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Lee MA, Hwang BW, Ha SW, Kim JH, Kim HS, Ahn SH. Endovascular Reperfusion Therapy in Minor Stroke with Neurologic Deterioration beyond 24 Hours from Onset. Neurointervention 2023; 18:159-165. [PMID: 37871978 PMCID: PMC10626039 DOI: 10.5469/neuroint.2023.00353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/04/2023] [Accepted: 10/06/2023] [Indexed: 10/25/2023] Open
Abstract
PURPOSE Patients with minor stroke (National Institutes of Health Stroke Scale score ≤5) and large vessel occlusion (LVO) often experience neurological deterioration >24 hours after onset. However, the efficacy of endovascular reperfusion therapy in these patients remains unclear. The aim of this study was to determine the efficacy and safety of reperfusion therapy in patients with minor stroke and neurological deterioration >24 hours after onset. MATERIALS AND METHODS Data were retrospectively reviewed from patients between January 2019 and April 2022 who met the following criteria: (1) minor stroke and small definitive ischemic lesions at initial visit, (2) onset to neurological deterioration >24 hours, (3) cortical signs, Alberta Stroke Program Early computed tomography (CT) Score >6 points, and large artery occlusion confirmed by CT angiography at neurological deterioration. Efficacy and safety outcomes were based on final thrombolysis in cerebral infarction (TICI), incidence of symptomatic intracranial hemorrhage (ICH), and mortality. Outcomes were assessed using the modified Rankin Scale (mRS) at 3 months. Good outcome was defined as a mRS of 0, 1, or 2. RESULTS Data from 26 patients (38.4% female, mean age 75.8 years) were analyzed; 18 (69.2%) had a good outcome. A final TICI of 2b or 3 was observed in 24 (92.3%) patients. No other adverse events, including dissection, vasospasm or distal embolization, were observed during the procedures. Hemorrhagic events occurred in 8 patients after the procedure; however, there were no symptomatic ICHs. Good prognostic factors were younger age (P=0.062) and carotid stenting (P=0.025). CONCLUSION Endovascular reperfusion therapy performed in selected patients with minor stroke, LVO, and neurological deterioration >24 hours after stroke onset demonstrated favorable outcomes and safety.
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Affiliation(s)
- Min A Lee
- Department of Neurology, School of Medicine, Chosun University, Gwangju, Korea
| | - Byoung Wook Hwang
- Department of Neurology, School of Medicine, Chosun University, Gwangju, Korea
| | - Sang Woo Ha
- Department of Neurosurgery, School of Medicine, Chosun University, Gwangju, Korea
| | - Jae Ho Kim
- Department of Neurosurgery, School of Medicine, Chosun University, Gwangju, Korea
| | - Hak Sung Kim
- Department of Neurosurgery, School of Medicine, Chosun University, Gwangju, Korea
| | - Seong Hwan Ahn
- Department of Neurology, School of Medicine, Chosun University, Gwangju, Korea
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Hwang BW, Lee MA, Ha SW, Kim JH, Kim HS, Ahn SH. Rescue Endovascular Treatment to Prevent Neurological Deterioration in Acute Symptomatic Bilateral Vertebral Artery Occlusion. Neurointervention 2023; 18:182-189. [PMID: 37871977 PMCID: PMC10626042 DOI: 10.5469/neuroint.2023.00381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/10/2023] [Accepted: 10/14/2023] [Indexed: 10/25/2023] Open
Abstract
Bilateral vertebral artery occlusive disease has been considered as a favorable condition with good collaterals. However, the prognosis of acute ischemic stroke secondary to symptomatic bilateral vertebral artery occlusion (BVAO) and endovascular treatment (EVT) has rarely been reported. We retrospectively selected patients with acute ischemic stroke admitted for symptomatic BVAO between January 2020 and February 2023. All patients with ischemic stroke were evaluated for ischemic lesion and arterial status using brain imaging and angiography. The prognosis of acute stroke with symptomatic BVAO was compared between EVT and conventional treatment. Outcomes were evaluated using modified Rankin Scale (mRS) score at 3 months follow-up. Within the study period, 17 of 2,655 acute ischemic stroke patients were diagnosed with ischemic stroke with symptomatic BVAO. The median age of these patients was 70 (interquartile range 44-89) years, and 13 (76%) were male. Seven patients received emergent EVT with stenting and 10 patients received conventional medical treatment only. Nine of 10 patients with conventional treatment had in-hospital stroke progression and developed new ischemic lesions in the pons and midbrain. Five patients with fetal and hypoplastic posterior communicating artery presented bilateral cerebral peduncular lesions. At 3 months follow-up, 6 patients (35%) had favorable outcomes (mRS 0-2), of which 5 were treated with vertebral artery stenting and 1 received conventional treatment. Ischemic stroke in patients with acute symptomatic BVAO is uncommon. However, stroke progression is common, and the prognosis of most patients is poor. Rescue management such as EVT might be considered for symptomatic BVAO.
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Affiliation(s)
- Byoung Wook Hwang
- Department of Neurology, School of Medicine, Chosun University, Gwangju, Korea
| | - Min A Lee
- Department of Neurology, School of Medicine, Chosun University, Gwangju, Korea
| | - Sang Woo Ha
- Department of Neurosurgery, School of Medicine, Chosun University, Gwangju, Korea
| | - Jae Ho Kim
- Department of Neurosurgery, School of Medicine, Chosun University, Gwangju, Korea
| | - Hak Sung Kim
- Department of Neurosurgery, School of Medicine, Chosun University, Gwangju, Korea
| | - Seong Hwan Ahn
- Department of Neurology, School of Medicine, Chosun University, Gwangju, Korea
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Jeon S, Yu B, Lee GJ, Lee MA, Park Y, Cho J, Lee J, Choi ST, Choi KK. Liver Transplant After Severe Liver Trauma: The First Report in a Korean Adult. EXP CLIN TRANSPLANT 2023; 21:619-622. [PMID: 37584543 DOI: 10.6002/ect.2023.0144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
Following a motor-vehicle accident, a 57-year-old man was diagnosed with a grade 4 liver injury (American Association for the Surgery of Trauma organ injury scale) with multiple contrast extravasations. He initially underwent nonoperative management, which included transcatheter arterial embolization. However, he experienced a hemorrhage after the first embo-lization procedure, and so the procedure was repeated. Thereafter, he was diagnosed with liver failure based on findings from computed tomography and liver function tests. On day 28 of hospitalization, the patient underwent deceased donor liver transplant. He experienced several complications, including acute renal failure, pneumonia, and bile leak. These were managed successfully, and the patient was discharged 4 months after the transplant. Although liver transplant procedure for hepatic trauma is technically challenging and risky, it should be considered a viable treatment option in some patients (such as patients with severe liver injury). This is the first reported case, to our knowledge, of a liver transplant performed successfully in a patient with severe hepatic trauma in Korea.
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Affiliation(s)
- Sebeom Jeon
- From the Department of Trauma Surgery, Gachon University, Gil Medical Center, Incheon, Korea
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Yoshino T, Cervantes A, Bando H, Martinelli E, Oki E, Xu RH, Mulansari NA, Govind Babu K, Lee MA, Tan CK, Cornelio G, Chong DQ, Chen LT, Tanasanvimon S, Prasongsook N, Yeh KH, Chua C, Sacdalan MD, Sow Jenson WJ, Kim ST, Chacko RT, Syaiful RA, Zhang SZ, Curigliano G, Mishima S, Nakamura Y, Ebi H, Sunakawa Y, Takahashi M, Baba E, Peters S, Ishioka C, Pentheroudakis G. Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with metastatic colorectal cancer. ESMO Open 2023; 8:101558. [PMID: 37236086 PMCID: PMC10220270 DOI: 10.1016/j.esmoop.2023.101558] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/28/2023] Open
Abstract
The European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with metastatic colorectal cancer (mCRC), published in late 2022, were adapted in December 2022, according to previously established standard methodology, to produce the Pan-Asian adapted (PAGA) ESMO consensus guidelines for the management of Asian patients with mCRC. The adapted guidelines presented in this manuscript represent the consensus opinions reached by a panel of Asian experts in the treatment of patients with mCRC representing the oncological societies of China (CSCO), Indonesia (ISHMO), India (ISMPO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), the Philippines (PSMO), Singapore (SSO), Taiwan (TOS) and Thailand (TSCO), co-ordinated by ESMO and the Japanese Society of Medical Oncology (JSMO). The voting was based on scientific evidence and was independent of the current treatment practices, drug access restrictions and reimbursement decisions in the different Asian countries. The latter are discussed separately in the manuscript. The aim is to provide guidance for the optimisation and harmonisation of the management of patients with mCRC across the different countries of Asia, drawing on the evidence provided by both Western and Asian trials, whilst respecting the differences in screening practices, molecular profiling and age and stage at presentation, coupled with a disparity in the drug approvals and reimbursement strategies, between the different countries.
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Affiliation(s)
- T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
| | - A Cervantes
- Department of Medical Oncology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia; CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - H Bando
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - E Martinelli
- Oncology Unit, Department of Precision Medicine, Università degli Studi della Campania 'L. Vanvitelli', Naples, Italy
| | - E Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - R-H Xu
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center and State Key Laboratory of Oncology in South China, Guangzhou, China
| | - N A Mulansari
- Hematology-Medical Oncology Division, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital/Universitas Indonesia, Jakarta, Indonesia
| | - K Govind Babu
- Department of Medical Oncology, HCG Hospital and St. John's Medical College, Bengaluru, India
| | - M A Lee
- Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - C K Tan
- Department of Oncology and Nuclear Medicine, Thomson Hospital Kota Damansara, Selangor, Malaysia
| | - G Cornelio
- Department of Medical Oncology, University of the Philipppines-Philippine General Hospital, St. Lukes Cancer Institute-Global City, The Philippines
| | - D Q Chong
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - L-T Chen
- Department of Internal Medicine, Kaohsiung Medical University Hospital and Centre for Cancer Research, Kaohsiung Medical University, Kaohsiung; National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - S Tanasanvimon
- Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok
| | - N Prasongsook
- Division of Medical Oncology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand
| | - K-H Yeh
- Department of Oncology, National Taiwan University Hospital, Taipei; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - C Chua
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - M D Sacdalan
- Department of Surgery, University of the Philippines-College of Medicine and University of the Philippines-Philippine General Hospital, Manila, The Philippines
| | - W J Sow Jenson
- Department of Radiotherapy & Oncology, Aurelius Hospital, Nilai, Malaysia
| | - S T Kim
- Division of Hematology-Oncology, Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Centre, Seoul, South Korea
| | - R T Chacko
- Department of Medical Oncology, Christian Medical College, Vellore, Tamil Nadu, India
| | - R A Syaiful
- Department of Surgery, Dr Cipto Mangunkusumo National General Hospital, University of Indonesia, Jakarta, Indonesia
| | - S Z Zhang
- Department of Colorectal Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - G Curigliano
- Istituto Europeo di Oncologia, IRCCS, Milan; Department of Oncology and Haematology, University of Milano, Milan, Italy
| | - S Mishima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Y Nakamura
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - H Ebi
- Division of Molecular Therapeutics, Aichi Cancer Center Research Institute, Nagoya
| | - Y Sunakawa
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki
| | - M Takahashi
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai
| | - E Baba
- Department of Oncology and Social Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - S Peters
- Oncology Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - C Ishioka
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
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Kim Y, Yu B, Jeon SB, Lee SH, Cho J, Gwak J, Park Y, Choi KK, Lee MA, Lee GJ, Lee J. Epidemiology and outcomes of patients with penetrating trauma in Incheon Metropolitan City: an observational study using National Emergency Department Information System data. J Trauma Inj 2022. [DOI: 10.20408/jti.2022.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Shin H, Sung AJ, Lee MA, Cho J, Lee GJ, Yu B, Choi KK. Salvation of a solitary kidney in a patient with grade IV renal trauma: a case report. J Trauma Inj 2022. [DOI: 10.20408/jti.2021.0091] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
There are many reasons for solitary kidney. Congenital causes include renal agenesis and dysplasia. Acquired causes include nephrectomy performed for reasons including traumatic kidney injury, disease (e.g., renal cell carcinoma), and donation for kidney transplantation. According to the European Association of Urology, the World Society of Emergency Surgery, and the American Association for the Surgery of Trauma guidelines, it is important to preserve the remaining renal function as much as possible when a solitary kidney patient has suffered a traumatic kidney injury. The authors present a case of kidney preservation in a solitary kidney patient with a traumatic grade IV renal injury through non-operative management involving superselective renal artery angioembolization.
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Yu B, Lee GJ, Lee MA, Choi KK, Gwak J, Park Y, Yoon YC, Cho J, Lee SH, Lee J. A case report of field amputation: the rescue of an entrapped patient through the "doctor car" system. J Trauma Inj 2022. [DOI: 10.20408/jti.2022.0012] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
In certain circumstances, invasive procedures such as creation of a surgical airway, insertion of a chest drain, intraosseous puncture, or amputation in the field are necessary. These invasive procedures can save lives. However, emergency medical service teams cannot perform such procedures according to the law in Korea. The upper arm of a 29-year-old male patient was stuck in a huge machine and the emergency medical service team could not rescue the patient. A doctor-car team was dispatched to the scene and the team performed the filed amputation to extricate the patient. He was brought to the trauma center immediately and underwent formal above-elbow amputation. Here we describe a case of field amputation to rescue a patient through a “doctor car” system, along with a literature review.
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Lee MA, Leem HJ, Yu J, Kim HS. Stable Li Metal-Electrolyte Interface Enabled by SEI Improvement and Cation Shield Functionality of the Azamacrocyclic Ligand in Carbonate Electrolytes. ACS Appl Mater Interfaces 2022; 14:35645-35653. [PMID: 35900885 DOI: 10.1021/acsami.2c07932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
To promote the reversible cycleability of Li metal negative electrodes, a Li-chelating azamacrocyclic ligand molecule is introduced into a carbonate-based electrolyte intended for lithium metal batteries. Reversible Li plating and stripping on the Cu electrode are found to be the outcomes of the bifunctional effects of adding the lithium nitrate-chelating azamacrocyclic ligand. The negatively shifted redox potential of the Li-chelating macrocyclic ligand, relative to that of the free Li-ion, acted as a cationic shielding molecule for smooth Li deposition, and the Li3N-based solid electrolyte interphase (SEI) film derived from the nitrate anion strengthened the interphasial characteristics of the Li metal negative electrode. Cationic shielding and Li3N-based SEI composition could help enhance the cycleability of the Li metal in a cascading manner. Consequently, the physicochemical characteristics of the lithium nitrate-chelated 1,4,8,11-tetramethyl-1,4,8,11-tetraazacylcotetradecane molecule exhibit stable Li/LiNi0.8Co0.1Mn0.1O2 cycleability.
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Affiliation(s)
- Min A Lee
- Advanced Batteries Research Center, Korea Electronics Technology Institute, 25, Saenari-ro, Seongnam 13509, Republic of Korea
- Department of Energy Engineering, Hanyang University, Seoul 04763 Republic of Korea
| | - Han Jun Leem
- Advanced Batteries Research Center, Korea Electronics Technology Institute, 25, Saenari-ro, Seongnam 13509, Republic of Korea
- SKKU Advanced Institute of Nanotechnology (SAINT), Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Jisang Yu
- Advanced Batteries Research Center, Korea Electronics Technology Institute, 25, Saenari-ro, Seongnam 13509, Republic of Korea
| | - Hyun-Seung Kim
- Advanced Batteries Research Center, Korea Electronics Technology Institute, 25, Saenari-ro, Seongnam 13509, Republic of Korea
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Choi KK, Cho J, Lee MA, Eun SM, Jeon YB. Successful management of a common carotid artery injury using a Pruitt-F3 Carotid Shunt: a case report. J Trauma Inj 2022. [DOI: 10.20408/jti.2021.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Yoon HJ, Kang J, Lee HY, Lee MA, Hwang NY, Kim HK, Kim J. Recurrence dynamics after curative surgery in patients with invasive mucinous adenocarcinoma of the lung. Insights Imaging 2022; 13:64. [PMID: 35380276 PMCID: PMC8982735 DOI: 10.1186/s13244-022-01208-5] [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: 12/08/2021] [Accepted: 03/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background We investigated the patterns and timing of recurrence and death as well as prognostic factors based on clinicopathological and radiological factors in patients who underwent surgical treatment for invasive mucinous adenocarcinoma (IMA). Methods We reviewed clinicopathological findings including spread through air spaces (STAS) and CT findings of IMA such as morphology, solidity, margin, well-defined heterogeneous ground-glass opacity, CT angiogram, and air bronchogram signs from 121 consecutive patients who underwent surgical resection. Prognostic factors for disease-free survival (DFS) and overall survival (OS) were identified. Hazard rate analyses were performed for the survival dynamics. Results T stage (hazard ratio [HR] = 4.102, p = 0.03), N stage (N2 vs. N0, HR = 7.653, p < 0.001), and consolidative CT morphology (HR = 3.556, p = 0.008) remained independent predictors for DFS. Age (HR = 1.110, p = 0.002), smoking (HR = 12.893, p < 0.001), T stage (HR = 13.005, p = 0.006), N stage (N2 vs. N0, HR = 7.653, p = 0.004), STAS (HR = 7.463, p = 0.008), and consolidative CT morphology (HR = 6.779, p = 0.007) remained independent predictors for OS. Consolidative morphology, higher T and N stage, and presence of STAS revealed initial sharp peaks after steep decline of the hazard rate curves for recurrence or death in follow-up period. Conclusions Consolidative morphology, higher T and N stage, smoking, and STAS were indicators of significantly greater risk of early recurrence or death in patients with IMA. Thus, these findings could be incorporated into future surveillance strategies. Supplementary Information The online version contains supplementary material available at 10.1186/s13244-022-01208-5.
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Affiliation(s)
- Hyun Jung Yoon
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, South Korea.,Department of Radiology, Veterans Health Service Medical Center, Seoul, South Korea
| | - Jun Kang
- Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Ho Yun Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, South Korea. .,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, 06351, South Korea.
| | - Min A Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, South Korea
| | - Na Young Hwang
- Samsung Cancer Research Institute, Samsung Medical Center, Seoul, South Korea
| | - Hong Kwan Kim
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jhingook Kim
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Bong JB, Lee MA, Kang HG. Newly diagnosed multiple sclerosis in a patient with ocular myasthenia gravis: A case report. Medicine (Baltimore) 2022; 101:e28887. [PMID: 35212290 PMCID: PMC8878705 DOI: 10.1097/md.0000000000028887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/01/2022] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Patients with myasthenia gravis may also have comorbid autoimmune diseases. Since both myasthenia gravis and neuromyelitis optica spectrum disease are mediated by antibodies, they are likely to occur together. However, since multiple sclerosis is an autoimmune disease that is not mediated by a specific antibody, it has fewer immune mechanisms in common with myasthenia gravis than neuromyelitis optica spectrum disease. We encountered a case of newly developed multiple sclerosis in a patient with myasthenia gravis. PATIENT CONCERNS A 46-year-old man was diagnosed with ocular myasthenia gravis 6 years ago and had been taking pyridostigmine to control his symptoms. DIAGNOSIS The patient developed right optic neuritis, and multiple sclerosis was suspected based on the brain magnetic resonance imaging findings. However, the required diagnostic criteria were not met. INTERVENTIONS Disease-modifying therapy was not initiated, and clinical progression of the disease was monitored. OUTCOMES One year after the onset of optic neuritis, the patient developed myelitis and was diagnosed with multiple sclerosis, prompting treatment with disease-modifying therapy. LESSONS When optic neuritis occurs in patients with myasthenia gravis, careful evaluation is necessary while considering the possibility that it may be the first symptom of a demyelinating central nervous system disease. Therefore, it is important to conduct shorter-interval monitoring and symptom screening for patients with neurological autoimmune diseases, such as myasthenia gravis, even if multiple sclerosis is not initially suspected, to achieve early detection of multiple sclerosis.
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Affiliation(s)
- Jeong Bin Bong
- Department of Neurology, Chosun University College of Medicine, Gwangju, South Korea
| | - Min A. Lee
- Department of Neurology, Chosun University College of Medicine, Gwangju, South Korea
| | - Hyun Goo Kang
- Department of Neurology, Jeonbuk National University Medical School and Hospital, Jeonju, South Korea
- Biomedical Research Institute, Jeonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, South Korea
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Lee MA, Lee JB, Lee JN, Woo SG, Yu J, Kim HS. Comparative study of fluorination effect on the linear carbonate molecule for reversible cycling of lithium metal batteries. J Electroanal Chem (Lausanne) 2022. [DOI: 10.1016/j.jelechem.2021.115900] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Park Y, Lee GJ, Lee MA, Choi KK, Gwak J, Hyun SY, Jeon YB, Yoon YC, Lee J, Yu B. Major Causes of Preventable Death in Trauma Patients. J Trauma Inj 2021. [DOI: 10.20408/jti.2020.0074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose Trauma is the top cause of death in people under 45 years of age. Deaths from severe trauma can have a negative economic impact due to the loss of people belonging to socio-economically active age groups. Therefore, efforts to reduce the mortality rate of trauma patients are essential. The purpose of this study was to investigate preventable mortality in trauma patients and to identify factors and healthcare-related challenges affecting mortality. Ultimately, these findings will help to improve the quality of trauma care. Methods We analyzed the deaths of 411 severe trauma patients who presented to Gachon University Gil Hospital regional trauma center in South Korea from January 2015 to December 2017, using an expert panel review. Results The preventable death rate of trauma patients treated at the Gachon University Gil Hospital regional trauma center was 8.0%. Of these, definitely preventable deaths comprised 0.5% and potentially preventable deaths 7.5%. The leading cause of death in trauma patients was traumatic brain injury. Treatment errors most commonly occurred in the intensive care unit (ICU). The most frequent management error was delayed treatment of bleeding. Conclusions Most errors in the treatment of trauma patients occurred in early stages of the treatment process and in the ICU. By identifying the main causes of preventable death and errors during the course of treatment, our research will help to reduce the preventable death rate. Appropriate trauma care systems and ongoing education are also needed to reduce preventable deaths from trauma.
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Gao FF, Quan JH, Lee MA, Ye W, Yuk JM, Cha GH, Choi IW, Lee YH. Trichomonas vaginalis induces apoptosis via ROS and ER stress response through ER-mitochondria crosstalk in SiHa cells. Parasit Vectors 2021; 14:603. [PMID: 34895315 PMCID: PMC8665556 DOI: 10.1186/s13071-021-05098-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 11/16/2021] [Indexed: 12/20/2022] Open
Abstract
Background Trichomonas vaginalis causes lesions on the cervicovaginal mucosa in women; however, its pathogenesis remains unclear. We have investigated the involvement of the endoplasmic reticulum (ER) in the induction of apoptosis by T. vaginalis and its molecular mechanisms in human cervical cancer SiHa cells. Methods Apoptosis, reactive oxygen species (ROS) production, mitochondrial membrane potential (MMP), ER stress response and Bcl-2 family protein expression were evaluated using immunocytochemistry, flow cytometry, 5,5′,6,6′-tetrachloro-1,1′,3,3′-tetraethyl-imidacarbocyanine iodide dye staining and western blotting. Results Trichomonas vaginalis induced mitochondrial ROS production, apoptosis, the ER stress response and mitochondrial dysfunction, such as MMP depolarization and an imbalance in Bcl-2 family proteins, in SiHa cells in a parasite burden- and infection time-dependent manner. Pretreatment with N-acetyl cysteine (ROS scavenger) or 4-phenylbutyric acid (4-PBA; ER stress inhibitor) significantly alleviated apoptosis, mitochondrial ROS production, mitochondrial dysfunction and ER stress response in a dose-dependent manner. In addition, T. vaginalis induced the phosphorylation of apoptosis signal regulating kinase 1 (ASK1) and c-Jun N-terminal kinases (JNK) in SiHa cells, whereas 4-PBA or SP600125 (JNK inhibitor) pretreatment significantly attenuated ASK1/JNK phosphorylation, mitochondrial dysfunction, apoptosis and ER stress response in SiHa cells, in a dose-dependent manner. Furthermore, T. vaginalis excretory/secretory products also induced mitochondrial ROS production, apoptosis and the ER stress response in SiHa cells, in a time-dependent manner. Conclusions Trichomonas vaginalis induces apoptosis through mitochondrial ROS and ER stress responses, and also promotes ER stress-mediated mitochondrial apoptosis via the IRE1/ASK1/JNK/Bcl-2 family protein pathways in SiHa cells. These data suggest that T. vaginalis-induced apoptosis is affected by ROS and ER stress response via ER–mitochondria crosstalk. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-05098-2.
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Affiliation(s)
- Fei Fei Gao
- Brain Korea 21 FOUR Project for Medical Science, Chungnam National University College of Medicine, Daejeon, 35015, Korea.,Department of Medical Science and Department of Infection Biology, Chungnam National University College of Medicine, 6 Munhwa-dong, Jung-gu, Daejeon, 35015, Korea
| | - Juan-Hua Quan
- Department of Gastroenterology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, China
| | - Min A Lee
- Department of Obstetrics and Gynecology, Chungnam National University, DeaJeon, 35015, Korea
| | - Wei Ye
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, China
| | - Jae-Min Yuk
- Brain Korea 21 FOUR Project for Medical Science, Chungnam National University College of Medicine, Daejeon, 35015, Korea.,Department of Medical Science and Department of Infection Biology, Chungnam National University College of Medicine, 6 Munhwa-dong, Jung-gu, Daejeon, 35015, Korea
| | - Guang-Ho Cha
- Department of Medical Science and Department of Infection Biology, Chungnam National University College of Medicine, 6 Munhwa-dong, Jung-gu, Daejeon, 35015, Korea
| | - In-Wook Choi
- Department of Medical Science and Department of Infection Biology, Chungnam National University College of Medicine, 6 Munhwa-dong, Jung-gu, Daejeon, 35015, Korea
| | - Young-Ha Lee
- Brain Korea 21 FOUR Project for Medical Science, Chungnam National University College of Medicine, Daejeon, 35015, Korea. .,Department of Medical Science and Department of Infection Biology, Chungnam National University College of Medicine, 6 Munhwa-dong, Jung-gu, Daejeon, 35015, Korea.
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Yoshino T, Argilés G, Oki E, Martinelli E, Taniguchi H, Arnold D, Mishima S, Li Y, Smruti BK, Ahn JB, Faud I, Chee CE, Yeh KH, Lin PC, Chua C, Hasbullah HH, Lee MA, Sharma A, Sun Y, Curigliano G, Bando H, Lordick F, Yamanaka T, Tabernero J, Baba E, Cervantes A, Ohtsu A, Peters S, Ishioka C, Pentheroudakis G. Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis treatment and follow-up of patients with localised colon cancer. Ann Oncol 2021; 32:1496-1510. [PMID: 34411693 DOI: 10.1016/j.annonc.2021.08.1752] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/02/2021] [Accepted: 08/05/2021] [Indexed: 12/24/2022] Open
Abstract
The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of localised colon cancer was published in 2020. It was decided by both the ESMO and the Japanese Society of Medical Oncology (JSMO) to convene a special virtual guidelines meeting in March 2021 to adapt the ESMO 2020 guidelines to take into account the ethnic differences associated with the treatment of localised colon cancer in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with localised colon cancer representing the oncological societies of Japan (JSMO), China (CSCO), India (ISMPO), Korea (KSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence and was independent of the current treatment practices and drug availability and reimbursement situations in the different Asian countries.
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Affiliation(s)
- T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
| | - G Argilés
- Luis Diaz Laboratory, MSKCC, Sloan Kettering Institute, New York, USA
| | - E Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - E Martinelli
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - H Taniguchi
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - D Arnold
- Asklepios Tumorzentrum Hamburg, AK Altona, Hamburg, Germany
| | - S Mishima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Y Li
- Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - B K Smruti
- Department of Medical Oncology, Lilavati Hospital and Research Centre and Bombay Hospital, Mumbai, India
| | - J B Ahn
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Seoul, Korea
| | - I Faud
- Department of Radiotherapy & Oncology, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - C E Chee
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore
| | - K-H Yeh
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - P-C Lin
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - C Chua
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - H H Hasbullah
- Oncology Unit, Faculty of Medicine, UiTM Sg Buloh, Selangor, Malaysia
| | - M A Lee
- Division of Medical Oncology, Department of Internal Medicine, Cancer Research Institute, College of Medicine, St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - A Sharma
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Y Sun
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - G Curigliano
- Istituto Europeo di Oncologia, IRCCS and University of Milano, Milan, Italy
| | - H Bando
- Department of Clinical Oncology, Aichi Cancer Center, Nagoya, Japan
| | - F Lordick
- Department of Oncology, Gastroenterology, Hepatology, Pulmonology, and Infectious Diseases, University Cancer Center, Leipzig University Medical Center, Leipzig, Germany
| | - T Yamanaka
- Department of Biostatistics, Yokohama City University, Kanagawa, Japan
| | - J Tabernero
- Department of Medical Oncology, Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), UVic-UCC, IOB-Quiron, Barcelona, Spain
| | - E Baba
- Department of Oncology and Social Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - A Cervantes
- CIBERONC, Department of Medical Oncology, Institute of Health Research, INCLIVIA, University of Valencia, Valencia, Spain
| | - A Ohtsu
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - S Peters
- Oncology Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - C Ishioka
- Department of Clinical Oncology, Tohoku University School of Medicine, Sendai, Japan
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16
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Lee MA, Lee SH, Choi KK, Park Y, Lee GJ, Yu B. Management of Traumatic Pancreatic Injuries: Evaluation of 7 Years of Experience at a Single Regional Trauma Center. J Trauma Inj 2021. [DOI: 10.20408/jti.2021.0070] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose Traumatic pancreatic injuries are rare, but their diagnosis and management are challenging. The aim of this study was to evaluate and report our experiences with the management of pancreatic injuries. Methods We identified all adult patients (age >15) with pancreatic injuries from our trauma registry over a 7-year period. Data related to patients’ demographics, diagnoses, operative information, complications, and hospital course were abstracted from the registry and medical records. Results A total of 45 patients were evaluated. Most patients had blunt trauma (89%) and 21 patients (47%) had pancreatic injuries of grade 3 or higher. Twenty-eight patients (62%) underwent laparotomy and 17 (38%) received nonoperative management (NOM). The overall in-hospital mortality rate was 24% (n=11), and only one patient died after NOM (due to a severe traumatic brain injury). Twenty-two patients (79%) underwent emergency laparotomy and six (21%) underwent delayed laparotomy. A drainage procedure was performed in 12 patients (43%), and pancreatectomy was performed in 16 patients (57%) (distal pancreatectomy [DP], n=8; DP with spleen preservation, n=5; pancreaticoduodenectomy, n=2; total pancreatectomy, n=1). Fourteen (31%) pancreas-specific complications occurred, and all complications were successfully managed without surgery. Solid organ injuries (n=14) were the most common type of associated abdominal injury (Abbreviated Injury Scale ≥3). Conclusions For traumatic pancreatic injuries, an appropriate treatment method should be considered after evaluation of the accompanying injury and the patient’s hemodynamic status. NOM can be performed without mortality in appropriately selected cases.
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Ryoo SB, Park JW, Lee DW, Lee MA, Kwon YH, Kim MJ, Moon SH, Jeong SY, Park KJ. Anterior resection syndrome: a randomized clinical trial of a 5-HT3 receptor antagonist (ramosetron) in male patients with rectal cancer. Br J Surg 2021; 108:644-651. [PMID: 33982068 DOI: 10.1093/bjs/znab071] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 01/31/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND No effective treatment exists for anterior resection syndrome (ARS) following sphincter-saving surgery for rectal cancer. This RCT assessed the safety and efficacy of a 5-HT3 receptor antagonist, ramosetron, for ARS. METHODS A single-centre, randomized, controlled, open-label, parallel group trial was conducted. Male patients with ARS 1 month after rectal cancer surgery or ileostomy reversal were enrolled and randomly assigned (1 : 1) to 5 μg of ramosetron (Irribow®) daily or conservative treatment for 4 weeks. Low ARS (LARS) score was calculated after randomization and 4 weeks after treatment. The study was designed as a superiority test with a primary endpoint of the proportion of patients with major LARS between the groups. Primary outcome analysis was based on the modified intention-to-treat population. Safety was assessed by monitoring adverse events during the study. RESULTS : A total of 100 patients were randomized to the ramosetron (49 patients) or conservative treatment group (51 patients). Two patients were excluded, and 48 and 50 patients were analysed in the ramosetron and control groups, respectively. The proportion of major LARS after 4 weeks was 58 per cent (28 of 48 patients) in the ramosetron group versus 82 per cent (41 of 50 patients) in the control group, with a difference of 23.7 per cent (95 per cent c.i. 5.58 to 39.98, P = 0.011). There were minor adverse events in five patients, which were hard stool, frequent stool or anal pain. These were not different between the two groups. There were no serious adverse events. CONCLUSION : Ramosetron could be safe and feasible for male patients with ARS. TRIAL REGISTRATION NUMBER NCT02869984 (http://www.clinicaltrials.gov).
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Affiliation(s)
- S-B Ryoo
- Division of Colorectal Surgery, Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Colorectal Cancer Centre, Seoul National University Cancer Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - J W Park
- Division of Colorectal Surgery, Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Colorectal Cancer Centre, Seoul National University Cancer Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - D W Lee
- Centre for Colorectal Cancer, Research Institute and Hospital, National Cancer Centre, Goyang, Korea
| | - M A Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Colorectal Cancer Centre, Seoul National University Cancer Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Y-H Kwon
- Division of Colorectal Surgery, Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - M J Kim
- Division of Colorectal Surgery, Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Colorectal Cancer Centre, Seoul National University Cancer Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - S H Moon
- Division of Colorectal Surgery, Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Colorectal Cancer Centre, Seoul National University Cancer Hospital, Seoul, Korea
| | - S-Y Jeong
- Division of Colorectal Surgery, Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Colorectal Cancer Centre, Seoul National University Cancer Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - K J Park
- Division of Colorectal Surgery, Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Colorectal Cancer Centre, Seoul National University Cancer Hospital, Seoul, Korea
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18
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Yu B, Lee G, Lee MA, Choi K, Gwak J, Park Y, Yoon YC, Lee J. The Management of Open Pelvic Fractures: A Report of 2 Cases. J Trauma Inj 2020. [DOI: 10.20408/jti.2020.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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19
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Yu B, Lee GJ, Choi KK, Lee MA, Gwak J, Park Y, Lee JN. Case Series of Zone III Resuscitative Endovascular Balloon Occlusion of the Aorta in Traumatic Shock Patients. J Trauma Inj 2020. [DOI: 10.20408/jti.2020.0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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20
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Lee MA, Lee GJ. To Celebrate the Publication of a Special Topic for REBOA. J Trauma Inj 2020. [DOI: 10.20408/jti.2020.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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21
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Lee MA, Kang J, Lee HY, Kim W, Shon I, Hwang NY, Kim HK, Choi YS, Kim J, Zo JI, Shim YM. Spread through air spaces (STAS) in invasive mucinous adenocarcinoma of the lung: Incidence, prognostic impact, and prediction based on clinicoradiologic factors. Thorac Cancer 2020; 11:3145-3154. [PMID: 32975379 PMCID: PMC7606017 DOI: 10.1111/1759-7714.13632] [Citation(s) in RCA: 18] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/02/2020] [Accepted: 08/03/2020] [Indexed: 12/11/2022] Open
Abstract
Background Spread through air spaces (STAS) has recently been demonstrated to exhibit a negative impact on lung adenocarcinoma prognosis. However, most of these studies investigated STAS in nonmucinous adenocarcinoma. Here, we investigated the incidence of STAS in invasive mucinous adenocarcinoma (IMA) of the lung and evaluated whether tumor STAS was a risk factor of disease recurrence in IMA. We also examined clinicoradiologic factors in patients with IMA harboring STAS. Methods We reviewed pathologic specimens and imaging characteristics of primary tumors from 132 consecutive patients who underwent surgical resection for IMA to evaluate STAS. Patients with and without STAS were compared with respect to clinical characteristics as well as computed tomography (CT) imaging using logistic regression. The relationships between all variables including STAS and survival were analyzed. Results Among a total of 132 patients, full pathologic specimens were available for 119 patients, and STAS was observed in 86 (72.3%). IMA patients with STAS were significantly associated with older age, presence of lobulated and spiculated margins on CT scan (P = 0.009, P = 0.006, and P = 0.027). In multivariate analysis for overall survival (OS), STAS was a borderline independent poor prognostic predictor (P = 0.028). Older age, history of smoking, higher T stage, presence of lymph node metastasis, and consolidative morphologic type remained independent predictors for OS. Conclusions STAS was associated with reduced OS and was a borderline independent poor prognostic factor in IMA. IMA with STAS was associated with older age and presence of lobulated and spiculated margins on CT scan. Key points Significant findings of the study Compared with other subtypes, IMA shows a higher incidence of STAS, which is an independent poor prognostic predictor even in IMA. Lobulated and spiculated margins on CT are associated with STAS. What this study adds Considering that STAS can carry the potential for aerogenous metastasis, predicting STAS using preoperative surrogate CT imaging is desirable to avoid limited resection.
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Affiliation(s)
- Min A Lee
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jun Kang
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Ho Yun Lee
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Wooil Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Insuk Shon
- Samsung Cancer Research Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Na Young Hwang
- Samsung Cancer Research Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Hong Kwan Kim
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yong Soo Choi
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jhingook Kim
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jae Ill Zo
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Young Mog Shim
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Lee GJ, Lee MA, Yoo B, Park Y, Jang MJ, Choi KK. Immediate Post-laparotomy Hypotension in Patients with Severe Traumatic Hemoperitoneum. J Trauma Inj 2020. [DOI: 10.20408/jti.2020.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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23
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Choi KK, Jang MJ, Lee MA, Lee GJ, Yoo B, Park Y, Lee JN. The Suitability of the CdC field Triage for Korean Trauma Care. J Trauma Inj 2020. [DOI: 10.20408/jti.2020.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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24
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Yu B, Lee G, Lee MA, Choi K, Hyun S, Jeon Y, Yoon YC, Lee J. Trauma Volume and Performance of a regional Trauma Center in Korea: Initial 5-year analysis. J Trauma Inj 2020. [DOI: 10.20408/jti.2020.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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25
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Kim ST, Kang JH, Lee J, Lee HW, Oh SY, Jang JS, Lee MA, Sohn BS, Yoon SY, Choi HJ, Hong JH, Kim MJ, Kim S, Park YS, Park JO, Lim HY. Capecitabine plus oxaliplatin versus gemcitabine plus oxaliplatin as first-line therapy for advanced biliary tract cancers: a multicenter, open-label, randomized, phase III, noninferiority trial. Ann Oncol 2019; 30:788-795. [PMID: 30785198 DOI: 10.1093/annonc/mdz058] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Capecitabine plus oxaliplatin (XELOX) has shown modest activity and tolerable toxicity in a phase II trial for biliary tract cancers (BTCs). Meanwhile, gemcitabine plus oxaliplatin (GEMOX) has been the reference arm in recent phase II and III trials for BTCs. We aimed to investigate the efficacy of XELOX versus GEMOX as first-line therapy for advanced BCTs. PATIENTS AND METHODS In this open-label, randomized, phase III, noninferiority trial, we randomly selected patients with metastatic BCTs to receive GEMOX (gemcitabine 1000 mg/m2 on days 1 and 8, and oxaliplatin 100 mg/m2 on day 1) or XELOX (capecitabine 1000 mg/m2, twice daily, on days 1-14 and oxaliplatin 130 mg/m2 on day 1) as first-line treatment, given every 3 weeks, totaling eight cycles. The primary end point was to prove the noninferiority of XELOX to GEMOX in terms of 6-month progression-free survival (PFS) rate. RESULTS In total, 114 patients randomly received GEMOX and 108 randomly received XELOX. The median PFS was 5.3 months for the GEMOX group and 5.8 months for the XELOX group. The 6-month PFS rate was 44.5% for the GEMOX group and 46.7% for the XELOX group. The 95% confidence interval of the 6-month PFS rate difference between both groups was -12% to 16%, meeting the criteria for noninferiority of XELOX to GEMOX. There was no difference in objective response (P=0.171) and median overall survival (P=0.131) between both groups. The most common grade three to four adverse events were neutropenia and thrombocytopenia. No patient died of treatment-related causes. The XELOX group had significantly lower frequencies of hospital visits than the GEMOX group (P<0.001). CONCLUSION XELOX showed significant noninferiority to GEMOX in terms of 6-month PFS rate. Thus, XELOX could be an alternative first-line treatment of BCTs. TRIAL REGISTRATION This study was registered in ClinicalTrials.gov (number NCT01470443).
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Affiliation(s)
- S T Kim
- Division of Hemato-oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
| | - J H Kang
- Division of Hemato-oncology, Department of Medicine, Gyeongsang National University Hospital, Jinju
| | - J Lee
- Division of Hemato-oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
| | - H W Lee
- Division of Hemato-oncology, Department of Medicine, Ajou University School of Medicine, Suwon
| | - S Y Oh
- Division of Hemato-oncology, Department of Medicine, Dong-A University School of Medicine, Busan
| | - J S Jang
- Division of Hemato-oncology, Department of Medicine, Chung-Ang University College of Medicine, Seoul
| | - M A Lee
- Division of Hemato-oncology, Department of Medicine, Seoul St Mary's Hospital, Catholic University, Seoul
| | - B S Sohn
- Division of Hemato-oncology, Department of Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul
| | - S Y Yoon
- Division of Hemato-oncology, Department of Medicine, Konkuk University Medical Center, Seoul
| | - H J Choi
- Division of Hemato-oncology, Department of Medicine, Yonsei University College of Medicine, Seoul
| | - J H Hong
- Division of Hemato-oncology, Department of Medicine, Incheon St Mary's Hospital, Catholic University, Incheon
| | - M-J Kim
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, South Korea
| | - S Kim
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, South Korea
| | - Y S Park
- Division of Hemato-oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
| | - J O Park
- Division of Hemato-oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul.
| | - H Y Lim
- Division of Hemato-oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul.
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Park Y, Chung M, Lee MA. Traumatic lumbar hernia: clinical features and management. Ann Surg Treat Res 2018; 95:340-344. [PMID: 30505826 PMCID: PMC6255748 DOI: 10.4174/astr.2018.95.6.340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 05/28/2018] [Accepted: 06/08/2018] [Indexed: 02/08/2023] Open
Abstract
Purpose Traumatic lumbar hernia is rare, thus making diagnosis and proper treatment challenging. Accordingly, we aimed to investigate the clinical manifestations and proper management strategies of traumatic lumbar hernias. Methods The medical records of patients with traumatic lumbar hernia treated at Gachon University Gil Hospital from March 2006 to February 2015, were retrospectively reviewed. Results We included 5 men and 4 women (mean age, 55 years; range, 23–71 years). In 8 patients, most injuries were caused by motor vehicle collisions, including those wherein a pedestrian was struck (5 cases of car accidents, 2 falls, and 1 involving penetrating materials); in 1 patient, the probable cause was severe cough. Eight patients underwent hernia repair surgery (5 open and 3 laparoscopic), and a prosthetic mesh was used in 7 patients. Hernia repairs were elective in 7 patients; emergency hernia repair was performed with right hemicolectomy in 1 patient. No severe complication or recurrence was observed. Only 2 patients had mild complications, such as postoperative seroma. Conclusion Traumatic lumbar hernia is a relatively rare injury of the posteriolateral abdominal wall. Lumbar hernia should be suspected in patients with high-energy injuries of the torso, and all such patients should undergo abdominopelvic computed tomography. After diagnosis, hernia repair can be electively performed without complications in most cases.
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Affiliation(s)
- Youngeun Park
- Department of Trauma, Gachon University Gil Medical Center, Incheon, Korea
| | - Min Chung
- Department of Trauma, Gachon University Gil Medical Center, Incheon, Korea
| | - Min A Lee
- Department of Trauma, Gachon University Gil Medical Center, Incheon, Korea
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Lee MA, Yu B, Lee J, Choi KK, Park JJ, Park Y, Han A, Gwak J, Lee GJ. Comparison of outcomes before and after establishing a regional trauma center and following a protocol to treat blunt splenic injury in South Korea: A retrospective study. HONG KONG J EMERG ME 2018. [DOI: 10.1177/1024907918773202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Nonoperative management for hemodynamically stable splenic injury has been accepted as appropriate treatment. Objectives: This study aimed to investigate the changes in management and clinical outcomes of splenic injury by introducing a protocol for splenic injury at a newly established regional trauma center. Methods: From January 2005 to December 2016, we reviewed the outcomes of all 257 patients who sustained blunt trauma to the spleen at the first regional trauma center in South Korea. This 11-year period was divided into two intervals, before 1 January 2014 (period I, n = 189 patients) and after 1 January 2014 (period II, n = 68 patients), when the trauma center was established and a formal management protocol was followed for patients with blunt traumatic splenic injuries. Results: The proportion of emergency operations performed for patients with more serious (grades 3–5) splenic injuries was lower in period II than in period I (29% vs 22%, respectively, p < 0.001) whereas the rate of angioembolization was higher (89% vs 39.0%, respectively, p < 0.001). The time to intervention, irrespective of whether emergency operation or angioembolization was performed, was shorter in period II than in period I (312.8 min vs 129 min, respectively, p = 0.001). A greater proportion of patients was managed non-operatively in period II (78% vs 71%), and the non-operative management success rate was higher in period II than it was in period I (100% vs 83%; p = 0.014). Similarly, the splenic salvage rate was higher in period II (78% vs 59%, p = 0.03). Conclusion: After establishing a regional trauma center and introducing a protocol for the management of blunt splenic injuries, the rates of non-operative management and splenic salvage improved significantly. The reasons for this may be multifactorial, being related to the early involvement of a trauma surgeon, expansion of angiographic facilities and resources, and the introduction and application of a protocol for managing blunt splenic injury.
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Affiliation(s)
- Min A Lee
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, South Korea
| | - Byungchul Yu
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, South Korea
| | - Jungnam Lee
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, South Korea
| | - Kang Kook Choi
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, South Korea
| | - Jae Jeong Park
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, South Korea
| | - Youngeun Park
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, South Korea
| | - Ahram Han
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, South Korea
| | - Jihun Gwak
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, South Korea
| | - Gil Jae Lee
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, South Korea
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Peck KR, Kim TJ, Lee MA, Lee KS, Han J. Pneumonia in immunocompromised patients: updates in clinical and imaging features. Precis Future Med 2018. [DOI: 10.23838/pfm.2018.00121] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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Lee MA, Kim TJ, Han J, Lee KS. Pulmonary sclerosing pneumocytoma with multiple satellite nodules mimicking tuberculosis. Precis Future Med 2018. [DOI: 10.23838/pfm.2018.00051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Lee MA, Yu B, Lee J, Park JJ, Lee GJ, Choi KK, Park Y, Gwak J, Han A. Effects of the establishment of a trauma center and a new protocol on patients with hemodynamically unstable pelvic fractures at a single institution in Korea. Eur J Trauma Emerg Surg 2018; 45:273-279. [PMID: 29344707 DOI: 10.1007/s00068-017-0899-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 12/27/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of this study was to determine whether the outcomes of patients with hemodynamically unstable pelvic bone fractures changed after the introduction of a protocol including extraperitoneal pelvic packing (EPP) and the establishment of a trauma center. METHODS We analyzed data of adult patients (≥ 18 years old) with hemodynamically unstable pelvic bone fractures who visited a single trauma center from February 2009 to October 2016. In July 2014, a new protocol for pelvic fractures was implemented, and a trauma center was established. Therefore, patient outcomes were compared by period (period I: pre-protocol vs. period II: post-protocol). RESULTS Seventy-nine patients with hemodynamically unstable pelvic bone fractures were recruited. The time to angiographic embolization after arrival at the emergency room decreased significantly in period II when compared to period I (182.9 vs. 268.9 min, respectively, p < 0.001). The time required to intervention, including EPP, also decreased, from 268.9 ± 132.4 min in period I to 141.9 ± 79.9 min in period II (p < 0.001). The overall mortality rate decreased from 47.2% in period I to 23.3% in period II (p = 0.033), and mortality related to hemorrhagic shock in particular, was significantly lowered, from 27.8% in period I to 4.7% in period II (p = 0.009). CONCLUSIONS The establishment of a trauma center and the implementation of a new protocol that included EPP were effective in the treatment of patients with hemodynamically unstable pelvic fractures.
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Affiliation(s)
- Min A Lee
- Department of Trauma Surgery, Gachon University Gil Medical Center, 21, Namdong-daero, 774 Beon-gil, Namdong-gu, Incheon, 21565, South Korea
| | - Byungchul Yu
- Department of Trauma Surgery, Gachon University Gil Medical Center, 21, Namdong-daero, 774 Beon-gil, Namdong-gu, Incheon, 21565, South Korea.
| | - Jungnam Lee
- Department of Trauma Surgery, Gachon University Gil Medical Center, 21, Namdong-daero, 774 Beon-gil, Namdong-gu, Incheon, 21565, South Korea
| | - Jae Jeong Park
- Department of Trauma Surgery, Gachon University Gil Medical Center, 21, Namdong-daero, 774 Beon-gil, Namdong-gu, Incheon, 21565, South Korea
| | - Gil Jae Lee
- Department of Trauma Surgery, Gachon University Gil Medical Center, 21, Namdong-daero, 774 Beon-gil, Namdong-gu, Incheon, 21565, South Korea
| | - Kang Kook Choi
- Department of Trauma Surgery, Gachon University Gil Medical Center, 21, Namdong-daero, 774 Beon-gil, Namdong-gu, Incheon, 21565, South Korea
| | - Youngeun Park
- Department of Trauma Surgery, Gachon University Gil Medical Center, 21, Namdong-daero, 774 Beon-gil, Namdong-gu, Incheon, 21565, South Korea
| | - Jihun Gwak
- Department of Trauma Surgery, Gachon University Gil Medical Center, 21, Namdong-daero, 774 Beon-gil, Namdong-gu, Incheon, 21565, South Korea
| | - Ahram Han
- Department of Trauma Surgery, Gachon University Gil Medical Center, 21, Namdong-daero, 774 Beon-gil, Namdong-gu, Incheon, 21565, South Korea
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Lim TK, Yu BC, Ma DS, Lee GJ, Lee MA, Hyun SY, Ph.D, Jeon YB, Ph.D, Choi KK. Correlation between Optic Nerve Sheath Diameter Measured by Computed Tomography and Elevated Intracranial Pressure in Patients with Traumatic Brain Injury. Journal of Trauma and Injury 2017. [DOI: 10.20408/jti.2017.30.4.140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Tae Kyoo Lim
- Department of Traumatology, Gachon University Gil Medical Center, Incheon, Korea
| | - Byug Chul Yu
- Department of Traumatology, Gachon University Gil Medical Center, Incheon, Korea
| | - Dae Sung Ma
- Department of Traumatology, Gachon University Gil Medical Center, Incheon, Korea
| | - Gil Jae Lee
- Department of Traumatology, Gachon University Gil Medical Center, Incheon, Korea
| | - Min A Lee
- Department of Traumatology, Gachon University Gil Medical Center, Incheon, Korea
| | - Sung Yeol Hyun
- Department of Traumatology, Gachon University Gil Medical Center, Incheon, Korea
| | - Ph.D
- Department of Traumatology, Gachon University Gil Medical Center, Incheon, Korea
| | - Yang Bin Jeon
- Department of Traumatology, Gachon University Gil Medical Center, Incheon, Korea
| | - Ph.D
- Department of Traumatology, Gachon University Gil Medical Center, Incheon, Korea
| | - Kang Kook Choi
- Department of Traumatology, Gachon University Gil Medical Center, Incheon, Korea
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Han A, Lee MA, Park Y, Kang JM, Kim JH, Lee J. Type B Aortic Dissection with Visceral Artery Involvement Following Blunt Trauma: A Case Report. Journal of Trauma and Injury 2017. [DOI: 10.20408/jti.2017.30.4.206] [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: 11/05/2022] Open
Affiliation(s)
- Ahram Han
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Min A Lee
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Youngeun Park
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Jin Mo Kang
- Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Jung Ho Kim
- Radiology, Gachon University Gil Medical Center, Incheon, Korea
| | - Jungnam Lee
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
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Affiliation(s)
- Min A Lee
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Myung Jin Jang
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Gil Jae Lee
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
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Lee MA, Choi KK, Yu B, Park JJ, Park Y, Gwak J, Lee J, Jeon YB, Ma DS, Lee GJ. Acute Physiology and Chronic Health Evaluation II Score and Sequential Organ Failure Assessment Score as Predictors for Severe Trauma Patients in the Intensive Care Unit. Korean J Crit Care Med 2017; 32:340-346. [PMID: 31723655 PMCID: PMC6786684 DOI: 10.4266/kjccm.2017.00255] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/01/2017] [Accepted: 06/02/2017] [Indexed: 11/30/2022] Open
Abstract
Background The Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system and the Sequential Organ Failure Assessment (SOFA) scoring system are widely used for critically ill patients. We evaluated whether APACHE II score and SOFA score predict the outcome for trauma patients in the intensive care unit (ICU). Methods We retrospectively analyzed trauma patients admitted to the ICU in a single trauma center between January 2014 and December 2015. The APACHE II score was figured out based on the data acquired from the first 24 hours of admission; the SOFA score was evaluated based on the first 3 days in the ICU. A total of 241 patients were available for analysis. Injury Severity score, APACHE II score, and SOFA score were evaluated. Results The overall survival rate was 83.4%. The non-survival group had a significantly high APACHE II score (24.1 ± 8.1 vs. 12.3 ± 7.2, P < 0.001) and SOFA score (7.7 ± 1.7 vs. 4.3 ± 1.9, P < 0.001) at admission. SOFA score had the highest areas under the curve (0.904). During the first 3 days, SOFA score remained high in the non-survival group. In the non-survival group, cardiovascular system, neurological system, renal system, and coagulation system scores were significantly higher. Conclusions In ICU trauma patients, both SOFA and APACHE II scores were good predictors of outcome, with the SOFA score being the most effective. In trauma ICU patients, the trauma scoring system should be complemented, recognizing that multi-organ failure is an important factor for mortality.
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Affiliation(s)
- Min A Lee
- Department of Trauma, Gachon University Gil Medical Center, Incheon, Korea
| | - Kang Kook Choi
- Department of Trauma, Gachon University Gil Medical Center, Incheon, Korea
| | - Byungchul Yu
- Department of Trauma, Gachon University Gil Medical Center, Incheon, Korea
| | - Jae Jeong Park
- Department of Trauma, Gachon University Gil Medical Center, Incheon, Korea
| | - Youngeun Park
- Department of Trauma, Gachon University Gil Medical Center, Incheon, Korea
| | - Jihun Gwak
- Department of Trauma, Gachon University Gil Medical Center, Incheon, Korea
| | - Jungnam Lee
- Department of Trauma, Gachon University Gil Medical Center, Incheon, Korea
| | - Yang Bin Jeon
- Department of Trauma, Gachon University Gil Medical Center, Incheon, Korea
| | - Dae Sung Ma
- Department of Trauma, Gachon University Gil Medical Center, Incheon, Korea
| | - Gil Jae Lee
- Department of Trauma, Gachon University Gil Medical Center, Incheon, Korea
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Na JW, Lee JN, Yu BC, Lee MA, Park JJ, Lee GJ. Treatment Option for High Grade Spleen Injury and Predictive Factors for Non-operative Management. Journal of Trauma and Injury 2017. [DOI: 10.20408/jti.2017.30.3.91] [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: 11/05/2022] Open
Affiliation(s)
- Joung Won Na
- Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Jung Nam Lee
- Gachon University Gil Hospital Trauma Center, Incheon, Korea
| | - Byung Chul Yu
- Gachon University Gil Hospital Trauma Center, Incheon, Korea
| | - Min A Lee
- Gachon University Gil Hospital Trauma Center, Incheon, Korea
| | - Jae Jung Park
- Gachon University Gil Hospital Trauma Center, Incheon, Korea
| | - Gil Jae Lee
- Gachon University Gil Hospital Trauma Center, Incheon, Korea
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Lee MA, Kwon H. ISQUA17-1734EFFECTIVENESS OF AN EDUCATION OF POINT-OF-CARE ULTRASOUND GUIDELINE IN AN EMERGENCY DEPARTMENT. Int J Qual Health Care 2017. [DOI: 10.1093/intqhc/mzx125.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ryu MY, Lee MA, Ahn YH, Kim KS, Yoon SH, Snyder EY, Cho KG, Kim SU. Brain Transplantation of Neural Stem Cells Cotransduced with Tyrosine Hydroxylase and GTP Cyclohydrolase 1 in Parkinsonian Rats. Cell Transplant 2017; 14:193-202. [PMID: 15929554 DOI: 10.3727/000000005783983133] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Neural stem cells (NSCs) of the central nervous system (CNS) recently have attracted a great deal of interest not only because of their importance in basic research on neural development, but also in terms of their therapeutic potential in neurological diseases, such as Parkinson's disease (PD). To examine if genetically modified NSCs are a suitable source for the cell and gene therapy of PD, an immortalized mouse NSC line, C17.2, was transduced with tyrosine hydroxylase (TH) gene and with GTP cyclohydrolase 1 (GTPCH1) gene, which are important enzymes in dopamine biosynthesis. The expression of TH in transduced C17.2-THGC cells was confirmed by RT-PCR, Western blot analysis, and immunocytochemistry, and expression of GTPCH1 by RT-PCR. The level of L-DOPA released by C17.2-THGC cells, as determined by HPLC assay, was 3793 pmol/106 cells, which is 760-fold higher than that produced by C17.2-TH cells, indicating that GTPCH1 expression is important for L-DOPA production by transduced C17.2 cells. Following the implantation of C17.2-THGcC NSCs into the striata of parkinsonian rats, a marked improvement in amphetamine-induced turning behavior was observed in parkinsonian rats grafted with C17.2-THGC cells but not in the control rats grafted with C17.2 cells. These results indicate that genetically modified NSCs grafted into the brain of the parkinsonian rats are capable of survival, migration, and neuronal differentiation. Collectively, these results suggest that NSCs have great potential as a source of cells for cell therapy and an effective vehicle for therapeutic gene transfer in Parkinson's disease.
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Affiliation(s)
- M Y Ryu
- Department of Neurosurgery, Ajou University School of Medicine, Suwon, Korea
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Lee MA, Lee J, Chung M, Lee G, Park J, Choi K, Yoo BC. The Impact of Trauma Center Establishment on Laparotomy Patterns and Outcomes in Severe Hemoperitoneum Patients. Journal of Trauma and Injury 2017. [DOI: 10.20408/jti.2017.30.1.6] [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: 11/05/2022] Open
Affiliation(s)
- Min A Lee
- Department of Surgery, Gil Medical Center, Gachon University, Incheon, Korea
| | - Jungnam Lee
- Department of Surgery, Gil Medical Center, Gachon University, Incheon, Korea
| | - Min Chung
- Department of Surgery, Gil Medical Center, Gachon University, Incheon, Korea
| | - Giljae Lee
- Department of Surgery, Gil Medical Center, Gachon University, Incheon, Korea
| | - Jaejeong Park
- Department of Surgery, Gil Medical Center, Gachon University, Incheon, Korea
| | - Kangkook Choi
- Department of Surgery, Gil Medical Center, Gachon University, Incheon, Korea
| | - Byung Chul Yoo
- Department of Surgery, Gil Medical Center, Gachon University, Incheon, Korea
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Gwak J, Yoon YC, Lee MA, Yu B, Jang MJ, Choi KK. Blush on Computed Tomography and Transcatheter Arterial Embolization in Pelvic Fracture. Journal of Trauma and Injury 2016. [DOI: 10.20408/jti.2016.29.4.161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Jihun Gwak
- Department of Trauma Surgery, Gachon University, Gil Medical Center, Incheon, Korea
| | - Yong-Cheol Yoon
- Department of Trauma Surgery, Gachon University, Gil Medical Center, Incheon, Korea
| | - Min A Lee
- Department of Trauma Surgery, Gachon University, Gil Medical Center, Incheon, Korea
| | - Byungchul Yu
- Department of Trauma Surgery, Gachon University, Gil Medical Center, Incheon, Korea
| | - Myung Jin Jang
- Department of Trauma Surgery, Gachon University, Gil Medical Center, Incheon, Korea
| | - Kang Kook Choi
- Department of Trauma Surgery, Gachon University, Gil Medical Center, Incheon, Korea
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Park Y, Chung M, Lee GJ, Lee MA, Park JJ, Choi KK, Hyun SY, Jeon YB, Ma DS, Yoon YC, Lee J, Yoo B. Characteristics of Korean Trauma Patients: A Single-center Analysis Using the Korea Trauma Database. Journal of Trauma and Injury 2016. [DOI: 10.20408/jti.2016.29.4.155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Youngeun Park
- Department of Trauma Surgery, Gachon University, Gil Medical Center, Incheon, Korea
| | - Min Chung
- Department of Trauma Surgery, Gachon University, Gil Medical Center, Incheon, Korea
| | - Gil Jae Lee
- Department of Trauma Surgery, Gachon University, Gil Medical Center, Incheon, Korea
| | - Min A Lee
- Department of Trauma Surgery, Gachon University, Gil Medical Center, Incheon, Korea
| | - Jae Jeong Park
- Department of Trauma Surgery, Gachon University, Gil Medical Center, Incheon, Korea
| | - Kang Kook Choi
- Department of Trauma Surgery, Gachon University, Gil Medical Center, Incheon, Korea
| | - Sung Youl Hyun
- Department of Trauma Surgery, Gachon University, Gil Medical Center, Incheon, Korea
| | - Yang Bin Jeon
- Department of Trauma Surgery, Gachon University, Gil Medical Center, Incheon, Korea
| | - Dae Sung Ma
- Department of Trauma Surgery, Gachon University, Gil Medical Center, Incheon, Korea
| | - Yong-Cheol Yoon
- Department of Trauma Surgery, Gachon University, Gil Medical Center, Incheon, Korea
| | - Jungnam Lee
- Department of Trauma Surgery, Gachon University, Gil Medical Center, Incheon, Korea
| | - Byungchul Yoo
- Department of Trauma Surgery, Gachon University, Gil Medical Center, Incheon, Korea
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Gwak J, Lee MA, Ma DS, Choi KK. Enteroatmospheric Fistula Associated with Open Abdomen. Journal of Trauma and Injury 2016. [DOI: 10.20408/jti.2016.29.4.195] [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: 11/05/2022] Open
Affiliation(s)
- Jihun Gwak
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Min A Lee
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Dae Sung Ma
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Kang Kook Choi
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
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Affiliation(s)
- Jihun Gwak
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Min A Lee
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Byungchul Yu
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Kang Kook Choi
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
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Lee MA, Cullen NG, Newman SAN, Dodds KG, McEwan JC, Shackell GH. Genetic analysis and genomic selection of stayability and productive life in New Zealand ewes. J Anim Sci 2016; 93:3268-77. [PMID: 26439995 DOI: 10.2527/jas.2014-8259] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Genetic parameters for ewes were estimated for stayability (STAY) and productive life (Prodlife). Records from 658,871 animals from 241 seed stock or ram breeder flocks and one research flock were used to estimate parameters for ram breeder flock STAY and Prodlife. These flocks would have a culling policy based on criteria typical of a commercial enterprise, but including culls based on knowledge such as estimated breeding values. A subset of 35,688 of these animals from 4 ram breeder and one research flock was used to infer the animals that might be culled based on the perspective of a commercial flock as these flocks recorded reasons for culling. These data were used to estimate parameters for commercial flock STAY and Prodlife. Heritability for ram breeder flock STAY until age 3 to 6 yr ranged from 0.07 to 0.09. The heritability of commercial flock STAY was similar in yr 5 and 6, but lower at 0.05 (age 3) and 0.07 (age 4). Heritability of Prodlife for ram breeder flock and commercial flock was respectively 0.10 and 0.13. The genetic correlations between ram breeder flock STAY and commercial flock STAY ranged from 0.20 to 0.99. Both STAY and Prodlife were most correlated genetically with the trait number of lambs born, at about 0.4, and to a lesser degree, live weight up to the age of 12 mo for the traits analyzed with lower genetic correlations estimated for the commercial flocks. Live weight at 18 mo and fleece weight had little or no correlation with STAY and Prodlife. From the data set used to estimate genetic parameters from a ram breeder flock, 4,330 animals were genotyped with the Illumina OvineSNP50 BeadChip and the genotypes used to develop genomic predictions via genomic best linear unbiased prediction. The animals used in the training data set were multibreed, but were heavily Romney breed based. The genomic prediction accuracy for ram breeder flock STAY, according to breed, was dependent on sample size and ranged from 0.4 to 0.44 for Romney and 0.26 to 0.4 for Coopworth. Accuracies for Perendale and Composites, for which sample sizes were less, were more variable. This study has derived genetic parameters for STAY and Prodlife and investigated genomic predictions for these traits. As these traits are of low heritability, sex limited and expressed late in life genomic selection will be useful.
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Lee MA, Choi KK, Lee GJ, Yu BC, Ma DS, Jeon YB, Lee JN, Chung M. Right Diaphragmatic Injury Accompanied by Herniation of the Liver: A Case Report. Journal of Trauma and Injury 2016. [DOI: 10.20408/jti.2016.29.2.43] [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: 11/05/2022] Open
Affiliation(s)
- Min A Lee
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Kang Kook Choi
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Gil Jae Lee
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Byung Chul Yu
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Dae Sung Ma
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Yang Bin Jeon
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Jung Nam Lee
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Min Chung
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
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Lee MA, Shin KM, Lim JK, Cho SH, Kim HJ, Kim GC, Lee SM, Yoo SS. Nodular tracheobronchitis in a patient with lymphoma: an unusual presentation of viridans streptococcal respiratory tract infection. Clin Respir J 2016; 12:327-330. [PMID: 27149343 DOI: 10.1111/crj.12496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 04/04/2016] [Accepted: 04/19/2016] [Indexed: 11/29/2022]
Abstract
Bacterial tracheobronchitis without lung parenchymal involvement is extremely rare in adults, except in patients who are intubated or mechanically ventilated. We present a case of nodular tracheobronchitis caused by viridans streptococci in a non-ventilated lymphoma patient. To our knowledge, this is the first report of viridans streptococcal infection that has caused nodular tracheobronchitis.
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Affiliation(s)
- Min A Lee
- Department of Radiology, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Kyung Min Shin
- Department of Radiology, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Jae-Kwang Lim
- Department of Radiology, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Seung Hyun Cho
- Department of Radiology, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Hye Jung Kim
- Department of Radiology, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Gab Chul Kim
- Department of Radiology, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - So Mi Lee
- Department of Radiology, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Seung Soo Yoo
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
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Kang YE, Kim JM, Joung KH, Lee JH, You BR, Choi MJ, Ryu MJ, Ko YB, Lee MA, Lee J, Ku BJ, Shong M, Lee KH, Kim HJ. The Roles of Adipokines, Proinflammatory Cytokines, and Adipose Tissue Macrophages in Obesity-Associated Insulin Resistance in Modest Obesity and Early Metabolic Dysfunction. PLoS One 2016; 11:e0154003. [PMID: 27101398 PMCID: PMC4839620 DOI: 10.1371/journal.pone.0154003] [Citation(s) in RCA: 176] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 03/22/2016] [Indexed: 12/15/2022] Open
Abstract
The roles of adipokines, proinflammatory cytokines, and adipose tissue macrophages in obesity-associated insulin resistance have been explored in both animal and human studies. However, our current understanding of obesity-associated insulin resistance relies on studies of artificial metabolic extremes. The purpose of this study was to explore the roles of adipokines, proinflammatory cytokines, and adipose tissue macrophages in human patients with modest obesity and early metabolic dysfunction. We obtained omental adipose tissue and fasting blood samples from 51 females undergoing gynecologic surgery. We investigated serum concentrations of proinflammatory cytokines and adipokines as well as the mRNA expression of proinflammatory and macrophage phenotype markers in visceral adipose tissue using ELISA and quantitative RT-PCR. We measured adipose tissue inflammation and macrophage infiltration using immunohistochemical analysis. Serum levels of adiponectin and leptin were significantly correlated with HOMA-IR and body mass index. The levels of expression of MCP-1 and TNF-α in visceral adipose tissue were also higher in the obese group (body mass index ≥ 25). The expression of mRNA MCP-1 in visceral adipose tissue was positively correlated with body mass index (r = 0.428, p = 0.037) but not with HOMA-IR, whereas TNF-α in visceral adipose tissue was correlated with HOMA-IR (r = 0.462, p = 0.035) but not with body mass index. There was no obvious change in macrophage phenotype or macrophage infiltration in patients with modest obesity or early metabolic dysfunction. Expression of mRNA CD163/CD68 was significantly related to mitochondrial-associated genes and serum inflammatory cytokine levels of resistin and leptin. These results suggest that changes in the production of inflammatory biomolecules precede increased immune cell infiltration and induction of a macrophage phenotype switch in visceral adipose tissue. Furthermore, serum resistin and leptin have specific roles in the regulation of adipose tissue macrophages in patients with modest obesity or early metabolic dysfunction.
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Affiliation(s)
- Yea Eun Kang
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Ji Min Kim
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Kyong Hye Joung
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Ju Hee Lee
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Bo Ram You
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Min Jeong Choi
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Min Jeong Ryu
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Young Bok Ko
- Department of Obstetrics and Gynecology, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Min A. Lee
- Department of Obstetrics and Gynecology, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Junguee Lee
- Department of Pathology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Bon Jeong Ku
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
- Department of internal medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Minho Shong
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
- Department of internal medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Ki Hwan Lee
- Department of Obstetrics and Gynecology, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hyun Jin Kim
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
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Lee MA, Choi KK, Lee GJ, Yu BC, Ma DS, Jeon YB, Chung M, Lee JN. A Blunt Traumatic Vertebral Artery Injury: A Case Report. Journal of Trauma and Injury 2016. [DOI: 10.20408/jti.2016.29.1.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Min A Lee
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Kang Kook Choi
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Gil Jae Lee
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Byung Chul Yu
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Dae Sung Ma
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Yang Bin Jeon
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Min Chung
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Jung Nam Lee
- Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea
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Ko YB, Kim BR, Yoon K, Choi EK, Seo SH, Lee Y, Lee MA, Yang JB, Park MS, Rho SB. WIF1 can effectively co-regulate pro-apoptotic activity through the combination with DKK1. Cell Signal 2014; 26:2562-72. [PMID: 25086206 DOI: 10.1016/j.cellsig.2014.07.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 06/26/2014] [Accepted: 07/21/2014] [Indexed: 12/21/2022]
Abstract
Wnt inhibitory factor-1 (WIF1) is a conserved lipid-binding protein that interrupts Wnt ligands by interacting with their Frizzled receptors. Thus, they may suppress the activation of the Wnt/β-catenin triggered signaling cascade. Recently, we found that WIF1 can effectively co-regulate pro-apoptotic activity through the combination with Dickkopf-1 (DKK1). The tumor suppressor p53 protein expression was remarkably increased in the WIF1- and DKK1-transfected cells, along with p21. In contrast, expressions of the anti-apoptotic proteins, c-Myc and Bcl-2, were noticeably reduced. In addition, WIF1 and/or DKK1 significantly activated the transcription of p21 and p53, whereas c-Myc and Bcl-2 activities were remarkably reduced. The tumor suppressor WIF1 was also found to be capable of suppressing tumor growth through the inhibition of tumor angiogenesis in the cellular biological/physiological condition through the targeting of the PI3K/Akt/mTOR signaling pathway, while also being recognized as a Wnt antagonist factor in the Wnt cascade. Consistently, WIF1 conspicuously decreased the VEGF-induced phosphorylation of the PI3K/Akt signaling cascade components, including PDK1, mTOR, TSC-2, GSK-3β, and the p70S6K protein. Collectively, our results indicate for the first time that the tumor suppressor WIF1 is involved in angiogenesis and supplies a possible molecular target for the treatment of distinct malignant cancers, as well as several other associated diseases.
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Affiliation(s)
- Young Bok Ko
- Department of Obstetrics and Gynecology, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon 301-721, Republic of Korea
| | - Boh-Ram Kim
- Research Institute, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of Korea
| | - Kyungsil Yoon
- Research Institute, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of Korea
| | - Eun Kyung Choi
- Research Institute, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of Korea
| | - Seung Hee Seo
- Research Institute, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of Korea
| | - Yeonah Lee
- Department of Obstetrics and Gynecology, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon 301-721, Republic of Korea
| | - Min A Lee
- Department of Obstetrics and Gynecology, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon 301-721, Republic of Korea
| | - Jung Bo Yang
- Department of Obstetrics and Gynecology, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon 301-721, Republic of Korea
| | - Mi Sun Park
- Department of Obstetrics and Gynecology, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon 301-721, Republic of Korea
| | - Seung Bae Rho
- Research Institute, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of Korea.
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Zhao L, Kang I, Fang X, Wang W, Lee MA, Hollins RR, Marshall MR, Chung S. Gamma-tocotrienol attenuates high-fat diet-induced obesity and insulin resistance by inhibiting adipose inflammation and M1 macrophage recruitment. Int J Obes (Lond) 2014; 39:438-46. [PMID: 25042861 DOI: 10.1038/ijo.2014.124] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 06/27/2014] [Accepted: 07/13/2014] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND OBJECTIVE We have previously demonstrated that gamma tocotrienol (γT3) potently inhibits adipocyte hyperplasia in human adipose-derived stem cells (hASCs). In this study, our objective was to investigate the γT3 effects on early-onset obesity, inflammation and insulin resistance in vivo. METHODS Young C57BL/6J mice were fed a high-fat (HF) diet supplemented with 0.05% γT3 for 4 weeks. The concentrations of γT3 in plasma and adipose tissue were measured using high-performance liquid chromatography. Effects of γT3 on body weight gain, adipose volume, plasma levels of fasting glucose, insulin (enzyme-linked immunosorbent assay (ELISA)), proinflammatory cytokines (mouse cytokine array), insulin signaling (western blotting) and gene expression (quantitative real-time PCR, qPCR) in the liver and adipose tissue were examined. Influences of γT3 on [3H]-2-deoxyglucose uptake and lipopolysaccharide (LPS)-mediated NFκB signaling (western blotting) were assessed in hASCs. Effects of γT3 on macrophage M1/M2 activation were investigated using qPCR in mouse bone marrow-derived macrophages. RESULTS After a 4-week treatment, γT3 accumulated in adipose tissue and reduced HF diet-induced weight gain in epididymal fat, mesenteric fat and the liver. Compared with HF diet-fed mice, HF+γT3-fed mice were associated with (1) decreased plasma levels of fasting glucose, insulin and proinflammatory cytokines, (2) improved glucose tolerance and (3) enhanced insulin signaling in adipose tissue. There were substantial decreases in macrophage specific markers, and monocyte chemoattractant protein-1, indicating that γT3 reduced the recruitment of adipose tissue macrophages (ATMs). In addition, γT3 treatment in human adipocytes resulted in (1) activation of insulin-stimulated glucose uptake and (2) a significant suppression of MAP kinase and NFκB activation. In parallel, γT3 treatment led to a reduction of LPS-mediated M1 macrophage polarization. CONCLUSION Our results demonstrated that γT3 ameliorates HF diet-mediated obesity and insulin resistance by inhibiting systemic and adipose inflammation, as well as ATM recruitment.
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Affiliation(s)
- L Zhao
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, FL, USA
| | - I Kang
- 1] Department of Food Science and Human Nutrition, University of Florida, Gainesville, FL, USA [2] Department of Nutrition and Health Sciences, University of Nebraska, Lincoln, NE, USA
| | - X Fang
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - W Wang
- Department of Nutrition and Health Sciences, University of Nebraska, Lincoln, NE, USA
| | - M A Lee
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, FL, USA
| | - R R Hollins
- Department of Surgery, College of Medicine, University of Nebraska, Omaha, NE, USA
| | - M R Marshall
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, FL, USA
| | - S Chung
- 1] Department of Food Science and Human Nutrition, University of Florida, Gainesville, FL, USA [2] Department of Nutrition and Health Sciences, University of Nebraska, Lincoln, NE, USA
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Choi JA, Lee MA, Kim MS. Long-term outcomes of penetrating keratoplasty in keratoconus: analysis of the factors associated with final visual acuities. Int J Ophthalmol 2014; 7:517-21. [PMID: 24967202 DOI: 10.3980/j.issn.2222-3959.2014.03.24] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 03/08/2014] [Indexed: 11/02/2022] Open
Abstract
AIM To investigate the long-term results of penetrating keratoplasty (PK) in patients with keratoconus (KC) and to evaluate factors that might influence the final visual outcome. METHODS We retrospectively reviewed the data of all patients with clinical KC who had undergone PK by a single corneal surgeon in a single center from May 1980 to December 2005. The age of the patients, preoperative best-corrected visual acuity (BCVA), corneal thickness, death to preservation time, and preservation to transplantation time were recorded. Additionally, postoperative complications such as graft rejection, development of glaucoma and specular microscopy were checked during the follow-up. RESULTS Sixty-nine eyes from 69 patients were finally included. The follow-up period was 8.64±6.13y. Graft rejection occurred in 4 eyes of 69 cases (5.8%), and the time to graft rejection was 2.1±1.3y. A Kaplan-Meier survival analysis showed that the estimated cumulative probability of graft rejection at 6, 13, and 17y after PK were 95.6%, 90.0%, and 78.8%, respectively. When we evaluated factors that might influence final BCVA in eyes, no disparity donor-host trephine size (same graft size) as well as higher spherical equivalent, and average K-value were associated with higher final BCVA. (P=0.006, 0.051, 0.092, and 0.021 in eyes with follow-up <8y; P=0.068, 0.065, and 0.030 in eyes with follow-up ≥8y, respectively). CONCLUSION The long-term results of PK in patients with KC were favorable with a high percentage of good BCVA. Less myopic change and low average K-reading, as well as a surgical technique using the same size donor-recipient button may provide better visual outcomes particularly in patients with KC.
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Affiliation(s)
- Jin A Choi
- Department of Ophthalmology, St. Vincent's Hospital, College of Medicine, the Catholic University of Korea, #93 Jungbudae-ro, Paldal-gu, Suwon-si, Kyunggi-do 442-723, Korea
| | - Min A Lee
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, #505 Banpo-dong, Seocho-ku, Seoul 137-701, Korea
| | - Man-Soo Kim
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, #505 Banpo-dong, Seocho-ku, Seoul 137-701, Korea
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