and Gynecology, Puli Christian Hospital, Puli Township, Taiwan
| | - P K-T Chen
- Department of Plastic Surgery, Taipei Medical University Hospital, Taipei, Taiwan
| | - K Olisova
- Department of Medical Research, Taiji Clinic, Taipei, Taiwan
| | - H Ko
- Department of Fetal Medicine, Taiji Clinic, Taipei, Taiwan
| | - T-Y Chang
- Department of Fetal Medicine, Taiji Clinic, Taipei, Taiwan
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Ko H, Lee SM, Chang HK, Min SY, Cho K, Park MS. Laparoscopic total extra-peritoneal (TEP) inguinal hernia repair under local anesthesia by topical lidocaine injection. Hernia 2023; 27:113-118. [PMID: 35939245 DOI: 10.1007/s10029-022-02653-3] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/12/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Laparoscopic total extra-peritoneal (TEP) inguinal hernia repair is usually performed under general anesthesia (GA) for muscle relaxation. However, TEP hernia repair may be reluctant in high-risk patients of GA. The aim of this study was to compare the outcomes of the TEP under GA and local anesthesia (LA). METHODS We retrospectively analyzed patients with inguinal hernia who underwent TEP under GA or LA in a single center from December 2016 to May 2018. The outcomes, such as demographics, duration of surgery, length of hospital stay, visual analog scale (VAS), and postoperative complications, were compared in each group. RESULTS Seventy-six patients with inguinal hernia underwent TEP under GA (n = 52) or LA (n = 24). Total operation time (mean ± standard deviation; GA, 111.6 ± 23.0 min; LA, 76.3 ± 18.0 min; p < 0.001) and length of hospital stay (GA, 38.3 ± 11.6 min; LA, 30.3 ± 15.6 min; p < 0.014) were shorter in LA group compared to GA group. There were no significant differences in postoperative VAS (1 h, p = 0.247; 4 h, p = 0.086; 12 h, p = 0.469; 24 h, p = 0.411), postoperative adverse effects (vomiting, p = 0.570; urinary retention, p = 0.214; headache, p = 0.494), and postoperative complications (seroma, p = 0.348; scrotal edema, p = 0.178; recurrence, p = 0.822) between LA group and GA group. CONCLUSION Compared with GA, there were no differences in postoperative pain and complications in patients who underwent TEP hernia repair under LA. Furthermore, in LA group, total operation time and length of hospital stay were shortened.
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Affiliation(s)
- H Ko
- Department of Surgery, College of Medicine, Kyung Hee University, 23, Kyung Hee Dae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - S M Lee
- Department of Surgery, College of Medicine, Kyung Hee University, 23, Kyung Hee Dae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - H K Chang
- Department of Surgery, College of Medicine, Kyung Hee University, 23, Kyung Hee Dae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - S Y Min
- Department of Surgery, College of Medicine, Kyung Hee University, 23, Kyung Hee Dae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - K Cho
- Department of Surgery, College of Medicine, Kyung Hee University, 23, Kyung Hee Dae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - M-S Park
- Department of Surgery, College of Medicine, Kyung Hee University, 23, Kyung Hee Dae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
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Kimminau E, Karnezos T, Ko H, Fasina Y, Kim W. Phytogenic blend administered through water impacts Salmonella infection in broiler chickens. J APPL POULTRY RES 2022. [DOI: 10.1016/j.japr.2022.100320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Ko H, Park Y, Kim J, Yang G, Byun H, Kim Y, Jung W, Park G, Lee H, Hong C, Kim K, Chang J. Axillary-Lateral Thoracic Vessel Juncture Radiotherapy Dose Constraints for Predicting Long-Term Lymphedema Risk in Patients with Breast Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Kim J, Kim J, Ko H, Kim T, Choi S, Sung W, Shin S, Chang J. Risk Stratification Based on Whole Body Tumor Burden can be Key for Refining the Role of Combining Radiation Therapy and Immune Checkpoint Inhibitors in Metastatic Disease. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Jiang SX, Feizi Farivar J, MacIsaac J, Tam E, Choi M, Luyun P, Ko H, Ramji A. A214 SIMPLIFICATION OF CARE FOR HCV IS EFFECTIVE DURING THE COVID PANDEMIC: A RETROSPECTIVE STUDY OF HCV TREATMENT UTILIZING THE BRITISH COLUMBIA HEPATITIS C NETWORK. J Can Assoc Gastroenterol 2022. [PMCID: PMC8859372 DOI: 10.1093/jcag/gwab049.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The COVID-19 pandemic has impacted healthcare access, including to curative treatment for hepatitis C (HCV) infection in the form of direct-acting antivirals (DAAs). A 49% decrease in DAA dispensations in Canada during the pandemic has been reported, but little is known about these treated populations.
Aims
To explore the patient characteristics and treatment patterns in those who were treated for HCV during the COVID pandemic.
Methods
A retrospective chart review was conducted at one site of utilizing the British Columbia Hepatitis C Network. Only patients included into the database were analyzed. Patients started on treatment between 03/17/2020-03/16/2021 were included as the “pandemic group” and patients from the 03/17/2019-03/16/2020 were included as a comparison “pre-pandemic group”. Data were extracted for clinicodemographic variables, laboratory investigations, treatment start date, regimen, and sustained virologic response at 12 weeks (SVR12).
Results
97 patients were treated during the pandemic compared to 143 patients the year prior, representing a 32% decline. Patients treated during the pandemic were predominantly new referrals (n=70, 72% vs n=64, 45% pre-pandemic, p<0.01) and had fewer total appointments (median 2 per patient vs 4 per patient pre-pandemic, p<0.01). There was a median of 1 in-person visit and 1 telehealth appointment per patient during the pandemic (vs median 2 per patient of each type pre-pandemic).
Pandemic patients were younger (mean age 56.0 years vs 59.6 pre-pandemic, p=0.04), and a greater proportion were on opioid agonist therapy (28% vs 13% pre-pandemic, p<0.01). Less transient elastography (TE) was performed during the pandemic (69% vs 89% pre-pandemic). Amongst those with TE scores, a lower proportion of those treated during the pandemic were cirrhotic (13% vs 21% pre-pandemic).
During the pandemic, treatment patterns shifted towards more prescriptions for glecaprevir/pibrentasvir (56% of all prescriptions vs 44% pre-pandemic) and sofosbuvir/velpatasvir (37% vs 29% pre-pandemic). There was slightly less use of sofosbuvir/velpatasvir/voxilaprevir at (2% vs 4% pre-pandemic).
The proportion of patients who completed lab work for SVR was similar during the pandemic (n=83/97, 85.6%) compared to pre-pandemic (n=120/143, 83.9%). Similarly, SVR12 remained high during the pandemic at 98.7% (vs 99.3% pre-pandemic). Of all 97 patients prescribed DAAs during the pandemic, 92 (94.8%) completed treatment.
Conclusions
Less persons were treated during the COVID pandemic, which may deter progress towards HCV elimination targets. Very high SVR12 and treatment completion rates during the pandemic suggest that patients can be effectively treated with less pre-treatment investigations and fewer appointments.
Funding Agencies
None
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Affiliation(s)
- S X Jiang
- Internal Medicine, The University of British Columbia Faculty of Medicine, Vancouver, BC, Canada
| | | | - J MacIsaac
- Pacific Gastroenterology Associates, Vancouver, BC, Canada
| | - E Tam
- Pacific Gastroenterology Associates, Vancouver, BC, Canada
| | - M Choi
- Gastrointestinal Research Institute, Vancouver, BC, Canada
| | - P Luyun
- Gastrointestinal Research Institute, Vancouver, BC, Canada
| | - H Ko
- Medicine, University of British Columbia, Vancouver, BC, Canada
| | - A Ramji
- Medicine, University of British Columbia, Vancouver, BC, Canada
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Song Y, Lim J, Lim T, Im K, Kim N, Nam Y, Jeon Y, Ko H, Park I, Shin J, Cho S. Human mesenchymal stem cells derived from umbilical cord and bone marrow exert immunomodulatory effects in different mechanisms. Cytotherapy 2021. [DOI: 10.1016/s1465324921003455] [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: 11/25/2022]
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11
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Donaldson K, Mitchell RA, Enns RA, Bressler B, Rosenfeld G, Leung Y, Ramji A, Ko H. A164 PATTERNS IN MEDICAL THERAPY AND CLINICAL OUTCOMES IN PATIENTS WITH CONCOMITANT INFLAMMATORY BOWEL DISEASE AND PRIMARY SCLEROSING CHOLANGITIS: A SINGLE CENTRE RETROSPECTIVE ANALYSIS. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Inflammatory bowel disease (IBD) in patients with primary sclerosing cholangitis (PSC) is characterized by pancolitis with rectal sparing and is associated with an increased risk of colorectal and biliary malignancies. Currently, pharmacologic management of IBD in the setting of PSC is the same as in IBD alone.
Aims
To assess patterns in medical therapy, and incidence of adverse outcomes in patients with concomitant IBD and PSC.
Methods
A retrospective review was conducted on all PSC-IBD patients followed between January 2010 and June 2018. The Endoscopic Mayo Score was used to grade IBD severity in PSC-ulcerative colitis (UC).
Results
69 patients were identified, 44 (63.8%) were male. The mean ages of IBD and PSC diagnosis were 28.6 (SD 14.9) and 37.0 (SD 18.9) years, respectively. The median length of follow up was 12 (range 2–49) years. 52 (75.4%) patients had UC, and 17 (24.6%) had Crohn’s disease (CD). 28 (87.5%) PSC-UC patients had pancolitis, and 4 (12.5 %) had proctitis. Among those with pancolitis, 8 (28.6%) had relative rectal sparing. 4 (14.3%) patients had more severe inflammation proximally, whereas only 1 (3.6%) had more severe distal inflammation. 23 (82.1%) patients had the same degree of inflammation throughout. 14 (93.3%) PSC-CD patients had colitis/ileocolitis and 1 (6.7%) had ileitis. Among those with PSC-UC, 16 (50.0%), 12 (37.5%), and 4 (12.5%) patients had grade 1, 2, and 3 disease, respectively. 62 (89.9%) PSC-IBD patients were treated with aminosalicylates, and 26 (37.7%) with biologics at some point in their IBD course. 26 (37.7%) were treated with aminosalicylates alone. 4 (5.8%) did not require any IBD therapy. Cholangiocarcinoma, colorectal cancer, and gallbladder cancer developed in 8 (11.6%), 1 (1.4%), and 1 (1.4%) PSC-IBD patients, respectively. 16 (23.2%) patients required partial or total colectomy. Indication for surgery was inflammation or stenosis, dysplasia, and neoplasia in 13 (81.3%), 2 (12.5%), and 1 (6.3%) patients, respectively.
Conclusions
The majority of this cohort had UC with mild disease activity. Pancolitis was common, with frequent rectal sparing and more severe right-sided inflammation. Despite the predominance of low-grade colitis, a large portion of patients required treatment with biologics. The incidence of adverse outcomes underscores the need for strict adherence to recommended surveillance practices. Low grade endoscopic activity, typical of the quiescent IBD course in PSC-IBD, may mask low grade histologic inflammation, which in turn may contribute to the increased risk of colonic neoplasia. Further studies are needed to determine the best management strategy for IBD in patients with PSC.
Funding Agencies
None
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Affiliation(s)
- K Donaldson
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - R A Mitchell
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - R A Enns
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - B Bressler
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - G Rosenfeld
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Y Leung
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - A Ramji
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - H Ko
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
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Chahal D, Bedi HK, Marquez V, Yoshida EM, Ko H, Salh B. A208 PREDICTORS OF OUTCOMES IN PSC: RETROSPECTIVE ANALYSIS OF TWO TERTIARY CARE CENTERS IN BC. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Primary sclerosing cholangitis (PSC) is a chronic inflammatory disorder of the bile ducts. PSC can rapidly progress to cholangiocarcinoma and death. Many clinical features of PSC, as well as its relationship with diseases such as IBD, remain ill-defined. These features are important for disease modeling and clinical trial design.
Aims
To identify features of PSC that may aid in disease modeling and outcomes prediction.
Methods
Patients with a diagnosis of PSC with visits between 2012 and 2018 were identified and data were extracted. Survival analysis was performed, with time defined as time of PSC diagnosis to time at clinical endpoint. The clinical endpoint for survival analysis was defined as development of cholangiocarcinoma, liver transplantation or death. Univariate and multivariate Cox-regression was then performed.
Results
169 patients (99 male, 70 female) were identified. Of these, 102 (60.4%) had a diagnosis of IBD (84 UC). 138 were Caucasian, 9 East Asian, 9 South Asian and 13 Middle East. Mean age at PSC diagnosis was 39.3, IBD diagnosis 29.3 years. Mean time to next diagnosis in those with PSC-IBD was 7.7 years. Of those with PSC-IBD, IBD preceded the diagnosis of PSC in 69 (67.6%) patients. 22 (13.0%) had concurrent liver disease, including 14 AIH and 1 PBC overlap. In those with UC, disease was most often pancolitis (57.8%), with noticeable rate of backwash ileitis (23.3%). There were 26 patients with current or prior use of Infliximab, 14 with Humira, and 6 with Vedolizumab. 28 (16.6%) patients had a partial or total colectomy. 35 (20.7%) patients had diagnoses of cancer, including 16 cholangiocarcinoma, 2 gall bladder carcinoma, and 4 colorectal. 33 (19.5%) patients received liver transplant, and 31 (18.3%) died. Most frequent cause of death was cholangiocarcinoma (12, 38.7%). Univariate analysis identified increased age at PSC diagnosis, presence of IBD, increased age at IBD diagnosis, diagnosis of IBD prior to PSC, increased time from diagnosis of IBD to PSC, diagnosis of UC as opposed to Crohn’s, and lack of Infliximab use as significant predictors of our clinical endpoints (p<0.05). Multivariate analysis only identified increased age at PSC diagnosis, presence of IBD, and diagnosis of IBD prior to PSC as predictors.
Conclusions
PSC affects persons of various ethnic backgrounds. Diagnosis of IBD appears to precede PSC in most PSC-IBD cases, and the temporal relationship may impact outcomes, possibly due to delayed diagnosis of PSC. UC has a worse disease course than Crohn’s. Cholangiocarcinoma still accounts for a large burden of overall death in PSC, and strategies for early diagnosis should be explored. More studies are required to delineate the relationship between biologic use and PSC outcomes. The major limitation of our study is the smaller sample size that may have limited statistical power.
Funding Agencies
NoneNone
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Affiliation(s)
- D Chahal
- Gastroenterology, University of British Columbia, Vancouver, BC, Canada
| | - H K Bedi
- Gastroenterology, The University of British Columbia Faculty of Medicine, Vancouver, BC, Canada
| | - V Marquez
- Gastroenterology, University of British Columbia, Vancouver, BC, Canada
| | - E M Yoshida
- Gastroenterology, University of British Columbia, Vancouver, BC, Canada
| | - H Ko
- Medicine, University of British Columbia, Vancouver, BC, Canada
| | - B Salh
- Gastroenterology, University of British Columbia, Vancouver, BC, Canada
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Chen Y, Ko H, Zemelman BV, Seidemann E, Nauhaus I. Uniform spatial pooling explains topographic organization and deviation from receptive-field scale invariance in primate V1. Nat Commun 2020; 11:6390. [PMID: 33319775 PMCID: PMC7738493 DOI: 10.1038/s41467-020-19954-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 02/06/2020] [Accepted: 11/06/2020] [Indexed: 11/29/2022] Open
Abstract
Receptive field (RF) size and preferred spatial frequency (SF) vary greatly across the primary visual cortex (V1), increasing in a scale invariant fashion with eccentricity. Recent studies reveal that preferred SF also forms a fine-scale periodic map. A fundamental open question is how local variability in preferred SF is tied to the overall spatial RF. Here, we use two-photon imaging to simultaneously measure maps of RF size, phase selectivity, SF bandwidth, and orientation bandwidth—all of which were found to be topographically organized and correlate with preferred SF. Each of these newly characterized inter-map relationships strongly deviate from scale invariance, yet reveal a common motif—they are all accounted for by a model with uniform spatial pooling from scale invariant inputs. Our results and model provide novel and quantitative understanding of the output from V1 to downstream circuits. Two-photon imaging in macaque V1 captured maps of tuning selectivity for four spatial parameters, all of which correlated with peak spatial frequency. These inter-map relationships reveal a common motif—they are described by uniform spatial pooling from a family of scale invariant Gabor receptive fields.
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Affiliation(s)
- Y Chen
- Department of Psychology, University of Texas, Austin, TX, USA.,Department of Neuroscience, University of Texas, Austin, TX, USA.,Center for Perceptual Systems, University of Texas, Austin, TX, USA
| | - H Ko
- Department of Psychology, University of Texas, Austin, TX, USA.,Center for Perceptual Systems, University of Texas, Austin, TX, USA
| | - B V Zemelman
- Department of Neuroscience, University of Texas, Austin, TX, USA.,Center for Learning and Memory, University of Texas, Austin, TX, USA
| | - E Seidemann
- Department of Psychology, University of Texas, Austin, TX, USA.,Department of Neuroscience, University of Texas, Austin, TX, USA.,Center for Perceptual Systems, University of Texas, Austin, TX, USA
| | - I Nauhaus
- Department of Psychology, University of Texas, Austin, TX, USA. .,Department of Neuroscience, University of Texas, Austin, TX, USA. .,Center for Perceptual Systems, University of Texas, Austin, TX, USA.
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14
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Pi S, Mitchell RA, Mohajerani A, Farivar J, Ko H, Ramji A. A136 PREDICTIVE FACTORS OF CIRRHOSIS IN HCV PATIENTS WITH LOW PRE-TREATMENT APRI AND/OR FIB-4 SCORES. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
It is essential to evaluate the stage of hepatic fibrosis prior to the initiation of HCV therapy. In addition to being a major prognostic factor, the presence of cirrhosis requires monitoring for hepatocellular carcinoma (HCC), esophageal varices, and decompensated liver disease. In some cases the presence of cirrhosis may affect the choice of therapy. In tertiary hepatology clinics, transient elastography (TE) is routinely used to assess fibrosis; however access to TE is limited. Fibrosis-4 (FIB4) and AST-to-platelet ratio index (APRI) are simple, easily available non-invasive methods of fibrosis measurement based on routine serum biomarkers. Studies evaluating HCV treatment pathways have reported that the use of FIB4 and APRI are cost-effective strategies for excluding cirrhosis thereby reducing the need for TE prior to treatment. Although the NPV of these tests are well described, a minority of patients will have advanced fibrosis despite low APRI and/or FIB4 scores.
Aims
To investigate predictive factors of cirrhosis in HCV patients with low pre-treatment APRI and/or FIB-4 scores.
Methods
Retrospective observational study with data obtained from the Pacific Gastroenterology Associates (PGA), a tertiary care outpatient Gastroenterology clinic located in Vancouver, British Columbia. Inclusions: Chronic HCV patients treated between Jan 2015 to 2019, pre-treatment TE values ≥12.5 kPa, FIB-4 <1.45 and/or APRI <0.7. Exclusions: those without cirrhosis, or incomplete evaluation prior to HCV treatment. Cirrhosis was defined as those with TE ≥12.5 kPa with clinical, radiographic, or pathologic features of cirrhosis.
Results
52 patients were identified. 11 patients did not have clinical, radiographic, or pathologic features of cirrhosis and 3 patients were excluded for insufficient data. Thus, 39 patients were included in multivariate analysis. The mean age was 59 years and 66% (25/38) were male gender. 10% (4/38) were Genotype 3 (G3). Presence of G3 was not included in the multivariate analysis due to low number of observations.
Conclusions
Generally, an APRI <0.7 and FIB-4 <1.45 have good test characteristics for excluding fibrosis. Our study demonstrates that patients with obesity, dyslipidemia, excessive alcohol use, or known steatosis on ultrasound may have cirrhosis despite low serum biomarker scores. Co-existence of other liver diseases such as alcohol related or non-alcoholic fatty liver disease (NAFLD) should prompt further evaluation for fibrosis assessment beyond biomarkers as these persons may have more advanced liver disease.
Funding Agencies
None
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Affiliation(s)
- S Pi
- Gastroenterology, University of British Columbia, Vancouver, BC, Canada
| | - R A Mitchell
- Gastroenterology, University of British Columbia, Vancouver, BC, Canada
| | - A Mohajerani
- Pacific Gastroenterology Associates GI Research Institute, Vancouver, BC, Canada
| | - J Farivar
- Pacific Gastroenterology Associates GI Research Institute, Vancouver, BC, Canada
| | - H Ko
- Medicine, University of British Columbia, Vancouver, BC, Canada
| | - A Ramji
- Gastrointestinal Research Institute, Vancouver, BC, Canada
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15
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Abstract
Abstract
Background
Methotrexate (MTX) is effective for dermatologic and rheumatologic conditions such as psoriasis (Ps), psoriatic arthritis (PsO) and rheumatoid arthritis (RA). Long-term MTX use may be complicated by hepatic fibrosis, although patient, disease factors and the mechanism remain unclear. Transient elastography (TE) is a non-invasive measure of hepatic fibrosis that is often used as surveillance in this patient population.
Patients with Ps and PsO have higher rates of non-alcoholic fatty liver disease. The controlled attenuation parameter (CAP) measurement is a non-invasive test that correlates with histologic degree of steatosis. To our knowledge, no studies have evaluated hepatic steatosis via CAP scores in MTX use.
Aims
To determine the prevalence of steatosis and significant fibrosis (F≥stage 2) in persons on MTX therapy and to determine the predictive factors for these events.
Methods
A single centred retrospective cohort study was performed. Patients on >6 months of MTX for a dermatologic or rheumatologic disease who had undergone TE from January 2015 to September 2019 were included. Demographic variables, laboratory investigations, TE and CAP scores were collected. Multivariate analysis was performed to determine predictors of steatosis and fibrosis.
Results
A total of 177 patients on methotrexate were included. Ps was the most frequent diagnosis (n=52) followed by RA (n=50) and PsO (n=38). Steatosis (CAP≥245 dB/m) was present in 73.9% of patients. Patients with steatosis had significantly more fibrosis and a higher BMI than those without steatosis (CAP<245 dB/m). Higher CAP score was correlated with increased lifetime dose of methotrexate by Pearson correlation analysis (r=0.48, p=0.001) (n=85 patients). Multivariate regression analysis revealed that diabetes mellitus (OR 10.5, 95% CI 1.38–80.60), hypertension (OR 4.97, 95% CI 1.66–14.84), and BMI> 30 (OR 10.1, 95% CI 1.88–37.14) were predictors of steatosis (CAP≥245 dB/m). Predictors of METAVIR≥F2 (TE≥8.0 kPa) by multivariate regression analysis included CAP score of ≥270 (OR 8.36, 95% CI 1.88–37.14), diabetes mellitus (OR 2.85, 95% CI 1.09–7.48), hypertension (OR 5.4, 95% CI 2.23–13.0), dyslipidemia (OR 3.71, 95% CI 1.50–9.18) and alcohol use (OR 3.06, 95% CI 1.2–7.49).
Conclusions
In patients on MTX for rheumatologic and dermatologic diseases, hepatic steatosis was common and predicted significant fibrosis. Additionally, increasing MTX exposure is correlated with steatosis. Features of the metabolic syndrome including diabetes, hypertension or obesity were predictors of both steatosis and fibrosis (F≥2). Further study is needed to evaluate if steatosis is a mechanism by which fibrosis occurs in patients on MTX, or if it due to other patient factors.
Funding Agencies
None
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Affiliation(s)
- M Tomaszewski
- University of British Columbia, Vancouver, BC, Canada
| | - M Dahiya
- University of British Columbia, Vancouver, BC, Canada
| | - A Mohajerani
- Gastrointestinal Research Institute, Vancouver, BC, Canada
| | - H Punja
- University of British Columbia, Vancouver, BC, Canada
| | - H Ko
- University of British Columbia, Vancouver, BC, Canada
| | - A Ramji
- University of British Columbia, Vancouver, BC, Canada
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16
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Perdrizet K, Stockley T, Law J, Shabir M, Zhang T, Le L, Lau A, Tsao M, Kamel-Reid S, Pal P, Cabanero M, Schwock J, Ko H, Liu G, Bradbury P, Sacher A, Shepherd F, Leighl N. P1.01-30 Non-Small Cell Lung Cancer (NSCLC) Next Generation Sequencing (NGS): Integrating Genomic Sequencing into a Publicly Funded Health Care Model. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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17
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Duong VT, Dang TT, Kim JP, Kim K, Ko H, Hwang CH, Koo KI. Twelve-day medium pumping into tubular cell-laden scaffold using a lab-made PDMS connector. Eur Cell Mater 2019; 38:1-13. [PMID: 31332770 DOI: 10.22203/ecm.v038a01] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
In the current study, a method is proposed to supply culture medium into a two-layered cell-laden tubular scaffold in order to enhance cell proliferation, confluence, and viability. The two-layered cell-laden tubular scaffold was made of calcium-alginate mixed with fibroblast cells (NIH/3T3) using a lab-made double- coaxial laminar-flow generator. Afterwards, the tubular scaffold was connected to a syringe pump system using a polydimethylsiloxane (PDMS) micro-connector for long-term cell culture. Three medium pumping conditions were applied and compared: a heart-beat-mimicking pumping (20 µL/s, 1 s period, and 50 % pulse width), a continuous pumping (20 µL/s) and a non-pumping. Non-leaky connections between the tubular scaffolds and the micro-connector outlet were sustained for 13.5 ± 0.83 d in heartbeat-mimicking pumping and 11.8 ± 0.33 d in continuous pumping condition, due to the elasticity of the tubular scaffolds. Importantly, the two pumping conditions resulted in more cell proliferation, confluence, and viability than the non-pumping condition. Furthermore, analysis of newly-produced type-I collagen matrix indicated that the cells under the two pumping conditions formed a tissue-like structure. The proposed technique could further be applied to vascular co-culturing for vascular engineered tissue.
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Affiliation(s)
| | | | | | | | | | | | - K-I Koo
- Department of Biomedical Engineering, University of Ulsan, Ulsan, Republic of Korea. room 409, building 18, University of Ulsan, 93 Daehak-ro, Nam-gu, Ulsan (44610), Republic of
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18
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Lee S, Lee H, Lee K, Kim J, Ko H. 1012 Activation of hedgehog signaling suppresses psoriasis-like epidermal hyperplasia and skin inflammation. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.1088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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19
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Donaldson K, Enns RA, Bressler B, Ko H. A107 DISEASE DISTRIBUTION AND CLINICAL FEATURES OF INFLAMMATORY BOWEL DISEASE IN PATIENTS WITH PRIMARY SCLEROSING CHOLANGITIS: A SINGLE-CENTRE RETROSPECTIVE ANALYSIS. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.106] [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: 11/13/2022] Open
Affiliation(s)
- K Donaldson
- St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Canada
| | - R A Enns
- St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Canada
| | - B Bressler
- St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Canada
| | - H Ko
- St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Canada
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20
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Ashammakhi N, Ahadian S, Xu C, Montazerian H, Ko H, Nasiri R, Barros N, Khademhosseini A. Bioinks and bioprinting technologies to make heterogeneous and biomimetic tissue constructs. Mater Today Bio 2019; 1:100008. [PMID: 32159140 PMCID: PMC7061634 DOI: 10.1016/j.mtbio.2019.100008] [Citation(s) in RCA: 220] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/17/2019] [Accepted: 05/18/2019] [Indexed: 12/12/2022] Open
Abstract
The native tissues are complex structures consisting of different cell types, extracellular matrix materials, and biomolecules. Traditional tissue engineering strategies have not been able to fully reproduce biomimetic and heterogeneous tissue constructs because of the lack of appropriate biomaterials and technologies. However, recently developed three-dimensional bioprinting techniques can be leveraged to produce biomimetic and complex tissue structures. To achieve this, multicomponent bioinks composed of multiple biomaterials (natural, synthetic, or hybrid natural-synthetic biomaterials), different types of cells, and soluble factors have been developed. In addition, advanced bioprinting technologies have enabled us to print multimaterial bioinks with spatial and microscale resolution in a rapid and continuous manner, aiming to reproduce the complex architecture of the native tissues. This review highlights important advances in heterogeneous bioinks and bioprinting technologies to fabricate biomimetic tissue constructs. Opportunities and challenges to further accelerate this research area are also described.
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Affiliation(s)
- N. Ashammakhi
- Center for Minimally Invasive Therapeutics (C-MIT), University of California – Los Angeles, Los Angeles, CA, 90095, USA
- Department of Bioengineering, University of California – Los Angeles, Los Angeles, CA, 90095, USA
- Division of Plastic Surgery, Department of Surgery, Oulu University, Oulu, 8000, Finland
| | - S. Ahadian
- Center for Minimally Invasive Therapeutics (C-MIT), University of California – Los Angeles, Los Angeles, CA, 90095, USA
- Department of Bioengineering, University of California – Los Angeles, Los Angeles, CA, 90095, USA
| | - C. Xu
- Center for Minimally Invasive Therapeutics (C-MIT), University of California – Los Angeles, Los Angeles, CA, 90095, USA
- Department of Bioengineering, University of California – Los Angeles, Los Angeles, CA, 90095, USA
- School of Dentistry, The University of Queensland, Herston, QLD, 4006, Australia
| | - H. Montazerian
- Center for Minimally Invasive Therapeutics (C-MIT), University of California – Los Angeles, Los Angeles, CA, 90095, USA
- Department of Bioengineering, University of California – Los Angeles, Los Angeles, CA, 90095, USA
| | - H. Ko
- Center for Minimally Invasive Therapeutics (C-MIT), University of California – Los Angeles, Los Angeles, CA, 90095, USA
- Department of Bioengineering, University of California – Los Angeles, Los Angeles, CA, 90095, USA
| | - R. Nasiri
- Center for Minimally Invasive Therapeutics (C-MIT), University of California – Los Angeles, Los Angeles, CA, 90095, USA
- Department of Bioengineering, University of California – Los Angeles, Los Angeles, CA, 90095, USA
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, 11365-11155, Iran
| | - N. Barros
- Center for Minimally Invasive Therapeutics (C-MIT), University of California – Los Angeles, Los Angeles, CA, 90095, USA
- Department of Bioengineering, University of California – Los Angeles, Los Angeles, CA, 90095, USA
| | - A. Khademhosseini
- Center for Minimally Invasive Therapeutics (C-MIT), University of California – Los Angeles, Los Angeles, CA, 90095, USA
- Department of Bioengineering, University of California – Los Angeles, Los Angeles, CA, 90095, USA
- Department of Radiological Sciences, University of California – Los Angeles, Los Angeles, CA, 90095, USA
- Department of Chemical and Biomolecular Engineering, University of California – Los Angeles, Los Angeles, CA, 90095, USA
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21
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Ko H, MaloneBeach E, Miller A. INTERNALIZATION OF DOMAIN-SPECIFIC AGE STEREOTYPES: COMPARISONS BETWEEN UNIVERSITY STUDENTS, FACULTY, AND STAFF. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- H Ko
- Central Michigan University
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22
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Kim J, Tak S, Yoo Y, Ko H. FEASIBILITY OF AN INTEGRATIVE ACTIVITY PROGRAM FOR LOW-EDUCATED ELDERS WITH MILD DEMENTIA. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.506] [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: 11/12/2022] Open
Affiliation(s)
- J Kim
- Seoul National University
| | - S Tak
- Seoul National University
| | - Y Yoo
- Seoul National University
| | - H Ko
- Seoul National University
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23
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Wang X, Li X, Zhang L, Wong S, Wang M, Tse G, Dai R, Nakatsu G, Coker O, Chen Z, Ko H, Chan J, Liu T, Cheng C, Cheng A, To K, Plewczynski D, Sung J, Yu J, Gin T, Chan M, Wu W. Oncogenes expand during evolution to withstand somatic amplification. Ann Oncol 2018; 29:2254-2260. [PMID: 30204835 DOI: 10.1093/annonc/mdy397] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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24
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Cao S, Parelkar S, Ko H, Thompson P, Hayward L. CMT AND NEUROGENIC DISEASE. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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25
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Nap-Hill E, Suzuki M, Galorport C, Yonge J, Amar J, Bressler B, Ko H, Lam E, Ramji A, Rosenfeld G, Telford JJ, Whittaker S, Enns RA. A225 A NEW STANDARD: AN OPEN-LABEL TRIAL EXAMINING THE EFFECTIVENESS OF INDIVIDUALIZED WEB BASED COLONOSCOPY PREPARATION INSTRUCTION. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.225] [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: 11/13/2022] Open
Affiliation(s)
- E Nap-Hill
- Department of Medicine, Division of Gastroenterology, St. Paul’s Hospital, UBC, Vancouver, BC, Canada
| | - M Suzuki
- Department of Medicine, Division of Gastroenterology, St. Paul’s Hospital, UBC, Vancouver, BC, Canada
| | - C Galorport
- Department of Medicine, Division of Gastroenterology, St. Paul’s Hospital, UBC, Vancouver, BC, Canada
| | - J Yonge
- Department of Medicine, Division of Gastroenterology, St. Paul’s Hospital, UBC, Vancouver, BC, Canada
| | - J Amar
- Department of Medicine, Division of Gastroenterology, St. Paul’s Hospital, UBC, Vancouver, BC, Canada
| | - B Bressler
- Department of Medicine, Division of Gastroenterology, St. Paul’s Hospital, UBC, Vancouver, BC, Canada
| | - H Ko
- Department of Medicine, Division of Gastroenterology, St. Paul’s Hospital, UBC, Vancouver, BC, Canada
| | - E Lam
- Department of Medicine, Division of Gastroenterology, St. Paul’s Hospital, UBC, Vancouver, BC, Canada
| | - A Ramji
- Department of Medicine, Division of Gastroenterology, St. Paul’s Hospital, UBC, Vancouver, BC, Canada
| | - G Rosenfeld
- Department of Medicine, Division of Gastroenterology, St. Paul’s Hospital, UBC, Vancouver, BC, Canada
| | - J J Telford
- Department of Medicine, Division of Gastroenterology, St. Paul’s Hospital, UBC, Vancouver, BC, Canada
| | - S Whittaker
- Department of Medicine, Division of Gastroenterology, St. Paul’s Hospital, UBC, Vancouver, BC, Canada
| | - R A Enns
- Department of Medicine, Division of Gastroenterology, St. Paul’s Hospital, UBC, Vancouver, BC, Canada
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26
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Yau A, Galorport C, Ko H, Coffin CS. A182 HEPATOCELLULAR CARCINOMA (HCC) SCREENING PRACTICES IN CHRONIC HEPATITIS B (HBV) AMONG CANADIAN GASTROENTEROLOGISTS AND HEPATOLOGISTS: AN ONLINE SURVEY. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.183] [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: 11/13/2022] Open
Affiliation(s)
- A Yau
- Medicine, University of British Columbia, Vancouver, BC, Canada
| | - C Galorport
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - H Ko
- Medicine, University of British Columbia, Vancouver, BC, Canada
| | - C S Coffin
- Medicine, University of Calgary, Calgary, AB, Canada
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27
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Yonge J, Galorport C, Bressler B, Ko H, Telford JJ, Enns RA. A55 ASSESSMENT OF THE APPROPRIATE USE OF GASTROINTESTINAL ENDOSCOPY AT A TERTIARY CARE CENTRE. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.056] [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: 11/14/2022] Open
Affiliation(s)
- J Yonge
- St. Paul’s Hospital, Vancouver, BC, Canada
| | | | - B Bressler
- St. Paul’s Hospital, Vancouver, BC, Canada
| | - H Ko
- St. Paul’s Hospital, Vancouver, BC, Canada
| | | | - R A Enns
- St. Paul’s Hospital, Vancouver, BC, Canada
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28
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Suzuki MM, Bardi M, Takach O, Galorport C, Yonge J, Harris N, Lam E, Telford JJ, Rosenfeld G, Ko H, Enns RA. A21 RANDOMIZED PROSPECTIVE STUDY: IMPACT OF THE PATIENT EDUCATION WEBSITE ON THE QUALITY OF OUTPATIENT BOWEL PREPARATION FOR COLONOSCOPY:. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.022] [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: 11/12/2022] Open
Affiliation(s)
- M M Suzuki
- Gastroenterology, Pacific Gastroenterology Associates, Vancouver, BC, Canada
| | - M Bardi
- Medicine, UBC, Vancouver, BC, Canada
| | - O Takach
- University of British Columbia, Burnaby, BC, Canada
| | - C Galorport
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - J Yonge
- University of British Columbia, Burnaby, BC, Canada
| | - N Harris
- Gastroenterology, St. Paul’s Hospital, Kamloops, BC, Canada
| | - E Lam
- Gastroenterology, St. Paul’s Hospital, Kamloops, BC, Canada
| | - J J Telford
- University of British Columbia, Burnaby, BC, Canada
| | | | - H Ko
- Medicine, University of British Columbia, Vancouver, BC, Canada
| | - R A Enns
- Medicine, St Paul, Vancouver, BC, Canada
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29
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Nap-Hill E, Suzuki M, Galorport C, Yonge J, Amar J, Bressler B, Ko H, Lam E, Ramji A, Rosenfeld G, Telford JJ, Whittaker S, Enns RA. A57 A NEW STANDARD: AN OPEN-LABEL TRIAL EXAMINING THE EFFECTIVENESS OF INDIVIDUALIZED WEB BASED COLONOSCOPY PREPARATION INSTRUCTION. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.058] [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: 11/14/2022] Open
Affiliation(s)
- E Nap-Hill
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - M Suzuki
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - C Galorport
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - J Yonge
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - J Amar
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - B Bressler
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - H Ko
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - E Lam
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - A Ramji
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - G Rosenfeld
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - J J Telford
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - S Whittaker
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - R A Enns
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
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Park JI, Choe A, Kim MP, Ko H, Lee TH, Noh SM, Kim JC, Cheong IW. Water-adaptive and repeatable self-healing polymers bearing bulky urea bonds. Polym Chem 2018. [DOI: 10.1039/c7py01655g] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [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
A crosslinked copolymer having a reversible covalent bond between a bulky amine and an isocyanate presents reshapable, repeatable, and water-adaptive self-healing properties.
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Affiliation(s)
- J. I. Park
- Department of Applied Chemistry
- Kyungpook National University
- Daegu 41566
- Republic of Korea
| | - A. Choe
- School of Energy and Chemical Engineering
- Ulsan National Institute of Science and Technology
- Ulsan 44919
- Korea
| | - M. P. Kim
- School of Energy and Chemical Engineering
- Ulsan National Institute of Science and Technology
- Ulsan 44919
- Korea
| | - H. Ko
- School of Energy and Chemical Engineering
- Ulsan National Institute of Science and Technology
- Ulsan 44919
- Korea
| | - T. H. Lee
- Research Center for Green Fine Chemicals
- Korea Research Institute of Chemical Technology
- Ulsan
- Republic of Korea
| | - S. M. Noh
- Research Center for Green Fine Chemicals
- Korea Research Institute of Chemical Technology
- Ulsan
- Republic of Korea
| | - J. C. Kim
- Research Center for Green Fine Chemicals
- Korea Research Institute of Chemical Technology
- Ulsan
- Republic of Korea
| | - I. W. Cheong
- Department of Applied Chemistry
- Kyungpook National University
- Daegu 41566
- Republic of Korea
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Ko H, Seong M, Jeong HE. A micropatterned elastomeric surface with enhanced frictional properties under wet conditions and its application. Soft Matter 2017; 13:8419-8425. [PMID: 29082413 DOI: 10.1039/c7sm01493g] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Engineered surfaces that have high friction under wet or lubricated conditions are important in many practical applications. However, it is not easy to achieve stable high friction under wet conditions because a layer of fluid prevents direct solid-solid contact. Here, we report a micropatterned elastomeric surface with superior wet friction. The surface has unique arch-shaped microstructures arrayed in a circle on the surface to provide high friction on wet or flooded surfaces. The arch-shaped micropatterned surface exhibits remarkably enhanced and stable friction under wet conditions, surpassing even the performance of the hexagonal patterns of tree frogs, owing to the large contact surface and the optimal shape of drainage channels. Robotic substrate transportation systems equipped with the micropatterned surfaces can manipulate a delicate wet substrate without any sliding in a highly stable and reproducible manner, demonstrating the superior frictional capabilities of the surface under wet conditions.
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Affiliation(s)
- H Ko
- Department of Mechanical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea.
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Verma S, Wolkenstein P, Le L, Lee J, Widemann B, Brownell I, Jarnagin K, Lavker R, Legius E, Anderson R, Plotkin S, Weinberg H, Casey D, Ko H, LaRosa S, Knight P, Parides M, Bora N, Morris J, Riccardi V, Korf B, Blakeley J. LB951 Establishing a roadmap for therapeutics development for cutaneous neurofibromas. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.025] [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: 11/26/2022]
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Cheng Y, Ko H. GENDERED ALLOCATION OF SUPPORT FOR AGING PARENTS AND PARENTS-IN-LAW IN TAIWAN. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3015] [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: 11/13/2022] Open
Affiliation(s)
- Y. Cheng
- New graduate, Sunnyvale, California
| | - H. Ko
- Central Michigan University, Mt. Pleasant, Michigan,
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Shin J, Kim J, Kim J, Ko H, Gwon D. A prospective randomized study of a covered metallic ureteral stent versus double J Stent for malignant ureteral obstruction: PRODUCE study (NCT01823575). J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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35
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Choi H, Kim S, Ko H, Kim Y, Park CG. Development and preliminary evaluation of culturally specific web-based intervention for parents of adolescents. J Psychiatr Ment Health Nurs 2016; 23:489-501. [PMID: 27500792 DOI: 10.1111/jpm.12327] [Citation(s) in RCA: 10] [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] [Accepted: 06/20/2016] [Indexed: 12/28/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Problematic parent-child relationships have been identified as one of the main predictors of adolescents' mental health problems, but there are few existing interventions that address this issue. The format and delivery method of existing interventions for parents are relatively inaccessible for parents with full-time jobs and families living in rural areas. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: The newly developed 'Stepping Stone' culturally specific web-based intervention, which is intended to help Korean parents of adolescents to acquire both knowledge and communication and conflict management skills, was found to be feasible and well-accepted by parents. This study enabled us to identify areas for improvement in the content and format of the intervention and strategies. This will potentially increase effect sizes for the outcome variables of parents' perception and behaviours. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This web-based intervention could be delivered across diverse settings, such as schools and community mental health centers, to increase parents' knowledge of adolescent's mental health and allow for early detection of mental health problems. Mental health nurses working in schools may spend a significant amount of time addressing students' mental health issues; thus, this web-based intervention could be a useful resource to share with parents and children. In this way, the mental health nurses could facilitate parental engagement in the intervention and then help them to continue to apply and practice the knowledge and skills obtained through the program. ABSTRACT Introduction There is a need for accessible, culturally specific web-based interventions to address parent-child relationships and adolescents' mental health. Aims This study developed and conducted a preliminary evaluation of a 4-week web-based intervention for parents of adolescents aged 11 to 16 years in Korea. Methods We used a two-group, repeated measures, quasi-experimental study design to assess the feasibility of developing and implementing a web-based intervention for parents. Descriptive statistics, chi-square and t tests, and mixed effect modeling were used for data analysis. Results The intervention and 1-month follow-up survey were completed by 47 parents in the intervention group and 46 parents in the attention control (AC) group. The intervention was found to be feasible and well-accepted by parents. Discussion This culturally specific web-based intervention is a useful tool for knowledge dissemination among large numbers of parents. Areas for improvement in the content and format of the intervention and strategies to elicit significant parent-child interactions are provided. Implications for practice and conclusion The intervention could be disseminated in collaboration with mental health nurses working in schools to facilitate parents' participation.
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Affiliation(s)
- H Choi
- College of Nursing & The Research Institute of Nursing Science, Seoul National University, Seoul, Korea.
| | - S Kim
- College of Nursing, Seoul National University, Seoul, Korea
| | - H Ko
- College of Nursing, Seoul National University, Seoul, Korea
| | - Y Kim
- College of Nursing, Seoul National University, Seoul, Korea
| | - C G Park
- University of Illinois at Chicago, College of Nursing, Chicago, IL
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Moran L, Ko H, Misso M, Marsh K, Noakes M, Talbot M, Frearson M, Thondan M, Stepto N, Teede H. Dietary composition in the treatment of polycystic ovary syndrome: a systematic review to inform evidence-based guidelines. Hum Reprod Update 2013. [DOI: 10.1093/humupd/dmt051] [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: 11/13/2022] Open
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Ko H, Park SY, Cha EJ, Sohn JS. Primary small cell carcinoma of the urinary bladder: a case report demonstrates cytological findings in SurePath liquid-based cytology. Cytopathology 2013; 25:135-6. [PMID: 23682948 DOI: 10.1111/cyt.12067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- H Ko
- Department of Pathology, Konyang University Hospital, Daejeon, South Korea
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Youn HS, You H, Im I, Lee Y, Bae MH, Lee SK, Ko H, Kim YC, Eom SH. Design, synthesis and X-ray crystallographic study of NAmPRTase inhibitors as anti-cancer agents. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311092336] [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] Open
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Wang C, Tsai Y, Cheung Y, Ko H, Ni Y, Feng P, Chen Y, Yang P, Chang G. Baseline results of lung cancer screening program for family lung cancer risk with low-dose spiral CT in Taiwan. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.7098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kim C, Ko H, Ryu W. LONGITUDINAL FOLLOW-UP STUDY FOR CHANGES IN LIPIDS AND LIPOPROTEINS DURING THE PERIMENOPAUSE. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70390-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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42
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Jung MN, Ha SY, Kim HS, Ko HJ, Ko H, Lee WH, Oh DC, Murakami Y, Yao T, Chang JH. The shape control of ZnO based nanostructures. J Nanosci Nanotechnol 2006; 6:3628-32. [PMID: 17252825] [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] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Tetrapod-shape ZnO nanostructures are formed on Si substrates by vapor phase transportation method. The effects of two important growth parameters, growth temperature and VI/II ratio, are investigated. The growth temperature is varied in the range from 600 degrees C to 900 degrees C to control the vapor pressure of group II-element and the formation process of nanostructures. VI/II ratio was changed by adjusting the flux of carrier gas which affects indirectly the supplying rate of group VI-element. From the scanning electron microscopy (SEM), systematic variation of shape including cluster, rod, wire and tetrapod was observed. ZnO tetrapods, formed at 800 degrees C under the carrier gas flux of 0.5 cc/mm2 min, show considerably uniform shape with 100 nm thick and 1-1.5 microm long legs. Also stoichiometric composition (O/Zn - 1) was observed without any second phase structures. While, the decrease of growth temperature and the increase of carrier gas flux, results in the irregular shaped nanostructures with non-stoichiometric composition. The excellent luminescence properties, strong excitonic UV emission at 3.25 eV without deep level emission, indicate that the high crystalline quality tetrapod structures can be formed at the optimized growth conditions.
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Affiliation(s)
- M N Jung
- Major of Semiconductor Physics, KMU, Pusan, Korea
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Ha SY, Jung MN, Park SH, Ko HJ, Ko H, Oh DC, Yao T, Chang JH. Growth of well-aligned ZnO nanorods using auge catalyst by vapor phase transportation. J Nanosci Nanotechnol 2006; 6:3624-7. [PMID: 17252824] [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] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Well-aligned ZnO nanorods have been achieved using new alloy (AuGe) catalyst. Zn powder was used as a source material and it was transported in a horizontal tube furnace onto an AuGe deposited Si substrates. The structural and optical properties of ZnO nanorods were characterized by scanning electron microscopy, high resolution X-ray diffraction, and photoluminescence. ZnO nanorods grown at 650 degrees C on 53 nm thick AuGe layer show uniform shape with the length of 8 +/- 0.5 microm and the diameter of 150 +/- 5 nm. Also, the tilting angle of ZnO nanorods (+/- 5.5 degrees) is confirmed by HRXRD. High structural quality of the nanorods is conformed by the photoluminescence measurement. All samples show strong UV emission without considerable deep level emission. However, weak deep level emission appears at high (700 degrees C) temperature due to the increase of oxygen desertion.
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Affiliation(s)
- S Y Ha
- Major of Semiconductor Physics, Korea Maritime University, Pusan, Korea
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Ko H. Testing for hypersensitivity reactions to intravenous drug and biologic agents: Recommendations in product labels. J Allergy Clin Immunol 2005. [DOI: 10.1016/j.jaci.2004.12.738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kim C, Ko H, Ryu W. 3P-0802 Effect of fibrate on lipoprotein (a) level in hypertriglyceridemic patients. ATHEROSCLEROSIS SUPP 2003. [DOI: 10.1016/s1567-5688(03)91020-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Higgins TL, Murray M, Kett DH, Fulda G, Kramer KM, Gelmont D, Dedhia HV, Levy H, Teres D, Zaloga GP, Ko H, Thompson KA. Trace element homeostasis during continuous sedation with propofol containing EDTA versus other sedatives in critically ill patients. Intensive Care Med 2001; 26 Suppl 4:S413-21. [PMID: 11310904 DOI: 10.1007/pl00003785] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To evaluate changes in serum and urinary zinc, cobalt, copper, iron, and calcium concentrations in critically ill patients receiving propofol containing disodium edetate (disodium ethylenediaminetetraacetic acid [EDTA]) versus sedative agents without EDTA. DESIGN This was a randomised, open-label, parallel-group study with randomisation stratified by baseline Acute Physiology and Chronic Health Evaluation (APACHE II) scores. SETTING Intensive care units (ICU) in 23 medical centres. PATIENTS Medical, surgical, or trauma ICU patients 17 years of age or older who required mechanical ventilator support and sedation. INTERVENTIONS A total of 106 patients received propofol containing 0.005 % EDTA (propofol EDTA), and 104 received other sedative agents without EDTA (non-EDTA). Only the first 108 patients were assessed for urinary trace metal excretion. Twenty-four-hour urine samples were collected on days 2, 3, and 7 and every 7 days thereafter for determination of zinc, cobalt, copper, iron, and calcium excretion; EDTA levels; urine osmolality; albumin levels; and glucose levels. The first 143 patients were assessed for serum concentration of zinc, cobalt, copper, iron, and calcium; creatinine; blood urea nitrogen; and albumin at baseline and once during each 24-hour urine collection. MEASUREMENTS AND RESULTS For the assessment of trace metals, patients receiving propofol EDTA demonstrated increased mean urinary excretion of zinc, copper, and iron compared with the normal range. All patients receiving sedatives demonstrated increased urinary excretion of zinc and copper above normal reference values. Compared with the non-EDTA sedative group, the propofol EDTA group demonstrated increased urinary excretion of zinc and iron. Mean serum concentrations of zinc and total calcium were decreased in both patient groups. Serum zinc concentrations increased from baseline to day 3 in the non-EDTA sedative group but not in the propofol EDTA group. Renal function, measured by blood urea nitrogen, serum creatinine, and creatinine clearance, did not deteriorate during ICU sedation with either regimen. CONCLUSION This study showed that critical illness is associated with increased urinary losses of zinc, copper, and iron. Propofol EDTA-treated patients had greater urinary losses of zinc and iron and lower serum zinc concentrations compared with the non-EDTA sedative group. No adverse events indicative of trace metal deficiency were observed in either group. The clinical significance of trace metal losses during critical illness is unclear and requires further study.
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Affiliation(s)
- T L Higgins
- Critical Care Division, Baystate Medical Center, Springfield, MA 01199, USA
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Abstract
Mild hypothermia as an intervention after perinatal asphyxia may prevent neurological damage in the newborn. We used stimulus-induced field potentials to monitor recovery from oxygen and glucose deprivation (OGD) in neocortex slices of 6-8-day-old wistar rats. OGD after a latency of 10.7+/-2.1 min (mean+/-S.E.) resulted in an anoxic depolarisation with an amplitude of 5.4+/-2.4 mV. Mild hypothermia of 31 degrees C (vs. 35 degrees C in the control group) was applied for 60 min after end of OGD. The 20, 40, 60 and 80% recovery of the field potential amplitude was significantly faster in the hypothermia group in comparison to the control group. These data indicate that mild postischemic hypothermia may have neuroprotective effects after perinatal asphyxia.
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Affiliation(s)
- H Ko
- Department of Neonatology, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353, Berlin, Germany.
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