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Lee KJ, Moon JS, Lim JG, Huh H, Ahn JE, Kim L, Kim NY, Ko JS. PARVB and HSD17B13 variants are associated with nonalcoholic fatty liver disease in children. J Gastroenterol Hepatol 2024. [PMID: 38418429 DOI: 10.1111/jgh.16521] [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: 08/09/2023] [Revised: 01/02/2024] [Accepted: 02/05/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND AND AIM The aim of this study was to investigate the comprehensive genetic effects of exploratory variants of LYPLAL1, GCKR, HSD17B13, TRIB1, APOC3, MBOAT7, and PARVB on pediatric nonalcoholic fatty liver disease in addition to the previously reported variants of TM6SF2, PNPLA3, and SAMM50 in Korean children. METHODS A prospective case-control study was conducted involving 309 patients diagnosed using ultrasound and 339 controls. Anthropometric measurements, liver function tests, and metabolic marker analysis were conducted, and fibrosis scores were calculated. Transient elastography was performed in 69 some patients with nonalcoholic fatty liver disease. TaqMan allelic discrimination assays were used for genotyping. The genetic risk scores were calculated using significant variants, namely, HSD17B13, PARVB, PNPLA3, SAMM50, and TM6SF2, to evaluate the additive effect. RESULTS Risk allele carriers of the PARVB variant showed significantly higher levels of aminotransferases, gamma-glutamyl transferase, alkaline phosphatase, pediatric nonalcoholic fatty liver disease fibrosis score, and aspartate aminotransferase/platelet ratio index. Individuals with a homozygous variant of HSD17B13 showed significantly lower levels of aminotransferase, gamma-glutamyl transferase, liver stiffness measurement, and aspartate aminotransferase/platelet ratio index than those with other genotypes. These parameters did not significantly differ among other variants of LYPLAL1, GCKR, TRIB1, APOC3, and MBOAT7. The genetic risk scores was identified as an independent risk factor for nonalcoholic fatty liver disease and had a positive association with severity. CONCLUSION HSD17B13 has protective effects on the severity of pediatric nonalcoholic fatty liver disease. Variants of HSD17B13, PARVB, PNPLA3, SAMM50, and TM6SF2 had an additive effect on nonalcoholic fatty liver disease.
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Affiliation(s)
- Kyung Jae Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Jin Soo Moon
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Gyu Lim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Homin Huh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong Eun Ahn
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Lia Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Nan Young Kim
- Hallym Institute of Translational Genomics & Bioinformatics, Hallym University Medical Center, Anyang, Korea
| | - Jae Sung Ko
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
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Kim YT, Lee KJ, Kim SH. Biceps Rerouting Regardless of a Biceps-Labral Lesion During Rotator Cuff Repair Results in Lower Retear Rates and Comparable Clinical Outcomes to Subpectoral Biceps Tenodesis. Arthroscopy 2024:S0749-8063(24)00068-9. [PMID: 38311266 DOI: 10.1016/j.arthro.2024.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 01/09/2024] [Accepted: 01/12/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE To evaluate the radiographic and clinical outcomes when rerouting a pathologic biceps during arthroscopic rotator cuff repair by comparing it with concomitant subpectoral biceps tenodesis (SPBT). METHODS This retrospective, historical cohort study was conducted with patients who underwent an arthroscopic repair of a full-thickness rotator cuff tear, with intraoperative confirmation of biceps pathology including partial tears, subluxation, pulley lesions, or type II SLAP lesions. Until May 2018, such patients were treated with concomitant subpectoral tenodesis (group SPBT). Afterward, biceps rerouting (BR) was done regardless of biceps pathology (group BR) without biceps or SLAP repair. Radiographic parameters, including fatty degeneration, acromiohumeral distance, Sugaya classification, and retears, were evaluated using preoperative and 1-year postoperative magnetic resonance imaging results. Clinical evaluation with a minimum 2-year follow-up included pain visual analog scale, American Shoulder and Elbow Surgeons, Simple Shoulder Test, and Constant-Murley scores. Whether individual patients exceeded these scores' minimal clinically important difference also was determined. RESULTS A total of 64 patients (group SPBT = 32; group BR = 32) were included in the final analysis. The duration of clinical follow-up was 36.2 ± 9.3 months in group SPBT and 29.4 ± 6.9 months in the BR group (P = .002). Compared with group SPBT, group BR demonstrated a significantly lower retear rate (SPBT vs BR: 34.4% vs 12.5%, P = .039). In the BR group, 8 of 32 (25%) patients demonstrated a postoperative LHBT tear. The 4 cuff retears in group BR only took place within these patients. Other postoperative radiographic and clinical outcomes were comparable between the groups. Within each group, significant postoperative improvements were demonstrated (P < .05 for all clinical scores). CONCLUSIONS Even in the presence of a pathologic LHBT and/or a type II SLAP lesion, augmenting the rotator cuff repair with BR significantly reduced retear rates while achieving clinical scores comparable with SPBT in a minimum 2-year follow-up. LEVEL OF EVIDENCE Level III, retrospective comparative study.
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Affiliation(s)
- Yong Tae Kim
- Department of Orthopaedic Surgery, Hallym University Dongtan Sacred Heart Hospital, Gyeonggi, Korea
| | - Kyung Jae Lee
- Department of Orthopaedic Surgery, Chung-Ang University Hospital, Seoul, Korea
| | - Sae Hoon Kim
- Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Korea.
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Wang P, Liu Y, Kang SY, Lyu C, Han X, Ho T, Lee KJ, Meng X, Park YK, Jung HW. Clean-DM1, a Korean Polyherbal Formula, Improves High Fat Diet-Induced Diabetic Symptoms in Mice by Regulating IRS/PI3K/AKT and AMPK Expressions in Pancreas and Liver Tissues. Chin J Integr Med 2024; 30:125-134. [PMID: 37118530 DOI: 10.1007/s11655-023-3548-9] [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] [Accepted: 01/04/2023] [Indexed: 04/30/2023]
Abstract
OBJECTIVE To investigate the effects of Clean-DM1 (C-DM1), a polyherbal formulation of Radix Scrophulariae, Radix Astragali, Rhizoma Atractylodis, and Radix Salviae Miltiorrhizae, on high-fat diet (HFD)-induced diabetes mice. METHODS The information about active components of C-DM1 extract and molecular mechanism was obtained from network pharmacology analysis. Main compounds of C-DM1 extract by high performance liquid chromatography-mass spectrometry (HPLC-MS) analysis were conducted for quality control. For in vivo study, mice were induced diabetes by HFD for 12 weeks. The mice in the normal group (Nor) were maintained with a regular diet and treated with saline by gavage. The HFD model mice were randomly divided into 3 groups, including a HFD diabetic model group, a C-DM1 extract-administered group (C-DM1, 500 mg/kg), and metformin-administered groups (Met, 500 mg/kg), 8 mice in each group. Food intake, body weight (BW), and fasting blood glucose (FBG) levels were recorded weekly for 4 weeks. After 4 weeks of treatment, alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood glucose, low-density lipoprotein cholesterol (LDL-C) were determined using an automated clinical chemistry analyzer, and homeostatic model for assessing insulin resistance (HOMA-IR) levels and oral glucose tolerance test (OGTT) were detected. The histopathological changes of liver and pancreatic tissues were observed by hematoxylin-eosin staining. Insulin receptor substrate (IRS)/phosphatidylinositol 3 kinase (PI3K)/ protein kinase B (AKT) and adenosine 5'-monophosphate-activated protein kinase (AMPK) expressions in liver and pancreas tissues were detected by Western blot analysis. RESULTS HPLC-MS identified dihydroisotanshinone, dihydroisotanshinone I, cryptotanshinone, harpagoside, and atractyloside A in C-DM1 extract. The administration of C-DM1 extract significantly decreased body weight, calorie intake, and the levels of blood glucose and insulin in the diabetic mice (P<0.05 or P<0.01). The C-DM1 extract administration improved the impaired glucose tolerance and insulin resistance in the diabetic mice and significantly decreased the levels of LDL-C, ALT and AST (P<0.01). The C-DM1 extract inhibited the histopathological changes of fatty liver and hyperplasia of pancreatic islets in the diabetic mice. The C-DM1 extract significantly increased the phosphorylation of IRS, AKT, and AMPK and the expression of PI3K in pancreas and liver tissues (P<0.05 or P<0.01), which was consistent with the analysis results of network pharmacology. CONCLUSION C-DM1 extract improved diabetes symptoms in long-term HFD-induced mice by regulation of IRS/PI3K/AKT and AMPK expressions in pancreas and liver tissues, suggesting that C-DM1 formulation may help prevent the progression of T2DM.
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Affiliation(s)
- Piao Wang
- Department of Herbology, College of Korean Medicine, Dongguk University, Gyeongju, 38066, Korea
| | - Yi Liu
- Department of Herbology, College of Korean Medicine, Dongguk University, Gyeongju, 38066, Korea
- College of Pharmacy & Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, 03760, Korea
| | - Seok Yong Kang
- Department of Herbology, College of Korean Medicine, Dongguk University, Gyeongju, 38066, Korea
- Korean Medicine R&D Center, Dongguk University, Gyeongju, 38066, Korea
| | - Chenzi Lyu
- Department of Herbology, College of Korean Medicine, Dongguk University, Gyeongju, 38066, Korea
- Shanxi Key Laboratory of Traditional Herbal Medicines Processing, Shanxi University of Chinese Medicine, Jinzhong, Shanxi Province, 030619, China
| | - Xiang Han
- Shanxi Key Laboratory of Traditional Herbal Medicines Processing, Shanxi University of Chinese Medicine, Jinzhong, Shanxi Province, 030619, China
| | - Tianjun Ho
- Department of Herbology, College of Korean Medicine, Dongguk University, Gyeongju, 38066, Korea
| | - Kyung Jae Lee
- Department of Herbology, College of Korean Medicine, Dongguk University, Gyeongju, 38066, Korea
| | - Xianglong Meng
- Shanxi Key Laboratory of Traditional Herbal Medicines Processing, Shanxi University of Chinese Medicine, Jinzhong, Shanxi Province, 030619, China
| | - Yong-Ki Park
- Department of Herbology, College of Korean Medicine, Dongguk University, Gyeongju, 38066, Korea
- Korean Medicine R&D Center, Dongguk University, Gyeongju, 38066, Korea
| | - Hyo Won Jung
- Department of Herbology, College of Korean Medicine, Dongguk University, Gyeongju, 38066, Korea.
- Korean Medicine R&D Center, Dongguk University, Gyeongju, 38066, Korea.
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Lee KJ, Ko JS, Park KY, Kang KS, Lee K, Hong J, Kim SC, Lee Y, Kang B, Kim YB, Kim HJ, Eun BW, Cho HK, Kim YJ, Kim MJ, Lee J, Lee TJ, Oh SH, Park S, Hwang EH, Sohn S, Lim JG, Kim Y, Lee YJ. A Report on a Nationwide Surveillance System for Pediatric Acute Hepatitis of Unknown Etiology in Korea. J Korean Med Sci 2023; 38:e401. [PMID: 38050913 PMCID: PMC10695753 DOI: 10.3346/jkms.2023.38.e401] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 09/07/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Several cases of pediatric acute hepatitis of unknown etiology related to adenoviral infections have been reported in Europe since January 2022. The aim of this study was to compare the incidence, severity, possible etiology, and prognosis of the disease with those in the past in Korea. METHODS The surveillance group collected data between May and November 2022 using a surveillance system. Acute hepatitis of unknown etiology was defined in patients aged < 16 years with a serum transaminase level > 500 IU/L, not due to hepatitis A-E or other underlying causes. For comparison, data from 18 university hospitals were retrospectively collected as a control group between January 2021 and April 2022. RESULTS We enrolled 270 patients (mean age, 5 years). The most common symptom was fever. However, the incidence was similar between 2021 and 2022. Liver function test results, number of patients with acute liver failure (ALF), liver transplantation (LT), death, and adenovirus detection rates did not differ between the two groups. None of the adenovirus-positive patients in either group experienced ALF, LT, or death. In the surveillance group, adenovirus-associated virus-2 was detected in four patients, one of whom underwent LT. Patients with an unknown etiology showed significantly higher bilirubin levels, a lower platelet count, and a higher LT rate than patients with a possible etiology. CONCLUSION The incidence of pediatric acute hepatitis of unknown etiology and adenovirus detection rate have not increased in Korea.
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Affiliation(s)
- Kyung Jae Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Sung Ko
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Kie Young Park
- Department of Pediatrics, Gangneung Asan Hospital, College of Medicine, Ulsan University, Gangneung, Korea
| | - Ki Soo Kang
- Department of Pediatrics, Jeju National University Hospital, Jeju, Korea
| | - Kunsong Lee
- Department of Pediatrics, Dankook University Hospital, Cheonan, Korea
| | - Jeana Hong
- Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Soon Chul Kim
- Department of Pediatrics, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
| | - Yoon Lee
- Department of Pediatrics, Korea University Medical Center Anam Hospital, Seoul, Korea
| | - Ben Kang
- Department of Pediatrics, School of Medicine, Kyungpook National University, Kyungpook National University Children's Hospital, Daegu, Korea
| | - Yu Bin Kim
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
| | - Hyun Jin Kim
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Byung Wook Eun
- Department of Pediatrics, Eulji University Eulji General Hospital, Seoul, Korea
| | - Hye-Kyung Cho
- Department of Pediatrics, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Yae-Jean Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi Jin Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Lee
- Department of Pediatrics, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Taek-Jin Lee
- Department of Pediatrics, CHA University School of Medicine, Pocheon, Korea
| | - Seak Hee Oh
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Sowon Park
- Department of Pediatrics, Severance Children's Hospital, Severance Pediatric Liver Research Group, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Ha Hwang
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Sangjun Sohn
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Jin Gyu Lim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - YooJin Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Yeoun Joo Lee
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea.
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5
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Smarra C, Goncharov B, Barausse E, Antoniadis J, Babak S, Nielsen ASB, Bassa CG, Berthereau A, Bonetti M, Bortolas E, Brook PR, Burgay M, Caballero RN, Chalumeau A, Champion DJ, Chanlaridis S, Chen S, Cognard I, Desvignes G, Falxa M, Ferdman RD, Franchini A, Gair JR, Graikou E, Grießmeier JM, Guillemot L, Guo YJ, Hu H, Iraci F, Izquierdo-Villalba D, Jang J, Jawor J, Janssen GH, Jessner A, Karuppusamy R, Keane EF, Keith MJ, Kramer M, Krishnakumar MA, Lackeos K, Lee KJ, Liu K, Liu Y, Lyne AG, McKee JW, Main RA, Mickaliger MB, Niţu IC, Parthasarathy A, Perera BBP, Perrodin D, Petiteau A, Porayko NK, Possenti A, Leclere HQ, Samajdar A, Sanidas SA, Sesana A, Shaifullah G, Speri L, Spiewak R, Stappers BW, Susarla SC, Theureau G, Tiburzi C, van der Wateren E, Vecchio A, Krishnan VV, Wang J, Wang L, Wu Z. Second Data Release from the European Pulsar Timing Array: Challenging the Ultralight Dark Matter Paradigm. Phys Rev Lett 2023; 131:171001. [PMID: 37955508 DOI: 10.1103/physrevlett.131.171001] [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: 06/30/2023] [Revised: 09/15/2023] [Accepted: 09/25/2023] [Indexed: 11/14/2023]
Abstract
Pulsar Timing Array experiments probe the presence of possible scalar or pseudoscalar ultralight dark matter particles through decade-long timing of an ensemble of galactic millisecond radio pulsars. With the second data release of the European Pulsar Timing Array, we focus on the most robust scenario, in which dark matter interacts only gravitationally with ordinary baryonic matter. Our results show that ultralight particles with masses 10^{-24.0} eV≲m≲10^{-23.3} eV cannot constitute 100% of the measured local dark matter density, but can have at most local density ρ≲0.3 GeV/cm^{3}.
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Affiliation(s)
- Clemente Smarra
- SISSA-International School for Advanced Studies, Via Bonomea 265, 34136, Trieste, Italy and INFN, Sezione di Trieste
- IFPU-Institute for Fundamental Physics of the Universe, Via Beirut 2, 34014 Trieste, Italy
| | - Boris Goncharov
- Gran Sasso Science Institute (GSSI), I-67100 L'Aquila, Italy
- INFN, Laboratori Nazionali del Gran Sasso, I-67100 Assergi, Italy
| | - Enrico Barausse
- SISSA-International School for Advanced Studies, Via Bonomea 265, 34136, Trieste, Italy and INFN, Sezione di Trieste
- IFPU-Institute for Fundamental Physics of the Universe, Via Beirut 2, 34014 Trieste, Italy
| | - J Antoniadis
- Institute of Astrophysics, FORTH, Nikolaou Plastira 100, 70013, Heraklion, Greece
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
| | - S Babak
- Université Paris Cité CNRS, Astroparticule et Cosmologie, 75013 Paris, France
| | - A-S Bak Nielsen
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
- Fakultät für Physik, Universität Bielefeld, Postfach 100131, 33501 Bielefeld, Germany
| | - C G Bassa
- ASTRON, Netherlands Institute for Radio Astronomy, Oude Hoogeveensedijk 4, 7991 PD, Dwingeloo, The Netherlands
| | - A Berthereau
- Laboratoire de Physique et Chimie de l'Environnement et de l'Espace, Université d'Orléans/CNRS, 45071 Orléans Cedex 02, France
- Observatoire Radioastronomique de Nançay, Observatoire de Paris, Université PSL, Université d'Orléans, CNRS, 18330 Nançay, France
| | - M Bonetti
- Dipartimento di Fisica "G. Occhialini", Universitá degli Studi di Milano-Bicocca, Piazza della Scienza 3, I-20126 Milano, Italy
- INFN, Sezione di Milano-Bicocca, Piazza della Scienza 3, I-20126 Milano, Italy
- INAF - Osservatorio Astronomico di Brera, via Brera 20, I-20121 Milano, Italy
| | - E Bortolas
- Dipartimento di Fisica "G. Occhialini", Universitá degli Studi di Milano-Bicocca, Piazza della Scienza 3, I-20126 Milano, Italy
- INFN, Sezione di Milano-Bicocca, Piazza della Scienza 3, I-20126 Milano, Italy
- INAF - Osservatorio Astronomico di Brera, via Brera 20, I-20121 Milano, Italy
| | - P R Brook
- Institute for Gravitational Wave Astronomy and School of Physics and Astronomy, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom
| | - M Burgay
- INAF - Osservatorio Astronomico di Cagliari, via della Scienza 5, 09047 Selargius (CA), Italy
| | - R N Caballero
- Hellenic Open University, School of Science and Technology, 26335 Patras, Greece
| | - A Chalumeau
- Dipartimento di Fisica "G. Occhialini", Universitá degli Studi di Milano-Bicocca, Piazza della Scienza 3, I-20126 Milano, Italy
| | - D J Champion
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
| | - S Chanlaridis
- Institute of Astrophysics, FORTH, Nikolaou Plastira 100, 70013, Heraklion, Greece
| | - S Chen
- Kavli Institute for Astronomy and Astrophysics, Peking University, Beijing 100871, People's Republic of China
| | - I Cognard
- Laboratoire de Physique et Chimie de l'Environnement et de l'Espace, Université d'Orléans/CNRS, 45071 Orléans Cedex 02, France
- Observatoire Radioastronomique de Nançay, Observatoire de Paris, Université PSL, Université d'Orléans, CNRS, 18330 Nançay, France
| | - G Desvignes
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
| | - M Falxa
- Université Paris Cité CNRS, Astroparticule et Cosmologie, 75013 Paris, France
- Laboratoire de Physique et Chimie de l'Environnement et de l'Espace, Université d'Orléans/CNRS, 45071 Orléans Cedex 02, France
| | - R D Ferdman
- School of Physics, Faculty of Science, University of East Anglia, Norwich NR4 7TJ, United Kingdom
| | - A Franchini
- Dipartimento di Fisica "G. Occhialini", Universitá degli Studi di Milano-Bicocca, Piazza della Scienza 3, I-20126 Milano, Italy
- INFN, Sezione di Milano-Bicocca, Piazza della Scienza 3, I-20126 Milano, Italy
| | - J R Gair
- Max Planck Institute for Gravitational Physics (Albert Einstein Institute), Am Muühlenberg 1, 14476 Potsdam, Germany
| | - E Graikou
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
| | - J-M Grießmeier
- Laboratoire de Physique et Chimie de l'Environnement et de l'Espace, Université d'Orléans/CNRS, 45071 Orléans Cedex 02, France
- Observatoire Radioastronomique de Nançay, Observatoire de Paris, Université PSL, Université d'Orléans, CNRS, 18330 Nançay, France
| | - L Guillemot
- Laboratoire de Physique et Chimie de l'Environnement et de l'Espace, Université d'Orléans/CNRS, 45071 Orléans Cedex 02, France
- Observatoire Radioastronomique de Nançay, Observatoire de Paris, Université PSL, Université d'Orléans, CNRS, 18330 Nançay, France
| | - Y J Guo
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
| | - H Hu
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
| | - F Iraci
- INAF - Osservatorio Astronomico di Cagliari, via della Scienza 5, 09047 Selargius (CA), Italy
- Universitá di Cagliari, Dipartimento di Fisica, S.P. Monserrato-Sestu Km 0,700-09042 Monserrato (CA), Italy
| | - D Izquierdo-Villalba
- Dipartimento di Fisica "G. Occhialini", Universitá degli Studi di Milano-Bicocca, Piazza della Scienza 3, I-20126 Milano, Italy
- INFN, Sezione di Milano-Bicocca, Piazza della Scienza 3, I-20126 Milano, Italy
| | - J Jang
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
| | - J Jawor
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
| | - G H Janssen
- ASTRON, Netherlands Institute for Radio Astronomy, Oude Hoogeveensedijk 4, 7991 PD, Dwingeloo, The Netherlands
- Department of Astrophysics/IMAPP, Radboud University Nijmegen, P.O. Box 9010, 6500 GL Nijmegen, The Netherlands
| | - A Jessner
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
| | - R Karuppusamy
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
| | - E F Keane
- School of Physics, Trinity College Dublin, College Green, Dublin 2, D02 PN40, Ireland
| | - M J Keith
- Jodrell Bank Centre for Astrophysics, Department of Physics and Astronomy, University of Manchester, Manchester M13 9PL, United Kingdom
| | - M Kramer
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
- Jodrell Bank Centre for Astrophysics, Department of Physics and Astronomy, University of Manchester, Manchester M13 9PL, United Kingdom
| | - M A Krishnakumar
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
- Fakultät für Physik, Universität Bielefeld, Postfach 100131, 33501 Bielefeld, Germany
| | - K Lackeos
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
| | - K J Lee
- Institute of Astrophysics, FORTH, Nikolaou Plastira 100, 70013, Heraklion, Greece
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
- Observatoire Radioastronomique de Nançay, Observatoire de Paris, Université PSL, Université d'Orléans, CNRS, 18330 Nançay, France
| | - K Liu
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
| | - Y Liu
- Fakultät für Physik, Universität Bielefeld, Postfach 100131, 33501 Bielefeld, Germany
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
| | - A G Lyne
- Jodrell Bank Centre for Astrophysics, Department of Physics and Astronomy, University of Manchester, Manchester M13 9PL, United Kingdom
| | - J W McKee
- E.A. Milne Centre for Astrophysics, University of Hull, Cottingham Road, Kingston-upon-Hull, HU6 7RX, United Kingdom
- Centre of Excellence for Data Science, Artificial Intelligence and Modelling (DAIM), University of Hull, Cottingham Road, Kingston-upon-Hull, HU6 7RX, United Kingdom
| | - R A Main
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
| | - M B Mickaliger
- Jodrell Bank Centre for Astrophysics, Department of Physics and Astronomy, University of Manchester, Manchester M13 9PL, United Kingdom
| | - I C Niţu
- Jodrell Bank Centre for Astrophysics, Department of Physics and Astronomy, University of Manchester, Manchester M13 9PL, United Kingdom
| | - A Parthasarathy
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
| | - B B P Perera
- Arecibo Observatory, HC3 Box 53995, Arecibo, Puerto Rico 00612
| | - D Perrodin
- INAF - Osservatorio Astronomico di Cagliari, via della Scienza 5, 09047 Selargius (CA), Italy
| | - A Petiteau
- Université Paris Cité CNRS, Astroparticule et Cosmologie, 75013 Paris, France
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - N K Porayko
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
- Dipartimento di Fisica "G. Occhialini", Universitá degli Studi di Milano-Bicocca, Piazza della Scienza 3, I-20126 Milano, Italy
| | - A Possenti
- INAF - Osservatorio Astronomico di Cagliari, via della Scienza 5, 09047 Selargius (CA), Italy
| | | | - A Samajdar
- Institut für Physik und Astronomie, Universität Potsdam, Haus 28, Karl-Liebknecht-Str. 24/25, 14476, Potsdam, Germany
| | - S A Sanidas
- Jodrell Bank Centre for Astrophysics, Department of Physics and Astronomy, University of Manchester, Manchester M13 9PL, United Kingdom
| | - A Sesana
- Dipartimento di Fisica "G. Occhialini", Universitá degli Studi di Milano-Bicocca, Piazza della Scienza 3, I-20126 Milano, Italy
- INFN, Sezione di Milano-Bicocca, Piazza della Scienza 3, I-20126 Milano, Italy
- INAF - Osservatorio Astronomico di Brera, via Brera 20, I-20121 Milano, Italy
| | - G Shaifullah
- Dipartimento di Fisica "G. Occhialini", Universitá degli Studi di Milano-Bicocca, Piazza della Scienza 3, I-20126 Milano, Italy
- INFN, Sezione di Milano-Bicocca, Piazza della Scienza 3, I-20126 Milano, Italy
- INAF - Osservatorio Astronomico di Cagliari, via della Scienza 5, 09047 Selargius (CA), Italy
| | - L Speri
- Max Planck Institute for Gravitational Physics (Albert Einstein Institute), Am Muühlenberg 1, 14476 Potsdam, Germany
| | - R Spiewak
- Jodrell Bank Centre for Astrophysics, Department of Physics and Astronomy, University of Manchester, Manchester M13 9PL, United Kingdom
| | - B W Stappers
- Jodrell Bank Centre for Astrophysics, Department of Physics and Astronomy, University of Manchester, Manchester M13 9PL, United Kingdom
| | - S C Susarla
- Ollscoil na Gaillimhe-University of Galway, University Road, Galway H91 TK33, Ireland
| | - G Theureau
- Laboratoire de Physique et Chimie de l'Environnement et de l'Espace, Université d'Orléans/CNRS, 45071 Orléans Cedex 02, France
- Observatoire Radioastronomique de Nançay, Observatoire de Paris, Université PSL, Université d'Orléans, CNRS, 18330 Nançay, France
- Laboratoire Univers et Théories LUTh, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - C Tiburzi
- INAF - Osservatorio Astronomico di Cagliari, via della Scienza 5, 09047 Selargius (CA), Italy
| | - E van der Wateren
- ASTRON, Netherlands Institute for Radio Astronomy, Oude Hoogeveensedijk 4, 7991 PD, Dwingeloo, The Netherlands
- Department of Astrophysics/IMAPP, Radboud University Nijmegen, P.O. Box 9010, 6500 GL Nijmegen, The Netherlands
| | - A Vecchio
- Institute for Gravitational Wave Astronomy and School of Physics and Astronomy, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom
| | | | - J Wang
- Fakultät für Physik, Universität Bielefeld, Postfach 100131, 33501 Bielefeld, Germany
- Ruhr University Bochum, Faculty of Physics and Astronomy, Astronomical Institute (AIRUB), 44780 Bochum, Germany
- Advanced Institute of Natural Sciences, Beijing Normal University, Zhuhai 519087, China
| | - L Wang
- Jodrell Bank Centre for Astrophysics, Department of Physics and Astronomy, University of Manchester, Manchester M13 9PL, United Kingdom
| | - Z Wu
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
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Kim YT, Lee KJ, Jang YH, Yang S, Lee TQ, McGarry M, Kim SH. Cadaveric Biomechanical Study of Partial Glenoid Arthroplasty Versus the Latarjet Procedure for Anterior Glenoid Bone Loss. Am J Sports Med 2023; 51:3217-3225. [PMID: 37715516 DOI: 10.1177/03635465231192086] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
BACKGROUND For severe anterior glenoid bone loss due to recurrent shoulder instability, the Latarjet procedure offers a dynamic sling effect in addition to bone augmentation. Yet, it heavily alters the surrounding anatomy, while fixation and graft union issues are also common. PURPOSE/HYPOTHESIS The purpose of this study was to compare a novel printed 3-dimensional (3D) partial glenoid arthroplasty (PGA) implant with the classic Latarjet procedure. It was hypothesized that by replicating the original glenoid geometry and preserving soft tissue anatomy, PGA may better reproduce normal joint kinematics. In addition, the locking screw construct may offer stronger fixation. STUDY DESIGN Controlled laboratory study. METHODS A total of 14 matched cadaveric shoulders were tested. The PGA implant was 3D printed in titanium based on preoperative computed tomography. The intact, 25% anterior glenoid bone loss, and postoperative states were tested in the scapular and coronal planes. The following parameters were measured: articular surface area and stepoff, rotational range of motion and the humeral head apex position during rotation, and load and linear stiffness at 25% anterior translation and at 2-mm construct displacement. RESULTS The baseline dimensions of the glenoid articular surface were comparable between the groups. The articular surface area after PGA was significantly larger (P = .006) with less articular stepoff (P = .030). PGA better approximated the intact state's external (P = .006) and total (P = .019) rotational range of motion in the scapular plane. The course of the humeral head apex after PGA better followed that of the intact state (P < .001). Resistance against anterior translation after PGA was not significantly different compared with after the Latarjet procedure. Greater linear stiffness (P = .031) and loading (P = .002) at 2-mm construct displacement were demonstrated in the PGA group. CONCLUSION In addressing anterior glenoid bone loss, PGA better approximated intact glenohumeral joint kinematics compared with the Latarjet procedure with less articular stepoff in a cadaveric model. PGA was comparable in resisting anterior translation while being significantly stronger against loading at 2-mm construct displacement. Further clinical studies are warranted to validate this novel procedure. CLINICAL RELEVANCE A 3D-printed PGA implant may offer an alternative treatment option for severe glenoid bone loss due to shoulder instability, overcoming the previous drawbacks of the Latarjet procedure, including altered kinematics, fixation failure, and hardware issues.
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Affiliation(s)
- Yong Tae Kim
- Department of Orthopedic Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea
| | - Kyung Jae Lee
- Department of Orthopedic Surgery, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Young Hoon Jang
- Department of Orthopedic Surgery, CM Hospital, Seoul, Republic of Korea
| | - Sook Yang
- Research Center, Cusmedi, Suwon, Republic of Korea
| | - Thay Q Lee
- Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, California, USA
| | - Michelle McGarry
- Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, California, USA
| | - Sae Hoon Kim
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea
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Lee KJ, Chkheidze R, Alrefai H, Margaroli C, Gaggar A, Nguyen T, Anderson JC, Bash R, Miller CR, Willey CD. Spatially Resolved Whole Transcriptome Analysis of Histologically-Characterized Tissue Microarray of Patient-Matched Primary and Recurrent Glioblastomas to Identify Underlying Mechanisms of Treatment Resistance. Int J Radiat Oncol Biol Phys 2023; 117:e127. [PMID: 37784683 DOI: 10.1016/j.ijrobp.2023.06.922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Glioblastoma multiforme (GBM) is a lethal CNS malignancy. Radiation therapy increases overall survival, but tumors often recur in high-radiation dose regions. Additionally, recent investigations have underscored the importance of intra-tumoral heterogeneity as a driver of GBM biology. The purpose of this investigation is to characterize transcriptome differences in primary and recurrent GBM patient clinical samples using a digital spatial profiling approach to better appreciate treatment resistance mechanisms. MATERIALS/METHODS To address the lack of understanding of molecular mechanisms of resistance in GBM, patient-matched primary and recurrent GBM pathological specimens were identified within the brain tissue biorepository and tissue cores were selected for generation of a tissue microarray (TMA). Hematoxylin and eosin staining with histomorphological (cellular tumor, pseudopalisading necrosis, invasive edge, and perivascular inflammation) scoring were performed in a blinded fashion for every core. This array was then molecularly characterized using digital spatial profiling of the transcriptome. Quality assurance including filtering of lowly expressed genes followed by downstream analyses of the data were performed using the manufacturer's recommended methods within their Bioconductor library. Gene Set Enrichment Analysis (GSEA) was then performed on the ranked gene lists. RESULTS After recommended filtering, 6171 genes and 248 regions of interest remained for downstream analysis representing 22 unique patients across four different tumor histomorphological types. Significance testing revealed 679 genes that were differentially expressed between primary and recurrent tumor samples (at FDR<1%). On GSEA analysis, the chromosomal positional locus that contains genes most strongly up-regulated is 12q14, a locus that was previously identified as genomically amplified in multiple patient-derived xenograft lines after radiation selection. Additionally, recurrent tumors display a transcriptional profile more similar to the mesenchymal subtype, whereas primary tumors have a more classical transcriptional phenotype. The epithelial-to-mesenchymal transition pathway is particularly strongly up-regulated in recurrent tumors. CONCLUSION Recurrent selection at previously identified genomic loci and molecular pathways underscores a possible conserved set of pathways for treatment resistance. This analysis has yielded a set of gene and molecular pathways that will guide future work in our lab targeting treatment resistance using novel therapeutics and radiation techniques in GBM. Future directions include assessing the feasibility of mapping these clinical samples onto our previously generated panel of comprehensively characterized patient-derived xenograft lines.
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Affiliation(s)
- K J Lee
- University of Alabama at Birmingham, Birmingham, AL
| | | | | | | | | | - T Nguyen
- The University of Alabama at Birmingham, Birmingham, AL
| | - J C Anderson
- The University of Alabama at Birmingham, Birmingham, AL
| | - R Bash
- University of Alabama at Birmingham, Birmingham, AL
| | | | - C D Willey
- University of Alabama at Birmingham Department of Radiation Oncology, Birmingham, AL
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Lee KJ, Jang YH, Nam JH, Yoo HJ, Kim SH. Spontaneous Deltoid Tear in Cuff Tear Arthropathy and Its Effect on the Outcome of Reverse Total Shoulder Arthroplasty: A Comparison Using Propensity Score Matching. Clin Orthop Surg 2023; 15:627-636. [PMID: 37529192 PMCID: PMC10375814 DOI: 10.4055/cios22343] [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: 10/27/2022] [Revised: 02/19/2023] [Accepted: 02/19/2023] [Indexed: 08/03/2023] Open
Abstract
Background Deltoid function critically influences the results of reverse total shoulder arthroplasty (RTSA), and spontaneous deltoid attrition tears are frequently detected in cuff tear arthropathy (CTA) patients; however, the clinical impacts of these tears on RTSA outcomes are undetermined. Our aim was to determine the effect of spontaneous deltoid attrition tears on postoperative outcomes after RTSA without an additional deltoid procedure. Methods Seventy-two patients who underwent RTSA for CTA with preoperative magnetic resonance imaging (MRI) and a minimum clinical follow-up of 1 year (mean, 32 months) were retrospectively reviewed in the study. Patients with a history of previous shoulder surgery or injury were excluded. The presence and location of deltoid attrition tears were determined in preoperative MRI. Propensity score matching (1:1) was performed to construct tear and no-tear groups. Finally, 21 patients, matched with respect to age, sex, hand dominance, symptom duration, medical comorbidity (obesity, diabetes mellitus, and coronary artery disease), Hamada grade, and implant type, were assigned to each group. Clinical outcomes (functional scores, isometric power, and range of motion) in the two groups were compared. Results Deltoid attrition tears were detected in 21 of the 72 enrolled cases (29.1%). Anterolateral deltoid was the most frequent location and no tear was detected in the posterior deltoid. The tear rate increased with disease severity (Hamada G2, 4.8%; G3, 23.8%; > G4, 71.4%). No pre- or postoperative clinical variables differed significantly between the tear and no tear groups. Conclusions Deltoid attrition tears were detected in 29% of CTA patients who underwent RTSA. The most common site was the anterolateral region and tear prevalence tended to increase with CTA progression. However, RTSA was found to provide satisfactory outcomes regardless of the presence of a deltoid attrition tear.
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Affiliation(s)
- Kyung Jae Lee
- Department of Orthopedic Surgery, Chung-Ang University Medical Center, Chung-Ang University School of Medicine, Seoul, Korea
| | - Young Hoon Jang
- Department of Orthopedic Surgery, Uijeongbu Eulji Medical Center, Eulji University, Seoul, Korea
| | - Ji Hoon Nam
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
| | - Hye Jin Yoo
- Department of Radiology and Institute of Radiation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sae Hoon Kim
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
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Lee YM, Lee Y, Choi SY, Kim HJ, Hong SJ, Kang Y, Lee EH, Lee KJ, Choi Y, Yi DY, Kim S, Kang B. A Nationwide Survey on Gastrointestinal Endoscopy Practice Patterns among Pediatric Endoscopists in South Korea. Pediatr Gastroenterol Hepatol Nutr 2023; 26:79-87. [PMID: 36950059 PMCID: PMC10025574 DOI: 10.5223/pghn.2023.26.2.79] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 06/11/2022] [Accepted: 08/23/2022] [Indexed: 03/24/2023] Open
Abstract
Purpose Gastrointestinal (GI) endoscopy is an important tool for diagnosing and treating GI diseases in children. This study aimed to analyze the current GI endoscopy practice patterns among South Korean pediatric endoscopists. Methods Twelve members of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition developed a questionnaire. The questionnaire was emailed to pediatric gastroenterologists attending general and tertiary hospitals in South Korea. Results The response rate was 86.7% (52/60), and 49 of the respondents (94.2%) were currently performing endoscopy. All respondents were performing esophagogastroduodenoscopy, and 43 (87.8%) were performing colonoscopy. Relatively rare procedures for children, such as double-balloon enteroscopy (DBE) (4.1%), endoscopic retrograde cholangiopancreatography (ERCP) (2.0%), and endoscopic ultrasound (EUS) (2.0%), were only performed by pediatric gastroenterologists at very few centers, but were performed by adult endoscopists in most of the centers; of all the respondents, 83.7% (41/49) performed emergency endoscopy. In most centers, the majority of the endoscopies were performed under sedation, with midazolam (100.0%) and ketamine (67.3%) as the most frequently used sedatives. Conclusion While most pediatric GI endoscopists perform common GI endoscopic procedures, rare procedures, such as DBE, ERCP, and EUS, are only performed by pediatric gastroenterologists at very few centers, and by adult GI endoscopists at most of the centers. For such rare procedures, close communication and cooperation with adult GI endoscopists are required.
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Affiliation(s)
- Yoo Min Lee
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Yoon Lee
- Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea
| | - So Yoon Choi
- Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Hyun Jin Kim
- Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea
| | - Suk Jin Hong
- Department of Pediatrics, Daegu Catholic University Medical Center, Daegu, Korea
| | - Yunkoo Kang
- Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Eun Hye Lee
- Department of Pediatrics, Eulji General Hospital, Seoul, Korea
| | - Kyung Jae Lee
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Youjin Choi
- Department of Pediatrics, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Dae Yong Yi
- Department of Pediatrics, Chungang University Medical Center, Seoul, Korea
| | - Seung Kim
- Department of Pediatrics, Yonsei University Severance Children’s Hospital, Seoul, Korea
| | - Ben Kang
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
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Kim YB, Kim JY, Choi S, Lee YM, Choi SY, Kim SC, Jang HJ, Lee Y, Jeong IS, Yi DY, Kang Y, Lee KJ, Choe BH, Kang B. Fecal Calprotectin Levels Significantly Correlate with Polyp Size in Children and Adolescents with Juvenile Colorectal Polyps. Pediatr Gastroenterol Hepatol Nutr 2023; 26:34-42. [PMID: 36816439 PMCID: PMC9911176 DOI: 10.5223/pghn.2023.26.1.34] [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: 12/30/2021] [Revised: 06/11/2022] [Accepted: 08/30/2022] [Indexed: 01/14/2023] Open
Abstract
PURPOSE We aimed to investigate factors that correlate with fecal calprotectin (FC) levels in children and adolescents with colorectal polyps. METHODS Pediatric patients aged <19 years who underwent colonoscopic polypectomy for a juvenile polyps (JPs) and FC tests were simultaneously conducted in a multicenter, retrospective study. Baseline demographics, colonoscopic and histological findings, and laboratory tests, including FC levels, were investigated. Correlations between the factors were investigated, and linear regression analysis revealed factors that correlated with FC levels. FC levels measured after polypectomies were investigated and the FC levels pre- and post-polypectomies were compared. RESULTS A total of 33 patients were included in the study. According to Pearson correlation analysis, the polyp size was the only factor that showed a statistically significant correlation with FC levels (r=0.75, p<0.001). Furthermore, according to the multivariate linear regression analysis, polyp size was the only factor that showed a statistically significant correlation with FC levels (adjusted R2 =0.5718, β=73.62, p<0.001). The median FC level was 400 mg/kg (interquartile range [IQR], 141.6-1,000 mg/kg), and the median polyp size was 14 mm (IQR, 9-20 mm). Nineteen patients underwent post-polypectomy FC tests. FC levels showed a significant decrease after polypectomy from a median of 445.2 mg/kg (IQR, 225-1,000) to 26.5 mg/kg (11.5-51) (p<0.001). CONCLUSION FC levels significantly correlated with polyp size in children and adolescents with JPs.
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Affiliation(s)
- Yu Bin Kim
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
| | - Ju Young Kim
- Department of Pediatrics, Eulji University Hospital, Daejeon, Korea
| | - Sujin Choi
- Department of Pediatrics, School of Medicine, Kyunpook National University, Daegu, Korea
| | - Yoo Min Lee
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - So Yoon Choi
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Soon Chul Kim
- Department of Pediatrics, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
| | - Hyo-Jeong Jang
- Department of Pediatrics, Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea
| | - Yoon Lee
- Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea
| | - In Sook Jeong
- Department of Pediatrics, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea
| | - Dae Yong Yi
- Department of Pediatrics, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Yunkoo Kang
- Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kyung Jae Lee
- Department of Pediatrics, Hallym University College of Medicine, Chuncheon, Korea
| | - Byung-Ho Choe
- Department of Pediatrics, School of Medicine, Kyunpook National University, Daegu, Korea
| | - Ben Kang
- Department of Pediatrics, School of Medicine, Kyunpook National University, Daegu, Korea
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Choi SH, Park SD, Lee MJ, Lee KJ. Comparison of trans-radial access and femoral access in cardiogenic shock patient who had undergone primary percutaneous coronary intervention from SMART RESCUE trial. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction
Throughout the years of percutaneous coronary intervention (PCI), the debate regarding access route, whether it being trasns-radial or femoral, is an ongoing agenda yet to be solved. Recent guidelines suggest trans-radial approach as an option to be considered in acute coronary syndrome (ACS). However, data on cardiogenic shock patients undergoing PCI is relatively sparse.
Purpose
Compare the clinical implication of trans-radial and femoral approach in cardiogenic shock patients who had undergone PCI.
Method
Cardiogenic shock patients who had undergone PCI from January 2014 to December of 2018 were enrolled. Patients were divided according to their access route respectfully. Primary outcome was composite endpoints including all-cause death, re-admission due to heart failure, myocardial infarction (MI) and cerebrovascular accident.
Result
A total of 694 (572 via femoral approach, 122 via radial approach) cardiogenic shock patients who received PCI were enrolled. Mean age femoral and radial groups was 66.59±12.51 and 66.66±12.8 respectfully. Disease severity was higher for femoral patients compared to radial patients as represented by their LM involvement, mechanical organ support (extracorporeal membrane oxygenation, continuous renal replacement therapy, mechanical ventilation), left ventricular ejection fraction (LVEF) and vasoactive inotropic score. Cox regression analysis after adjusting for conventional risk factors showed that femoral route was a poor prognosticator with respect to composite endpoints (HR=2.059, 95% CI 1.249–3.397, p value = 0.005). Radial approach patients had higher survival probability compared to femoral approach patients (Figure 1).
Conclusion
Radial approach in cardiogenic shock patients who are in need for PCI with relatively less severe clinical condition could be a reasonable option for access route.
Funding Acknowledgement
Type of funding sources: Private hospital(s). Main funding source(s): Inha University Hospital
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Affiliation(s)
- S H Choi
- Inha University Hospital, Cardiology , Incheon , Korea (Republic of)
| | - S D Park
- Inha University Hospital, Cardiology , Incheon , Korea (Republic of)
| | - M J Lee
- Inha University Hospital, Critical Care Medicine , Incheon , Korea (Republic of)
| | - K J Lee
- Inha University Hospital, Cardiology , Incheon , Korea (Republic of)
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Choi SY, Choi S, Kang B, Choe BH, Lee YJ, Park JH, Kim YB, Kim JY, Lee K, Lee KJ, Kang KS, Lee YM, Kim HJ, Kang Y, Jang HJ, Yi DY, Hong SJ, Choi YJ, Hong J, Kim SC. Epidemiological Trends of Pediatric Inflammatory Bowel Disease in Korea: A Multicenter Study of the Last 3 Years Including the COVID-19 Era. J Korean Med Sci 2022; 37:e279. [PMID: 36163477 PMCID: PMC9512678 DOI: 10.3346/jkms.2022.37.e279] [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: 06/30/2022] [Accepted: 07/29/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Studies on how the coronavirus pandemic has affected pediatric inflammatory bowel disease (PIBD) are lacking. We aimed to investigate the trends in epidemiology, characteristics, initial management, and short-term outcomes of PIBD in South Korea over the recent three years including the era of coronavirus disease 2019 (COVID-19). METHODS This multicenter study retrospectively investigated temporal trends in the epidemiology of PIBD in Korea. Annual occurrences, disease phenotypes, and initial management at diagnosis were analyzed from January 2018 to June 2021. RESULTS A total of 486 patients from 17 institutions were included in this epidemiological evaluation. Analysis of the occurrence trend confirmed a significant increase in PIBD, regardless of the COVID-19 pandemic. In Crohn's disease, patients with post-coronavirus outbreaks had significantly higher fecal calprotectin levels than those with previous onset (1,339.4 ± 717.04 vs. 1,595.5 ± 703.94, P = 0.001). Patients with post-coronavirus-onset ulcerative colitis had significantly higher Pediatric Ulcerative Colitis Activity Index scores than those with previous outbreaks (48 ± 17 vs. 36 ± 15, P = 0.004). In the initial treatment of Crohn's disease, the use of 5-aminosalicylic acid (5-ASA) and steroids significantly decreased (P = 0.006 and 0.001, respectively), and enteral nutrition and the use of infliximab increased significantly (P = 0.045 and 0.009, respectively). There was a significant increase in azathioprine use during the initial treatment of ulcerative colitis (P = 0.020). CONCLUSION Regardless of the COVID-19 pandemic, the number of patients with PIBD is increasing significantly annually in Korea. The initial management trends for PIBD have also changed. More research is needed to establish appropriate treatment guidelines considering the epidemiological and clinical characteristics of Korean PIBD.
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Affiliation(s)
- So Yoon Choi
- Department of Pediatrics, Kosin University College of Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Sujin Choi
- Department of Pediatrics, School of Medicine, Kyungpook National University, Kyungpook National University Children's Hospital, Daegu, Korea
| | - Ben Kang
- Department of Pediatrics, School of Medicine, Kyungpook National University, Kyungpook National University Children's Hospital, Daegu, Korea
| | - Byung-Ho Choe
- Department of Pediatrics, School of Medicine, Kyungpook National University, Kyungpook National University Children's Hospital, Daegu, Korea
| | - Yeoun Joo Lee
- Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea
| | - Jae Hong Park
- Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea
| | - Yu Bin Kim
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
| | - Jae Young Kim
- Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Kunsong Lee
- Department of Pediatrics, Dankook University Hospital, Cheonan, Korea
| | - Kyung Jae Lee
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Ki Soo Kang
- Department of Pediatrics, Jeju National University Hospital, Jeju, Korea
| | - Yoo Min Lee
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Hyun Jin Kim
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Yunkoo Kang
- Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hyo-Jeong Jang
- Department of Pediatrics, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Dae Yong Yi
- Department of Pediatrics, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Suk Jin Hong
- Department of Pediatrics, Daegu Catholic University School of Medicine, Daegu, Korea
| | - You Jin Choi
- Department of Pediatrics, Inje University College of Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Jeana Hong
- Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Soon Chul Kim
- Department of Pediatrics, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea.
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Kim JY, Kim YB, Choi S, Lee YM, Kim HJ, Kim SC, Jang HJ, Choi SY, Yi DY, Lee Y, Choi YJ, Kang Y, Lee KJ, Hong SJ, Hwang JH, Kwak S, Choe BH, Kang B. Associations of Polyp Characteristics in Children and Adolescents Presenting with Less Than Five Colorectal Polyps: A Full Colonoscopy Is Still Required. Gut Liver 2022; 17:441-448. [PMID: 36052612 DOI: 10.5009/gnl210404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 06/01/2022] [Accepted: 06/07/2022] [Indexed: 11/04/2022] Open
Abstract
Background/Aims A full colonoscopy is currently required in children and adolescents with colorectal polyps, because of their potential of neoplastic transformation and complications such as intussusception. We aimed to analyze the associations of polyp characteristics in children and adolescents with colorectal polyps. Based on these findings, we also aimed to reevaluate the necessity of conducting a full colonoscopy. Methods Pediatric patients <18 years of age who had undergone a colonoscopic polypectomy and those with <5 colorectal polyps were included in this multicenter, retrospective study. Baseline clinicodemographics, colonoscopic and histologic findings were investigated. Results A total of 91 patients were included. Multivariate logistic regression analysis showed that polyp size was the only factor associated with the presence of any polyps located proximal to the splenic flexure (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.28 to 4.28; p=0.007). Furthermore, polyp location proximal to the splenic flexure and sessile morphology were associated with the presence of any adenomatous polyp (OR, 8.51; 95% CI, 1.43 to 68.65; p=0.023; OR, 18.41; 95% CI, 3.45 to 173.81; p=0.002, respectively). Conclusions In children and adolescents presenting with <5 colorectal polyps, polyp size and the presence of any adenomatous polyp were positively associated with polyp location proximal to the splenic flexure. This finding supports the necessity of a full colonoscopic exam in pediatric patients with colorectal polyps for the detection of polyps before the occurrence of complications such as intussusception or neoplastic transformation.
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Affiliation(s)
- Ju Young Kim
- Department of Pediatrics, Daejeon Eulji Medical Center, Eulji University, Daejeon, Korea
| | - Yu Bin Kim
- Department of Pediatrics, Ajou University Hospital, Suwon, Korea
| | - Sujin Choi
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yoo Min Lee
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Hyun Jin Kim
- Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea
| | - Soon Chul Kim
- Department of Pediatrics, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea
| | - Hyo-Jeong Jang
- Department of Pediatrics, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
| | - So Yoon Choi
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Dae Yong Yi
- Department of Pediatrics, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Yoon Lee
- Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea
| | - You Jin Choi
- Department of Pediatrics, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Yunkoo Kang
- Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kyung Jae Lee
- Department of Pediatrics, Hallym University College of Medicine, Chuncheon, Korea
| | - Suk Jin Hong
- Departments of Pediatrics, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Jun Hyun Hwang
- Departments of Preventive Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Sanggyu Kwak
- Departments of Medical Statistics, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Byung-Ho Choe
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ben Kang
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
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14
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Choi SY, Lee KJ, Kim SC, Lee EH, Lee YM, Kim YB, Yi DY, Kim JY, Kang B, Jang HJ, Hong SJ, Choi YJ, Kim HJ. Cardiac Complications Associated with Eating Disorders in Children: A Multicenter Retrospective Study. Pediatr Gastroenterol Hepatol Nutr 2022; 25:432-440. [PMID: 36148287 PMCID: PMC9482826 DOI: 10.5223/pghn.2022.25.5.432] [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: 02/21/2022] [Revised: 05/30/2022] [Accepted: 07/20/2022] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Eating disorders often result in somatic complications, including cardiac abnormalities. Cardiac abnormalities may involve any part of the heart, including the cardiac conduction system, and can lead to sudden cardiac death. The current study aimed to evaluate the incidence of cardiac complications in pediatric patients with eating disorders and their associated factors. METHODS We retrospectively analyzed patients aged 10-18 years who were diagnosed with DSM-V (Diagnostic and Statistical Manual of Mental Disorder-V) eating disorders and underwent electrocardiography (ECG) and/or echocardiography between January 2015 and May 2020. RESULTS In total, 127 patients were included, of whom 113 (89.0%) were female. The median body mass index (BMI) was 15.05±3.69 kg/m2. Overall, 74 patients (58.3%) had ECG abnormalities, with sinus bradycardia being the most common abnormality (91.9%). Patients with ECG abnormalities had significantly lower BMI (14.35±2.78 kg/m2 vs. 16.06± 4.55 kg/m2, p<0.001) than patients without ECG abnormalities, as well as lower phosphorus and higher cholesterol levels. Among the 46 patients who underwent echocardiographic evaluation, 23 (50.0%) had echocardiographic abnormalities, with pericardial effusion being the most common (60.9%). The median left ventricular mass (LVM) and ejection fraction were 67.97±21.25 g and 66.91±28.76%, respectively. LVM and BMI showed a positive correlation (r=0.604, p<0.001). After weight gain, the amount of pericardial effusion was reduced in 3 patients, and 30 patients presented with normal ECG findings. CONCLUSION Cardiac abnormalities are relatively frequent in patients with eating disorders. Physicians should focus on this somatic complication and careful monitoring is required.
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Affiliation(s)
- So Yoon Choi
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Kyung Jae Lee
- Department of Pediatrics, College of Medicine, Hallym University, Chuncheon, Korea
| | - Soon Chul Kim
- Department of Pediatrics, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
| | - Eun Hye Lee
- Department of Pediatrics, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Yoo Min Lee
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Yu-Bin Kim
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
| | - Dae Yong Yi
- Department of Pediatrics, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Ju Young Kim
- Department of Pediatrics, Daejeon Eulji Medical Center, Eulji University, Daejeon, Korea
| | - Ben Kang
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyo-Jeong Jang
- Department of Pediatrics, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Suk Jin Hong
- Department of Pediatrics, Daegu Catholic University School of Medicine, Daegu, Korea
| | - You Jin Choi
- Department of Pediatrics, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Hyun Jin Kim
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
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15
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Lee KJ, Choi SY, Lee YM, Kim HW. Neutralizing Antibody Response, Safety, and Efficacy of mRNA COVID-19 Vaccines in Pediatric Patients with Inflammatory Bowel Disease: A Prospective Multicenter Case-Control Study. Vaccines (Basel) 2022; 10:vaccines10081265. [PMID: 36016153 PMCID: PMC9415578 DOI: 10.3390/vaccines10081265] [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: 07/13/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 01/14/2023] Open
Abstract
The vaccination of immunocompromised children against coronavirus disease 2019 is an important public health issue. We evaluated the serological response, safety, and efficacy of the BNT162b2 vaccine in children with and without inflammatory bowel disease (IBD). A prospective, multicenter, case–control study was conducted in a pediatric population, including patients with IBD, aged 12–18 years. Clinical characteristics, safety profile, and serum samples for surrogate virus-neutralizing antibody testing pre- and post-BNT162b2 vaccination were assessed. The breakthrough infection rate during the Omicron outbreak was calculated to evaluate efficacy. Fifteen controls and twenty-three patients with IBD were enrolled. After two vaccine doses, the median level of percentage inhibition was highly increased, without significant differences between the groups (control 96.9 and IBD 96.3). However, it was significantly reduced in IBD patients receiving combination therapy (anti-tumor necrosis factor-α + immunomodulators) relative to those in other therapies and controls. Serious adverse events were not observed. The breakthrough infection rate was 42.1%, without statistical differences between the groups. Immunization with BNT162b2 in patients with IBD was comparable with that in healthy adolescents in terms of immunogenicity and safety. Nevertheless, the efficacy of BNT162b2 in preventing infection caused by the Omicron variant in the pediatric population was insufficient.
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Affiliation(s)
- Kyung Jae Lee
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang 14068, Korea
- Department of Pediatrics, College of Medicine, Hallym University, Chuncheon 24252, Korea
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul 03080, Korea
| | - So Yoon Choi
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Korea
| | - Yoo Min Lee
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon 14584, Korea
| | - Han Wool Kim
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang 14068, Korea
- Department of Pediatrics, College of Medicine, Hallym University, Chuncheon 24252, Korea
- Correspondence: ; Tel.: +82-31-380-3730
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16
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Lee KJ, Ryoo E, Lee YM, Yoon JM, Jang HJ, Choi SY, Choi YJ, Kim HJ, Chung JY, Shim JO. Saccharomyces boulardii and Lactulose for Childhood Functional Constipation: A Multicenter Randomized Controlled Trial. J Neurogastroenterol Motil 2022; 28:454-462. [PMID: 35799239 PMCID: PMC9274472 DOI: 10.5056/jnm21130] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 12/22/2021] [Accepted: 01/06/2022] [Indexed: 11/20/2022] Open
Abstract
Background/Aims The effects of probiotics in children vary based on diseases and probiotic strains. We aim to investigate the effectiveness of Saccharomyces boulardii and lactulose for treating childhood functional constipation. Methods This open-label randomized controlled trial was conducted at 10 university hospitals in Korea. Children who were diagnosed with functional constipation were allocated to 3 groups (lactulose monotherapy, combination therapy, and S. boulardii monotherapy). The primary outcome was treatment success rate that was accordingly defined as ≥ 3 bowel movements without incontinence at week 12. The cumulative successful maintenance and drug maintenance rates without drug changes were calculated throughout the study period. We compared stool frequency, incontinence, consistency, and painful defecation at week 2 among the 3 groups. Results Overall, 187 children were assigned to the lactulose monotherapy (n = 69), combination therapy (n = 68), or S. boulardii monotherapy (n = 50) groups. The primary outcome was significantly higher in the lactulose monotherapy group (26.1%) or combination therapy group (41.2%) than in the S. boulardii monotherapy group (8.0%). The S. boulardii monotherapy group showed a significantly lower cumulative successful maintenance and drug maintenance rate than the other 2 groups. There were no significant intergroup differences in the frequency of defecation, incontinence, painful defecation, or stool consistency during the follow-up at week 2. Conclusion S. boulardii monotherapy was not superior to lactulose monotherapy or combination therapy and showed a higher drug change rate, supporting the current recommendation of probiotics in the treatment of childhood functional constipation.
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Affiliation(s)
- Kyung Jae Lee
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Gangwon-do, Korea
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, Korea (Current address)
| | - Eell Ryoo
- Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea
| | - Yoo Min Lee
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Gyeonggi-do, Korea
| | - Jung Min Yoon
- Department of Pediatrics, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Hyo-Jeong Jang
- Department of Pediatrics, Keimyung University Dongsan Hospital, Keimyung University College of Medicine, Daegu, Korea
| | - So Yoon Choi
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
- Department of Pediatrics, Haeundaepaik Hospital, Inje University College of Medicine, Busan, Korea
| | - You Jin Choi
- Department of Pediatrics, Inje University Ilsan Paik Hospital, Goyang, Gyeonggi-do, Korea
| | - Hyun Jin Kim
- Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea
| | - Ju Young Chung
- Department of Pediatrics, Sanggye-Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jung Ok Shim
- Department of Pediatrics, Korea University College of Medicine, Korea University Guro Hospital, Seoul, Korea
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17
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Choi YJ, Park EJ, Lee YM, Kim SC, Kang B, Lee KJ, Jang HJ, Lee EH, Kim JY, Choi SY, Jin Kim H, Kang Y, Choe BH, Lee J, Yi DY. Effects of anxiety on sedation among pediatric patients undergoing esophagogastroduodenoscopy. Clin Child Psychol Psychiatry 2022; 27:793-803. [PMID: 35452583 DOI: 10.1177/13591045221096308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We investigated whether the severity of anxiety among children undergoing endoscopy could affect sedation. We prospectively recruited patients under 18 years of age who were scheduled to undergo esophagogastroduodenoscopy (EGD). Baseline anxiety was evaluated using the Spence Children's Anxiety Scale (SCAS). Our analysis considered the type and dose of sedative drugs, degree of sedation, and complications associated with sedation according to the scale score. The mean total SCAS T-scores and each subscale score were significantly higher in the 6-12-year age group. The mean T-score among patients who exhibited irritability during EGD was higher than that among other patients, with significant differences in the Total, Obsessive Disorder, Panic Agoraphobia and General Anxiety subscales. The midazolam doses of children exhibiting irritability were more likely to need higher (p = 0.006). Other sedation-related complications were not associated with the T-scores in each subscale. Total sleep time was not associated with any T-score subscales. Anxiety levels were significantly higher among 6-12-year-olds and children exhibiting irritability. Anxiety was often associated with irritability, difficulties achieving adequate sedation during EGD, and additional sedative drug administration. We recommend higher doses or more potent drugs to facilitate endoscopy for children with high anxiety levels.
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Affiliation(s)
- You Jin Choi
- Department of Pediatrics, 119750Inje University Ilsan Paik Hospital, Republic of Korea.,119750Inje University College of Medicine, Republic of Korea
| | - Eun Jin Park
- Department of Psychiatry, 119750Inje University Ilsan Paik Hospital, Republic of Korea
| | - Yoo Min Lee
- Department of Pediatrics, 26730Soonchunhyang University Bucheon Hospital, Republic of Korea.,26730Soonchunhyang University College of Medicine, Republic of Korea
| | - Soon Chul Kim
- Department of Pediatrics, 90158Jeonbuk National University Medical School, Republic of Korea.,90158Jeonbuk National University Hospital, Republic of Korea
| | - Ben Kang
- Department of Pediatrics, School of Medicine, 65672Kyungpook National University, Republic of Korea
| | - Kyung Jae Lee
- Department of Pediatrics, 158781Hallym University Sacred Heart Hospital, Republic of Korea.,158781Hallym University College of Medicine, Republic of Korea
| | - Hyo-Jeong Jang
- Department of Pediatrics, 65673Keimyung University School of Medicine Dongsan Medical Center, Republic of Korea
| | - Eun Hye Lee
- Department of Pediatrics, 65401Nowon Eulji Medical Center, Republic of Korea.,65401Eulji University School of Medicine, Republic of Korea
| | - Ju Young Kim
- Department of Pediatrics, 65401Eulji University Hospital, Republic of Korea
| | - So Yoon Choi
- Department of Pediatrics, 65366Kosin University Gospel Hospital, Republic of Korea.,65366Kosin University College of Medicine, Republic of Korea
| | - Hyun Jin Kim
- Department of Pediatrics, 65409Chungnam National University Hospital, Republic of Korea
| | - Yunkoo Kang
- Department of Pediatrics, 37974Yonsei University Wonju College of Medicine, Republic of Korea
| | - Byung-Ho Choe
- Department of Pediatrics, School of Medicine, 65672Kyungpook National University, Republic of Korea
| | - Jeewon Lee
- 26730Soonchunhyang University College of Medicine, Republic of Korea.,Department of Neuropsychiatry, 26730Soonchunhyang University Bucheon Hospital, Republic of Korea
| | - Dae Yong Yi
- Department of Pediatrics, 26729Chung-Ang University Hospital, Republic of Korea.,College of Medicine, 26729Chung-Ang University, Republic of Korea
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18
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Lee KJ, Kim J, Kim Y, Yang E, Yun KR, Kim SH. Analysis of the reasons why patients cancel shoulder surgery despite recommendation. Clin Shoulder Elb 2022; 25:121-128. [PMID: 35698781 PMCID: PMC9185113 DOI: 10.5397/cise.2021.00689] [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: 11/18/2021] [Accepted: 01/05/2022] [Indexed: 11/30/2022] Open
Abstract
Background To determine the reasons and factors that contribute to the cancellations of shoulder surgeries at a tertiary referral center and to analyze the characteristics of these patients. Methods Patients scheduled for shoulder surgery from June 2017 to July 2019 were allocated to a surgery group (n=224) or a cancellation group (n=96). These groups were compared with respect to patient characteristics, types of surgery, distance from patient’s home to the hospital, traveling time to the hospital, and waiting period before surgery. Reasons for cancellation and responses were acquired using a telephone interview and were subsequently analyzed. Results The cancellation group was older, had a less frequent history of trauma, and had a lower proportion of patients undergoing arthroscopic rotator cuff repair than the surgery group (p=0.009, p=0.014, and p=0.017, respectively). In addition, mean distance from the patients’ homes to the hospital and preoperative waiting time were both longer in the cancellation group (p=0.001 and p<0.01, respectively). The most common reason given for cancellation was another medical condition (28.1%). Conclusions Older age, need for arthroscopic rotator cuff repair surgery, longer distance from the patient’s home to the hospital, and longer waiting period significantly increased the chance of cancellation. The main reason for canceling surgery was a concurrent medical condition. Therefore, identification of other medical conditions in advance is an important consideration when surgeons recommend shoulder surgery to patients. Surgeons should also consider patient's age, type of surgery, distance from the hospital, and waiting time when assessing the possibility of surgery cancellation.
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Kim YB, Kim JY, Choi S, Kim HJ, Lee YM, Lee Y, Jang HJ, Lee EH, Lee KJ, Kim SC, Choi SY, Kang Y, Yi DY, Choi YJ, Choe BH, Kang B. Potential Utility of Fecal Calprotectin in Discriminating Colorectal Polyps From Other Major Etiologies in Children Presenting With Isolated Hematochezia. J Korean Med Sci 2022; 37:e72. [PMID: 35257527 PMCID: PMC8901882 DOI: 10.3346/jkms.2022.37.e72] [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: 11/17/2021] [Accepted: 01/26/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Colorectal polyps are the most common cause of isolated hematochezia in children, which requires a colonoscopy for diagnosis. We aimed to investigate the potential utility of fecal calprotectin (FC) in assessing colorectal polyps detected by colonoscopy among children presenting with isolated hematochezia. METHODS Pediatric patients of the age of < 18 years who had undergone both colonoscopy and FC tests for isolated hematochezia from June 2016 to May 2020 were included in the present multicenter, retrospective, cross-sectional study. Comparative analysis was conducted between major causes of isolated hematochezia and FC cut-offs for discriminating colorectal polyps were explored. RESULTS A total 127 patients were included. Thirty-five patients (27.6%) had colorectal polyps, followed by anal fissure (14.2%), ulcerative colitis (UC; 12.6%), and others. A significant difference in FC levels was observed between patients with colorectal polyps (median, 278.7 mg/kg), anal fissures (median, 42.2 mg/kg), and UC (median, 981 mg/kg) (P < 0.001). According to receiver operating characteristic curve analysis, among patients diagnosed with colorectal polyp or anal fissure, the most accurate FC cut-off for discriminating colorectal polyps from anal fissures on colonoscopy was 225 mg/kg (sensitivity, 59.4%; specificity, 94.4%; positive predictive value [PPV], 95.0%; negative predictive value [NPV], 56.7%; area under the curve [AUC], 0.8; 95% confidence interval [CI], 0.678-0.923; P < 0.001), while among patients diagnosed with colorectal polyp or UC, the most accurate FC cut-off for discriminating colorectal polyps from UC on colonoscopy was 879 mg/kg (sensitivity, 81.2%; specificity, 56.2%; PPV, 78.8%; NPV, 60.0%; AUC, 0.687; 95% CI, 0.521-0.852; P < 0.001). CONCLUSION FC may assist in assessing the cause of lower gastrointestinal tract bleeding in children who present with isolated hematochezia.
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Affiliation(s)
- Yu Bin Kim
- Department of Pediatrics, Ajou University Medical Center, Suwon, Korea
| | - Ju Young Kim
- Department of Pediatrics, Eulji University Hospital, Daejeon, Korea
| | - Sujin Choi
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyun Jin Kim
- Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea
| | - Yoo Min Lee
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Yoon Lee
- Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea
| | - Hyo-Jeong Jang
- Department of Pediatrics, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Eun Hye Lee
- Department of Pediatrics, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Kyung Jae Lee
- Department of Pediatrics, Hallym University College of Medicine, Chuncheon, Korea
| | - Soon Chul Kim
- Department of Pediatrics, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
| | - So Yoon Choi
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Yunkoo Kang
- Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dae Yong Yi
- Department of Pediatrics, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
| | - You Jin Choi
- Department of Pediatrics, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Byung-Ho Choe
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ben Kang
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea.
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20
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Choi IY, Ju HJ, Lee KJ, Shin HD. First Report of Powdery Mildew Caused by Podosphaera xanthii on Salvia farinacea in Korea. Plant Dis 2022; 106:1068. [PMID: 34402635 DOI: 10.1094/pdis-07-21-1427-pdn] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- I Y Choi
- Department of Agricultural Biology, Jeonbuk National University, Jeonju 54896, Korea
- Department of Agricultural Convergence Technology, Jeonbuk National University, Jeonju 54896, Korea
| | - H J Ju
- Department of Agricultural Biology, Jeonbuk National University, Jeonju 54896, Korea
- Department of Agricultural Convergence Technology, Jeonbuk National University, Jeonju 54896, Korea
| | - K J Lee
- Division of Biotechnology, College of Environmental and Bioresource Sciences, Jeonbuk National University, Iksan 54596, Korea
| | - H D Shin
- Division of Environmental Science and Ecological Engineering, Korea University, Seoul 02841, Korea
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21
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Lee KJ, Kim YT, Choi M, Kim SH. Characteristics and outcomes of L-shaped and reverse L-shaped rotator cuff tears. Bone Joint J 2022; 104-B:394-400. [PMID: 35227097 DOI: 10.1302/0301-620x.104b3.bjj-2021-1468.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS The aim of this study was to compare the characteristics and outcomes of L-shaped and reverse L-shaped rotator cuff tears. METHODS A total of 82 shoulders (81 patients) after arthroscopic rotator cuff repair were retrospectively enrolled. The mean age of the patients was 62 years (SD 6), 33 shoulders (40.2%) were in male patients, and 57 shoulders (69.5%) were the right shoulder. Of these, 36 shoulders had an L-shaped tear (group L) and 46 had a reverse L-shaped tear (group RL). Both groups were compared regarding characteristics, pre- and postoperative pain, and functional outcomes. Muscle status was assessed by preoperative MRI, and re-tear rates by postoperative ultrasonography or MRI. RESULTS Patients in group RL were significantly older than in group L (p = 0.008), and group RL was significantly associated with female sex (odds ratio 2.5 (95% confidence interval 1.03 to 6.32); p = 0.041). Mean postoperative pain visual analogue scale (VAS) score was significantly greater (group L = 0.8 (SD 1.5), group RL = 1.7 (SD 2.2); p = 0.033) and mean postoperative American Shoulder and Elbow Surgeons (ASES) score was significantly lower in group RL than group L (group L = 91.4 (SD 13.1), group RL = 83.8 (SD 17.9); p = 0.028). However, postoperative mean VAS for pain and ASES score were not lower than the patient-acceptable symptom state scores. Mean retracted tear length was significantly larger in group L (group L = 24.6 mm (SD 6.5), group RL = 20.0 mm (SD 6.8); p = 0.003). Overall re-tear rate for 82 tears was 11.0% (nine shoulders), and re-tear rates in group L and RL were similar at 11.1% (four shoulders) and 10.9% (five shoulders), respectively (p = 1.000). No significant intergroup difference was found for fatty degeneration (FD) or muscle atrophy. Within group L, postoperative FD grades of supraspinatus and subscapularis worsened significantly (p = 0.034 and p = 0.008, respectively). Mean postoperative pain VAS (male = 1.2 (SD 1.8), female = 1.3 (SD 2.0)) and ASES scores (male = 88.7 (SD 15.5), female = 86.0 (SD 16.8)) were similar in male and female patients (p = 0.700 and p = 0.475, respectively). Regression analysis showed age was not a prognostic factor of postoperative pain VAS or ASES scores (p = 0.188 and p = 0.150, respectively). CONCLUSION Older age and female sex were associated with reverse L-shaped tears. Although the postoperative functional outcomes of patients with reverse L-shaped tears were satisfactory, the clinical scores were poorer than those of patients with L-shaped tears. Surgeons should be aware of the differences in clinical outcome between L-shaped and reverse L-shaped rotator cuff tears. Cite this article: Bone Joint J 2022;104-B(3):394-400.
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Affiliation(s)
- Kyung Jae Lee
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yong Tae Kim
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Minseok Choi
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sae Hoon Kim
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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22
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Lee KJ, Moon JS, Kim NY, Ko JS. Effects of PNPLA3, TM6SF2 and SAMM50 on the development and severity of non-alcoholic fatty liver disease in children. Pediatr Obes 2022; 17:e12852. [PMID: 34490745 DOI: 10.1111/ijpo.12852] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 08/09/2021] [Accepted: 08/16/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Although genetic variants of PNPLA3, TM6SF2 and SAMM50 have been reported to increase the risk of non-alcoholic fatty liver disease (NAFLD), no pediatric studies have evaluated the association between SAMM50 and NAFLD. OBJECTIVE This study aimed to investigate the risk factors, including genetic variants, of pediatric NAFLD. METHODS NAFLD was defined as the presence of hepatic steatosis on ultrasound. We included 228 patients with NAFLD (body mass index-Z [BMI-Z] = 2.51 ± 1.01) and 225 controls (BMI-Z = 0.22 ± 1.48). We genotyped four variants of PNPLA3 (rs738409), TM6SF2 (rs58542926) and SAMM50 (rs2073080 and rs3761472) by TaqMan allelic discrimination. The pediatric NAFLD fibrosis score, aspartate transaminase (AST)/platelet ratio index and fibrosis-4 score were used to evaluate the degree of fibrosis. We calculated the genetic risk score for additive effects according to the sum of risk alleles. RESULTS The mean age was 12.6 ± 3.5 years. The four genetic variants, male sex and BMI-Z, independently increased susceptibility to NAFLD. These four variants, in addition to fasting insulin and triglycerides, remained significant risk factors with higher odds ratios in children with overweight. These variants increased the alanine aminotransferase (ALT) level and three fibrosis scores independently. As the genetic risk score increased, AST, ALT and the fibrosis scores increased independently. CONCLUSION PNPLA3, TM6SF2 and SAMM50 are associated with the development and severity of pediatric NAFLD. The impact of genetic variants is greater in children with overweight. The four genetic variants have synergetic effects on the severity of pediatric NAFLD.
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Affiliation(s)
- Kyung Jae Lee
- Department of Pediatrics, Hallym University College of Medicine, Chuncheon, South Korea
| | - Jin Soo Moon
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Nan Young Kim
- Hallym Institute of Translational Genomics & Bioinformatics, Hallym University Medical Center, Anyang, Republic of Korea
| | - Jae Sung Ko
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
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23
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Lee Y, Yi DY, Lee YM, Choi SY, Choi YJ, Lee KJ. A Multicenter Study of Real-world Practice for Management of Abnormal Liver Function Tests in Children with Acute Infectious Diseases. J Korean Med Sci 2021; 36:e310. [PMID: 34873882 PMCID: PMC8648609 DOI: 10.3346/jkms.2021.36.e310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/14/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Abnormal liver function tests (LFTs) are commonly seen in pediatric patients with acute infectious diseases. Few studies and no definite clinical guidelines for these conditions are available. The present study aimed to elucidate the causes and factors associated with prolongation of liver enzyme elevation. We also investigated actual real-world practices in Korea. METHODS A retrospective study was performed on all patients younger than 18 years, who visited six tertiary teaching hospitals around Korea in 2018 for acute infectious diseases and showed alanine aminotransferase (ALT) levels above 60 IU/L without other specific conditions that could cause ALT elevation. We categorized the infections that cause LFT elevation into six groups: respiratory infection, gastrointestinal infection, urinary tract infection, other febrile disease, Epstein-Barr virus infection, and cytomegalovirus infection. We collected data on the medical specialty of the attending physician who followed up the subject, follow-up duration, percentage of follow-up loss, and their investigation. RESULTS A total of 613 patients were enrolled in this study, half of whom (50.7%) were younger than 12 months. The mean initial aspartate aminotransferase and ALT values were 171.2 ± 274.1 and 194.9 ± 316.1 IU/L (range 23-2,881, 60-2,949 IU/L), respectively; however, other LFTs were within the normal range. Respiratory infection was the most common diagnosis (45.0%), and rhinovirus was the most commonly identified pathogen (9.8%). The follow-up rate was higher with pediatric gastroenterologists (90.5%) and non-gastroenterology pediatricians (76.4%) than with pediatric residents and emergency doctors. Older age was related to better ALT recovery (odds ratio [OR] of age for month = 1.003; 95% confidence interval [CI], 1.001-1.004; P = 0.004), while the number of infection episodes (OR = 0.626; 95% CI, 0.505-0.777; P < 0.001) was associated with poor ALT recovery. Abdominal sonography was the most commonly used diagnostic tool (36.9%), followed by the hepatotropic virus workup. The modalities of hepatitis workup were significantly differently applied by physicians based on their specialties and institutions. CONCLUSION Abnormal liver function test after a systemic infection was common in respiratory infection and under the age of 1 year. Age, number of infections, and initial results of LFTs were related to ALT recovery time. Inter-physician, inter-institution, and inter-specialty variances were observed in real-world practice.
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Affiliation(s)
- Yoon Lee
- Department of Pediatrics, Korea University Medical Center Anam Hospital, Seoul, Korea
| | - Dae Yong Yi
- Department of Pediatrics, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Yoo Min Lee
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of medicine, Bucheon, Korea
| | - So Yoon Choi
- Department of Pediatrics, Kosin Gospel Hospital, Kosin University College of Medicine, Busan, Korea
- Department of Pediatrics, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - You Jin Choi
- Department of Pediatrics, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Kyung Jae Lee
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
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24
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Morissette P, Li N, Ballard JE, Vavrek M, Adams GL, Regan C, Regan H, Lee KJ, Wang W, Burton A, Chen F, Gerenser P, Li Y, Kraus RL, Tellers D, Palani A, Zhu Y, Sun C, Bianchi E, Colarusso S, De Simone D, Frattarelli T, Pasquini NM, Amin RP. Guiding Chemically Synthesized Peptide Drug Lead Optimization by Derisking Mast Cell Degranulation-Related Toxicities of a NaV1.7 Peptide Inhibitor. Toxicol Sci 2021; 185:170-183. [PMID: 34897513 DOI: 10.1093/toxsci/kfab138] [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] [Indexed: 12/20/2022] Open
Abstract
Studies have shown that some peptides and small molecules can induce non IgE-mediated anaphylactoid reactions through mast cell activation. Upon activation, mast cells degranulate and release vasoactive and proinflammatory mediators, from cytoplasmic granules into the extracellular environment which can induce a cascade of severe adverse reactions. This study describes a lead optimization strategy to select NaV1.7 inhibitor peptides that minimize acute mast cell degranulation (MCD) toxicities. Various in vitro, in vivo, and PKPD models were used to screen candidates and guide peptide chemical modifications to mitigate this risk. Anesthetized rats dosed with peptides demonstrated treatment-related decreases in blood pressure and increases in plasma histamine concentrations which were reversible with a mast cell stabilizer, supporting the MCD mechanism. In vitro testing in rat mast cells with NaV1.7 peptides demonstrated a concentration-dependent increase in histamine. Pharmacodynamic modeling facilitated establishing an in vitro to in vivo correlation for histamine as a biomarker for blood pressure decline via the MCD mechanism. These models enabled assessment of structure-activity relationship (SAR) to identify substructures that contribute to peptide-mediated MCD. Peptides with hydrophobic and cationic characteristics were determined to have an elevated risk for MCD, which could be reduced or avoided by incorporating anionic residues into the protoxin II scaffold. Our analyses support that in vitro MCD assessment in combination with PKPD modeling can guide SAR to improve peptide lead optimization and ensure an acceptable early in vivo tolerability profile with reduced resources, cycle time, and animal use.
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Affiliation(s)
- Pierre Morissette
- Nonclinical Drug Safety (NDS), Merck & Co., Inc, West Point, Pennsylvania 19486, USA
| | - Nianyu Li
- Nonclinical Drug Safety (NDS), Merck & Co., Inc, West Point, Pennsylvania 19486, USA
| | - Jeanine E Ballard
- Pharmacokinetics, Pharmacodynamics and Drug Metabolism (PPDM), Merck & Co., Inc, West Point, Pennsylvania 19486, USA
| | - Marissa Vavrek
- Pharmacokinetics, Pharmacodynamics and Drug Metabolism (PPDM), Merck & Co., Inc, West Point, Pennsylvania 19486, USA
| | - Gregory L Adams
- Discovery Chemistry Peptide, Merck & Co., Inc, West Point, Pennsylvania 19486, USA
| | - Chris Regan
- Nonclinical Drug Safety (NDS), Merck & Co., Inc, West Point, Pennsylvania 19486, USA
| | - Hillary Regan
- Nonclinical Drug Safety (NDS), Merck & Co., Inc, West Point, Pennsylvania 19486, USA
| | - K J Lee
- Pharmacokinetics, Pharmacodynamics and Drug Metabolism (PPDM), Merck & Co., Inc, West Point, Pennsylvania 19486, USA
| | - Weixun Wang
- Pharmacokinetics, Pharmacodynamics and Drug Metabolism (PPDM), Merck & Co., Inc, West Point, Pennsylvania 19486, USA
| | - Aimee Burton
- Nonclinical Drug Safety (NDS), Merck & Co., Inc, West Point, Pennsylvania 19486, USA
| | - Feifei Chen
- Nonclinical Drug Safety (NDS), Merck & Co., Inc, West Point, Pennsylvania 19486, USA
| | - Pamela Gerenser
- Nonclinical Drug Safety (NDS), Merck & Co., Inc, West Point, Pennsylvania 19486, USA
| | - Yuxing Li
- Nonclinical Drug Safety (NDS), Merck & Co., Inc, West Point, Pennsylvania 19486, USA
| | - Richard L Kraus
- Nonclinical Drug Safety (NDS), Merck & Co., Inc, West Point, Pennsylvania 19486, USA
| | - David Tellers
- Discovery Chemistry Peptide, Merck & Co., Inc, West Point, Pennsylvania 19486, USA
| | - Anand Palani
- Discovery Chemistry Peptide, Merck & Co., Inc, West Point, Pennsylvania 19486, USA
| | - Yuping Zhu
- Discovery Chemistry Peptide, Merck & Co., Inc, West Point, Pennsylvania 19486, USA
| | - Chengzao Sun
- Discovery Chemistry Peptide, Merck & Co., Inc, West Point, Pennsylvania 19486, USA
| | - Elisabetta Bianchi
- Peptides and Small Molecules R&D Department, IRBM Spa , Pomezia, Rome 00071, Italy
| | - Stefania Colarusso
- Peptides and Small Molecules R&D Department, IRBM Spa , Pomezia, Rome 00071, Italy
| | - Daniele De Simone
- Peptides and Small Molecules R&D Department, IRBM Spa , Pomezia, Rome 00071, Italy
| | - Tommaso Frattarelli
- Peptides and Small Molecules R&D Department, IRBM Spa , Pomezia, Rome 00071, Italy
| | | | - Rupesh P Amin
- Nonclinical Drug Safety (NDS), Merck & Co., Inc, West Point, Pennsylvania 19486, USA
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25
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Hong SJ, Kang B, Hwang JH, Kim YB, Lee YM, Jang HJ, Lee KJ, Kim SC, Kang Y, Kim HJ, Kim JY, Choi YJ, Lee EH, Choi SY, Lee E, Choe BH, Chae SA, Choi S, Suh WS, Song J, Yi DY. The occurrence of infection-related systemic diseases in Korean children and adolescents has decreased after the spread of the COVID-19 pandemic: a multicenter retrospective study. Transl Pediatr 2021; 10:2888-2896. [PMID: 34976755 PMCID: PMC8649603 DOI: 10.21037/tp-21-315] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 10/07/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The occurrences of infection-related systematic diseases, such as Henoch-Schönlein Purpura (HSP), intussusception, and mucocutaneous lymph node syndrome (MCLS) may have decreased, similarly to the decreased occurrence of infectious diseases following the Coronavirus disease 2019 (COVID-19) pandemic. We aimed to investigate whether there was a change in the occurrence of these diseases in South Korea after the spread of the COVID-19 pandemic. METHODS In this multicenter, retrospective study conducted in 16 medical centers in South Korea patients diagnosed with HSP, intussusception, and MCLS at the age of <18 years between January 2016 and December 2020 were included. New occurrences of these three diseases were investigated monthly and annually, while to compare between the pre- and post-COVID-19 era cases, new occurrences between 2017-2019 and 2020 were compared. Additionally, the total annual occurrence rate was calculated by dividing each center's occurrence into the annual population per 100,000 of the population <18 years in each region that the center covers. RESULTS A total 6,857 patients were included in this study. From 2017 to 2020, the number of patients diagnosed with HSP, intussusception, MCLS at the age of <18 years were 1,301, 1,693, and 3,863 patients, respectively. The average number of patients during the three years before the COVID-19 pandemic were each 379.7, 505.3, and 1,112.0 for HSP, intussusception, MCLS, respectively, which each decreased by 57.3%, 65.0%, 52.6% to 162, 177, 527 in 2020, respectively. Furthermore, the total annual occurrence rate showed a significant decrease in 2020 compared to 2017 to 2019 in all three diseases (2017-2020; HSP: 11.85, 12.96, 10.52, and 5.48; intussusception: 13.94, 16.97, 16.31, and 5.98; MCLS: 33.89, 35.11, 34.69, and 17.82, respectively). CONCLUSIONS We revealed that the occurrence of HSP, intussusception, and MCLS, which are representative of infection-related systemic diseases in the pediatric population, decreased significantly after the spread of the COVID-19 pandemic.
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Affiliation(s)
- Suk Jin Hong
- Department of Pediatrics, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Ben Kang
- Division of Pediatric Gastroenterology, Kyungpook National University Children's Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Jun Hyun Hwang
- Department of Preventive Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Yu Bin Kim
- Department of Pediatrics, Ajou University Medical Center, Suwon, Republic of Korea
| | - Yoo Min Lee
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
| | - Hyo-Jeong Jang
- Department of Pediatrics, Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Republic of Korea
| | - Kyung Jae Lee
- Department of Pediatrics, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Soon Chul Kim
- Department of Pediatrics, Jeonbuk National University Medical School and Hospital, Jeonju, Republic of Korea
| | - Yunkoo Kang
- Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Hyun Jin Kim
- Department of Pediatrics, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Ju Young Kim
- Department of Pediatrics, Eulji University Hospital, Daejeon, Republic of Korea
| | - You Jin Choi
- Department of Pediatrics, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Eun Hye Lee
- Department of Pediatrics, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Republic of Korea
| | - So Yoon Choi
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Eunjoo Lee
- Department of Pediatrics, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Byung-Ho Choe
- Department of Pediatrics, Kyunpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Soo Ahn Chae
- Department of Pediatrics, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Sujin Choi
- Division of Pediatric Gastroenterology, Kyungpook National University Children's Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Won Suk Suh
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
| | - Jeonglyn Song
- Chung-Ang University Industry Academic Cooperation Foundation, Seoul, Republic of Korea, Republic of Korea
| | - Dae Yong Yi
- Department of Pediatrics, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
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26
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Leung LC, Lee KJ, Jin A. Organizing a Successful Practice and Considering Tax and Estate Planning. Otolaryngol Clin North Am 2021; 55:161-170. [PMID: 34538635 DOI: 10.1016/j.otc.2021.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
To care for your family and to do "good" for your alma mater, religious organization, and the other charities you love, you need to do "well," which is to build a successful practice. To achieve a successful practice, following the principles of the dozen A's is helpful: Ability, Availability, Amicability, Approachable, Attuned, Aware, Attentive to patients, Attentive to others, Attentive to details, Apology (ability to apologize and accept apology gracefully), Assimilate, Affordable. Another way to put it is "skills to treat, heart to care at a sensible price."
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Affiliation(s)
- Lawton C Leung
- Withers Bergman LLP, Private Client and Tax Team, 157 Church Street, 12th Floor, New Haven, CT 06510-2100, USA
| | - K J Lee
- Hofstra University Donald and Barbara Zucker School of Medicine; Quinnipiac University Frank H. Netter MD School of Medicine; Yale University School of Medicine; HaloMedia Group.
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27
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Lee JB, Jung JW, Kim WO, Ryoo YW, Lee KJ, Kim SA. Case of Rapidly Progressing Angiosarcoma after Total Hip Arthroplasty. Ann Dermatol 2021; 33:377-381. [PMID: 34341642 PMCID: PMC8273325 DOI: 10.5021/ad.2021.33.4.377] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/01/2020] [Accepted: 04/04/2020] [Indexed: 11/08/2022] Open
Abstract
The occurrence of malignant tumor in proximity to an arthroplasty prosthesis has been a matter of debate since it was first reported in 1978. Upon considering the number of orthopedic implants used, the occurrence of malignancy is rare. Especially in case of angiosarcoma, only a few cases have been reported worldwide. In this case, we report an extremely rare case of angiosarcoma arising at the site of a revision total hip arthroplasty. A 69-year-old female had received total hip replacement on her left hip due to osteoarthritis 8 months ago. Four months later, she complained pain on her operated area, X-ray showed loosening of implanted cup on her left hip. Thereafter, erythematous and purpuric papules and nodules were developed and spread around on her left hip. Through the skin biopsy she was diagnosed with angiosarcoma, and then she died of a sharp deterioration. Herein, we report a rare case of angiosarcoma occurred after total hip replacement with a review of the literature.
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Affiliation(s)
- Joon Bum Lee
- Department of Dermatology, School of Medicine, Keimyung University, Daegu, Korea
| | - Jin Woong Jung
- Department of Dermatology, School of Medicine, Keimyung University, Daegu, Korea
| | - Won Oh Kim
- Department of Dermatology, School of Medicine, Keimyung University, Daegu, Korea
| | - Young Wook Ryoo
- Department of Dermatology, School of Medicine, Keimyung University, Daegu, Korea
| | - Kyung Jae Lee
- Department of Orthopedic Surgery, School of Medicine, Keimyung University, Daegu, Korea
| | - Sung Ae Kim
- Department of Dermatology, School of Medicine, Keimyung University, Daegu, Korea
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28
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Affiliation(s)
- K J Lee
- American Academy of Otolaryngology-Head & Neck Surgery
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29
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Lee YM, Kang B, Kim YB, Kim HJ, Lee KJ, Lee Y, Choi SY, Lee EH, Yi DY, Jang HJ, Choi YJ, Hong SJ, Kim JY, Kang Y, Kim SC. Procedural Sedation for Pediatric Upper Gastrointestinal Endoscopy in Korea. J Korean Med Sci 2021; 36:e136. [PMID: 34032029 PMCID: PMC8144592 DOI: 10.3346/jkms.2021.36.e136] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 04/12/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Sedative upper endoscopy is similar in pediatrics and adults, but it is characteristically more likely to lead to respiratory failure. Although recommended guidelines for pediatric procedural sedation are available within South Korea and internationally, Korean pediatric endoscopists use different drugs, either alone or in combination, in practice. Efforts are being made to minimize the risk of sedation while avoiding procedural challenges. The purpose of this study was to collect and analyze data on the sedation methods used by Korean pediatric endoscopists to help physicians perform pediatric sedative upper endoscopy (PSUE). METHODS The PSUE procedures performed in 15 Korean pediatric gastrointestinal endoscopic units within a year were analyzed. Drugs used for sedation were grouped according to the method of use, and the depth of sedation was evaluated based on the Ramsay scores. The procedures and their complications were also assessed. RESULTS In total, 734 patients who underwent PSUE were included. Sedation and monitoring were performed by an anesthesiologist at one of the institutions. The sedative procedures were performed by a pediatric endoscopist at the other 14 institutions. Regarding the number of assistants present during the procedures, 36.6% of procedures had one assistant, 38.8% had 2 assistants, and 24.5% had 3 assistants. The average age of the patients was 11.6 years old. Of the patients, 19.8% had underlying diseases, 10.0% were taking medications such as epilepsy drugs, and 1.0% had snoring or sleep apnea history. The average duration of the procedures was 5.2 minutes. The subjects were divided into 5 groups as follows: 1) midazolam + propofol + ketamine (M + P + K): n = 18, average dose of 0.03 + 2.4 + 0.5 mg/kg; 2) M + P: n = 206, average dose of 0.06 + 2.1 mg/kg; 3) M + K: n = 267, average dose of 0.09 + 0.69 mg/kg; 4) continuous P infusion for 20 minutes: n = 15, average dose of 6.6 mg/kg; 5) M: n = 228, average dose of 0.11 mg/kg. The average Ramsay score for the five groups was 3.7, with significant differences between the groups (P < 0.001). Regarding the adverse effects, desaturation and increased oxygen supply were most prevalent in the M + K group. Decreases and increases in blood pressure were most prevalent in the M + P + K group, and bag-mask ventilation was most used in the M + K group. There were no reported incidents of intubation or cardiopulmonary resuscitation. A decrease in oxygen saturation was observed in 37 of 734 patients, and it significantly increased in young patients (P = 0.001) and when ketamine was used (P = 0.014). Oxygen saturation was also correlated with dosage (P = 0.037). The use of ketamine (P < 0.001) and propofol (P < 0.001) were identified as factors affecting the Ramsay score in the logistic regression analysis. CONCLUSION Although the drug use by Korean pediatric endoscopists followed the recommended guidelines to an extent, it was apparent that they combined the drugs or reduced the doses depending on the patient characteristics to reduce the likelihood of respiratory failure. Inducing deep sedation facilitates comfort during the procedure, but it also leads to a higher risk of complications.
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Affiliation(s)
- Yoo Min Lee
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Ben Kang
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yu Bin Kim
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
| | - Hyun Jin Kim
- Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea
| | - Kyung Jae Lee
- Department of Pediatrics, Hallym University College of Medicine, Chuncheon, Korea
| | - Yoon Lee
- Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea
| | - So Yoon Choi
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
- Department of Pediatrics, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Eun Hye Lee
- Department of Pediatrics, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Dae Yong Yi
- Department of Pediatrics, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Hyo Jeong Jang
- Department of Pediatrics, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - You Jin Choi
- Department of Pediatrics, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Suk Jin Hong
- Department of Pediatrics, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Ju Young Kim
- Department of Pediatrics, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Yunkoo Kang
- Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Soon Chul Kim
- Department of Pediatrics, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea.
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30
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Park S, Lee S, Lee KJ, Park S, Chongthanaphisut P, Jang J, Lee S, Liu X, Dobrowolska M, Furdyna JK. Quantitative determination of spin-orbit-induced magnetic field in GaMnAs by field-scan planar Hall measurements. Sci Rep 2021; 11:10263. [PMID: 33986425 PMCID: PMC8119966 DOI: 10.1038/s41598-021-89748-6] [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: 11/16/2020] [Accepted: 04/29/2021] [Indexed: 11/09/2022] Open
Abstract
Spin-orbit-induced (SOI) effective magnetic field in GaMnAs film with in-plane magnetic anisotropy has been investigated by planar Hall effect measurements. The presence of SOI field was identified by a shift between planar Hall resistance (PHR) hystereses observed with positive and negative currents. The difference of switching fields occurring between the two current polarities, which is determined by the strength of the SOI field, is shown to depend on the external field direction. In this paper we have developed a method for obtaining the magnitude of the SOI fields based on magnetic free energy that includes the effects of magnetic anisotropy and the SOI field. Using this approach, the SOI field for a given current density was accurately obtained by fitting to the observed dependence of the switching fields on the applied field directions. Values of the SOI field obtained with field scan PHR measurements give results that are consistent with those obtained by analyzing the angular dependence of PHR, indicating the reliability of the field scan PHR method for quantifying the SOI-field in GaMnAs films. The magnitude of the SOI field systematically increases with increasing current density, demonstrating the usefulness of SOI fields for manipulation of magnetization by current in GaMnAs films.
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Affiliation(s)
- Seongjoon Park
- Physics Department, Korea University, Seoul, 136-701, Republic of Korea
| | - Shinwoo Lee
- Physics Department, Korea University, Seoul, 136-701, Republic of Korea
| | - Kyung Jae Lee
- Physics Department, Korea University, Seoul, 136-701, Republic of Korea
| | - SeongJin Park
- Physics Department, Korea University, Seoul, 136-701, Republic of Korea
| | | | - Jiyeong Jang
- Physics Department, Korea University, Seoul, 136-701, Republic of Korea
| | - Sanghoon Lee
- Physics Department, Korea University, Seoul, 136-701, Republic of Korea.
| | - Xinyu Liu
- Physics Department, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - M Dobrowolska
- Physics Department, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Jacek K Furdyna
- Physics Department, University of Notre Dame, Notre Dame, IN, 46556, USA
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31
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Ko YH, Lee KJ, Das S, Gupta N, Magnusson R. Micro-electromechanical-system-tuned resonant filters spanning the 8-12 µm band. Opt Lett 2021; 46:1329-1332. [PMID: 33720179 DOI: 10.1364/ol.418545] [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] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/16/2021] [Indexed: 06/12/2023]
Abstract
The spectral band covering ∼8-12µm is atmospherically transparent and therefore important for terrestrial imaging, day/night situational awareness systems, and spectroscopic applications. There is a dearth of tunable filters spanning the band. Here, we propose and demonstrate a new, to the best of our knowledge, tunable-filter method engaging the fundamental physics of the guided-mode resonance (GMR) effect realized with a non-periodic lattice. The polarization-dependent filter is fashioned with a one-dimensional Ge grating on a ZnSe substrate and interrogated with a ∼1.5mm Gaussian beam to show clear transmittance nulls. To expand the tuning range, the device parameters are optimized for sequential operation in TM and TE polarization states. The theoretical model exhibits a tunable range exceeding 4 µm, thus covering the band fully. In the experiment, a prototype device exhibits a spectral range of 8.6-10.0 µm in TM and 9.9-11.7 µm in TE polarization or >3µm total. With additional efforts in fabrication, we expect to achieve the full range.
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32
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Lin L, Zhang CF, Wang P, Gao H, Guan X, Han JL, Jiang JC, Jiang P, Lee KJ, Li D, Men YP, Miao CC, Niu CH, Niu JR, Sun C, Wang BJ, Wang ZL, Xu H, Xu JL, Xu JW, Yang YH, Yang YP, Yu W, Zhang B, Zhang BB, Zhou DJ, Zhu WW, Castro-Tirado AJ, Dai ZG, Ge MY, Hu YD, Li CK, Li Y, Li Z, Liang EW, Jia SM, Querel R, Shao L, Wang FY, Wang XG, Wu XF, Xiong SL, Xu RX, Yang YS, Zhang GQ, Zhang SN, Zheng TC, Zou JH. No pulsed radio emission during a bursting phase of a Galactic magnetar. Nature 2020; 587:63-65. [PMID: 33149293 DOI: 10.1038/s41586-020-2839-y] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/31/2020] [Indexed: 11/10/2022]
Abstract
Fast radio bursts (FRBs) are millisecond-duration radio transients of unknown physical origin observed at extragalactic distances1-3. It has long been speculated that magnetars are the engine powering repeating bursts from FRB sources4-13, but no convincing evidence has been collected so far14. Recently, the Galactic magnetar SRG 1935+2154 entered an active phase by emitting intense soft γ-ray bursts15. One FRB-like event with two peaks (FRB 200428) and a luminosity slightly lower than the faintest extragalactic FRBs was detected from the source, in association with a soft γ-ray/hard-X-ray flare18-21. Here we report an eight-hour targeted radio observational campaign comprising four sessions and assisted by multi-wavelength (optical and hard-X-ray) data. During the third session, 29 soft-γ-ray repeater (SGR) bursts were detected in γ-ray energies. Throughout the observing period, we detected no single dispersed pulsed emission coincident with the arrivals of SGR bursts, but unfortunately we were not observing when the FRB was detected. The non-detection places a fluence upper limit that is eight orders of magnitude lower than the fluence of FRB 200428. Our results suggest that FRB-SGR burst associations are rare. FRBs may be highly relativistic and geometrically beamed, or FRB-like events associated with SGR bursts may have narrow spectra and characteristic frequencies outside the observed band. It is also possible that the physical conditions required to achieve coherent radiation in SGR bursts are difficult to satisfy, and that only under extreme conditions could an FRB be associated with an SGR burst.
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Affiliation(s)
- L Lin
- Department of Astronomy, Beijing Normal University, Beijing, People's Republic of China
| | - C F Zhang
- Department of Astronomy, Peking University, Beijing, People's Republic of China.,National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - P Wang
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - H Gao
- Department of Astronomy, Beijing Normal University, Beijing, People's Republic of China
| | - X Guan
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - J L Han
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China.,University of Chinese Academy of Sciences, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - J C Jiang
- Department of Astronomy, Peking University, Beijing, People's Republic of China.,National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - P Jiang
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - K J Lee
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China. .,Kavli Institute for Astronomy and Astrophysics, Peking University, Beijing, People's Republic of China.
| | - D Li
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China. .,University of Chinese Academy of Sciences, Chinese Academy of Sciences, Beijing, People's Republic of China.
| | - Y P Men
- Department of Astronomy, Peking University, Beijing, People's Republic of China.,National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - C C Miao
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - C H Niu
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - J R Niu
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - C Sun
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - B J Wang
- Department of Astronomy, Peking University, Beijing, People's Republic of China.,National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Z L Wang
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - H Xu
- Department of Astronomy, Peking University, Beijing, People's Republic of China.,National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - J L Xu
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - J W Xu
- Department of Astronomy, Peking University, Beijing, People's Republic of China.,National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Y H Yang
- School of Astronomy and Space Science, Nanjing University, Nanjing, People's Republic of China
| | - Y P Yang
- South-Western Institute for Astronomy Research, Yunnan University, Kunming, People's Republic of China
| | - W Yu
- Shanghai Astronomical Observatory, Chinese Academy of Science, Shanghai, People's Republic of China
| | - B Zhang
- Department of Physics and Astronomy, University of Nevada, Las Vegas, NV, USA.
| | - B-B Zhang
- School of Astronomy and Space Science, Nanjing University, Nanjing, People's Republic of China.,Department of Physics and Astronomy, University of Nevada, Las Vegas, NV, USA.,Key Laboratory of Modern Astronomy and Astrophysics (Nanjing University), Ministry of Education, Nanjing, People's Republic of China
| | - D J Zhou
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China.,University of Chinese Academy of Sciences, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - W W Zhu
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - A J Castro-Tirado
- Instituto de Astrofísica de Andalucía (IAA-CSIC), Granada, Spain.,Departamento de Ingeniería de Sistemas y Automática, Escuela de Ingenierías, Universidad de Málaga, Málaga, Spain
| | - Z G Dai
- School of Astronomy and Space Science, Nanjing University, Nanjing, People's Republic of China.,Key Laboratory of Modern Astronomy and Astrophysics (Nanjing University), Ministry of Education, Nanjing, People's Republic of China
| | - M Y Ge
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Y D Hu
- Instituto de Astrofísica de Andalucía (IAA-CSIC), Granada, Spain.,Facultad de Ciencias, Universidad de Granada, Granada, Spain
| | - C K Li
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Y Li
- University of Chinese Academy of Sciences, Chinese Academy of Sciences, Beijing, People's Republic of China.,Purple Mountain Observatory, Chinese Academy of Sciences, Nanjing, People's Republic of China
| | - Z Li
- Department of Astronomy, Beijing Normal University, Beijing, People's Republic of China
| | - E W Liang
- Guangxi Key Laboratory for Relativistic Astrophysics, School of Physical Science and Technology, Guangxi University, Nanning, People's Republic of China
| | - S M Jia
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - R Querel
- National Institute of Water and Atmospheric Research (NIWA), Lauder, New Zealand
| | - L Shao
- College of Physics, Hebei Normal University, Shijiazhuang, People's Republic of China
| | - F Y Wang
- School of Astronomy and Space Science, Nanjing University, Nanjing, People's Republic of China.,Key Laboratory of Modern Astronomy and Astrophysics (Nanjing University), Ministry of Education, Nanjing, People's Republic of China
| | - X G Wang
- Guangxi Key Laboratory for Relativistic Astrophysics, School of Physical Science and Technology, Guangxi University, Nanning, People's Republic of China
| | - X F Wu
- Purple Mountain Observatory, Chinese Academy of Sciences, Nanjing, People's Republic of China
| | - S L Xiong
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - R X Xu
- Department of Astronomy, Peking University, Beijing, People's Republic of China.,Kavli Institute for Astronomy and Astrophysics, Peking University, Beijing, People's Republic of China
| | - Y-S Yang
- School of Astronomy and Space Science, Nanjing University, Nanjing, People's Republic of China
| | - G Q Zhang
- School of Astronomy and Space Science, Nanjing University, Nanjing, People's Republic of China
| | - S N Zhang
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing, People's Republic of China.,University of Chinese Academy of Sciences, Chinese Academy of Sciences, Beijing, People's Republic of China.,Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - T C Zheng
- Guangxi Key Laboratory for Relativistic Astrophysics, School of Physical Science and Technology, Guangxi University, Nanning, People's Republic of China
| | - J-H Zou
- College of Physics, Hebei Normal University, Shijiazhuang, People's Republic of China
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Lee S, Kim SK, Park H, Lee YJ, Park SH, Lee KJ, Lee DG, Kang H, Kim JE. Contribution of Autophagy-Notch1-Mediated NLRP3 Inflammasome Activation to Chronic Inflammation and Fibrosis in Keloid Fibroblasts. Int J Mol Sci 2020; 21:ijms21218050. [PMID: 33126764 PMCID: PMC7663397 DOI: 10.3390/ijms21218050] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/22/2020] [Accepted: 10/26/2020] [Indexed: 02/06/2023] Open
Abstract
Keloid is a representative chronic fibroproliferative condition that occurs after tissue injury. Emerging evidence showed that activation of NACHT, LRR, and PYD domains-containing protein 3 (NLRP3) inflammasome is involved in the pro-inflammatory response in injured tissues. However, the role of NLRP3 inflammasome in keloid progression remains unclear. Notch signaling, which activates NLRP3 inflammasome, is known to contribute to scar formation in keloid, but the cause of enhanced Notch signaling in keloid is not clear. We sought to investigate whether autophagy regulates Notch1 signaling in keloid fibroblasts and determine whether Notch1 signaling might regulate NLRP3 inflammasomes and myofibroblast differentiation. An in vitro model of keloid was established by culturing primary keloid fibroblasts from patients. Expression levels of Notch1, NLRP3 inflammasome proteins, pro-inflammatory cytokines, and myofibroblast markers in keloid fibroblasts were examined and compared with those in normal fibroblasts. Autophagy known to mediate Notch1 degradation was also monitored in fibroblasts. Small interfering RNA (siRNA) targeting Notch1 was used to transfect keloid fibroblasts to further examine the role of Notch signaling in NLRP3 inflammasome activation. Expression levels of Notch1 and NLRP3 inflammasome in keloid fibroblasts increased compared to those in normal fibroblasts. Such increases were accompanied by increased LC3 levels and reduced autophagic flux. Notch1 silencing in keloid fibroblasts by siRNA transfection significantly suppressed increased levels of overall NLRP3 inflammasome complex proteins, NF-kB, and α-smooth muscle actin. Autophagy induction by rapamycin treatment in keloid fibroblasts effectively suppressed expression levels of Notch1 and NLRP3 inflammasome proteins. Decreased autophagy activity in keloid can result in Notch1-mediated myofibroblast activation and NLRP3 inflammasome signaling activation which is critical for chronic inflammation. Collectively, these results identify Notch1 as a novel activator of NLRP3 inflammasome signaling leading to chronic tissue damage and myofibroblast differentiation in keloid progression.
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Affiliation(s)
- Seongju Lee
- Department of Anatomy, College of Medicine, and Program in Biomedical Science & Engineering, Inha University, Incheon 22212, Korea; (S.L.); (S.K.K.); (H.P.)
| | - Sun Kyeon Kim
- Department of Anatomy, College of Medicine, and Program in Biomedical Science & Engineering, Inha University, Incheon 22212, Korea; (S.L.); (S.K.K.); (H.P.)
| | - Hyungsun Park
- Department of Anatomy, College of Medicine, and Program in Biomedical Science & Engineering, Inha University, Incheon 22212, Korea; (S.L.); (S.K.K.); (H.P.)
| | - Yu Jin Lee
- Department of Dermatology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Korea; (Y.J.L.); (S.H.P.); (K.J.L.); (D.G.L.); (H.K.)
| | - Song Hee Park
- Department of Dermatology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Korea; (Y.J.L.); (S.H.P.); (K.J.L.); (D.G.L.); (H.K.)
| | - Kyung Jae Lee
- Department of Dermatology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Korea; (Y.J.L.); (S.H.P.); (K.J.L.); (D.G.L.); (H.K.)
| | - Dong Geon Lee
- Department of Dermatology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Korea; (Y.J.L.); (S.H.P.); (K.J.L.); (D.G.L.); (H.K.)
| | - Hoon Kang
- Department of Dermatology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Korea; (Y.J.L.); (S.H.P.); (K.J.L.); (D.G.L.); (H.K.)
| | - Jung Eun Kim
- Department of Dermatology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Korea; (Y.J.L.); (S.H.P.); (K.J.L.); (D.G.L.); (H.K.)
- Correspondence: ; Tel.: +82-2-2030-2845
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Lee KJ, Ko YH, Gupta N, Magnusson R. Unpolarized resonant notch filters for the 8-12 µm spectral region. Opt Lett 2020; 45:4452-4455. [PMID: 32796981 DOI: 10.1364/ol.398744] [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] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/06/2020] [Indexed: 06/11/2023]
Abstract
The long-wave infrared (LWIR) spectral region spanning ∼8-12µm is useful for many scientific and industrial applications. As traditional multilayer film components are not straightforwardly realized at these bands, we provide design, fabrication, and testing of polarization independent bandstop filters based on the guided-mode resonance (GMR) effect. Focusing on the zero-contrast grating architecture, we successfully fabricate prototype filters in the Ge-on-ZnSe materials system. Applying mask-based photolithography and dry etching, photoresist patterns form the desired Ge grating structures. The resulting devices exhibit clean transmittance nulls and acceptably high sidebands. Moreover, we verify polarization independent notch filtering by assembling two identical GMR filters with gratings oriented orthogonally. This approach to realize effective GMR elements will be useful for various fields including photonic and optoelectronic devices operating in the LWIR region.
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Ahamed SH, Lee KJ, Tang PH. Role of a modified ultrafast MRI brain protocol in clinical paediatric neuroimaging. Clin Radiol 2020; 75:914-920. [PMID: 32782127 DOI: 10.1016/j.crad.2020.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 07/06/2020] [Indexed: 11/18/2022]
Abstract
AIM To establish a role for modified ultrafast magnetic resonance imaging (MRI) of the brain in clinical paediatric patients based on clinically acceptable image quality and diagnostic accuracy. MATERIALS AND METHODS A prospective study was conducted with institutional review board approval on an ultrafast MRI brain protocol consisting of sagittal T1-weighted, axial T2-weighted, axial fluid-attenuated inversion recovery (FLAIR), axial diffusion-weighted imaging (DWI), and axial T2∗-weighted sequences. Preliminary investigations revealed that the default ultrafast T2-weighted sequence was prone to pulsation artefacts. A modified ultrafast T2-weighted sequence was therefore developed to replace the default ultrafast T2-weighted sequence. Thirty-five patients with clinical indication for neuroimaging underwent ultrafast MRI, modified ultrafast T2-weighted sequence and standard MRI at 3 T. Image quality of ultrafast MRI sequences were graded as clinically "diagnostic" or "non-diagnostic" and compared against the corresponding standard MRI sequences as the reference standard. The modified ultrafast T2-weighted sequence surpassed the default ultrafast T2-weighted sequence in image quality. The ultrafast MRI protocol was therefore replaced with the modified ultrafast T2-weighted sequence creating a modified ultrafast MRI protocol. The clinical reports of modified ultrafast MRI were compared against standard MRI for diagnostic concordance, categorised further as "normal", "clinically significant", or "clinically minor" abnormalities. RESULTS Ultrafast T1-weighted, FLAIR, and DWI sequences had comparable image quality to standard MRI sequences. The ultrafast T2∗-weighted sequence had significantly higher non-diagnostic images (42.9%) compared to the standard MRI sequence (2.9%). The default ultrafast T2-weighted sequence had significantly higher non-diagnostic images compared to the modified ultrafast T2-weighted sequence and standard T2-weighted sequence (82.9%, 5.7%, 8.6%, respectively). There was 100% concordance for normal and clinically significant abnormalities and 23% discordance for clinically minor abnormalities. Modified ultrafast MRI takes 5 minutes 41 seconds compared to standard MRI time of 14 minutes 57 seconds. CONCLUSION The modified ultrafast MRI protocol for brain imaging demonstrates clinically acceptable image quality in four out of five sequences and has high accuracy in diagnosing normal and clinically significant abnormalities when compared against the standard MRI protocol for brain imaging. It could potentially benefit a select group of paediatric patients who require neuroimaging.
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Affiliation(s)
- S H Ahamed
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore.
| | - K J Lee
- Singapore Bioimaging Consortium, Agency for Science, Technology and Research (A∗STAR), 11 Biopolis Way, #02-02 Helios, 138667, Singapore
| | - P H Tang
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore
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36
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Ha M, Son YR, Kim J, Park SM, Hong CM, Choi D, Kang W, Kim JH, Lee KJ, Park D, Han ME, Oh SO, Lee D, Kim YH. TEK is a novel prognostic marker for clear cell renal cell carcinoma. Eur Rev Med Pharmacol Sci 2020; 23:1451-1458. [PMID: 30840266 DOI: 10.26355/eurrev_201902_17102] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Clear cell renal cell carcinoma (ccRCC) is the most common type of kidney cancer. However, effective therapeutics for ccRCC are lacking. Novel biomarkers could provide critical information when determining prognoses for patients with ccRCC. In this study, we sought to determine if the expression of receptor tyrosine kinase (TEK) could be a potential novel prognostic biomarker for ccRCC. TEK, originally identified as an endothelial cell-specific receptor, plays an important role in the modulation of vasculogenesis and remodeling. Altered TEK expression has been observed in tumor tissues (e.g., oral squamous cell carcinomas, leukemia) and breast, gastric and thyroid cancers. However, the role of TEK in ccRCC remains unknown. PATIENTS AND METHODS Differential TEK expression between non-metastatic (stage M0) and metastatic (stage M1) ccRCC patient cohorts was determined from The Cancer Genome Atlas (TCGA) and the International Cancer Genome Consortium (ICGC). Furthermore, TEK expression was assessed as a prognostic factor using the time-dependent area under the curve (AUC) of Uno's C-index, the AUC value of the receiver operating characteristics (ROC) at 5 years, Kaplan-Meier survival curves and multivariate analyses. RESULTS A Kaplan-Meier curve analysis revealed that the downregulation of TEK expression was associated with a poor prognosis for patients with ccRCC with good discrimination (p<0.0001 and p=0.0044 for the TGCA and ICGC cohorts, respectively). Analyses of C-indices and receiver operating characteristic AUC values further support this discriminative ability. Moreover, multivariate analyses showed the prognostic significance of TEK expression levels (p<0.001). CONCLUSIONS Although additional clinical investigations will be needed, our results suggest that TEK is a potential biomarker for ccRCC.
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Affiliation(s)
- M Ha
- Department of Anatomy, Pusan National University School of Medicine, Yangsan, Republic of Korea.
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McMeniman EK, Peach E, Lee KJ, Yanes T, Jagirdar K, Stark MS, Soyer HP, Duffy DL, McInerney-Leo AM, Sturm RA. CDKN2A testing threshold in a high-risk Australian melanoma cohort: number of primaries, family history and young age of onset impact risk. J Eur Acad Dermatol Venereol 2020; 34:e797-e798. [PMID: 32386439 DOI: 10.1111/jdv.16627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- E K McMeniman
- Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute, Brisbane, QLD, Australia.,Dermatology Department, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - E Peach
- Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute, Brisbane, QLD, Australia
| | - K J Lee
- Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute, Brisbane, QLD, Australia
| | - T Yanes
- Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute, Brisbane, QLD, Australia
| | - K Jagirdar
- Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute, Brisbane, QLD, Australia
| | - M S Stark
- Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute, Brisbane, QLD, Australia
| | - H P Soyer
- Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute, Brisbane, QLD, Australia.,Dermatology Department, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - D L Duffy
- Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute, Brisbane, QLD, Australia.,QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - A M McInerney-Leo
- Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute, Brisbane, QLD, Australia
| | - R A Sturm
- Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute, Brisbane, QLD, Australia
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Abstract
Otolaryngologists are in a good position to advocate for our patients and our specialty. We can do it as a volunteer or as a full-time job running for political office at the state or federal level. To be taken seriously, we need to offer solutions besides citing the problems. We encourage otolaryngologists to work with our Academy and its ENT-PAC (Ear, Nose, Throat Political Action Committee). Medicine is a great profession and Otolaryngology-Head and Neck Surgery is an even better specialty.
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Affiliation(s)
- K J Lee
- Hofstra University Donald and Barbara Zucker School of Medicine; Quinnipiac University Frank H. Netter MD School of Medicine; Yale University School of Medicine.
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Kim MJ, Lee KJ. Analysis of the dietary factors associated with suspected pediatric nonalcoholic fatty liver disease and potential liver fibrosis: Korean National Health and Nutrition Examination Survey 2014-2017. BMC Pediatr 2020; 20:121. [PMID: 32171275 PMCID: PMC7071743 DOI: 10.1186/s12887-020-02022-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 03/05/2020] [Indexed: 02/06/2023] Open
Abstract
Background The prevalence of nonalcoholic fatty liver disease (NAFLD) has increased as the obese pediatric population has increased. NAFLD causes progressive liver injury and the only effective treatment is lifestyle modifications. However, few studies have examined the dietary risk factors for pediatric NAFLD or liver fibrosis. Here, we evaluated the dietary factors associated with suspected NAFLD and potential liver fibrosis in Korean children. Methods Data collected from 1674 children and adolescents aged 10–18 years during the 2014–2017 Korean National Health and Nutrition Examination Surveys analyzed. The 24-h recall method measured the food consumed 1 day before the survey. The “suspected NAFLD” group included excessive body mass index (BMI) subjects ≥ 85th percentile) with alanine aminotransferase (ALT) levels exceeding the upper normal limit (24.1 U/L for boys and 17.7 U/L for girls); the “healthy control” group included subjects with a BMI and ALT level below these thresholds. Sodium intake was assessed by the urinary sodium-to-urinary specific gravity unit ratio (U-Na-to-SGU ratio). A pediatric NAFLD index (PNFI) higher than 3 indicated potential liver fibrosis. Results The overall prevalence of suspected NAFLD and potential liver fibrosis was 8.2 and 4.5%, respectively. The suspected NAFLD group had a larger proportion of males and subject with a greater height, BMI standard deviation score (BMI-SDS), systolic and diastolic blood pressure SDS, waist circumference, hemoglobin A1c, and levels of total cholesterol, triglycerides, aspartate aminotransferase (AST) and ALT than the control group. The suspected NAFLD group presented significantly higher U-Na-to-SGU ratios and cholesterol intake. The PNFI > 3 subgroup included a significantly larger proportion of males and subjects with higher BMI-SDS, AST and ALT values, and intake of water, carbohydrate, protein, calcium, phosphorus, iron and vitamin B2. After adjusting for confounders, male, BMI-SDS, AST, and protein and carbohydrate intake were independent risk factors for potential liver fibrosis. Niacin intake was an independent protective factor for potential liver fibrosis. Conclusions Children with suspected NAFLD had higher urinary sodium level and cholesterol intake than healthy controls. Protein and carbohydrate intake were independent risk factors for potential liver fibrosis; niacin was an independent protective factor.
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Affiliation(s)
- Mi Jin Kim
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Kyung Jae Lee
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
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McMeniman EK, Duffy DL, Jagirdar K, Lee KJ, Peach E, McInerney-Leo AM, De'Ambrosis B, Rayner JE, Smithers BM, Soyer HP, Sturm RA. The interplay of sun damage and genetic risk in Australian multiple and single primary melanoma cases and controls. Br J Dermatol 2020; 183:357-366. [PMID: 31794051 DOI: 10.1111/bjd.18777] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Skin phenotype, host genotype and ultraviolet (UV) damage play a role in the development of melanoma. OBJECTIVES To ascertain whether the level of UV damage at the site of melanomas was associated with genetic polymorphisms. METHODS Deep phenotyping was performed on 1244 individuals; 281 with multiple primary melanomas (MPMs), 304 with single primary melanoma (SPM) and 659 convenience controls. Genotype data was generated using the Illumina CoreExome microarray platform, assaying over 500 000 single-nucleotide polymorphisms. A subset of variants were combined to assess a polygenic risk score (PRS) for melanoma. RESULTS Most MPM cases were diagnosed in patients aged > 40 years, in sites with visible chronic UV damage. Women and those diagnosed at age ≤ 40 years were less likely to have perilesional UV damage. Patients with MPM had higher frequencies of MITF E318K, MC1R R-alleles and the ASIP risk haplotype. Individuals who had melanoma in a visibly UV-damaged site were more likely to carry MC1R rs75570604 [odds ratio (OR) 2·5], 9q31.2 rs10816595 (OR 1·4) and MTAP rs869329 (OR 1·4). These same alleles were more common in patients with MPM who were diagnosed at age ≤ 40 years. The mean PRS was significantly higher in MPM than in SPM and controls. Naevus count was comparable in early-onset MPM cases and those diagnosed at age > 40 years. CONCLUSIONS Our cohort demonstrated higher frequencies of previously reported alleles associated with melanoma. MPM melanomas more commonly occur in UV-damaged areas, and these individuals are more likely to carry MC1R red hair colour alleles. Awareness of the interplay of genetic vulnerability with UV damage can stratify risk and guide recommendations for melanoma screening. What's already known about this topic? Skin phenotype, host genotype and ultraviolet (UV) damage all play a role in melanoma development. One of the main risk factors is a personal history of melanoma; second and subsequent primary melanomas account for over 20% of all melanomas registered in Queensland. Multiple loci are associated with melanoma risk, including many low-penetrance loci, which may have a cumulatively significant risk. Population-wide screening programmes for melanoma are not yet economically viable. What does this study add? Patients diagnosed with melanoma at age ≤ 40 years were more likely than older patients to have melanomas in non-UV-damaged sites. Patients with multiple melanomas had higher frequencies of MITF E318K, MC1R R-alleles, and the ASIP extended risk haplotype than patients with single melanoma. CDKN2A, MC1R and MTAP variants were more frequent in patients who developed melanomas at a younger age, but also in those whose melanomas were all on visibly UV-damaged sites. What is the translational message? Incorporating these genetic findings into the known risk factors of skin phenotype and visible UV damage may allow for a more customized and economically feasible approach to early detection of melanoma, particularly in younger patients. Plain language summary available online.
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Affiliation(s)
- E K McMeniman
- Dermatology Research Centre, The University of Queensland Diamantina Institute, Brisbane, Queensland, Australia.,Dermatology Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - D L Duffy
- Dermatology Research Centre, The University of Queensland Diamantina Institute, Brisbane, Queensland, Australia.,QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - K Jagirdar
- Dermatology Research Centre, The University of Queensland Diamantina Institute, Brisbane, Queensland, Australia
| | - K J Lee
- Dermatology Research Centre, The University of Queensland Diamantina Institute, Brisbane, Queensland, Australia
| | - E Peach
- Dermatology Research Centre, The University of Queensland Diamantina Institute, Brisbane, Queensland, Australia
| | - A M McInerney-Leo
- Dermatology Research Centre, The University of Queensland Diamantina Institute, Brisbane, Queensland, Australia
| | - B De'Ambrosis
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Dermatology Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,South East Dermatology, Annerley Square, Annerley, Brisbane, Queensland, Australia
| | - J E Rayner
- Dermatology Research Centre, The University of Queensland Diamantina Institute, Brisbane, Queensland, Australia
| | - B M Smithers
- Queensland Melanoma Project, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - H P Soyer
- Dermatology Research Centre, The University of Queensland Diamantina Institute, Brisbane, Queensland, Australia.,Dermatology Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - R A Sturm
- Dermatology Research Centre, The University of Queensland Diamantina Institute, Brisbane, Queensland, Australia
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Han JU, Kim BG, Yang C, Choi WH, Jeong J, Lee KJ, Kim H. Prospective randomized comparison of cerebrospinal fluid aspiration and conventional popping methods using 27-gauge spinal needles in patients undergoing spinal anaesthesia. BMC Anesthesiol 2020; 20:32. [PMID: 32000680 PMCID: PMC6993332 DOI: 10.1186/s12871-020-0954-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 01/23/2020] [Indexed: 11/22/2022] Open
Abstract
Background Performing spinal anaesthesia using the conventional popping method with a 27-gauge (27G) spinal needle is technically difficult. In this study, we compared the aspiration and conventional popping method for spinal anaesthesia using 27G Quincke-type needles. Methods This prospective, randomized study enrolled 90 patients, aged 19 to 65 years, with American Society of Anesthesiologists physical status I-III, who were undergoing spinal anaesthesia. Patients were randomly assigned to one of two groups using a computer-generated random number table: patients receiving spinal anaesthesia using the aspiration method, in which the needle is advanced with continuous aspiration, or the conventional popping method. The primary outcome measure was the success rate of the first attempt to perform dural puncture. Number of attempts and passages, withdrawal cases, successful attempt time, total procedure time, and actual depth of dural puncture were recorded. Results Eighty-eight patients were included in the study. In the aspiration group, the success rate of first attempt for dural puncture was 93.3%, compared with 72.1% in the popping group (P = 0.019). Success involving needle withdrawal was recorded in 4 (8.9%) patients in the aspiration group and 13 (30.2%) in the popping group (P = 0.024). In the popping group, the number of attempts was significantly higher (P = 0.044), and total procedure time was significantly longer (P = 0.023). Actual depths of dural puncture were deeper in the popping group than in the aspiration group (P = 0.019). Conclusions The aspiration method using a 27G Quincke-type needle offers clinical benefits for dural puncture compared with the conventional popping method for spinal anaesthesia. Trial registration Clinical research information service number: KCT0002815, registered 21/Apr/2018. Retrospectively registered.
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Affiliation(s)
- J U Han
- Department of Anesthesiology and Pain Medicine, Inha University College of Medicine, 27, Inhang-ro, Jung-gu, Incheon, Republic of Korea
| | - B G Kim
- Department of Anesthesiology and Pain Medicine, Inha University College of Medicine, 27, Inhang-ro, Jung-gu, Incheon, Republic of Korea
| | - C Yang
- Department of Anesthesiology and Pain Medicine, Inha University College of Medicine, 27, Inhang-ro, Jung-gu, Incheon, Republic of Korea
| | - W H Choi
- Department of Anesthesiology and Pain Medicine, Inha University College of Medicine, 27, Inhang-ro, Jung-gu, Incheon, Republic of Korea
| | - J Jeong
- Department of Anesthesiology and Pain Medicine, Inha University College of Medicine, 27, Inhang-ro, Jung-gu, Incheon, Republic of Korea
| | - K J Lee
- Department of Anesthesiology and Pain Medicine, Inha University College of Medicine, 27, Inhang-ro, Jung-gu, Incheon, Republic of Korea
| | - H Kim
- Department of Anesthesiology and Pain Medicine, Inha University College of Medicine, 27, Inhang-ro, Jung-gu, Incheon, Republic of Korea.
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Lee KJ, Soyer HP. Smartphones, artificial intelligence and digital histopathology take on basal cell carcinoma diagnosis. Br J Dermatol 2019; 182:540-541. [PMID: 31429070 DOI: 10.1111/bjd.18374] [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: 11/27/2022]
Affiliation(s)
- K J Lee
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, 4102, Australia
| | - H P Soyer
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, 4102, Australia
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Rayner JE, McMeniman EK, Duffy DL, De'Ambrosis B, Smithers BM, Jagirdar K, Lee KJ, Soyer HP, Sturm RA. Phenotypic and genotypic analysis of amelanotic and hypomelanotic melanoma patients. J Eur Acad Dermatol Venereol 2019; 33:1076-1083. [PMID: 30680790 DOI: 10.1111/jdv.15446] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/19/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND Amelanotic/hypomelanotic melanoma is associated with poorer outcomes due to a more advanced disease stage at diagnosis. OBJECTIVE To determine phenotypic risks and genotypic associations with amelanotic/hypomelanotic melanoma to develop a clinical and genetic profile that could assist in identifying high-risk individuals. METHODS The Brisbane Naevus Morphology Study conducted from 2009 to 2016 has recruited a core of 1254 participants. Participants were drawn from a combination of volunteers from dermatology outpatient clinics, private dermatology clinics, the Brisbane Longitudinal Twin Study and QSkin study. Case participants had a personal history of melanoma and control participants no personal history of melanoma. We specifically examined seven known candidate pigmentation and melanoma genes and pigmentary phenotypic characteristics in participants with amelanotic/hypomelanotic melanoma compared to pigmented melanomas. This assayed single nucleotide polymorphisms in MC1R, TYR, HERC/OCA2, IRF4, MTAP, PLA2G6 and MITF. RESULTS Forty-seven participants had at least one amelanotic/hypomelanotic melanoma, and 389 had pigmented melanomas, with amelanotic/hypomelanotic melanoma patients significantly older than pigmented melanoma participants (63.3 ± 13.0 vs. 54.6 ± 15.3 years; P < 0.001). Amelanotic/hypomelanotic melanoma patients were more likely than pigmented melanoma patients to have red hair (34% vs. 15%; P = 0.01), severe hand freckling (13% vs. 5%; P = 0.01) and propensity to sunburn (63% vs. 44%; P = 0.01). MC1R R/R genotype was much more frequent in our amelanotic/hypomelanotic melanoma population (31.1% vs. 11%; P < 0.001; OR 26.4 vs. 5.9; control 1.0). Amelanotic/hypomelanotic melanoma was associated with TYR rs1126809*A/A [OR (CI 95%) 2.7 (1.1-6.8) vs. 1.2 (0.8-1.9)] and PLA2G6 rs11570734*A/A [OR (CI 95%) 3.7 (1.0-13.6) vs. 1.3 (0.9-2.0)]. The MTAP melanoma risk SNP genotype, associated with darker pigmentation, (rs4636294*A/A) was less common in amelanotic/hypomelanotic melanoma patients [OR (CI 95%) 0.8 (0.3-2.1) vs. 2.0 (1.3-3.1)]. CONCLUSIONS Knowledge of phenotypic and genotypic associations of amelanotic/hypomelanotic melanoma can help predict risks and associations of this difficult to diagnose melanoma, which may ultimately assist clinical management and patient skin self-examination.
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Affiliation(s)
- J E Rayner
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Qld, Australia
| | - E K McMeniman
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Qld, Australia
- Dermatology Department, Princess Alexandra Hospital, Brisbane, Qld, Australia
| | - D L Duffy
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Qld, Australia
- QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia
| | - B De'Ambrosis
- Dermatology Department, Princess Alexandra Hospital, Brisbane, Qld, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
- South East Dermatology, Annerley Square, Brisbane, Qld, Australia
| | - B M Smithers
- Queensland Melanoma Project, School of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - K Jagirdar
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Qld, Australia
| | - K J Lee
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Qld, Australia
| | - H P Soyer
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Qld, Australia
- Dermatology Department, Princess Alexandra Hospital, Brisbane, Qld, Australia
| | - R A Sturm
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Qld, Australia
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Shin YH, Gong HS, Lee KJ, Baek GH. Older Age and Higher Body Mass Index Are Associated With a More Degraded Trabecular Bone Score Compared to Bone Mineral Density. J Clin Densitom 2019; 22:266-271. [PMID: 28712983 DOI: 10.1016/j.jocd.2017.06.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 03/22/2017] [Revised: 06/11/2017] [Accepted: 06/14/2017] [Indexed: 01/27/2023]
Abstract
Trabecular bone score (TBS) may detect subjects with a more degraded microarchitecture but whose bone mineral density (BMD) reflects normal or osteopenia. The purpose of this study was to evaluate whether age and body sizes were associated with the discordance between BMD and TBS. We analyzed BMD and TBS in 1505 Korean women over 40 yr of age who had no history of osteoporotic fractures or conditions that affect bone metabolism. We considered 3 groups to have TBS values that reflected a more degraded TBS than their BMD values: (1) normal BMD but partially degraded TBS, (2) normal BMD but degraded TBS, and (3) osteopenia but degraded TBS. We compared subjects in these 3 groups with other subjects in terms of age and body sizes, and used multivariable logistic regression to analyze the odds ratios (ORs) for the occurrence of a more degraded TBS than their BMD level using age and body mass index (BMI). One hundred sixty subjects (10.6%) were found to have a more degraded TBS than their BMD level; these subjects were older, heavier, and had higher BMIs than the other subjects. Age (OR: 1.038, 95% confidence interval: 1.020-1.057, p< 0.001) and BMI (OR: 1.223, 95% confidence interval: 1.166-1.283, p< 0.001) were statistically significant in the multivariable analysis for the occurrence of this feature. Women with a more degraded TBS than their BMD level are older and have higher BMIs than the other subjects. It may be helpful to consider the possibility of trabecular bone degradation when clinically evaluating fracture risk in patients who are older or who have high BMIs with normal BMD or osteopenia.
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Affiliation(s)
- Young Ho Shin
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyun Sik Gong
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Kyung Jae Lee
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Goo Hyun Baek
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
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Matthews LG, Inder TE, Pascoe L, Kapur K, Lee KJ, Monson BB, Doyle LW, Thompson DK, Anderson PJ. Longitudinal Preterm Cerebellar Volume: Perinatal and Neurodevelopmental Outcome Associations. Cerebellum 2018; 17:610-627. [PMID: 29949094 PMCID: PMC6126980 DOI: 10.1007/s12311-018-0946-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Impaired cerebellar development is an important determinant of adverse motor and cognitive outcomes in very preterm (VPT) infants. However, longitudinal MRI studies investigating cerebellar maturation from birth through childhood and associated neurodevelopmental outcomes are lacking. We aimed to compare cerebellar volume and growth from term-equivalent age (TEA) to 7 years between VPT (< 30 weeks' gestation or < 1250 g) and full-term children; and to assess the association between these measures, perinatal factors, and 7-year outcomes in VPT children, and whether these relationships varied by sex. In a prospective cohort study of 224 VPT and 46 full-term infants, cerebellar volumes were measured on MRI at TEA and 7 years. Useable data at either time-point were collected for 207 VPT and 43 full-term children. Cerebellar growth from TEA to 7 years was compared between VPT and full-term children. Associations with perinatal factors and 7-year outcomes were investigated in VPT children. VPT children had smaller TEA and 7-year volumes and reduced growth. Perinatal factors were associated with smaller cerebellar volume and growth between TEA and 7 years, namely, postnatal corticosteroids for TEA volume, and female sex, earlier birth gestation, white and deep nuclear gray matter injury for 7-year volume and growth. Smaller TEA and 7-year volumes, and reduced growth were associated with poorer 7-year IQ, language, and motor function, with differential relationships observed for male and female children. Our findings indicate that cerebellar growth from TEA to 7 years is impaired in VPT children and relates to early perinatal factors and 7-year outcomes.
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Affiliation(s)
- Lillian G Matthews
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA.
- Murdoch Children's Research Institute, Melbourne, Australia.
- Department of Paediatrics, University of Melbourne, Melbourne, Australia.
| | - T E Inder
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
| | - L Pascoe
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - K Kapur
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - K J Lee
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - B B Monson
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - L W Doyle
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Royal Women's Hospital, Melbourne, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
| | - D K Thompson
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - P J Anderson
- Murdoch Children's Research Institute, Melbourne, Australia
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
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Lee KJ, Liu K. Tinnitus: A Stepchild in Our Specialty. Otolaryngol Head Neck Surg 2018; 159:599-600. [PMID: 29966488 DOI: 10.1177/0194599818785146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Many patients are not satisfied with their doctor's answer when they complain about tinnitus. The proposed classification can be used to communicate with patients as well as guide future research. Type A itemizes the treatable causes of tinnitus. Type B itemizes tinnitus with a lack of medical explanation. Type C tinnitus is caused by diagnosable and treatable conditions, as listed in tinnitus type A, but the tinnitus persists after the successful treatment of the other symptoms.
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Affiliation(s)
- K J Lee
- 1 Department of Otolaryngology-Head and Neck Surgery, Lenox Hill Hospital, Zucker School of Medicine, Hofstra University, Hempstead, New York, USA.,2 Section of Otolaryngology-Head and Neck Surgery, School of Medicine, Yale University, Guilford, Connecticut, USA
| | - Keyu Liu
- 3 Department of Biomedical Engineering, School of Engineering and Applied Science, Columbia University, New York, New York, USA
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Cuzzilla R, Spittle AJ, Lee KJ, Rogerson S, Cowan FM, Doyle LW, Cheong JLY. Postnatal Brain Growth Assessed by Sequential Cranial Ultrasonography in Infants Born <30 Weeks' Gestational Age. AJNR Am J Neuroradiol 2018; 39:1170-1176. [PMID: 29773561 DOI: 10.3174/ajnr.a5679] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 03/05/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Brain growth in the early postnatal period following preterm birth has not been well described. This study of infants born at <30 weeks' gestational age and without major brain injury aimed to accomplish the following: 1) assess the reproducibility of linear measures made from cranial ultrasonography, 2) evaluate brain growth using sequential cranial ultrasonography linear measures from birth to term-equivalent age, and 3) explore perinatal predictors of postnatal brain growth. MATERIALS AND METHODS Participants comprised 144 infants born at <30 weeks' gestational age at a single center between January 2011 and December 2013. Infants with major brain injury seen on cranial ultrasonography or congenital or chromosomal abnormalities were excluded. Brain tissue and fluid spaces were measured from cranial ultrasonography performed as part of routine clinical care. Brain growth was assessed in 3 time intervals: <7, 7-27, and >27 days' postnatal age. Data were analyzed using intraclass correlation coefficients and mixed-effects regression. RESULTS A total of 429 scans were assessed for 144 infants. Several linear measures showed excellent reproducibility. All measures of brain tissue increased with postnatal age, except for the biparietal diameter, which decreased within the first postnatal week and increased thereafter. Gestational age of ≥28 weeks at birth was associated with slower growth of the biparietal diameter and ventricular width compared with gestational age of <28 weeks. Postnatal corticosteroid administration was associated with slower growth of the corpus callosum length, transcerebellar diameter, and vermis height. Sepsis and necrotizing enterocolitis were associated with slower growth of the transcerebellar diameter. CONCLUSIONS Postnatal brain growth in infants born at <30 weeks' gestational age can be evaluated using sequential linear measures made from routine cranial ultrasonography and is associated with perinatal predictors of long-term development.
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Affiliation(s)
- R Cuzzilla
- From the Victorian Infant Brain Studies research group (R.C., A.J.S., K.J.L., L.W.D., J.L.Y.C.), Murdoch Childrens Research Institute, Melbourne, Australia .,Departments of Obstetrics and Gynaecology (R.C., S.R., L.W.D., J.L.Y.C.).,Neonatal Services (R.C., A.J.S., S.R., L.W.D., J.L.Y.C.), The Royal Women's Hospital, Melbourne, Australia
| | - A J Spittle
- From the Victorian Infant Brain Studies research group (R.C., A.J.S., K.J.L., L.W.D., J.L.Y.C.), Murdoch Childrens Research Institute, Melbourne, Australia.,Physiotherapy (A.J.S.), University of Melbourne, Melbourne, Australia.,Neonatal Services (R.C., A.J.S., S.R., L.W.D., J.L.Y.C.), The Royal Women's Hospital, Melbourne, Australia
| | - K J Lee
- From the Victorian Infant Brain Studies research group (R.C., A.J.S., K.J.L., L.W.D., J.L.Y.C.), Murdoch Childrens Research Institute, Melbourne, Australia.,Paediatrics (K.J.L., L.W.D.)
| | - S Rogerson
- Departments of Obstetrics and Gynaecology (R.C., S.R., L.W.D., J.L.Y.C.).,Neonatal Services (R.C., A.J.S., S.R., L.W.D., J.L.Y.C.), The Royal Women's Hospital, Melbourne, Australia
| | - F M Cowan
- Department of Paediatrics (F.M.C.), Imperial College, London, UK
| | - L W Doyle
- From the Victorian Infant Brain Studies research group (R.C., A.J.S., K.J.L., L.W.D., J.L.Y.C.), Murdoch Childrens Research Institute, Melbourne, Australia.,Departments of Obstetrics and Gynaecology (R.C., S.R., L.W.D., J.L.Y.C.).,Paediatrics (K.J.L., L.W.D.).,Neonatal Services (R.C., A.J.S., S.R., L.W.D., J.L.Y.C.), The Royal Women's Hospital, Melbourne, Australia
| | - J L Y Cheong
- From the Victorian Infant Brain Studies research group (R.C., A.J.S., K.J.L., L.W.D., J.L.Y.C.), Murdoch Childrens Research Institute, Melbourne, Australia.,Departments of Obstetrics and Gynaecology (R.C., S.R., L.W.D., J.L.Y.C.).,Neonatal Services (R.C., A.J.S., S.R., L.W.D., J.L.Y.C.), The Royal Women's Hospital, Melbourne, Australia
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Kim JW, Lee KJ, Yang HR, Chang JY, Moon JS, Khang YH, Ko JS. Prevalence and risk factors of elevated alanine aminotransferase among Korean adolescents: 2001-2014. BMC Public Health 2018; 18:617. [PMID: 29751750 PMCID: PMC5948921 DOI: 10.1186/s12889-018-5548-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 10/29/2017] [Accepted: 05/04/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND An elevated alanine aminotransferase (ALT) level is a surrogate marker of non-alcoholic fatty liver disease (NAFLD), the most common liver disorder in adolescents. The majority of previous NAFLD studies in adolescents were performed in selected obese populations or had a cross-sectional design without a time-trend analysis. The purpose of this study was to estimate the prevalence and time trends of elevated ALT levels in a general adolescent population and to identify factors associated with ALT elevation. METHODS We analysed data of adolescent participants (aged 10-18 years) from the Korean National Health and Nutrition Examination Survey 2001-2014, a representative sample of the general population in South Korea. Suspected NAFLD was defined as ALT elevation (> 30 U/L) without hepatitis B surface antigen. In all statistical analyses, sampling weight- and design-based data were used. RESULTS ALT was elevated in 5.3% (standard error: 0.3%) of the study population of adolescent participants (N = 8455). No significant trends were found from 2001 to 2014 in the prevalence of elevated ALT among male and female adolescents. In multiple logistic regression analysis, elevated ALT was independently associated with sex (odds ratio [OR] male versus female 4.5; 95% CI, 3.3-6.2), obesity (OR 7.6; 95% CI, 5.3-11.0), and truncal obesity (OR 2.5; 95% CI, 1.8-3.5). Furthermore, male sex, obesity, truncal obesity and high household income level were associated with log-transformed ALT levels in multiple regression analysis. CONCLUSIONS In Korean adolescents of both genders, the prevalence of elevated ALT levels was stable from 2001 to 2014. This study has revealed that sex, obesity, truncal obesity and household income level are associated with ALT elevation in adolescents.
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Affiliation(s)
- Ju Whi Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyung Jae Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Hye Ran Yang
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Ju Young Chang
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Jin Soo Moon
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Young-Ho Khang
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, South Korea
| | - Jae Sung Ko
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea.
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Laino AM, Berry EG, Jagirdar K, Lee KJ, Duffy DL, Soyer HP, Sturm RA. Iris pigmented lesions as a marker of cutaneous melanoma risk: an Australian case-control study. Br J Dermatol 2018; 178:1119-1127. [PMID: 29315480 DOI: 10.1111/bjd.16323] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Iris naevi and iris freckles have a frequency of 4% and 50% in the European population, respectively. They are associated with dysplastic naevi, but few studies have examined their link to cutaneous melanoma. OBJECTIVES To assess whether iris pigmented lesions are a predictive indicator for cutaneous melanoma. METHODS This is a melanoma case-control study of 1254 European-background Australians. Sun exposure and melanoma history, a saliva sample for DNA analysis and eye photographs taken with a digital camera were collected from 1117 participants. Iris images were assessed by up to four trained observers for the number of iris pigmented lesions. The data were analysed for correlations between iris pigmented lesions and melanoma history. RESULTS Case participants over the age of 40 had similar numbers of iris pigmented lesions to age matched controls (mean 5·7 vs. 5·2, P = 0·02), but in younger case and control participants there was a greater difference (mean 3·96 vs. 2·19, P = 0·004). A logistic regression adjusted for age, sex, skin, hair and eye colour, skin freckling and naevus count found that the presence of three or more iris pigmented lesions increases the melanoma risk 1·45-fold [95% confidence interval (CI) 1·07-1·95]. HERC2/OCA2 rs12913832 and IRF4 rs12203592 influenced both eye colour and the number of iris pigmented lesions. On the HERC2/OCA2 A/A and A/G genotype background there was an increasing proportion of blue eye colour when carrying the IRF4 T allele (P = 3 × 10-4 ) and a higher number of iris pigmented lesions with the IRF4 T/T homozygote (P = 3 × 10-9 ). CONCLUSIONS Iris pigmented lesion count provides additional predictive information for melanoma risk above that from conventional risk factors.
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Affiliation(s)
- A M Laino
- Dermatology Research Centre, The University of Queensland, UQ Diamantina Institute, Translational Research Institute, Brisbane, 4102, Australia
| | - E G Berry
- Dermatology Research Centre, The University of Queensland, UQ Diamantina Institute, Translational Research Institute, Brisbane, 4102, Australia.,Department of Dermatology, Emory University School of Medicine, Atlanta, 30309, GA, U.S.A
| | - K Jagirdar
- Dermatology Research Centre, The University of Queensland, UQ Diamantina Institute, Translational Research Institute, Brisbane, 4102, Australia
| | - K J Lee
- Dermatology Research Centre, The University of Queensland, UQ Diamantina Institute, Translational Research Institute, Brisbane, 4102, Australia
| | - D L Duffy
- Dermatology Research Centre, The University of Queensland, UQ Diamantina Institute, Translational Research Institute, Brisbane, 4102, Australia.,QIMR Berghofer Medical Research Institute, Brisbane, 4006, Australia
| | - H P Soyer
- Dermatology Research Centre, The University of Queensland, UQ Diamantina Institute, Translational Research Institute, Brisbane, 4102, Australia.,Department of Dermatology, Princess Alexandra Hospital, Brisbane, 4102, Australia
| | - R A Sturm
- Dermatology Research Centre, The University of Queensland, UQ Diamantina Institute, Translational Research Institute, Brisbane, 4102, Australia
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50
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Rodwell L, Romaniuk H, Nilsen W, Carlin JB, Lee KJ, Patton GC. Adolescent mental health and behavioural predictors of being NEET: a prospective study of young adults not in employment, education, or training. Psychol Med 2018; 48:861-871. [PMID: 28874224 DOI: 10.1017/s0033291717002434] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Young adults who are not in employment, education, or training (NEET) are at risk of long-term economic disadvantage and social exclusion. Knowledge about risk factors for being NEET largely comes from cross-sectional studies of vulnerable individuals. Using data collected over a 10-year period, we examined adolescent predictors of being NEET in young adulthood. METHODS We used data on 1938 participants from the Victorian Adolescent Health Cohort Study, a community-based longitudinal study of adolescents in Victoria, Australia. Associations between common mental disorders, disruptive behaviour, cannabis use and drinking behaviour in adolescence, and NEET status at two waves of follow-up in young adulthood (mean ages of 20.7 and 24.1 years) were investigated using logistic regression, with generalised estimating equations used to account for the repeated outcome measure. RESULTS Overall, 8.5% of the participants were NEET at age 20.7 years and 8.2% at 24.1 years. After adjusting for potential confounders, we found evidence of increased risk of being NEET among frequent adolescent cannabis users [adjusted odds ratio (ORadj) = 1.74; 95% confidence interval (CI) 1.10-2.75] and those who reported repeated disruptive behaviours (ORadj = 1.71; 95% CI 1.15-2.55) or persistent common mental disorders in adolescence (ORadj = 1.60; 95% CI 1.07-2.40). Similar associations were present when participants with children were included in the same category as those in employment, education, or training. CONCLUSIONS Young people with an early onset of mental health and behavioural problems are at risk of failing to make the transition from school to employment. This finding reinforces the importance of integrated employment and mental health support programmes.
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Affiliation(s)
- L Rodwell
- Clinical Epidemiology and Biostatistics Unit,Murdoch Childrens Research Institute,Parkville, VIC,Australia
| | - H Romaniuk
- Clinical Epidemiology and Biostatistics Unit,Murdoch Childrens Research Institute,Parkville, VIC,Australia
| | - W Nilsen
- Work Research Institute,Oslo and Akershus University College of Applied Sciences,Oslo,Norway
| | - J B Carlin
- Clinical Epidemiology and Biostatistics Unit,Murdoch Childrens Research Institute,Parkville, VIC,Australia
| | - K J Lee
- Clinical Epidemiology and Biostatistics Unit,Murdoch Childrens Research Institute,Parkville, VIC,Australia
| | - G C Patton
- Department of Paediatrics,Faculty of Medicine,Dentistry and Health Sciences,The University of Melbourne,Melbourne, VIC,Australia
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