1
|
Park W, Wei S, Xie CL, Han JH, Kim BS, Kim B, Jin JS, Yang ES, Cho MK, Ryu D, Yang HX, Bae SJ, Ha KT. Targeting pyruvate dehydrogenase kinase 1 overcomes EGFR C797S mutation-driven osimertinib resistance in non-small cell lung cancer. Exp Mol Med 2024:10.1038/s12276-024-01221-2. [PMID: 38689087 DOI: 10.1038/s12276-024-01221-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/16/2024] [Accepted: 02/25/2024] [Indexed: 05/02/2024] Open
Abstract
Osimertinib, a selective third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), effectively targets the EGFR T790M mutant in non-small cell lung cancer (NSCLC). However, the newly identified EGFR C797S mutation confers resistance to osimertinib. In this study, we explored the role of pyruvate dehydrogenase kinase 1 (PDK1) in osimertinib resistance. Patients exhibiting osimertinib resistance initially displayed elevated PDK1 expression. Osimertinib-resistant cell lines with the EGFR C797S mutation were established using A549, NCI-H292, PC-9, and NCI-H1975 NSCLC cells for both in vitro and in vivo investigations. These EGFR C797S mutant cells exhibited heightened phosphorylation of EGFR, leading to the activation of downstream oncogenic pathways. The EGFR C797S mutation appeared to increase PDK1-driven glycolysis through the EGFR/AKT/HIF-1α axis. Combining osimertinib with the PDK1 inhibitor leelamine helped successfully overcome osimertinib resistance in allograft models. CRISPR-mediated PDK1 knockout effectively inhibited tumor formation in xenograft models. Our study established a clear link between the EGFR C797S mutation and elevated PDK1 expression, opening new avenues for the discovery of targeted therapies and improving our understanding of the roles of EGFR mutations in cancer progression.
Collapse
Affiliation(s)
- Wonyoung Park
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan, Gyeongsangnam-do, 50612, Republic of Korea
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan, Gyeongsangnam-do, 50612, Republic of Korea
| | - Shibo Wei
- Department of Precision Medicine, School of Medicine, Sungkyunkwan University School of Medicine, Suwon, Gyeonggi-do, 16419, Republic of Korea
| | - Chu-Long Xie
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Jung Ho Han
- Korean Medicine Application Center, Korea Institute of Oriental Medicine, Daegu, 41062, Republic of Korea
| | - Bo-Sung Kim
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan, Gyeongsangnam-do, 50612, Republic of Korea
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan, Gyeongsangnam-do, 50612, Republic of Korea
| | - Bosung Kim
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan, Gyeongsangnam-do, 50612, Republic of Korea
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan, Gyeongsangnam-do, 50612, Republic of Korea
| | - Jung-Sook Jin
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan, Gyeongsangnam-do, 50612, Republic of Korea
| | - Eun-Sun Yang
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan, Gyeongsangnam-do, 50612, Republic of Korea
| | - Min Kyoung Cho
- Department of Molecular Biology and Immunology, Kosin University College of Medicine, Busan, 49267, Republic of Korea
| | - Dongryeol Ryu
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005, Republic of Korea
| | - Hao-Xian Yang
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Sung-Jin Bae
- Department of Molecular Biology and Immunology, Kosin University College of Medicine, Busan, 49267, Republic of Korea.
| | - Ki-Tae Ha
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan, Gyeongsangnam-do, 50612, Republic of Korea.
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan, Gyeongsangnam-do, 50612, Republic of Korea.
| |
Collapse
|
2
|
Park J, Park SH, Kwon YR, Yoon SJ, Lim JH, Han JH, Shin JE, Eun HS, Park MS, Lee SM. Long-term outcomes of very low birth weight infants with intraventricular hemorrhage: a nationwide population study from 2011 to 2019. World J Pediatr 2024:10.1007/s12519-024-00799-x. [PMID: 38615088 DOI: 10.1007/s12519-024-00799-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 01/30/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Advancements in neonatal care have increased preterm infant survival but paradoxically raised intraventricular hemorrhage (IVH) rates. This study explores IVH prevalence and long-term outcomes of very low birth weight (VLBW) infants in Korea over a decade. METHODS Using Korean National Health Insurance data (NHIS, 2010-2019), we identified 3372 VLBW infants with IVH among 4,129,808 live births. Health-related claims data, encompassing diagnostic codes, diagnostic test costs, and administered procedures were sourced from the NHIS database. The results of the developmental assessments are categorized into four groups based on standard deviation (SD) scores. Neonatal characteristics and complications were compared among the groups. Logistic regression models were employed to identify significant changes in the incidence of complications and to calculate odds ratios with corresponding 95% confidence intervals for each risk factor associated with mortality and morbidity in IVH. Long-term growth and development were compared between the two groups (years 2010-2013 and 2014-2017). RESULTS IVH prevalence was 12% in VLBW and 16% in extremely low birth weight (ELBW) infants. Over the past decade, IVH rates increased significantly in ELBW infants (P = 0.0113), while mortality decreased (P = 0.0225). Major improvements in certain neurodevelopmental outcomes and reductions in early morbidities have been observed among VLBW infants with IVH. Ten percent of the population received surgical treatments such as external ventricular drainage (EVD) or a ventriculoperitoneal (VP) shunt, with the choice of treatment methods remaining consistent over time. The IVH with surgical intervention group exhibited higher incidences of delayed development, cerebral palsy, seizure disorder, and growth failure (height, weight, and head circumference) up to 72 months of age (P < 0.0001). Surgical treatments were also significantly associated with abnormal developmental screening test results. CONCLUSIONS The neurodevelopmental outcomes of infants with IVH, especially those subjected to surgical treatments, continue to be a matter of concern. It is imperative to prioritize specialized care for patients receiving surgical treatments and closely monitor their growth and development after discharge to improve developmental prognosis. Supplementary file2 (MP4 77987 kb).
Collapse
Affiliation(s)
- Joonsik Park
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Republic of Korea
| | - Sook-Hyun Park
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Republic of Korea
| | - Yu-Ra Kwon
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Republic of Korea
| | - So Jin Yoon
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Republic of Korea
| | - Joo Hee Lim
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Republic of Korea
| | - Jung Ho Han
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Republic of Korea
| | - Jeong Eun Shin
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Republic of Korea
| | - Ho Seon Eun
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Republic of Korea
| | - Min Soo Park
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Republic of Korea
| | - Soon Min Lee
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Republic of Korea.
| |
Collapse
|
3
|
Lee Y, Chowdhury T, Kim S, Yu HJ, Kim KM, Kang H, Kim MS, Kim JW, Kim YH, Ji SY, Hwang K, Han JH, Hwang J, Yoo SK, Lee KS, Choe G, Won JK, Park SH, Lee YK, Shin JH, Park CK, Kim CY, Kim JI. Central neurocytoma exhibits radial glial cell signatures with FGFR3 hypomethylation and overexpression. Exp Mol Med 2024; 56:975-986. [PMID: 38609519 PMCID: PMC11059271 DOI: 10.1038/s12276-024-01204-3] [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: 07/12/2023] [Revised: 12/01/2023] [Accepted: 01/30/2024] [Indexed: 04/14/2024] Open
Abstract
We explored the genomic events underlying central neurocytoma (CN), a rare neoplasm of the central nervous system, via multiomics approaches, including whole-exome sequencing, bulk and single-nuclei RNA sequencing, and methylation sequencing. We identified FGFR3 hypomethylation leading to FGFR3 overexpression as a major event in the ontogeny of CN that affects crucial downstream events, such as aberrant PI3K-AKT activity and neuronal development pathways. Furthermore, we found similarities between CN and radial glial cells based on analyses of gene markers and CN tumor cells and postulate that CN tumorigenesis is due to dysregulation of radial glial cell differentiation into neurons. Our data demonstrate the potential role of FGFR3 as one of the leading drivers of tumorigenesis in CN.
Collapse
Affiliation(s)
- Yeajina Lee
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
- Genomic Medicine Institute, Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Tamrin Chowdhury
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sojin Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyeon Jong Yu
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyung-Min Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ho Kang
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min-Sung Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jin Wook Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yong-Hwy Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - So Young Ji
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Kihwan Hwang
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Jung Ho Han
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Jinha Hwang
- Department of Laboratory Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Seong-Keun Yoo
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Kyu Sang Lee
- Department of Pathology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Gheeyoung Choe
- Department of Pathology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Jae-Kyung Won
- Department of Pathology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sung-Hye Park
- Department of Pathology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yong Kyu Lee
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, MD, 21205, USA
| | - Joo Heon Shin
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, MD, 21205, USA
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Chul-Kee Park
- Genomic Medicine Institute, Medical Research Center, Seoul National University, Seoul, Republic of Korea.
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
| | - Chae-Yong Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
| | - Jong-Il Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea.
- Genomic Medicine Institute, Medical Research Center, Seoul National University, Seoul, Republic of Korea.
| |
Collapse
|
4
|
Go KO, Ji SY, Kwon JE, Hwang K, Cho M, Park BH, Park KS, Kim JM, Koo CH, Jeon YT, Park S, Ryu JH, Han JH. Intraoperative Brainstem Auditory Evoked Potentials and Postoperative Nausea and Vomiting After Microvascular Decompression. World Neurosurg 2024:S1878-8750(24)00426-1. [PMID: 38493889 DOI: 10.1016/j.wneu.2024.03.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 03/11/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND We performed this study to investigate the effect of intraoperative brainstem auditory evoked potential (IBAEP) changes on the development of postoperative nausea and vomiting (PONV) after microvascular decompression (MVD) for neurovascular cross compression. METHODS A total of 373 consecutive cases were treated with MVD. The use of rescue antiemetics after surgery was used as an objective indicator of PONV. IBAEP monitoring was routinely performed in all. RESULTS The use of rescue antiemetics was significantly associated with female sex (OR = 3.427; 95% CI, 2.077-5.654; P < 0.001), PCA use (OR = 3.333; 95% CI, 1.861-5.104; P < 0.001), and operation time (OR = 1.017; 95% CI, 1.008-1.026; P < 0.001). A Wave V peak delay of more than 1.0 milliseconds showed a significant relation with the use of rescue antiemetics (OR = 1.787; 95% CI, 1.114-2.867; P = 0.016) and a strong significant relation with the use of rescue antiemetics more than 5 times (OR = 2.426; 95% CI, 1.372-4.290; P = 0.002). CONCLUSIONS A wave V peak delay of more than 1.0 milliseconds might have value as a predictor of PONV after MVD. More detailed neurophysiological studies will identify the exact pathophysiology underlying PONV after MVD.
Collapse
Affiliation(s)
- Kyeong-O Go
- Department of Neurosurgery, Gyeongsang National University Hospital, Jinju-si, Gyengsangnam-Do, South Korea
| | - So Young Ji
- Department of Neurosurgery, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-Do, South Korea; Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Ji-Eyon Kwon
- Department of Neurosurgery, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-Do, South Korea; Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Kihwan Hwang
- Department of Neurosurgery, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-Do, South Korea; Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Minjae Cho
- Department of Neurosurgery, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-Do, South Korea
| | - Byung Hwa Park
- Department of Neurology, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-Do, South Korea
| | - Kyung Seok Park
- Department of Neurology, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-Do, South Korea; Department of Neurology, Seoul National University College of Medicine, Seoul, South Korea
| | - Jong-Min Kim
- Department of Neurology, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-Do, South Korea; Department of Neurology, Seoul National University College of Medicine, Seoul, South Korea
| | - Chang-Hoon Koo
- Department of Anesthesiology, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-Do, South Korea; Department of Anesthesiology, Seoul National University College of Medicine, Seoul, South Korea
| | - Young-Tae Jeon
- Department of Anesthesiology, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-Do, South Korea; Department of Anesthesiology, Seoul National University College of Medicine, Seoul, South Korea
| | - Sanghon Park
- Department of Anesthesiology, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-Do, South Korea; Department of Anesthesiology, Seoul National University College of Medicine, Seoul, South Korea
| | - Jung-Hee Ryu
- Department of Anesthesiology, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-Do, South Korea; Department of Anesthesiology, Seoul National University College of Medicine, Seoul, South Korea
| | - Jung Ho Han
- Department of Neurosurgery, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-Do, South Korea; Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea.
| |
Collapse
|
5
|
Lee EJ, Kim YS, Kim JH, Woo KW, Park YH, Ha JH, Li W, Kim TI, An BK, Cho HW, Han JH, Choi JG, Chung HS. Uncovering the colorectal cancer immunotherapeutic potential: Evening primrose (Oenothera biennis) root extract and its active compound oenothein B targeting the PD-1/PD-L1 blockade. Phytomedicine 2024; 125:155370. [PMID: 38266440 DOI: 10.1016/j.phymed.2024.155370] [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] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/05/2024] [Accepted: 01/15/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND The emergence of immune checkpoint inhibitors, a novel class of immunotherapy drugs, represents a major breakthrough in cancer immunotherapy, substantially improving patient survival post-treatment. Blocking programmed death-ligand 1 (PD-L1) and programmed death protein-1 (PD-1) has demonstrated promising clinical results in various human cancer types. The US FDA has recently permitted only monoclonal antibody (mAb)-based PD-L1 or PD-1 blockers. Although these antibodies exhibit high antitumor efficacy, their size- and affinity-induced side effects limit their applicability. PURPOSE As small-molecule-based PD-1/PD-L1 blockers capable of reducing the side effects of antibody therapies are needed, this study focuses on exploring natural ingredient-based small molecules that can target hPD-L1/PD-1 using herbal medicines and their components. METHODS The antitumor potential of evening primrose (Oenothera biennis) root extract (EPRE), a globally utilized traditional herbal medicine, folk remedy, and functional food, was explored. A coculture system was established using human PD-L1-expressed murine MC38 cells (hPD-L1-MC38s) and CD8+ tumor-infiltrating T lymphocytes (CD8+ TILs) expressing humanized PD-1. The in vivo experiments utilized a colorectal cancer (CRC) C57BL/6 J mouse model bearing MC38 cells expressing humanized PD-L1 and PD-1 proteins. RESULTS EPRE and its active compound oenothein B effectively hindered the molecular interaction between hPD-L1 and hPD-1. EPRE stimulated tumor-specific T lymphocytes of a hPD-L1/PD-1 CRC mice. This action resulted in the elevated infiltration of cytotoxic CD8+T lymphocytes and subsequent tumor growth reduction. Moreover, the combined therapy of oenothein B, a PD-1/PD-L1 blocker, and FOLFOX (5-fluorouracil plus oxaliplatin) cooperatively suppressed hPD-L1-MC38s growth in the ex vivo model through activated CD8+ TIL antitumor immune response. Oenothein B exhibited a high binding affinity for hPD-L1 and hPD-1. We believe that this study is the first to uncover the inhibitory effects of EPRE and its component, oenothein B, on PD-1/PD-L1 interactions. CONCLUSION This study identified a promising small-molecule candidate from natural products that blocks the hPD-L1/PD-1 signaling pathway. These findings emphasize the potential of EPRE and oenothein B as effective anticancer drugs.
Collapse
Affiliation(s)
- Eun-Ji Lee
- Korean Medicine Application Center, Korea Institute of Oriental Medicine (KIOM), 70, Cheomdan-ro, Dong-gu, Daegu 41062, Republic of Korea
| | - Young Soo Kim
- Korean Medicine Application Center, Korea Institute of Oriental Medicine (KIOM), 70, Cheomdan-ro, Dong-gu, Daegu 41062, Republic of Korea
| | - Ji Hye Kim
- Korean Medicine Application Center, Korea Institute of Oriental Medicine (KIOM), 70, Cheomdan-ro, Dong-gu, Daegu 41062, Republic of Korea
| | - Kyeong Wan Woo
- National Development Institute of Korea Medicine, 27, Wondogwandeok-gil, Jangheung-eup, Jangheung-gun, Jeollanam-do 59319, Republic of Korea
| | - Young-Hoon Park
- New Drug Development Center, Daegu-Gyeongbuk Medical Innovation Foundation (DGMIF), 80, Cheombok-ro, Dong-gu, Daegu 41061, Republic of Korea
| | - Jung-Hye Ha
- New Drug Development Center, Daegu-Gyeongbuk Medical Innovation Foundation (DGMIF), 80, Cheombok-ro, Dong-gu, Daegu 41061, Republic of Korea
| | - Wei Li
- Korean Medicine Application Center, Korea Institute of Oriental Medicine (KIOM), 70, Cheomdan-ro, Dong-gu, Daegu 41062, Republic of Korea
| | - Tae In Kim
- Korean Medicine Application Center, Korea Institute of Oriental Medicine (KIOM), 70, Cheomdan-ro, Dong-gu, Daegu 41062, Republic of Korea
| | - Byeong Kwan An
- National Development Institute of Korea Medicine, 94, Hwarang-ro, Gyeongsan-si, Gyeongsangbuk-do 38540, Republic of Korea
| | - Hyun Woo Cho
- National Development Institute of Korea Medicine, 27, Wondogwandeok-gil, Jangheung-eup, Jangheung-gun, Jeollanam-do 59319, Republic of Korea
| | - Jung Ho Han
- Korean Medicine Application Center, Korea Institute of Oriental Medicine (KIOM), 70, Cheomdan-ro, Dong-gu, Daegu 41062, Republic of Korea
| | - Jang-Gi Choi
- Korean Medicine Application Center, Korea Institute of Oriental Medicine (KIOM), 70, Cheomdan-ro, Dong-gu, Daegu 41062, Republic of Korea.
| | - Hwan-Suck Chung
- Korean Medicine Application Center, Korea Institute of Oriental Medicine (KIOM), 70, Cheomdan-ro, Dong-gu, Daegu 41062, Republic of Korea; Korean Convergence Medical Science Major, KIOM Campus, University of Science and Technology (UST), 70, Cheomdan-ro, Dong-gu, Daegu 41062, Republic of Korea.
| |
Collapse
|
6
|
Koo CH, Ji SY, Han JH, Kim J, Bae YK, Jeon YT, Ryu JH. Effect of patient-controlled analgesia on development of postoperative nausea and vomiting in patients undergoing microvascular decompression: a prospective randomized controlled trial. J Neurosurg 2024:1-8. [PMID: 38335521 DOI: 10.3171/2023.12.jns231817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/04/2023] [Indexed: 02/12/2024]
Abstract
OBJECTIVE Postoperative nausea and vomiting (PONV) occurs frequently after microvascular decompression (MVD). Fentanyl, an opioid, is strongly related to the development of PONV, and ketorolac, a nonsteroidal anti-inflammatory drug, has been approved for postoperative pain management. However, how ketorolac-based patient-controlled analgesia (PCA) causes PONV or how its efficacy differs from that of fentanyl-based PCA after MVD is unclear. In this study, the authors compared ketorolac-based with fentanyl-based PCA in terms of the incidence and severity of PONV and analgesia after MVD. METHODS This prospective, double-blind, single-center, randomized controlled trial conducted from December 2021 to February 2023 included patients with MVD who were randomly allocated to the ketorolac- or fentanyl-based PCA group postoperatively. The incidence (primary outcome) and severity of PONV and rescue antiemetic requirements were determined during the first 48 hours postoperatively. Additionally, postoperative pain scores, rescue analgesic requirement, PCA usage, and satisfaction scores were assessed during the study period. PONV severity and postoperative pain scores were assessed using an 11-point numeric rating scale (0 = none, 10 = extremely). Satisfaction scores for PONV and pain were determined (0 = very dissatisfied, 10 = very satisfied). Categorical variables were analyzed using the chi-square or Fisher's exact test. Continuous variables were analyzed using the Student t-test or Mann-Whitney U-test based on normal distribution. RESULTS Of 185 screened patients, 91 were excluded based on predetermined exclusion criteria; 87 patients (43 in the ketorolac group and 44 in the fentanyl group) were analyzed and showed no significant differences in demographic data between groups. PONV incidence (48.8% vs 79.5%, p = 0.003) and severity (p = 0.004) were lower in the ketorolac-based PCA group than in the fentanyl-based PCA group. In the ketorolac group, there was a significant reduction in rescue antiemetic requirements compared with the fentanyl group (p = 0.049). The number of discontinuations was lower in the ketorolac-based PCA group than in the fentanyl-based PCA group (p = 0.001), whereas no significant differences in postoperative pain were found between the two groups. CONCLUSIONS In patients with MVD, ketorolac-based PCA resulted in a decrease in PONV incidence and severity compared with fentanyl-based PCA, with analgesic effects similar to those of fentanyl-based PCA. This study provides clinical evidence that ketorolac-based PCA may be a valid alternative to fentanyl-based PCA in postoperative care.
Collapse
Affiliation(s)
- Chang-Hoon Koo
- Departments of1Anesthesiology & Pain Medicine and
- Departments of2Anesthesiology & Pain Medicine and
| | - So Young Ji
- 3Neurosurgery, Seoul National University Bundang Hospital, Seongnam
- 4Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Ho Han
- 3Neurosurgery, Seoul National University Bundang Hospital, Seongnam
- 4Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
| | - Junkyu Kim
- Departments of1Anesthesiology & Pain Medicine and
| | - Yu Kyung Bae
- Departments of1Anesthesiology & Pain Medicine and
| | - Young-Tae Jeon
- Departments of1Anesthesiology & Pain Medicine and
- Departments of2Anesthesiology & Pain Medicine and
| | - Jung-Hee Ryu
- Departments of1Anesthesiology & Pain Medicine and
- Departments of2Anesthesiology & Pain Medicine and
| |
Collapse
|
7
|
Park SY, Jeong SJ, Han JH, Shin JE, Lee JH, Kang CM. Natal factors affecting developmental defects of enamel in preterm infants: a prospective cohort study. Sci Rep 2024; 14:2089. [PMID: 38267499 PMCID: PMC10808204 DOI: 10.1038/s41598-024-52525-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/19/2024] [Indexed: 01/26/2024] Open
Abstract
This study investigated natal factors influencing developmental defects of enamel (DDE) in premature infants using a newly refined preterm developmental defects of enamel (PDDE) index. Dental examinations were conducted on a cohort of 118 preterm infants (average age 3.5 ± 1.4 years) to record PDDE scores, while reviewing their medical records to examine natal factors. According to the logistic regression analysis, factors related to DDE prevalence were advanced maternal age, gestational age < 28 weeks, birth weight < 1000 g, 1 min APGAR score < 7, and hospitalization period > 2 months, which were significantly higher by 2.91, 5.53, 7.63, 10.02, and 4.0 times, respectively. According to regression analysis with generalized linear models, the PDDE scores were approximately 7.65, 4.96, and 15.0 points higher in premature children diagnosed with bronchopulmonary dysplasia, intraventricular hemorrhage, and necrotizing enterocolitis, respectively. When endotracheal intubation was performed, the PDDE score was 5.06 points higher. The prevalence of PDDE was primarily observed bilaterally in the maxillary anterior teeth. Extremely preterm infants showed significantly delayed tooth eruption, suggesting that the influence of gestational age on dental development rates. Identifying the factors related to DDE in premature children can inform early dental interventions to support the oral health of high-risk children.
Collapse
Affiliation(s)
- Shang-Yon Park
- Department of Pediatric Dentistry, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Su Jin Jeong
- Statistics Support Part, Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Jung Ho Han
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jeong Eun Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae-Ho Lee
- Department of Pediatric Dentistry, Yonsei University College of Dentistry, Seoul, Republic of Korea
- Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Chung-Min Kang
- Department of Pediatric Dentistry, Yonsei University College of Dentistry, Seoul, Republic of Korea.
- Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Republic of Korea.
| |
Collapse
|
8
|
Park W, Han JH, Wei S, Yang ES, Cheon SY, Bae SJ, Ryu D, Chung HS, Ha KT. Natural Product-Based Glycolysis Inhibitors as a Therapeutic Strategy for Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor-Resistant Non-Small Cell Lung Cancer. Int J Mol Sci 2024; 25:807. [PMID: 38255882 PMCID: PMC10815680 DOI: 10.3390/ijms25020807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/02/2024] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
Non-small cell lung cancer (NSCLC) is a leading cause of cancer-related deaths worldwide. Targeted therapy against the epidermal growth factor receptor (EGFR) is a promising treatment approach for NSCLC. However, resistance to EGFR tyrosine kinase inhibitors (TKIs) remains a major challenge in its clinical management. EGFR mutation elevates the expression of hypoxia-inducible factor-1 alpha to upregulate the production of glycolytic enzymes, increasing glycolysis and tumor resistance. The inhibition of glycolysis can be a potential strategy for overcoming EGFR-TKI resistance and enhancing the effectiveness of EGFR-TKIs. In this review, we specifically explored the effectiveness of pyruvate dehydrogenase kinase inhibitors and lactate dehydrogenase A inhibitors in combating EGFR-TKI resistance. The aim was to summarize the effects of these natural products in preclinical NSCLC models to provide a comprehensive understanding of the potential therapeutic effects. The study findings suggest that natural products can be promising inhibitors of glycolytic enzymes for the treatment of EGFR-TKI-resistant NSCLC. Further investigations through preclinical and clinical studies are required to validate the efficacy of natural product-based glycolytic inhibitors as innovative therapeutic modalities for NSCLC.
Collapse
Affiliation(s)
- Wonyoung Park
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea;
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan 50612, Republic of Korea; (E.-S.Y.); (S.-Y.C.)
| | - Jung Ho Han
- Korean Medicine Application Center, Korea Institute of Oriental Medicine, Daegu 41062, Republic of Korea;
| | - Shibo Wei
- Department of Molecular Cell Biology, School of Medicine, Sungkyunkwan University, Suwon 16419, Republic of Korea;
| | - Eun-Sun Yang
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan 50612, Republic of Korea; (E.-S.Y.); (S.-Y.C.)
| | - Se-Yun Cheon
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan 50612, Republic of Korea; (E.-S.Y.); (S.-Y.C.)
| | - Sung-Jin Bae
- Department of Molecular Biology and Immunology, Kosin University College of Medicine, Busan 49267, Republic of Korea;
| | - Dongryeol Ryu
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju 61005, Republic of Korea;
| | - Hwan-Suck Chung
- Korean Medicine Application Center, Korea Institute of Oriental Medicine, Daegu 41062, Republic of Korea;
| | - Ki-Tae Ha
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea;
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan 50612, Republic of Korea; (E.-S.Y.); (S.-Y.C.)
| |
Collapse
|
9
|
Kang H, Ji SY, Kim C, Koo J, Song J, Choi BY, Hwang K, Han JH. Hearing preservation after stereotactic radiosurgery for sporadic intracanalicular vestibular schwannomas classified as Koos grade 1. Cancer Med 2024; 13:e6990. [PMID: 38348957 PMCID: PMC10839155 DOI: 10.1002/cam4.6990] [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: 10/10/2023] [Revised: 12/19/2023] [Accepted: 01/22/2024] [Indexed: 02/15/2024] Open
Abstract
INTRODUCTION The mechanism of hearing loss following stereotactic radiosurgery (SRS) for vestibular schwannomas (VSs) remains unclear. There is conflicting evidence regarding cochlear nerve damage by transient volume expansion of VSs after radiosurgery and radiation-induced cochlear damage. This study aimed to investigate whether there is a specific patient population that can achieve definite hearing preservation after SRS for VSs. METHODS A total of 37 consecutive patients with sporadic unilateral intracanalicular VSs and serviceable hearing (Gardner-Roberson [G-R] class I or II) were treated with SRS from 2009 to 2023. This is a retrospective study. Survival analysis with Cox regression for hearing deterioration was performed. RESULTS The median age was 55 years old. The median tumor volume was 0.089 cm3 , and the median marginal dose was 12.0 Gy. Nonserviceable hearing deterioration occurred in 9 patients (24.3%), with a median onset of 11.9 months after SRS. The actuarial rates of serviceable hearing preservation were 86%, 82%, and 70% at 1, 2, and 3 years after SRS, respectively. In a multivariate analysis, only baseline pure tone average > 30 dB increased the risk of nonserviceable hearing deterioration with significant hazard ratio. There were 13 patients with petit VSs whose tumor volume was smaller than 0.05 cm3 , and 11 of them were treated by a 4-mm single shot with a marginal dose of 12 Gy. None of the 13 patients had nonserviceable hearing deterioration. CONCLUSIONS Petit VSs that can be treated with 4-mm single or double shots with a marginal dose of 12 Gy may achieve hearing preservation after SRS.
Collapse
Affiliation(s)
- Ho Kang
- Department of NeurosurgerySeoul National University Bundang Hospital, Seoul National University College of MedicineSeongnam‐siKorea
| | - So Young Ji
- Department of NeurosurgerySeoul National University Bundang Hospital, Seoul National University College of MedicineSeongnam‐siKorea
| | - Chae‐Yong Kim
- Department of NeurosurgerySeoul National University Bundang Hospital, Seoul National University College of MedicineSeongnam‐siKorea
| | - Ja‐Won Koo
- Department of OtorhinolaryngologySeoul National University Bundang Hospital, Seoul National University College of MedicineSeongnam‐siKorea
| | - Jae‐Jin Song
- Department of OtorhinolaryngologySeoul National University Bundang Hospital, Seoul National University College of MedicineSeongnam‐siKorea
| | - Byung Yoon Choi
- Department of OtorhinolaryngologySeoul National University Bundang Hospital, Seoul National University College of MedicineSeongnam‐siKorea
| | - Kihwan Hwang
- Department of NeurosurgerySeoul National University Bundang Hospital, Seoul National University College of MedicineSeongnam‐siKorea
| | - Jung Ho Han
- Department of NeurosurgerySeoul National University Bundang Hospital, Seoul National University College of MedicineSeongnam‐siKorea
| |
Collapse
|
10
|
Seo K, Hwang K, Noh M, Park J, Ahn KS, Ji SY, Han JH, Kim CY. Lower Plasma Amyloid Beta - 42 Levels Associated With Worse Survival in Patients With Glioma. In Vivo 2024; 38:425-430. [PMID: 38148047 PMCID: PMC10756474 DOI: 10.21873/invivo.13455] [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: 07/20/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND/AIM Glioma is often refractory. The accumulation of amyloid beta (Aβ) in the brain is commonly associated with Alzheimer's disease (AD), but there are studies suggesting that Aβ has tumor suppressor potential. The aim of this study was to identify a novel, non-invasive candidate biomarker for histological prediction and prognostic assessment of glioma. PATIENTS AND METHODS Serum was prepared from blood samples collected preoperatively from 48 patients with WHO grade II-IV glioma between October 2004 and December 2017 at a single tertiary institution. The concentration of Aβ42 was measured using the SMCxPRO immunoassay (Merck). The clinical and histological characteristics of the patients, including molecular subtypes, were reviewed. RESULTS The mean age of the patients was 52.2±12.5 years. The mean value of serum Aβ42 concentration was 7.6±7.8 pg/ml in the anaplastic astrocytoma (WHO grade III) group and 6.4±6.5 pg/ml in the glioblastoma multiforme (WHO grade IV) group. The Negative epidermal growth factor receptor (EGFR) expression was associated with higher serum Aβ42 levels (p=0.020). Kaplan-Meier analysis demonstrated that patients with high serum Aβ42 (>11.78 pg/ml) had significantly longer progression-free survival (PFS) (p=0.038) and overall survival (OS) (p=0.018). CONCLUSION This study investigated serum Aβ42 levels as a potential biomarker for glioma. The results showed that low serum Aβ42 levels were associated with EGFR expression and poor PFS and OS. Overall, these findings suggest a potential role of Aβ42 as a prognostic marker in astrocytomas.
Collapse
Affiliation(s)
- Kyeongjin Seo
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
- Department of Health Science and Technology, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
| | - Kihwan Hwang
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Minhee Noh
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jay Park
- The University of Edinburgh, Edinburgh Medical School, Edinburgh, U.K
| | - Kwang-Sung Ahn
- Functional Genome Institute, PDXen Biosystems Inc., Daejeon, Republic of Korea
| | - So Young Ji
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Jung Ho Han
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chae-Yong Kim
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea;
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
11
|
Park J, Park SH, Kim C, Yoon SJ, Lim JH, Han JH, Shin JE, Eun HS, Park MS, Lee SM. Growth and developmental outcomes of infants with hypoxic ischemic encephalopathy. Sci Rep 2023; 13:23100. [PMID: 38155236 PMCID: PMC10754824 DOI: 10.1038/s41598-023-50187-0] [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: 02/26/2023] [Accepted: 12/16/2023] [Indexed: 12/30/2023] Open
Abstract
Despite advances in obstetric care, hypoxic ischemic encephalopathy (HIE) remains a significant disease burden. We determined the national trends of HIE prevalence, therapeutic hypothermia (TH) use, mortality, and outcomes from 2012 to 2019. This study included term infants diagnosed with HIE between 2012 and 2019 from the National Health Insurance Service database. The prevalence of HIE was 2.4 per 1000 births without significant change during the period. TH was performed in approximately 6.7% of infants with HIE, and the annual variation ranged from 2.4 to 12.5%. The mortality among all term infants with HIE was 4.6%. The mortality rate among infants with HIE and TH significantly declined from 40 to 16.9% during the eight years. Infants with TH had higher mortality, increased use of inhaled nitric oxide, and more invasive ventilator use, indicating greater disease severity in the TH group. Infants with TH also showed significantly poorer outcomes, including delayed development, cerebral palsy, sensorineural hearing loss, and seizure, compared to infants without TH (p < 0.0001). With the increasing application of TH, mortality and developmental outcomes among infants with HIE have been improving in the past eight years in Korea. Further efforts to improve outcomes should be needed.
Collapse
Affiliation(s)
- Joonsik Park
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Sook Hyun Park
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Chloe Kim
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea
| | - So Jin Yoon
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Joo Hee Lim
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Jung Ho Han
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Jeong Eun Shin
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Ho Seon Eun
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Min Soo Park
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Soon Min Lee
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, Republic of Korea.
| |
Collapse
|
12
|
Han JH, Lee EJ, Park W, Choi JG, Ha KT, Chung HS. Cosmosiin Induces Apoptosis in Colorectal Cancer by Inhibiting PD-L1 Expression and Inducing ROS. Antioxidants (Basel) 2023; 12:2131. [PMID: 38136250 PMCID: PMC10740471 DOI: 10.3390/antiox12122131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/07/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
Immunotherapies, particularly those concerning immune checkpoint inhibitors, have transformed cancer treatment in recent years. Programmed death-ligand 1 (PD-L1) is a key target for immunotherapy that is overexpressed in the cells of colorectal cancer, a widespread malignant cancer that poses a significant healthcare challenge. This study investigated the effects of cosmosiin treatment on colorectal cancer cell lines. Cosmosiin is a naturally occurring flavone glycoside compound that has potential health benefits, including antioxidant and immunomodulatory effects. This study showed that cosmosiin effectively suppresses the expression of PD-L1 and triggers apoptosis, which is facilitated through pathways that are related to reactive oxygen species. These outcomes suggest that cosmosiin could be a promising candidate for an immune checkpoint inhibitor in the treatment of colorectal cancer.
Collapse
Affiliation(s)
- Jung Ho Han
- Korean Medicine (KM)-Application Center, Korea Institute of Oriental Medicine (KIOM), Daegu 41062, Republic of Korea; (J.H.H.); (E.-J.L.); (J.-G.C.)
| | - Eun-Ji Lee
- Korean Medicine (KM)-Application Center, Korea Institute of Oriental Medicine (KIOM), Daegu 41062, Republic of Korea; (J.H.H.); (E.-J.L.); (J.-G.C.)
| | - Wonyoung Park
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea; (W.P.); (K.-T.H.)
| | - Jang-Gi Choi
- Korean Medicine (KM)-Application Center, Korea Institute of Oriental Medicine (KIOM), Daegu 41062, Republic of Korea; (J.H.H.); (E.-J.L.); (J.-G.C.)
| | - Ki-Tae Ha
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea; (W.P.); (K.-T.H.)
| | - Hwan-Suck Chung
- Korean Medicine (KM)-Application Center, Korea Institute of Oriental Medicine (KIOM), Daegu 41062, Republic of Korea; (J.H.H.); (E.-J.L.); (J.-G.C.)
- Korean Convergence Medical Science Major, University of Science and Technology (UST), KIOM Campus, Daegu 41062, Republic of Korea
| |
Collapse
|
13
|
Yoon SJ, Kim D, Park SH, Han JH, Lim J, Shin JE, Eun HS, Lee SM, Park MS. Prediction of Postnatal Growth Failure in Very Low Birth Weight Infants Using a Machine Learning Model. Diagnostics (Basel) 2023; 13:3627. [PMID: 38132211 PMCID: PMC10743090 DOI: 10.3390/diagnostics13243627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
Accurate prediction of postnatal growth failure (PGF) can be beneficial for early intervention and prevention. We aimed to develop a machine learning model to predict PGF at discharge among very low birth weight (VLBW) infants using extreme gradient boosting. A total of 729 VLBW infants, born between 2013 and 2017 in four hospitals, were included. PGF was defined as a decrease in z-score between birth and discharge that was greater than 1.28. Feature selection and addition were performed to improve the accuracy of prediction at four different time points, including 0, 7, 14, and 28 days after birth. A total of 12 features with high contribution at all time points by feature importance were decided upon, and good performance was shown as an area under the receiver operating characteristic curve (AUROC) of 0.78 at 7 days. After adding weight change to the 12 features-which included sex, gestational age, birth weight, small for gestational age, maternal hypertension, respiratory distress syndrome, duration of invasive ventilation, duration of non-invasive ventilation, patent ductus arteriosus, sepsis, use of parenteral nutrition, and reach at full enteral nutrition-the AUROC at 7 days after birth was shown as 0.84. Our prediction model for PGF performed well at early detection. Its potential clinical application as a supplemental tool could be helpful for reducing PGF and improving child health.
Collapse
Affiliation(s)
- So Jin Yoon
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (S.J.Y.)
| | - Donghyun Kim
- Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul 03722, Republic of Korea
- InVisionLab Inc., Seoul 05854, Republic of Korea
| | - Sook Hyun Park
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (S.J.Y.)
| | - Jung Ho Han
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (S.J.Y.)
| | - Joohee Lim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (S.J.Y.)
| | - Jeong Eun Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (S.J.Y.)
| | - Ho Seon Eun
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (S.J.Y.)
| | - Soon Min Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (S.J.Y.)
| | - Min Soo Park
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (S.J.Y.)
| |
Collapse
|
14
|
Kim J, Jeong M, Yang S, Han JH, Bae SH. Incidence of Hearing Loss in Corpus Callosum Agenesis. Otol Neurotol 2023; 44:1033-1037. [PMID: 37733987 DOI: 10.1097/mao.0000000000004023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
OBJECTIVES Congenital corpus callosum agenesis (CCA) is one of the congenital anomalies in newborns, which usually presents with syndromic features. It can be asymptomatic or have variable neurological deficits. Some studies demonstrated that hearing loss can occur in patients with CCA; however, the exact prevalence remains unclear. Therefore, we aimed to investigate the prevalence of hearing loss in CCA using data from newborn hearing screening in a single tertiary referral center. METHODS A total of 126 patients with CCA combined with hearing loss diagnosed at our hospital from November 2005 to November 2022 were retrospectively included in our study. All patients had at least one screening or diagnostic auditory brainstem response result. Brain ultrasonography and magnetic resonance imaging were used to diagnose CCA. RESULTS Among 126 patients, 93 had automated auditory brainstem response within a month from birth. Of the 93 patients, 20 (21.5%) had a "refer" result in the screening tests in at least one ear. The final incidence of hearing loss in patients with CCA was 16.1%. We observed no hearing loss in 22 patients with isolated CCA. CONCLUSIONS Patients with CCA have a higher incidence of hearing loss. However, this is likely related to the concurrent condition of patients. CCA seems not to be a risk factor for hearing loss.
Collapse
Affiliation(s)
| | | | | | - Jung Ho Han
- Pediatrics, Yonsei University College of Medicine
| | - Seong Hoon Bae
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea
| |
Collapse
|
15
|
Han JH, Lee EJ, Park W, Ha KT, Chung HS. Natural compounds as lactate dehydrogenase inhibitors: potential therapeutics for lactate dehydrogenase inhibitors-related diseases. Front Pharmacol 2023; 14:1275000. [PMID: 37915411 PMCID: PMC10616500 DOI: 10.3389/fphar.2023.1275000] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 09/27/2023] [Indexed: 11/03/2023] Open
Abstract
Lactate dehydrogenase (LDH) is a crucial enzyme involved in energy metabolism and present in various cells throughout the body. Its diverse physiological functions encompass glycolysis, and its abnormal activity is associated with numerous diseases. Targeting LDH has emerged as a vital approach in drug discovery, leading to the identification of LDH inhibitors among natural compounds, such as polyphenols, alkaloids, and terpenoids. These compounds demonstrate therapeutic potential against LDH-related diseases, including anti-cancer effects. However, challenges concerning limited bioavailability, poor solubility, and potential toxicity must be addressed. Combining natural compounds with LDH inhibitors has led to promising outcomes in preclinical studies. This review highlights the promise of natural compounds as LDH inhibitors for treating cancer, cardiovascular, and neurodegenerative diseases.
Collapse
Affiliation(s)
- Jung Ho Han
- Korean Medicine (KM)-Application Center, Korea Institute of Oriental Medicine (KIOM), Daegu, Republic of Korea
| | - Eun-Ji Lee
- Korean Medicine (KM)-Application Center, Korea Institute of Oriental Medicine (KIOM), Daegu, Republic of Korea
| | - Wonyoung Park
- Korean Convergence Medical Science Major, KIOM Campus, University of Science and Technology (UST), Daegu, Republic of Korea
| | - Ki-Tae Ha
- Korean Convergence Medical Science Major, KIOM Campus, University of Science and Technology (UST), Daegu, Republic of Korea
| | - Hwan-Suck Chung
- Korean Medicine (KM)-Application Center, Korea Institute of Oriental Medicine (KIOM), Daegu, Republic of Korea
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan, Republic of Korea
| |
Collapse
|
16
|
Lee EJ, Choi JG, Han JH, Kim YW, Lim J, Chung HS. Single-Cell RNA Sequencing Reveals Immuno-Oncology Characteristics of Tumor-Infiltrating T Lymphocytes in Photodynamic Therapy-Treated Colorectal Cancer Mouse Model. Int J Mol Sci 2023; 24:13913. [PMID: 37762216 PMCID: PMC10531263 DOI: 10.3390/ijms241813913] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Photodynamic therapy (PDT) has shown promise in reducing metastatic colorectal cancer (CRC); however, the underlying mechanisms remain unclear. Modulating tumor-infiltrating immune cells by PDT may be achieved, which requires the characterization of immune cell populations in the tumor microenvironment by single-cell RNA sequencing (scRNA-seq). Here, we determined the effect of Chlorin e6 (Ce6)-mediated PDT on tumor-infiltrating T cells using scRNA-seq analysis. We used a humanized programmed death-1/programmed death ligand 1 (PD-1/PD-L1) MC38 cell allograft mouse model, considering its potential as an immunogenic cancer model and in combination with PD-1/PD-L1 immune checkpoint blockade. PDT treatment significantly reduced tumor growth in mice containing hPD-1/PD-L1 MC38 tumors. scRNA-seq analysis revealed that the PDT group had increased levels of CD8+ activated T cells and CD8+ cytotoxic T cells, but decreased levels of exhausted CD8+ T cells. PDT treatment also enhanced the infiltration of CD8+ T cells into tumors and increased the production of key effector molecules, including granzyme B and perforin 1. These findings provide insight into immune-therapeutic modulation for CRC patients and highlight the potential of PDT in overcoming immune evasion and enhancing antitumor immunity.
Collapse
Affiliation(s)
- Eun-Ji Lee
- Korean Medicine Application Center, Korea Institute of Oriental Medicine (KIOM), Daegu 41062, Republic of Korea; (E.-J.L.); (J.-G.C.); (J.H.H.)
| | - Jang-Gi Choi
- Korean Medicine Application Center, Korea Institute of Oriental Medicine (KIOM), Daegu 41062, Republic of Korea; (E.-J.L.); (J.-G.C.); (J.H.H.)
| | - Jung Ho Han
- Korean Medicine Application Center, Korea Institute of Oriental Medicine (KIOM), Daegu 41062, Republic of Korea; (E.-J.L.); (J.-G.C.); (J.H.H.)
| | - Yong-Wan Kim
- Dongsung Cancer Center, Dongsung Biopharmaceutical, Daegu 41061, Republic of Korea; (Y.-W.K.); (J.L.)
| | - Junmo Lim
- Dongsung Cancer Center, Dongsung Biopharmaceutical, Daegu 41061, Republic of Korea; (Y.-W.K.); (J.L.)
| | - Hwan-Suck Chung
- Korean Medicine Application Center, Korea Institute of Oriental Medicine (KIOM), Daegu 41062, Republic of Korea; (E.-J.L.); (J.-G.C.); (J.H.H.)
- Korean Convergence Medical Science Major, University of Science and Technology (UST), KIOM Campus, Daegu 41062, Republic of Korea
| |
Collapse
|
17
|
Wang LD, Zhang PH, Li Y, Li YH, Zhang B, Wang HJ, Wu J, Han JH, Li CN, Li N, Li XH, Ding GG, Wu ZS. [Deepening the Action on Salt Reduction in China-suggestions on strategy and implementation plan]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1-10. [PMID: 37190746 DOI: 10.3760/cma.j.cn112150-20221205-01176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Excessive sodium/salt intake is the leading dietary risk factor for the loss of healthy life in the Chinese population. The "Healthy China 2030" Action Plan set the goal of reducing salt intake by 20% by 2030. However, salt intake in China is still at a very high level in the world, with adults reaching 11 g/d, more than twice the recommended limit of 5 g/d. The current policies and action plans of China have targeted catering workers, children, adolescents, and home chefs in salt, oil, and sugar reduction actions. However, there are still obvious deficiencies in the coordinated promotion and implementation. This study, therefore, proposed a set of comprehensive strategies (named CHRPS that is composed of communication and education, salt reduction in home cooking, salt reduction in restaurants, reducing salt content in pre-packaged food, and surveillance and evaluation) and key implementation points for further deepening the salt reduction action in China. These strategies were developed based on the main sources of dietary sodium for Chinese residents, the status of"knowledge, attitude and practice"in salt reduction, evidence of effective intervention measures, existing policies and requirements, and the salt reduction strategies of the World Health Organization and experience from some other countries. As a scientific reference, the CHRPS strategies will help the government and relevant organizations quickly implement salt reduction work and facilitate the earlier realization of China's salt reduction goal.
Collapse
Affiliation(s)
- L D Wang
- Chinese Preventive Medicine Association, Beijing 100062
| | - P H Zhang
- The George Institute for Global Health (Australia) Beijing Representative Office, Beijing 100600
| | - Y Li
- The George Institute for Global Health (Australia) Beijing Representative Office, Beijing 100600
| | - Y H Li
- Chinese Center for Health Education, Beijing 100011
| | - B Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050
| | - H J Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050
| | - J Wu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050
| | - J H Han
- Chinese Nutrition Society, Beijing 100020
| | - C N Li
- Chinese Center for Health Education, Beijing 100011
| | - N Li
- China National Center for Food Safety Risk Assessment, Beijing 100024
| | - X H Li
- People's Medical Publishing House, Beijing 100021
| | - G G Ding
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050
| | - Z S Wu
- Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Diseases, Capital Medical University, Beijing 100029
| |
Collapse
|
18
|
Cho MK, Jin JS, Jo Y, Han JH, Shin S, Bae SJ, Ryu D, Joo J, Park JK, Ha KT. Frankincense ameliorates endometriosis via inducing apoptosis and reducing adhesion. Integr Med Res 2023; 12:100947. [PMID: 37168676 PMCID: PMC10165193 DOI: 10.1016/j.imr.2023.100947] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/10/2023] [Accepted: 02/20/2023] [Indexed: 04/05/2023] Open
Abstract
Background Frankincense, a resin derived from trees of the Boswellia genus, has been used as an incense and a type of herbal medicine for treating inflammatory diseases such arthritis, chronic bowel illness, and asthma. While endometriosis is a well-known inflammatory gynecological illness caused by the ectopic attachment and development of uterine tissue over the menstrual cycle, the impact of frankincense on this illness is poorly understood. The purpose of this study was to explore the effects of frankincense on endometriosis. Methods We used a network pharmacological assessment, in vitro and in vivo investigations with a human endometriotic cell line as well as a syngeneic uterine transfer mouse model. High-performance liquid chromatographic analysis was used to compare water-extracted frankincense (Fr) to its reference compounds and validate the sample. Results A network pharmacological analysis suggested a positive effect of Fr on endometriosis. Fr relieved endometriosis by reducing ectopic endometrial adherence and development, according to both in vivo and in vitro models. We suggested that the ER stress/p53-apoptosis and chemokine-migration/adhesion pathways underlie Fr's anti-endometriotic action using RNA sequencing and bioinformatic analysis. Conclusion This study revealed the potential effect of Fr on endometriosis using an experimental investigation. Fr may have the potential to be an effective and safe treatment for endometriosis.
Collapse
|
19
|
Seo SH, Hwang K, Ji SY, Han JH, Kim CY. Surgical Management and Long-Term Results of Rathke's Cleft Cyst. J Korean Neurosurg Soc 2023; 66:82-89. [PMID: 36274248 PMCID: PMC9837479 DOI: 10.3340/jkns.2022.0143] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/21/2022] [Accepted: 09/02/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE Rathke's cleft cysts (RCCs) are nonneoplastic cysts. Most of them are asymptomatic and stable; when symptomatic, RCCs are surgically fenestrated and drained. However, the outcomes remain unclear. The authors evaluated the outcomes of RCC decompression. METHODS Between 2004 and 2019, 32 RCCs were decompressed in a single tertiary institution. The clinical characteristics, intraoperative findings, postoperative complications, and endocrinological and surgical outcomes were retrospectively reviewed. Patients who underwent sequential imaging at least twice and at least 12 months after surgery were included in the analysis. RESULTS Patients' mean age was 40.8±14.9 years, and 62.5% were women. The mean follow-up duration was 62.3±48.6 months. In 21 patients (65.6%), no residual cysts were identified on postoperative magnetic resonance imaging. Of the 18 patients with preoperative visual field defects, 17 (94.4%) experienced postoperative visual improvement. Postoperative complications included endocrinological deterioration in 11 patients (34.4%), permanent diabetes insipidus in 11 (34.4%), infection in four (12.5%), intrasellar hemorrhage in three (9.4%), and cerebrospinal fluid leak in two (6.3%). Follow-up images revealed cyst recurrence in nine patients (28.1%), an average of 20.4 months after surgery; in three patients, the cysts were symptomatic, and resection was repeated. Multivariable analysis revealed that postoperative endocrinological deterioration was the only independent factor associated with cyst recurrence (p=0.028; hazard ratio, 6.800). CONCLUSION Our findings showed that although only cyst fenestration for decompression was performed to preserve pituitary function, more pituitary dysfunction occurred than expected. Besides, the postoperative hormonal deterioration itself acted as a risk factor for cyst recurrence. In conclusion, surgery for RCC should be more careful.
Collapse
Affiliation(s)
- Seung-Ho Seo
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kihwan Hwang
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
| | - So Young Ji
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jung Ho Han
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
| | - Chae-Yong Kim
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
20
|
Cho MK, Jin L, Han JH, Jin JS, Cheon SY, Shin S, Bae SJ, Park J, Ha KT. Corrigendum: Water-extracted Prunella vulgaris alleviates endometriosis by reducing aerobic glycolysis. Front Pharmacol 2022; 13:1112004. [PMID: 36582524 PMCID: PMC9793708 DOI: 10.3389/fphar.2022.1112004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fphar.2022.872810.].
Collapse
Affiliation(s)
- Min Kyoung Cho
- Korean Medicine Research Center for Healthy Aging Pusan National University, Yangsan, South Korea
| | - Ling Jin
- Korean Medicine Research Center for Healthy Aging Pusan National University, Yangsan, South Korea,Department of Korean Medical Science School of Korean Medicine Pusan National University, Yangsan, South Korea
| | - Jung Ho Han
- Korean Medicine Research Center for Healthy Aging Pusan National University, Yangsan, South Korea,Department of Korean Medical Science School of Korean Medicine Pusan National University, Yangsan, South Korea
| | - Jung-Suk Jin
- Korean Medicine Research Center for Healthy Aging Pusan National University, Yangsan, South Korea
| | - Se-Yun Cheon
- Korean Medicine Research Center for Healthy Aging Pusan National University, Yangsan, South Korea
| | - Su Shin
- Department of Korean Medical Science School of Korean Medicine Pusan National University, Yangsan, South Korea
| | - Sung-Jin Bae
- Department of Anatomy Kosin University College of Medicine, Busan, South Korea
| | - JangKyung Park
- Department of Korean Obstetrics and Gynecology Pusan National University Korean Medicine Hospital, Yangsan, South Korea,*Correspondence: JangKyung Park, ; Ki-Tae Ha,
| | - Ki-Tae Ha
- Korean Medicine Research Center for Healthy Aging Pusan National University, Yangsan, South Korea,Department of Korean Medical Science School of Korean Medicine Pusan National University, Yangsan, South Korea,*Correspondence: JangKyung Park, ; Ki-Tae Ha,
| |
Collapse
|
21
|
Park S, Han JH, Hwang J, Yon DK, Lee SW, Kim JH, Koyanagi A, Jacob L, Oh H, Kostev K, Dragioti E, Radua J, Eun HS, Shin JI, Smith L. The global burden of sudden infant death syndrome from 1990 to 2019: a systematic analysis from the Global Burden of Disease study 2019. QJM 2022; 115:735-744. [PMID: 35385121 DOI: 10.1093/qjmed/hcac093] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/26/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Sudden infant death syndrome (SIDS) still remains one of the leading causes of infant death worldwide, especially in high-income countries. To date, however, there is no detailed information on the global health burden of SIDS. AIMS To characterize the global disease burden of SIDS and its trends from 1990 to 2019 and to compare the burden of SIDS according to the socio-demographic index (SDI). DESIGN Systematic analysis based on the Global Burden of Disease (GBD) 2019 data. METHODS Epidemiological data of 204 countries from 1990 to 2019 were collected via various methods including civil registration and vital statistics in the original GBD study. Estimates for mortality and disease burden of SIDS were modeled. Crude mortality and mortality rates per 100 000 population were analyzed. Disability-adjusted life years (DALYs) and DALY rates were also assessed. RESULTS In 2019, mortality rate of SIDS accounted for 20.98 [95% Uncertainty Interval, 9.15-46.16] globally, which was a 51% decrease from 1990. SIDS was most prevalent in Western sub-Saharan Africa, High-income North America and Oceania in 2019. The burden of SIDS was higher in males than females consistently from 1990 to 2019. Higher SDI and income level was associated with lower burden of SIDS; furthermore, countries with higher SDI and income had greater decreases in SIDS burden from 1990 to 2019. CONCLUSIONS The burden of SIDS has decreased drastically from 1990 to 2019. However, the improvements have occurred disproportionately between regions and SDI levels. Focused preventive efforts in under-resourced populations are needed.
Collapse
Affiliation(s)
- S Park
- From the Yonsei College of Medicine, Seoul, 03722, Republic of Korea
| | - J H Han
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - J Hwang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - D K Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, 02447, Republic of Korea
| | - S W Lee
- Department of Data Science, Sejong University College of Software Convergence, Seoul, 05006, Republic of Korea
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, 16419, Republic of Korea
| | - J H Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - A Koyanagi
- Department of Research and Development Unit, Parc Sanitari Sant Joan de Deu/CIBERSAM, Universitat de Barcelona, Fundacio Sant Joan de Deu, Sant Boi de Llobregat, Barcelona, 08830, Spain
- Life and Medical Sciences, ICREA, Pg. Lluis Companys 23, Barcelona, 08010, Spain
| | - L Jacob
- Department of Research and Development Unit, Parc Sanitari Sant Joan de Deu/CIBERSAM, Universitat de Barcelona, Fundacio Sant Joan de Deu, Sant Boi de Llobregat, Barcelona, 08830, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, 28029, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, 78180, France
| | - H Oh
- School of Social Work, University of Southern California, Los Angeles, CA, 90089, USA
| | - K Kostev
- University Clinic of Marburg, Marburg, 35043, Germany
| | - E Dragioti
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, 58183, Sweden
| | - J Radua
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, WC2R 2LS, UK
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERSAM, Barcelona, 08036, Spain
- Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, 17176, Sweden
| | - H S Eun
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - J I Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - L Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| |
Collapse
|
22
|
Kwon JE, Park HJ, Ji SY, Han JH, Hong YK, Kim CY. SURG-09. EFFICACY OF A BIWEEKLY 3-STAGE STEREOTACTIC RADIOSURGERY FOR LARGE BRAIN METASTASES: THE EFFECT OF EGFR TYROSINE-KINASE INHIBITOR ON TUMOR RESPONSE AND CLINICAL OUTCOMES. Neuro Oncol 2022. [PMCID: PMC9660990 DOI: 10.1093/neuonc/noac209.975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Stereotactic radiosurgery(SRS) is one of primary treatment modalities for brain metastases(BM), however local control and radiation necrosis of large BM remain challenging. To overcome these limitations, biweekly 3-stage SRS for LBM was performed in this study. Total 53 patients were treated for 62 LBM. Female was 27(50.9%), and mean age was 63.7±11.8years. The mean KPS was 79.2±9.0 and GPA score was 1.9±0.7. Non-small cell lung cancer(NSCLC) was the most common primary cancer in 31 patients, others include 6 small cell lung cancer(SCLC), 9 gastro-intestinal tract cancer, 5 gynecological cancer, and etc. Epidermal growth factor receptor(EGFR) mutation was identified in 13 patients, and EGFR tyrosine-kinase inhibitor(TKI) was used in 10 patients during and after staged SRS. The mean tumor volume was 19.1cm3. The mean marginal dose of 11.7Gy was delivered to the 50% isodose line based on new treatment planning every two weeks. The mean tumor volume at the second and third stage was 14.8cm3 and 11.0cm3, respectively. The lesions from squamous cell carcinoma of NSCLC decreased most rapidly, and followed by gynecological cancer, SCLC and adenocarcinoma of NSCLC(volume ratio at 3rd stage was 0.39, 0.53, 0.56, and 0.64, respectively). The most significant factor related with tumor volume reduction at 3rd stage was usage of EGFR-TKI(p=0.016; LR analysis). The mean overall survival(OS) was 15.3months, and estimated OS were 62% and 46% at 6 and 12months. In the multivariate analysis, KPS(OR=0.918; 95% CI,0.871-0.968; p=0.002) and usage of EGFR-TKI(OR=0.216; 95% CI,0.059-0.790; p=0.021) were significantly associated with OS. The mean OS of the group of usage of EGFR-TKI was significantly longer than that of the others(20.7months, and 13.1months; p=0.029; log-rank test). The biweekly 3-stage SRS seems to be effective treatment for patients with LBM, especially in patients who were treated with EGFR-TKI during and/or after SRS, also cautiously considering the primary tumor origin.
Collapse
Affiliation(s)
- Ji-Eyon Kwon
- Seoul National University Bundang Hospital , Gyeonggi-do , Republic of Korea
| | - Hyun Joo Park
- Seoul National University Bundang Hospital , Gyeonggi-do , Republic of Korea
| | - So Young Ji
- Seoul National University Bundang Hospital , Gyeonggi-do , Republic of Korea
| | - Jung Ho Han
- Seoul National University Bundang Hospital , Gyeonggi-do , Republic of Korea
| | - Yong-Kil Hong
- Hallym University Sacred Heart Hospital , Gyeonggi-do , Republic of Korea
| | - Chae-Yong Kim
- Seoul National University Bundang Hospital , Gyeonggi-do , Republic of Korea
| |
Collapse
|
23
|
Yu X, Shi ZB, Jiang M, Yu GY, Zhu YL, Yang ZC, Chen W, Zhu YR, Fang KR, Tong RH, Han JH, Zhang XR. Analysis of synthetic electron cyclotron emission from the high field side of HL-2M tokamak plasmas. Rev Sci Instrum 2022; 93:083518. [PMID: 36050087 DOI: 10.1063/5.0098907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/26/2022] [Indexed: 06/15/2023]
Abstract
A synthetic electron cyclotron emission (ECE) diagnostic is used to interpret ECE signals from preset plasma equilibrium profiles, including magnetic field, electron density, and electron temperature. According to the simulation results, the electron temperature (Te) profile covering the harmonic overlap region can be obtained by receiving ECE signals at the high field side (HFS) of the HL-2M plasma. The third harmonic ECE at the low field side (LFS) cannot pass through the second harmonic resonance layer at the HFS unless the optical thickness (τ) of the second harmonic becomes gray (τ ≤ 2). In addition, the impact of the relativistic frequency down-shift has been evaluated and corrected. The measurable range of the HFS ECE has been calculated by scanning different parameters (electron density, temperature, and magnetic field). Higher plasma parameters allow a wider radial range of electron temperature measurements. The minimum inner measurable position can reach R = 120 cm (r/a = -0.89) when the product of core temperature (Te0) and density (ne0) is greater than 35 × 1019 keV m-3, which is extended by more than 30 cm inward compared with that of the LFS measurement. The HFS ECE will greatly improve the diagnostic ability of ECE systems on the HL-2M tokamak.
Collapse
Affiliation(s)
- X Yu
- Southwestern Institute of Physics, Chengdu 610041, China
| | - Z B Shi
- Southwestern Institute of Physics, Chengdu 610041, China
| | - M Jiang
- Southwestern Institute of Physics, Chengdu 610041, China
| | - G Y Yu
- Department of Electrical and Computer Engineering, University of California, Davis, California 95616, USA
| | - Y L Zhu
- Department of Electrical and Computer Engineering, University of California, Davis, California 95616, USA
| | - Z C Yang
- Southwestern Institute of Physics, Chengdu 610041, China
| | - W Chen
- Southwestern Institute of Physics, Chengdu 610041, China
| | - Y R Zhu
- Southwestern Institute of Physics, Chengdu 610041, China
| | - K R Fang
- Southwestern Institute of Physics, Chengdu 610041, China
| | - R H Tong
- Southwestern Institute of Physics, Chengdu 610041, China
| | - J H Han
- Sichuan University, Chengdu 610065, China
| | - X R Zhang
- Key Laboratory of Materials Modification by Beams of the Ministry of Education, School of Physics, Dalian University of Technology, Dalian 116024, China
| |
Collapse
|
24
|
Han JH, Yoon SJ, Lee HS, Park G, Lim J, Shin JE, Eun HS, Park MS, Lee SM. Application of Machine Learning Approaches to Predict Postnatal Growth Failure in Very Low Birth Weight Infants. Yonsei Med J 2022; 63:640-647. [PMID: 35748075 PMCID: PMC9226835 DOI: 10.3349/ymj.2022.63.7.640] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 03/22/2022] [Accepted: 03/25/2022] [Indexed: 01/05/2023] Open
Abstract
PURPOSE The aims of the study were to develop and evaluate a machine learning model with which to predict postnatal growth failure (PGF) among very low birth weight (VLBW) infants. MATERIALS AND METHODS Of 10425 VLBW infants registered in the Korean Neonatal Network between 2013 and 2017, 7954 infants were included. PGF was defined as a decrease in Z score >1.28 at discharge, compared to that at birth. Six metrics [area under the receiver operating characteristic curve (AUROC), accuracy, precision, sensitivity, specificity, and F1 score] were obtained at five time points (at birth, 7 days, 14 days, 28 days after birth, and at discharge). Machine learning models were built using four different techniques [extreme gradient boosting (XGB), random forest, support vector machine, and convolutional neural network] to compare against the conventional multiple logistic regression (MLR) model. RESULTS The XGB algorithm showed the best performance with all six metrics across the board. When compared with MLR, XGB showed a significantly higher AUROC (p=0.03) for Day 7, which was the primary performance metric. Using optimal cut-off points, for Day 7, XGB still showed better performances in terms of AUROC (0.74), accuracy (0.68), and F1 score (0.67). AUROC values seemed to increase slightly from birth to 7 days after birth with significance, almost reaching a plateau after 7 days after birth. CONCLUSION We have shown the possibility of predicting PGF through machine learning algorithms, especially XGB. Such models may help neonatologists in the early diagnosis of high-risk infants for PGF for early intervention.
Collapse
Affiliation(s)
- Jung Ho Han
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - So Jin Yoon
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
| | - Goeun Park
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
| | - Joohee Lim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong Eun Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Ho Seon Eun
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Min Soo Park
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Soon Min Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
| |
Collapse
|
25
|
Yoon SJ, Han JH, Cho KH, Park J, Lee SM, Park MS. Tools for assessing lung fluid in neonates with respiratory distress. BMC Pediatr 2022; 22:354. [PMID: 35725416 PMCID: PMC9208096 DOI: 10.1186/s12887-022-03361-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/04/2022] [Indexed: 12/02/2022] Open
Abstract
Background Transient tachypnea of the newborn (TTN), as a common cause of neonatal respiratory distress, needs to be distinguished from respiratory distress syndrome (RDS). Various modalities such as lung ultrasonography, cytokine analysis, and electrical cardiometry for the evaluation of lung fluid can be helpful for the exact diagnosis, however, clinical diagnosis has been applied mainly. This study aimed to evaluate the usefulness of the various tools for the diagnosis of TTN and RDS in neonates. Methods This study evaluated 22 late-preterm and term infants admitted to the neonatal intensive care unit of Gangnam Severance Hospital because of respiratory distress. Total 9 neonates were diagnosed with TTN and 13 had RDS. In addition to chest radiography, the LUS score was calculated by a neonatologist using the portable ultrasound device. Cytokines in the bronchoalveolar lavage fluid supernatant were measured. Thoracic fluid content was measured using an electrical cardiometry device. Results We enrolled 22 patients with median gestational age, 37.1 weeks, and birth weight 3100 g. There is no difference in patient characteristics between RDS and TTN group. Lung ultrasound score was significantly higher in RDS than TTN (11 vs 6, p = 0.001). Score 0 is shown in all infants with TTN. Score 1 is shown as significantly more in RDS than TTN. Between the TTN and RDS groups, there were significant differences in the changes of thoracic fluid content (2 vs − 1.5, p < 0.001), IL-1β levels (2.5 vs 11.3, p = 0.02), and TNF-α levels (20.1 vs 11.2, p = 0.04). Conclusion We found lung ultrasound and electrical cardiometry to be reliable diagnostic tools for assessing infants with respiratory distress among late-preterm and term infants. Further studies with a large number of patients are needed to confirm their clinical usefulness.
Collapse
Affiliation(s)
- So Jin Yoon
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jung Ho Han
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kee Hyun Cho
- Department of Pediatrics, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - Joonsik Park
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Soon Min Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Min Soo Park
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
26
|
Kim J, Hwang K, Kwon HJ, Lee JE, Lee KS, Choe G, Han JH, Kim CY. Clinicopathologic Characteristics of Grade 2/3 Meningiomas: A Perspective on the Role of Next-Generation Sequencing. Front Oncol 2022; 12:885155. [PMID: 35774130 PMCID: PMC9236884 DOI: 10.3389/fonc.2022.885155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 05/04/2022] [Indexed: 12/19/2022] Open
Abstract
Background Grade 2/3 meningiomas have locally aggressive behaviors often requiring additional treatment plans after surgical resection. Herein, we explored the clinical significance of next-generation sequencing (NGS) in characterizing the molecular profiles of high-grade meningiomas. Methods Patients with intracranial meningioma who underwent surgical resection in a single institution were retrospectively reviewed. Clinicopathologic relevance was evaluated using recurrence-free survival (RFS) as an outcome measure. NGS for the targeted gene regions was performed in 40 participants. Results Among the 713 individuals in the study population, 143 cases (20.1%) were identified as having grade 2 or 3 meningiomas with a significantly lower female predominance. While the difference in RFS between grade 2 and 3 meningiomas was insignificant, a few conventional grade 2 cases, but with TERT promoter hotspot mutation, were highly progressive and refractory to the treatment. From the NGS study, recurrent mutations in TRAF and AKT1 were identified with a higher prevalence (17.5% and 12.5%, respectively) compared with grade 2/3 meningiomas reported in previous literature. However, their relations to other histopathologic properties or clinical factors were rarely observed. Conclusions Grade 2/3 meningiomas show a broad spectrum of molecular profiles, as they have heterogeneous histologic characteristics.
Collapse
Affiliation(s)
- Junhyung Kim
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Kihwan Hwang
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Hyun Jung Kwon
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Ji Eun Lee
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Kyu Sang Lee
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
- *Correspondence: Chae-Yong Kim, ; Kyu Sang Lee,
| | - Gheeyoung Choe
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Jung Ho Han
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Chae-Yong Kim
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
- *Correspondence: Chae-Yong Kim, ; Kyu Sang Lee,
| |
Collapse
|
27
|
Lim J, Yoon SJ, Shin JE, Han JH, Lee SM, Eun HS, Park MS, Park KI. Growth Pattern With Morbidities From Birth to 5 Years of Age in Very Low Birth Weight Infants: Comparison of the Korean National Network and National Health Insurance Service. J Korean Med Sci 2022; 37:e162. [PMID: 35607740 PMCID: PMC9127431 DOI: 10.3346/jkms.2022.37.e162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/26/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Long-term growth data of very low birth weight (VLBW) infants are currently collected in the Korean Neonatal Network (KNN) and National Health Insurance Service (NHIS) database. However, variance in the number of infants, check-up time, and check-up parameters led to decreased credibility of cumulated data. We aimed to compare the data on serial growth outcomes by major morbidities from birth to 5 years in VLBW infants between the KNN and NHIS databases. METHODS We combined the NHIS and KNN data of VLBW infants born between 2013 and 2015. The check-up times in the NHIS database were at 4-6, 9-12, 18-24, 30-36, 42-48, and 54-60 months of age, whereas in the KNN were at 18-24 months of corrected age and at 36 months of age. RESULT Among 8,864 VLBW infants enrolled based on the birth certificates from the Statistics Korea, 6,086 infants (69%) were enrolled in the KNN, and 5,086 infants (57%) participated in the NHIS health check-up. Among 6,068 infants, 3,428 infants (56%) were enrolled at a corrected age of 18-24 months and 2,572 infants (42%) were enrolled at a chronological age of 33-36 months according to the KNN follow-up registry. However, based on the national birth statistics data, the overall follow-up rate of the KNN at 36 months of age was as low as 29%. The NHIS screening rate was lower at first (23%); however, it increased over time to exceed the KNN follow-up rate. Growth failure (weight under 10th percentile) at corrected ages of 18-24 months and 36 months were more common in the NHIS than KNN (42% vs. 20%, 37% vs. 34.5%). Infants with bronchopulmonary dysplasia and periventricular leukomalacia showed similar rates of growth failure at 2 years but varying rates at 3 years between the KNN and NHIS. CONCLUSION By integrating the KNN and NHIS data indirectly at continuous time points according to morbidities, we found that there are discontinuities and discrepancies between the two databases among VLBW infants. Establishing an integrated system by patient level linking the KNN and NHIS databases can lead to better understanding and improved neonatal outcomes in VLBW infants in Korea.
Collapse
Affiliation(s)
- Joohee Lim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - So Jin Yoon
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong Eun Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Ho Han
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Soon Min Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
| | - Ho Seon Eun
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Min Soo Park
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Kook In Park
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
28
|
Koo CH, Ji SY, Bae YK, Jeon YT, Han JH, Ryu JH. Antiemetic prophylaxis with ramosetron for postoperative nausea and vomiting in patients undergoing microvascular decompression: a prospective, randomized controlled trial. J Korean Neurosurg Soc 2022; 65:853-860. [PMID: 35430789 PMCID: PMC9666236 DOI: 10.3340/jkns.2021.0288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/07/2022] [Indexed: 12/05/2022] Open
Abstract
Objective This prospective, randomized, double-blinded trial aimed to evaluate the efficacy and safety of prophylactic ramosetron administration against postoperative nausea and vomiting (PONV) in patients undergoing microvascular decompression (MVD).
Methods In this study, 100 patients undergoing MVD were randomly allocated to the control (normal saline, 2 mL) or ramosetron (ramosetron, 0.3 mg) groups at the end of surgery. The incidence and severity of PONV, need for rescue antiemetics, patient satisfaction score, duration of hospital stay, and the occurrence of adverse events were evaluated 48 hours post-surgery.
Results Data obtained from 97 patients were included in the final analysis. The incidence of PONV was significantly lower in the ramosetron group than in the control group throughout the 48-hour postoperative period (29.2% vs. 51.0%, p=0.028). A similar trend was observed with regard to PONV severity (p=0.041). The need for rescue antiemetics, satisfaction score, duration of hospital stays, and the occurrence of adverse events did not significantly differ between the groups.
Conclusion Prophylactic ramosetron administration reduced the incidence and severity of PONV in patients undergoing MVD without causing serious adverse events. Thus, ramosetron use may improve patient recovery following MVD.
Collapse
|
29
|
Cho MK, Jin L, Han JH, Jin JS, Cheon SY, Shin S, Bae SJ, Park JK, Ha KT. Water-Extracted Prunella vulgaris Alleviates Endometriosis by Reducing Aerobic Glycolysis. Front Pharmacol 2022; 13:872810. [PMID: 35444541 PMCID: PMC9014096 DOI: 10.3389/fphar.2022.872810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 03/15/2022] [Indexed: 12/31/2022] Open
Abstract
Endometriosis is a chronic inflammatory disorder caused by abnormal adhesion of endometrial tissue to the outside of the uterus. The combination of surgery, non-steroidal anti-inflammatory drugs, and hormone treatment is well established therapy for endometriosis, however, case reports have showed that high rates of relapse and unpleasant side effect. For these reasons, recently, the studies have been focused on the Warburg-like metabolic shift of endometriosis. Prunella vulgaris is one of traditionally used herbal medicine for inflammatory disease and the anti-estrogenic effects of P. vulgaris is well-established. Therefore, in this work, we evaluated water-extracted P. vulgaris (PV) as a potential treatment for endometriosis. To this, we artificially induced endometriosis in ovarectomized mice by intra-peritoneal inoculation of uterus extracts. PV was orally administered, and PV significantly alleviated endometriosis, particularly the growth of ectopic endometrial lesions in artificially endometriosis-induced mice. For the mechanism study of anti-endometriosis by PV, we designed an in vitro study using human normal endometrial stromal cells (T-HESCs) and human endometrial cell (12Z) obtained from patients with endometriosis. PV strongly induced the apoptosis of 12Z cells rather than T-HESCs by control the activity or expression of aerobic glycolysis enzymes, such as lactate dehydrogenase A (LDHA), pyruvate dehydrogenase A, and pyruvate dehydrogenase kinase 1/3. In addition, lactate production was enhanced, and oxygen consumption rate was suppressed in 12Z cells upon PV treatment. These changes in aerobic glycolysis eventually caused mitochondrial damage following decreased mitochondrial membrane potential and excessive mitochondrial ROS production. Especially, ulsolic acid (UA), one of the compounds in PV considerably led 12Z cell apoptosis with inhibition of LDHA activity. Therefore, UA could be a major active substance of PV in terms of endometriosis inhibitors. In conclusion, this study provides the evidence that the beneficial efficacy of PV for the prevention/treatment of endometriosis.
Collapse
Affiliation(s)
- Min Kyoung Cho
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan, South Korea
| | - Ling Jin
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan, South Korea,Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan, South Korea
| | - Jung Ho Han
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan, South Korea,Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan, South Korea
| | - Jung-Suk Jin
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan, South Korea
| | - Se-Yun Cheon
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan, South Korea
| | - Su Shin
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan, South Korea
| | - Sung-Jin Bae
- Department of Anatomy, Kosin University College of Medicine, Busan, South Korea
| | - Jang-Kyung Park
- Department of Korean Obstetrics and Gynecology, Pusan National University Korean Medicine Hospital, Yangsan, South Korea,*Correspondence: Jang-Kyung Park, ; Ki-Tae Ha,
| | - Ki-Tae Ha
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan, South Korea,Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan, South Korea,*Correspondence: Jang-Kyung Park, ; Ki-Tae Ha,
| |
Collapse
|
30
|
Han JH, Yoon SJ, Lim JH, Shin JE, Eun HS, Park MS, Park KI, Lee SM. The impact of neonatal morbidities on child growth and developmental outcomes in very low birth weight infants: a nationwide cohort study. Eur J Pediatr 2022; 181:197-205. [PMID: 34236516 DOI: 10.1007/s00431-021-04177-x] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/11/2021] [Accepted: 06/22/2021] [Indexed: 11/26/2022]
Abstract
Growth in preterm infants has long-term implications for neurodevelopmental outcomes. We aimed to estimate the nationwide growth outcomes from birth to 5 years in infants born under 1500 g and to analyze the effects of major morbidities in preterm infants on growth. In total, 2961 children born in 2013 with a birth weight under 1500 g who underwent an infant health checkup between 2013 and 2018 according to the National Health Insurance Service database were included. Checkups were conducted at 4-6, 9-12, 18-24, 30-36, 42-48, and 54-60 months of age. Information was obtained from the International Classification of Diseases-10 codes or a questionnaire administered during the check-up. At 60 months of age, the mean percentiles of weight, height, and head circumference fell within only the 30-40th percentile of normal growth values. About 30% of infants had growth parameters below the 10th percentile and showed worse neurodevelopmental outcomes. Using multiple logistic regression, infants with bronchopulmonary dysplasia showed a significantly higher incidence of growth restriction in all three categories of weight (odds ratio [OR] 1.50), height (OR 1.33), and head circumference (OR 1.36) at 60 months. Sepsis was associated with growth restriction in weight (OR 1.43) and head circumference (OR 1.33). Periventricular leukomalacia infants had relatively small head circumferences (OR 1.91) and poor developmental screening results (OR 2.89).Conclusion: Catch-up growth remains a major issue in infants born under 1500 g, especially those with some morbidities from preterm birth. Regular checkups to monitor and early intervention to achieve normal growth are essential. What is Known: • Growth in preterm infants has long-term implications for neurodevelopmental and cardiometabolic outcomes. • Data are lacking on the time-serial effects of many preterm morbidities simultaneously on long-term growth outcomes. What is New: • All growth parameters of VLBW infants, including weight, height, and head circumference, fell within the 30-40th percentile of normal growth for infants at 60 months of age, indicating that catch-up growth for VLBW infants remains an issue. • VLBW infants with major preterm morbidities, including BPD, PVL, and sepsis, showed difficulties in achieving normal catch-up growth and neurodevelopment at 60 months of age.
Collapse
Affiliation(s)
- Jung Ho Han
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Korea
| | - So Jin Yoon
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Korea
| | - Joo Hee Lim
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Korea
| | - Jeong Eun Shin
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Korea
| | - Ho Seon Eun
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Korea
| | - Min Soo Park
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Korea
| | - Kook In Park
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Korea
| | - Soon Min Lee
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Korea.
| |
Collapse
|
31
|
Jin L, Cho M, Kim BS, Han JH, Park S, Lee IK, Ryu D, Kim JH, Bae SJ, Ha KT. Drug evaluation based on phosphomimetic PDHA1 reveals the complexity of activity-related cell death in A549 non-small cell lung cancer cells. BMB Rep 2021. [PMID: 34488935 PMCID: PMC8633525 DOI: 10.5483/bmbrep.2021.54.11.101] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Cancer cells predominantly generate energy via glycolysis, even in the presence of oxygen, to support abnormal cell proliferation. Suppression of PDHA1 by PDK1 prevents the conversion of cytoplasmic pyruvate into Acetyl-CoA. Several PDK inhibitors have been identified, but their clinical applications have not been successful for unclear reasons. In this study, endogenous PDHA1 in A549 cells was silenced by the CRISPR/Cas9 system, and PDHA1WT and PDHA13SD were transduced. Since PDHA13SD cannot be phosphorylated by PDKs, it was used to evaluate the specific activity of PDK inhibitors. This study highlights that PDHA1WT and PDHA13SD A549 cells can be used as a cell-based PDK inhibitor-distinction system to examine the relationship between PDH activity and cell death by established PDK inhibitors. Leelamine, huzhangoside A and otobaphenol induced PDH activity-dependent apoptosis, whereas AZD7545, VER-246608 and DCA effectively enhanced PDHA1 activity but little toxic to cancer cells. Furthermore, the activity of phosphomimetic PDHA1 revealed the complexity of its regulation, which requires further in-depth investigation.
Collapse
Affiliation(s)
- Ling Jin
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan 50612, Korea
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan 50612, Korea
| | - Minkyoung Cho
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan 50612, Korea
| | - Bo-Sung Kim
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan 50612, Korea
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan 50612, Korea
| | - Jung Ho Han
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan 50612, Korea
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan 50612, Korea
| | - Sungmi Park
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - In-Kyu Lee
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
- Research Institute of Aging and Metabolism, Kyungpook National University, Daegu 41404, Korea
| | - Dongryeol Ryu
- Department of Molecular Cell Biology, School of Medicine, Sungkyunkwan University, Suwon 16419, Korea
| | - Jae Ho Kim
- Department of Physiology, College of Medicine, Pusan National University, Yangsan 50612, Korea
| | - Sung-Jin Bae
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan 50612, Korea
| | - Ki-Tae Ha
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan 50612, Korea
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan 50612, Korea
| |
Collapse
|
32
|
Hwang K, Noh M, Park J, Ji SY, Han JH, Ahn KS, Kim CY. BIOM-15. SERUM AMYLOID-β42 AS A NONINVASIVE BIOMARKER FOR PROGNOSIS AND HISTOLOGIC FEATURES OF GLIOMA. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab196.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
INTRODUCTION
Glioma is the most common primary tumor in central nervous system and is often refractory. Histopathologic examination is essential to establish initial diagnosis, and multiple imaging studies are conducted to assess for treatment response. However, those conventional approaches usually accompanies high risks and costs during treatment. The purpose of this study is to find a novel candidate of noninvasive biomarker for histologic prediction and prognostic assessment of glioma.
METHODS
Serum was prepared from blood samples collected preoperatively from 65 patients with WHO grade II–IV glioma from October 2004 to December 2017 in a single tertiary-level institution. Concentration of amyloid beta-42 (Aβ42) was measured by SMCxPRO (Merck) immunoassay. Clinical characteristics and histologic features of the patients including the molecular subtype were reviewed. Progression-free survival has been evaluated for the primary outcome.
RESULTS
The mean age of the patients was 53.7±12.2 years. 37 (56.9%) patients were males and 21 (32.3%) cases were primary tumors. In Kaplan-Meier survival analysis, higher serum Aβ42 (>5.7 pg/ml) group showed poor outcome with a statistical significance (p=0.014). In multivariate regression analysis, the concentration of serum Aβ42 showed a significant association with EGFR expression, or Ki-67 labeling index. The higher concentration of serum Aβ42 was associated with EGFR wild type (odds ratio 0.237, p=0.022), high cell proliferation (β=0.339, p=0.007) and poor outcome (hazard ratio 0.339, p=0.046).
CONCLUSION
Serum Aβ42 level is a possible good candidate of noninvasive biomarkers for prediction of histologic features and prognosis in glioma patients. Further studies with large cohorts might be mandatory for the clinical use of Aβ42.
Collapse
Affiliation(s)
- Kihwan Hwang
- Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Minhee Noh
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jay Park
- The University of Edinburgh, Edinburgh, UK
| | - So Young Ji
- Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Jung Ho Han
- Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | | | - Chae-Yong Kim
- Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| |
Collapse
|
33
|
Cho M, Ji SY, Go KO, Park KS, Kim JM, Jeon YT, Ryu JH, Park S, Han JH. The novel prognostic value of postoperative follow-up lateral spread response after microvascular decompression for hemifacial spasm. J Neurosurg 2021:1-5. [PMID: 34479201 DOI: 10.3171/2021.3.jns21137] [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: 01/18/2021] [Accepted: 03/05/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The lateral spread response (LSR) is an aberrant electrophysiological response in which a stimulus on one branch of the facial nerve spills over to other branches of the nerve, which can be captured by electrodes near each branch. The authors performed this study to evaluate the prognostic value of the follow-up LSR with a sufficient time interval from intraoperative LSR (IO-LSR) after microvascular decompression (MVD) for hemifacial spasm (HFS), excluding the interference of various intraoperative situations. METHODS A total of 247 patients treated with MVD for HFS between June 2011 and March 2019 were enrolled in this study. The IO-LSR was routinely evaluated in all patients. The LSR was checked again on postoperative day (POD) 2 after surgery (POD2-LSR). A total of 228 patients (92.3%) were considered cured at the last clinical follow-up. RESULTS The IO-LSR disappeared in 189 patients (76.5%), and among them, 181 patients (95.8%) were cured 1 year after surgery. The POD2-LSR disappeared in 193 patients (78.1%), and 185 patients (95.9%) among them were cured. Among the 189 patients in which the IO-LSR disappeared, the POD2-LSR reappeared in 26 patients (13.8%). In contrast, the POD2-LSR disappeared in 30 (51.7%) of 58 patients for whom the IO-LSR continued at the end of surgery. When classified into groups according to the status of the IO-LSR and POD2-LSR, in the group of patients in whom both LSRs disappeared, the cure rate was 98.2%, which was significantly higher than that of the other 3 groups (p < 0.05, Cochran-Armitage trend test). The use of both LSRs was found to be significantly associated with better predictability (p < 0.05, McNemar's test). CONCLUSIONS Postoperative follow-up LSR examination may be beneficial in predicting clinical outcomes after MVD for HFS, especially when considered together with IO-LSR.
Collapse
Affiliation(s)
- Minjae Cho
- Departments of1Neurosurgery
- 6Public Health Clinic, Division of Health Policy, Korea Ministry of Health and Welfare, Sejong, South Korea
| | | | - Kyeong-O Go
- 2Department of Neurosurgery, Gyeongsang National University Hospital, Gyeongsangnam-do, South Korea
| | | | | | - Young-Tae Jeon
- 4Anesthesiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do
| | - Jung-Hee Ryu
- 4Anesthesiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do
| | - Sanghon Park
- 5Department of Anesthesiology, Sheikh Khalifa Specialty Hospital, Ras al-Khaimah, United Arab Emirates; and
| | | |
Collapse
|
34
|
Hwang K, Lee JH, Kim SH, Go KO, Ji SY, Han JH, Kim CY. The Combination PARP Inhibitor Olaparib With Temozolomide in an Experimental Glioblastoma Model. In Vivo 2021; 35:2015-2023. [PMID: 34182476 DOI: 10.21873/invivo.12470] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 03/23/2021] [Revised: 04/17/2021] [Accepted: 05/04/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND/AIM Poly (ADP-ribose) polymerase (PARP) inhibition could enhance the efficacy of temozolomide and prolong survival in patients with glioblastoma. The aim of this study was to evaluate the combination of the PARP inhibitor olaparib with temozolomide in the treatment of glioblastoma. MATERIALS AND METHODS The in vitro and in vivo antitumor effects of the PARP inhibitor olaparib together with temozolomide were evaluated. The in vitro experimental glioblastoma model involved O6-methylguanine methyltransferase (MGMT) promoter-methylated (U87MG, U251MG) and MGMT promoter-unmethylated (T98G) glioblastoma cell lines using In this model cell viability and apoptosis were assessed. For the in vivo studies, nude mice bearing orthotopically xenografted glioblastoma cell lines (U87MG) were randomized to four experimental groups: i) the untreated, ii) temozolomide alone, iii) olaparib alone and iv) olaparib and temozolomide combination groups. Mice were treated daily for 4 weeks and monitored for tumor growth and survival. RESULTS In vitro we found that the combination of olaparib with temozolomide enhanced temozolomide-induced cytotoxicity in all glioblastoma cell lines regardless of the status of MGMT promoter methylation. In vivo, mice treated with temozolomide alone or in combination with olaparib showed greater survival than those untreated or with the olaparib monotherapy, as well as significantly decreased tumor volume. There was no significant difference in survival and tumor volume between temozolomide alone and the combination treatment. CONCLUSION The combination of the PARP inhibitor olaparib with temozolomide could be promising candidates for combination therapy of glioblastoma regardless of the MGMT promoter methylation status.
Collapse
Affiliation(s)
- Kihwan Hwang
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Jin-Han Lee
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sang Ho Kim
- School of Medicine, The University of Auckland, Auckland, New Zealand
| | - Kyeong-O Go
- Department of Neurosurgery, Gyeongsang National University Hospital, Gyengsangnam-do, Republic of Korea
| | - So Young Ji
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Jung Ho Han
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Chae-Yong Kim
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea; .,Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
35
|
Kwon JE, Ji SY, Hwang K, Lee KS, Choe G, Kim CY, Han JH. Management challenges associated with a pineal region chordoma: illustrative case. Journal of Neurosurgery: Case Lessons 2021; 1:CASE21110. [PMID: 35855099 PMCID: PMC9245841 DOI: 10.3171/case21110] [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] [Received: 03/11/2021] [Accepted: 04/26/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND
Chordomas, which are rare malignant neoplasms arising from notochordal remnants, often cause gradually progressive clinical symptoms. Intradural cranial chordomas (ICCs) are extremely rare and generally have a favorable prognosis. However, the authors reported the case of a primary ICC originating in the pineal gland presenting with recurrent thalamic hemorrhage and displaying an aggressive postoperative clinical course.
OBSERVATIONS
A 41-year-old man arrived at the emergency department with morning headaches and recurrent syncope that had lasted several months. Computed tomography and magnetic resonance imaging (MRI) revealed a pineal gland mass causing obstructive hydrocephalus and a subacute hematoma in the right thalamus. Three weeks after an endoscopic third ventriculostomy was performed, recurrent hemorrhage was observed in the right thalamus. The tumor was promptly removed surgically. The yellowish-white tumor did not exhibit abundant bleeding. No evidence of intratumoral hemorrhage around the hematoma pocket was found. Histopathological examination revealed the characteristics of a chordoma with minimal vascularity. MRI performed 10 weeks postoperatively for worsening headaches revealed abnormal enhancement of multiple cranial nerves, suggesting leptomeningeal seeding (LMS) of the tumor.
LESSONS
Despite radiotherapy and intrathecal chemotherapy, the patient’s neurological status worsened; he died 2 years postoperatively. A pineal ICC may cause recurrent thalamic hemorrhage and potentially fatal LMS, even in the early postoperative period.
Collapse
Affiliation(s)
- Ji-Eyon Kwon
- Departments of Neurosurgery and
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
| | - So Young Ji
- Departments of Neurosurgery and
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Kihwan Hwang
- Departments of Neurosurgery and
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyu Sang Lee
- Pathology, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea; and
| | - Gheeyoung Choe
- Pathology, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea; and
| | - Chae-Yong Kim
- Departments of Neurosurgery and
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Jung Ho Han
- Departments of Neurosurgery and
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
| |
Collapse
|
36
|
Han JH, Kim M, Kim HJ, Jang SB, Bae SJ, Lee IK, Ryu D, Ha KT. Targeting Lactate Dehydrogenase A with Catechin Resensitizes SNU620/5FU Gastric Cancer Cells to 5-Fluorouracil. Int J Mol Sci 2021; 22:ijms22105406. [PMID: 34065602 PMCID: PMC8161398 DOI: 10.3390/ijms22105406] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 02/06/2023] Open
Abstract
Resistance to anticancer therapeutics occurs in virtually every type of cancer and becomes a major difficulty in cancer treatment. Although 5-fluorouracil (5FU) is the first-line choice of anticancer therapy for gastric cancer, its effectiveness is limited owing to drug resistance. Recently, altered cancer metabolism, including the Warburg effect, a preference for glycolysis rather than oxidative phosphorylation for energy production, has been accepted as a pivotal mechanism regulating resistance to chemotherapy. Thus, we investigated the detailed mechanism and possible usefulness of antiglycolytic agents in ameliorating 5FU resistance using established gastric cancer cell lines, SNU620 and SNU620/5FU. SNU620/5FU, a gastric cancer cell harboring resistance to 5FU, showed much higher lactate production and expression of glycolysis-related enzymes, such as lactate dehydrogenase A (LDHA), than those of the parent SNU620 cells. To limit glycolysis, we examined catechin and its derivatives, which are known anti-inflammatory and anticancer natural products because epigallocatechin gallate has been previously reported as a suppressor of LDHA expression. Catechin, the simplest compound among them, had the highest inhibitory effect on lactate production and LDHA activity. In addition, the combination of 5FU and catechin showed additional cytotoxicity and induced reactive oxygen species (ROS)-mediated apoptosis in SNU620/5FU cells. Thus, based on these results, we suggest catechin as a candidate for the development of a novel adjuvant drug that reduces chemoresistance to 5FU by restricting LDHA.
Collapse
Affiliation(s)
- Jung Ho Han
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan 50612, Korea;
- Healthy Aging Korean Medical Research Center, Pusan National University, Yangsan 50612, Korea;
| | - MinJeong Kim
- Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, Suwon 16419, Korea;
| | - Hyeon Jin Kim
- Department of Molecular Biology, College of Natural Science, Busan 46241, Korea; (H.J.K.); (S.B.J.)
| | - Se Bok Jang
- Department of Molecular Biology, College of Natural Science, Busan 46241, Korea; (H.J.K.); (S.B.J.)
| | - Sung-Jin Bae
- Healthy Aging Korean Medical Research Center, Pusan National University, Yangsan 50612, Korea;
| | - In-Kyu Lee
- Department of Internal Medicine, School of Medicine Kyungpook National University, Daegu 41566, Korea;
| | - Dongryeol Ryu
- Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, Suwon 16419, Korea;
- Correspondence: (D.R.); (K.-T.H.)
| | - Ki-Tae Ha
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan 50612, Korea;
- Healthy Aging Korean Medical Research Center, Pusan National University, Yangsan 50612, Korea;
- Correspondence: (D.R.); (K.-T.H.)
| |
Collapse
|
37
|
Kim HO, Kim JC, Chung BY, Kang SY, Park CW, Han JH. Harlequin syndrome with petechiae caused by a pituitary adenoma. J Eur Acad Dermatol Venereol 2021; 35:e605-e607. [PMID: 33974308 DOI: 10.1111/jdv.17338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- H O Kim
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - J C Kim
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - B Y Chung
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - S Y Kang
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - C W Park
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - J H Han
- Department of Neurosurgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| |
Collapse
|
38
|
Yoon SJ, Lim J, Han JH, Shin JE, Eun HS, Park MS, Park KI, Lee SM. Impact of neonatal resuscitation changes on outcomes of very-low-birth-weight infants. Sci Rep 2021; 11:9003. [PMID: 33903706 PMCID: PMC8076314 DOI: 10.1038/s41598-021-88561-5] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 04/06/2021] [Indexed: 11/12/2022] Open
Abstract
The improvement of delivery room care, according to the 2015 International Consensus, may affect neonatal outcome, especially in very-low-birth-weight infants. We aimed to investigate the current practice of neonatal resuscitation by year and analyze the association with neonatal outcomes. A total of 8142 very-low-birth-weight infants, registered in the Korean Neonatal Network between 2014 and 2017 were included. A significant decreasing trend of intubation (64.5% vs 55.1%, P < 0.0001) and markedly increasing trend of positive pressure ventilation (PPV) (11.5% vs 22.9%, P < 0.0001) were noted. The annual PPV rate differed significantly by gestation (P < 0.0001). The highest level of resuscitation was also shown as an independent risk factor for mortality within 7 days and for bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), and periventricular leukomalacia. PPV and intubation were associated with significantly decreased risk of mortality and morbidities compared to epinephrine use. When considering association, the incidence of mortality within 7 days, IVH, PVL, and BPD or mortality showed significant differences by combination of year, gestational age, and level of resuscitation. According to updated guidelines, changes in the highest level of resuscitation significantly associated with reducing mortality and morbidities. More meticulous delivery room resuscitation focusing on extreme prematurity is needed.
Collapse
Affiliation(s)
- So Jin Yoon
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Republic of Korea
| | - Joohee Lim
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Republic of Korea
| | - Jung Ho Han
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Republic of Korea
| | - Jeong Eun Shin
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Republic of Korea
| | - Ho Seon Eun
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Republic of Korea
| | - Min Soo Park
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Republic of Korea
| | - Kook In Park
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Republic of Korea
| | - Soon Min Lee
- Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Republic of Korea.
| |
Collapse
|
39
|
Lim J, Yoon SJ, Shin JE, Han JH, Lee SM, Eun HS, Park MS, Park KI. Outcomes of infants born to pregnant women with syphilis: a nationwide study in Korea. BMC Pediatr 2021; 21:47. [PMID: 33478429 PMCID: PMC7821395 DOI: 10.1186/s12887-021-02502-9] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/12/2021] [Indexed: 01/25/2023] Open
Abstract
Background Despite the expansion of antenatal syphilis screening programs, congenital syphilis (CS) remains a concern. Purpose This study aimed to analyze the manifestation and progress of CS, including treatment and follow-up, based on a nationwide study. Methods From the Korean National Health Insurance Service database, a total of 548 infants were examined for CS during their first year of life from 2013 to 2018. Neurosyphilis and complications were investigated using the International Classification of Diseases-10 codes. Results The birth rate of infants from mothers with syphilis was 2.8 per 10,000 live births for 5 years, which is not indicative of a decreasing trend. Overall, 148 infants were proven or highly probable or possible of having CS with treatment for 10 days; 66 infants were possible or less likely of having CS with only 1-day treatment. Jaundice (56 %) was common, followed by hearing impairment (14 %), renal disease (8 %), and mental retardation (8 %). Fourteen cases of neurosyphilis occurred. Infants with complications, including mental retardation, eye involvement, hearing impairment, or renal disease, were significantly associated with neurosyphilis (OR 8.49, P < 0.0001). Of 250 patients who received treatment, 92.8 % were treated with one medication: benzathine penicillin was used in 73 % of patients. Only four patients were re-treated due to treatment failure. In addition to the treponemal test, fluorescent treponemal antibody-absorption was the most utilized tool for diagnosis and follow-up. Conclusions Establishing standardized guidelines for the evaluation of CS, as well as the establishment of treatment regimens and follow up-plans for the disease, at a national level would help improve maternal and neonatal care and facilitate the eradication of CS in Korea.
Collapse
Affiliation(s)
- Joohee Lim
- Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, 03722, Seoul, Republic of Korea
| | - So Jin Yoon
- Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, 03722, Seoul, Republic of Korea
| | - Jeong Eun Shin
- Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, 03722, Seoul, Republic of Korea
| | - Jung Ho Han
- Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, 03722, Seoul, Republic of Korea
| | - Soon Min Lee
- Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, 03722, Seoul, Republic of Korea.
| | - Ho Seon Eun
- Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, 03722, Seoul, Republic of Korea
| | - Min Soo Park
- Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, 03722, Seoul, Republic of Korea
| | - Kook In Park
- Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, 03722, Seoul, Republic of Korea
| |
Collapse
|
40
|
Park JH, Choi BS, Han JH, Kim CY, Cho J, Bae YJ, Sunwoo L, Kim JH. MRI Texture Analysis for the Prediction of Stereotactic Radiosurgery Outcomes in Brain Metastases from Lung Cancer. J Clin Med 2021; 10:jcm10020237. [PMID: 33440723 PMCID: PMC7827024 DOI: 10.3390/jcm10020237] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/08/2021] [Accepted: 01/08/2021] [Indexed: 12/30/2022] Open
Abstract
This study aims to evaluate the utility of texture analysis in predicting the outcome of stereotactic radiosurgery (SRS) for brain metastases from lung cancer. From 83 patients with lung cancer who underwent SRS for brain metastasis, a total of 118 metastatic lesions were included. Two neuroradiologists independently performed magnetic resonance imaging (MRI)-based texture analysis using the Imaging Biomarker Explorer software. Inter-reader reliability as well as univariable and multivariable analyses were performed for texture features and clinical parameters to determine independent predictors for local progression-free survival (PFS) and overall survival (OS). Furthermore, Harrell’s concordance index (C-index) was used to assess the performance of the independent texture features. The primary tumor histology of small cell lung cancer (SCLC) was the only clinical parameter significantly associated with local PFS in multivariable analysis. Run-length non-uniformity (RLN) and short-run emphasis were the independent texture features associated with local PFS. In the non-SCLC (NSCLC) subgroup analysis, RLN and local range mean were associated with local PFS. The C-index of independent texture features was 0.79 for the all-patients group and 0.73 for the NSCLC subgroup. In conclusion, texture analysis on pre-treatment MRI of lung cancer patients with brain metastases may have a role in predicting SRS response.
Collapse
Affiliation(s)
- Jung Hyun Park
- Department of Radiology, Ajou University School of Medicine, Ajou University Medical Center, Suwon 443-380, Korea;
- Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea; (J.C.); (Y.J.B.); (L.S.); (J.H.K.)
| | - Byung Se Choi
- Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea; (J.C.); (Y.J.B.); (L.S.); (J.H.K.)
- Correspondence: ; Tel.: +82-31-787-7625; Fax: +82-31-787-4011
| | - Jung Ho Han
- Department of Neurosurgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea; (J.H.H.); (C.-Y.K.)
| | - Chae-Yong Kim
- Department of Neurosurgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea; (J.H.H.); (C.-Y.K.)
| | - Jungheum Cho
- Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea; (J.C.); (Y.J.B.); (L.S.); (J.H.K.)
| | - Yun Jung Bae
- Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea; (J.C.); (Y.J.B.); (L.S.); (J.H.K.)
| | - Leonard Sunwoo
- Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea; (J.C.); (Y.J.B.); (L.S.); (J.H.K.)
| | - Jae Hyoung Kim
- Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea; (J.C.); (Y.J.B.); (L.S.); (J.H.K.)
| |
Collapse
|
41
|
Jin L, Kim EY, Chung TW, Han CW, Park SY, Han JH, Bae SJ, Lee JR, Kim YW, Jang SB, Ha KT. Hemistepsin A suppresses colorectal cancer growth through inhibiting pyruvate dehydrogenase kinase activity. Sci Rep 2020; 10:21940. [PMID: 33318678 PMCID: PMC7736850 DOI: 10.1038/s41598-020-79019-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 11/24/2020] [Indexed: 12/19/2022] Open
Abstract
Most cancer cells primarily produce their energy through a high rate of glycolysis followed by lactic acid fermentation even in the presence of abundant oxygen. Pyruvate dehydrogenase kinase (PDK) 1, an enzyme responsible for aerobic glycolysis via phosphorylating and inactivating pyruvate dehydrogenase (PDH) complex, is commonly overexpressed in tumors and recognized as a therapeutic target in colorectal cancer. Hemistepsin A (HsA) is a sesquiterpene lactone isolated from Hemistepta lyrata Bunge (Compositae). Here, we report that HsA is a PDK1 inhibitor can reduce the growth of colorectal cancer and consequent activation of mitochondrial ROS-dependent apoptotic pathway both in vivo and in vitro. Computational simulation and biochemical assays showed that HsA directly binds to the lipoamide-binding site of PDK1, and subsequently inhibits the interaction of PDK1 with the E2 subunit of PDH complex. As a result of PDK1 inhibition, lactate production was decreased, but oxygen consumption was increased. Mitochondrial ROS levels and mitochondrial damage were also increased. Consistent with these observations, the apoptosis of colorectal cancer cells was promoted by HsA with enhanced activation of caspase-3 and -9. These results suggested that HsA might be a potential candidate for developing a novel anti-cancer drug through suppressing cancer metabolism.
Collapse
Affiliation(s)
- Ling Jin
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Busandaehak-ro 49, Yangsan, Gyeonsangnam-do, 50612, Republic of Korea
- Healthy Aging Korean Medical Research Center, Pusan National University, Yangsan, Gyeongsangnam-do, 50612, Republic of Korea
| | - Eun-Yeong Kim
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Busandaehak-ro 49, Yangsan, Gyeonsangnam-do, 50612, Republic of Korea
- Healthy Aging Korean Medical Research Center, Pusan National University, Yangsan, Gyeongsangnam-do, 50612, Republic of Korea
| | - Tae-Wook Chung
- Healthy Aging Korean Medical Research Center, Pusan National University, Yangsan, Gyeongsangnam-do, 50612, Republic of Korea
| | - Chang Woo Han
- Department of Molecular Biology, College of Natural Sciences, Pusan National University, Geumjeong-gu, Busan, 46241, Republic of Korea
| | - So Young Park
- Department of Molecular Biology, College of Natural Sciences, Pusan National University, Geumjeong-gu, Busan, 46241, Republic of Korea
| | - Jung Ho Han
- Healthy Aging Korean Medical Research Center, Pusan National University, Yangsan, Gyeongsangnam-do, 50612, Republic of Korea
| | - Sung-Jin Bae
- Healthy Aging Korean Medical Research Center, Pusan National University, Yangsan, Gyeongsangnam-do, 50612, Republic of Korea
| | - Jong Rok Lee
- Department of Pharmaceutical Engineering, Daegu Haany University, Gyeongsan, Gyeongsangbuk-do, 38610, Republic of Korea
| | - Young Woo Kim
- School of Korean Medicine, Dongguk University, Gyeongju, 38066, Korea
| | - Se Bok Jang
- Department of Molecular Biology, College of Natural Sciences, Pusan National University, Geumjeong-gu, Busan, 46241, Republic of Korea
| | - Ki-Tae Ha
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Busandaehak-ro 49, Yangsan, Gyeonsangnam-do, 50612, Republic of Korea.
- Healthy Aging Korean Medical Research Center, Pusan National University, Yangsan, Gyeongsangnam-do, 50612, Republic of Korea.
| |
Collapse
|
42
|
Park B, Bang CH, Lee C, Han JH, Choi W, Kim J, Park GS, Rhie JW, Lee JH, Kim C. 3D wide-field multispectral photoacoustic imaging of human melanomas in vivo: a pilot study. J Eur Acad Dermatol Venereol 2020; 35:669-676. [PMID: 33037671 DOI: 10.1111/jdv.16985] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/22/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND The Breslow depth is an important parameter to determine the excision margin and prognosis of melanoma. However, it is difficult to accurately determine the actual Breslow depth before surgery using the existing ocular micrometer and biopsy technique. OBJECTIVES To evaluate the use of 3D wide-field multispectral photoacoustic imaging to non-invasively measure depth and outline the boundary of melanomas for optimal surgical margin selection. METHODS Six melanoma patients were examined in vivo using the 3D multispectral photoacoustic imaging system. For five cases of melanomas (one in situ, three nodular, and one acral lentiginous type melanoma), the spectrally unmixed photoacoustic depths were calculated and compared against histopathological depths. RESULTS Spectrally unmixed photoacoustic depths and histopathological depths match well within a mean absolute error of 0.36 mm. In particular, the measured minimum and maximum depths in the in situ and nodular type of melanoma were 0.6 and 9.1 mm, respectively. In the 3D photoacoustic image of one metastatic melanoma, feeding vessels were visualized in the melanoma, suggesting the neovascularization around the tumour. CONCLUSIONS The 3D multispectral photoacoustic imaging not only provides well-measured depth and sizes of various types of melanomas, it also visualizes the metastatic type of melanoma. Obtaining accurate depth and boundary information of melanoma before surgery would play a useful role in the complete excision of melanoma during surgery.
Collapse
Affiliation(s)
- B Park
- Departments of Electrical Engineering, Creative IT Engineering, Mechanical Engineering, and Medical Device Innovation Center, Pohang University of Science and Technology (POSTECH), Pohang, Korea
| | - C H Bang
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - C Lee
- Departments of Electrical Engineering, Creative IT Engineering, Mechanical Engineering, and Medical Device Innovation Center, Pohang University of Science and Technology (POSTECH), Pohang, Korea
| | - J H Han
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - W Choi
- Departments of Electrical Engineering, Creative IT Engineering, Mechanical Engineering, and Medical Device Innovation Center, Pohang University of Science and Technology (POSTECH), Pohang, Korea
| | - J Kim
- Departments of Electrical Engineering, Creative IT Engineering, Mechanical Engineering, and Medical Device Innovation Center, Pohang University of Science and Technology (POSTECH), Pohang, Korea.,Department of Cogno-Mechatronics Engineering, College of Nanoscience & Nanotechnology, Pusan National University, Busan, Korea
| | - G S Park
- Department of Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - J W Rhie
- Department of Plastic and Reconstructive Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - J H Lee
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - C Kim
- Departments of Electrical Engineering, Creative IT Engineering, Mechanical Engineering, and Medical Device Innovation Center, Pohang University of Science and Technology (POSTECH), Pohang, Korea
| |
Collapse
|
43
|
Go KO, Ji S, Hwang K, Han JH, Choi HS, Kim YJ, Choi BS, Kim IA, Choe G, Jung JM, Hong YK, Kim CY. GCT-13. THE TREATMENT OUTCOMES OF INTRACRANIAL GERM CELL TUMORS WITH KSPNO PROTOCOL: SINGLE CENTER RETROSPECTIVE ANALYSIS. Neuro Oncol 2020. [PMCID: PMC7715121 DOI: 10.1093/neuonc/noaa222.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Dho et al. (BTRT, 2017) reported that 1.1% (127/11,827) of primary brain tumors are intracranial germ cell tumors (iGCT) in Korea. We analyzed the epidemiology and treatment results of germ cell tumors in our institution. From 2004 to 2019, among 6494 patients with intracranial neoplasms the 61 (0.9%) patients with iGCTs were enrolled: histologically diagnosed in 50 patients and clinically in 11 respectively. Pediatric patients underwent treatment according to the KSPNO protocol, and adult patients were treated with bleomycin, etoposide, and cisplatin regimens. The median age was 20 years (range: 1–42) and the follow-up period was 7.7 months (range: 10.0–203.4 months), respectively. The tumors arise most frequently in the pineal area (n=30, 49.2%). There were no significant differences in outcomes between protocols, but in KSPNO protocol group showed lower tumor recurrence rate (11.5% vs. 20%, p=0.494) and mortality (0% vs. 5.2%, p=0.503). According to the pathological subtype, the outcomes showed statistically significant differences between germinoma and non-germinomatous germ cell tumor (NGGCT) groups. The 10-year progression-free survival was 93.2% and 67.1% in the germinoma and the NGGCT group, respectively (p=0.009). The NGGCT pathological type (p=0.021) was a significant recurrence associated factor in multivariate analysis. Significant adverse events (CTCAE version 5.0 grade≥3) were showed in 14 patients (7 patients in both KSPNO and other treatment protocol groups). Pure germinoma has a higher survival rate and a lower recurrence rate than NGGCT. And KSPNO protocol might be safe and effective. For appropriate treatment for iGTCs, a multidisciplinary approach might be needed.
Collapse
Affiliation(s)
- Kyeong-O Go
- Department of Neurosurgery, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Soyoung Ji
- Department of Neurosurgery, Seoul National University, Bundang Hospital, Seoul, Republic of Korea
| | - Kihwan Hwang
- Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jung Ho Han
- Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyoung Soo Choi
- Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - You Jung Kim
- Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Byung Se Choi
- Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - In Ah Kim
- Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Gheeyoung Choe
- Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin-Myung Jung
- Department of Neurosurgery, Gyeongsang National University Hospital, Jingu, Republic of Korea
- Department of Neurosurgery, Institute of Health Science, College of Medicine, Gyeongsang National University, Jinju, Réunion
| | - Yong-Kil Hong
- Seoul St, Mary’s Hospital, Seoul, Republic of Korea
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chae-Yong Kim
- Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
44
|
Kim CY, Kwon JY, Go KO, Hwang K, Han JH, Choi HS, Kim YJ, Choi BS, Kim IA, Choe G, Kim SK, Phi JH, Wang KC, Cho BK. GCT-12. INTRACRANIAL GROWING TERATOMA SYNDROME: CLINICAL IMPLICATION FROM SINGLE UNIVERSITY EXPERIENCES. Neuro Oncol 2020. [PMCID: PMC7715154 DOI: 10.1093/neuonc/noaa222.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
In general, intracranial germ cell tumors (GCT) are sensitive to chemotherapy, radiation therapy, and have favorable outcomes. However, a rare chemotherapeutic retro conversion phenomenon, known as intracranial growing teratoma syndrome (iGTS), shown a poorer prognosis. We analyze the diagnostic characteristics and the result of treatment response for the patients with iGTS treated in our institutes (SNUH and SNUBH, from 1997 to 2019). The electronic medical records and PACS were used for reviewing the clinical information, follow-up MRI images, tumor markers (alpha-fetoprotein, human chorionic gonadotropin, in serum or cerebrospinal fluids), and pathological findings. Out of 328 intracranial GCT patients, seventeen were finally identified as iGTS. Sixteen out of 17 patients were non-germinomatous GCTs, and 1 were germinomas. Initial pathology was common in order of immature teratoma (26.7%), other than immature teratoma (11.5%), and germinoma (0.5%). All of the tumors showed typical ‘honeycomb appearance’ in their follow-up MRI images. Sixteen out of 17 tumors were surgically resected as 2nd look surgery. Among them, 13 tumors were gross totally resected. Twelve were alive without evidence of recurrences during follow-up periods, and the other was dead from the progression of the disease. Among the other than the gross total resection group (n=4), two patients were dead, one recurred the tumor, and the other is following up with stable disease after adjuvant radiation therapy. Early detection and total resection of the tumor as possible might be meaningful for favor prognosis, especially in non-germinomatous GCTs patients.
Collapse
Affiliation(s)
- Chae-Yong Kim
- Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ji-Yeon Kwon
- Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Kyeong-O Go
- Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Kihwan Hwang
- Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jung Ho Han
- Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyoung Soo Choi
- Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - You Jung Kim
- Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Byung Se Choi
- Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - In Ah Kim
- Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Gheeyoung Choe
- Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seung-Ki Kim
- Seoul National University Children’s Hospital, Seoul, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ji Hoon Phi
- Seoul National University Children’s Hospital, Seoul, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyu-Chang Wang
- Seoul National University Children’s Hospital, Seoul, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Byung-Kyu Cho
- Department of Neurosurgery, Armed Forces Capital Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| |
Collapse
|
45
|
Hwang K, Go KO, Kim SH, Lee H, Han JH, Kim CY. DDRE-23. THE COMBINATION PARP INHIBITOR OLAPARIB WITH TEMOZOLOMIDE IN AN EXPERIMENTAL GLIOBLASTOMA MODEL. Neuro Oncol 2020. [DOI: 10.1093/neuonc/noaa215.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Poly (ADP-ribose) polymerase (PARP) inhibition could enhance the efficacy of temozolomide and prolong survival in patients with glioblastoma. The aim of this study was to evaluate the combination of the PARP inhibitor olaparib with temozolomide in the treatment of glioblastoma by evaluating in vitro and in vivo antitumor effects in an experimental glioblastoma model. The authors investigated antitumor effects of olaparib on temozolomide-induced cytotoxicity on O6-methylguanine methyltransferase (MGMT) promotor methylated (U87MG, U251MG) and MGMT promotor unmethylated (T98G) glioblastoma cell lines using in vitro cell viability and apoptosis assay. We found that the combination of olaparib with temozolomide enhanced temozolomide-induced cytotoxicity in all glioblastoma cell lines regardless of the status of MGMT promotor methylation. For in vivo studies, nude mice bearing orthotopically xenografted glioblastoma cell lines (U87MG) were randomized to four experimental groups: (i) untreated, (ii) temozolomide alone, (iii) olaprib alone and, (iv) olaparib+temozolomide. Mice were treated daily for 4 weeks and monitored for tumor growth, and survival. However, the addition of olaparib had no impact on the efficacy of temozolomide. The combination of PARP inhibitor olaparib with temozolomide could be an effective therapeutic approach for treatment of glioblastoma regardless of MGMT promotor methylation status, although the efficacy still should be evaluated by in vivo and clinical studies.
Collapse
Affiliation(s)
- Kihwan Hwang
- Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Kyeong-O Go
- Gyeongsang National University Hospital, Jinju-si, Republic of Korea
| | - Sang Ho Kim
- School of Medicine, The University of Auckland, Auckland, New Zealand
| | - Hyunwoo Lee
- Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Jung Ho Han
- Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Chae-Yong Kim
- Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| |
Collapse
|
46
|
Han JH, Shin JE, Lee SM, Eun HS, Park MS, Park KI. Hearing Impairments in Preterm Infants: Factors Associated with Discrepancies between Screening and Confirmatory Test Results. Neonatal Med 2020. [DOI: 10.5385/nm.2020.27.3.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
47
|
Hwang K, Kim YH, Kim JH, Lee JH, Yang HK, Hwang JM, Kim CY, Han JH. The outcomes of conservatively observed asymptomatic nonfunctioning pituitary adenomas with optic nerve compression. J Neurosurg 2020; 134:1808-1815. [PMID: 32502994 DOI: 10.3171/2020.4.jns192778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 04/06/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The authors investigated the natural history of asymptomatic nonfunctioning pituitary adenomas (NFPAs) with optic nerve compression. METHODS This study retrospectively analyzed the natural history of asymptomatic NFPAs with documented optic nerve compression on MRI diagnosed between 2000 and 2016 from 2 institutions. The patients were followed up with regular endocrinological, ophthalmological, and radiological evaluations, and the endpoint was new endocrinopathy or neurological deficits. RESULTS The study comprised 81 patients. The median age at diagnosis was 58.0 years and the follow-up duration was 60.0 months. As the denominator of overall pituitary patients, 2604 patients were treated with surgery after diagnosis at the 2 institutions during the same period. The mean initial and last measured values for tumor diameter were 23.7 ± 8.9 mm and 26.2 ± 11.4 mm, respectively (mean ± SD). Tumor growth was observed in 51 (63.0%) patients; however, visual deterioration was observed in 14 (17.3%) patients. Ten (12.3%) patients experienced endocrine deterioration. Fourteen (17.3%) patients underwent surgery for either visual deterioration (in 12 patients) or endocrine dysfunction (in 2 patients). After surgery, all patients experienced improvements in visual or hormonal function. The actuarial rates of treatment-free survival at 2, 3, and 5 years were 96.1%, 93.2%, and 85.6%, respectively. In the multivariate analysis, initial cavernous sinus invasion (HR 4.985, 95% CI 1.597-15.56; p = 0.006) was the only independent risk factor for eventual treatment. CONCLUSIONS The neuroendocrinological deteriorations were not frequent and could be recovered by surgery with early detection on regular follow-up in asymptomatic NFPAs with documented optic nerve compression on MRI. Therefore, conservative management could be an acceptable strategy for these tumors. Careful follow-up is required for tumors with cavernous sinus invasion.
Collapse
Affiliation(s)
| | | | - Jung Hee Kim
- 3Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jung Hyun Lee
- 3Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hee Kyung Yang
- 4Ophthalmology, Seoul National University Bundang Hospital, Seongnam-si; and
| | - Jeong-Min Hwang
- 4Ophthalmology, Seoul National University Bundang Hospital, Seongnam-si; and
| | | | | |
Collapse
|
48
|
Kang MJ, Pyun JM, Baek MJ, Hwang K, Han JH, Park YH, Kim CY, Kim S. Predictors of pre-operative cognitive impairment in meningioma patients over 60 years old. BMC Neurol 2020; 20:225. [PMID: 32493294 PMCID: PMC7268376 DOI: 10.1186/s12883-020-01806-0] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 05/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to assess the cognitive function of patients over 60 years old with meningioma using a domain-specific neuropsychological test and to investigate the relevant factors affecting pre-operative cognitive decline in different subdomains. METHODS We retrospectively investigated 46 intracranial meningioma patients between the ages of 60 and 85 years. All patients underwent brain MRI and neuropsychological test. Tumor size, location, peritumoral edema, and medial temporal atrophy (MTA) were examined to determine the association with cognitive impairment. We performed a logistic regression analysis to examine the odds ratios (ORs) for cognitive decline of four subdomains: verbal memory, language, visuospatial, and executive functions. RESULTS Tumor size and age were associated with executive dysfunction (OR 1.083, 95% confidence interval (CI) 1.006-1.166, and OR 1.209, 95% CI 1.018-1.436, respectively). There was no statistically significant association in other cognitive domains (language, verbal memory, and visuospatial function) with variables in regression analysis. CONCLUSIONS We conclude that tumor size and age are positively related with executive function in pre-operative meningioma patients over 60 years old.
Collapse
Affiliation(s)
- Min Ju Kang
- Department of Neurology, Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Jung-Min Pyun
- Department of Neurology, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea
- Department of Neurology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Min Jae Baek
- Department of Neurology, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea
| | - Kihwan Hwang
- Department of Neurosurgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jung Ho Han
- Department of Neurosurgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Ho Park
- Department of Neurology, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea.
- Department of Neurology, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Chae-Yong Kim
- Department of Neurosurgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea.
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - SangYun Kim
- Department of Neurology, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea
- Department of Neurology, Seoul National University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
49
|
Wee CW, Kim KS, Kim CY, Han JH, Kim YJ, Kim IA. Feasibility of hippocampus-sparing VMAT for newly diagnosed glioblastoma treated by chemoradiation: pattern of failure analysis. Radiat Oncol 2020; 15:98. [PMID: 32375876 PMCID: PMC7204282 DOI: 10.1186/s13014-020-01552-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 04/27/2020] [Indexed: 12/11/2022] Open
Abstract
Background To identify the pattern of failure and oncological safety of hippocampus (HC)-sparing IMRT (HSRT) in newly diagnosed glioblastoma (GBM) patients. Materials and methods Eighty-two GBM patients treated with temozolomide-based chemoradiation using HSRT between 2014 and 2018 were retrospectively reviewed. HSRT consisted of a sparing of Dmax of the contralateral HC < 17 Gy. Fifteen patients were unable to achieve the dose-constraints for adequate target coverage. The dose to ipsilateral HC was kept as low as possible. The pattern of failure was investigated, focusing on the area in the vicinity of the spared HC (organ and + 1 cm area). The median HSRT dose was 60 Gy in 30 fractions. Results The median follow-up for survivors was 11.7 months. The median progression-free and overall survival were 9.7 and 23.5 months, respectively. Six (7.3%) and eight (9.8%) patients eventually demonstrated progressive disease at the contralateral HC and HC + 1 cm, respectively. The 12-month contralateral HC and HC + 1 cm failure-free rate were 97.2 and 93.4%, respectively. However, no patient (0%) and two patients (2.4%) showed failure at contralateral HC and HC + 1 cm at initial progression, respectively. The dominant pattern of failure at the contralateral HC was by subependymal seeding (66.7%). Conclusion The incidence of failure at the contralateral HC and HC + 1 cm is very low and mostly accompanied by disseminated disease progression after HSRT. Since HSRT does not compromise oncological outcomes, it could be considered especially for GBM patients who are expected to have favorable survival outcomes.
Collapse
Affiliation(s)
- Chan Woo Wee
- Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Kyung Su Kim
- Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Chae-Yong Kim
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Jung Ho Han
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Yu Jung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - In Ah Kim
- Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea. .,Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea. .,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
50
|
Go KO, Hwang K, Han JH. Surgical Nuances to Reduce and Manage Cerebrospinal Fluid Leaks after Microvascular Decompression. J Clin Med 2020; 9:jcm9040902. [PMID: 32218220 PMCID: PMC7230255 DOI: 10.3390/jcm9040902] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/16/2020] [Accepted: 03/23/2020] [Indexed: 11/16/2022] Open
Abstract
Background: No dural substitute has proven to be complication-free in a large clinical trial, even suggesting some benefit during watertight closure. However, primary dural closure is not always possible due to dural shrinkage from electrocautery for dural bleeding. Objective: This study is performed to analyze the clinical outcomes related to cerebrospinal fluid (CSF) leakage after microvascular decompression (MVD) using a simple surgical technique. Methods: Three hundred and sixty consecutive cases were treated with MVD and followed up for more than one month after surgery. Bleeding from the cut veins during dural incision was controlled by pulling stay sutures instead of electrocautery to avoid dural shrinkage. Additionally, a wet cottonoid was placed on the cerebellar side dural flap to prevent dural dehydration. During dural closure, primary dural closure was always attempted. If not possible, a “plugging muscle” method was used for watertight dural closure. Results: The mean age was 54.1 ± 10.8 years (range, 24–85 years), and 238 (66.1%) were female. Primary MVD was performed in 345 (95.8%) patients. The mean operation time (from skin incision to skin closure) was 96.7 ± 33.0 min (range, 38–301 min). Primary dural closure was possible in 344 (95.6%) patients. The “plugging muscle method” was performed more frequently in patients older than 60 years (8 of 99 cases, 8.08%) than in younger cases (8 of 261 cases, 3.07%) (p = 0.039; chi-squared test). After surgery, 5 (1.4%) patients were treated for middle ear effusion, and another 5 (1.4%) patients experienced transient CSF rhinorrhea, which was spontaneously resolved within 1 to 7 days. No patients required additional treatments for CSF leakage. Conclusion: A simple technique using pulling stay sutures to stop bleeding from the dural edges and placing a wet cottonoid on the exposed dura can make primary dural closure easier.
Collapse
Affiliation(s)
- Kyeong-O Go
- Department of Neurosurgery, Gyeongsang National University Hospital, Gyengsangnam-do 52727, Korea;
| | - Kihwan Hwang
- Department of Neurosurgery, Seoul National University Bundang Hospital, Gyeonggi-do 13620, Korea;
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Jung Ho Han
- Department of Neurosurgery, Seoul National University Bundang Hospital, Gyeonggi-do 13620, Korea;
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul 03080, Korea
- Correspondence:
| |
Collapse
|