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Park SY, Lindner MS, Brick K, Noll N, Ounit R, Noa LJ, Sabzwari R, Trible R, Sniffen JC, Roth P, Khan A, Rodriguez A, Sahra S, Davis MJ, Brar IS, Balasundaram G, Nolte FS, Blauwkamp TA, Perkins BA, Bercovici S. Detection of Mpox Virus Using Microbial Cell-Free DNA: The Potential of Pathogen-Agnostic Sequencing for Rapid Identification of Emerging Pathogens. J Infect Dis 2024; 229:S144-S155. [PMID: 37824825 DOI: 10.1093/infdis/jiad452] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/09/2023] [Accepted: 10/09/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND The 2022 global outbreak of Monkeypox virus (MPXV) highlighted challenges with polymerase chain reaction detection as divergent strains emerged and atypical presentations limited the applicability of swab sampling. Recommended testing in the United States requires a swab of lesions, which arise late in infection and may be unrecognized. We present MPXV detections using plasma microbial cell-free DNA (mcfDNA) sequencing. METHODS Fifteen plasma samples from 12 case-patients were characterized through mcfDNA sequencing. Assay performance was confirmed through in silico inclusivity and exclusivity assessments. MPXV isolates were genotyped using mcfDNA, and phylodynamic information was imputed using publicly available sequences. RESULTS MPXV mcfDNA was detected in 12 case-patients. Mpox was not suspected in 5, with 1 having documented resolution of mpox >6 months previously. Six had moderate to severe mpox, supported by high MPXV mcfDNA concentrations; 4 died. In 7 case-patients, mcfDNA sequencing detected coinfections. Genotyping by mcfDNA sequencing identified 22 MPXV mutations at 10 genomic loci in 9 case-patients. Consistent with variation observed in the 2022 outbreak, 21 of 22 variants were G > A/C > T. Phylogenetic analyses imputed isolates to sublineages arising at different time points and from different geographic locations. CONCLUSIONS We demonstrate the potential of plasma mcfDNA sequencing to detect, quantify, and, for acute infections with high sequencing coverage, subtype MPXV using a single noninvasive test. Sequencing plasma mcfDNA may augment existing mpox testing in vulnerable patient populations or in patients with atypical symptoms or unrecognized mpox. Strain type information may supplement disease surveillance and facilitate tracking emerging pathogens.
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Affiliation(s)
- Sarah Y Park
- Medical Affairs, Karius, Inc, Redwood City, California
| | | | - Kevin Brick
- Analytics, Karius, Inc., Redwood City, California
| | | | - Rachid Ounit
- Analytics, Karius, Inc., Redwood City, California
| | - Luis J Noa
- Infectious Disease Section, AdventHealth Orlando, Florida
| | - Rabeeya Sabzwari
- Infectious Diseases, Edward Hines Jr Veterans Affairs Hospital, Hines, Illinois
| | | | | | - Prerana Roth
- Infectious Diseases, Prisma Health-Upstate, Greenville, South Carolina
| | - Amir Khan
- Infectious Diseases, Carle Foundation Hospital, Urbana, Illinois
| | | | - Syeda Sahra
- Department of Infectious Diseases, Oklahoma University Medical Center, Oklahoma City
| | - Michael J Davis
- Department of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, MN
| | - Inderjeet S Brar
- Infectious Diseases, Baptist Memorial Health Care, Memphis, Tennessee
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Bakhtiyar SS, Maksimuk TE, Gutowski J, Park SY, Cain MT, Rove JY, Reece TB, Cleveland JC, Pomposelli JJ, Bababekov YJ, Nydam TL, Schold JD, Pomfret EA, Hoffman JRH. Association of procurement technique with organ yield and cost following donation after circulatory death. Am J Transplant 2024:S1600-6135(24)00237-5. [PMID: 38521350 DOI: 10.1016/j.ajt.2024.03.027] [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: 01/13/2024] [Revised: 03/15/2024] [Accepted: 03/15/2024] [Indexed: 03/25/2024]
Abstract
Donation after circulatory death (DCD) could account for the largest expansion of the donor allograft pool in the contemporary era. However, the organ yield and associated costs of normothermic regional perfusion (NRP) compared to super-rapid recovery (SRR) with ex-situ normothermic machine perfusion, remain unreported. The Organ Procurement and Transplantation Network (December 2019 to June 2023) was analyzed to determine the number of organs recovered per donor. A cost analysis was performed based on our institution's experience since 2022. Of 43 502 donors, 30 646 (70%) were donors after brain death (DBD), 12 536 (29%) DCD-SRR and 320 (0.7%) DCD-NRP. The mean number of organs recovered was 3.70 for DBD, 3.71 for DCD-NRP (P < .001), and 2.45 for DCD-SRR (P < .001). Following risk adjustment, DCD-NRP (adjusted odds ratio 1.34, confidence interval 1.04-1.75) and DCD-SRR (adjusted odds ratio 2.11, confidence interval 2.01-2.21; reference: DBD) remained associated with greater odds of allograft nonuse. Including incomplete and completed procurement runs, the total average cost of DCD-NRP was $9463.22 per donor. By conservative estimates, we found that approximately 31 donor allografts could be procured using DCD-NRP for the cost equivalent of 1 allograft procured via DCD-SRR with ex-situ normothermic machine perfusion. In conclusion, DCD-SRR procurements were associated with the lowest organ yield compared to other procurement methods. To facilitate broader adoption of DCD procurement, a comprehensive understanding of the trade-offs inherent in each technique is imperative.
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Affiliation(s)
- Syed Shahyan Bakhtiyar
- Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado, Aurora, Colorado, USA.
| | - Tiffany E Maksimuk
- Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado, Aurora, Colorado, USA
| | - John Gutowski
- University of Colorado Hospital Transplant Center, Aurora, Colorado, USA
| | - Sarah Y Park
- Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado, Aurora, Colorado, USA
| | - Michael T Cain
- Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado, Aurora, Colorado, USA; University of Colorado Hospital Transplant Center, Aurora, Colorado, USA
| | - Jessica Y Rove
- Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado, Aurora, Colorado, USA; University of Colorado Hospital Transplant Center, Aurora, Colorado, USA
| | - T Brett Reece
- Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado, Aurora, Colorado, USA; University of Colorado Hospital Transplant Center, Aurora, Colorado, USA
| | - Joseph C Cleveland
- Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado, Aurora, Colorado, USA; University of Colorado Hospital Transplant Center, Aurora, Colorado, USA
| | - James J Pomposelli
- University of Colorado Hospital Transplant Center, Aurora, Colorado, USA; Division of Transplant Surgery, Department of Surgery, University of Colorado, Aurora, Colorado, USA
| | - Yanik J Bababekov
- University of Colorado Hospital Transplant Center, Aurora, Colorado, USA; Division of Transplant Surgery, Department of Surgery, University of Colorado, Aurora, Colorado, USA
| | - Trevor L Nydam
- University of Colorado Hospital Transplant Center, Aurora, Colorado, USA; Division of Transplant Surgery, Department of Surgery, University of Colorado, Aurora, Colorado, USA
| | - Jesse D Schold
- Division of Transplant Surgery, Department of Surgery, University of Colorado, Aurora, Colorado, USA; Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
| | - Elizabeth A Pomfret
- University of Colorado Hospital Transplant Center, Aurora, Colorado, USA; Division of Transplant Surgery, Department of Surgery, University of Colorado, Aurora, Colorado, USA
| | - Jordan R H Hoffman
- Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado, Aurora, Colorado, USA; University of Colorado Hospital Transplant Center, Aurora, Colorado, USA
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Wood JB, Russell K, Davis TE, Park SY, Smollin MJ, Schneider JG. Plasma Microbial Cell-Free DNA Sequencing for Pathogen Detection and Quantification in Children With Musculoskeletal Infections. J Pediatric Infect Dis Soc 2024; 13:211-219. [PMID: 38330338 DOI: 10.1093/jpids/piae012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 02/07/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Nearly half of all pediatric musculoskeletal infections (MSKIs) are culture negative. Plasma microbial cell-free DNA (mcfDNA) sequencing is noninvasive and not prone to the barriers of culture. We evaluated the performance of plasma mcfDNA sequencing in identifying a pathogen, and examined the duration of pathogen detection in children with MSKIs. METHODS We conducted a prospective study of children, aged 6 months to 18 years, hospitalized from July 2019 to May 2022 with MSKIs, in whom we obtained serial plasma mcfDNA sequencing samples and compared the results with cultures. RESULTS A pathogen was recovered by culture in 23 of 34 (68%) participants, and by initial mcfDNA sequencing in 25 of 31 (81%) participants. Multiple pathogens were detected in the majority (56%) of positive initial samples. Complete concordance with culture (all organisms accounted for by both methods) was 32%, partial concordance (at least one of the same organism(s) identified by both methods) was 36%, and discordance was 32%. mcfDNA sequencing was more likely to show concordance (complete or partial) if obtained prior to a surgical procedure (82%), compared with after (20%), (RR 4.12 [95% CI 1.25, 22.93], p = .02). There was no difference in concordance based on timing of antibiotics (presample antibiotics 60% vs no antibiotics 75%, RR 0.8 [95% CI 0.40, 1.46], p = .65]). mcfDNA sequencing was positive in 67% of culture-negative infections and detected a pathogen for a longer interval than blood culture (median 2 days [IQR 1, 6 days] vs 1 day [1, 1 day], p < .01). CONCLUSIONS Plasma mcfDNA sequencing may be useful in culture-negative pediatric MSKIs if the sample is obtained prior to surgery. However, results must be interpreted in the appropriate clinical context as multiple pathogens are frequently detected supporting the need for diagnostic stewardship.
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Affiliation(s)
- James B Wood
- Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Center for Pediatric and Adolescent Comparative Effectiveness Research, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Kelsey Russell
- Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Tom E Davis
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | | | - Jack G Schneider
- Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Park SY, Ardura MI, Zhang SX. Diagnostic limitations and challenges in current clinical guidelines and potential application of metagenomic sequencing to manage pulmonary invasive fungal infections in patients with haematological malignancies. Clin Microbiol Infect 2024:S1198-743X(24)00115-0. [PMID: 38460819 DOI: 10.1016/j.cmi.2024.03.003] [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: 07/28/2023] [Revised: 02/24/2024] [Accepted: 03/04/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Pulmonary invasive fungal infections (pIFI) disproportionately affect patients with haematological malignancies (HM). Establishing a rapid and accurate diagnosis of pIFI is challenging. Multiple guidelines recommend diagnostic testing of invasive fungal infections but lack consensus and may contribute to inconsistent diagnostic approaches. OBJECTIVE To identify key diagnostic challenges and review metagenomic sequencing data. SOURCES PubMed, professional consortium, and scientific society websites search to identify relevant, published, evidence-based clinical guidelines within the past 5 years. PubMed searchs for papers describing clinically relevant novel diagnostic technologies. CONTENT Current guidelines for patients with HM and suspected pIFI recommend chest computed tomography imaging and specimen testing with microscopic examination (including calcofluor white stain, histopathology, cytopathology, etc.), Aspergillus galactomannan, β-D-glucan, PCR, and culture, each with certain limitations. Emerging real-world data support the adjunctive use of metagenomic sequencing-based tests for the timely diagnosis of pIFI. IMPLICATIONS High-quality evidence from robust clinical trials is needed to determine whether guidelines should be updated to include novel diagnostic technologies. Trials should ask whether the combination of powerful novel diagnostics, such as pathogen-agnostic metagenomic sequencing technologies in conjunction with conventional testing can optimize the diagnostic yield for all potential pIFI pathogens that impact the health of patients with HM.
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Affiliation(s)
| | - Monica I Ardura
- Section of Infectious Diseases & Host Defense Program, Nationwide Children's Hospital, Columbus, OH, USA; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Sean X Zhang
- Medical Mycology Laboratory, Johns Hopkins Hospital, Baltimore, MD, USA; Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
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5
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Park SY, Coufal NG, Dominguez SR, Farnaes L, Messacar K, Goldman FD. Gaps in diagnosing suspected infection in immunocompromised children with cancer: A systematic review. Pediatr Blood Cancer 2024; 71:e30794. [PMID: 38059641 DOI: 10.1002/pbc.30794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/16/2023] [Accepted: 11/18/2023] [Indexed: 12/08/2023]
Abstract
While the survival of children with cancer has improved over time, infection remains a major morbidity and mortality risk. We conducted a systematic literature review to determine the unmet needs in diagnosing infection in immunocompromised children with cancer. The comprehensive search strategy followed the guidelines established by the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 statement, and spanned multiple bibliographic databases and other public sources from January 1, 2012 to June 23, 2022. From 5188 records, 34 unique pediatric-focused studies met inclusion criteria. This review highlights the lack of published data on infectious disease testing in pediatric oncology patients, and the need for well-designed clinical impact and cost-effectiveness studies of both existing and novel diagnostic platforms. Such studies are necessary to optimize diagnostic and antimicrobial stewardship, leading to improvement in patient outcomes.
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Affiliation(s)
- Sarah Y Park
- Medical Affairs, Karius, Inc., Redwood City, California, USA
| | - Nicole G Coufal
- Pediatric Critical Care, Department of Pediatrics, University of California, San Diego, California, USA
- Rady Children's Hospital, San Diego, California, USA
| | - Samuel R Dominguez
- Section of Infectious Diseases, Department of Pediatrics, Children's Hospital Colorado-University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Pathology and Laboratory Medicine, Children's Colorado, Aurora, Colorado, USA
| | - Lauge Farnaes
- Scientific Advisory Board, Karius, Inc., Redwood City, California, USA
| | - Kevin Messacar
- Section of Infectious Diseases, Department of Pediatrics, Children's Hospital Colorado-University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Frederick D Goldman
- Division of Hematology Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Hill JA, Park SY, Gajurel K, Taplitz R. A Systematic Literature Review to Identify Diagnostic Gaps in Managing Immunocompromised Patients With Cancer and Suspected Infection. Open Forum Infect Dis 2024; 11:ofad616. [PMID: 38221981 PMCID: PMC10787371 DOI: 10.1093/ofid/ofad616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/05/2023] [Indexed: 01/16/2024] Open
Abstract
Patients with cancer are increasingly vulnerable to infections, which may be more severe than in the general population. Improvements in rapid and timely diagnosis to optimize management are needed. We conducted a systematic literature review to determine the unmet need in diagnosing acute infections in immunocompromised patients with cancer and identified 50 eligible studies from 5188 records between 1 January 2012 and 23 June 2022. There was considerable heterogeneity in study designs and parameters, laboratory methods and definitions, and assessed outcomes, with limited evaluation of diagnostic impact on clinical outcomes. Culture remains the primary diagnostic strategy. Fewer studies employing molecular technologies exist, but emerging literature suggests that pathogen-agnostic molecular tests may add to the diagnostic armamentarium. Well-designed clinical studies using standardized methodologies are needed to better evaluate performance characteristics and clinical and economic impacts of emerging diagnostic techniques to improve patient outcomes.
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Affiliation(s)
- Joshua A Hill
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Sarah Y Park
- Medical Affairs, Karius, Inc, Redwood City, California, USA
| | - Kiran Gajurel
- Division of Infectious Diseases, Carolinas Medical Center, Atrium Health, Charlotte, North Carolina, USA
| | - Randy Taplitz
- Department of Medicine, City of Hope National Medical Center, Duarte, California, USA
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Cain MT, Park SY, Schäfer M, Hay-Arthur E, Justison GA, Zhan QP, Campbell D, Mitchell JD, Randhawa SK, Meguid RA, David EA, Reece TB, Cleveland JC, Hoffman JR. Lung recovery utilizing thoracoabdominal normothermic regional perfusion during donation after circulatory death: The Colorado experience. JTCVS Tech 2023; 22:350-358. [PMID: 38152164 PMCID: PMC10750961 DOI: 10.1016/j.xjtc.2023.09.027] [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: 06/21/2023] [Revised: 08/22/2023] [Accepted: 09/21/2023] [Indexed: 12/29/2023] Open
Abstract
Objective Donation after circulatory death (DCD) procurement and transplantation after thoracoabdominal normothermic regional perfusion (TA-NRP) remains a novel technique to improve cardiac and hepatic allograft preservation but may be complicated by lung allograft pulmonary edema. We present a single-center series on early implementation of a lung-protective protocol with strategies to mitigate posttransplant pulmonary edema in DCD lung allografts after TA-NRP procurement. Methods Data from all lung transplantations performed using a TA-NRP procurement strategy from October 2022 to April 2023 are presented. Donor management consisted of key factors to reduce lung allograft pulmonary edema: aggressive predonation and early posttransplant diuresis, complete venous drainage at TA-NRP initiation, and early pulmonary artery venting upon initiation of systemic perfusion. Donor and recipient characteristics, procurement characteristics such as TA-NRP intervals, and 30-day postoperative outcomes were assessed. Results During the study period, 8 lung transplants were performed utilizing TA-NRP procurement from DCD donors. Donor ages ranged from 16 to 39 years and extubation time to declaration of death ranged from 10 to 90 minutes. Time from declaration to TA-NRP initiation was 7 to 17 minutes with TA-NRP perfusion times of 49 to 111 minutes. Median left and right allograft warm ischemia times were 55.5 minutes (interquartile range, 46.5-67.5 minutes) and 41.0 minutes (interquartile range, 39.0-53.0 minutes, respectively, with 2 recipients supported with cardiopulmonary bypass or venoarterial extracorporeal membrane oxygenation during implantation. No postoperative extracorporeal membrane oxygenation was required. There were no pulmonary-related deaths; however, 1 patient died from complications of severe necrotizing pancreatitis with a normal functioning allograft. All patients were extubated within 24 hours. Index intensive care unit length of stay ranged from 3 to 11 days with a hospital length of stay of 13 to 37 days. Conclusions Despite concern regarding quality of DCD lung allografts recovered using the TA-NRP technique, we report initial success using this procurement method. Implementation of strategies to mitigate pulmonary edema can result in acceptable outcomes following lung transplantation. Demonstration of short- and long-term safety and efficacy of this technique will become increasingly important as the use of TA-NRP for thoracic and abdominal allografts in DCD donors expands.
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Affiliation(s)
- Michael T. Cain
- Division of Cardiothoracic Surgery, University of Colorado Denver Anschutz Medical Campus, Aurora, Colo
| | - Sarah Y. Park
- Division of Cardiothoracic Surgery, University of Colorado Denver Anschutz Medical Campus, Aurora, Colo
| | - Michal Schäfer
- Division of Cardiothoracic Surgery, University of Colorado Denver Anschutz Medical Campus, Aurora, Colo
| | - Emily Hay-Arthur
- Division of Cardiothoracic Surgery, University of Colorado Denver Anschutz Medical Campus, Aurora, Colo
| | - George A. Justison
- Division of Cardiothoracic Surgery, University of Colorado Denver Anschutz Medical Campus, Aurora, Colo
| | - Qui Peng Zhan
- Division of Cardiothoracic Surgery, University of Colorado Denver Anschutz Medical Campus, Aurora, Colo
| | - David Campbell
- Division of Cardiothoracic Surgery, University of Colorado Denver Anschutz Medical Campus, Aurora, Colo
| | - John D. Mitchell
- Division of Cardiothoracic Surgery, University of Colorado Denver Anschutz Medical Campus, Aurora, Colo
| | - Simran K. Randhawa
- Division of Cardiothoracic Surgery, University of Colorado Denver Anschutz Medical Campus, Aurora, Colo
| | - Robert A. Meguid
- Division of Cardiothoracic Surgery, University of Colorado Denver Anschutz Medical Campus, Aurora, Colo
| | - Elizabeth A. David
- Division of Cardiothoracic Surgery, University of Colorado Denver Anschutz Medical Campus, Aurora, Colo
| | - T. Brett Reece
- Division of Cardiothoracic Surgery, University of Colorado Denver Anschutz Medical Campus, Aurora, Colo
| | - Joseph C. Cleveland
- Division of Cardiothoracic Surgery, University of Colorado Denver Anschutz Medical Campus, Aurora, Colo
| | - Jordan R.H. Hoffman
- Division of Cardiothoracic Surgery, University of Colorado Denver Anschutz Medical Campus, Aurora, Colo
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Jung J, Moon SM, Kim DY, Kim SH, Lee WJ, Heo ST, Park JY, Bae S, Lee MJ, Kim B, Park SY, Jeong HW, Kim Y, Kwak YG, Song KH, Park KH, Park SH, Kim YK, Kim ES, Kim HB. Appropriateness of antibiotic use for patients with asymptomatic bacteriuria or urinary tract infection with positive urine culture: a retrospective observational multi-centre study in Korea. J Hosp Infect 2023; 140:79-86. [PMID: 37562596 DOI: 10.1016/j.jhin.2023.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/24/2023] [Accepted: 07/29/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Antibiotic resistance threatens public health worldwide, and inappropriate use of antibiotics is one of the main causes. AIM To evaluate qualitative use of antibiotics in asymptomatic bacteriuria (ABU) and urinary tract infection (UTI). METHODS Cases of positive urine culture (≥105 colony-forning units/mL) performed in inpatient, outpatient and emergency departments in April 2021 were screened in 26 hospitals in the Republic of Korea. The cases were classified as ABU, lower UTI and upper UTI. The appropriateness of antibiotic use was evaluated retrospectively by infectious disease specialists using quality indicators based on clinical guidelines for ABU and UTI. RESULTS This study included a total of 2697 patients with ABU or UTI. The appropriateness of antibiotic use was assessed in 1157 patients with ABU, and in 677 and 863 patients with lower and upper UTI, respectively. Among the 1157 patients with ABU, 251 (22%) were prescribed antibiotics without appropriate indications. In 66 patients with ABU in which antibiotics were prescribed with appropriate indications, the duration was adequate in only 23 (34.8%) patients. The appropriateness of empirical and definite antibiotics was noted in 527 (77.8%) and 353 (68.0%) patients with lower UTI, and 745 (86.3%) and 583 (78.2%) patients with upper UTI, respectively. The duration of antibiotics was adequate in 321 (61.8%) patients with lower UTI and 576 (78.7%) patients with upper UTI. CONCLUSIONS This nationwide qualitative assessment of antibiotic use in ABU and UTI revealed that antibiotics were often prescribed inappropriately, and the duration of antibiotics was unnecessarily prolonged.
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Affiliation(s)
- J Jung
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - S M Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - D Y Kim
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - S-H Kim
- Division of Infectious Diseases, Samsung Changwon Hospital, Sungkyunkwan University, Changwon, Republic of Korea
| | - W J Lee
- Department of Internal Medicine, Hallym Hospital, Incheon, Republic of Korea
| | - S T Heo
- Division of Infectious Disease, Department of Internal Medicine, Jeju National University College of Medicine, Jeju, Republic of Korea
| | - J Y Park
- Department of Paediatrics, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - S Bae
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - M J Lee
- Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea
| | - B Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - S Y Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea; Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea; Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea; Centres for Digital Health, Yongin Severance Hospital, Yonsei University Health System, Yongin, Republic of Korea
| | - H W Jeong
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea; Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Y Kim
- Department of Internal Medicine, Wonkwang University College of Medicine, Iksan, Republic of Korea
| | - Y G Kwak
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - K-H Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - K-H Park
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - S H Park
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Y K Kim
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - E S Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H B Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
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9
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Park SY, Moon SM, Kim B, Lee MJ, Song KH, Kim ES, Kim TH, Kim HB. Applicability and limitations of quality indicator-based assessment of appropriateness in antimicrobial use: a comparison with expert opinion. J Hosp Infect 2023; 139:93-98. [PMID: 37419187 DOI: 10.1016/j.jhin.2023.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/06/2023] [Accepted: 06/26/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND The effective implementation of antimicrobial stewardship requires an a-priori assessment of the appropriateness of antimicrobial prescriptions. AIM To evaluate the effectiveness of quality indicators (QIs) in determining the appropriateness of antimicrobial prescriptions compared to that of expert opinions. METHODS The study assessed antimicrobial use in 20 hospitals in Korea, with infectious disease specialists rating the appropriateness based on QIs and expert opinions. The selected QIs were (1) taking two blood cultures, (2) taking cultures from suspected sites of infection, (3) prescribing empirical antimicrobials according to guidelines, and (4) changing from empirical to pathogen-directed therapy for hospitalized patients and (2, 3, and 4) for ambulatory patients. Applicability, compliance with QIs, and agreement between QIs and expert opinions were investigated. FINDINGS Overall, 7999 therapeutic uses of antimicrobials were investigated at the study hospitals. The experts rated 20.5% (1636/7999) as inappropriate use. For hospitalized patients, antimicrobial use was assessed based on all four QIs in 28.8% (1798/6234) of the cases. For ambulatory care patients, only 7.5% (102/1351) of the antimicrobial use cases were assessed using all three QIs. The agreement between expert opinions and all four QIs for hospitalized patients was minimal (κ = 0.332), whereas that between expert opinions and all three QIs for ambulatory patients was weak (κ = 0.598). CONCLUSION QIs have limitations in determining the appropriateness of antimicrobial use, and the degree of agreement with expert opinions was low. Therefore, these QI limitations should be considered when determining the appropriateness of antimicrobial use.
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Affiliation(s)
- S Y Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea; Centres for Digital Health, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea
| | - S M Moon
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - B Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - M J Lee
- Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - K-H Song
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - E S Kim
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - T H Kim
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, South Korea.
| | - H B Kim
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
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10
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Park SY, Chang EJ, Ledeboer N, Messacar K, Lindner MS, Venkatasubrahmanyam S, Wilber JC, Vaughn ML, Bercovici S, Perkins BA, Nolte FS. Plasma Microbial Cell-Free DNA Sequencing from over 15,000 Patients Identified a Broad Spectrum of Pathogens. J Clin Microbiol 2023; 61:e0185522. [PMID: 37439686 PMCID: PMC10446866 DOI: 10.1128/jcm.01855-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 06/23/2023] [Indexed: 07/14/2023] Open
Abstract
Microbial cell-free DNA (mcfDNA) sequencing is an emerging infectious disease diagnostic tool which enables unbiased pathogen detection and quantification from plasma. The Karius Test, a commercial mcfDNA sequencing assay developed by and available since 2017 from Karius, Inc. (Redwood City, CA), detects and quantifies mcfDNA as molecules/μL in plasma. The commercial sample data and results for all tests conducted from April 2018 through mid-September 2021 were evaluated for laboratory quality metrics, reported pathogens, and data from test requisition forms. A total of 18,690 reports were generated from 15,165 patients in a hospital setting among 39 states and the District of Columbia. The median time from sample receipt to reported result was 26 h (interquartile range [IQR] 25 to 28), and 96% of samples had valid test results. Almost two-thirds (65%) of patients were adults, and 29% at the time of diagnostic testing had ICD-10 codes representing a diverse array of clinical scenarios. There were 10,752 (58%) reports that yielded at least one taxon for a total of 22,792 detections spanning 701 unique microbial taxa. The 50 most common taxa detected included 36 bacteria, 9 viruses, and 5 fungi. Opportunistic fungi (374 Aspergillus spp., 258 Pneumocystis jirovecii, 196 Mucorales, and 33 dematiaceous fungi) comprised 861 (4%) of all detections. Additional diagnostically challenging pathogens (247 zoonotic and vector-borne pathogens, 144 Mycobacterium spp., 80 Legionella spp., 78 systemic dimorphic fungi, 69 Nocardia spp., and 57 protozoan parasites) comprised 675 (3%) of all detections. This is the largest reported cohort of patients tested using plasma mcfDNA sequencing and represents the first report of a clinical grade metagenomic test performed at scale. Data reveal new insights into the breadth and complexity of potential pathogens identified.
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Affiliation(s)
| | | | | | - Kevin Messacar
- University of Colorado, Children’s Hospital Colorado, Aurora, Colorado, USA
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11
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Rubio LA, Kjemtrup AM, Marx GE, Cronan S, Kilonzo C, Saunders MEM, Choat JL, Dietrich EA, Liebman KA, Park SY. Borrelia miyamotoi Infection in Immunocompromised Man, California, USA, 2021. Emerg Infect Dis 2023; 29:1011-1014. [PMID: 37081591 PMCID: PMC10124667 DOI: 10.3201/eid2905.221638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
Infection with Borrelia miyamotoi in California, USA, has been suggested by serologic studies. We diagnosed B. miyamotoi infection in an immunocompromised man in California. Diagnosis was aided by plasma microbial cell-free DNA sequencing. We conclude that the infection was acquired in California.
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12
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Pohl T, Sun YL, Obertelli A, Lee J, Gómez-Ramos M, Ogata K, Yoshida K, Cai BS, Yuan CX, Brown BA, Baba H, Beaumel D, Corsi A, Gao J, Gibelin J, Gillibert A, Hahn KI, Isobe T, Kim D, Kondo Y, Kobayashi T, Kubota Y, Li P, Liang P, Liu HN, Liu J, Lokotko T, Marqués FM, Matsuda Y, Motobayashi T, Nakamura T, Orr NA, Otsu H, Panin V, Park SY, Sakaguchi S, Sasano M, Sato H, Sakurai H, Shimizu Y, Stefanescu AI, Stuhl L, Suzuki D, Togano Y, Tudor D, Uesaka T, Wang H, Xu X, Yang ZH, Yoneda K, Zenihiro J. Multiple Mechanisms in Proton-Induced Nucleon Removal at ∼100 MeV/Nucleon. Phys Rev Lett 2023; 130:172501. [PMID: 37172241 DOI: 10.1103/physrevlett.130.172501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 03/17/2023] [Accepted: 03/29/2023] [Indexed: 05/14/2023]
Abstract
We report on the first proton-induced single proton- and neutron-removal reactions from the neutron-deficient ^{14}O nucleus with large Fermi-surface asymmetry S_{n}-S_{p}=18.6 MeV at ∼100 MeV/nucleon, a widely used energy regime for rare-isotope studies. The measured inclusive cross sections and parallel momentum distributions of the ^{13}N and ^{13}O residues are compared to the state-of-the-art reaction models, with nuclear structure inputs from many-body shell-model calculations. Our results provide the first quantitative contributions of multiple reaction mechanisms including the quasifree knockout, inelastic scattering, and nucleon transfer processes. It is shown that the inelastic scattering and nucleon transfer, usually neglected at such energy regime, contribute about 50% and 30% to the loosely bound proton and deeply bound neutron removal, respectively. These multiple reaction mechanisms should be considered in analyses of inclusive one-nucleon removal cross sections measured at intermediate energies for quantitative investigation of single-particle strengths and correlations in atomic nuclei.
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Affiliation(s)
- T Pohl
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - Y L Sun
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - A Obertelli
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - J Lee
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - M Gómez-Ramos
- Departamento de Física Atómica, Molecular y Nuclear, Facultad de Física, Universidad de Sevilla, Apartado 1065, E-41080 Sevilla, Spain
| | - K Ogata
- Department of Physics, Kyushu University, Fukuoka 812-8581, Japan
- Research Center for Nuclear Physics (RCNP), Osaka University, Ibaraki 567-0047, Japan
| | - K Yoshida
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
| | - B S Cai
- Sino-French Institute of Nuclear Engineering and Technology, Sun Yat-Sen University, Zhuhai, 519082 Guangdong, People's Republic of China
| | - C X Yuan
- Sino-French Institute of Nuclear Engineering and Technology, Sun Yat-Sen University, Zhuhai, 519082 Guangdong, People's Republic of China
| | - B A Brown
- Department of Physics and Astronomy and the Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824-1321, USA
| | - H Baba
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D Beaumel
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - A Corsi
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - J Gao
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, Peking University, Beijing 100871, People's Republic of China
| | - J Gibelin
- LPC Caen, ENSICAEN, Université de Caen, CNRS/IN2P3, F-14050 Caen, France
| | - A Gillibert
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - K I Hahn
- Department of Physics, Ewha Womans University, Seoul, South Korea
- Center for Exotic Nuclear Studies, Institute for Basic Science, Daejeon 34126, South Korea
| | - T Isobe
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D Kim
- Department of Physics, Ewha Womans University, Seoul, South Korea
- Center for Exotic Nuclear Studies, Institute for Basic Science, Daejeon 34126, South Korea
| | - Y Kondo
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - T Kobayashi
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - Y Kubota
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Center for Nuclear Study, University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
| | - P Li
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - P Liang
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - H N Liu
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- Key Laboratory of Beam Technology and Material Modification of Ministry of Education, College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875, People's Republic of China
| | - J Liu
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - T Lokotko
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - F M Marqués
- LPC Caen, ENSICAEN, Université de Caen, CNRS/IN2P3, F-14050 Caen, France
| | - Y Matsuda
- Cyclotron and Radioisotope Center, Tohoku University, Sendai 980-8578, Japan
- Department of Physics, Konan University, Kobe 658-8501, Japan
| | - T Motobayashi
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - T Nakamura
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - N A Orr
- LPC Caen, ENSICAEN, Université de Caen, CNRS/IN2P3, F-14050 Caen, France
| | - H Otsu
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - V Panin
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - S Y Park
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Ewha Womans University, Seoul, South Korea
| | - S Sakaguchi
- Department of Physics, Kyushu University, Fukuoka 812-8581, Japan
| | - M Sasano
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Sato
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Sakurai
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - Y Shimizu
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - A I Stefanescu
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering, IFIN-HH, 077125 Bucureşti-Măgurele, Romania
- Doctoral School of Physics, University of Bucharest, 077125 Bucureşti-Măgurele, Romania
| | - L Stuhl
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Center for Exotic Nuclear Studies, Institute for Basic Science, Daejeon 34126, South Korea
| | - D Suzuki
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Y Togano
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
- Department of Physics, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 172-8501, Japan
| | - D Tudor
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering, IFIN-HH, 077125 Bucureşti-Măgurele, Romania
- Doctoral School of Physics, University of Bucharest, 077125 Bucureşti-Măgurele, Romania
| | - T Uesaka
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Wang
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - X Xu
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - Z H Yang
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - K Yoneda
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - J Zenihiro
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
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Yun J, Yun S, Park JE, Cheong EN, Park SY, Kim N, Kim HS. Deep Learning of Time-Signal Intensity Curves from Dynamic Susceptibility Contrast Imaging Enables Tissue Labeling and Prediction of Survival in Glioblastoma. AJNR Am J Neuroradiol 2023; 44:543-552. [PMID: 37105676 PMCID: PMC10171378 DOI: 10.3174/ajnr.a7853] [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] [Received: 06/29/2022] [Accepted: 03/21/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND AND PURPOSE An autoencoder can learn representative time-signal intensity patterns to provide tissue heterogeneity measures using dynamic susceptibility contrast MR imaging. The aim of this study was to investigate whether such an autoencoder-based pattern analysis could provide interpretable tissue labeling and prognostic value in isocitrate dehydrogenase (IDH) wild-type glioblastoma. MATERIALS AND METHODS Preoperative dynamic susceptibility contrast MR images were obtained from 272 patients with IDH wild-type glioblastoma (training and validation, 183 and 89 patients, respectively). The autoencoder was applied to the dynamic susceptibility contrast MR imaging time-signal intensity curves of tumor and peritumoral areas. Representative perfusion patterns were defined by voxelwise K-means clustering using autoencoder latent features. Perfusion patterns were labeled by comparing parameters with anatomic reference tissues for baseline, signal drop, and percentage recovery. In the validation set (n = 89), a survival model was created from representative patterns and clinical predictors using Cox proportional hazard regression analysis, and its performance was calculated using the Harrell C-index. RESULTS Eighty-nine patients were enrolled. Five representative perfusion patterns were used to characterize tissues as high angiogenic tumor, low angiogenic/cellular tumor, perinecrotic lesion, infiltrated edema, and vasogenic edema. Of these, the low angiogenic/cellular tumor (hazard ratio, 2.18; P = .047) and infiltrated edema patterns (hazard ratio, 1.88; P = .009) in peritumoral areas showed significant prognostic value. The combined perfusion patterns and clinical predictors (C-index, 0.72) improved prognostication when added to clinical predictors (C-index, 0.55). CONCLUSIONS The autoencoder perfusion pattern analysis enabled tissue characterization of peritumoral areas, providing heterogeneity and dynamic information that may provide useful prognostic information in IDH wild-type glioblastoma.
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Affiliation(s)
- J Yun
- From the Departments of Convergence Medicine (J.Y., N.K.)
- Radiology and Research Institute of Radiology (J.Y., J.E.P., N.K., H.S.K.), Asan Medical Center
| | - S Yun
- Department of Radiology (S.Y.), Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - J E Park
- Radiology and Research Institute of Radiology (J.Y., J.E.P., N.K., H.S.K.), Asan Medical Center
| | - E-N Cheong
- Medical Science and Asan Medical Institute of Convergence Science and Technology (E.-N.C.), University of Ulsan College of Medicine, Seoul, Korea
| | - S Y Park
- Department of Statistics and Data Science (S.Y.P.), Korea National Open University, Seoul, Korea
| | - N Kim
- From the Departments of Convergence Medicine (J.Y., N.K.)
- Radiology and Research Institute of Radiology (J.Y., J.E.P., N.K., H.S.K.), Asan Medical Center
| | - H S Kim
- Radiology and Research Institute of Radiology (J.Y., J.E.P., N.K., H.S.K.), Asan Medical Center
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14
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Park SY, Hahn KI, Kang WG, Kazalov V, Kim GW, Kim YD, Lee EK, Lee MH, Leonard DS, Sala E, So JH, Yoon SC. Detection efficiency calibration for an array of fourteen HPGe detectors. Appl Radiat Isot 2023; 193:110654. [PMID: 36646029 DOI: 10.1016/j.apradiso.2023.110654] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 07/08/2022] [Revised: 01/03/2023] [Accepted: 01/09/2023] [Indexed: 01/12/2023]
Abstract
The CUP array of germanium (CAGe) is an array of fourteen high-purity germanium (HPGe) detectors. The detection efficiency of full-energy-peak emitted from the various samples assayed on the CAGe was calculated using the Monte Carlo simulation toolkit GEANT4. If the dead layer on the surface of the crystal is treated in the simulation as a continuous part of the active crystal, then the detection efficiency will be overestimated. Thus, the detection efficiency of the CAGe was adjusted using multi-nuclide source data and Monte Carlo simulations. The gamma spectra of the known activity source were obtained for each HPGe detector of the CAGe. The detection efficiency measured by the multi-source data was smaller than that of simulation data if the simulation treated the whole volume of germanium crystals as active for gamma detection. By optimizing the dead layers' thicknesses in the simulation, the detection efficiency calculated by the simulation could be matched to that of multi-source data.
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Affiliation(s)
- S Y Park
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon, 34126, South Korea
| | - K I Hahn
- Center for Exotic Nuclear Studies, Institute for Basic Science (IBS), Daejeon, 34126, South Korea
| | - W G Kang
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon, 34126, South Korea
| | - V Kazalov
- Baksan Neutrino Observatory, Institute for Nuclear Research of the Russian Academy of Science, Kabardino-Balkaria, 361609, Russia
| | - G W Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon, 34126, South Korea.
| | - Y D Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon, 34126, South Korea; Department of Physics and Astronomy, Sejong University, Seoul, 05006, South Korea; IBS School, University of Science and Technology (UST), Daejeon, 34113, South Korea
| | - E K Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon, 34126, South Korea
| | - M H Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon, 34126, South Korea; IBS School, University of Science and Technology (UST), Daejeon, 34113, South Korea
| | - D S Leonard
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon, 34126, South Korea
| | - E Sala
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon, 34126, South Korea
| | - J H So
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon, 34126, South Korea
| | - S C Yoon
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon, 34126, South Korea
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15
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Park SY, Oh SH, Park SH, Oh JH, Kim SH. Sex difference in neurological outcome and post-cardiac arrest care in out-of-hospital cardiac arrest patients treated with targeted temperature management. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Objectives
Conflicting results regarding sex-based differences in the outcomes of out-of-hospital cardiac arrest (OHCA) patients have been reported. Furthermore, no study has examined whether differences in in-hospital interventions and courses are driven by sex differences. This study evaluated the effect of sex on the in-hospital course of these patients as well as the survival rates and long-term neurological outcomes of comatose OHCA patients treated with targeted temperature management (TTM).
Methods
We retrospectively analyzed the Korean Hypothermia Network prospective registry composed of data collected from 22 hospitals in Korea between October 2015 and December 2018. To evaluate the effect of sex on patient outcomes, we created various multivariate logistic regression models including baseline characteristics, resuscitation, and in-hospital care variables with an interaction term (age × sex). We also performed a stratified analysis of different age groups (less than 50 years of age and older). Regarding the difference in in-hospital courses, we compared daily total and SOFA sub-scores between the sexes and analyzed whether the decision regarding early cardiac interventions and limitations in in-hospital care were associated with sex.
Results
Among 1339 patients included in the study, 952 were men and 387 were women. There were no differences in age or modified comorbidity index values between the gender groups. Women were more likely to experience cardiac arrest at home and unwitnessed arrests, whereas men were more likely to have shockable initial rhythm, cardiac cause arrest, and ST-segment elevation myocardial infarction (STEMI) on initial electrocardiography and undergo early coronary interventions. The rate of survival to discharge was similar, but men showed better 6-month neurological outcomes. After adjusting for confounders, the male sex was not associated with survival to discharge or good 6-month neurological outcomes. There was no association between sex and outcome in patients of reproductive age and no interaction between age and sex. Regarding the in-hospital course, the daily total and SOFA sub-scores were similar in both sexes. The adjusted effect of sex was not associated with the clinician’s decision to perform early cardiac interventions. The decision to discontinue life-sustaining treatment was determined by poor prognostic factors, not by sex.
Conclusions
The findings suggested that men had more favorable 6-month survivals and good neurological outcomes compared to women since they had more favorable resuscitation variables. However, after adjusting for confounders, there was no difference between the sexes. This result was consistent with the data in patients of reproductive age. The results regarding in-hospital course showed that daily patient severity scores, early cardiac interventions, resource consumption, and the rates of withdrawal/withholding of in-hospital care were similar in men and women.
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Affiliation(s)
- S Y Park
- The Catholic University of Korea Yeouido St. Mary's Hospital, Department of emergency medicine , Seoul , Korea (Republic of)
| | - S H Oh
- The Catholic University of Korea Seoul St. Mary's Hospital, Department of emergency medicine , Seoul , Korea (Republic of)
| | - S H Park
- The Catholic University of Korea Yeouido St. Mary's Hospital, Department of emergency medicine , Seoul , Korea (Republic of)
| | - J H Oh
- The Catholic University of Korea Eunpyeong St. Mary's Hospital, Department of emergency medicine , Seoul , Korea (Republic of)
| | - S H Kim
- The Catholic University of Korea Eunpyeong St. Mary's Hospital, Department of emergency medicine , Seoul , Korea (Republic of)
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Enciu M, Liu HN, Obertelli A, Doornenbal P, Nowacki F, Ogata K, Poves A, Yoshida K, Achouri NL, Baba H, Browne F, Calvet D, Château F, Chen S, Chiga N, Corsi A, Cortés ML, Delbart A, Gheller JM, Giganon A, Gillibert A, Hilaire C, Isobe T, Kobayashi T, Kubota Y, Lapoux V, Motobayashi T, Murray I, Otsu H, Panin V, Paul N, Rodriguez W, Sakurai H, Sasano M, Steppenbeck D, Stuhl L, Sun YL, Togano Y, Uesaka T, Wimmer K, Yoneda K, Aktas O, Aumann T, Chung LX, Flavigny F, Franchoo S, Gasparic I, Gerst RB, Gibelin J, Hahn KI, Kim D, Kondo Y, Koseoglou P, Lee J, Lehr C, Li PJ, Linh BD, Lokotko T, MacCormick M, Moschner K, Nakamura T, Park SY, Rossi D, Sahin E, Söderström PA, Sohler D, Takeuchi S, Toernqvist H, Vaquero V, Wagner V, Wang S, Werner V, Xu X, Yamada H, Yan D, Yang Z, Yasuda M, Zanetti L. Extended p_{3/2} Neutron Orbital and the N=32 Shell Closure in ^{52}Ca. Phys Rev Lett 2022; 129:262501. [PMID: 36608181 DOI: 10.1103/physrevlett.129.262501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/24/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
The one-neutron knockout from ^{52}Ca in inverse kinematics onto a proton target was performed at ∼230 MeV/nucleon combined with prompt γ spectroscopy. Exclusive quasifree scattering cross sections to bound states in ^{51}Ca and the momentum distributions corresponding to the removal of 1f_{7/2} and 2p_{3/2} neutrons were measured. The cross sections, interpreted within the distorted-wave impulse approximation reaction framework, are consistent with a shell closure at the neutron number N=32, found as strong as at N=28 and N=34 in Ca isotopes from the same observables. The analysis of the momentum distributions leads to a difference of the root-mean-square radii of the neutron 1f_{7/2} and 2p_{3/2} orbitals of 0.61(23) fm, in agreement with the modified-shell-model prediction of 0.7 fm suggesting that the large root-mean-square radius of the 2p_{3/2} orbital in neutron-rich Ca isotopes is responsible for the unexpected linear increase of the charge radius with the neutron number.
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Affiliation(s)
- M Enciu
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - H N Liu
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- Key Laboratory of Beam Technology of Ministry of Education, College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875, China
- Department of Physics, Royal Institute of Technology, SE-10691 Stockholm, Sweden
| | - A Obertelli
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - P Doornenbal
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - F Nowacki
- Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000 Strasbourg, France
| | - K Ogata
- Department of Physics, Kyushu University, Fukuoka 819-0395, Japan
- Research Center for Nuclear Physics (RCNP), Osaka University, Ibaraki 567-0047, Japan
| | - A Poves
- Departamento de Fisica Teorica and IFT UAM-CSIC, Universidad Autonoma de Madrid, Spain
| | - K Yoshida
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
| | - N L Achouri
- LPC Caen, Normandie Université, ENSICAEN, UNICAEN, CNRS/IN2P3, F-14000 Caen, France
| | - H Baba
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - F Browne
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D Calvet
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - F Château
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - S Chen
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
- State Key Laboratory of Nuclear Physics and Technology, Peking University, Beijing 100871, China
| | - N Chiga
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - A Corsi
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M L Cortés
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - A Delbart
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - J-M Gheller
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Giganon
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Gillibert
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - C Hilaire
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - T Isobe
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - T Kobayashi
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - Y Kubota
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Center for Nuclear Study, University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
| | - V Lapoux
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - T Motobayashi
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - I Murray
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, F-91405 Orsay cedex, France
| | - H Otsu
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - V Panin
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - N Paul
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- Laboratoire Kastler Brossel, Sorbonne Université, CNRS, ENS, PSL Research University, Collège de France, Case 74, 4 Place Jussieu, 75005 Paris, France
| | - W Rodriguez
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Pontificia Universidad Javeriana, Facultad de Ciencias, Departamento de Física, Bogotá, Colombia
- Universidad Nacional de Colombia, Sede Bogotá, Facultad de Ciencias, Departamento de Física, Bogotá 111321, Colombia
| | - H Sakurai
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - M Sasano
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D Steppenbeck
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - L Stuhl
- Center for Nuclear Study, University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
- Institute for Nuclear Research, Atomki, P.O. Box 51, Debrecen H-4001, Hungary
- Institute for Basic Science, Daejeon 34126, Korea
| | - Y L Sun
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - Y Togano
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 172-8501, Japan
| | - T Uesaka
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - K Wimmer
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - K Yoneda
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - O Aktas
- Department of Physics, Royal Institute of Technology, SE-10691 Stockholm, Sweden
| | - T Aumann
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstrasse 1, 64291 Darmstadt, Germany
| | - L X Chung
- Institute for Nuclear Science & Technology, VINATOM, 179 Hoang Quoc Viet, Cau Giay, Hanoi, Vietnam
| | - F Flavigny
- LPC Caen, Normandie Université, ENSICAEN, UNICAEN, CNRS/IN2P3, F-14000 Caen, France
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, F-91405 Orsay cedex, France
| | - S Franchoo
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, F-91405 Orsay cedex, France
| | - I Gasparic
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Ruđer Bošković Institute, Bijenička cesta 54, 10000 Zagreb, Croatia
| | - R-B Gerst
- Institut für Kernphysik, Universität zu Köln, D-50937 Cologne, Germany
| | - J Gibelin
- LPC Caen, Normandie Université, ENSICAEN, UNICAEN, CNRS/IN2P3, F-14000 Caen, France
| | - K I Hahn
- Institute for Basic Science, Daejeon 34126, Korea
- Ewha Womans University, Seoul 03760, Korea
| | - D Kim
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Institute for Basic Science, Daejeon 34126, Korea
- Ewha Womans University, Seoul 03760, Korea
| | - Y Kondo
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo, 152-8551, Japan
| | - P Koseoglou
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstrasse 1, 64291 Darmstadt, Germany
| | - J Lee
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - C Lehr
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - P J Li
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - B D Linh
- Institute for Nuclear Science & Technology, VINATOM, 179 Hoang Quoc Viet, Cau Giay, Hanoi, Vietnam
| | - T Lokotko
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - M MacCormick
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, F-91405 Orsay cedex, France
| | - K Moschner
- Institut für Kernphysik, Universität zu Köln, D-50937 Cologne, Germany
| | - T Nakamura
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo, 152-8551, Japan
| | - S Y Park
- Institute for Basic Science, Daejeon 34126, Korea
- Ewha Womans University, Seoul 03760, Korea
| | - D Rossi
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - E Sahin
- Department of Physics, University of Oslo, N-0316 Oslo, Norway
| | - P-A Söderström
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - D Sohler
- Institute for Nuclear Research, Atomki, P.O. Box 51, Debrecen H-4001, Hungary
| | - S Takeuchi
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo, 152-8551, Japan
| | - H Toernqvist
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstrasse 1, 64291 Darmstadt, Germany
| | - V Vaquero
- Instituto de Estructura de la Materia, CSIC, E-28006 Madrid, Spain
| | - V Wagner
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - S Wang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - V Werner
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- Helmholtz Forschungsakademie Hessen für FAIR (HFHF), GSI Helmholtzzentrum für Schwerionenforschung, Campus Darmstadt, 64289 Darmstadt, Germany
| | - X Xu
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - H Yamada
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo, 152-8551, Japan
| | - D Yan
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Z Yang
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - M Yasuda
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo, 152-8551, Japan
| | - L Zanetti
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
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17
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Lau C, Matthew Hill T, Messacar K, Nolte FS, Park SY. 327. Understanding Current Clinical Scenarios for Plasma Microbial Cell-free DNA Diagnostic Testing toward Informing Diagnostic Stewardship. Open Forum Infect Dis 2022. [PMCID: PMC9751982 DOI: 10.1093/ofid/ofac492.405] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Plasma microbial cell-free (mcfDNA) testing has emerged as a promising tool for unbiased detection of pathogens in patients with suspected infections. A systematic evaluation of the patient populations in which this test is used may provide insight into applications for clinical use. We describe demographic and clinical characteristics of patients tested with plasma mcfDNA linked to the Premier Healthcare Database (PHD). Methods A retrospective cross-sectional analysis was conducted using the PHD: a US hospital-based, service-level, all-payer database containing information primarily from geographically diverse communities, teaching hospitals, and health systems. Patients with plasma mcfDNA testing 4/1/2018-12/31/2020 were deterministically linked to the PHD. Patient characteristics were collected via chargemaster data, ICD-10 diagnosis, and procedure codes. Immunocompromised (IC) status was identified using 2021 Agency for Healthcare Research (AHRQ) ICD-based definitions. The AHRQ Elixhauser Comorbidity Index score was derived using ICD-10 codes to indicate comorbidity burden. Results A total of 778 patients in the PHD underwent plasma mcfDNA testing during the study period, 88% of whom were tested in the inpatient setting (Table 1). Thirteen percent had a discharge diagnosis of sepsis with an unspecified organism. Median inpatient length of stay was 10 days with a median of 4 days from time of admission to plasma mcfDNA testing. Forty-seven percent of patients were IC with a majority (62%) having an Elixhauser score ≥ 7, suggestive of a high comorbidity burden (Table 2). Two hundred forty-nine (32%) inpatients required intensive care unit (ICU) level care for a median 15 days.
![]() ![]() Conclusion Plasma mcfDNA testing is primarily being used in the inpatient setting in a wide variety of clinical scenarios, particularly among seriously ill and immunocompromised patients, who tend to have broad infectious disease differentials and high morbidity and mortality risks. Understanding the current populations, indications, and timing of mcfDNA testing may contribute to developing diagnostic stewardship research and guidelines to optimize impact on clinical outcomes. Disclosures Constance Lau, MPH, Karius, Inc.: Current employee|Karius, Inc.: Stocks/Bonds T. Matthew Hill, PharmD, PhD, Karius, Inc: Paid employee|Karius, Inc: Stocks/Bonds Frederick S. Nolte, PhD, D(ABMM), F(AAM), Karius: Employee.
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Affiliation(s)
| | | | - Kevin Messacar
- University of Colorado, Children’s Hospital Colorado, Aurora, Colorado
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18
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Jung TW, Kim H, Park SY, Cho W, Oh H, Lee HJ, Abd El-Aty AM, Hacimuftuoglu A, Jeong JH. Stachydrine alleviates lipid-induced skeletal muscle insulin resistance via AMPK/HO-1-mediated suppression of inflammation and endoplasmic reticulum stress. J Endocrinol Invest 2022; 45:2181-2191. [PMID: 35834165 DOI: 10.1007/s40618-022-01866-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 07/06/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Insulin resistance develops due to skeletal muscle inflammation and endoplasmic reticulum (ER) stress. Stachydrine (STA), extracted from Leonurus heterophyllus, has been shown to suppress proliferation and induce apoptosis in breast cancer cells and exert anti-inflammatory properties in the brain, heart, and liver. However, the roles of STA in insulin signaling in skeletal muscle remain unclear. Herein, we examined the impacts of STA on insulin signaling in skeletal muscle under hyperlipidemic conditions and its related molecular mechanisms. METHODS Various protein expression levels were determined by Western blotting. Levels of mouse serum cytokines were measured by ELISA. RESULTS We found that STA-ameliorated inflammation and ER stress, leading to attenuation of insulin resistance in palmitate-treated C2C12 myocytes. STA dose-dependently enhanced AMPK phosphorylation and HO-1 expression. Administration of STA attenuated not only insulin resistance but also inflammation and ER stress in the skeletal muscle of high-fat diet (HFD)-fed mice. Additionally, STA-ameliorated glucose tolerance and insulin sensitivity, as well as serum TNFα and MCP-1, in mice fed a HFD. Small interfering (si) RNA-associated suppression of AMPK or HO-1 expression abolished the effects of STA in C2C12 myocytes. CONCLUSIONS These results suggest that STA activates AMPK/HO-1 signaling, resulting in reduced inflammation and ER stress, thereby improving skeletal muscle insulin resistance. Using STA as a natural ingredient, this research successfully treated insulin resistance and type 2 diabetes.
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Affiliation(s)
- T W Jung
- Department of Pharmacology, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - H Kim
- Department of Pharmacology, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - S Y Park
- Department of Pharmacology, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
- Department of Global Innovative Drugs, Graduate School of Chung-Ang University, Seoul, Republic of Korea
| | - W Cho
- Department of Pharmacology, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - H Oh
- Department of Pharmacology, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - H J Lee
- Department of Anatomy and Cell Biology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
- Department of Global Innovative Drugs, Graduate School of Chung-Ang University, Seoul, Republic of Korea
| | - A M Abd El-Aty
- Department of Pharmacology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
- Department of Medical Pharmacology, Medical Faculty, Ataturk University, 25240, Erzurum, Türkiye
| | - A Hacimuftuoglu
- Department of Medical Pharmacology, Medical Faculty, Ataturk University, 25240, Erzurum, Türkiye
| | - J H Jeong
- Department of Pharmacology, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.
- Department of Global Innovative Drugs, Graduate School of Chung-Ang University, Seoul, Republic of Korea.
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19
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Park SY, Smith NJ, Dong H, Szabo A, Zundel T, Durham LA. COV8: Characterization, Contributing Factors, And Outcomes Of Bleeding Complication In Extracorporeal Membrane Oxygenation for SARS-CoV-2 Pneumonia: A Single-Institution Experience. ASAIO J 2022. [DOI: 10.1097/01.mat.0000841084.40700.8c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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20
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Park SY, Kim J, Chung HY. Denosumab-induced hypocalcemia in a patient with hyperthyroidism: a case report. Osteoporos Int 2022; 33:305-308. [PMID: 34232341 PMCID: PMC8758617 DOI: 10.1007/s00198-021-06059-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/29/2021] [Indexed: 11/26/2022]
Abstract
Denosumab is a humanized monoclonal antibody targeting the receptor activator of nuclear factor kappa-B ligand (RANKL). Denosumab is an effective treatment for osteoporosis but can cause hypocalcemia. We present a case of denosumab-induced hypocalcemia in a patient with hyperthyroidism with a high bone turnover state. A 48-year-old postmenopausal woman was diagnosed with hyperthyroidism and osteoporosis and received antithyroid drugs (propylthiouracil 200 mg/day) and denosumab. After 2 months of taking medication, the patient complained of numbness and tingling in the hands and feet and was diagnosed with hypocalcemia (calcium, 5.8 mg/dL; ionized calcium, 0.83 mmol/L). Alfacalcidol (0.5 μg/day) and calcium carbonate (3000 mg/day) were prescribed. Subsequently, the patient's symptoms improved, and her serum calcium level normalized. The risk of denosumab-induced hypocalcemia may be increased in patients with diseases related to high bone turnover, such as hyperthyroidism; therefore, caution is needed.
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Affiliation(s)
- S Y Park
- Department of Endocrinology and Metabolism, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - J Kim
- Department of Endocrinology and Metabolism, Chaum, Seoul, Republic of Korea
| | - H Y Chung
- Department of Endocrinology and Metabolism, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea.
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21
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Park SY, Scotting O, Yen TWF, Evans DB, Wang TS, Dream S. Underdiagnosis of primary hyperparathyroidism in patients with osteoarthritis undergoing arthroplasty. Surgery 2021; 171:731-735. [PMID: 34844753 DOI: 10.1016/j.surg.2021.09.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/31/2021] [Accepted: 09/29/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Primary hyperparathyroidism (HPT) is commonly underdiagnosed and undertreated. Joint pain is a nonspecific symptom associated with osteoarthritis or primary HPT. We hypothesize that patients treated for osteoarthritis are underdiagnosed with primary HPT. METHODS Adult patients diagnosed with hip/knee osteoarthritis at the Medical College of Wisconsin from January 2000 to October 2020 were queried. Patients with a calcium level drawn within 1 year of diagnosis of osteoarthritis were included. Patients who had undergone prior parathyroidectomy were excluded. Patients were stratified by serum calcium level, HPT diagnosis, and PTH level. Arthroplasty rates were compared between groups. RESULTS Of 54,788 patients, 9,967 patients (18.2%) had a high serum calcium level, of whom 1,089 (10.9%) had a diagnosis of HPT. Only 76 (7.0%) patients with HPT underwent parathyroidectomy, 208 (19.1%) underwent knee/hip arthroplasty, and 14 (1.3%) underwent both. Arthroplasty was performed in 1,793 patients without evaluation and/or definitive treatment for HPT. There were higher rates of arthroplasty performed in patients with a high serum calcium level compared with those without (21.2% vs 17.4%, P < .001). CONCLUSION Patients with high serum calcium levels were more likely to undergo arthroplasty than those with normocalcemia. Hypercalcemia in the setting of hip or knee osteoarthritis should prompt a full evaluation for primary HPT.
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Affiliation(s)
- Sarah Y Park
- Medical College of Wisconsin, Department of Surgery, Milwaukee, WI
| | - Oliver Scotting
- Medical College of Wisconsin, Department of Orthopedic Surgery, Milwaukee, WI. https://twitter.com/OScotting
| | - Tina W F Yen
- Medical College of Wisconsin, Department of Surgery, Milwaukee, WI
| | - Douglas B Evans
- Medical College of Wisconsin, Department of Surgery, Milwaukee, WI
| | - Tracy S Wang
- Medical College of Wisconsin, Department of Surgery, Milwaukee, WI. https://twitter.com/tracyswangNYMKE
| | - Sophie Dream
- Medical College of Wisconsin, Department of Surgery, Milwaukee, WI.
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22
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Park SY, Plambeck C, Joyce LD, Joyce DL. Bleeding After LVAD Implant: If Things Do Not Add Up, Take a Look! Innovations (Phila) 2021; 16:488-490. [PMID: 34605310 DOI: 10.1177/15569845211042369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 63-year-old male underwent re-exploration after HVAD implantation due to persistent postoperative bleeding. We present an unusual cause of postoperative bleeding after LVAD implantation for which early re-exploration and consideration of unusual etiologies is appropriate.
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Affiliation(s)
- Sarah Y Park
- 5506 Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Christopher Plambeck
- 5506 Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Lyle D Joyce
- 5506 Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - David L Joyce
- 5506 Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
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23
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Browne F, Chen S, Doornenbal P, Obertelli A, Ogata K, Utsuno Y, Yoshida K, Achouri NL, Baba H, Calvet D, Château F, Chiga N, Corsi A, Cortés ML, Delbart A, Gheller JM, Giganon A, Gillibert A, Hilaire C, Isobe T, Kobayashi T, Kubota Y, Lapoux V, Liu HN, Motobayashi T, Murray I, Otsu H, Panin V, Paul N, Rodriguez W, Sakurai H, Sasano M, Steppenbeck D, Stuhl L, Sun YL, Togano Y, Uesaka T, Wimmer K, Yoneda K, Aktas O, Aumann T, Boretzky K, Caesar C, Chung LX, Flavigny F, Franchoo S, Gasparic I, Gerst RB, Gibelin J, Hahn KI, Holl M, Kahlbow J, Kim D, Körper D, Koiwai T, Kondo Y, Koseoglou P, Lee J, Lehr C, Linh BD, Lokotko T, MacCormick M, Miki K, Moschner K, Nakamura T, Park SY, Rossi D, Sahin E, Schindler F, Simon H, Söderström PA, Sohler D, Takeuchi S, Törnqvist H, Tscheuschner J, Vaquero V, Wagner V, Wang S, Werner V, Xu X, Yamada H, Yan D, Yang Z, Yasuda M, Zanetti L. Pairing Forces Govern Population of Doubly Magic ^{54}Ca from Direct Reactions. Phys Rev Lett 2021; 126:252501. [PMID: 34241497 DOI: 10.1103/physrevlett.126.252501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/03/2021] [Accepted: 03/29/2021] [Indexed: 06/13/2023]
Abstract
Direct proton-knockout reactions of ^{55}Sc at ∼220 MeV/nucleon were studied at the RIKEN Radioactive Isotope Beam Factory. Populated states of ^{54}Ca were investigated through γ-ray and invariant-mass spectroscopy. Level energies were calculated from the nuclear shell model employing a phenomenological internucleon interaction. Theoretical cross sections to states were calculated from distorted-wave impulse approximation estimates multiplied by the shell model spectroscopic factors, which describe the wave function overlap of the ^{55}Sc ground state with states in ^{54}Ca. Despite the calculations showing a significant amplitude of excited neutron configurations in the ground-state of ^{55}Sc, valence proton removals populated predominantly the ground state of ^{54}Ca. This counterintuitive result is attributed to pairing effects leading to a dominance of the ground-state spectroscopic factor. Owing to the ubiquity of the pairing interaction, this argument should be generally applicable to direct knockout reactions from odd-even to even-even nuclei.
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Affiliation(s)
- F Browne
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - S Chen
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Hong Kong, Pokfulam 999077, Hong Kong
- State Key Laboratory of Nuclear Physics and Technology, Peking University, Beijing 100871, China
| | - P Doornenbal
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - A Obertelli
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - K Ogata
- Research Center for Nuclear Physics (RCNP), Osaka University, Ibaraki 567-0047, Japan
- Department of Physics, Osaka City University, Osaka 558-8585, Japan
| | - Y Utsuno
- Center for Nuclear Study, University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
| | - K Yoshida
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
| | - N L Achouri
- LPC Caen, ENSICAEN, Université de Caen, CNRS/IN2P3, F-14050 Caen, France
| | - H Baba
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D Calvet
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - F Château
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - N Chiga
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - A Corsi
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M L Cortés
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - A Delbart
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - J-M Gheller
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Giganon
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Gillibert
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - C Hilaire
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - T Isobe
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - T Kobayashi
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - Y Kubota
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Center for Nuclear Study, University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
| | - V Lapoux
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - H N Liu
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- KTH Royal Institute of Technology, 10691 Stockholm, Sweden
| | - T Motobayashi
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - I Murray
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- IPN Orsay, CNRS and Univiersité Paris-Saclay, F-91406 Orsay Cedex, France
| | - H Otsu
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - V Panin
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - N Paul
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - W Rodriguez
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Universidad Nacional de Colombia, Sede Bogotá, Facultad de Ciencias, Departmento de Física, Bogotá 111321, Colombia
- Pontificia Universidad Javeriana, Facultad de Ciencias, Departamento de Física, Bogotá, Colombia
| | - H Sakurai
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - M Sasano
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D Steppenbeck
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - L Stuhl
- Center for Nuclear Study, University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
- Institute for Basic Science, Daejeon 34126, Korea
| | - Y L Sun
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - Y Togano
- Department of Physics, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - T Uesaka
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - K Wimmer
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - K Yoneda
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - O Aktas
- KTH Royal Institute of Technology, 10691 Stockholm, Sweden
| | - T Aumann
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstr. 1, 64291 Darmstadt, Germany
| | - K Boretzky
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstr. 1, 64291 Darmstadt, Germany
| | - C Caesar
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstr. 1, 64291 Darmstadt, Germany
| | - L X Chung
- Institute for Nuclear Science & Technology, VINATOM, P.O. Box 5T-160, Nghia Do, Hanoi, Vietnam
| | - F Flavigny
- IPN Orsay, CNRS and Univiersité Paris-Saclay, F-91406 Orsay Cedex, France
| | - S Franchoo
- IPN Orsay, CNRS and Univiersité Paris-Saclay, F-91406 Orsay Cedex, France
| | - I Gasparic
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- Ruđer Bošković Institute, Bijenička cesta 54,10000 Zagreb, Croatia
| | - R-B Gerst
- Institut für Kernphysik, Universität zu Köln, D-50937 Cologne, Germany
| | - J Gibelin
- LPC Caen, ENSICAEN, Université de Caen, CNRS/IN2P3, F-14050 Caen, France
| | - K I Hahn
- Ewha Womans University, Seoul 03760, Korea
- Institute for Basic Science, Daejeon 34126, Korea
| | - M Holl
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - J Kahlbow
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - D Kim
- Ewha Womans University, Seoul 03760, Korea
- Institute for Basic Science, Daejeon 34126, Korea
| | - D Körper
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstr. 1, 64291 Darmstadt, Germany
| | - T Koiwai
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - Y Kondo
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - P Koseoglou
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstr. 1, 64291 Darmstadt, Germany
| | - J Lee
- Department of Physics, The University of Hong Kong, Pokfulam 999077, Hong Kong
| | - C Lehr
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - B D Linh
- Institute for Nuclear Science & Technology, VINATOM, P.O. Box 5T-160, Nghia Do, Hanoi, Vietnam
| | - T Lokotko
- Department of Physics, The University of Hong Kong, Pokfulam 999077, Hong Kong
| | - M MacCormick
- IPN Orsay, CNRS and Univiersité Paris-Saclay, F-91406 Orsay Cedex, France
| | - K Miki
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - K Moschner
- Institut für Kernphysik, Universität zu Köln, D-50937 Cologne, Germany
| | - T Nakamura
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - S Y Park
- Ewha Womans University, Seoul 03760, Korea
- Institute for Basic Science, Daejeon 34126, Korea
| | - D Rossi
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstr. 1, 64291 Darmstadt, Germany
| | - E Sahin
- Department of Physics, University of Oslo, N-0316 Oslo, Norway
| | - F Schindler
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - H Simon
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstr. 1, 64291 Darmstadt, Germany
| | - P-A Söderström
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - D Sohler
- Atomki, P.O. Box 51, Debrecen H-4001, Hungary
| | - S Takeuchi
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - H Törnqvist
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstr. 1, 64291 Darmstadt, Germany
| | - J Tscheuschner
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - V Vaquero
- Instituto de Estructura de la Materia, CSIC, E-28006 Madrid, Spain
| | - V Wagner
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - S Wang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - V Werner
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - X Xu
- Department of Physics, The University of Hong Kong, Pokfulam 999077, Hong Kong
| | - H Yamada
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - D Yan
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Z Yang
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - M Yasuda
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - L Zanetti
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
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Kim HJ, Choi GS, Song SH, Park JS, Park SY, Lee SM, Choi JA. An initial experience with a novel technique of single-port robotic resection for rectal cancer. Tech Coloproctol 2021; 25:857-864. [PMID: 34052901 DOI: 10.1007/s10151-021-02457-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 05/04/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The da Vinci single-port (SP) system is designed to facilitate single-incision robotic surgery in a narrow space. We developed a new procedure of rectal resection using this system. The aim of the present study was to evaluate the technical feasibility and safety of SP robotic rectal resection for rectal cancer patients based on our initial experience. METHODS A study was conducted on consecutive patients with mid or low rectal cancer who had SP robotic resection at our institution between July and September 2020. The demographic characteristics, perioperative data, and pathology results of the patients were retrospectively analyzed. RESULTS There were 5 patients (3 males, 2 females, median age 57 years (range 36-73 years). The median tumor height from the anal verge was 4 cm (range 3-5 cm). Two patients received preoperative chemoradiotherapy for advanced rectal cancer. A single docking was conducted, and the median docking time was 4 min 20 s (range 3 min 30 s to 5 min). The median total operation time was 195 min (range 155-240 min), and the median time of pelvic dissection was 45 min (range 36-62 min). All patients had circumferential and distal tumor-free resection margins. One patient experienced an anastomosis-related complication. The median duration of hospital stay was 7 days (range 7-8 days). CONCLUSIONS Our initial experience suggests that SP robotic rectal resection is safe and feasible. Further clinical trials comparing SP and multiport robotic rectal resection should be conducted to verify the superior aspects of this new system.
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Affiliation(s)
- H J Kim
- Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University , 807 Hogukro, Buk-gu, Daegu, 41404, South Korea
| | - G-S Choi
- Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University , 807 Hogukro, Buk-gu, Daegu, 41404, South Korea.
| | - S H Song
- Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University , 807 Hogukro, Buk-gu, Daegu, 41404, South Korea
| | - J S Park
- Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University , 807 Hogukro, Buk-gu, Daegu, 41404, South Korea
| | - S Y Park
- Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University , 807 Hogukro, Buk-gu, Daegu, 41404, South Korea
| | - S M Lee
- Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University , 807 Hogukro, Buk-gu, Daegu, 41404, South Korea
| | - J A Choi
- Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University , 807 Hogukro, Buk-gu, Daegu, 41404, South Korea
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Kim AY, Kim H, Park SY, Park SH, Lee JM, Kim JS, Park JW, Park CK, Park JH, Ko YJ. Investigation of the optimal medium and application strategy for foot-and-mouth disease vaccine antigen production. J Appl Microbiol 2021; 131:1113-1122. [PMID: 33544957 DOI: 10.1111/jam.15024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 11/03/2020] [Accepted: 02/01/2021] [Indexed: 12/14/2022]
Abstract
AIMS For the effective production of 146S particles, which determines foot-and-mouth disease (FMD) vaccine efficacy, we aimed to identify the optimal medium that is easy-to-use, productive and economically affordable for the large-scale production of FMD vaccine. METHODS AND RESULTS Nine combinations of cell growth media and replacement media were tested for virus propagation. Apart from the replacement strategy, we tested a simple addition strategy involving the addition of 30% v/v of fresh medium to the total spent medium using the Cellvento BHK-200 (Vento). Unlike other tested media that produced poor yields of 146S particles when the spent media were not eliminated, Vento exhibited high productivity with the 30% addition strategy. CONCLUSIONS Considering its lower price and media consumption compared to those of other media that require media replacement, the 30% addition strategy of Vento is highly effective. Furthermore, owing to its simple application strategy, it makes the scale-up process easy and helps in saving the time and labour involved in spent media removal. SIGNIFICANCE AND IMPACT OF THE STUDY Through the first comparative assessment of commercial media for the 146S particle recovery, this study suggests the best practical medium for the industrial-scale production of FMD vaccines.
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Affiliation(s)
- A-Y Kim
- Animal and Plant Quarantine Agency, Gimcheon, Gyeonsangbuk-do, Republic of Korea
| | - H Kim
- Animal and Plant Quarantine Agency, Gimcheon, Gyeonsangbuk-do, Republic of Korea.,College of Veterinary Medicine & Animal Disease Intervention Center, Kyungpook National University, Daegu, Republic of Korea
| | - S Y Park
- Animal and Plant Quarantine Agency, Gimcheon, Gyeonsangbuk-do, Republic of Korea
| | - S H Park
- Animal and Plant Quarantine Agency, Gimcheon, Gyeonsangbuk-do, Republic of Korea
| | - J-M Lee
- Animal and Plant Quarantine Agency, Gimcheon, Gyeonsangbuk-do, Republic of Korea
| | - J-S Kim
- Animal and Plant Quarantine Agency, Gimcheon, Gyeonsangbuk-do, Republic of Korea
| | - J-W Park
- Animal and Plant Quarantine Agency, Gimcheon, Gyeonsangbuk-do, Republic of Korea
| | - C-K Park
- College of Veterinary Medicine & Animal Disease Intervention Center, Kyungpook National University, Daegu, Republic of Korea
| | - J-H Park
- Animal and Plant Quarantine Agency, Gimcheon, Gyeonsangbuk-do, Republic of Korea
| | - Y-J Ko
- Animal and Plant Quarantine Agency, Gimcheon, Gyeonsangbuk-do, Republic of Korea
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Jung HS, Jang S, Chung HY, Park SY, Kim HY, Ha YC, Lee YK, Nho JH. Incidence of subsequent osteoporotic fractures after distal radius fractures and mortality of the subsequent distal radius fractures: a retrospective analysis of claims data of the Korea National Health Insurance Service. Osteoporos Int 2021; 32:293-299. [PMID: 32876712 DOI: 10.1007/s00198-020-05609-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022]
Abstract
UNLABELLED A better understanding of the features of subsequent fractures after distal radius fracture (DRF) is important for the prevention of further osteoporotic fractures. This study found that the cumulative incidence of subsequent osteoporotic fractures in South Korea increased over time and that the mortality rates of subsequent DRFs were lower than those of first-time DRFs. INTRODUCTION We examined the incidence of osteoporotic fractures following distal radius fractures (DRFs) and the mortality rate after subsequent DRFs using claims data from the Korea National Health Insurance (KNHI) Service. METHODS We identified records for 41,417 patients with first-time DRFs in 2012. The occurrence of osteoporotic fractures of the spine, hip, wrist, and humerus at least 6 months after the index DRF was tracked through 2016. All fractures were identified by specific diagnosis and procedure codes. One-year mortality rates and standardized mortality ratios (SMRs) for initial and subsequent DRFs were calculated for all patients. RESULTS The 4-year cumulative incidence of all subsequent osteoporotic fractures was 14.74% (6105/41,417; 9.47% in men, 15.9% in women). The number of associated subsequent fractures was 2850 for the spine (46.68%), 2271 for the wrist (37.2%), 708 for the hip (11.6%), and 276 for the humerus (4.52%). The cumulative mortality rate 1 year after the first-time and subsequent DRF was 1.47% and 0.71%, respectively, and the overall SMR was 1.48 (95% CI: 1.37-1.61) and 0.71 (95% CI: 0.42-1.21), respectively. CONCLUSION The cumulative incidence of osteoporotic fractures following DRFs increased over the study period and was higher among women. The cumulative mortality rates and SMRs of subsequent DRFs were lower than those of first-time DRFs at the 1-year follow-up. Given the increasing incidence rate of DRFs, the incidence of subsequent osteoporotic fractures may also increase.
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Affiliation(s)
- H-S Jung
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - S Jang
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Republic of Korea
| | - H-Y Chung
- Department of Endocrinology and Metabolism, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - S Y Park
- Department of Endocrinology and Metabolism, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - H-Y Kim
- Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| | - Y-C Ha
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Y-K Lee
- Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - J-H Nho
- Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, 59, Daesagwan-ro, Yongsan-gu, Seoul, 04401, Republic of Korea.
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Yun JM, Choi S, Kim K, Kim SM, Son JS, Lee G, Jeong SM, Park SY, Kim YY, Park SM. All-cause mortality, cardiovascular mortality, and incidence of cardiovascular disease according to a screening program of cardiovascular risk in South Korea among young adults: a nationwide cohort study. Public Health 2020; 190:23-29. [PMID: 33338899 DOI: 10.1016/j.puhe.2020.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 08/03/2020] [Accepted: 10/29/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES We aimed to determine whether there are any differences in all-cause and cause-specific mortality with cardiovascular disease (CVD) risk between health screening attenders and non-attenders among young adults. STUDY DESIGN We performed a retrospective cohort study using claim data from the Korean National Health Insurance Service database. METHODS Individuals aged 20-39 years who had received health screening at least once between 2002 and 2005 were classified as attenders, and the others were classified as non-attenders. After propensity score matching according to attendance of health screening, 2,060,409 attenders and 2,060,409 non-attenders were included. We estimated adjusted hazard ratios (HRs) and 95% confidence interval (CI) for all-cause mortality, cause-specific mortality, and hospitalization of CVD from 2006 to 2015. RESULTS Survival from all-cause mortality was greater among attenders than among non-attenders (log rank P < 0.001). Similarly, death from CVD (log rank P = 0.007) and CVD events (log rank P < 0.001) were less likely among attenders. The risk for all-cause mortality in attenders was significantly lower than that in non-attenders (HR = 0.83, 95% CI = 0.81 to 0.84). The risk for CVD mortality (HR = 0.80, 95% CI = 0.73 to 0.87) and hospitalization of CVD (HR = 0.92, 95% CI = 0.91 to 0.94) were lower in attenders. In stratified analyses, the risk for all-cause and cause-specific mortalities was lower among attenders regardless of insurance type. CONCLUSIONS Among young adults, the risk for all-cause mortality, CVD mortality, and hospitalization of CVD were lower for those who underwent health screenings. Future studies that evaluate the cost-effectiveness of health screening with additional consideration of psychosocial aspects are needed.
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Affiliation(s)
- J M Yun
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - S Choi
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
| | - K Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
| | - S M Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
| | - J S Son
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - G Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - S-M Jeong
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - S Y Park
- Big Data Steering Department, National Health Insurance Service, Wonju, South Korea
| | - Y-Y Kim
- Big Data Steering Department, National Health Insurance Service, Wonju, South Korea
| | - S M Park
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea.
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Choi I, Park SY, Lee SW, Kang Z, Jin YS, Kim IW. Dissolution enhancement of sorafenib tosylate by co-milling with tetradecanol post-extracted using supercritical carbon dioxide. Pharmazie 2020; 75:13-17. [PMID: 32033627 DOI: 10.1691/ph.2020.9120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
Sorafenib (SOR) is an important multikinase inhibitor for the treatment of cancers. It is commercially available (Nexavar from Bayer) in the form of sorafenib tosylate (SORt) due to its very low solubility. Studies have been made to further improve the dissolution behavior of the tosylate form (SORt), which could ultimately moderate the currently high daily dose. In the present study, SORt nanoparticles (SORt-NP) were prepared through a process that combined two industrially well-accepted techniques of co-milling and supercritical extraction. SORt was co-milled with hydrophilic polymers and tetradecanol, and the tetradecanol was post-extracted using supercritical carbon dioxide. The process enabled the formation of SORt-NP without using any toxic organic solvents, and the drug/excipient ratio (1:0.38) was substantially higher than determined in other studies (1:5.4-10). The enhanced dissolution behavior of SORt-NP was possible with an optimized number of milling cycles. Combining co-milling and supercritical extraction was able to form overall porous network structures with reduced crystallite size, which accelerated the dissolution of SORt-NP. The current method could be easily extended to other poorly soluble drugs as a general approach to improve their dissolution behaviors.
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Blauvelt A, Leonardi C, Elewski B, Crowley JJ, Guenther LC, Gooderham M, Langley RG, Vender R, Pinter A, Griffiths CEM, Tada Y, Elmaraghy H, Lima RG, Gallo G, Renda L, Burge R, Park SY, Zhu B, Papp K. A head-to-head comparison of ixekizumab vs. guselkumab in patients with moderate-to-severe plaque psoriasis: 24-week efficacy and safety results from a randomized, double-blinded trial. Br J Dermatol 2020; 184:1047-1058. [PMID: 32880909 PMCID: PMC8246960 DOI: 10.1111/bjd.19509] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2020] [Indexed: 12/12/2022]
Abstract
Background Significantly more patients with moderate‐to‐severe plaque psoriasis treated with the interleukin (IL)‐17A inhibitor ixekizumab vs. the IL‐23p19 inhibitor guselkumab in the IXORA‐R head‐to‐head trial achieved 100% improvement in Psoriasis Area and Severity Index (PASI 100) at week 12. Objectives To compare skin and nail clearance and patient‐reported outcomes for ixekizumab vs. guselkumab, up to week 24. Methods IXORA‐R enrolled adults with moderate‐to‐severe plaque psoriasis, defined as static Physician’s Global Assessment ≥ 3, PASI ≥ 12 and involved body surface area ≥ 10%. Statistical comparisons were performed using the Cochran–Mantel–Haenszel test stratified by pooled site. Time‐to‐first‐event comparisons were performed using Kaplan–Meier analysis, and P‐values were generated using adjusted log‐rank tests stratified by treatment group. Cumulative days at clinical and patient‐reported responses were compared by ancova. The trial was registered with ClinicalTrials.gov (NCT03573323). Results Of the 1027 patients randomly assigned, 90% completed the trial (465 of 520 ixekizumab and 459 of 507 guselkumab). As early as week 2 and through week 16, more patients on ixekizumab achieved PASI 100 (P < 0·01). At week 24, ixekizumab was noninferior to guselkumab (50% vs. 52%, difference −2·3%), with no statistically significant difference in PASI 100 (P = 0·41). More patients receiving ixekizumab showed completely clear nails at week 24 (52% vs. 31%, P = 0·007). The median time to first PASI 50/75/90 and PASI 100 were 2 and 7·5 weeks shorter, respectively, for patients on ixekizumab vs. guselkumab (P < 0·001). Patients on ixekizumab also had a greater cumulative benefit, with more days at PASI 90 and 100, with Dermatology Life Quality Index of 0 or 1, and itch free (P < 0·05). The frequency of serious adverse events was 3% for each group, with no new safety signals. Conclusions Ixekizumab was noninferior to guselkumab in complete skin clearance and superior in clearing nails at week 24. Ixekizumab cleared skin more rapidly in patients with moderate‐to‐severe plaque psoriasis, with a greater cumulative benefit, than guselkumab. Overall, the safety findings were consistent with the known safety profile for ixekizumab. What is already known about this topic?Patients with plaque psoriasis desire both high levels of clearance and rapid onset of treatment effects. Ixekizumab is a high‐affinity monoclonal antibody that selectively targets interleukin (IL)‐17A. In the 12‐week report of the IXORA‐R study, ixekizumab demonstrated significantly higher efficacy at early timepoints than the IL‐23p19 inhibitor guselkumab, with more patients achieving 100% improvement in Psoriasis Area and Severity Index (PASI 100) and improved quality of life as early as week 4.
What does this study add?Patients on ixekizumab vs. guselkumab achieved similar levels of skin clearance and superior efficacy in the resolution of nail psoriasis at week 24. Patients on ixekizumab vs. guselkumab had a greater cumulative benefit, with more days at PASI 90 and 100, more days when psoriasis did not impact their quality of life, and more itch‐free days. The safety profiles of both drugs were consistent with those in previous studies.
Linked Comment: Puig. Br J Dermatol 2021; 184:992–993.
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Affiliation(s)
- A Blauvelt
- Oregon Medical Research Center, Portland, OR, USA
| | | | - B Elewski
- Deparment of Dermatology, University of Alabama, Birmingham, AL, USA
| | - J J Crowley
- Bakersfield Dermatology and Skin Cancer Medical Group, Bakersfield, CA, USA
| | | | - M Gooderham
- SKiN Centre for Dermatology, Peterborough, ON, Canada
| | | | - R Vender
- Dermatrials Research Inc, Hamilton, ON, Canada
| | - A Pinter
- Clinic for Dermatology, Venereology and Allergology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - C E M Griffiths
- Dermatology Centre, Salford Royal Hospital, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, UK
| | - Y Tada
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - H Elmaraghy
- Eli Lilly and Company, Indianapolis, IN, USA
| | - R G Lima
- Eli Lilly and Company, Indianapolis, IN, USA
| | - G Gallo
- Eli Lilly and Company, Indianapolis, IN, USA
| | - L Renda
- Eli Lilly and Company, Indianapolis, IN, USA
| | - R Burge
- Eli Lilly and Company, Indianapolis, IN, USA
| | - S Y Park
- Eli Lilly and Company, Indianapolis, IN, USA
| | - B Zhu
- Eli Lilly and Company, Indianapolis, IN, USA
| | - K Papp
- Probity Medical Research, Inc., Waterloo, ON, Canada
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Lee JH, Park SY, Ahn C, Yoo YM, Kim CW, Kim JE, Jo NR, Kang HY, Jung EM, Kim KS, Choi KC, Lee SD, Jeung EB. Second-phase validation study of an alternative developmental toxicity test using mouse embryonic stem cell-derived embryoid bodies. J Physiol Pharmacol 2020; 71. [PMID: 32633240 DOI: 10.26402/jpp.2020.2.06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 02/28/2020] [Indexed: 11/03/2022]
Abstract
The embryoid body test (EBT) is a developmental toxicity test method that measures the size of embryoid bodies (EBs) and the viability of mouse embryonic stem cells (mESCs) and fibroblasts (3T3 cells). The previous pre-validation study confirmed the high accuracy (above 80%) of EBT using 26 coded test chemicals. This second-phase validation study assessed the inter-laboratory reproducibility (5 chemicals in common) and predictive capacity (10 chemicals in each laboratory) test using the coded test chemicals at three laboratories. For the prediction model, the accuracy is increased when more data is accumulated. Therefore, we updated the prediction model and analyzed the results of the second year with the newly created-prediction model. Statistical analysis of the inter-laboratory reproducibility test results indicated that accuracy, sensitivity, and specificity were 87%, 78%, and 100%, respectively. The results of the statistical analysis of the predictive capacity test showed an accuracy of 80%, sensitivity of 78%, and specificity of 81%. In conclusion, the EBT can accurately classify various embryotoxicants within a short period and with relatively little effort. Therefore, EBT can be used as a good way to test developmental toxicity.
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Affiliation(s)
- J-H Lee
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - S Y Park
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - C Ahn
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Y-M Yoo
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - C-W Kim
- Laboratory of Biochemistry and Immunology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - J-E Kim
- R&D Center for Advanced Pharmaceuticals and Evaluation, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - N R Jo
- Department of Information and Statistics, College of Natural Sciences, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - H Y Kang
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea.,Immunotherapy Convergence Research Center, Korea Research Institute of Bioscience and Biotechnology, Yuseong-gu, Daejeon, Republic of Korea
| | - E-M Jung
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - K-S Kim
- R&D Center for Advanced Pharmaceuticals and Evaluation, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - K-C Choi
- Laboratory of Biochemistry and Immunology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - S D Lee
- Department of Information and Statistics, College of Natural Sciences, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - E-B Jeung
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea.
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Hasty JM, Felix GE, Amador M, Barrera R, Santiago GS, Nakasone L, Park SY, Okoji S, Honda E, Asuncion B, Save M, Munoz-Jordan JL, Martinez-Conde S, Medina FA, Waterman SH, Petersen LR, Johnston DI, Hemme RR. Entomological Investigation Detects Dengue Virus Type 1 in Aedes ( Stegomyia) albopictus (Skuse) during the 2015-16 Outbreak in Hawaii. Am J Trop Med Hyg 2020; 102:869-875. [PMID: 32043443 PMCID: PMC7124917 DOI: 10.4269/ajtmh.19-0732] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A dengue outbreak occurred on Hawaii Island between September 2015 and March 2016. Entomological investigations were undertaken between December 2015 and February 2016 to determine which Aedes mosquito species were responsible for the outbreak. A total of 3,259 mosquitoes were collected using a combination of CDC autocidal gravid ovitraps, Biogents BG-Sentinel traps, and hand-nets; immature mosquitoes were collected during environmental surveys. The composition of species was Aedes albopictus (58%), Aedes aegypti (25%), Wyeomyia mitchelli (7%), Aedes vexans (5%), Culex quinquefasciatus (4%), and Aedes japonicus (1%). Adult mosquitoes were analyzed by real-time reverse transcription polymerase chain reaction (PCR) for the presence of dengue virus (DENV) RNA. Of the 185 pools of female mosquitoes tested, 15 containing Ae. albopictus were positive for the presence of DENV type 1 RNA. No virus was detected in pools of the remaining species. Phylogenetic analysis showed the virus strain belonged to genotype I and was closely related to strains that were circulating in the Pacific between 2008 and 2014. This is the first report of detection of DENV in Ae. albopictus from Hawaii.
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Affiliation(s)
| | - Gilberto E Felix
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico
| | - Manuel Amador
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico
| | - Roberto Barrera
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico
| | - Gilberto S Santiago
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico
| | | | - Sarah Y Park
- Hawaii State Department of Health, Honolulu, Hawaii
| | - Steven Okoji
- Hawaii State Department of Health, Honolulu, Hawaii
| | - Eric Honda
- Hawaii State Department of Health, Honolulu, Hawaii
| | | | - Maricia Save
- Hawaii State Department of Health, Honolulu, Hawaii
| | - Jorge L Munoz-Jordan
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico
| | - Stephanie Martinez-Conde
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico
| | - Freddy A Medina
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico
| | - Stephen H Waterman
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico
| | - Lyle R Petersen
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | | | - Ryan R Hemme
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico
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Akaike T, Qazi J, Anderson A, Behnia FS, Shinohara MM, Akaike G, Hippe DS, Thomas H, Takagishi SR, Lachance K, Park SY, Tarabadkar ES, Iyer JG, Blom A, Parvathaneni U, Vesselle H, Nghiem P, Bhatia S. High somatostatin receptor expression and efficacy of somatostatin analogues in patients with metastatic Merkel cell carcinoma. Br J Dermatol 2020; 184:319-327. [PMID: 32320473 DOI: 10.1111/bjd.19150] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Merkel cell carcinoma (MCC) is an aggressive, high-grade, cutaneous neuroendocrine tumour (NET). Agents blocking programmed death 1/programmed death ligand 1 have efficacy in metastatic MCC (mMCC), but half of patients do not derive durable benefit. Somatostatin analogues (SSAs) are commonly used to treat low- and moderate-grade NETs that express somatostatin receptors (SSTRs). OBJECTIVES To assess SSTR expression and the efficacy of SSAs in mMCC, a high-grade NET. Methods In this retrospective study of 40 patients with mMCC, SSTR expression was assessed radiologically by somatostatin receptor scintigraphy (SRS; n = 39) and/or immunohistochemically when feasible (n = 9). Nineteen patients (18 had SRS uptake in MCC tumours) were treated with SSA. Disease control was defined as progression-free survival (PFS) of ≥ 120 days after initiation of SSA. RESULTS Thirty-three of 39 patients (85%) had some degree (low 52%, moderate 23%, high 10%) of SRS uptake. Of 19 patients treated with SSA, seven had a response-evaluable target lesion; three of these seven patients (43%) experienced disease control, with a median PFS of 237 days (range 152-358). Twelve of 19 patients did not have a response-evaluable lesion due to antecedent radiation; five of these 12 (42%) experienced disease control (median PFS of 429 days, range 143-1757). The degree of SSTR expression (determined by SRS and/or immunohistochemistry) did not correlate significantly with the efficacy endpoints. CONCLUSIONS In contrast to other high-grade NETs, mMCC tumours appear frequently to express SSTRs. SSAs can lead to clinically meaningful disease control with minimal side-effects. Targeting of SSTRs using SSA or other novel approaches should be explored further for mMCC.
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Affiliation(s)
- T Akaike
- Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - J Qazi
- Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - A Anderson
- Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - F S Behnia
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - M M Shinohara
- Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - G Akaike
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - D S Hippe
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - H Thomas
- Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - S R Takagishi
- Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - K Lachance
- Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - S Y Park
- Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - E S Tarabadkar
- Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - J G Iyer
- Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - A Blom
- Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - U Parvathaneni
- Department of Radiation Oncology, University of Washington, Seattle, WA, USA
| | - H Vesselle
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - P Nghiem
- Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA.,Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - S Bhatia
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA, USA
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Abstract
Angiostrongyliasis, caused by the Angiostrongylus cantonensis roundworm, became reportable in the state of Hawaii in 2007. We confirmed 82 reported cases between 2007 and 2017. There was a median of seven cases per year, and the majority (57%) of cases occurred between January and April. Most (83%) cases were found on the island of Hawaii, with geographic information system (GIS) analysis identifying hot spots on the east side of the island. However, cases were identified on the other major islands as well, suggesting the risk of exposure is present statewide. Comparisons of cases from 2007 to 2017 with cases from previous assessments found no statistical differences in cerebrospinal fluid results, peripheral blood results, or ages of cases. However, differences in geographic distribution of the cases were statistically significant. Improved testing and increasing awareness of the disease have contributed to our efforts to better understand the general risk factors and modes of transmission present in Hawaii and also helped improve our prevention efforts, although we still do not fully understand the specific causes of cases being concentrated in certain parts of the state over others. Continued outreach efforts, including public forums and publication of preliminary clinical guidelines, aim to inform and improve our public health response and efforts to prevent angiostrongyliasis.
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Affiliation(s)
| | | | - Joe L Elm
- Hawaii Department of Health, Honolulu, Hawaii
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34
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Johnston DI, Viray MA, Ushiroda JM, He H, Whelen AC, Sciulli RH, Kunimoto GY, Y Park S. Investigation and Response to an Outbreak of Dengue: Island of Hawaii, 2015-2016. Public Health Rep 2020; 135:230-237. [PMID: 32040922 DOI: 10.1177/0033354920904068] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES From September 2015 through March 2016, Hawaii had the largest outbreak of locally transmitted dengue since 1944. We report on the Hawaii Department of Health's (HDOH's) investigation, findings, and response to the outbreak. METHODS We defined cases of dengue using a modified version of the Council of State and Territorial Epidemiologists' case definition for dengue virus infections. We conducted epidemiologic investigations, including interviews with case-persons, review of medical records, laboratory testing, genetic sequencing of specimens, and geographic information system (GIS) data analysis. Outbreak response included community outreach and vector-control activities. RESULTS We identified 264 confirmed cases of dengue; illness onset dates ranged from September 11, 2015, to March 17, 2016, all with reported travel to or residence on the Island of Hawaii. Of 264 persons with confirmed dengue, 238 (90.2%) were Hawaii residents. Thirty-seven (14.0%) persons required hospitalization; no cases of severe dengue or death were reported. GIS hot-spot analysis identified a cluster of cases on the western side of the island. Established risk factors for dengue exposure included holes in window or door screens, presence of standing water, and not using insect repellent or wearing protective clothing. CONCLUSIONS To prevent or mitigate the spread of future arboviral introductions and outbreaks, the public health response should focus on behavioral and cultural attitudes, emphasizing personal mosquito protection and mosquito control at the community level. Outbreak responses can also be enhanced through the use of advanced GIS techniques, such as hot-spot analysis, to provide situational awareness and guide response efforts.
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Affiliation(s)
- David I Johnston
- Disease Outbreak Control Division, Hawaii State Department of Health, Honolulu, HI, USA
| | - Melissa A Viray
- Disease Outbreak Control Division, Hawaii State Department of Health, Honolulu, HI, USA
| | - Jenny M Ushiroda
- Disease Investigation Branch, Hawaii State Department of Health, Honolulu, HI, USA
| | - Hua He
- Disease Investigation Branch, Hawaii State Department of Health, Honolulu, HI, USA
| | - A Christian Whelen
- State Laboratories Division, Hawaii State Department of Health, Honolulu, HI, USA
| | - Rebecca H Sciulli
- State Laboratories Division, Hawaii State Department of Health, Honolulu, HI, USA
| | - Gail Y Kunimoto
- Medical Microbiology Branch, State Laboratories Division, Hawaii State Department of Health, Honolulu, HI, USA
| | - Sarah Y Park
- Disease Outbreak Control Division, Hawaii State Department of Health, Honolulu, HI, USA
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35
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Blauvelt A, Papp K, Gottlieb A, Jarell A, Reich K, Maari C, Gordon KB, Ferris LK, Langley RG, Tada Y, Lima RG, Elmaraghy H, Gallo G, Renda L, Park SY, Burge R, Bagel J. A head-to-head comparison of ixekizumab vs. guselkumab in patients with moderate-to-severe plaque psoriasis: 12-week efficacy, safety and speed of response from a randomized, double-blinded trial. Br J Dermatol 2020; 182:1348-1358. [PMID: 31887225 PMCID: PMC7317420 DOI: 10.1111/bjd.18851] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Patients with psoriasis value rapid and complete skin clearance. No head-to-head studies have focused on early responses to interleukin (IL)-17 vs. IL-23 inhibitors. OBJECTIVES To compare early and complete skin clearance by the IL-17A inhibitor ixekizumab vs. the IL-23p19 inhibitor guselkumab. METHODS IXORA-R, a 24-week, randomized, double-blinded study, enrolled adults with moderate-to-severe plaque psoriasis [static Physician's Global Assessment of Disease (sPGA) score of ≥ 3, Psoriasis Area and Severity Index (PASI) ≥ 12, and ≥ 10% body surface area]. Patients were randomized (1 : 1) to receive the approved dose of subcutaneous ixekizumab or guselkumab. Primary end point was 100% improvement in PASI (PASI 100) at week 12. Major secondary end points included other levels of improved PASI and sPGA at different time points. Comparisons were made using the Cochran-Mantel-Haenszel test with a multiple testing strategy. Nonresponder imputation was used for missing data. After the completion of the study, the final secondary end point (PASI 100 at 24 weeks) and safety data through week 24 will be reported. RESULTS In total, 1027 patients were randomized. The primary end point PASI 100 at week 12 was met [215/520 ixekizumab (41%); 126/507 guselkumab (25%); P < 0·001]. All major secondary end points measured up to week 12 were met, including PASI 50 at week 1 and PASI 75 at week 2. Serious adverse event frequency was 3% for each group; no new safety signals were identified. CONCLUSIONS Ixekizumab was superior to guselkumab for rapidly improving signs and symptoms in patients with moderate-to-severe plaque psoriasis by week 12. Adverse events were similar to previous ixekizumab and guselkumab studies. Compared with the IL-23 inhibitor guselkumab, ixekizumab can offer complete skin clearance more rapidly to patients with moderate-to-severe plaque psoriasis. What's already known about this topic? Patients with plaque psoriasis desire both high levels of clearance and rapid onset of treatment effects. Ixekizumab, a high-affinity monoclonal antibody that selectively targets interleukin (IL)-17A, has demonstrated greater and faster skin clearance than etanercept and ustekinumab, with consistent long-term efficacy, safety and durability of response. Clinical trial data and systematic reviews have suggested that IL-17 inhibitors can improve a patient's psoriasis more rapidly than IL-23 inhibitors. What does this study add? The head-to-head study design directly compares the efficacy and speed of response of ixekizumab and the IL-23 inhibitor guselkumab in moderate-to-severe plaque psoriasis. The primary end point was met, showing superiority of ixekizumab over guselkumab for achieving complete skin clearance at week 12. The safety profile of ixekizumab was consistent with previous studies. Ixekizumab can deliver patients complete skin clearance and improved quality of life more rapidly than guselkumab.
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Affiliation(s)
- A Blauvelt
- Oregon Medical Research Center, Portland, OR, U.S.A
| | - K Papp
- Probity Medical Research, Inc., Waterloo, Ontario, Canada
| | - A Gottlieb
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A
| | - A Jarell
- Northeast Dermatology Associates, Portsmouth, NH, U.S.A
| | - K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Skinflammation® Center, Hamburg, Germany
| | - C Maari
- Innovaderm Research, Montreal, QC, Canada
| | - K B Gordon
- Medical College of Wisconsin, Milwaukee, WI, U.S.A
| | - L K Ferris
- Department of Dermatology, University of Pittsburgh, Pittsburgh, PA, U.S.A
| | - R G Langley
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - Y Tada
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - R G Lima
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | - H Elmaraghy
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | - G Gallo
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | - L Renda
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | - S Y Park
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | - R Burge
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | - J Bagel
- Psoriasis Treatment Center of Central New Jersey, East Windsor, NJ, U.S.A
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Kwak MK, Lee EJ, Park JW, Park SY, Kim BJ, Kim TH, Suh K, Koh JM, Lee SH, Byun DW. Correction to: CD4 T cell count is positively associated with lumbar spine bone mass in HIV-infected men under the age of 50 years. Osteoporos Int 2019; 30:2363. [PMID: 31506788 DOI: 10.1007/s00198-019-05115-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Two sentences in the Discussion section were incorrect.
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Affiliation(s)
- M K Kwak
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, University College of Medicine, Soonchunhyang, Seoul, 04401, South Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, 7, Keunjaebong-gil, Hwaseong-Si, Gyeonggi-Do, 18450, South Korea
| | - E J Lee
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Soonchunhyang University Hospital, Soonchunhyang University, 59 Daesagwan-ro, Yongsan-gu, Seoul, 04401, South Korea
| | - J W Park
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang, University College of Medicine, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan-si, Chungcheongnam-do, 31151, South Korea
| | - S Y Park
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Soonchunhyang University Hospital, Soonchunhyang University, 59 Daesagwan-ro, Yongsan-gu, Seoul, 04401, South Korea
| | - B-J Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - T H Kim
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Soonchunhyang University Hospital, Soonchunhyang University, 59 Daesagwan-ro, Yongsan-gu, Seoul, 04401, South Korea
| | - K Suh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, University College of Medicine, Soonchunhyang, Seoul, 04401, South Korea
| | - J-M Koh
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - S H Lee
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
| | - D-W Byun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, University College of Medicine, Soonchunhyang, Seoul, 04401, South Korea.
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Chen S, Lee J, Doornenbal P, Obertelli A, Barbieri C, Chazono Y, Navrátil P, Ogata K, Otsuka T, Raimondi F, Somà V, Utsuno Y, Yoshida K, Baba H, Browne F, Calvet D, Château F, Chiga N, Corsi A, Cortés ML, Delbart A, Gheller JM, Giganon A, Gillibert A, Hilaire C, Isobe T, Kahlbow J, Kobayashi T, Kubota Y, Lapoux V, Liu HN, Motobayashi T, Murray I, Otsu H, Panin V, Paul N, Rodriguez W, Sakurai H, Sasano M, Steppenbeck D, Stuhl L, Sun YL, Togano Y, Uesaka T, Wimmer K, Yoneda K, Achouri N, Aktas O, Aumann T, Chung LX, Flavigny F, Franchoo S, Gašparić I, Gerst RB, Gibelin J, Hahn KI, Kim D, Koiwai T, Kondo Y, Koseoglou P, Lehr C, Linh BD, Lokotko T, MacCormick M, Moschner K, Nakamura T, Park SY, Rossi D, Sahin E, Sohler D, Söderström PA, Takeuchi S, Törnqvist H, Vaquero V, Wagner V, Wang S, Werner V, Xu X, Yamada H, Yan D, Yang Z, Yasuda M, Zanetti L. Quasifree Neutron Knockout from ^{54}Ca Corroborates Arising N=34 Neutron Magic Number. Phys Rev Lett 2019; 123:142501. [PMID: 31702209 DOI: 10.1103/physrevlett.123.142501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Indexed: 06/10/2023]
Abstract
Exclusive cross sections and momentum distributions have been measured for quasifree one-neutron knockout reactions from a ^{54}Ca beam striking on a liquid hydrogen target at ∼200 MeV/u. A significantly larger cross section to the p_{3/2} state compared to the f_{5/2} state observed in the excitation of ^{53}Ca provides direct evidence for the nature of the N=34 shell closure. This finding corroborates the arising of a new shell closure in neutron-rich calcium isotopes. The distorted-wave impulse approximation reaction formalism with shell model calculations using the effective GXPF1Bs interaction and ab initio calculations concur our experimental findings. Obtained transverse and parallel momentum distributions demonstrate the sensitivity of quasifree one-neutron knockout in inverse kinematics on a thick liquid hydrogen target with the reaction vertex reconstructed to final state spin-parity assignments.
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Affiliation(s)
- S Chen
- Department of Physics, The University of Hong Kong, Pokfulam, 999077, Hong Kong
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- School of Physics and State Key Laboratory of Nuclear Physics and Technology, Peking University, Beijing 100871, China
| | - J Lee
- Department of Physics, The University of Hong Kong, Pokfulam, 999077, Hong Kong
| | - P Doornenbal
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - A Obertelli
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - C Barbieri
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - Y Chazono
- Research Center for Nuclear Physics (RCNP), Osaka University, Ibaraki 567-0047, Japan
| | - P Navrátil
- TRIUMF, 4004 Westbrook Mall, Vancouver, BC, V6T 2A3, Canada
| | - K Ogata
- Research Center for Nuclear Physics (RCNP), Osaka University, Ibaraki 567-0047, Japan
| | - T Otsuka
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Department of Physics and Center for Nuclear Study, University of Tokyo, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- Instituut voor Kern- en Stralingsfysica, Katholieke Universiteit Leuven, B-3001 Leuven, Belgium
| | - F Raimondi
- ESNT, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - V Somà
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - Y Utsuno
- Department of Physics and Center for Nuclear Study, University of Tokyo, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
| | - K Yoshida
- Research Center for Nuclear Physics (RCNP), Osaka University, Ibaraki 567-0047, Japan
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
| | - H Baba
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - F Browne
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - D Calvet
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - F Château
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - N Chiga
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - A Corsi
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - M L Cortés
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - A Delbart
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - J-M Gheller
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - A Giganon
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - A Gillibert
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - C Hilaire
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - T Isobe
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - J Kahlbow
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - T Kobayashi
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - Y Kubota
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Center for Nuclear Study, University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
| | - V Lapoux
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - H N Liu
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- Department of Physics, Royal Institute of Technology, SE-10691 Stockholm, Sweden
| | | | - I Murray
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Institut de Physique Nucléaire, CNRS-IN2P3, Univ. Paris-Sud, Université Paris-Saclay, 91406 Orsay Cedex, France
| | - H Otsu
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - V Panin
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - N Paul
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - W Rodriguez
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Universidad Nacional de Colombia, Sede Bogota, Facultad de Ciencias, Departamento de Fisica, Bogotá 111321, Colombia
| | - H Sakurai
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - M Sasano
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | | | - L Stuhl
- Center for Nuclear Study, University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
| | - Y L Sun
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - Y Togano
- Department of Physics, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 172-8501, Japan
| | - T Uesaka
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - K Wimmer
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - K Yoneda
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - N Achouri
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - O Aktas
- Department of Physics, Royal Institute of Technology, SE-10691 Stockholm, Sweden
| | - T Aumann
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany
| | - L X Chung
- Institute for Nuclear Science and Technology, VINATOM, P.O. Box 5T-160, Nghia Do, Hanoi, Vietnam
| | - F Flavigny
- Institut de Physique Nucléaire, CNRS-IN2P3, Univ. Paris-Sud, Université Paris-Saclay, 91406 Orsay Cedex, France
| | - S Franchoo
- Institut de Physique Nucléaire, CNRS-IN2P3, Univ. Paris-Sud, Université Paris-Saclay, 91406 Orsay Cedex, France
| | - I Gašparić
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Ruđer Bošković Institute, Bijenička cesta 54,10000 Zagreb, Croatia
| | - R-B Gerst
- Institut für Kernphysik, Universität zu Köln, 50923 Köln, Germany
| | - J Gibelin
- LPC Caen, ENSICAEN, Université de Caen, CNRS/IN2P3, F-14050 Caen, France
| | - K I Hahn
- Department of Science Education and Department of Physics, Ewha Womans University, Seoul 03760, Korea
| | - D Kim
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Department of Science Education and Department of Physics, Ewha Womans University, Seoul 03760, Korea
| | - T Koiwai
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - Y Kondo
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - P Koseoglou
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany
| | - C Lehr
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - B D Linh
- Institute for Nuclear Science and Technology, VINATOM, P.O. Box 5T-160, Nghia Do, Hanoi, Vietnam
| | - T Lokotko
- Department of Physics, The University of Hong Kong, Pokfulam, 999077, Hong Kong
| | - M MacCormick
- Institut de Physique Nucléaire, CNRS-IN2P3, Univ. Paris-Sud, Université Paris-Saclay, 91406 Orsay Cedex, France
| | - K Moschner
- Institut für Kernphysik, Universität zu Köln, 50923 Köln, Germany
| | - T Nakamura
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - S Y Park
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Department of Science Education and Department of Physics, Ewha Womans University, Seoul 03760, Korea
| | - D Rossi
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - E Sahin
- Department of Physics, University of Oslo, N-0316 Oslo, Norway
| | - D Sohler
- Institute for Nuclear Research of the Hungarian Academy of Sciences (MTA Atomki), P.O. Box 51, Debrecen H-4001, Hungary
| | - P-A Söderström
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - S Takeuchi
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - H Törnqvist
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany
| | - V Vaquero
- Instituto de Estructura de la Materia, CSIC, 28006 Madrid, Spain
| | - V Wagner
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - S Wang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - V Werner
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - X Xu
- Department of Physics, The University of Hong Kong, Pokfulam, 999077, Hong Kong
| | - H Yamada
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - D Yan
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Z Yang
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - M Yasuda
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - L Zanetti
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
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Kang DO, Park SY, Park Y, Jang WY, Kim W, Choi BG, Na JO, Choi CU, Kim EJ, Rha SW, Park CG, Hong SJ, Seo HS. P1249Prognostic impact of sarcopenia on major adverse cardiovascular outcomes in coronary artery disease patients undergoing successful percutaneous coronary intervention. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Sarcopenia is an emerging marker of frailty. Its prognostic impact on atherosclerotic cardiovascular disease (ASCVD) requires further investigation.
Purpose
We investigated the long-term prognostic impact of computed tomography (CT)-determined sarcopenia in patients with coronary artery disease (CAD).
Methods
Total 475 CAD patients those who underwent successful percutaneous coronary intervention (PCI) and performed CT scan within 30 days of PCI were enrolled. The cross-sectional area of skeletal muscle at the first lumbar vertebra (L1) level was measured. Sarcopenia was defined as L1 skeletal muscle index of less than 34.60 cm2/m2 for men and of less than 25.90 cm2/m2 for women. Primary outcome was 3-year all-cause mortality and secondary outcome was 3-year major adverse cardiovascular event (MACE), a composite of all-cause mortality, any myocardial infarction, and repeat revascularization.
Results
Sarcopenia was present in 214 (45.1%) of 475 patients. The incidence of 3-year all-cause mortality and MACE was significantly higher in patients with sarcopenia than in those without sarcopenia (17.7% vs. 5.7%, p<0.001; and 35.0% vs. 11.2%, p<0.001, respectively). In the fully adjusted multivariable analysis, sarcopenia was an independent predictor of higher risk of 3-year all-cause mortality (odds ratio [OR]: 2.98; 95% confidence interval [CI]: 1.35 to 6.58, p=0.007) and MACE (OR: 4.39; 95% CI: 2.49 to 7.73, p<0.001). The results were consistent after propensity-score matched analysis with 100 pairs of study population (C-statistics = 0.868).
Kaplan–Meier analysis of 3-year outcomes Overall population PSM population Sarcopenia (n=214) No sarcopenia (n=261) Log-rank p-value Sarcopenia (n=100) No sarcopenia (n=100) Log-rank p-value All-cause mortality 36 (17.7) 14 (5.7) <0.001 19 (20.0) 7 (7.7) 0.013 Non-fatal MI 12 (6.6) 5 (2.0) 0.021 6 (7.0) 2 (2.3) 0.134 Repeat revascularization 32 (20.3) 14 (6.2) <0.001 17 (23.3) 8 (8.0) 0.027 Total MACEs 68 (35.0) 27 (11.2) <0.001 36 (39.3) 14 (15.4) 0.001 Data are expressed as n (%). MACE = major adverse cardiovascular event; MI = myocardial infarction; PSM = propensity-score matched.
Clinical impact of sarcopenia on CAD
Conclusion
Sarcopenia is a useful predictor of adverse clinical outcomes in patients with CAD undergoing PCI. CT-determined sarcopenia may further aid in risk stratification and decision-making for patients with established ASCVD.
Acknowledgement/Funding
National Research Foundation of Korea (NRF-2016R1A2B3013825), Ministry of Future Creation and Science of Korea (2018K000255)
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Affiliation(s)
- D O Kang
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - S Y Park
- Korea University Guro Hospital, Department of Radiology, Seoul, Korea (Republic of)
| | - Y Park
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - W Y Jang
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - W Kim
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - B G Choi
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - J O Na
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - C U Choi
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - E J Kim
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - S.-W Rha
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - C G Park
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - S.-J Hong
- Korea University Guro Hospital, Department of Radiology, Seoul, Korea (Republic of)
| | - H S Seo
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
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Kang DO, Park SY, Park Y, Jang WY, Kim W, Choi BG, Na JO, Choi CU, Kim EJ, Rha SW, Park CG, Hong SJ, Seo HS. 4098Reduced skeletal muscle mass is associated to worsened long-term clinical outcomes in patients with coronary artery disease: a quantitative analysis by computed tomography. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Sarcopenia is closely associated to poor clinical outcomes in patients with atherosclerotic cardiovascular disease (ASCVD). However, it is unclear whether the skeletal muscle mass at baseline has quantitative effect on future cardiovascular outcomes.
Purpose
We investigated the quantitative effect of skeletal muscle mass on future cardiovascular outcomes in patients with coronary artery disease (CAD).
Methods
Total 475 patients those who underwent successful percutaneous coronary intervention (PCI) for CAD and performed computed tomography (CT) scan within 30 days of PCI were enrolled. The cross-sectional area of skeletal muscle at the first lumbar vertebra (L1) level was measured. Whole study population was divided into 4 groups according to the sex-specific quartiles of skeletal muscle index (SMI). Primary outcome was all-cause mortality and secondary outcome was major adverse cardiovascular event (MACE) within 3 years of follow-up.
Results
Mean follow-up duration was 4.11±3.02 years and average time period from the date of PCI to CT scan was −3.33±11.72 days. The incidence of 3-year all-cause mortality (23.2% vs. 9.9% vs. 6.6% vs. 4.4%, p<0.001) and MACE (42.9% vs. 24.0% vs. 14.3% vs. 6.2%, p<0.001) was significantly higher in the group of lower quartiles of L1-SMI. In the fully adjusted multivariable analysis, lower quartiles of L1-SMI was an independent predictor of higher risk of all-cause mortality and MACE (lowest vs. highest quartile; OR: 4.90, 95% CI: 1.54 to 15.5, p=0.007; and OR: 12.3, 95% CI: 4.99 to 30.4, p<0.001, respectively).
Results of 3-year clinical outcomes SMI Q1 (n=124) SMI Q2 (n=116) SMI Q3 (n=112) SMI Q4 (n=123) Log-rank p-value All-cause mortality 27 (23.2) 11 (9.9) 7 (6.6) 5 (4.4) <0.001 Non-fatal MI 9 (8.7) 3 (3.0) 2 (2.0) 3 (2.6) 0.038 Repeat revascularization 20 (24.9) 15 (15.2) 7 (7.1) 4 (3.8) <0.001 Total MACEs 47 (42.9) 26 (24.0) 15 (14.3) 7 (6.2) <0.001 Data are expressed as n (%). MACE = major adverse cardiovascular event; MI = myocardial infarction; SMI = skeletal muscle index; Q = quartile.
Impact of reduced skeletal muscle on CAD
Conclusion
Skeletal muscle mass at baseline is a powerful predictor of future adverse clinical outcomes in patients with CAD undergoing successful PCI. Quantitative assessment of skeletal muscle mass at L1 level by CT scan provides prognostic implication for future cardiovascular risk stratification.
Acknowledgement/Funding
National Research Foundation of Korea (NRF-2016R1A2B3013825), Ministry of Future Creation and Science of Korea (2018K000255)
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Affiliation(s)
- D O Kang
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - S Y Park
- Korea University Guro Hospital, Department of Radiology, Seoul, Korea (Republic of)
| | - Y Park
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - W Y Jang
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - W Kim
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - B G Choi
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - J O Na
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - C U Choi
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - E J Kim
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - S.-W Rha
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - C G Park
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - S.-J Hong
- Korea University Guro Hospital, Department of Radiology, Seoul, Korea (Republic of)
| | - H S Seo
- Korea University Guro Hospital, Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
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Kim WY, Kang BJ, Chung CR, Park SH, Oh JY, Park SY, Cho WH, Sim YS, Cho YJ, Park S, Kim JH, Hong SB. Prone positioning before extracorporeal membrane oxygenation for severe acute respiratory distress syndrome: A retrospective multicenter study. Med Intensiva 2019; 43:402-409. [PMID: 29983197 PMCID: PMC10036879 DOI: 10.1016/j.medin.2018.04.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 01/06/2018] [Revised: 04/05/2018] [Accepted: 04/29/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the clinical outcomes of patients with severe acute respiratory distress syndrome (ARDS) subjected to prone positioning before extracorporeal membrane oxygenation (ECMO). DESIGN A retrospective analysis of a multicenter cohort was carried out. SETTING Patients admitted to the Intensive Care Units of 11 hospitals in Korea. PATIENTS Patients were divided into those who underwent prone positioning before ECMO (n=28) and those who did not (n=34). INTERVENTIONS None. VARIABLES OF INTEREST Thirty-day mortality, ECMO weaning failure rate, mechanical ventilation weaning success rate, mechanical ventilation-free days at day 60. RESULTS The prone group had lower median peak inspiratory pressure and lower median dynamic driving pressure before ECMO. Thirty-day mortality was 21% in the prone group and 41% in the non-prone group (p=0.098). The prone group also showed a lower ECMO weaning failure rate, and a higher mechanical ventilation weaning success rate and more mechanical ventilation-free days at day 60. In the non-prone group, median dynamic compliance marginally decreased shortly after ECMO, but no significant change was observed in the prone group. CONCLUSIONS Prone positioning before ECMO was not associated to increased mortality and tended to exert a protective effect.
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Affiliation(s)
- W-Y Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - B J Kang
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - C R Chung
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S H Park
- Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - J Y Oh
- Division of Pulmonology and Critical Care Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Republic of Korea
| | - S Y Park
- Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - W H Cho
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Y S Sim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Y-J Cho
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - S Park
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - J-H Kim
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - S-B Hong
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Park SY, Lee SJ, Han JH, Koh YW. Association between 18F-FDG uptake in PET/CT, Nrf2, and NQO1 expression and their prognostic significance in non-small cell lung cancer. Neoplasma 2019; 66:619-626. [PMID: 30868898 DOI: 10.4149/neo_2018_181007n742] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 01/15/2019] [Indexed: 11/08/2022]
Abstract
Two pentose phosphate pathway-related proteins, NF-E2-related factor 2 (Nrf2)/ NAD(P)H dehydrogenase (Quinone) 1 (NQO1) regulate the expression of glucose metabolism and antioxidant genes. We evaluated the prognostic significance of NRF2, NQO1 and 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) parameter and their relationship with non-small cell lung cancer (NSCLC) histology. A total of 241 patients, who underwent surgical resection for NSCLC, were reviewed retrospectively. Preoperative 18F-FDG PET and immunohistochemical results of Nrf2 and NQO1 were evaluated. In SQCC, the maximum standardized uptake value (SUVmax) was significantly higher in NQO1-high than in NQO1-low expression (p=0.023). In adenocarcinoma, SUVmax was not correlated with NQO1 expression. Patients with a high NQO1 expression showed poor recurrence-free survival (RFS) and overall survival (OS) than patients with a low NQO1 expression in squamous cell carcinoma (SQCC) (p=0.002 and p=0.014, respectively). NQO1 expression was not associated with clinical outcome in adenocarcinoma. Nrf2 expression was not correlated with prognosis in two types of NSCLC. High SUVmax was associated with poor RFS (p=0.03) but is not related to poor OS (p=0.569) in SQCC. In multivariate analyses, NQO1 expression and SUVmax were not independent prognostic factors in SQCC. However, in multivariate analysis combining NQO1 and SUVmax values, both low SUVmax and low NQO1 was independent prognostic factor for RFS and OS (HR= 3.790, p = 0.033 and HR= 2.961, p = 0.045, respectively). In conclusion, both low SUVmax and low NQO1 was an independent prognostic factor in SQCC alone. The sample size was small but there was a positive correlation between NQO1 expression and SUVmax in SQCC.
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Affiliation(s)
- S Y Park
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Yonsei University, Seoul, South Korea
| | - S J Lee
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Ajou University, Suwon, South Korea
| | - J H Han
- Department of Pathology, Ajou University School of Medicine, Ajou University, Suwon, South Korea
| | - Y W Koh
- Department of Pathology, Ajou University School of Medicine, Ajou University, Suwon, South Korea
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Bae H, Cho NH, Park SY. PI-RADS version 2: optimal time range for determining positivity of dynamic contrast-enhanced MRI in peripheral zone prostate cancer. Clin Radiol 2019; 74:895.e27-895.e34. [PMID: 31327469 DOI: 10.1016/j.crad.2019.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 06/24/2019] [Indexed: 11/30/2022]
Abstract
AIM To analyse the optimal time cut-off for determining positivity of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) in peripheral zone (PZ) prostate cancer (PCa). MATERIALS AND METHODS A consecutive series of 89 patients with PZ PCa who had undergone diffusion-weighted imaging (DWI) and subtraction DCE MRI were included. An experienced reader visually analysed the earliest time after contrast medium injection to visualise the best contrast between an index tumour and normal PZ on DCE MRI (i.e., best contrast time). The best contrast time cut-off for clinically significant cancer (csPCa) according to Epstein criteria or International Society of Urological Pathology (ISUP) grade ≥2 was analysed by an experienced reader, and applied to a less-experienced reader. For the index lesion of DWI category 3, the added value of DCE MRI (increased true positive and negative rates of PI-RADSv2 for csPCa) was evaluated using the cut-off time. RESULTS The best contrast time cut-off for csPCa was ≤72 seconds for Epstein criteria and ≤56 seconds for ISUP grade ≥2 by an experienced reader. The weighted kappa to determine positivity of DCE MRI was 0.622 for ≤72 seconds and 0.527 for ≤56 seconds between the two readers. The added value of DCE MRI was 55-75% by an experienced reader and 39.1-69.6% by a less-experienced reader. CONCLUSION For interpreting PI-RADSv2, imaging findings within 60-72 seconds following contrast media injection seem to reliably determine positivity of DCE MRI in PZ, and have added value for detecting csPCa.
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Affiliation(s)
- H Bae
- Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - N H Cho
- Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - S Y Park
- Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Kim CG, Kim KH, Pyo KH, Xin CF, Hong MH, Ahn BC, Kim Y, Choi SJ, Yoon HI, Lee JG, Lee CY, Park SY, Park SH, Cho BC, Shim HS, Shin EC, Kim HR. Hyperprogressive disease during PD-1/PD-L1 blockade in patients with non-small-cell lung cancer. Ann Oncol 2019; 30:1104-1113. [PMID: 30977778 DOI: 10.1093/annonc/mdz123] [Citation(s) in RCA: 176] [Impact Index Per Article: 35.2] [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: 12/17/2022] Open
Abstract
BACKGROUND Immune checkpoint blockade with Programmed cell death 1 (PD-1)/PD-L1 inhibitors has been effective in various malignancies and is considered as a standard treatment modality for patients with non-small-cell lung cancer (NSCLC). However, emerging evidence show that PD-1/PD-L1 blockade can lead to hyperprogressive disease (HPD), a flair-up of tumor growth linked to dismal prognosis. This study aimed to evaluate the incidence of HPD and identify the determinants associated with HPD in patients with NSCLC treated with PD-1/PD-L1 blockade. PATIENTS AND METHODS We enrolled patients with recurrent and/or metastatic NSCLC treated with PD-1/PD-L1 inhibitors between April 2014 and November 2018. Clinicopathologic variables, dynamics of tumor growth, and treatment outcomes were analyzed in patients with NSCLC who received PD-1/PD-L1 blockade. HPD was defined according to tumor growth kinetics (TGK), tumor growth rate (TGR), and time to treatment failure (TTF). Immunophenotyping of peripheral blood CD8+ T lymphocytes was conducted to explore the potential predictive biomarkers of HPD. RESULTS A total of 263 patients were analyzed. HPD was observed in 55 (20.9%), 54 (20.5%), and 98 (37.3%) patients according to the TGK, TGR, and TTF. HPD meeting both TGK and TGR criteria was associated with worse progression-free survival [hazard ratio (HR) 4.619; 95% confidence interval (CI) 2.868-7.440] and overall survival (HR, 5.079; 95% CI, 3.136-8.226) than progressive disease without HPD. There were no clinicopathologic variables specific for HPD. In the exploratory biomarker analysis with peripheral blood CD8+ T lymphocytes, a lower frequency of effector/memory subsets (CCR7-CD45RA- T cells among the total CD8+ T cells) and a higher frequency of severely exhausted populations (TIGIT+ T cells among PD-1+CD8+ T cells) were associated with HPD and inferior survival rate. CONCLUSION HPD is common in NSCLC patients treated with PD-1/PD-L1 inhibitors. Biomarkers derived from rationally designed analysis may successfully predict HPD and worse outcomes, meriting further investigation of HPD.
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Affiliation(s)
- C G Kim
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon; Division of Medical Oncology, Department of Internal Medicine
| | - K H Kim
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon; Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul
| | - K-H Pyo
- Division of Medical Oncology, Department of Internal Medicine; JE-UK Institute for Cancer Research, JEUK Co. Ltd, Gumi
| | - C-F Xin
- JE-UK Institute for Cancer Research, JEUK Co. Ltd, Gumi
| | - M H Hong
- Division of Medical Oncology, Department of Internal Medicine
| | - B-C Ahn
- Division of Medical Oncology, Department of Internal Medicine
| | - Y Kim
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon
| | - S J Choi
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon
| | - H I Yoon
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul
| | - J G Lee
- Department of Thoracic and Cardiovascular Surgery
| | - C Y Lee
- Department of Thoracic and Cardiovascular Surgery
| | - S Y Park
- Department of Thoracic and Cardiovascular Surgery
| | - S-H Park
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon
| | - B C Cho
- Division of Medical Oncology, Department of Internal Medicine
| | - H S Shim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - E-C Shin
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon.
| | - H R Kim
- Division of Medical Oncology, Department of Internal Medicine.
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Kwak MK, Lee EJ, Park JW, Park SY, Kim BJ, Kim TH, Suh K, Koh JM, Lee SH, Byun DW. CD4 T cell count is inversely associated with lumbar spine bone mass in HIV-infected men under the age of 50 years. Osteoporos Int 2019; 30:1501-1510. [PMID: 30915506 DOI: 10.1007/s00198-019-04942-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 03/14/2019] [Indexed: 01/21/2023]
Abstract
UNLABELLED HIV-infected men under the age of 50 years had a lower bone mass compared to that of HIV-uninfected men. Lower CD4 T cell counts, independent of whether antiretroviral therapy (ART) was used, were associated with lower BMD. HIV-infected patients with low CD4 T cell counts may need follow-up and intervention regarding bone health, including younger patients. INTRODUCTION HIV-infected patients have a low bone mineral density (BMD) owing to multifactorial interaction between common osteoporosis risk factors and HIV-related factors, including chronic inflammation and ART. Although HIV infection and ART might affect bone metabolism, little data is available for patients aged under 50 years. We aimed to investigate the association of HIV infection-induced low CD4 T cell counts and ART with BMD in men aged under 50 years. METHODS We performed an age- and body mass index-matched case-control study. BMD values of HIV-infected and HIV-uninfected men (< 50 years) were compared, and HIV-infected men were stratified by CD4 T cell counts and ART use. RESULTS After adjusting confounders, HIV-infected men with CD4 T cell counts ≥ 500 cells/μL (n = 28) and < 500 cells/μL (n = 139) had lower BMD at the femoral neck (FN, p < 0.001) and total hip (TH, p < 0.001) than HIV-uninfected men (n = 167). HIV-infected men with CD4 T cell counts < 500/μL had lower BMD at the lumbar spine (LS, p = 0.034) than those with counts of ≥ 500 cells/μL, but not at FN and TH. The CD4 T cell count (γ = 0.169, p = 0.031) was positively correlated with BMD at LS. There was no significant difference in the BMD (p = 0.499-> 0.999) between the ART-naïve (n = 75) and ART-user group (n = 92). CONCLUSIONS Despite their relatively younger age, HIV-infected men had a lower BMD than HIV-uninfected men. Lower CD4 T cell counts, irrespective of ART, might result in lower bone mass.
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Affiliation(s)
- M K Kwak
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, 04401, South Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Dontan Sacred Heart Hospital, 7, Keunjaebong-gil, Hwaseong-Si, Gyeonggi-Do, 18450, South Korea
| | - E J Lee
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, 59 Daesagwan-ro, Yongsan-gu, Seoul, 04401, South Korea
| | - J W Park
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan-si, Chungcheongnam-do, 31151, South Korea
| | - S Y Park
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, 59 Daesagwan-ro, Yongsan-gu, Seoul, 04401, South Korea
| | - B -J Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - T H Kim
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, 59 Daesagwan-ro, Yongsan-gu, Seoul, 04401, South Korea
| | - K Suh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, 04401, South Korea
| | - J -M Koh
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - S H Lee
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
| | - D -W Byun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, 04401, South Korea.
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Jeong KJ, Park SY, Cho KH, Sohn JS, Lee J, Kim YK, Kang J, Park CG, Han JW, Lee HY. Correction: The Rho/ROCK pathway for lysophosphatidic acid-induced proteolytic enzyme expression and ovarian cancer cell invasion. Oncogene 2019; 38:5108-5110. [PMID: 30926886 DOI: 10.1038/s41388-019-0769-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The original version of this article contained an error in the published figures Fig 2 and Fig 3f, where the information was inadvertently duplicated. This error does not alter the conclusions of the paper. The corrected figures are published in this correction notice. The authors sincerely apologize for this error.
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Affiliation(s)
- K J Jeong
- Department of Pharmacology, Myunggok Medical Research Institute, College of Medicine, Konyang University, Daejeon, Korea
| | - S Y Park
- Department of Pharmacology, Myunggok Medical Research Institute, College of Medicine, Konyang University, Daejeon, Korea
| | - K H Cho
- Department of Pharmacology, Myunggok Medical Research Institute, College of Medicine, Konyang University, Daejeon, Korea
| | - J S Sohn
- Department of Pathology, Myunggok Medical Research Institute, College of Medicine, Konyang University, Daejeon, Korea
| | - J Lee
- Department of Microbiology, Myunggok Medical Research Institute, College of Medicine, Konyang University, Daejeon, Korea
| | - Y K Kim
- Department of Pharmacology, College of Pharmacy, Sookmyung Women's University, Seoul, Korea
| | - J Kang
- Department of Pharmacology, Myunggok Medical Research Institute, College of Medicine, Konyang University, Daejeon, Korea
| | - C G Park
- Department of Pharmacology, Myunggok Medical Research Institute, College of Medicine, Konyang University, Daejeon, Korea
| | - J W Han
- Department of Biochemistry and Molecular Biology, School of Pharmacy, Sungkyunkwan University, Suwon, Korea
| | - H Y Lee
- Department of Pharmacology, Myunggok Medical Research Institute, College of Medicine, Konyang University, Daejeon, Korea.
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Liu HN, Obertelli A, Doornenbal P, Bertulani CA, Hagen G, Holt JD, Jansen GR, Morris TD, Schwenk A, Stroberg R, Achouri N, Baba H, Browne F, Calvet D, Château F, Chen S, Chiga N, Corsi A, Cortés ML, Delbart A, Gheller JM, Giganon A, Gillibert A, Hilaire C, Isobe T, Kobayashi T, Kubota Y, Lapoux V, Motobayashi T, Murray I, Otsu H, Panin V, Paul N, Rodriguez W, Sakurai H, Sasano M, Steppenbeck D, Stuhl L, Sun YL, Togano Y, Uesaka T, Wimmer K, Yoneda K, Aktas O, Aumann T, Chung LX, Flavigny F, Franchoo S, Gašparić I, Gerst RB, Gibelin J, Hahn KI, Kim D, Koiwai T, Kondo Y, Koseoglou P, Lee J, Lehr C, Linh BD, Lokotko T, MacCormick M, Moschner K, Nakamura T, Park SY, Rossi D, Sahin E, Sohler D, Söderström PA, Takeuchi S, Törnqvist H, Vaquero V, Wagner V, Wang S, Werner V, Xu X, Yamada H, Yan D, Yang Z, Yasuda M, Zanetti L. How Robust is the N=34 Subshell Closure? First Spectroscopy of ^{52}Ar. Phys Rev Lett 2019; 122:072502. [PMID: 30848641 DOI: 10.1103/physrevlett.122.072502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/22/2019] [Indexed: 06/09/2023]
Abstract
The first γ-ray spectroscopy of ^{52}Ar, with the neutron number N=34, was measured using the ^{53}K(p,2p) one-proton removal reaction at ∼210 MeV/u at the RIBF facility. The 2_{1}^{+} excitation energy is found at 1656(18) keV, the highest among the Ar isotopes with N>20. This result is the first experimental signature of the persistence of the N=34 subshell closure beyond ^{54}Ca, i.e., below the magic proton number Z=20. Shell-model calculations with phenomenological and chiral-effective-field-theory interactions both reproduce the measured 2_{1}^{+} systematics of neutron-rich Ar isotopes, and support a N=34 subshell closure in ^{52}Ar.
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Affiliation(s)
- H N Liu
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- Department of Physics, Royal Institute of Technology, SE-10691 Stockholm, Sweden
| | - A Obertelli
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - P Doornenbal
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - C A Bertulani
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- Texas A&M University-Commerce, P.O. Box 3011, Commerce, Texas 75429, USA
| | - G Hagen
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - J D Holt
- TRIUMF 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - G R Jansen
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - T D Morris
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - A Schwenk
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - R Stroberg
- TRIUMF 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - N Achouri
- Institut de Physique Nucléaire, CNRS-IN2P3, Université Paris-Sud, Université Paris-Saclay, 91406 Orsay Cedex, France
| | - H Baba
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - F Browne
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D Calvet
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - F Château
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - S Chen
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- State Key Laboratory of Nuclear Physics and Technology, Peking University, Beijing 100871, People's Republic of China
- Department of Physics, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - N Chiga
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - A Corsi
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M L Cortés
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - A Delbart
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - J-M Gheller
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Giganon
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Gillibert
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - C Hilaire
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - T Isobe
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - T Kobayashi
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - Y Kubota
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Center for Nuclear Study, University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
| | - V Lapoux
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - T Motobayashi
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - I Murray
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Institut de Physique Nucléaire, CNRS-IN2P3, Université Paris-Sud, Université Paris-Saclay, 91406 Orsay Cedex, France
| | - H Otsu
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - V Panin
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - N Paul
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - W Rodriguez
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Universidad Nacional de Colombia, Sede Bogota, Facultad de Ciencias, Departamento de Física, 111321, Bogotá, Colombia
| | - H Sakurai
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - M Sasano
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D Steppenbeck
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - L Stuhl
- Center for Nuclear Study, University of Tokyo, RIKEN campus, Wako, Saitama 351-0198, Japan
| | - Y L Sun
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - Y Togano
- Department of Physics, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 172-8501, Japan
| | - T Uesaka
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - K Wimmer
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - K Yoneda
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - O Aktas
- Department of Physics, Royal Institute of Technology, SE-10691 Stockholm, Sweden
| | - T Aumann
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - L X Chung
- Institute for Nuclear Science & Technology, VINATOM, P.O. Box 5T-160, Nghia Do, Hanoi, Vietnam
| | - F Flavigny
- Institut de Physique Nucléaire, CNRS-IN2P3, Université Paris-Sud, Université Paris-Saclay, 91406 Orsay Cedex, France
| | - S Franchoo
- Institut de Physique Nucléaire, CNRS-IN2P3, Université Paris-Sud, Université Paris-Saclay, 91406 Orsay Cedex, France
| | - I Gašparić
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Ruđer Bošković Institute, Bijenička cesta 54, 10000 Zagreb, Croatia
| | - R-B Gerst
- Institut für Kernphysik, Universität zu Köln, D-50937 Cologne, Germany
| | - J Gibelin
- LPC Caen, ENSICAEN, Université de Caen, CNRS/IN2P3, F-14050 Caen, France
| | - K I Hahn
- Ewha Womans University, Seoul 120-750, Korea
| | - D Kim
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Ewha Womans University, Seoul 120-750, Korea
| | - T Koiwai
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - Y Kondo
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo, 152-8551, Japan
| | - P Koseoglou
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmoltzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany
| | - J Lee
- Department of Physics, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - C Lehr
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - B D Linh
- Institute for Nuclear Science & Technology, VINATOM, P.O. Box 5T-160, Nghia Do, Hanoi, Vietnam
| | - T Lokotko
- Department of Physics, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - M MacCormick
- Institut de Physique Nucléaire, CNRS-IN2P3, Université Paris-Sud, Université Paris-Saclay, 91406 Orsay Cedex, France
| | - K Moschner
- Institut für Kernphysik, Universität zu Köln, D-50937 Cologne, Germany
| | - T Nakamura
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo, 152-8551, Japan
| | - S Y Park
- Ewha Womans University, Seoul 120-750, Korea
| | - D Rossi
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - E Sahin
- Department of Physics, University of Oslo, N-0316 Oslo, Norway
| | - D Sohler
- MTA Atomki, P.O. Box 51, Debrecen H-4001, Hungary
| | - P-A Söderström
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - S Takeuchi
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo, 152-8551, Japan
| | - H Törnqvist
- GSI Helmoltzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany
| | - V Vaquero
- Instituto de Estructura de la Materia, CSIC, E-28006 Madrid, Spain
| | - V Wagner
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - S Wang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - V Werner
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - X Xu
- Department of Physics, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - H Yamada
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo, 152-8551, Japan
| | - D Yan
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Z Yang
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - M Yasuda
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo, 152-8551, Japan
| | - L Zanetti
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
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Ahn S, Kim HJ, Kang E, Kim EK, Kim SH, Kim JH, Kim IA, Park SY. Abstract P4-04-10: Genomic profiling of multifocal breast cancer reveals inter-lesion heterogeneity. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-04-10] [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]
Abstract
Abstract
Introduction: Multifocal breast cancers are common, and tend to show more aggressive clinical features than unifocal breast cancers. While each foci of multifocal breast cancers with similar histology shares the same hormone and ERBB2 receptor status in most cases, substantial genomic differences among lesions have been reported. We aimed to investigate the potential genomic differences between multifocal breast cancer lesions.
Materials and methods: Twenty-one patients with multifocal breast cancer documented in the resection specimen were included. We selected two lesions with the same histology from each of these 21 patients. Capture-based targeted next generation sequencing was performed using a cancer gene panel consisting of 170 genes for single nucleotide variants (SNV) and small insertions/deletions (Indel), and copy number alterations.
Results: The most frequent mutation was TP53 (38.1%), followed by PIK3CA (28.6%). Pathogenic mutations (SNV and Indel) were detected in 13 of 21 patients, of whom 11 shared oncogenic variants in the two lesions. The remaining two patients had different mutation results in TP53 and PIK3CA, respectively. Genomic heterogeneity of copy number alteration was observed in 6 (28.6%) of 21 patients, including difference of FGFR1 status in two patients and difference of FGFR2 status in one patient.
Conclusion: Despite similar histologic features of multifocal tumors, genomic inter-lesion heterogeneity was identified in about one-fourth of patients. The spatial genomic heterogeneity in multifocal breast cancers needs to be considered in representative sampling and molecular tests for personalized medicine.
Citation Format: Ahn S, Kim HJ, Kang E, Kim E-K, Kim SH, Kim JH, Kim IA, Park SY. Genomic profiling of multifocal breast cancer reveals inter-lesion heterogeneity [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-04-10.
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Affiliation(s)
- S Ahn
- Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - HJ Kim
- Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - E Kang
- Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - E-K Kim
- Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - SH Kim
- Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - JH Kim
- Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - IA Kim
- Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - SY Park
- Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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Kim SH, Koung Jin S, Kim YJ, Ahn S, Park SY, Chae SM, Kang E, Kim EK, Kim IA, Kim JH. Abstract P4-03-10: Identifying germline APOBEC3B deletion using hereditary cancer panel in Korean patients with operable breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-03-10] [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]
Abstract
Abstract
Background: APOBEC3B is a cytosine deaminase implicated in host immune defense to virus and mutagenesis in cancer. Germline APOBEC3B deletion is known as risk factors for breast cancer with hypermutation and immune activation from previous database-based studies. This study was aimed to evaluate the incidence of germline APOBEC3B deletion in Korean patients with operable breast cancer.
Method: The copy number variants of germline APOBEC3B deletion was analyzed from leukocyte DNA of 103 breast cancer patients whose bloods were collected in 2009 for pharmacogenomic study at Seoul National University Bundang Hospital. Hybrid-capture based next-generation sequencing panel targeting 53 hereditary cancer genes were used. We also measured tumor infiltrating lymphocytes (TILs) and programmed cell death-ligand 1 (PD-L1) expression in tumor or immune cell with a rabbit monoclonal antibody (E1L3N).
Results: Median age of breast cancer diagnosis was 46 (25-72). In APOBEC3B deletion analysis, 10 (9.7%), 36 (35.0%), and 57 (55.3%) patients were identified as two-copy deletion (A3Bdel/del), one-one copy deletion (A3Bdel/wt) and no deletion (A3Bwt/wt), respectively. In non-APOBEC3B analysis, 9 (8.7%) patients were identified as pathogenic variant: RAD51D(n=1), GJB2(n=1), BRCA1(n=1), BRCA2 (n=2), ATM(n=1), USH2A(n=1), RET(n=1), BARD1(n=1). We observed no significant association between germline APOBEC3B deletion with any clinicopathologic features of breast cancer such as age, family history of cancer, and bilateral breast cancer. Triple-negative subtype was associated with A3Bwt/wt Tumors (35.1% in A3Bwt/wt vs. 5.6% in A3Bdel/wt vs20% in A3Bdel/del; P=0.018). After a median follow-up time of 92.8 months, APOBEC3B deletion was not predictive of recurrence or survival. In patients with sufficient tumor samples for the assessment of TIL (n=63) and PD-1 (n=71), A3Bdel/del tumor was associated with higher TILs (>10%) than other tumor types (6/7 patients in A3Bdel/del vs. 13/24 in A3Bdel/wt vs. 15/32 in A3Bwt/wt: Fisher's exact test in A3Bdel/del, P=0.029). However, PD-L1 expression was not associated with APOBEC3B deletion status (1/7 patients >1% PD-L1 in A3Bdel/del vs. 4/26 in A3Bdel/wt vs. 8/38 in A3Bwt/wt: P=0.901).
Germline APOBEC3B deletion and TILs (n=63) TIL (0-10%)TIL (>10%)TotalA3B(wt/wt)17 (53.1%)15 (46.9%)32A3B(del/wt)11 (45.8%)13 (54.2%)24A3B(del/del)1 (14.3%)6 (85.7%)7
Conclusion: We identified germline APOBEC3B deletion in 9.7% of Korean patients with operable breast cancer. The relationship between A3Bdel/del tumor and high TILs suggests that these tumors might be potential candidates for future immunotherapy.
Citation Format: Kim SH, Koung Jin S, Kim YJ, Ahn S, Park SY, Chae SM, Kang E, Kim E-K, Kim IA, Kim JH. Identifying germline APOBEC3B deletion using hereditary cancer panel in Korean patients with operable breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-03-10.
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Affiliation(s)
- SH Kim
- Seoul National University Bundang Hospital, Seongnam, Korea
| | - S Koung Jin
- Seoul National University Bundang Hospital, Seongnam, Korea
| | - YJ Kim
- Seoul National University Bundang Hospital, Seongnam, Korea
| | - S Ahn
- Seoul National University Bundang Hospital, Seongnam, Korea
| | - SY Park
- Seoul National University Bundang Hospital, Seongnam, Korea
| | - SM Chae
- Seoul National University Bundang Hospital, Seongnam, Korea
| | - E Kang
- Seoul National University Bundang Hospital, Seongnam, Korea
| | - E-K Kim
- Seoul National University Bundang Hospital, Seongnam, Korea
| | - IA Kim
- Seoul National University Bundang Hospital, Seongnam, Korea
| | - JH Kim
- Seoul National University Bundang Hospital, Seongnam, Korea
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Affiliation(s)
- SY Park
- Ewha Womans University, Seoul, South Korea
| | - H Lee
- Ewha Womans University, Seoul, South Korea
| | - M Kang
- Ewha Womans University, Seoul, South Korea
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Kim KS, Kang SY, Park CK, Kim GA, Park SY, Cho H, Seo CW, Lee DY, Lim HW, Lee HW, Park JE, Woo TH, Oh JE. A Compressed-Sensing Based Blind Deconvolution Method for Image Deblurring in Dental Cone-Beam Computed Tomography. J Digit Imaging 2018; 32:478-488. [PMID: 30238344 DOI: 10.1007/s10278-018-0120-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/30/2022] Open
Abstract
In cone-beam computed tomography (CBCT), reconstructed images are inherently degraded, restricting its image performance, due mainly to imperfections in the imaging process resulting from detector resolution, noise, X-ray tube's focal spot, and reconstruction procedure as well. Thus, the recovery of CBCT images from their degraded version is essential for improving image quality. In this study, we investigated a compressed-sensing (CS)-based blind deconvolution method to solve the blurring problem in CBCT where both the image to be recovered and the blur kernel (or point-spread function) of the imaging system are simultaneously recursively identified. We implemented the proposed algorithm and performed a systematic simulation and experiment to demonstrate the feasibility of using the algorithm for image deblurring in dental CBCT. In the experiment, we used a commercially available dental CBCT system that consisted of an X-ray tube, which was operated at 90 kVp and 5 mA, and a CMOS flat-panel detector with a 200-μm pixel size. The image characteristics were quantitatively investigated in terms of the image intensity, the root-mean-square error, the contrast-to-noise ratio, and the noise power spectrum. The results indicate that our proposed method effectively reduced the image blur in dental CBCT, excluding repetitious measurement of the system's blur kernel.
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Affiliation(s)
- K S Kim
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - S Y Kang
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - C K Park
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - G A Kim
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - S Y Park
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - Hyosung Cho
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea.
| | - C W Seo
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - D Y Lee
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - H W Lim
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - H W Lee
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - J E Park
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - T H Woo
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - J E Oh
- Division of Convergence Technology, National Cancer Center, Goyang, 10408, Republic of Korea
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