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Kim DH, Lee S, Ahn J, Kim JH, Lee E, Lee I, Byun S. Transcriptomic and metabolomic analysis unveils nanoplastic-induced gut barrier dysfunction via STAT1/6 and ERK pathways. Environ Res 2024; 249:118437. [PMID: 38346486 DOI: 10.1016/j.envres.2024.118437] [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] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/18/2024] [Accepted: 02/05/2024] [Indexed: 02/18/2024]
Abstract
The widespread prevalence of micro and nanoplastics in the environment raises concerns about their potential impact on human health. Recent evidence demonstrates the presence of nanoplastics in human blood and tissues following ingestion and inhalation, yet the specific risks and mechanisms of nanoplastic toxicity remain inadequately understood. In this study, we aimed to explore the molecular mechanisms underlying the toxicity of nanoplastics at both systemic and molecular levels by analyzing the transcriptomic/metabolomic responses and signaling pathways in the intestines of mice after oral administration of nanoplastics. Transcriptome analysis in nanoplastic-administered mice revealed a notable upregulation of genes involved in pro-inflammatory immune responses. In addition, nanoplastics substantially reduced the expression of tight junction proteins, including occludin, zonula occluden-1, and tricellulin, which are crucial for maintaining gut barrier integrity and function. Importantly, nanoplastic administration increased gut permeability and exacerbated dextran sulfate sodium-induced colitis. Further investigation into the underlying molecular mechanisms highlighted significant activation of signaling transsducer and activator of transcription (STAT)1 and STAT6 by nanoplastic administration, which was in line with the elevation of interferon and JAK-STAT pathway signatures identified through transcriptome enrichment analysis. Additionally, the consumption of nanoplastics specifically induced nuclear factor kappa-B (NF-κB) and extracellular signal-regulated kinase (ERK)1/2 signaling pathways in the intestines. Collectively, this study identifies molecular mechanisms contributing to adverse effects mediated by nanoplastics in the intestine, providing novel insights into the pathophysiological consequences of nanoplastic exposure.
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Affiliation(s)
- Da Hyun Kim
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea
| | - Sungho Lee
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea
| | - Jisong Ahn
- Research Group of Traditional Food, Korea Food Research Institute, Wanju, 55365, Republic of Korea; Department of Food Science and Technology, Chonbuk National University, Jeonju, 54896, Republic of Korea
| | - Jae Hwan Kim
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea
| | - Eunjung Lee
- Research Group of Traditional Food, Korea Food Research Institute, Wanju, 55365, Republic of Korea; Department of Food Biotechnology, Korea University of Science and Technology, Daejeon, Republic of Korea.
| | - Insuk Lee
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea; POSTECH Biotech Center, Pohang University of Science and Technology (POSTECH), Pohang, 37673, Republic of Korea.
| | - Sanguine Byun
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea; POSTECH Biotech Center, Pohang University of Science and Technology (POSTECH), Pohang, 37673, Republic of Korea.
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2
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Mitchell RJ, Wijekulasuriya S, Mayor A, Borges FK, Tonelli AC, Ahn J, Seymour H. Principles for management of hip fracture for older adults taking direct oral anticoagulants: an international consensus statement. Anaesthesia 2024. [PMID: 38319797 DOI: 10.1111/anae.16226] [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] [Accepted: 12/04/2023] [Indexed: 02/08/2024]
Abstract
Hip fracture is a common serious injury among older adults, yet the management of hip fractures for patients taking direct oral anticoagulants remains inconsistent worldwide. Drawing from a synthesis of available evidence and expert opinion, best practice approaches for managing patients with a hip fracture and who are taking direct oral anticoagulants pre-operatively were considered by a working group of the Fragility Fracture Network Hip Fracture Audit Special Interest Group. The literature and related clinical guidelines were reviewed and a two-round modified Delphi study was conducted with a panel of experts from 16 countries and involved seven clinical specialities. Four consensus statements were achieved: peripheral nerve blocks can reasonably be performed on presentation for patients with hip fracture who are receiving direct oral anticoagulants; hip fracture surgery can reasonably be performed for patients taking direct oral anticoagulants < 36 h from last dose; general anaesthesia could reasonably be administered for patients with hip fracture and who are taking direct oral anticoagulants < 36 h from last dose (assuming eGFR > 60 ml.min-1 .1.73 m-2 ); and it is generally reasonable to consider recommencing direct oral anticoagulants (considering blood loss and haemoglobin) < 48 h after hip fracture surgery. No consensus was achieved regarding timing of spinal anaesthesia. The consensus statements were developed to aid clinicians in their decision-making and to reduce practice variations in the management of patients with hip fracture and who are taking direct oral anticoagulants. Each statement will need to be considered specific to each individual patient's treatment.
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Affiliation(s)
- R J Mitchell
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - S Wijekulasuriya
- Department of Anaesthesia, Huddersfield Royal Infirmary, Huddersfield, UK
| | - A Mayor
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - F K Borges
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - A C Tonelli
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Michigan, Ann Arbour, MI, USA
| | - J Ahn
- Department of Geriatric Medicine, Fiona Stanley Fremantle Hospitals Group, Perth, WA, Australia
| | - H Seymour
- Department of Geriatric Medicine, Fiona Stanley Fremantle Hospitals Group, Perth, WA, Australia
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3
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Lee CM, Lee S, Kim ES, Kim HB, Park WB, Moon SM, Kim YK, Park KH, Kwak YG, Kim B, Kim YS, Kim CJ, Gil HY, Ahn J, Song KH. Disease burden of bacteraemia with extended-spectrum beta-lactamase-producing and carbapenem-resistant Enterobacterales in Korea. J Hosp Infect 2024; 144:85-93. [PMID: 38072088 DOI: 10.1016/j.jhin.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/10/2023] [Accepted: 11/15/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Despite the significant impact of multi-drug-resistant bacteraemia, especially extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) and carbapenem-resistant Enterobacterales (CRE), the burden of disease has not been investigated thoroughly. AIM To evaluate the clinical outcomes and socio-economic burden of ESBL-E and CRE bacteraemia nationwide in the Republic of Korea. METHODS A search was undertaken for all cases of ESBL-E and CRE bacteraemia and matched controls in 10 hospitals in the Republic of Korea over 6 months. Patients with ESBL-E or CRE bacteraemia were classified as the R group, and matched controls with antibiotic-susceptible bacteraemia and without infection were classified as the S and N groups, respectively. Patients' clinical data were collected, and the economic burden was estimated based on medical expenses, loss of productivity and total costs. FINDINGS In total, 795 patients were identified, including 265 patients with ESBL-E or CRE bacteraemia and their matched controls. The mean total length of stay for patients with ESBL-E and CRE in the R group was 1.53 and 1.90 times that of patients in the S group, respectively. The 90-day mortality rates for ESBL-E in the R and S groups were 12.1% and 5.6%, respectively, and the corresponding figures for CRE were 28.6% and 12.0%. There were significant differences in the total costs between the R, S and N groups for both ESBL-E and CRE (ESBL-E: $11,151 vs $8712 vs $6063, P=0.004; CRE: $40,464 vs $8748 vs $7279, P=0.024). CONCLUSION The clinical and economic burden imposed by ESBL-E or CRE bacteraemia was extremely high. These findings suggest that efforts to control resistant bacteraemia are necessary to reduce this burden.
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Affiliation(s)
- C M Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - S Lee
- Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Pusan, South Korea
| | - E S Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - H B Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - W B Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - S M Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea; Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Y K Kim
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, South Korea
| | - K-H Park
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, South Korea
| | - Y G Kwak
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - B Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Y S Kim
- Division of Infectious Diseases, Chungnam National University School of Medicine, Daejeon, South Korea
| | - C-J Kim
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, South Korea
| | - H-Y Gil
- Real World Evidence Team, Pfizer Pharmaceuticals Korea Ltd, Seoul, South Korea
| | - J Ahn
- Department of Health Convergence, Ewha Womans University, Seoul, South Korea.
| | - K-H Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
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4
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Gorman BG, Campbell E, Mullen BL, Deo N, Ahn J, Carley S, Castro MR, Todd A, Vidal NY. Association between Hashimoto's thyroiditis and melanoma: a retrospective matched cohort study. Arch Dermatol Res 2023; 315:2721-2724. [PMID: 37477680 DOI: 10.1007/s00403-023-02669-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 05/16/2023] [Accepted: 07/13/2023] [Indexed: 07/22/2023]
Abstract
An inflammatory microenvironment has been shown to increase risk for malignant melanoma, suggesting that melanoma may be related to a pro-inflammatory state. Though Hashimoto's thyroiditis is one of the most common autoimmune diseases, there are no investigations of its relationship with melanoma. We aim to determine if Hashimoto's increases risk of developing melanoma. A retrospective, validated cohort of patients with a diagnosis of Hashimoto's between 2005 and 2020 were identified using the Olmsted County database. Patients were age and sex matched to controls without a Hashimoto's diagnosis. The primary outcomes were development of melanoma and time to first melanoma diagnosis. 4805 patients were included in the study, with 1726 (36%) having a diagnosis of Hashimoto's. Hashimoto's patients had no significant difference in risk of melanoma (relative risk 0.96, 95% CI 0.78-1.17) or nonmelanoma skin cancer (relative risk 0.95, 95% CI 0.86-1.06) compared with matched controls. This suggests that the local proinflammatory environment present in Hashimoto's does not contribute significantly to melanoma risk. Larger studies may be needed to further characterize the relationship between these diseases.
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Affiliation(s)
- B G Gorman
- Mayo Clinic Alix School of Medicine, 200 First Street SW, Rochester, MN, 55905, USA.
- Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, USA.
| | - E Campbell
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - B L Mullen
- Mayo Clinic Alix School of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - N Deo
- Mayo Clinic Alix School of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - J Ahn
- Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - S Carley
- Sharp Rees-Stealy Dermatology, San Diego, CA, USA
| | - M R Castro
- Division of Endocrinology, Mayo Clinic, Rochester, MN, USA
| | - A Todd
- Clinical Trials and Biostatistics Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - N Y Vidal
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
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5
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Inda-Webb ME, Jimenez M, Liu Q, Phan NV, Ahn J, Steiger C, Wentworth A, Riaz A, Zirtiloglu T, Wong K, Ishida K, Fabian N, Jenkins J, Kuosmanen J, Madani W, McNally R, Lai Y, Hayward A, Mimee M, Nadeau P, Chandrakasan AP, Traverso G, Yazicigil RT, Lu TK. Sub-1.4 cm 3 capsule for detecting labile inflammatory biomarkers in situ. Nature 2023; 620:386-392. [PMID: 37495692 DOI: 10.1038/s41586-023-06369-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 05/10/2022] [Accepted: 06/26/2023] [Indexed: 07/28/2023]
Abstract
Transient molecules in the gastrointestinal tract such as nitric oxide and hydrogen sulfide are key signals and mediators of inflammation. Owing to their highly reactive nature and extremely short lifetime in the body, these molecules are difficult to detect. Here we develop a miniaturized device that integrates genetically engineered probiotic biosensors with a custom-designed photodetector and readout chip to track these molecules in the gastrointestinal tract. Leveraging the molecular specificity of living sensors1, we genetically encoded bacteria to respond to inflammation-associated molecules by producing luminescence. Low-power electronic readout circuits2 integrated into the device convert the light emitted by the encapsulated bacteria to a wireless signal. We demonstrate in vivo biosensor monitoring in the gastrointestinal tract of small and large animal models and the integration of all components into a sub-1.4 cm3 form factor that is compatible with ingestion and capable of supporting wireless communication. With this device, diseases such as inflammatory bowel disease could be diagnosed earlier than is currently possible, and disease progression could be more accurately tracked. The wireless detection of short-lived, disease-associated molecules with our device could also support timely communication between patients and caregivers, as well as remote personalized care.
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Affiliation(s)
- M E Inda-Webb
- Synthetic Biology Group, MIT Synthetic Biology Center, Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- Research Laboratory of Electronics, Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - M Jimenez
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Q Liu
- Electrical and Computer Engineering Department, Boston University, Boston, MA, USA
| | - N V Phan
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - J Ahn
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - C Steiger
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - A Wentworth
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - A Riaz
- Electrical and Computer Engineering Department, Boston University, Boston, MA, USA
| | - T Zirtiloglu
- Electrical and Computer Engineering Department, Boston University, Boston, MA, USA
| | - K Wong
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - K Ishida
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - N Fabian
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Comparative Medicine, MIT, Cambridge, MA, USA
| | - J Jenkins
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - J Kuosmanen
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - W Madani
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - R McNally
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Y Lai
- Synthetic Biology Group, MIT Synthetic Biology Center, Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- Research Laboratory of Electronics, Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - A Hayward
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Division of Comparative Medicine, MIT, Cambridge, MA, USA
| | - M Mimee
- Department of Microbiology, Biological Sciences Division and Pritzker School of Molecular Engineering, The University of Chicago, Chicago, IL, USA
| | | | - A P Chandrakasan
- Department of Electrical Engineering and Computer Science, MIT, Cambridge, MA, USA
| | - G Traverso
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA.
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - R T Yazicigil
- Electrical and Computer Engineering Department, Boston University, Boston, MA, USA.
| | - T K Lu
- Synthetic Biology Group, MIT Synthetic Biology Center, Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
- Research Laboratory of Electronics, Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA.
- Senti Biosciences, South San Francisco, CA, USA.
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6
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Deo N, Campbell E, Gorman BG, Mullen BM, Ahn J, Carley S, Castro MR, Todd A, Vidal NY. Incidence of Melanoma is Not Elevated in Patients with Graves’ Disease: A Retrospective Matched Cohort Study. JAAD Int 2023; 11:222-223. [PMID: 37152216 PMCID: PMC10154956 DOI: 10.1016/j.jdin.2023.03.001] [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: 03/31/2023] Open
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7
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Carbone L, Ahn J, Adler R, Cervinka T, Craven C, Geerts W, Hsu J, Huang D, Karunakar M, Kiratli B, Krause P, Morse L, Mirick Mueller G, Nana A, Rogers E, Rivera J, Spitler C, Weaver F, Obremskey W. Acute Lower Extremity Fracture Management in Chronic Spinal Cord Injury: 2022 Delphi Consensus Recommendations. JB JS Open Access 2022; 7:JBJSOA-D-21-00152. [PMID: 36518619 PMCID: PMC9742097 DOI: 10.2106/jbjs.oa.21.00152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
UNLABELLED Our objective was to develop a clinical practice guideline (CPG) for the treatment of acute lower extremity fractures in persons with a chronic spinal cord injury (SCI). METHODS Information from a previous systematic review that addressed lower extremity fracture care in persons with an SCI as well as information from interviews of physical and occupational therapists, searches of the literature, and expert opinion were used to develop this CPG. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system was used to determine the quality of evidence and the strength of the recommendations. An overall GRADE quality rating was applied to the evidence. CONCLUSIONS Individuals with a chronic SCI who sustain an acute lower extremity fracture should be provided with education regarding the risks and benefits of operative and nonoperative management, and shared decision-making for acute fracture management should be used. Nonoperative management historically has been the default preference; however, with the advent of greater patient independence, improved surgical techniques, and advanced therapeutics and rehabilitation, increased use of surgical management should be considered. Physical therapists, kinesiotherapists, and/or occupational therapists should assess equipment needs, skills training, and caregiver assistance due to changes in mobility resulting from a lower extremity fracture. Therapists should be involved in fracture management as soon as possible following fracture identification. Pressure injuries, compartment syndrome, heterotopic ossification, nonunion, malunion, thromboembolism, pain, and autonomic dysreflexia are fracture-related complications that clinicians caring for patients who have an SCI and a lower extremity fracture may encounter. Strategies for their treatment are discussed. The underlying goal is to return the patient as closely as possible to their pre-fracture functional level with operative or nonoperative management.
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Affiliation(s)
- L.D. Carbone
- Charlie Norwood Veterans Affairs Medical Center, Augusta, Georgia,Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - J. Ahn
- Orthopaedic Trauma Service, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - R.A. Adler
- Central Virginia Veterans Affairs Health Care System, Richmond, Virginia,Virginia Commonwealth University, Richmond, Virginia
| | - T. Cervinka
- Department of Rehabilitation, Hospital Nova, Jyväskylä, Finland
| | - C. Craven
- KITE Research Institute, University Health Network, Toronto, Ontario, Canada,Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - W. Geerts
- Thromboembolism Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - J.R. Hsu
- Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, North Carolina
| | - D. Huang
- Spinal Cord Injury Care Line, Michael E. DeBakey VA Medical Center, Houston, Texas,H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
| | - M.A. Karunakar
- Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, North Carolina
| | - B.J. Kiratli
- Spinal Cord Injury Center, VA Palo Alto Health Care System, Palo Alto, California
| | - P.C. Krause
- Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - L.R. Morse
- Department of Rehabilitation Medicine, University of Minnesota School of Medicine, Minneapolis, Minnesota
| | - G.E. Mirick Mueller
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota,Hennepin County Medical Center, Minneapolis, Minnesota
| | - A. Nana
- Department of Orthopaedic Surgery, JPS Health Network, Fort Worth, Texas
| | - E. Rogers
- Spinal Cord Injury Service, VA Puget Sound Health Care System, Seattle, Washington
| | - J.C. Rivera
- Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - C. Spitler
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - F.M. Weaver
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research & Development, Department of Veterans Affairs, Hines VA Hospital, Hines, Illinois,Parkinson School of Health Sciences and Public Health, Loyola University, Maywood, Illinois
| | - W. Obremskey
- Center for Musculoskeletal Research, Division of Orthopaedic Trauma, Vanderbilt Orthopaedic Institute, Vanderbilt University Medical Center, Nashville, Tennessee,Email for corresponding author:
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Shin SY, Jung M, Byeon K, Kang K, Park Y, Hwang Y, Lee S, Jin E, Roh S, Kim J, Ahn J, Lee S, Choi E, Ahn M, Lip G. External validation of the biomarker based ABCD score in atrial fibrillation patients with a non gender CHA2DS2 VASc score 0 to 1, A Korean multicenter retrospective cohort. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.545] [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
Patients with low to intermediate risk atrial fibrillation (AF), defined as non-gender CHA2DS2-VASc score of 0–1, are still at risk of stroke. This study verified the usefulness of ABCD score (Age [≥60 years], B-type natriuretic peptide [BNP] or N-terminal pro-BNP [≥300 pg/ml], Creatinine clearance [<50 ml/min/1.73 m2], and Dimension of the left atrium [≥45 mm]) for stroke risk stratification in non-gender CHA2DS2-VASc score 0–1.
Methods
This multi-center cohort study retrospectively analyzed AF patients with non-gender CHA2DS2-VASc score 0–1. The primary endpoint was the incidence of stroke with or without anti-thrombotic treatment (ATT). An ABCD score was also validated.
Results
Overall, 2694 patients (56.3±9.5 years; female, 726 [26.9%]) were followed-up for 4.0±2.8 years. The overall stroke rate was 0.84/100 person-years (P-Y), stratified as follows: 0.46/100P-Y for an ABCD score 0; 1.02/100P-Y for an ABCD score≥1. The ABCD score was superior to the non-gender CHA2DS2-VASc score in stroke risk stratification (C-index=0.618, P=0.015; net reclassification improvement=0.576, P=0.040; integrated differential improvement=0.033, P=0.066). ATT was prescribed in 2353 patients (86.5%), and the stroke rate was significantly lower in patients receiving non-vitamin K antagonist oral anticoagulant (NOAC) therapy and an ABCD score≥1 than in those without ATT (0.44/100P-Y versus 1.55/100 P-Y; hazard ratio=0.26, 95% confidence interval 0.11–0.63, P=0.003).
Conclusion
The biomarker-based ABCD score demonstrated improved stroke risk stratification in AF patients with non-gender CHA2DS2-VASc score 0–1. Furthermore, NOAC with an ABCD score≥1 was associated with significantly lower stroke rate in AF patients with a non-gender CHA2DS2-VASc score 0–1.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Korean Disease Control and Prevention Agency
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Affiliation(s)
- S Y Shin
- Chung-Ang University Hospital , Seoul , Korea (Republic of)
| | - M Jung
- Chung-Ang University Hospital , Seoul , Korea (Republic of)
| | - K Byeon
- Chung-Ang University Hospital , Seoul , Korea (Republic of)
| | - K Kang
- Chung-Ang University Hospital , Seoul , Korea (Republic of)
| | - Y Park
- Gachon University Gil Medical Center , Incheon , Korea (Republic of)
| | - Y Hwang
- St. Vincent's Hospital , Suwon , Korea (Democratic People's Republic of)
| | - S Lee
- Kangbuk Samsung Hospital , Seoul , Korea (Republic of)
| | - E Jin
- Kyunghee University , Seoul , Korea (Republic of)
| | - S Roh
- Korea University Guro Hospital , Seoul , Korea (Democratic People's Republic of)
| | - J Kim
- Korea University Ansan Hospital, Cardiology , Ansan-Si , Korea (Republic of)
| | - J Ahn
- Pusan National University Hospital , Pusan , Korea (Republic of)
| | - S Lee
- Seoul National University Hospital , Seoul , Korea (Republic of)
| | - E Choi
- Seoul National University Hospital , Seoul , Korea (Republic of)
| | - M Ahn
- Wonju Severance Christian Hospital , Wonju , Korea (Republic of)
| | - G Lip
- University of Liverpool , Liverpool , United Kingdom
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Ahn J, Jeong BO. Clinical and radiological outcome of the locked plate osteosynthesis in distal metadiaphyseal tibial fracture according to the severity of comminution: Varus reduction would not be preferable with lower clinical outcomes. Niger J Clin Pract 2022; 25:1693-1698. [PMID: 36308241 DOI: 10.4103/njcp.njcp_173_22] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND The optimal treatment for distal tibial fractures remains a matter of debate. Nonetheless, plate osteosynthesis produces favorable results to intramedullary stabilization in aspects of alignment restoration. AIM The aim of the study was to compare the radiologic and clinical outcomes of distal metadiaphyseal tibial fracture between a simple/wedge fracture (SWF) and a comminuted fracture (CF) using minimally invasive plate osteosynthesis (MIPO). PATIENTS AND METHODS This retrospective study analyzed patients with SWF or CF of the distal tibial metadiaphysis that was surgically treated with a locking compression plate. Postoperative radiographic assessments and the time to radiologic union were noted. Clinical assessments were evaluated using both the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the foot function index (FFI). Postoperative complications were documented. RESULTS Seventy-one cases were analyzed over a mean follow-up period of 20.9 months. Thirty-six patients had SWF and 35 patients presented with CF. The mean time to radiologic union, amounts of postoperative coronal angulation, and incidence of malunion showed no statistical differences. Fibular fixation was more applied in the CF group (P < 0.001). Moreover, the clinical scores revealed no differences. Nonetheless, in the valgus union group, the AOFAS ankle-hindfoot score was 90.9 compared to 84.1 in the varus union group (P = 0.042) and the FFI was 9.2% compared to 20.2% in the varus union group (P = 0.017). CONCLUSION Plate osteosynthesis for SWF or CF of the distal tibial metadiaphysis led to high union rates and good clinical outcomes. There was no significant difference in the radiologic and clinical results according to the presence of fracture comminution. Nonetheless, the valgus union group showed better clinical outcomes than the varus union group. Clinically, it would be preferred to avoid intraoperative varus reduction.
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Affiliation(s)
- J Ahn
- Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Korea
| | - B O Jeong
- Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Korea
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Reuss J, Wonser D, Smith K, Ahn J, Byers S, Creswell K, Kim C, Parikh K, Thompson J, Crawford J, Cohen E, Zeck J, Gutierrez M, Liu S. EP08.01-044 A Phase 2 Multi-Cohort Study of Tiragolumab, Atezolizumab and Bevacizumab in Advanced Non-Squamous Non-Small Cell Lung Cancer. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.616] [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: 10/14/2022]
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Yang S, Jeon E, Jung K, Jung J, Ahn J, Kim B, Lee JC, Kim J, Hwang JH. 1303P Feasibility of endoscopic ultrasound-guided fine needle biopsy tissue sampling for whole exome sequencing in pancreatic cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Arora S, Zimmermann F, Solberg O, Nytroen K, Aaberge L, Okada K, Ahn J, Honda Y, Khush K, Pijls N, Angeras O, Karason K, Gullestad L, Fearon W. Multicenter Evaluation of Volumetric Intravascular Ultrasound Early After Heart Transplantation and Long-Term Prognosis. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.783] [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: 10/18/2022] Open
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Abstract
OBJECTIVES The present study aimed to investigate the incidence of and risk factors for postoperative pneumonia and aspiration pneumonia after hip fracture surgery. DESIGN Retrospective cohort study from 2005 to 2021. SETTING Asan Medical Center in Seoul, Republic of Korea. PARTICIPANTS A total 1,208 patients aged ≥ 65 years who underwent hip fracture surgery. MEASUREMENTS Postoperative pneumonia was defined as cases with new infiltration on chest x-ray or chest computed tomography (CT) after surgery or confirmed by a pulmonologist's consultation and diagnosis. Aspiration pneumonia was defined as: 1) radiologic findings of hospital-acquired pneumonia on chest radiographs or CT, medical record of aspiration pneumonia confirmed by a pulmonologist's consultation, and history of vomiting or aspiration, or 2) gravity-dependent opacity on chest CT when the history of vomiting or aspiration is ambiguous. Patient demographics, past medical history, pre-injury Koval score, Charlson Comorbidity Index (CCI), blood test results, length of hospital stay, and in-hospital mortality were evaluated. A comparison analysis and binary logistic regression were performed to identify the incidence and risk factors for postoperative pneumonia and aspiration pneumonia. RESULTS Postoperative pneumonia was diagnosed in 47 patients (3.9%), including 20 with aspiration pneumonia (1.7%). In the multivariate analysis, postoperative delirium (odds ratio [OR], 3.42; P < 0.001), American Society of Anesthesiologists (ASA) scores ≥ 3 (OR, 2.11; P = 0.021), and CCI (OR, 1.21; P = 0.013) were significant risk factors for postoperative pneumonia. Male sex (OR, 3.01; P = 0.017), postoperative delirium (OR, 3.16; P = 0.014), and preoperative serum albumin levels < 3.5 g/dL (OR, 7.00; P = 0.010) were significant risk factors for aspiration pneumonia. CONCLUSION ASA classification ≥ 3, higher CCI, and postoperative delirium were the risk factors for postoperative pneumonia. Male sex, postoperative delirium, and lower preoperative serum albumin level were the risk factors for aspiration pneumonia. Thus, physicians should pay attention to patients with the risk factors.
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Affiliation(s)
- J Ahn
- Ji Wan Kim, Department of Orthopedic Surgery, University of Ulsan, College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea, Phone: +82-2-3010-3530, Fax: +82-2-2045-4542, Email address: , ORCID: 0000-0002-3524-8706
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Ahn J, Kim MJ, Yoo A, Ahn J, Ha TY, Jung CH, Seo HD, Jang YJ. Identifying Codium fragile extract components and their effects on muscle weight and exercise endurance. Food Chem 2021; 353:129463. [PMID: 33743428 DOI: 10.1016/j.foodchem.2021.129463] [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: 07/28/2020] [Revised: 02/04/2021] [Accepted: 02/22/2021] [Indexed: 01/29/2023]
Abstract
Codium fragile (CF) is a type of green algae consumed as kimchi in Asia. UPLC-QTOF-MS/MS analysis showed that CF contain lysophosphatidyl choline, canthaxanthin, retinoic acid, α-tocopherol, and unsaturated fatty acids, which reportedly improve skeletal muscle health. However, the effect of CF on skeletal muscle mass and function remains to be elucidated. In mice fed with CF extracts, exercise endurance and muscle weight increased. CF extracts enhanced protein synthesis and myogenic differentiation through the mTORC1 pathway. CF extracts also promoted oxidative muscle fiber formation and mitochondrial biogenesis through the PGC-1α-related signaling pathway. Upregulation of PGC-1α by CF extracts was abolished by EX527 SIRT1 inhibitor treatment. Changed signaling molecules in the CF extracts were partially regulated by canthaxanthin, a new compound in CF extracts, suggesting that canthaxanthin contribute synergistically to the effect of CF extracts. Therefore, CF is a potential food source for sport nutrition or prevention of sarcopenia.
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Affiliation(s)
- Jisong Ahn
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju-gun 55365, Republic of Korea; Department of Food Science and Technology, Chonbuk National University, Jeonju-si 54896, Republic of Korea
| | - Min Jung Kim
- Healthcare Research Group, Korea Food Research Institute, Wanju-gun 55365, Republic of Korea
| | - Ahyoung Yoo
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju-gun 55365, Republic of Korea; Department of Food and Nutrition, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Jiyun Ahn
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju-gun 55365, Republic of Korea; Division of Food Biotechnology, University of Science and Technology, Daejeon 34113, Republic of Korea
| | - Tae Youl Ha
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju-gun 55365, Republic of Korea; Division of Food Biotechnology, University of Science and Technology, Daejeon 34113, Republic of Korea
| | - Chang Hwa Jung
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju-gun 55365, Republic of Korea; Division of Food Biotechnology, University of Science and Technology, Daejeon 34113, Republic of Korea
| | - Hyo Deok Seo
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju-gun 55365, Republic of Korea
| | - Young Jin Jang
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju-gun 55365, Republic of Korea; Major of Food Science & Technology, Seoul Women's University, Seoul 01797, Republic of Korea.
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Ahn J, Son HJ, Seo HD, Ha TY, Ahn J, Lee H, Shin SH, Jung CH, Jang YJ. γ-Oryzanol Improves Exercise Endurance and Muscle Strength by Upregulating PPARδ and ERRγ Activity in Aged Mice. Mol Nutr Food Res 2021; 65:e2000652. [PMID: 33932312 DOI: 10.1002/mnfr.202000652] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 04/05/2021] [Indexed: 12/24/2022]
Abstract
SCOPE γ-Oryzanol, a well-known antioxidant, has been used by body builders and athletes to boost strength and increase muscle gain, without major side effects. However, the effect of γ-Oryzanol on sarcopenia and the underlying molecular mechanism is poorly understood. RESULTS Aged mice fed with the γ-Oryzanol diet do not show significant changes in muscle weight, but show increased running endurance as well as improved grip strength. The expression and activity of PPARδ and ERRγ are increased in skeletal muscle of γ-Oryzanol supplemented mice. γ-Oryzanol upregulates oxidative muscle fibers by MEF2 transcription factor, and PGC-1α and ERRα expressions. Fatty acid oxidation related genes and mitochondria biogenesis are upregulated by γ-Oryzanol. In addition, γ-Oryzanol inhibits TGF-β-Smad-NADPH oxidase 4 pathway and inflammatory cytokines such as TNF-α, IL-1β, IL-6, and p65 NF-κB subunit, which cause skeletal muscle weakness. Collectively, γ-Oryzanol attenuates muscle weakness pathway and increases oxidative capacity by increasing PPARδ and ERRγ activity, which contributes to enhance strength and improve oxidative capacity in muscles, consequently enhancing exercise capacity in aged mice. Particularly, γ-Oryzanol directly binds to PPARδ. CONCLUSIONS These are the first findings showing that γ-Oryzanol enhances skeletal muscle function in aged mice by regulating PPARδ and ERRγ activity without muscle gain.
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Affiliation(s)
- Jisong Ahn
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju, 55365, Republic of Korea
- Department of Food Science and Technology, Chonbuk National University, Jeonju, 54896, Republic of Korea
| | - Hyo Jeong Son
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju, 55365, Republic of Korea
| | - Hyo Deok Seo
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju, 55365, Republic of Korea
| | - Tae Youl Ha
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju, 55365, Republic of Korea
- Division of Food Biotechnology, University of Science and Technology, Daejeon, 34113, Republic of Korea
| | - Jiyun Ahn
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju, 55365, Republic of Korea
- Division of Food Biotechnology, University of Science and Technology, Daejeon, 34113, Republic of Korea
| | - Hyunjung Lee
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju, 55365, Republic of Korea
| | - Seung Ho Shin
- Department of Food and Nutrition, Gyeongsang National University, Jinju, 52828, Republic of Korea
- The Hormel Institute, University of Minnesota, Austin, MN, 55912, USA
| | - Chang Hwa Jung
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju, 55365, Republic of Korea
- Division of Food Biotechnology, University of Science and Technology, Daejeon, 34113, Republic of Korea
| | - Young Jin Jang
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju, 55365, Republic of Korea
- Major of Food Science & Technology, Seoul Women's University, Seoul, 01797, Republic of Korea
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Dawan J, Kim JC, Ahn J. Insights into collateral susceptibility and collateral resistance in Acinetobacter baumannii during antimicrobial adaptation. Lett Appl Microbiol 2021; 73:168-175. [PMID: 33893654 DOI: 10.1111/lam.13488] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/26/2021] [Accepted: 04/12/2021] [Indexed: 11/29/2022]
Abstract
The susceptibility of Acinetobacter baumannii exposed to primary antibiotic can be either increased or decreased when exposed to secondary antibiotic. This study was designed to assess the relative fitness, collateral susceptibility and collateral resistance of polymyxin B- (PMB-) adapted A. baumannii to ciprofloxacin (CIP), meropenem (MER), PMB, tetracycline (TET) and tobramycin (TOB). Strains of wild-type A. baumannii KACC 12454 (ABKACC ), wild-type A. baumannii CCARM 12088 (ABCCARM ), PMB-adapted ABKACC , PMB-adapted ABCCARM , stabilized ABKACC and stabilized ABCCARM were used in this study. Compared to the wild-type ABKACC , the MICs of PMB were increased from 2 to 128 μg ml-1 against PMB-adapted ABKACC , while MICs of CIP, MER, TET and TOB were decreased from 2 to 1 μg ml-1 , 16 to 1 μg ml-1 , 16 to 2 μg ml-1 and 64 to 16 μg ml-1 , respectively. The PMB-adapted ABCCARM was resistant to CIP (32 μg ml-1 ) and PMB (64 μg ml-1 ) compared to the wild-type ABCCARM . The resistance of stabilized ABKACC and ABCCARM to all antibiotics was lost after antibiotic-free culture in the exception of CIP and TET. The susceptibilities of wild-type, PMB-adapted and stabilized ABKACC and ABCCARM to CIP, MER, PMB, TET and TOB were increased in the presence of β-lactamase and efflux pump inhibitors. The high levels of relative fitness were observed for stabilized ABKACC , PMB-adapted ABCCARM and stabilized ABCCARM . The stabilized ABKACC and PMB-adapted ABCCARM were highly heteroresistance to PMB and TET, respectively. The PMB-adapted ABKACC and ABCCARM showed various antibiotic patterns, known as collateral susceptibility and collateral resistance. The results provide useful information for designing effective antibiotic regimens that can enhance the antibiotic activity against A. baumannii infections.
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Affiliation(s)
- J Dawan
- Department of Biomedical Science and Institute of Bioscience and Biotechnology, Kangwon National University, Chuncheon, Republic of Korea
| | - J-C Kim
- Department of Biomedical Science and Institute of Bioscience and Biotechnology, Kangwon National University, Chuncheon, Republic of Korea
| | - J Ahn
- Department of Biomedical Science and Institute of Bioscience and Biotechnology, Kangwon National University, Chuncheon, Republic of Korea
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18
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Hopkins A, Lerner K, Grinich E, Ahn J, Choi Y, Simpson E. 321 The frequency and utility of drug cessation trials in older adults with chronic eczematous dermatitis of unknown etiology. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.343] [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: 10/21/2022]
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Dilawari A, Rentscher KE, Zhai W, Zhou X, Ahles TA, Ahn J, Bethea TN, Carroll JE, Cohen HJ, Graham DA, Jim H, McDonald B, Nakamura ZM, Patel SK, Root JC, Small BJ, Saykin AJ, Tometich D, Van Dyk K, Mandelblatt JS. Medical Care Disruptions During the First Six-Months of the COVID19 Pandemic: The Experience of Older Breast Cancer Survivors. Res Sq 2021. [PMID: 33880464 PMCID: PMC8057243 DOI: 10.21203/rs.3.rs-416077/v1] [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] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Purpose. Older cancer survivors required medical care during the COVID-19 pandemic despite infection risks, but there are limited data on medical care in this age group. Methods. We evaluated care disruptions in a longitudinal cohort of non-metastatic breast cancer survivors ages 60–98 from five US regions (n=321). Survivors completed a web-based or telephone survey from May 27, 2020 to September 11, 2020. Care disruptions included self-reported interruptions in ability to see doctors, receive treatment or supportive therapies, or fill prescriptions. Logistic regression models evaluated bivariate and multivariate associations between care disruptions and education, medical, psychosocial and COVID-19-related factors. Multivariate models included age, county COVID-19 rates, comorbidity and post-diagnosis time. Results. There was a high response rate (n=262, 81.6%). Survivors were 32.2 months post-diagnosis (SD 17.5, range 4–73). Nearly half (48%) reported a medical disruption. The unadjusted odds of care disruptions were significantly higher with more education (OR 1.23 per one-year increase, 95% CI 1.09–1.39, p =0.001) and greater depression (OR 1.04 per one-point increase in CES-D score, CI 1.003–1.08, p=0.033); tangible support decreased the odds of disruptions (OR 0.99, 95% CI 0.97–0.99 per one-point increase, p=0.012). There was a trend for associations between disruptions and comorbidity (unadjusted OR 1.13 per 1 added comorbidity, 95% CI 0.99–1.29, p=0.07). Adjusting for covariates, only higher education (p=0.001) and tangible social support (p=0.006) remained significantly associated with having care disruptions. Conclusions. Older breast cancer survivors reported high rates of medical care disruptions during the COVID-19 pandemic and psychosocial factors were associated with care disruptions.
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Affiliation(s)
- A Dilawari
- Medstar Washington Hospital Center Washington, DC.,Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - K E Rentscher
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA.,Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA
| | - W Zhai
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.,Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC
| | - X Zhou
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.,Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC
| | - T A Ahles
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - J Ahn
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA
| | - T N Bethea
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - J E Carroll
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA.,Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC
| | - H J Cohen
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC
| | - D A Graham
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ
| | - Hsl Jim
- Moffitt Cancer Center, Tampa, FL
| | - B McDonald
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine and Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN
| | - Z M Nakamura
- Department of Psychiatry, University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - S K Patel
- City of Hope National Medical Center, Los Angeles, CA
| | - J C Root
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - B J Small
- University of South Florida, Tampa, FL
| | - A J Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine and Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN
| | | | - K Van Dyk
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC
| | - J S Mandelblatt
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
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Brandes F, Striefler JK, Dörr A, Schmiester M, Märdian S, Koulaxouzidis G, Kaul D, Behzadi A, Thuss-Patience P, Ahn J, Pelzer U, Bullinger L, Flörcken A. Impact of a specialised palliative care intervention in patients with advanced soft tissue sarcoma - a single-centre retrospective analysis. BMC Palliat Care 2021; 20:16. [PMID: 33446180 PMCID: PMC7809873 DOI: 10.1186/s12904-020-00702-1] [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] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 12/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Soft tissue sarcomas (STS) account for less than 1% of all malignancies. Approximately 50% of the patients develop metastases with limited survival in the course of their disease. For those patients, palliative treatment aiming at symptom relief and improvement of quality of life is most important. However, data on symptom burden and palliative intervention are limited in STS patients. AIM Our study evaluates the effectiveness of a palliative care intervention on symptom relief and quality of life in STS patients. DESIGN/SETTING We retrospectively analysed 53 inpatient visits of 34 patients with advanced STS, admitted to our palliative care unit between 2012 and 2018. Symptom burden was measured with a standardised base assessment questionnaire at admission and discharge. RESULTS Median disease duration before admission was 24 months, 85% of patients had metastases. The predominant indication for admission was pain, weakness and fatigue. Palliative care intervention led to a significant reduction of pain: median NRS for acute pain was reduced from 3 to 1 (p < 0.001), pain within the last 24 h from 5 to 2 (p < 0.001) and of the median MIDOS symptom score: 18 to 13 (p < 0.001). Also, the median stress level, according to the distress thermometer, was reduced significantly: 7.5 to 5 (p = 0.027). CONCLUSIONS Our data underline that specialised palliative care intervention leads to significant symptom relief in patients with advanced STS. Further efforts should aim for an early integration of palliative care in these patients focusing primarily on the identification of subjects at high risk for severe symptomatic disease.
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Affiliation(s)
- F Brandes
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - J K Striefler
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - A Dörr
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - M Schmiester
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - S Märdian
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Centre for Musculoskeletal Surgery, Campus Virchow-Klinikum, Berlin, Germany
| | - G Koulaxouzidis
- Department of Surgery, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Plastic and Reconstructive Surgery, Berlin, Germany
| | - D Kaul
- Department of Radiation Oncology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - A Behzadi
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - P Thuss-Patience
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - J Ahn
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - U Pelzer
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - L Bullinger
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
- German Cancer Consortium (DKTK), partner site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Flörcken
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
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Kim D, Dion V, Ahn J, Erdelyi S, Sabhaney V. 349 The Physical Examination Is Unreliable in Determining the Location of the Ankle Physis in Healthy Children. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.364] [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: 11/30/2022]
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Lambert L, Knight K, Roseman M, Gordon K, Ahn J. Plate Waste Study of Fruit and Vegetable Consumption of Middle School Students. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.06.159] [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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Chauhan A, Dreta B, Sackstein P, Ahn J, Cheson B. 891MO Role of baseline PET SUVmax in predicting early progression in follicular lymphoma (FL): A single-center retrospective analysis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.009] [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] Open
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Ahn J, Ariyaratne T, Peacock A, Deltetto I, Taylor C, Kim E. PCV11 Cost-Effectiveness of Intravascular Ultrasound (IVUS) during Drug-Eluting Stent Implantation in Korea. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.029] [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: 10/23/2022]
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Pih G, Ahn J, Na H, Lee J, Jung K, Kim D, Choi K, Song H, Lee G, Jung H. P-180 Serum lipid levels and gastric cancer risk: A prospective case-control study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Ahn J, Ha TY, Ahn J, Jung CH, Seo HD, Kim MJ, Kim YS, Jang YJ. Undaria pinnatifida extract feeding increases exercise endurance and skeletal muscle mass by promoting oxidative muscle remodeling in mice. FASEB J 2020; 34:8068-8081. [PMID: 32293073 DOI: 10.1096/fj.201902399rr] [Citation(s) in RCA: 10] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 03/25/2020] [Accepted: 03/31/2020] [Indexed: 01/10/2024]
Abstract
Dietary habits can alter the skeletal muscle performance and mass, and Undaria pinnatifida extracts are considered a potent candidate for improving the muscle mass and function. Therefore, in this study, we aimed to assess the effect of U pinnatifida extracts on exercise endurance and skeletal muscle mass. C57BL/6 mice were fed a 0.25% U pinnatifida extract-containing diet for 8 weeks. U pinnatifida extract-fed mice showed increased running distance, total running time, and extensor digitorum longus and gastrocnemius muscle weights. U pinnatifida extract supplementation upregulated the expression of myocyte enhancer factor 2C, oxidative muscle fiber markers such as myosin heavy chain 1 (MHC1), and oxidative biomarkers in the gastrocnemius muscles. Compared to the controls, U pinnatifida extract-fed mice showed larger mitochondria and increased gene and protein expression of molecules involved in mitochondrial biogenesis and oxidative phosphorylation, including nuclear respiratory factor 2 and mitochondrial transcription factor A. U pinnatifida extract supplementation also increased the mRNA expression of angiogenesis markers, including VEGFa, VEGFb, FGF1, angiopoietin 1, and angiopoietin 2, in the gastrocnemius muscles. Importantly, U pinnatifida extracts upregulated the estrogen-related receptor γ and peroxisome proliferator-activated receptor gamma co-activator 1-alpha (PGC-1α)/AMP-activated protein kinase (AMPK)/sirtuin 1 (SIRT1) networks, which are partially increased by fucoxanthin, hesperetin, and caffeic acid treatments. Collectively, U pinnatifida extracts enhance mitochondrial biogenesis, increase oxidative muscle fiber, and promote angiogenesis in skeletal muscles, resulting in improved exercise capacity and skeletal muscle mass. These effects are attributable to fucoxanthin, hesperetin, and caffeic acid, bioactive components of U pinnatifida extracts.
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Affiliation(s)
- Jisong Ahn
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju-gun, Republic of Korea
- Department of Food Science and Technology, Chonbuk National University, Jeonju-si, Republic of Korea
| | - Tae Youl Ha
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju-gun, Republic of Korea
- Division of Food Biotechnology, University of Science and Technology, Daejeon, Republic of Korea
| | - Jiyun Ahn
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju-gun, Republic of Korea
- Division of Food Biotechnology, University of Science and Technology, Daejeon, Republic of Korea
| | - Chang Hwa Jung
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju-gun, Republic of Korea
- Division of Food Biotechnology, University of Science and Technology, Daejeon, Republic of Korea
| | - Hyo Deok Seo
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju-gun, Republic of Korea
| | - Min Jung Kim
- Healthcare Research Group, Korea Food Research Institute, Wanju-gun, Republic of Korea
| | - Young-Soo Kim
- Department of Food Science and Technology, Chonbuk National University, Jeonju-si, Republic of Korea
| | - Young Jin Jang
- Natural Materials and Metabolism Research Group, Korea Food Research Institute, Wanju-gun, Republic of Korea
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Tsai S, Pirruccio K, Ahn J. The brief window of time comprising a wheelchair transfer confers a significant fracture risk on elderly Americans. Public Health 2020; 182:1-6. [PMID: 32105994 DOI: 10.1016/j.puhe.2020.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 05/14/2019] [Revised: 12/23/2019] [Accepted: 01/10/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Wheelchairs grant increased mobility to their users but can result in injuries of varying severities, including fractures which are often associated with wheelchair transfers. However, this fracture burden remains poorly characterized in elderly Americans. The purpose of this study was to report demographic and environmental risk factors for these injuries. STUDY DESIGN We used data from the National Electronic Injury Surveillance System (NEISS) for the years 2007-2017 to perform a retrospective, cross-sectional analysis of wheelchair transfer fractures in patients aged 65 years and older. METHODS Each yearly sample in the NEISS database was queried between 2007 and 2017 for fractures associated with wheelchair transfers in patients aged 65 years or older. The narrative sections of the database were individually read and reviewed to identify cases in which a patient explicitly transferred into or out of a wheelchair while sustaining said fracture. RESULTS Between 2007 and 2017, the average number of patients aged 65 years and older presenting to US emergency departments was 3924 (95% confidence interval [CI] = 2792-5055). A significantly higher percentage of fractures (61.8%; 95% CI = 56.7%-66.8%) is associated with transferring out of wheelchairs. Moreover, such fractures were often associated with transferring to and from beds (29.9%; 95% CI = 25.4%-34.3%), with the hip (37.5%; 95% CI = 33.3%-41.6%) being the most commonly fractured anatomical region overall. A majority of patients required admission to the hospital (60.2%; 95%CI = 52.4%-68.0%) and most wheelchair transfer fractures occurred at home (44.1%; 95% CI = 36.7%-51.5%), with women (71.9%; 95% CI = 68.3%-75.6%) comprising the majority of these patients. CONCLUSIONS Our findings show that wheelchair transfers are associated with significant risk of severe fracture in elderly Americans. As such, wheelchair transfer events merit extra attention from healthcare providers because they comprise a brief window of time relative to the number of occupancy hours in full-time wheelchair users yet can result in significant morbidity and mortality. Preventative measures and patient education should be encouraged to preserve patient mobility and reduce injury.
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Affiliation(s)
- S Tsai
- Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - K Pirruccio
- Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - J Ahn
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Ahn J, Yu HY. P966 Impact of systolic dysfunction and elevated left ventricular end diastolic pressure on three years clinical outcome in patients with atrial fibrillation. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.598] [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
Systolic and diastolic dysfunction is related with adverse clinical outcomes in the patients with sinus rhythm. Purpose: The aim of this study is to clarify the prognostic significance of both systolic and diastolic dysfunction in the patients with chronic persistent atrial fibrillation (AF). Methods: A total of 114 consecutive patients who have chronic persistent AF. Whole patients were divided into 2 groups according to left ventricular ejection fraction (LVEF): those with an LVEF < 50 (n = 24) (REF) and those with an LVEF ≥ 50 (n = 90) (PEF). And PEF group was also divided into two groups according to left ventricular end diastolic filling pressure (LVEDP): patients with LVEDP ≥ 15 mmHg (n = 38) and those with < 15 mmHg (n = 52). Results: 3-year clinical outcomes were compared between each groups (PEF groups vs. REF groups and LVEDP ≥ 15 mmHg vs LVEDP < 15 mmHg). The incidence of death, hospitalization, stroke, bleeding, AF with rapid ventricular rhythm (RVR) and heart failure (HF) hospitalization were similar PEF and REF group. However, during 3-year follow up period, the incidence of HF hospitalization (29.2% vs 8.9%, p < 0.02) and AF with RVR (20.8% vs 3.3%, p < 0.01) were frequent in REF group compared with PEF group. In multivariate analysis, REF is an only predictor of HF hospitalization (Table 1). Conclusion: During 3-year follow up period, systolic dysfunction is an important predictor of HF hospitalization in AF patients. However, elevated LVEDP is not related with 3-year adverse clinical outcomes in AF patients without systolic dysfunction.
Table 1 variable Odd Ratio (HR) 95% Confidence Interval (CI) P Age .973 .925-1.023 .286 Diabetes mellitus .487 .138-1.721 .264 BNP 1.000 1.000-1.000 .908 Hypertension 1.061 .330-3.413 .921 LVEDP > 15 mmHg 1.302 .396-4.285 .664 EF < 50 4.712 1.478-15.016 .009 Predictors of 3-year follow-up clinical outcomes of all participants
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Affiliation(s)
- J Ahn
- Soonchunhyang University Gumi Hospital, Gumi, Korea (Republic of)
| | - H Y Yu
- Soonchunhyang University, Nursing, Cheonan, Korea (Republic of)
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Yoon H, Park H, Lee H, Sohn I, Ahn J, Lee S. P1.04-48 Prediction of Tumor Doubling Time of Lung Adenocarcinoma Using Radiomics Margin Characteristics. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.951] [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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Son H, Jang Y, Ahn J, Jung C, Ha T. P.1282, 6-Dimethoxy-1, 4-benzoquinone increases skeletal muscle mass through Akt/mTOR signaling pathway. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.184] [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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Choe JC, Cha KS, Shin JY, Ahn J, Park JS, Lee HW, Oh JH, Choi JH, Lee HC, Hong TJ. 3334Updated meta-analysis of biodegradable polymer drug-eluting stent versus second-generation durable polymer drug-eluting stent implantations. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0086] [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
Data regarding clinical outcomes of biodegradable polymer drug-eluting stent (BP-DES) versus second-generation durable polymer drug-eluting stent (DP-DES) in patients undergoing percutaneous coronary intervention (PCI) are inconclusive.
Purpose
We aimed to perform a meta-analysis to investigate the clinical outcomes of BP-DES compared with second-generation DP-DES in patients who have undergone PCI.
Methods
We searched PubMed, MEDLINE, EMBASE, and Cochrane databases through January 2019 for randomized controlled trials comparing BP-DES with second-generation DP-DES in patients treated with PCI. All-cause death, cardiac death, myocardial infarction (MI), target vessel revascularization (TVR), target lesion revascularization (TLR), definite/probable stent thrombosis (ST) were compared between the groups. Additionally, a landmark analysis with the landmark set at 1 year and a subgroup analysis according to stent characteristics were performed.
Results
Data from 23 trials including 28802 randomized patients were analyzed. At a median follow up of 3.1 years, no significant differences were found in terms of all-cause death (odds ratio [OR] 1.05, 95% confidence interval [CI] 0.95–1.16), cardiac death (OR 1.01, 95% CI 0.87–1.17), MI (OR 0.92, 95% CI 0.82–1.03), TVR (OR 0.97, 95% CI 0.86–1.11), TLR (OR 0.97, 95% CI 0.85–1.11), and definite/probable ST (OR 0.86, 95% CI 0.70–1.07) between the groups. Landmark analysis showed that there were similar risks in all-cause death (OR 1.04, 95% CI 0.93–1.17), cardiac death (OR 1.11, 95% CI 0.92–1.36), MI (OR 0.94, 95% CI 0.79–1.13), TVR (OR 0.95, 95% CI 0.73–1.23), TLR (OR 1.00, 95% CI 0.80–1.24), and definite/probable ST (OR 0.92, 95% CI 0.67–1.28) between the groups. The similar tendency of any study endpoints between the groups was consistent in the subgroup, including stent platform (stainless steel vs. alloy), the drug coating distribution (abluminal vs. circumferential), the polymer degradation period (<6 months vs. >6 months), or the drug release duration (<6 months vs. >6 months) of BP-DES, or the DAPT duration (≥6 months vs. ≥12 months). However, the uses of BP-DES with sirolimus-eluting (OR 0.84, 95% CI 0.72–0.98) or ultrathin strut (defined as <70μm; OR 0.81, 95% CI 0.68–0.97) were predictive for lower risk of MI.
Clinical outcomes
Conclusions
In our updated meta-analysis, BP-DES implantation was associated with comparable clinical outcomes compared with second-generation DP-DES implantation. However, PCI with ultrathin biodegradable polymer sirolimus-eluting stent could reduce the risk of MI.
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Affiliation(s)
- J C Choe
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - K S Cha
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J Y Shin
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J Ahn
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J S Park
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - H W Lee
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J H Oh
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J H Choi
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - H C Lee
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - T J Hong
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
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Kim Y, Ha T, Ahn J. P.56Role of NcoR1 and PGC-1 for mitochondrial dysfunction in skeletal muscle of ovariectomized mice. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.085] [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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Lim HE, Ahn J, Han SJ, Shim J, Kim YH, Choi EK, Oh S, Shin SY, Lip GYH. P1026Risk factors for the occurrence of stroke after atrial fibrillation ablation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0617] [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
Risk factors for the occurrence of embolic stroke (ES) after atrial fibrillation (AF) ablation have not been fully elucidated. Our aim was to assess incidence of ES during long-term follow-up following AF ablation and to identify predicting factors associated with post-ablation ES.
Methods
We enrolled patients who experienced ES after AF ablation and body mass index-matched controls from AF ablation registries. Epicardial adipose tissue (EAT) was assessed using multislice computed tomography prior to ablation.
Results
A total of 3,464 patients who underwent AF ablation were recruited. During a mean follow-up of 47.2 months, ES occurred in 47 patients (1.36%) with a mean CHA2DS2-VAS score of 2.15 and overall incidence of ES was 0.34 per 100 patients/year. Compared with control group (n=190), ES group had more higher prior thromboembolic event and AF recurrence rates, larger LA size, lower creatinine clearance rate (CCr), and greater total and periatrial EAT volumes although no differences in AF type, CHA2DS2-VASc score, ablation extent, and anti-thrombotics use were found. On multivariate regression analysis, a prior history of thromboembolism, CCr, and periatrial EAT volume were independently associated with ES occurrence after AF ablation.
Cox regression analysis Risk factor Univariate Multivariate HR (95% CI) p value HR (95% CI) p value Age 1.017 (0.984–1.051) 0.31 Prior thromboembolism 2.488 (1.134–5.460) 0.023 2.916 (1.178–7.219) 0.021 CHA2DS2-VASc score 1.139 (0.899–1.445) 0.282 CCr 0.984 (0.970–0.999) 0.038 0.982 (0.996–0.998) 0.029 LA diameter (mm) 1.070 (1.012–1.130) 0.017 1.072 (0.999–1.150) 0.054 EAT_total (ml) 1.020 (1.010–1.029) <0.001 1.008 (0.993–1.023) 0.297 EAT_periatrial (ml) 1.085 (1.045–1.126) <0.001 1.065 (1.005–1.128) 0.032 PVI + additional ablation 0.846 (0.460–1.557) 0.592 No anticoagulant use 0.651 (0.346–1.226) 0.184 Recurrence 2.011 (1.007–4.013) 0.048 1.240 (0.551–2.793) 0.603 CCr, creatinine clearance rate; EAT, epicardial adipose tissue; LA, left atrium; PVI, pulmonary vein isolation.
K-M curve for stroke-free survival
Conclusions
Incidence of ES after AF ablation was lower than expected rate based on CHA2DS2-VASc score even though anticoagulants use was limited. Periatrial EAT volume, a prior thromboembolism event, and CCr were independent factors in predicting ES irrespective of AF recurrence and CHA2DS2-VASc score in patients who underwent AF ablation.
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Affiliation(s)
- H E Lim
- Hallym University Sacred Heart Hospital, Cardiology, Anyang-Si, Gyeonggi-Do, Korea (Republic of)
| | - J Ahn
- Pusan National University Hospital, Cardiology, Pusan, Korea (Republic of)
| | - S J Han
- Hallym University Sacred Heart Hospital, Cardiology, Anyang-Si, Gyeonggi-Do, Korea (Republic of)
| | - J Shim
- Korea University Anam Hospital, Cardiology, Seoul, Korea (Republic of)
| | - Y H Kim
- Korea University Anam Hospital, Cardiology, Seoul, Korea (Republic of)
| | - E K Choi
- Seoul National University Hospital, Cardiology, Seoul, Korea (Republic of)
| | - S Oh
- Seoul National University Hospital, Cardiology, Seoul, Korea (Republic of)
| | - S Y Shin
- Chung-Ang University Hospital, Cardiology, Seoul, Korea (Republic of)
| | - G Y H Lip
- Liverpool Heart and Chest Hospital, Cardiovascular Science Centre, Liverpool, United Kingdom
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Ahn J, Ko KP, Lee M, Chi SG. NORE1A induces a feedback termination of TNF signaling by antagonizing TNFR1 through ITCH-mediated destruction complex. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz238.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Jang S, Lee KW, Magdalene T, Ahn J, Lee MG, Chi SG. XAF1 and ZNF313 complex stimulates ER stress-induced apoptosis via direct GRP78 inhibition. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz238.021] [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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Choe JC, Cha KS, Shin JY, Ahn J, Park JS, Lee HW, Oh JH, Choi JH, Lee HC, Hong TJ. P2799Long-term outcomes after percutaneous coronary intervention with biodegradable polymer drug-eluting stent versus second-generation durable polymer drug-eluting stent: evidence from a meta-analysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1112] [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: 11/13/2022] Open
Abstract
Abstract
Background
The true benefit of biodegradable polymer drug-eluting stent (BP-DES) over second-generation durable polymer drug-eluting stent (DP-DES) expected to be represented during late period of follow-up after percutaneous coronary intervention (PCI), but prior meta-analysis only evaluated short-term outcomes.
Purpose
We aimed to compare the long-term clinical outcomes after PCI with BP-DES versus second-generation DP-DES by a meta-analysis of randomized controlled trials.
Methods
Randomized controlled trials comparing BP-DES with second-generation DP-DES implantations were searched through PubMed, MEDLINE, EMBASE, and Cochrane databases. All-cause death, cardiac death, myocardial infarction (MI), target vessel revascularization (TVR), target lesion revascularization (TLR), and definite/probable stent thrombosis (ST) were compared between the groups. In addition, a landmark analysis with the landmark set at 1-year and a subgroup analysis based on stent characteristics were performed.
Results
Fifteen trials that included a total of 21311 randomized patients with at least 2 years follow-up were analyzed. At a median follow-up of 4.2 years, no significant differences in the risks of all-cause death (odds ratio [OR] 1.03, 95% confidence interval [CI] 0.94–1.14), cardiac death (OR 1.03, 95% CI 0.88–1.20), MI (OR 0.90, 95% CI 0.79–1.01), TVR (OR 0.96, 95% CI 0.82–1.12), TLR (OR 0.97, 95% CI 0.85–1.11), and definite/probable ST (OR 0.84, 95% CI 0.67–1.05) were found between the groups. In the 1-year landmark analysis, the rates of all-cause death (OR 1.04, 95% CI 0.93–1.17), cardiac death (OR 1.11, 95% CI 0.92–1.36), MI (OR 0.94, 95% CI 0.79–1.13), TVR (OR 0.95, 95% CI 0.73–1.23), TLR (OR 1.00, 95% CI 0.80–1.24), and definite/probable ST (OR 0.94, 95% CI 0.67–1.31) were similar between the groups. There were comparable rates of any study endpoints between the groups regardless of stent platform (stainless steel vs. alloy), the polymer degradation period (<6 months vs. >6 months) or the drug release duration (<6 months vs. >6 months) of BP-DES, or the DAPT duration (≥6 months vs. ≥12 months). However, the use of BP-DES with sirolimus eluting (OR 0.82, 95% CI 0.70–0.97), circumferential drug distribution (OR 0.79, 95% CI 0.65–0.96), thin strut (defined as <100μm; OR 0.83, 95% CI 0.70–0.97), or ultrathin strut (defined as <70μm; OR 0.78, 95% CI 0.64–0.94) were associated with lower rates of MI than did second-generation DP-DES. Moreover, BP-DES with circumferential drug distribution (OR 0.82, 95% CI 0.69–0.98) was predictive for reduced rates of TVR.
Clinical outcomes
Conclusions
In this meta-analysis, long-term clinical outcomes were equivalent between BP-DES and second-generation DP-DES implantations. However, among BP-DESs, the improved risks of MI in those with sirolimus eluting, circumferential drug distribution, thin strut, or ultrathin strut and decreased rates of TVR in those with circumferential drug distribution were noted.
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Affiliation(s)
- J C Choe
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - K S Cha
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J Y Shin
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J Ahn
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J S Park
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - H W Lee
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J H Oh
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J H Choi
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - H C Lee
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - T J Hong
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
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Roh YH, Lee ES, Ahn J, Kim HS, Gong HS, Baek KH, Chung HY. Factors affecting willingness to get assessed and treated for osteoporosis. Osteoporos Int 2019; 30:1395-1401. [PMID: 30944954 DOI: 10.1007/s00198-019-04952-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 03/14/2019] [Indexed: 01/06/2023]
Abstract
UNLABELLED Individuals with poor knowledge of osteoporosis and lower socioeconomic status, including being single and having a lower level of annual income, are less likely to be assessed or treated for osteoporosis. Individuals with particular osteoporosis risk factors such as smokers and heavy drinkers are overlooked for diagnosis. Further study is needed to identify and address the existing barriers and to promote osteoporosis management for women with these risk factors. INTRODUCTION Despite the negative health consequences of osteoporosis and the availability of effective treatment, a pervasive and persistent prevention care gap for osteoporosis remains present throughout the world. We attempted to identify the factors affecting the willingness of patients to either undergo or avoid assessment and treatment for osteoporosis. METHODS A nationwide online survey was conducted in 926 Korean women over age 50. The survey included questions addressing three domains: (1) clinical and socio-demographic characteristics, (2) questions concerning the reasons for undergoing or avoiding osteoporosis assessment or treatment, and (3) knowledge of osteoporosis as measured using the modified Korean version of Facts on Osteoporosis Quiz. The assessed and non-assessed participants were compared in terms of their clinical and socioeconomic statuses, reasons for undergoing or avoiding osteoporosis management, and levels of knowledge of osteoporosis. RESULTS The highest-ranked reason for undergoing osteoporosis assessment was fear of osteoporotic fracture, while the highest-ranked reason for avoiding osteoporosis assessment was not feeling a need to get tested for osteoporosis. Participants who sought assessment for osteoporosis were older and more likely to be married, and had greater knowledge of osteoporosis than those who did not seek assessment. The two groups were found to be similar in terms of tobacco use and daily alcohol use. Patients who had been diagnosed with osteoporosis but either did not initiate or discontinued osteoporosis treatment within 1 year were younger and had lower levels of annual income than those who began and continued treatment. CONCLUSION Individuals with poor knowledge of osteoporosis and those of lower socioeconomic status, including those who were single and had a lower level of annual income, were less likely to be assessed and treated for osteoporosis. Individuals with particular osteoporosis risk factors such as smokers and heavy drinkers are overlooked for diagnosis. Further study is needed to identify and address the existing barriers and to promote osteoporosis management for women with these risk factors.
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Affiliation(s)
- Y H Roh
- Department of Orthopaedic Surgery, Ewha Womans University Medical Center, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - E S Lee
- Department of Obstetrics and Gynecology, Soonchunhyang University Seoul Hospital, College of Medicine, Soonchunhyang University, Seoul, South Korea
| | - J Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea Medical Institute, Seoul, South Korea
| | - H S Kim
- Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, College of Medicine, Soonchunhyang University, Seoul, South Korea
| | - H S Gong
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, College of Medicine, Seoul National University, Seoul, South Korea
| | - K H Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - H Y Chung
- Division of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, South Korea.
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Ahn J, Woodfint RM, Lee J, Wu H, Ma J, Suh Y, Hwang S, Cressman M, Lee K. Comparative identification, nutritional, and physiological regulation of chicken liver-enriched genes. Poult Sci 2019; 98:3007-3013. [PMID: 30796787 DOI: 10.3382/ps/pez057] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/27/2019] [Indexed: 01/22/2023] Open
Abstract
The liver performs a number of vital functions in the chicken. In order to identify unique gene expression patterns and link them to potential functions in the chicken liver, genes enriched in the liver of chickens needed to be investigated in a comparative manner. In this study, 41 liver-enriched genes were identified through chicken microarray, and many of them were validated through comparative analysis of mice and humans. Thirteen of them were unique in chickens, and their liver enhancement was confirmed by reverse transcription PCR. Furthermore, the expression of those 13 chicken liver-enriched genes was investigated, in response to nutritional and physiological challenges. Real-time PCR revealed that expression of PIT54 (P < 0.01), phosphoribosyl pyrophosphate synthetase 2 (PRPS2) (P < 0.05), sulfotransferase (SULT) (P < 0.05), and cytochrome P450 family 2 subfamily C, polypeptide 18 (CYP2C18) (P < 0.05) were significantly decreased in the liver during fasting compared to ad libitum control. During the post-laying stage, expression of GAL8 was significantly increased (P < 0.01), but CYP2C18 expression was significantly reduced (P < 0.05). Liver-enriched genes that were identified in this study and their expression patterns under fasting and the post-laying stage will serve as future targets to gain a better understanding of liver physiology, function and development in poultry.
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Affiliation(s)
- J Ahn
- Department of Animal Sciences, The Ohio State University, Columbus, Ohio 43210
| | - R M Woodfint
- Department of Animal Sciences, The Ohio State University, Columbus, Ohio 43210
| | - J Lee
- Department of Animal Sciences, The Ohio State University, Columbus, Ohio 43210
| | - H Wu
- Department of Animal Sciences, The Ohio State University, Columbus, Ohio 43210
| | - J Ma
- Department of Animal Sciences, The Ohio State University, Columbus, Ohio 43210
| | - Y Suh
- Department of Animal Sciences, The Ohio State University, Columbus, Ohio 43210
| | - S Hwang
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Wanju-gun, Jeonbuk 55365, Republic of Korea
| | - M Cressman
- Department of Animal Sciences, The Ohio State University, Columbus, Ohio 43210
| | - K Lee
- Department of Animal Sciences, The Ohio State University, Columbus, Ohio 43210
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Ahn J, Kim H, Cho S. Therapy-related acute leukemia with mixed phenotype initially misdiagnosed as therapy-related all. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.471] [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: 11/16/2022]
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Kim H, Lim Y, Cho S, Ahn J. Measurement uncertainty of coagulation assays using the ACL TOP 750 CTS and the Stago STA Compact haemostasis testing systems. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Jang YJ, Ahn J, Son HJ, Jung CH, Ahn J, Ha TY. Hydrangea serrata
Tea Enhances Running Endurance and Skeletal Muscle Mass. Mol Nutr Food Res 2019; 63:e1801149. [DOI: 10.1002/mnfr.201801149] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 04/29/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Young Jin Jang
- Research Group of Natural Materials and MetabolismKorea Food Research Institute Wanju‐gun 55365 Republic of Korea
| | - Jisong Ahn
- Research Group of Natural Materials and MetabolismKorea Food Research Institute Wanju‐gun 55365 Republic of Korea
- Department of Food Science and TechnologyChonbuk National University Jeonju‐si 54896 Republic of Korea
| | - Hyo Jeong Son
- Research Group of Natural Materials and MetabolismKorea Food Research Institute Wanju‐gun 55365 Republic of Korea
| | - Chang Hwa Jung
- Research Group of Natural Materials and MetabolismKorea Food Research Institute Wanju‐gun 55365 Republic of Korea
- Division of Food BiotechnologyUniversity of Science and Technology Daejeon 34113 Republic of Korea
| | - Jiyun Ahn
- Research Group of Natural Materials and MetabolismKorea Food Research Institute Wanju‐gun 55365 Republic of Korea
- Division of Food BiotechnologyUniversity of Science and Technology Daejeon 34113 Republic of Korea
| | - Tae Youl Ha
- Research Group of Natural Materials and MetabolismKorea Food Research Institute Wanju‐gun 55365 Republic of Korea
- Division of Food BiotechnologyUniversity of Science and Technology Daejeon 34113 Republic of Korea
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Huang Q, Ahn J, Parisi D, Chang T, Hassager O, Panyukov S, Rubinstein M, Vlassopoulos D. Unexpected Stretching of Entangled Ring Macromolecules. Phys Rev Lett 2019; 122:208001. [PMID: 31172770 PMCID: PMC6778440 DOI: 10.1103/physrevlett.122.208001] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Indexed: 05/11/2023]
Abstract
In the melt state at equilibrium, entangled nonconcatenated ring macromolecules adapt more compact conformations compared to their linear analogs and do not form an entanglement network. We show here that, when subjected to uniaxial stretching, they exhibit a unique response, which sets them apart from any other polymer. Remarkably, whereas both linear and ring polymers strain-harden, the viscosity of the rings increases dramatically (the melt thickens) at very low stretch rates due to the unraveling of their conformations along the stretching direction. At high rates, stretching leads to viscosity thinning similar to that of entangled linear polymers, albeit with subtle differences.
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Affiliation(s)
- Q Huang
- Department of Chemical and Biochemical Engineering, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
| | - J Ahn
- Division of Advanced Materials Science and Department of Chemistry, Pohang University of Science and Technology, Pohang 790784, Korea
| | - D Parisi
- Institute of Electronic Structure and Laser, Foundation for Research and Technology Hellas (FORTH), Heraklion, Crete 70013, Greece
- Department of Materials Science and Technology, University of Crete, Heraklion, Crete 71003, Greece
| | - T Chang
- Division of Advanced Materials Science and Department of Chemistry, Pohang University of Science and Technology, Pohang 790784, Korea
| | - O Hassager
- Department of Chemical and Biochemical Engineering, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
| | - S Panyukov
- P. N. Lebedev Physics Institute, Russian Academy of Sciences, Moscow 117924, Russia
| | - M Rubinstein
- Departments of Mechanical Engineering and Materials Science, Biomedical Engineering, Chemistry, and Physics, Duke University, Durham, North Carolina 27708, USA
| | - D Vlassopoulos
- Institute of Electronic Structure and Laser, Foundation for Research and Technology Hellas (FORTH), Heraklion, Crete 70013, Greece
- Department of Materials Science and Technology, University of Crete, Heraklion, Crete 71003, Greece
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Page DB, Pucilowska J, Bennetts L, Kim I, Sanchez K, Martel M, Conlin A, Moxon N, Mellinger S, Acheson A, Kemmer K, Mitri Z, Vuky J, Ahn J, Abaya C, Manigault T, Basho R, Urba WJ, McArthur HL. Abstract P2-09-03: Updated efficacy of first or second-line pembrolizumab (pembro) plus capecitabine (cape) in metastatic triple negative breast cancer (mTNBC) and correlations with baseline lymphocyte and naïve CD4+ T-cell count. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-09-03] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: In mTNBC, anti-PD-1/L1 monotherapy is most effective when administered early in the course of disease, with recent trials demonstrating overall response rates (ORR) of 23-26% in the first-line setting and 5-6% in later lines. This may reflect iatrogenic lymphopenia from preceding cytotoxic chemotherapy. Furthermore, curative-intent chemotherapy is associated with prolonged suppression of naïve CD4+ cells, a T-cell subset that may play a critical role in the generation of de novo anti-tumor immune responses. We present the final clinical results of a pilot study evaluating the safety and efficacy of combining pembrolizumab plus standard-of-care capecitabine in the first/second-line mTNBC setting. We also explore potential associations between clinical benefit and lymphopenia, preceding chemotherapy, and absolute naïve CD4+ counts.
Methods: In a pilot study, we evaluated the tolerability and preliminary efficacy of concurrent pembro (200mg IV q21 day) plus investigator-selected 1st/2nd line paclitaxel (80mg/m2 IV weekly) or oral cape (2,000mg BID, weekly 1 on/1 off). The primary endpoint was tolerability, defined as the proportion of subjects receiving >6 weeks concurrent therapy without dose discontinuation with toxicities reported per CTCAE v4.0. The secondary endpoint was 12-week objective response rate (ORR) by RECIST1.1. Exploratory endpoints included peripheral blood cell enumeration by real-time flow cytometry and routine clinical laboratory. Naïve CD4+ cells were defined as CD45+ CD3+ TCRab+ CD4+ CD45RA+ CCR7+. Here, we report the results of the pilot phase of the cape cohort (NCT02734290).
Results: Twelve of 14 subjects were treated in the first-line setting. All subjects (14/14, 100%) tolerated cape+pembro for >6 weeks, with toxicities consistent with monotherapy cape experience (diarrhea: grade I-II 50%, grade III 7%; hand-foot: grade I-II 71%) that improved with dose-reduction as needed. At 12 weeks, the ORR was 6/14 (42.9%), and the clinical benefit rate (ORR + stable disease) was 8/14 (57.1%). Depressed absolute lymphocyte count at baseline (ALC<1.0/uL: 33% CBR; ALC≥1.0/uL: 75% CBR) and recent exposure to cytotoxic chemotherapy (<6 months: 33% CBR; >6 months: 75% CBR) were associated with reduced clinical benefit. By flow cytometry, subjects experiencing clinical benefit had higher baseline absolute naïve CD4+ counts (average 283 cells/uL v. 93 cells/uL, p=.069).
Conclusions: This study met the primary endpoint of safety for cape plus pembro in mTNBC, with encouraging clinical activity. These data are supportive of further studies evaluating combination chemotherapy plus anti-PD-1/L1 mTNBC. We observed greater clinical benefit in subjects with non-suppressed ALC, less exposure to recent chemo, and higher baseline naïve CD4+ counts, suggesting that iatrogenic immunosuppression can impair response to immune checkpoint therapy in mTNBC. These findings should be confirmed in ongoing randomized trials of immune checkpoint +/- chemotherapy in mTNBC, and should be considered in the design of future clinical trials.
Citation Format: Page DB, Pucilowska J, Bennetts L, Kim I, Sanchez K, Martel M, Conlin A, Moxon N, Mellinger S, Acheson A, Kemmer K, Mitri Z, Vuky J, Ahn J, Abaya C, Manigault T, Basho R, Urba WJ, McArthur HL. Updated efficacy of first or second-line pembrolizumab (pembro) plus capecitabine (cape) in metastatic triple negative breast cancer (mTNBC) and correlations with baseline lymphocyte and naïve CD4+ T-cell count [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-09-03.
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Affiliation(s)
- DB Page
- Earle A. Chiles Research Institute, Portland, OR; OHSU Knight Cancer Institute, Portland, OR; Cedars-Sinai Medical Center, Los Angeles, CA
| | - J Pucilowska
- Earle A. Chiles Research Institute, Portland, OR; OHSU Knight Cancer Institute, Portland, OR; Cedars-Sinai Medical Center, Los Angeles, CA
| | - L Bennetts
- Earle A. Chiles Research Institute, Portland, OR; OHSU Knight Cancer Institute, Portland, OR; Cedars-Sinai Medical Center, Los Angeles, CA
| | - I Kim
- Earle A. Chiles Research Institute, Portland, OR; OHSU Knight Cancer Institute, Portland, OR; Cedars-Sinai Medical Center, Los Angeles, CA
| | - K Sanchez
- Earle A. Chiles Research Institute, Portland, OR; OHSU Knight Cancer Institute, Portland, OR; Cedars-Sinai Medical Center, Los Angeles, CA
| | - M Martel
- Earle A. Chiles Research Institute, Portland, OR; OHSU Knight Cancer Institute, Portland, OR; Cedars-Sinai Medical Center, Los Angeles, CA
| | - A Conlin
- Earle A. Chiles Research Institute, Portland, OR; OHSU Knight Cancer Institute, Portland, OR; Cedars-Sinai Medical Center, Los Angeles, CA
| | - N Moxon
- Earle A. Chiles Research Institute, Portland, OR; OHSU Knight Cancer Institute, Portland, OR; Cedars-Sinai Medical Center, Los Angeles, CA
| | - S Mellinger
- Earle A. Chiles Research Institute, Portland, OR; OHSU Knight Cancer Institute, Portland, OR; Cedars-Sinai Medical Center, Los Angeles, CA
| | - A Acheson
- Earle A. Chiles Research Institute, Portland, OR; OHSU Knight Cancer Institute, Portland, OR; Cedars-Sinai Medical Center, Los Angeles, CA
| | - K Kemmer
- Earle A. Chiles Research Institute, Portland, OR; OHSU Knight Cancer Institute, Portland, OR; Cedars-Sinai Medical Center, Los Angeles, CA
| | - Z Mitri
- Earle A. Chiles Research Institute, Portland, OR; OHSU Knight Cancer Institute, Portland, OR; Cedars-Sinai Medical Center, Los Angeles, CA
| | - J Vuky
- Earle A. Chiles Research Institute, Portland, OR; OHSU Knight Cancer Institute, Portland, OR; Cedars-Sinai Medical Center, Los Angeles, CA
| | - J Ahn
- Earle A. Chiles Research Institute, Portland, OR; OHSU Knight Cancer Institute, Portland, OR; Cedars-Sinai Medical Center, Los Angeles, CA
| | - C Abaya
- Earle A. Chiles Research Institute, Portland, OR; OHSU Knight Cancer Institute, Portland, OR; Cedars-Sinai Medical Center, Los Angeles, CA
| | - T Manigault
- Earle A. Chiles Research Institute, Portland, OR; OHSU Knight Cancer Institute, Portland, OR; Cedars-Sinai Medical Center, Los Angeles, CA
| | - R Basho
- Earle A. Chiles Research Institute, Portland, OR; OHSU Knight Cancer Institute, Portland, OR; Cedars-Sinai Medical Center, Los Angeles, CA
| | - WJ Urba
- Earle A. Chiles Research Institute, Portland, OR; OHSU Knight Cancer Institute, Portland, OR; Cedars-Sinai Medical Center, Los Angeles, CA
| | - HL McArthur
- Earle A. Chiles Research Institute, Portland, OR; OHSU Knight Cancer Institute, Portland, OR; Cedars-Sinai Medical Center, Los Angeles, CA
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Lee J, Cha J, Shin S, Kim Y, Lee S, Cha H, Kim J, Kim D, Kang E, Ahn J, Kim H, Pak K, Yoon J, Park S. Comparison of clinical outcomes between laser-assisted zona pellucida opening and thinning. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.625] [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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Kim J, Cha J, Lee J, Shin S, Kim Y, Lee S, Cha H, Kim D, Kang E, Ahn J, Kim H, Pak K, Yoon J, Park S. When semen viscosity was overcome, it did not afeect the clinical outcomes of fresh embryo transfer cycles regardless of insemination methods. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.827] [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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Rowe CK, Shnorhavorian M, Block P, Ahn J, Merguerian PA. Using social media for patient-reported outcomes: A study of genital appearance and sexual function in adult bladder exstrophy patients. J Pediatr Urol 2018; 14:322.e1-322.e6. [PMID: 30078549 DOI: 10.1016/j.jpurol.2018.05.029] [Citation(s) in RCA: 8] [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: 12/31/2017] [Accepted: 05/29/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION There have been few prior studies on patient-centered outcomes of adults with bladder exstrophy; those performed have been single institution reviews. In collaboration with the Association for the Bladder Exstrophy Communities (ABeC) - an international support network for patients and families living with bladder exstrophy - an anonymous social media survey was performed of patient-reported genital appearance and erectile function. OBJECTIVE The study evaluated the Penile Perception Score (PPS) and the International Index of Erectile Function (IIEF-15) in adult men with bladder exstrophy. It was hypothesized that scores would be significantly lower than prior reported scores for men without the condition. STUDY DESIGN After review by an anonymous patient advocate volunteer, the ABeC performed an anonymous online survey using social media. RESULTS Adult men with bladder exstrophy reported PPS, and satisfaction with penile length and axis that were lower than prior published controls (n = 54, P < 0.05). Orgasmic function, sexual desire, and overall satisfaction were also lower (n = 46, P < 0.05). There was no difference in erectile function or intercourse satisfaction compared to controls. There was an association between PPS and erectile function, intercourse satisfaction, and overall satisfaction (P < 0.05) (Summary Fig.). Respondents identified urinary issues, genital appearance, and sexual function as the three main domains that warranted further research. CONCLUSION This study found that PPS and IIEF-15 were low in adult men with bladder exstrophy, and worse perception of genital appearance was associated with worse sexual satisfaction. Social media is a novel tool for patient-centered outcomes research, and continued collaboration with patients and patient advocate groups is vital.
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Affiliation(s)
- C K Rowe
- Division of Pediatric Urology, Seattle Children's Hospital, Seattle, USA.
| | - M Shnorhavorian
- Division of Pediatric Urology, Seattle Children's Hospital, Seattle, USA
| | - P Block
- Division of Pediatric Urology, Seattle Children's Hospital, Seattle, USA
| | - J Ahn
- Division of Pediatric Urology, Seattle Children's Hospital, Seattle, USA
| | - P A Merguerian
- Division of Pediatric Urology, Seattle Children's Hospital, Seattle, USA
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Ahn J, Lim Y, Rha S. Comparsion of bare metal stent (BMS) and non-drug eluting bioresorbable vascular scaffold system (BVS) in small size infrapopliteal artery: Preclinical study in porcine femoral arteries. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.392] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Choe JC, Cha KS, Shin JY, Lee SH, Ahn J, Park JS, Lee HW, Oh JH, Choi JH, Lee HC, Hong TJ, Jeong MH. 1466Prognosis of biodegradable polymer drug-eluting stents versus second-generation durable polymer drug-eluting stents in acute myocardial infarction patients following percutaneous coronary intervention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1466] [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)
- J C Choe
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - K S Cha
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - J Y Shin
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - S H Lee
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - J Ahn
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - J S Park
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - H W Lee
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - J H Oh
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - J H Choi
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - H C Lee
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - T J Hong
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - M H Jeong
- Chonnam National University Hospital, Department of Cardiology, Gwangju, Korea Republic of
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Kim Y, Lee S, Sohn M, Lee J, Kim D, Lee S, Shin Y, Kim S, Oh G, Lee Y, Joo M, Han E, Han J, Ahn J, Chang W, Kim Y. Assessment tools for functional independence and residual disability after stroke: Are they comparable? Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.458] [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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Kim D, Na H, Ahn J, Lee J, Jung K, Choi K, Song H, Lee G, Jung H. Comparison of efficacy and safety between redo-endoscopic treatment and surgery for recurrent gastric neoplasms at the scar of prior endoscopic submucosal dissection. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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