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Ahn Y, Lee SM, Choi S, Choe J, Oh SY, Do KH, Seo JB. CT-guided pretreatment biopsy diagnosis in patients with thymic epithelial tumours: diagnostic accuracy and risk of seeding. Clin Radiol 2024; 79:263-271. [PMID: 38220515 DOI: 10.1016/j.crad.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/10/2023] [Accepted: 12/10/2023] [Indexed: 01/16/2024]
Abstract
AIM To investigate the diagnostic performance of computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) for thymic epithelial tumours (TETs) and the complication rate after PTNB including seeding after PTNB. MATERIALS AND METHODS This retrospective study identified PTNBs for anterior mediastinal lesions between May 2007 and September 2021. The diagnostic performance for TETs and complications were investigated. The concordance of the histological grades of TETs between PTNB and surgery was evaluated. The factors associated with pleural seeding after PTNB were determined using Cox regression analysis. RESULTS Of 387 PTNBs, 235 PTNBs from 225 patients diagnosed as TETs (124 thymomas and 101 thymic carcinomas) and 150 PTNBs from 133 patients diagnosed as other than TETs were included. The sensitivity, specificity, and accuracy for TETs were 89.4% (210/235), 100% (210/210), and 93.5% (360/385), respectively, with an immediate complication rate of 4.4% (17/385). The concordance rate of the histological grades between PTNB and surgery was 73.3% (77/105) after excluding uncategorised types of thymomas. During follow-up after PTNB (median duration, 38.8 months; range, 0.3-164.6 months), no tract seeding was observed. Pleural seeding was observed in 26 patients. Thymic carcinoma (hazard ratio [HR], 5.94; 95% confidence interval [CI], 2.07-17.08; p=0.001) and incomplete resection (HR, 3.29; 95% CI, 1.20-9.02; p=0.02) were associated with pleural seeding, while the biopsy approach type (transpleural versus parasternal) was not associated (p=0.12). CONCLUSIONS Pretreatment biopsy for TETs was accurate and safe and may be considered for diagnosing TETs, particularly when the diagnosis is challenging and histological diagnosis is mandatory.
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Affiliation(s)
- Y Ahn
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - S M Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
| | - S Choi
- Department of Cardiothoracic Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - J Choe
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - S Y Oh
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - K-H Do
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - J B Seo
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
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Park S, Lee SM. State observer-based Physics-Informed Machine Learning for leader-following tracking control of mobile robot. ISA Trans 2024; 146:582-591. [PMID: 38195292 DOI: 10.1016/j.isatra.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/02/2024] [Accepted: 01/02/2024] [Indexed: 01/11/2024]
Abstract
In this paper, the novel leader-following tracking control method is proposed for mobile robots, which consists estimation technique of the speed of the leader robot (LR), and a parameter-dependent controller for the follower robot (FR). To estimate the speed of LR, a novel Physics Informed Machine Learning (PIML) is proposed to learn the dynamics of the state observer via the error state model. The dynamics of the state observer in PIML play a significant role for stable learning and state estimation of uncertain models. The gain of the parameter-dependent controller is determined by the convex combination of the robust control technique via the polytopic model. Finally, the tracking performance of the proposed method is verified through the simulation and experiment.
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Affiliation(s)
- Sejun Park
- School of Electronic and Electrical Engineering, Kyungpook National University, Daegu 41566, Republic of Korea.
| | - S M Lee
- School of Electronic and Electrical Engineering, Kyungpook National University, Daegu 41566, Republic of Korea.
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Jin Y, Lee SM. Sampled-Data State Estimation for LSTM. IEEE Trans Neural Netw Learn Syst 2024; PP:1-14. [PMID: 38324431 DOI: 10.1109/tnnls.2024.3359211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
This article first introduces a sampled-data state estimator design method for continuous-time long short-term memory (LSTM) neural networks with irregularly sampled output. To this end, the structure of the LSTM is addressed to obtain its dynamic equation. As a result, the LSTM neural network is modeled as a continuous-time linear parameter-varying system that is dependent on the gate units. For this system, the sampled-data Luenberger-and Arcak-type state estimator design methods are presented in terms of linear matrix inequalities (LMIs) by using the properties of the gate units. Lastly, the proposed method not only provides a numerical example for analyzing absolute stability but also demonstrates it in practice by applying a pre-trained behavior generation model of a robot manipulator.
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Lee SM, Yoon K, Lee S, Ryu SY, Kim KG. Multi-Asymmetric Irradiation Method Using a Ring Array to Obtain an Emission-Capable LED Beam Power Effect to Observe Cancer Removal Status in a Surgical Microscope. Diagnostics (Basel) 2023; 13:3482. [PMID: 37998618 PMCID: PMC10670550 DOI: 10.3390/diagnostics13223482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 11/25/2023] Open
Abstract
The light emitting diodes (LEDs) used in surgical fluorescence microscopes have weak power, to induce fluorescence emission. The LED induces fluorescence emission throughout a lesion due to its large beam width; however, the beam irradiation intensity is not uniform within the beam width, resulting in a fluorescence emission induction difference. To overcome this problem, this study proposes an asymmetric irradiation array for supplying power uniformly throughout the beam width of the LED and increasing the intensity of the LED. To increase the irradiation power of the LEDs, a multi-asymmetric irradiation method with a ring-type array structure was used. The LED consisted of eight rings, and the space between the LEDs, the placement position, and the placement angle were analyzed to devise an experimental method using 3D printing technology. To test the irradiation power of the LED, the working distance (WD) between the LED and target was 30 cm. The bias voltage of the LED for irradiating the light source was 5.0 V and the measured power was 4.63 mW. The brightness (lux) was 1153 lx. Consequently, the LED satisfied the fluorescence emission induction conditions. The diameter of the LED-irradiated area was 9.5 cm. Therefore, this LED could be used to observe fluorescent emission-guided lesions. This study maximized the advantages of LEDs with optimal conditions for fluorescence emission by increasing the beam width, irradiation area, and energy efficiency, using a small number of LEDs at the maximum WD. The proposed method, optimized for fluorescence expression-induced surgery, can be made available at clinical sites by mass producing them through semiconductor processes.
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Affiliation(s)
- Seon Min Lee
- Department of Nursing, College of Nursing, 191 Hambakmoero, Yeonsu-gu, Incheon 21936, Republic of Korea;
- Medical Devices R&D Center, Gachon University Gil Medical Center, 21, 774 Beon-gil, Namdong-daero Namdong-gu, Incheon 21565, Republic of Korea; (K.Y.); (S.L.); (S.Y.R.)
- Department of Biomedical Engineering, College of Health Science & Medicine, Gachon University, 1342 Seongnamdaero, Sujeong-gu, Seongnam-si 13120, Gyeonggi-do, Republic of Korea
| | - Kicheol Yoon
- Medical Devices R&D Center, Gachon University Gil Medical Center, 21, 774 Beon-gil, Namdong-daero Namdong-gu, Incheon 21565, Republic of Korea; (K.Y.); (S.L.); (S.Y.R.)
- Department of Biomedical Engineering, College of Health Science & Medicine, Gachon University, 1342 Seongnamdaero, Sujeong-gu, Seongnam-si 13120, Gyeonggi-do, Republic of Korea
| | - Sangyun Lee
- Medical Devices R&D Center, Gachon University Gil Medical Center, 21, 774 Beon-gil, Namdong-daero Namdong-gu, Incheon 21565, Republic of Korea; (K.Y.); (S.L.); (S.Y.R.)
- Department of Biomedical Engineering, College of Health Science & Medicine, Gachon University, 1342 Seongnamdaero, Sujeong-gu, Seongnam-si 13120, Gyeonggi-do, Republic of Korea
| | - Seung Yeob Ryu
- Medical Devices R&D Center, Gachon University Gil Medical Center, 21, 774 Beon-gil, Namdong-daero Namdong-gu, Incheon 21565, Republic of Korea; (K.Y.); (S.L.); (S.Y.R.)
- Department of Biomedical Engineering, College of Health Science & Medicine, Gachon University, 1342 Seongnamdaero, Sujeong-gu, Seongnam-si 13120, Gyeonggi-do, Republic of Korea
- Department of Biohealth & Medical Engineering Major, Gachon University, 1342 Seongnamdaero, Sujeong-gu, Seongnam-si 13120, Gyeonggi-do, Republic of Korea
| | - Kwang Gi Kim
- Medical Devices R&D Center, Gachon University Gil Medical Center, 21, 774 Beon-gil, Namdong-daero Namdong-gu, Incheon 21565, Republic of Korea; (K.Y.); (S.L.); (S.Y.R.)
- Department of Biomedical Engineering, College of Health Science & Medicine, Gachon University, 1342 Seongnamdaero, Sujeong-gu, Seongnam-si 13120, Gyeonggi-do, Republic of Korea
- Department of Health Sciences and Technology, Gachon Advanced Institute for Health Sciences and Technology (GAIHST), Gachon University, 155 Gaetbeol-ro, Yeonsu-gu, Incheon 21999, Republic of Korea
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Adhikari G, Carlin N, Choi JJ, Choi S, Ezeribe AC, França LE, Ha C, Hahn IS, Hollick SJ, Jeon EJ, Jo JH, Joo HW, Kang WG, Kauer M, Kim BH, Kim HJ, Kim J, Kim KW, Kim SH, Kim SK, Kim WK, Kim YD, Kim YH, Ko YJ, Lee DH, Lee EK, Lee H, Lee HS, Lee HY, Lee IS, Lee J, Lee JY, Lee MH, Lee SH, Lee SM, Lee YJ, Leonard DS, Luan NT, Manzato BB, Maruyama RH, Neal RJ, Nikkel JA, Olsen SL, Park BJ, Park HK, Park HS, Park KS, Park SD, Pitta RLC, Prihtiadi H, Ra SJ, Rott C, Shin KA, Cavalcante DFFS, Scarff A, Spooner NJC, Thompson WG, Yang L, Yu GH. Search for Boosted Dark Matter in COSINE-100. Phys Rev Lett 2023; 131:201802. [PMID: 38039466 DOI: 10.1103/physrevlett.131.201802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/30/2023] [Indexed: 12/03/2023]
Abstract
We search for energetic electron recoil signals induced by boosted dark matter (BDM) from the galactic center using the COSINE-100 array of NaI(Tl) crystal detectors at the Yangyang Underground Laboratory. The signal would be an excess of events with energies above 4 MeV over the well-understood background. Because no excess of events are observed in a 97.7 kg·yr exposure, we set limits on BDM interactions under a variety of hypotheses. Notably, we explored the dark photon parameter space, leading to competitive limits compared to direct dark photon search experiments, particularly for dark photon masses below 4 MeV and considering the invisible decay mode. Furthermore, by comparing our results with a previous BDM search conducted by the Super-Kamionkande experiment, we found that the COSINE-100 detector has advantages in searching for low-mass dark matter. This analysis demonstrates the potential of the COSINE-100 detector to search for MeV electron recoil signals produced by the dark sector particle interactions.
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Affiliation(s)
- G Adhikari
- Department of Physics and Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - N Carlin
- Physics Institute, University of São Paulo, 05508-090, São Paulo, Brazil
| | - J J Choi
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - S Choi
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
| | - A C Ezeribe
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - L E França
- Physics Institute, University of São Paulo, 05508-090, São Paulo, Brazil
| | - C Ha
- Department of Physics, Chung-Ang University, Seoul 06973, Republic of Korea
| | - I S Hahn
- Department of Science Education, Ewha Womans University, Seoul 03760, Republic of Korea
- Center for Exotic Nuclear Studies, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - S J Hollick
- Department of Physics and Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - E J Jeon
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - J H Jo
- Department of Physics and Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - H W Joo
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
| | - W G Kang
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - M Kauer
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - B H Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - H J Kim
- Department of Physics, Kyungpook National University, Daegu 41566, Republic of Korea
| | - J Kim
- Department of Physics, Chung-Ang University, Seoul 06973, Republic of Korea
| | - K W Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - S H Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - S K Kim
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
| | - W K Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - Y D Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
- Department of Physics, Sejong University, Seoul 05006, Republic of Korea
| | - Y H Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
- Korea Research Institute of Standards and Science, Daejeon 34113, Republic of Korea
| | - Y J Ko
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - D H Lee
- Department of Physics, Kyungpook National University, Daegu 41566, Republic of Korea
| | - E K Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - H Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - H S Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - H Y Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - I S Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - J Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - J Y Lee
- Department of Physics, Kyungpook National University, Daegu 41566, Republic of Korea
| | - M H Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - S H Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - S M Lee
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
| | - Y J Lee
- Department of Physics, Chung-Ang University, Seoul 06973, Republic of Korea
| | - D S Leonard
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - N T Luan
- Department of Physics, Kyungpook National University, Daegu 41566, Republic of Korea
| | - B B Manzato
- Physics Institute, University of São Paulo, 05508-090, São Paulo, Brazil
| | - R H Maruyama
- Department of Physics and Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - R J Neal
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - J A Nikkel
- Department of Physics and Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - S L Olsen
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - B J Park
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - H K Park
- Department of Accelerator Science, Korea University, Sejong 30019, Republic of Korea
| | - H S Park
- Korea Research Institute of Standards and Science, Daejeon 34113, Republic of Korea
| | - K S Park
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - S D Park
- Department of Physics, Kyungpook National University, Daegu 41566, Republic of Korea
| | - R L C Pitta
- Physics Institute, University of São Paulo, 05508-090, São Paulo, Brazil
| | - H Prihtiadi
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - S J Ra
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - C Rott
- Department of Physics, Sungkyunkwan University, Suwon 16419, Republic of Korea
- Department of Physics and Astronomy, University of Utah, Salt Lake City, Utah 84112, USA
| | - K A Shin
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - D F F S Cavalcante
- Physics Institute, University of São Paulo, 05508-090, São Paulo, Brazil
| | - A Scarff
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - N J C Spooner
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - W G Thompson
- Department of Physics and Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - L Yang
- Department of Physics, University of California San Diego, La Jolla, California 92093, USA
| | - G H Yu
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- Department of Physics, Sungkyunkwan University, Suwon 16419, Republic of Korea
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Voong KR, Shokek OB, Hill C, Hu C, Hales RK, Greco SC, Meyer JJ, Wright JL, Lowe K, McNutt TR, Narang A, PhD CS, Lee SM. Improving Cancer Care by Incorporating the Patient's Voice in Symptom Management (IMPROVE): A Multicenter-Prospective Pilot Study. Int J Radiat Oncol Biol Phys 2023; 117:e264-e265. [PMID: 37785007 DOI: 10.1016/j.ijrobp.2023.06.1222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) IMPROVE is a prospective multicenter pilot study. It evaluates whether routine physician review of patient-reported outcomes measures (PROMs) during radiotherapy alters physicians' perception of cancer patients' treatment-related toxicity and influences symptom management. MATERIALS/METHODS We are enrolling patients with thoracic or gastrointestinal cancers amenable to conventional-fractionated radiotherapy. Patients may receive concurrent chemotherapy. Patients report (1) symptoms, using PRO-CTCAE measures, (2) the most burdensome symptom, and (3) how symptoms interfere with daily activities. Patients complete the measures before seeing their physician during each on-treatment visit. During weekly visits and before reviewing the patient's PROMs, physicians rate the symptom burden for each patient from 0 to 10, using available clinical data. These data include vital signs, lab work, physical exams, nursing assessments, and physicians' clinical judgment. After reviewing the patients' PROMs, physicians re-rate each patient's symptom burden and report any changes in recommended interventions. Changes could include (1) additional counseling, (2) new medications or interventions, (3) referrals to other services, or (4) further testing or evaluation. After each patient's course of radiotherapy, providers complete a Clinician Feedback Form about the impact of PROM review on symptom perception and management during treatment. This study commenced November 11, 2020 at a multi-site tertiary academic cancer center (using electronic or paper questionnaires) and July 21, 2021 at a multi-site community cancer center (using paper forms). RESULTS To be determined. CONCLUSION To be determined.
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Affiliation(s)
- K R Voong
- Johns Hopkins University, Baltimore, MD
| | - O B Shokek
- Wellspan York Cancer Center, York, PA, United States
| | - C Hill
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - C Hu
- Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
| | - R K Hales
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - S C Greco
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - J J Meyer
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - J L Wright
- Johns Hopkins Medicine, Department of Radiation Oncology, Baltimore, MD
| | - K Lowe
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - T R McNutt
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - A Narang
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - C Snyder PhD
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - S M Lee
- Department of Biostatistics, Columbia University School of Medicine, New York, NY
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Lee SM, Choi JH, Chie EK, Kang HC, Kim KS. Efficacy and Safety of Image-Guided Hypofractionated Radiotherapy for Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis. Int J Radiat Oncol Biol Phys 2023; 117:e313-e314. [PMID: 37785127 DOI: 10.1016/j.ijrobp.2023.06.2343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To evaluate the efficacy and safety of image-guided 10-fraction hypofractionated radiotherapy (RT) in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT). MATERIALS/METHODS Between 2016 and March 2022, 69 HCC with PVTT patients received RT (40-50Gy/10fx) in our institutions. The median prescribed dose of 50 Gy (range, 40-50 Gy, BED10; 56-75 Gy10) was delivered in 10 fractions in all patients. Follow-up imaging was performed at three-month intervals after the completion of RT. The extent of PVTT was described according to the Liver Cancer Study Group of Japan classification: Vp0 = no PVTT, Vp1 = segmental portal vein branch, Vp2 = right/left anterior/posterior portal vein, Vp3 = right/left portal vein and Vp4 = main portal vein. Response evaluation was performed using response evaluation criteria in solid tumors, version 1.1. Freedom from local progression (FFLP), progression-free survival (PFS), and overall survival (OS) were calculated from the start date of RT. RESULTS In this cohort, 4.3% of patients had Vp1 PVTT, 20.3% had Vp2, 37.7% had Vp3, and 37.7% had Vp4. The median PTV volume was 105.3 cc (interquartile range [IQR], 74.1-179.4 cc). Fifty-two (75.4%) patients received 50 Gy in 10 fractions. With a median follow-up of 10.2 months (IQR, 6-21 months), the median OS was 18.5 months, and 1-year FFLP, PFS, and OS rates were 84.8%, 26.9%, and 62.2% respectively. At 3 months after RT, 13.0% had a complete response, 36.2% had a partial response, 46.4% had a stable disease and 4.4% had a progressive disease. In the multivariate analysis, AFP ≥ 600 IU/ml (HR 2.06, p = 0.03), Child-Pugh Class B or C (HR 2.30, p = 0.02), and modified Union for International Cancer Control (mUICC) stage IVA or IVB (4.05, p = 0.02) were significantly related to OS. During the follow-up period, there were 2 (2.8%) cases of grade ≥3 toxicity: grade 3 AST/ALT elevation (n = 1), and acute cholangitis (n = 1). CONCLUSION Hypofractionated RT demonstrated promising local PVTT control with acceptable toxicity. These data suggest that 10-fraction image-guided hypofractionated RT (BED10 = 56-75 Gy10) is a feasible treatment option for PVTT in HCC patients.
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Affiliation(s)
- S M Lee
- Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - J H Choi
- Chung-Ang University Hospital, Seoul, Korea, Republic of (South) Korea
| | - E K Chie
- Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - H C Kang
- Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - K S Kim
- Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea, Republic of (South) Korea
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Sakthivel R, Kwon OM, Park MJ, Lee SM, Sakthivel R. Disturbance rejection for multi-weighted complex dynamical networks with actuator saturation and deception attacks via hybrid-triggered mechanism. Neural Netw 2023; 162:225-239. [PMID: 36921433 DOI: 10.1016/j.neunet.2023.02.031] [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: 09/05/2022] [Revised: 12/20/2022] [Accepted: 02/21/2023] [Indexed: 03/04/2023]
Abstract
In this work, we address hybrid-driven-based robust synchronization problem for multi-weighted complex dynamical networks with actuator saturation and deception attacks. The hybrid-triggered mechanism, which combines a switch between the event-triggered scheme and the time-triggered scheme, is often used to reduce the data transmission and the alleviate network burden. Further, the equivalent-input-disturbance technique is applied to eliminate the unknown disturbance effect of the addressed system. Moreover, a memory controller is designed under actuator saturation to ensure that the resultant augmented system is asymptotically synchronized even in the presence of deception attacks. Finally, three numerical examples are given to show the validity of the obtained theoretical results.
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Affiliation(s)
- R Sakthivel
- School of Electrical Engineering, Chungbuk National University, Cheongju 28644, South Korea
| | - O M Kwon
- School of Electrical Engineering, Chungbuk National University, Cheongju 28644, South Korea.
| | - M J Park
- Center of Global Converging Humanities, Kyung Hee University, 1732 Deogyeong-daero, Yongin 17104, South Korea
| | - S M Lee
- School of Electronic and Electrical Engineering, Kyungpook National University, Daehak-ro 80, South Korea
| | - R Sakthivel
- Department of Applied Mathematics, Bharathiar University, Coimbatore 641046, India; Department of Mathematics, Sungkyunkwan University, Suwon 440746, South Korea.
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9
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Hyun M, Kim H, Kim J, Lee J, Lee HJ, Rathor L, Meier J, Larner A, Lee SM, Moon Y, Choi J, Han SM, Heo JD. Melatonin protects against cadmium-induced oxidative stress via mitochondrial STAT3 signaling in human prostate stromal cells. Commun Biol 2023; 6:157. [PMID: 36750754 PMCID: PMC9905543 DOI: 10.1038/s42003-023-04533-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 01/26/2023] [Indexed: 02/09/2023] Open
Abstract
Melatonin protects against Cadmium (Cd)-induced toxicity, a ubiquitous environmental toxicant that causes adverse health effects by increasing reactive oxygen species (ROS) production and mitochondrial dysfunction. However, the underlying mechanism remains unclear. Here, we demonstrate that Cd exposure reduces the levels of mitochondrially-localized signal transducer and activator of transcription 3 (mitoSTAT3) using human prostate stromal cells and mouse embryonic fibroblasts. Melatonin enhances mitoSTAT3 abundance following Cd exposure, which is required to attenuate ROS damage, mitochondrial dysfunction, and cell death caused by Cd exposure. Moreover, melatonin increases mitochondrial levels of GRIM-19, an electron transport chain component that mediates STAT3 import into mitochondria, which are downregulated by Cd. In vivo, melatonin reverses the reduced size of mouse prostate tissue and levels of mitoSTAT3 and GRIM-19 induced by Cd exposure. Together, these data suggest that melatonin regulates mitoSTAT3 function to prevent Cd-induced cytotoxicity and could preserve mitochondrial function during Cd-induced stress.
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Affiliation(s)
- Moonjung Hyun
- grid.418982.e0000 0004 5345 5340Gyeongnam Biohealth Research Center, Gyeongnam Branch Institute, Korea Institute of Toxicology, Jinju, 52834 Republic of Korea
| | - Hyejin Kim
- grid.418982.e0000 0004 5345 5340Gyeongnam Biohealth Research Center, Gyeongnam Branch Institute, Korea Institute of Toxicology, Jinju, 52834 Republic of Korea
| | - Jehein Kim
- grid.418982.e0000 0004 5345 5340Gyeongnam Biohealth Research Center, Gyeongnam Branch Institute, Korea Institute of Toxicology, Jinju, 52834 Republic of Korea
| | - Juhong Lee
- grid.418982.e0000 0004 5345 5340Gyeongnam Biohealth Research Center, Gyeongnam Branch Institute, Korea Institute of Toxicology, Jinju, 52834 Republic of Korea
| | - Ho Jeong Lee
- grid.418982.e0000 0004 5345 5340Gyeongnam Biohealth Research Center, Gyeongnam Branch Institute, Korea Institute of Toxicology, Jinju, 52834 Republic of Korea
| | - Laxmi Rathor
- grid.15276.370000 0004 1936 8091Department of Physiology and Aging, College of Medicine, Institute on Aging, University of Florida, Gainesville, FL USA
| | - Jeremy Meier
- grid.410711.20000 0001 1034 1720Division of Hematology, UNC School of Medicine, University of North Carolina, Chapel Hill, NC USA
| | - Andrew Larner
- grid.224260.00000 0004 0458 8737Department of Biochemistry and Molecular Biology, Virginia Commonwealth University, Richmond, VA USA
| | - Seon Min Lee
- grid.418982.e0000 0004 5345 5340Gyeongnam Biohealth Research Center, Gyeongnam Branch Institute, Korea Institute of Toxicology, Jinju, 52834 Republic of Korea
| | - Yeongyu Moon
- grid.418982.e0000 0004 5345 5340Gyeongnam Biohealth Research Center, Gyeongnam Branch Institute, Korea Institute of Toxicology, Jinju, 52834 Republic of Korea
| | - Jungil Choi
- grid.418982.e0000 0004 5345 5340Gyeongnam Biohealth Research Center, Gyeongnam Branch Institute, Korea Institute of Toxicology, Jinju, 52834 Republic of Korea
| | - Sung Min Han
- Department of Physiology and Aging, College of Medicine, Institute on Aging, University of Florida, Gainesville, FL, USA.
| | - Jeong-Doo Heo
- Gyeongnam Biohealth Research Center, Gyeongnam Branch Institute, Korea Institute of Toxicology, Jinju, 52834, Republic of Korea.
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10
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Ko H, Lee SM, Chang HK, Min SY, Cho K, Park MS. Laparoscopic total extra-peritoneal (TEP) inguinal hernia repair under local anesthesia by topical lidocaine injection. Hernia 2023; 27:113-118. [PMID: 35939245 DOI: 10.1007/s10029-022-02653-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/12/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Laparoscopic total extra-peritoneal (TEP) inguinal hernia repair is usually performed under general anesthesia (GA) for muscle relaxation. However, TEP hernia repair may be reluctant in high-risk patients of GA. The aim of this study was to compare the outcomes of the TEP under GA and local anesthesia (LA). METHODS We retrospectively analyzed patients with inguinal hernia who underwent TEP under GA or LA in a single center from December 2016 to May 2018. The outcomes, such as demographics, duration of surgery, length of hospital stay, visual analog scale (VAS), and postoperative complications, were compared in each group. RESULTS Seventy-six patients with inguinal hernia underwent TEP under GA (n = 52) or LA (n = 24). Total operation time (mean ± standard deviation; GA, 111.6 ± 23.0 min; LA, 76.3 ± 18.0 min; p < 0.001) and length of hospital stay (GA, 38.3 ± 11.6 min; LA, 30.3 ± 15.6 min; p < 0.014) were shorter in LA group compared to GA group. There were no significant differences in postoperative VAS (1 h, p = 0.247; 4 h, p = 0.086; 12 h, p = 0.469; 24 h, p = 0.411), postoperative adverse effects (vomiting, p = 0.570; urinary retention, p = 0.214; headache, p = 0.494), and postoperative complications (seroma, p = 0.348; scrotal edema, p = 0.178; recurrence, p = 0.822) between LA group and GA group. CONCLUSION Compared with GA, there were no differences in postoperative pain and complications in patients who underwent TEP hernia repair under LA. Furthermore, in LA group, total operation time and length of hospital stay were shortened.
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Affiliation(s)
- H Ko
- Department of Surgery, College of Medicine, Kyung Hee University, 23, Kyung Hee Dae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - S M Lee
- Department of Surgery, College of Medicine, Kyung Hee University, 23, Kyung Hee Dae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - H K Chang
- Department of Surgery, College of Medicine, Kyung Hee University, 23, Kyung Hee Dae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - S Y Min
- Department of Surgery, College of Medicine, Kyung Hee University, 23, Kyung Hee Dae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - K Cho
- Department of Surgery, College of Medicine, Kyung Hee University, 23, Kyung Hee Dae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - M-S Park
- Department of Surgery, College of Medicine, Kyung Hee University, 23, Kyung Hee Dae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
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11
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Kim E, Cho HH, Cho SH, Park B, Hong J, Shin KM, Hwang MJ, You SK, Lee SM. Accelerated Synthetic MRI with Deep Learning-Based Reconstruction for Pediatric Neuroimaging. AJNR Am J Neuroradiol 2022; 43:1653-1659. [PMID: 36175085 PMCID: PMC9731246 DOI: 10.3174/ajnr.a7664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/31/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE Synthetic MR imaging is a time-efficient technique. However, its rather long scan time can be challenging for children. This study aimed to evaluate the clinical feasibility of accelerated synthetic MR imaging with deep learning-based reconstruction in pediatric neuroimaging and to investigate the impact of deep learning-based reconstruction on image quality and quantitative values in synthetic MR imaging. MATERIALS AND METHODS This study included 47 children 2.3-14.7 years of age who underwent both standard and accelerated synthetic MR imaging at 3T. The accelerated synthetic MR imaging was reconstructed using a deep learning pipeline. The image quality, lesion detectability, tissue values, and brain volumetry were compared among accelerated deep learning and accelerated and standard synthetic data sets. RESULTS The use of deep learning-based reconstruction in the accelerated synthetic scans significantly improved image quality for all contrast weightings (P < .001), resulting in image quality comparable with or superior to that of standard scans. There was no significant difference in lesion detectability between the accelerated deep learning and standard scans (P > .05). The tissue values and brain tissue volumes obtained with accelerated deep learning and the other 2 scans showed excellent agreement and a strong linear relationship (all, R 2 > 0.9). The difference in quantitative values of accelerated scans versus accelerated deep learning scans was very small (tissue values, <0.5%; volumetry, -1.46%-0.83%). CONCLUSIONS The use of deep learning-based reconstruction in synthetic MR imaging can reduce scan time by 42% while maintaining image quality and lesion detectability and providing consistent quantitative values. The accelerated deep learning synthetic MR imaging can replace standard synthetic MR imaging in both contrast-weighted and quantitative imaging.
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Affiliation(s)
- E Kim
- From the Departments of Medical and Biological Engineering (E.K.)
- Korea Radioisotope Center for Pharmaceuticals (E.K.), Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - H-H Cho
- Department of Radiology and Medical Research Institute (H.-H.C.), College of Medicine, Ewha Womans University, Seoul, South Korea
| | - S H Cho
- Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), School of Medicine, Kyungpook National University, Daegu, South Korea
- Department of Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - B Park
- Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), School of Medicine, Kyungpook National University, Daegu, South Korea
- Department of Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - J Hong
- Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), School of Medicine, Kyungpook National University, Daegu, South Korea
- Department of Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - K M Shin
- Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), School of Medicine, Kyungpook National University, Daegu, South Korea
- Department of Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - M J Hwang
- GE Healthcare Korea (M.J.H.), Seoul, South Korea
| | - S K You
- Department of Radiology (S.K.Y.), Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, South Korea
| | - S M Lee
- Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), School of Medicine, Kyungpook National University, Daegu, South Korea
- Department of Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), Kyungpook National University Chilgok Hospital, Daegu, South Korea
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12
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Park J, Han S, Lee SM. Restored Action Generative Adversarial Imitation Learning from observation for robot manipulator. ISA Trans 2022; 129:684-690. [PMID: 35292172 DOI: 10.1016/j.isatra.2022.02.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 02/21/2022] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
In this paper, a new imitation learning algorithm is proposed based on the Restored Action Generative Adversarial Imitation Learning (RAGAIL) from observation. An action policy is trained to move a robot manipulator similar to a demonstrator's behavior by using the restored action from state-only demonstration. To imitate the demonstrator, the trajectory is generated by Recurrent Generative Adversarial Networks (RGAN), and the action is restored from the output of the tracking controller constructed by the state and the generated target trajectory. The proposed imitation learning algorithm is not required to access the demonstrator's action (internal control signal such as force/torque command) and provides better learning performances. The effectiveness of the proposed method is validated through the experimental results of the robot manipulator.
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Affiliation(s)
- Jongcheon Park
- Cyber Physical Systems & Control Laboratory, School of Electronic and Electrical Engineering, Kyungpook National University, Daehak-ro 80, Republic of Korea
| | - Seungyong Han
- Cyber Physical Systems & Control Laboratory, School of Electronic and Electrical Engineering, Kyungpook National University, Daehak-ro 80, Republic of Korea
| | - S M Lee
- Cyber Physical Systems & Control Laboratory, School of Electronic and Electrical Engineering, Kyungpook National University, Daehak-ro 80, Republic of Korea.
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13
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Park HJ, An WS, Rha SH, Kim SE, Lee SM. Minimal change glomerulonephritis following the second dose of the Moderna COVID-19 vaccine. QJM 2022; 115:490-491. [PMID: 35380707 PMCID: PMC9383619 DOI: 10.1093/qjmed/hcac094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 03/30/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - S H Rha
- Department of Pathology, College of Medicine, Dong-A University, 26, Daesingongwon-ro, Dongdaesin-dong 3-ga, Seo-gu, Busan 49201, Republic of Korea
| | | | - S M Lee
- Address correspondence to Dr Su Mi Lee, Department of Internal Medicine, College of Medicine, Dong-A University, 26 Daesingongwon-ro, Seo-gu, Busan 49201, Republic of Korea.
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14
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Lee HJ, Lee JH, Lee SM, Kim NH, Moon YG, Tak TK, Hyun M, Heo JD. Cadmium induces cytotoxicity in normal mouse renal MM55.K cells. Int J Environ Health Res 2022; 32:131-140. [PMID: 32191530 DOI: 10.1080/09603123.2020.1739236] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 03/02/2020] [Indexed: 06/10/2023]
Abstract
The toxicity of cadmium (Cd) occurs through accumulation in the environment. The precise mechanism underlying Cd toxicity remains unclear. Therefore, in the present study, we studied the effects of Cd on MM55.K cells and investigated the mechanisms underlying Cd-induced cell death. CdCl2 significantly elevated apoptotic cell death, mitochondrial membrane potential (ΔΨm) loss, and caspase-dependent cell death. Moreover, immunoblotting results revealed that CdCl2 down-regulated the inhibitor of apoptotic protein such as survivin and Bcl-2 which led to the activation of caspase-3 and the cleavage of PARP in MM55.K cells. Besides, CdCl2 caused the up-regulation of ROS-related proteins such as HO-1 and ER stress-related proteins such as GRP78 and CHOP in MM55.K cells. CdCl2 toxicity resulted in the down-regulation of the AKT pathway that leads to the up-regulation of phosphorylated JNK and p38 in MM55.K cells. Thus, CdCl2 induce toxicity by AKT/MAPK regulation and causing ROS production, ER stress, ΔΨm loss, and apoptotic cell death in normal mouse renal cells.
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Affiliation(s)
- Ho Jeong Lee
- Biological Resources Research Group, Bioenvironmental Science & Toxicology Division, Gyeongnam Branch Institute, Korea Institute of Toxicology (KIT), Jinju, Republic of Korea
| | - Ju Hong Lee
- Biological Resources Research Group, Bioenvironmental Science & Toxicology Division, Gyeongnam Branch Institute, Korea Institute of Toxicology (KIT), Jinju, Republic of Korea
| | - Seon Min Lee
- Biological Resources Research Group, Bioenvironmental Science & Toxicology Division, Gyeongnam Branch Institute, Korea Institute of Toxicology (KIT), Jinju, Republic of Korea
| | - Na Hyun Kim
- Biological Resources Research Group, Bioenvironmental Science & Toxicology Division, Gyeongnam Branch Institute, Korea Institute of Toxicology (KIT), Jinju, Republic of Korea
| | - Yeon Gyu Moon
- Biological Resources Research Group, Bioenvironmental Science & Toxicology Division, Gyeongnam Branch Institute, Korea Institute of Toxicology (KIT), Jinju, Republic of Korea
| | - Tae Kil Tak
- Biological Resources Research Group, Bioenvironmental Science & Toxicology Division, Gyeongnam Branch Institute, Korea Institute of Toxicology (KIT), Jinju, Republic of Korea
| | - Moonjung Hyun
- Biological Resources Research Group, Bioenvironmental Science & Toxicology Division, Gyeongnam Branch Institute, Korea Institute of Toxicology (KIT), Jinju, Republic of Korea
| | - Jeong Doo Heo
- Biological Resources Research Group, Bioenvironmental Science & Toxicology Division, Gyeongnam Branch Institute, Korea Institute of Toxicology (KIT), Jinju, Republic of Korea
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15
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Kim KJ, Kim IS, Oh SH, Lee SM, Lee HJ, Kang SH, Lee JB, Ryu YL, Chang CL. Evaluation of an automated specimen processing system for staining and culture for acid-fast bacilli. Int J Tuberc Lung Dis 2021; 25:677-679. [PMID: 34330357 DOI: 10.5588/ijtld.21.0206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- K J Kim
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - I-S Kim
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - S-H Oh
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - S M Lee
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - H-J Lee
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - S H Kang
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - J B Lee
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Y L Ryu
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - C L Chang
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
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16
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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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Abstract
Forkhead box O1 (FoxO1) is a multifunctional initiator, mediator, and repressor of autoimmune diseases in an organ- or disease-specific manner. However, the role of FoxO1 in the salivary gland has not yet been elucidated. In this study, we discovered that FoxO1 and aquaporin 5 (AQP5) are both significantly downregulated in the patients with primary Sjögren syndrome, an autoimmune disease accompanying salivary gland dysfunction. Pharmacologic or genetic perturbation of FoxO1 in the rat salivary gland acinar cell line, SMG-C6, induced a significant downregulation of AQP5 expression, as observed in clinical specimens. There was a strong correlation between FoxO1 and AQP5 expression because FoxO1 is a direct regulator of AQP5 expression in salivary gland acinar cells through its interaction with the promoter region of AQP5. Serial injection of a FoxO1 inhibitor into mice induced a reduction of AQP5 expression in submandibular glands and, consequently, hyposalivation, which is one of the major clinical symptoms of primary Sjögren syndrome. However, there was no sign of inflammation or cell damage in the submandibular glands harvested from mice treated with the FoxO1 inhibitor. In conclusion, our findings indicate that FoxO1 in salivary gland tissue acts as a direct regulator of AQP5 expression. Thus, downregulation of FoxO1 observed in primary Sjögren syndrome is a putative mechanism for hyposalivation without the involvement of previously reported soluble factors in primary Sjögren syndrome patient sera.
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Affiliation(s)
- S M Lee
- Department of Pharmacology, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - S W Lee
- Department of Physiology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - M Kang
- Department of Pharmacology, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - J K Choi
- Department of Oral Medicine, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - K Park
- Department of Physiology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - J S Byun
- Department of Oral Medicine, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - D Y Kim
- Department of Pharmacology, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
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18
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Ji YK, Lee SM, Kim NH, Tu NV, Kim YN, Heo JD, Jeong EJ, Rho JR. Stereochemical Determination of Fistularins Isolated from the Marine Sponge Ecionemia acervus and Their Regulatory Effect on Intestinal Inflammation. Mar Drugs 2021; 19:md19030170. [PMID: 33809895 PMCID: PMC8004254 DOI: 10.3390/md19030170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/17/2021] [Accepted: 03/19/2021] [Indexed: 11/16/2022] Open
Abstract
By activity-guided fractionation based on inhibition of nitric oxide (NO) and prostaglandin E2 (PGE2), six fistularin compounds (1-6) were isolated from the marine sponge Ecionemia acervus (order Astrophorida). Based on stereochemical structure determination using Mosher's method, fistularin-3 was assigned as a new stereoisomer. On the basis of the stereochemistry of fistularin-3, the stereochemical homogeneity of all six compounds was established by comparing carbon and proton chemical shifts. For fistularin-1 (1) and -2 (2), quantum calculations were performed to confirm their stereochemistry. In a co-culture system of human epithelial Caco-2 cells and THP-1 macrophages, all six isolated compounds showed potent anti-inflammatory activities. These bioactive fistularins inhibited the production of NO, PGE2, TNF-α, IL-1β, and IL-6 induced by lipopolysaccharide and interferon gamma. Inducible NO synthase and cyclooxygenase-2 expression and MAPK phosphorylation were downregulated in response to the inhibition of NF-κB nuclear translocation. Among the compounds tested, fistularin-1 (1) and 19-deoxyfistularin-3 (4) showed the highest activity. These findings suggest the potential use of the marine sponge E. acervus and its metabolites as pharmaceuticals for the treatment of inflammation-related diseases including inflammatory bowel disease.
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Affiliation(s)
- Yeong Kwang Ji
- Department of Oceanography, Kunsan National University, Gunsan 54150, Korea;
| | - Seon Min Lee
- Gyeongnam Department of Environment & Toxicology, Korea Institute of Toxicology, 17 Jegok-gil, Munsan-eup 52834, Korea; (S.M.L.); (N.-H.K.); (J.D.H.)
| | - Na-Hyun Kim
- Gyeongnam Department of Environment & Toxicology, Korea Institute of Toxicology, 17 Jegok-gil, Munsan-eup 52834, Korea; (S.M.L.); (N.-H.K.); (J.D.H.)
| | - Nguyen Van Tu
- Institute of Tropical Biology, 85 Tran Quoc Toan Street District 3, Ho Chi Minh 700000, Vietnam;
| | - Yun Na Kim
- Department of Plant & Biomaterials Science, Gyeonsang National University, Jinju 52725, Korea;
| | - Jeong Doo Heo
- Gyeongnam Department of Environment & Toxicology, Korea Institute of Toxicology, 17 Jegok-gil, Munsan-eup 52834, Korea; (S.M.L.); (N.-H.K.); (J.D.H.)
| | - Eun Ju Jeong
- Department of Plant & Biomaterials Science, Gyeonsang National University, Jinju 52725, Korea;
- Correspondence: (E.J.J.); (J.-R.R.); Tel.: +82-55-772-3224 (E.J.J.); +82-63-469-4606 (J.-R.R.)
| | - Jung-Rae Rho
- Department of Oceanography, Kunsan National University, Gunsan 54150, Korea;
- Correspondence: (E.J.J.); (J.-R.R.); Tel.: +82-55-772-3224 (E.J.J.); +82-63-469-4606 (J.-R.R.)
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19
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Dwiyanto J, Hussain MH, Reidpath D, Ong KS, Qasim A, Lee SWH, Lee SM, Foo SC, Chong CW, Rahman S. Ethnicity influences the gut microbiota of individuals sharing a geographical location: a cross-sectional study from a middle-income country. Sci Rep 2021; 11:2618. [PMID: 33514807 PMCID: PMC7846579 DOI: 10.1038/s41598-021-82311-3] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 01/19/2021] [Indexed: 02/08/2023] Open
Abstract
No studies have investigated the influence of ethnicity in a multi-ethnic middle-income country with a long-standing history of co-habitation. Stool samples from 214 Malaysian community members (46 Malay, 65 Chinese, 49 Indian, and 54 Jakun) were collected. The gut microbiota of the participants was investigated using 16S amplicon sequencing. Ethnicity exhibited the largest effect size across participants (PERMANOVA Pseudo-F = 4.24, R2 = 0.06, p = 0.001). Notably, the influence of ethnicity on the gut microbiota was retained even after controlling for all demographic, dietary factors and other covariates which were significantly associated with the gut microbiome (PERMANOVA Pseudo-F = 1.67, R2 = 0.02, p = 0.002). Our result suggested that lifestyle, dietary, and uncharacterized differences collectively drive the gut microbiota variation across ethnicity, making ethnicity a reliable proxy for both identified and unidentified lifestyle and dietary variation across ethnic groups from the same community.
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Affiliation(s)
- Jacky Dwiyanto
- School of Science, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia.
| | - M H Hussain
- School of Science, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia
| | - D Reidpath
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.,South East Asia Community Observatory, Segamat, Malaysia
| | - K S Ong
- School of Science, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia
| | - A Qasim
- School of Science, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia.,Genomics Facility, Monash University Malaysia, Bandar Sunway, Malaysia
| | - S W H Lee
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - S M Lee
- School of Science, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia
| | - S C Foo
- School of Science, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia
| | - C W Chong
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Sadequr Rahman
- School of Science, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia. .,Tropical Medicine and Biology Platform, Monash University Malaysia, Bandar Sunway, Malaysia.
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20
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Park YJ, Kim SH, Kim TS, Lee SM, Cho BS, Seo CI, Kim HD, Kim J. Ribosomal protein S3 associates with the TFIIH complex and positively regulates nucleotide excision repair. Cell Mol Life Sci 2021; 78:3591-3606. [PMID: 33464383 DOI: 10.1007/s00018-020-03754-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 12/14/2020] [Accepted: 12/29/2020] [Indexed: 10/22/2022]
Abstract
In mammalian cells, the bulky DNA adducts caused by ultraviolet radiation are mainly repaired via the nucleotide excision repair (NER) pathway; some defects in this pathway lead to a genetic disorder known as xeroderma pigmentosum (XP). Ribosomal protein S3 (rpS3), a constituent of the 40S ribosomal subunit, is a multi-functional protein with various extra-ribosomal functions, including a role in the cellular stress response and DNA repair-related activities. We report that rpS3 associates with transcription factor IIH (TFIIH) via an interaction with the xeroderma pigmentosum complementation group D (XPD) protein and complements its function in the NER pathway. For optimal repair of UV-induced duplex DNA lesions, the strong helicase activity of the TFIIH complex is required for unwinding damaged DNA around the lesion. Here, we show that XP-D cells overexpressing rpS3 showed markedly increased resistance to UV radiation through XPD and rpS3 interaction. Additionally, the knockdown of rpS3 caused reduced NER efficiency in HeLa cells and the overexpression of rpS3 partially restored helicase activity of the TFIIH complex of XP-D cells in vitro. We also present data suggesting that rpS3 is involved in post-excision processing in NER, assisting TFIIH in expediting the repair process by increasing its turnover rate when DNA is damaged. We propose that rpS3 is an accessory protein of the NER pathway and its recruitment to the repair machinery augments repair efficiency upon UV damage by enhancing XPD helicase function and increasing its turnover rate.
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Affiliation(s)
- Y J Park
- Lab of Biochemistry, Division of Life Sciences, Korea University, Seoul, 02841, Korea
| | - S H Kim
- Lab of Biochemistry, Division of Life Sciences, Korea University, Seoul, 02841, Korea
| | - T S Kim
- Lab of Biochemistry, Division of Life Sciences, Korea University, Seoul, 02841, Korea
| | - S M Lee
- Lab of Biochemistry, Division of Life Sciences, Korea University, Seoul, 02841, Korea
| | - B S Cho
- Lab of Biochemistry, Division of Life Sciences, Korea University, Seoul, 02841, Korea
| | - C I Seo
- Lab of Biochemistry, Division of Life Sciences, Korea University, Seoul, 02841, Korea
| | - H D Kim
- TechnoComplex Building, HAEL Lab, Korea University, Seoul, 02841, Korea
| | - J Kim
- Lab of Biochemistry, Division of Life Sciences, Korea University, Seoul, 02841, Korea. .,TechnoComplex Building, HAEL Lab, Korea University, Seoul, 02841, Korea.
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21
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Kim NH, Lee SM, Kim YN, Jeon YJ, Heo JD, Jeong EJ, Rho JR. Standardized Fraction of Turbinaria ornata Alleviates Dextran Sulfate Sodium-Induced Chronic Colitis in C57BL/6 Mice via Upregulation of FOXP3 + Regulatory T Cells. Biomolecules 2020; 10:E1463. [PMID: 33092149 PMCID: PMC7590162 DOI: 10.3390/biom10101463] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/27/2020] [Accepted: 10/15/2020] [Indexed: 02/07/2023] Open
Abstract
Turbinaria ornata is a tropical brown algae (seaweed) known to have anti-inflammatory properties. In this study, we analyzed T. ornata extract (TOE) using liquid chromatography quadrupole time of flight mass spectrometry (LC-QTOF-MS) and nuclear magnetic resonance (NMR) and evaluated the in vivo efficacy of TOE against dextran sulfate sodium-induced chronic colitis in C57BL/6 mice. The bioactive fraction of TOE was administered orally daily for 6 weeks to mice under different treatments normal, colitis, and colitis + conventional drug (5-aminosalicylic acid, 5-ASA). Regarding clinical manifestation, the disease activity index and colon length of the colitis + TOE group were significantly reduced compared to those of the colitis group. The results of myeloperoxidase activity and histopathological examination showed similar results. Western blot analysis of colon tissues revealed that cyclooxygenase-2, tumor necrosis factor alpha (TNF-α), and phosphorylated signal transducer and activator of transcription-3 (p-STAT3) were significantly decreased in the colitis + 5-ASA group, whereas forkhead box P3 (FOXP3) was increased. qPCR results showed changes in T cell subsets; the administration of TOE upregulated regulatory T cell (Treg) expression, although T helper 17 cell (Th17) expression did not change significantly. Interestingly, the colitis + TOE group showed high levels of both Th1 and Th2 transcription factors, but the secreted cytokine interferon (IFN)-γ and interleukin (IL)-4 remained unchanged and somewhat reduced. Additionally, TNF-α gene expression was significantly reduced in the colitis + TOE group. IL-6 mRNA levels were also decreased, although not significantly. Four compounds were structurally elucidated using 1D- and 2D-NMR spectroscopy, and five compounds were fully identified or tentatively characterized using LC-QTOF-MS. In conclusion, TOE could alleviate chronic colitis via upregulation of Foxp3+ Treg cells and production of the anti-inflammatory cytokine IL-10, which directly inhibits macrophages and pro-inflammatory cytokine synthesis, leading to reduced colitis.
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Affiliation(s)
- Na-Hyun Kim
- Gyeongnam Department of Environment & Toxicology, Korea Institute of Toxicology, 17 Jegok-gil, Munsan-eup 52834, Korea; (N.-H.K.); (S.M.L.); (J.-D.H.)
| | - Seon Min Lee
- Gyeongnam Department of Environment & Toxicology, Korea Institute of Toxicology, 17 Jegok-gil, Munsan-eup 52834, Korea; (N.-H.K.); (S.M.L.); (J.-D.H.)
| | - Yun Na Kim
- Department of Agronomy and Medicinal Plant Resources, Gyeongnam National University of Science and Technology, Jinju 52725, Korea;
| | - You-Jin Jeon
- Department of Marine Life Sciences, Jeju National University, Jeju 63243, Korea;
| | - Jeong-Doo Heo
- Gyeongnam Department of Environment & Toxicology, Korea Institute of Toxicology, 17 Jegok-gil, Munsan-eup 52834, Korea; (N.-H.K.); (S.M.L.); (J.-D.H.)
| | - Eun Ju Jeong
- Department of Agronomy and Medicinal Plant Resources, Gyeongnam National University of Science and Technology, Jinju 52725, Korea;
| | - Jung-Rae Rho
- Department of Oceanography, Kunsan National University, Kunsan 54150, Korea
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22
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Shon JC, Lee SM, Jung JH, Wu Z, Kwon YS, Sim HJ, Seo JS. Integrated metabolomics and lipidomics reveals high accumulation of polyunsaturated lysoglycerophospholipids in human lung fibroblasts exposed to fine particulate matter. Ecotoxicol Environ Saf 2020; 202:110896. [PMID: 32622306 DOI: 10.1016/j.ecoenv.2020.110896] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 06/11/2023]
Abstract
Exposure to fine particulate matter (PM) comprising toxic compounds arising from air pollution is a major human health concern. It is linked to increased mortality and incidence of various lung diseases. However, the mechanisms underlying the toxic effects of PM on lung fibroblasts have not been fully explored. We used targeted quantitative metabolomics and lipidomics analysis along with cytotoxicity studies to comprehensively characterize the alterations in the metabolite profiles of human lung fibroblasts (HEL 299) upon exposure to PM2.5 and PM10. This exposure at 50 μg/mL for 72 h induced an abnormally high apoptotic response via triggering intracellular reactive oxygen species (ROS) production and mitochondrial dysfunction through an imbalance between pro- and anti-apoptotic signaling pathways. The cytotoxic effects of PM2.5 were more severe than those of PM10. Metabolomics and lipidomics analyses revealed that PM exposure triggered substantial changes in the cellular metabolite profile, which involved reduced mitochondria-related metabolites such as tricarboxylic acid (TCA) cycle intermediates, amino acids, and free fatty acids as well as increased lysoglycerophospholipids (LPLs) containing polyunsaturated fatty acids. The decrease in mitochondria-related metabolites suggested that PM exposure led to reduced TCA cycle capacity and energy production. Apoptotic and inflammatory responses as well as mitochondrial dysfunction were likely to be accelerated because of excessive accumulation of LPLs, contributing to the disruption of membrane rafts and Ca2+ homeostasis and causing increased mitochondrial ROS formation. These results provide valuable insights regarding the toxic effects of PM exposure. Our study also provides a new direction for research on PM exposure-related health disorders using different cell lines.
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Affiliation(s)
- Jong Cheol Shon
- Environmental Chemistry Research Group, Korea Institute of Toxicology, Jinju, 52834, Republic of Korea
| | - Seon Min Lee
- Biological Resources Research Group, Korea Institute of Toxicology, Jinju, 52834, Republic of Korea
| | - Jung-Hoon Jung
- Environmental Chemistry Research Group, Korea Institute of Toxicology, Jinju, 52834, Republic of Korea
| | - Zhexue Wu
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, 41566, Republic of Korea
| | - Young Sang Kwon
- Environmental Chemistry Research Group, Korea Institute of Toxicology, Jinju, 52834, Republic of Korea
| | - Hee-Jung Sim
- Environmental Chemistry Research Group, Korea Institute of Toxicology, Jinju, 52834, Republic of Korea
| | - Jong-Su Seo
- Environmental Chemistry Research Group, Korea Institute of Toxicology, Jinju, 52834, Republic of Korea.
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23
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Jung YM, Lee SM, Oh S, Lyoo SH, Park CW, Lee SD, Park JS, Jun JK. The concordance rate of non-chromosomal congenital malformations in twins based on zygosity: a retrospective cohort study. BJOG 2020; 128:857-864. [PMID: 32783284 DOI: 10.1111/1471-0528.16463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine the concordance rate of non-chromosomal congenital malformations in twin pairs based on zygosity. DESIGN Retrospective cohort study. SETTING A tertiary hospital in Korea. POPULATION Twin pairs born at Seoul National University Hospital between 2001 and 2019. METHODS Congenital malformations were diagnosed by postnatal workups of neonates or autopsy in cases of stillborn infants. Zygosity was confirmed by sex, chorionicity and DNA analysis. MAIN OUTCOME MEASURES Concordance rate of congenital malformations in twin pairs based on zygosity. RESULTS In total, 3386 twin pairs were included. The risk of a congenital malformation in the index twin increased significantly if the co-twin had the congenital malformation, and the concordance rate was higher in monozygotic (MZ) than in dizygotic (DZ) twins (37.04 versus 16.77, P < 0.001). An increased risk of a congenital malformation in the presence of the same congenital malformation in the co-twin was observed only for malformations of the nervous system, eye/ear/face/neck, circulatory system, cleft lip/palate, genital organs, urinary system and musculoskeletal system. Significantly higher concordance rates in MZ than in DZ twin pairs were observed only for the nervous system (40.00 versus 0.00, P < 0.001), circulatory system (32.97 versus 19.74, P = 0.021), cleft lip/palate (44.44 versus 0.00, P = 0.017) and urinary system (22.22 versus 0.00, P = 0.004), whereas significant differences were not found for the genital organs or musculoskeletal system. CONCLUSIONS Monozygotic twins had higher concordance rates than DZ twins only in specific organ systems. It may be speculated that nervous system, circulatory system, cleft lip/palate and urinary system are primarily genetically affected. TWEETABLE ABSTRACT Monozygotic twins had higher concordance rates than dizygotic twins only in specific organ systems.
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Affiliation(s)
- Y M Jung
- Department of Obstetrics and Gynaecology, Seoul National University College of Medicine, Seoul, Korea
| | - S M Lee
- Department of Obstetrics and Gynaecology, Seoul National University College of Medicine, Seoul, Korea
| | - S Oh
- Department of Biostatistics, Seoul National University Seoul Metropolitan Government Boramae Medical Centre, Seoul, Korea
| | - S H Lyoo
- Institute of Forensic and Anthropological Science, Medical Research Centre, Seoul National University, Seoul, Korea
| | - C-W Park
- Department of Obstetrics and Gynaecology, Seoul National University College of Medicine, Seoul, Korea.,Institute of Reproductive Medicine and Population, Medical Research Centre, Seoul National University, Seoul, Korea
| | - S D Lee
- Institute of Forensic and Anthropological Science, Medical Research Centre, Seoul National University, Seoul, Korea.,Department of Forensic Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - J S Park
- Department of Obstetrics and Gynaecology, Seoul National University College of Medicine, Seoul, Korea
| | - J K Jun
- Department of Obstetrics and Gynaecology, Seoul National University College of Medicine, Seoul, Korea.,Institute of Reproductive Medicine and Population, Medical Research Centre, Seoul National University, Seoul, Korea
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24
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Choi SJ, Kwak DW, Kil K, Kim SC, Kwon JY, Kim YH, Na S, Bae JG, Cha HH, Shim JY, Oh KY, Lee KA, Kim SM, Cho IA, Lee SM, Cho GJ, Jo YS, Choi GY, Choi SK, Hur SE, Hwang HS, Kim YJ. Vaginal compared with intramuscular progestogen for preventing preterm birth in high-risk pregnant women (VICTORIA study): a multicentre, open-label randomised trial and meta-analysis. BJOG 2020; 127:1646-1654. [PMID: 32536019 DOI: 10.1111/1471-0528.16365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the efficacy of two types of progestogen therapy for preventing preterm birth (PTB) and to review the relevant literature. DESIGN A multicentre, randomised, open-label, equivalence trial and a meta-analysis. SETTING Tertiary referral hospitals in South Korea. POPULATION Pregnant women with a history of spontaneous PTB or short cervical length (<25 mm). METHODS Eligible women were screened and randomised at 16-22 weeks of gestation to receive either 200 mg of vaginal micronised progesterone daily (vaginal group) or an intramuscular injection of 250 mg 17α-hydroxyprogesterone caproate weekly (IM group). Stratified randomisation was carried out according to participating centres and indications for progestogen therapy. This trial was registered at ClinicalTrials.gov (NCT02304237). MAIN OUTCOME MEASURE Preterm birth (PTB) before 37 weeks of gestation. RESULTS A total of 266 women were randomly assigned and a total of 247 women (119 and 128 women in the vaginal and IM groups, respectively) were available for the intention-to-treat analysis. Risks of PTB before 37 weeks of gestation did not significantly differ between the two groups (22.7 versus 25.8%, P = 0.571). The difference in PTB risk between the two groups was 3.1% (95% CI -7.6 to 13.8%), which was within the equivalence margin of 15%. The meta-analysis results showed no significant differences in the risk of PTB between the vaginal and IM progestogen treatments. CONCLUSION Compared with vaginal progesterone, treatment with intramuscular progestin might increase the risk of PTB before 37 weeks of gestation by as much as 13.8%, or reduce the risk by as much as 7.6%, in women with a history of spontaneous PTB or with short cervical length. TWEETABLE ABSTRACT Vaginal and intramuscular progestogen showed equivalent efficacy for preventing preterm birth before 37 weeks of gestation.
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Affiliation(s)
- S-J Choi
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - D W Kwak
- Ajou University School of Medicine, Suwon, Korea
| | - K Kil
- Yeouido St Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - S-C Kim
- Pusan National University College of Medicine, Pusan, Korea
| | - J-Y Kwon
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Y H Kim
- Chonnam National University Medical School, Gwangju, Korea
| | - S Na
- Kangwon National University Hospital, School of Medicine Kangwon National University, Chuncheon, Korea
| | - J-G Bae
- Keimyung University School of Medicine, Daegu, Korea
| | - H-H Cha
- Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - J-Y Shim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - K Y Oh
- School of Medicine, Eulji University, Daejeon, Korea
| | - K A Lee
- Kyung Hee University School of Medicine, Seoul, Korea
| | - S M Kim
- Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - I A Cho
- Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - S M Lee
- Seoul National University College of Medicine, Seoul, Korea
| | - G J Cho
- Korea University College of Medicine, Seoul, Korea
| | - Y S Jo
- St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - G Y Choi
- Soonchunhyang University Seoul Hospital, College of Medicine, Soonchunhyang University, Seoul, Korea
| | - S K Choi
- College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - S E Hur
- Konyang University Hospital, Daejeon, Korea
| | - H S Hwang
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - Y J Kim
- College of Medicine, Ewha Womans University, Seoul, Korea
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25
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Lee SM, Kim NH, Jeong EJ, Rho JR. Cytotoxic 4-Hydroxyprorocentrolide and Prorocentrolide C from Cultured Dinoflagellate Prorocentrum lima Induce Human Cancer Cell Death through Apoptosis and Cell Cycle Arrest. Toxins (Basel) 2020; 12:toxins12050304. [PMID: 32392799 PMCID: PMC7290926 DOI: 10.3390/toxins12050304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 11/16/2022] Open
Abstract
Prorocentrolide and its analogs, the novel naturally derived antitumor agents, have recently been identified in the dinoflagellate Prorocentrum lima. In the current study, the underlying inhibitory mechanisms of 4-hydroxyprorocentrolide (1) and prorocentrolide C (2) on the proliferation of human carcinoma cells were determined. 1 and 2 arrested the cell cycle at the S phase in A549 cells and G2/M phase in HT-29 cells, leading to apoptotic cell death, as determined using fluorescence-activated cell sorting analysis with Annexin V/PI double staining. Apoptosis induced by these compounds was associated with alterations in the expression of cell cycle-regulating proteins (cyclin D1, cyclin E1, CDK2, and CDK4), as well as alterations in the levels of apoptosis-related proteins (PPAR, Bcl-2, Bcl-xl, and survivin). These findings provide new insights into the antitumor mechanisms of 4-hydroxyprorocentrolide and prorocentrolide C and a basis for future investigations assessing prorocentrolide analogs as prospective therapeutic drugs.
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Affiliation(s)
- Seon Min Lee
- Gyeongnam Department of Environment & Toxicology, Korea Institute of Toxicology, 17 Jegok-gil, Munsan-eup 52834, Korea; (S.M.L.); (N.-H.K.)
| | - Na-Hyun Kim
- Gyeongnam Department of Environment & Toxicology, Korea Institute of Toxicology, 17 Jegok-gil, Munsan-eup 52834, Korea; (S.M.L.); (N.-H.K.)
| | - Eun Ju Jeong
- Department of Agronomy and Medicinal Plant Resources, Gyeongnam National University of Science and Technology, Jinju 52725, Korea
- Correspondence: (E.J.J.); (J.-R.R.); Tel.: +82-55 751 3224 (E.J.J.); +82-63 469 4606 (J.-R.R.)
| | - Jung-Rae Rho
- Department of Oceanography, Kunsan National University, Gunsan 54150, Korea
- Correspondence: (E.J.J.); (J.-R.R.); Tel.: +82-55 751 3224 (E.J.J.); +82-63 469 4606 (J.-R.R.)
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26
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Abstract
BACKGROUND: Long-term mortality following tuberculosis (TB) diagnosis in Korea remains unclear.METHODS: The present study used data from the National Health Insurance Service database, an extensive health-related database including most Korean residents. TB patients were identified using International Classification of Diseases, Tenth Revision coding (A15-19, U88.0-88.1) and the type of anti-TB drug(s) between 2003 and 2016. Long-term mortality and causes of death in TB patients were analysed.RESULTS: A total of 357 211 individuals had TB over the period from 2003 to 2016 and 103 682 died. The mean age of the cohort was 54.7 ± 20.7 years, and 59.8% were male. The survival probability of TB patients at 1, 5, and 10 years after diagnosis was 87.8%, 75.3%, and 63.3%, respectively. High mortality and TB-related death rates were especially prominent in the early stages after TB diagnosis. The overall standardized mortality ratio of TB patients to the general Korean population was 3.23 (95% confidence interval 3.21-3.25).CONCLUSION: Mortality in TB patients was especially high in the early stages of disease after TB diagnosis, and mostly due to TB. This figure was approximately three-times higher than the mortality rate in the general population.
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Affiliation(s)
- S C Park
- Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si, Gyeonggi-do
| | - M J Kang
- Research Institute, National Health Insurance Service Ilsan Hospital, Goyang-si, Gyeonggi-do
| | - C H Han
- Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si, Gyeonggi-do
| | - S M Lee
- Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si, Gyeonggi-do
| | - C J Kim
- Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si, Gyeonggi-do
| | - J M Lee
- Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si, Gyeonggi-do
| | - Y A Kang
- Division of Pulmonology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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27
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Cho JS, Jang BK, Lee SM, Lee IJ, Lee CH. Factors affecting the dormancy and germination of bleeding heart [Lamprocapnos spectabilis (L.) Fukuhara] seeds. Plant Biol (Stuttg) 2020; 22:514-521. [PMID: 31965672 DOI: 10.1111/plb.13089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 01/10/2020] [Indexed: 06/10/2023]
Abstract
Information on the optimal conditions to promote the germination of Lamprocapnos spectabilis (L.) Fukuhara seeds is limited; consequently, this study was conducted to establish the requirements to break seed dormancy and promote germination. The selected seeds had morphophysiological dormancy and had not begun embryo development. To study the dormancy breaking and embryo development processes, seeds were subjected to constant or changing temperature treatments during moist stratification. High temperature and humidity resulted in vigorous embryo growth, with the longest embryos occurring after 1 month of incubation at 20 °C. At 4 °C, the seeds required incubation period of at least 3 months to germinate. Embryo growth and germination were higher with changing high and low temperatures than under a constant temperature, and changing temperatures also considerably changed the endogenous hormone levels, embryo development and germination. Bioactive gibberellin (GA) content was higher in seeds incubated at 20 °C for 1 month, then at 4 °C for 2 months. The content of endogenous abscisic acid in seeds subjected to the same treatment decreased by 97.6% compared with that of the untreated seeds. Embryo growth and seed germination require changing high and low temperatures; however, exogenous GA3 could substitute for high temperatures, as it also causes accelerated germination. In this study, the seeds of L. spectabilis were identified as an intermediate simple type, a sub-level of morphophysiologically dormant seeds.
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Affiliation(s)
- J S Cho
- Major in Horticulture, School of Applied Plant Science & Biotechnology, Chungbuk National University, Cheongju, Republic of Korea
- Brain Korea 21 Center for Bio-Resource Development, Chungbuk National University, Cheongju, Republic of Korea
| | - B K Jang
- Major in Horticulture, School of Applied Plant Science & Biotechnology, Chungbuk National University, Cheongju, Republic of Korea
- Brain Korea 21 Center for Bio-Resource Development, Chungbuk National University, Cheongju, Republic of Korea
| | - S M Lee
- Environmental Agriculture Research Division, Gyeongsangnam-do Agricultural Research & Extension Service, Jinju, Republic of Korea
| | - I J Lee
- School of Applied Biosciences, Kyungpook National University, Daegu, Republic of Korea
| | - C H Lee
- Major in Horticulture, School of Applied Plant Science & Biotechnology, Chungbuk National University, Cheongju, Republic of Korea
- Brain Korea 21 Center for Bio-Resource Development, Chungbuk National University, Cheongju, Republic of Korea
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Lee SM, Kim NH, Lee S, Kim YN, Heo JD, Rho JR, Jeong EJ. (10 Z)-Debromohymenialdisine from Marine Sponge Stylissa sp. Regulates Intestinal Inflammatory Responses in Co-Culture Model of Epithelial Caco-2 Cells and THP-1 Macrophage Cells. Molecules 2019; 24:molecules24183394. [PMID: 31540496 PMCID: PMC6766964 DOI: 10.3390/molecules24183394] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 09/16/2019] [Accepted: 09/16/2019] [Indexed: 02/07/2023] Open
Abstract
Crohn’s disease (CD) and ulcerative colitis (UC), collectively referred to as inflammatory bowel disease (IBD), are autoimmune diseases characterized by chronic inflammation within the gastrointestinal tract. Debromohymenialdisine is an active pyrrole alkaloid that is well known to serve as a stable and effective inhibitor of Chk2. In the present study, we attempted to investigate the anti-inflammatory properties of (10Z)-debromohymenialdisine (1) isolated from marine sponge Stylissa species using an intestinal in vitro model with a transwell co-culture system. The treatment with 1 attenuated the production and gene expression of lipopolysaccharide (LPS)-induced Interleukin (IL)-6, IL-1β, prostaglandin E2 (PGE2), and tumor necrosis factor-α in co-cultured THP-1 macrophages at a concentration range of 1–5 μM. The protein expressions of inducible nitric oxide synthase (iNOS) and cyclooxygenase (COX)-2 were down-regulated in response to the inhibition of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB) translocation into the nucleus in cells. In addition, we observed that 1 markedly promoted the nuclear translocation of nuclear factor erythroid 2 related factor 2 (Nrf2) and subsequent increase of heme oxygenase-1 (HO-1) expression. These findings suggest the potential use of 1 as a pharmaceutical lead in the treatment of inflammation-related diseases including IBD.
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Affiliation(s)
- Seon Min Lee
- Gyeongnam Department of Environment & Toxicology, Korea Institute of Toxicology, 17 Jegok-gil, Munsan-eup 52834, Korea.
| | - Na-Hyun Kim
- Gyeongnam Department of Environment & Toxicology, Korea Institute of Toxicology, 17 Jegok-gil, Munsan-eup 52834, Korea.
| | - Sangbum Lee
- Department of Oceanography, Kunsan National University, Kunsan 54150, Korea.
| | - Yun Na Kim
- Department of Agronomy and Medicinal Plant Resources, Gyeongnam National University of Science and Technology, Jinju 52725, Korea.
| | - Jeong-Doo Heo
- Gyeongnam Department of Environment & Toxicology, Korea Institute of Toxicology, 17 Jegok-gil, Munsan-eup 52834, Korea.
| | - Jung-Rae Rho
- Department of Oceanography, Kunsan National University, Kunsan 54150, Korea.
| | - Eun Ju Jeong
- Department of Agronomy and Medicinal Plant Resources, Gyeongnam National University of Science and Technology, Jinju 52725, Korea.
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Daniel-Jambun D, Ong KS, Lim YY, Tan JBL, Yap SW, Lee SM. Bactericidal and cytotoxic activity of a diarylheptanoid (etlingerin) isolated from a ginger (Etlingera pubescens) endemic to Borneo. J Appl Microbiol 2019; 127:59-67. [PMID: 31006174 DOI: 10.1111/jam.14287] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 04/09/2019] [Accepted: 04/16/2019] [Indexed: 11/28/2022]
Abstract
AIMS The aim of this study was to investigate the antimicrobial activities of Etlingera pubescens, and to isolate and identify the antimicrobial compound. METHODS AND RESULTS The crude extracts of E. pubescens were obtained through methanol extraction, and evaluated for antimicrobial activities. From this extract, 1,7-bis(3,4-dihydroxyphenyl)heptan-3-yl acetate (etlingerin) was isolated. When compared to curcumin (a compound with a similar chemical structure), etlingerin showed twofold lower minimum inhibitory concentration values while also being bactericidal. Through time kill assay, etlingerin showed rapid killing effects (as fast as 60 min) against the Gram-positive bacteria (Staphylococcus aureus ATCC 43300 and Bacillus subtilis ATCC 8188). Further assessment revealed that etlingerin caused leakage of intracellular materials, therefore suggesting alteration in membrane permeability as its antimicrobial mechanism. Cytotoxicity study demonstrated that etlingerin exhibited approximately 5- to 12-fold higher IC50 values against several cell lines, as compared to curcumin. CONCLUSIONS Etlingerin isolated from E. pubescens showed better antibacterial and cytotoxic activities when compared to curcumin. Etlingerin could be safe for human use, though further cytotoxicity study using animal models is needed. SIGNIFICANCE AND IMPACT OF THE STUDY Etlingerin has a potential to be used in treating bacterial infections due to its good antimicrobial activity, while having potentially low cytotoxicity.
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Affiliation(s)
- D Daniel-Jambun
- School of Science, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - K S Ong
- School of Science, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
- Tropical Medicine and Biology, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Y Y Lim
- School of Science, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - J B L Tan
- School of Science, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - S W Yap
- Conservation and Environmental Management Division, Menara Tun Mustapha, Kota Kinabalu, Sabah, Malaysia
| | - S M Lee
- School of Science, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
- Tropical Medicine and Biology, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
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Fenn KM, Maurer MA, Lee SM, Crew KD, Trivedi MS, Accordino MK, Hershman DL, Kalinsky K. Abstract P6-18-35: A phase 1 study of erlotinib and metformin in advanced triple negative breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-18-35] [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: The epidermal growth factor receptor (EGFR) is frequently overexpressed in triple negative breast cancer (TNBC). However, EGFR inhibitors have not shown efficacy as monotherapy in TNBC. One strategy for overcoming resistance to EGFR inhibition is concomitant inhibition of downstream signaling. Metformin is a LKB1-dependent AMPK activator that inhibits both MAPK and AKT signaling. The combination of the EGFR inhibitor erlotinib and metformin synergistically induces apoptosis in TNBC cell lines and decreases tumor burden in PTEN-null EGFR-amplified mouse xenograft models. We evaluated the combination of erlotinib and metformin in a phase 1 study of patients with advanced TNBC.
Methods: Patients with advanced TNBC who had received at least one prior line of therapy for metastatic disease were eligible. Erlotinib dose was fixed at 150mg daily. Metformin dose escalation was planned according to a 3+3 design, beginning at 850mg BID and escalating to 850mg TID. One de-escalation to 500mg BID was allowed. Dose-limiting toxicities (DLT) were assessed during the first five weeks of therapy. The primary objectives were to determine the maximum tolerated dose (MTD) of metformin with fixed dose erlotinib and to determine the potential for clinical benefit. Secondary endpoints were response rate, stable disease rate, and progression free survival. Pre- and on-treatment skin biopsies were collected to determine the effect of the study drugs on their respective cell signaling targets, particularly EGFR, AMPK, and mTOR.
Results: Between March 2013 and May 2015, nine patients were screened and eight were enrolled. Median age was 48 years (range 37-79). Median number of prior therapies for metastatic disease was 2.5 (range 1-6). No DLT events were reported in either of the dose escalation cohorts during the DLT assessment period. AEs occurring in three or more patients and all grade III AEs are reported in Table 1. Grade III diarrhea despite maximum supportive care required dose reduction of metformin from 850mg TID to 850mg BID in one patient. Grade III rash led to study withdrawal in one patient. No grade IV AEs were reported. Per RECIST v1.1, the best observed response was stable disease in two patients (25%). Median time on study was 2.0 months (range 1.2-3.0). Skin biopsy marker assessment is ongoing and will be reported.
Conclusion: The combination of erlotinib and metformin was generally well tolerated in a population of pre-treated metastatic TNBC patients. No unexpected toxicities occurred. While no responses were achieved, stable disease was observed in patients who received this non-chemotherapy combination.
Adverse EventsEventMetformin 850mg BID n=3Metformin 850mg TID n=5All patients n=8 Number of patients (percent) All gradesGrade IIIAll gradesGrade IIIAll gradesGrade IIIRash3 (100)1 (33.3)5 (100)08 (100)1 (12.5)Diarrhea3 (100)05 (100)2 (40.0)8 (100)2 (25.0)Weight loss1 (33.3)05 (100)06 (75.0)0Dry skin1 (33.3)05 (100)06 (75.0)0Nausea2 (66.7)03 (60.0)05 (62.5)0Vomiting1 (33.3)03 (60.0)04 (50.0)0Dry mouth1 (33.3)03 (60.0)04 (50.0)0Dysgeusia1 (33.3)02 (40.0)03 (37.5)0Increased creatinine2 (66.7)01 (20.0)03 (37.5)0Fatigue1 (33.3)02 (40.0)03 (37.5)0Anorexia1 (33.3)02 (40.0)03 (37.5)0Hyponatremia1 (33.3)1 (33.3)001 (12.5)1 (12.5)
Citation Format: Fenn KM, Maurer MA, Lee SM, Crew KD, Trivedi MS, Accordino MK, Hershman DL, Kalinsky K. A phase 1 study of erlotinib and metformin in advanced triple negative 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 P6-18-35.
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Affiliation(s)
- KM Fenn
- Columbia University Irving Medical Center, New York, NY; Mailman School of Public Health, Columbia University, New York, NY
| | - MA Maurer
- Columbia University Irving Medical Center, New York, NY; Mailman School of Public Health, Columbia University, New York, NY
| | - SM Lee
- Columbia University Irving Medical Center, New York, NY; Mailman School of Public Health, Columbia University, New York, NY
| | - KD Crew
- Columbia University Irving Medical Center, New York, NY; Mailman School of Public Health, Columbia University, New York, NY
| | - MS Trivedi
- Columbia University Irving Medical Center, New York, NY; Mailman School of Public Health, Columbia University, New York, NY
| | - MK Accordino
- Columbia University Irving Medical Center, New York, NY; Mailman School of Public Health, Columbia University, New York, NY
| | - DL Hershman
- Columbia University Irving Medical Center, New York, NY; Mailman School of Public Health, Columbia University, New York, NY
| | - K Kalinsky
- Columbia University Irving Medical Center, New York, NY; Mailman School of Public Health, Columbia University, New York, NY
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Seo JH, Lee SM, Yu SN, Lee JW, Lee JE. Clinical usefulness of two-phase 18F-sodium-fluoride ( 18F-NaF) bone PET/CT for evaluating treatment response of bone metastases from breast cancer: Case report. Rev Esp Med Nucl Imagen Mol 2019; 38:238-242. [PMID: 30665751 DOI: 10.1016/j.remn.2018.09.009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/09/2018] [Accepted: 09/25/2018] [Indexed: 10/27/2022]
Abstract
We report the case of a breast cancer patient in whom a two-phase 18F-sodium-fluoride (18F-NaF) bone PET/CT was useful for detecting hidden bone metastases and assessing treatment response. The patient underwent a two-phase bone PET/CT to evaluate a newly developed lesion found on bone scintigraphy following surgery. In the perfusion and bone phase PET/CT images, focally increased perfusion and bony uptake were found in the sacrum and L5 vertebra, suggesting bone metastases of breast cancer. Therefore, the patient subsequently underwent palliative treatment. In another twoPET/CT studies (each including two-phase bone images) performed after 3and 6months of follow-up, the perfusion phase images showed an improvement of the lesion uptake more clearly than in the bone phase images in the visual and semi-quantitative analyses, and thus the perfusion phase images were more useful for clarifying the treatment response earlier than the bone phase images. This is the first case showing the clinical usefulness of 18F-NaF bone PET/CT with the perfusion imaging technique for evaluating bone metastases and the therapeutic response of metastatic bone lesions.
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Affiliation(s)
- J H Seo
- Department of Radiology, Soonchunhyang University Cheonan Hospital, 23-20 Byeongmyeong-dong, Dongnam-gu, Cheonan, Chungcheongnam-do 31151, República de Corea
| | - S M Lee
- Department of Nuclear Medicine, Soonchunhyang University Cheonan Hospital, 23-20 Byeongmyeong-dong, Dongnam-gu, Cheonan, Chungcheongnam-do, 31151, República de Corea.
| | - S N Yu
- Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, 23-20 Byeongmyeong-dong, Dongnam-gu, Cheonan, Chungcheongnam-do 31151, República de Corea
| | - J W Lee
- Department of Nuclear Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Simgok-ro 100 Gil 25, Seo-gu, Incheon 22711, República de Corea
| | - J E Lee
- Department of Surgery, Soonchunhyang University Cheonan Hospital, 23-20 Byeongmyeong-dong, Dongnam-gu, Cheonan, Chungcheongnam-do 31151, República de Corea
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Mak CY, Yam JC, Chen LJ, Lee SM, Young AL. Epidemiology of myopia and prevention of myopia progression in children in East Asia: a review. Hong Kong Med J 2018; 24:602-609. [PMID: 30530867 DOI: 10.12809/hkmj187513] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Myopia (short-sightedness) exhibits high prevalence in East Asia. Methods to mitigate myopia progression are important in preventing the vision-threatening complications associated with high myopia. In this review, we examine the regional epidemiology of myopia and provide updated evidence regarding interventions to slow myopia progression in children. METHODS We performed a literature search using PubMed from the date of inception through 25 June 2018. Studies involving myopia epidemiology and control of myopia progression were selected; only studies published in English were reviewed. Preference was given to prospective studies, as well as those conducted in Hong Kong or East Asia. RESULTS Atropine eye drops and pirenzepine eye gel are highly effective for controlling myopia progression in children. Orthokeratology, peripheral defocus contact lenses, bifocal or progressive addition spectacles, and increased involvement in outdoor activities are also effective for controlling myopia progression; however, myopia undercorrection and single vision contact lenses are ineffective. CONCLUSION Although various methods are effective for controlling myopia progression in children, no curative remedy exists for myopia. Health care professionals should be aware of the available methods, as well as their risks and benefits. Treatment should be individualised and based on the preferences of the patient's family, after full discussion of the risks and benefits of each modality.
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Affiliation(s)
- C Y Mak
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Shatin, Hong Kong.,Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - J Cs Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - L J Chen
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Shatin, Hong Kong.,Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | | | - A L Young
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Shatin, Hong Kong.,Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
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Yong YY, Dykes G, Lee SM, Choo WS. Biofilm inhibiting activity of betacyanins from red pitahaya (Hylocereus polyrhizus) and red spinach (Amaranthus dubius) against Staphylococcus aureus and Pseudomonas aeruginosa biofilms. J Appl Microbiol 2018; 126:68-78. [PMID: 30153380 DOI: 10.1111/jam.14091] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 05/25/2018] [Revised: 07/17/2018] [Accepted: 08/23/2018] [Indexed: 01/01/2023]
Abstract
AIMS To investigate the biofilm inhibitory activity of betacyanins from red pitahaya (Hylocereus polyrhizus) and red spinach (Amaranthus dubius) against Staphylococcus aureus and Pseudomonas aeruginosa biofilms. METHODS AND RESULTS The pulp of red pitahaya and the leaves of red spinach were extracted using methanol followed by subfractionation to obtain betacyanin fraction. The anti-biofilm activity was examined using broth microdilution assay on polystyrene surfaces and expressed as minimum biofilm inhibitory concentration (MBIC). The betacyanin fraction from red spinach showed better anti-biofilm activity (MBIC: 0·313-1·25 mg ml-1 ) against five Staph. aureus strains while the betacyanin fraction from red pitahaya showed better anti-biofilm activity (MBIC: 0·313-0·625 mg ml-1 ) against four P. aeruginosa strains. Both betacyanin fraction significantly reduced hydrophobicity of Staph. aureus and P. aeruginosa strains. Numbers of Staph. aureus and P. aeruginosa attached to polystyrene were also reduced without affecting their cell viability. CONCLUSION Betacyanins can act as anti-biofilm agents against the initial step of biofilm formation, particularly on a hydrophobic surface like polystyrene. SIGNIFICANCE AND IMPACT OF THE STUDY This study is the first to investigate the use of betacyanin as a biofilm inhibitory agent. Betacyanin could potentially be used to reduce the risk of biofilm-associated infections.
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Affiliation(s)
- Y Y Yong
- School of Science, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - G Dykes
- School of Public Health, Curtin University, Bentley, WA, Australia
| | - S M Lee
- School of Science, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - W S Choo
- School of Science, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
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Lee KS, Park HK, Chio YS, Lee SA, Heo R, Lee SM, Song JM, Kang DH, Song JK. P1758Clinical situations associated with inappropriately large regurgitant volume in the assessment of mitral regurgitation severity using proximal flow convergence method. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K S Lee
- Asan Medical Center, Cardiology, Seoul, Korea Republic of
| | - H K Park
- Asan Medical Center, Cardiology, Seoul, Korea Republic of
| | - Y S Chio
- Asan Medical Center, Cardiology, Seoul, Korea Republic of
| | - S A Lee
- Asan Medical Center, Cardiology, Seoul, Korea Republic of
| | - R Heo
- Asan Medical Center, Cardiology, Seoul, Korea Republic of
| | - S M Lee
- Asan Medical Center, Cardiology, Seoul, Korea Republic of
| | - J M Song
- Asan Medical Center, Cardiology, Seoul, Korea Republic of
| | - D H Kang
- Asan Medical Center, Cardiology, Seoul, Korea Republic of
| | - J K Song
- Asan Medical Center, Cardiology, Seoul, Korea Republic of
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Son YK, Kwon H, Lee HW, Jeong EG, Lee SM, Kim SE, Park Y, An WS. Modification of Erythrocyte Membrane Fatty Acid Contents After Kidney Transplantation: A Prospective Study. Transplant Proc 2018; 50:1332-1335. [PMID: 29880354 DOI: 10.1016/j.transproceed.2018.01.057] [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: 11/17/2017] [Accepted: 01/23/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Modifications of erythrocyte membrane fatty acid (FA) contents may affect cellular function or transmembrane receptors. One cross-sectional study has shown that kidney transplant (KTP) recipients have lower erythrocyte membrane oleic acid content than dialysis patients do. Therefore, we prospectively tested whether erythrocyte membrane contents of FA including oleic acid change after KTP. METHODS We recruited 23 KTP recipients (September 2011 through May 2014). Blood samples were obtained immediately before KTP and 6 months after. Erythrocyte membrane FA contents were measured by gas chromatography. RESULTS Mean age of the enrolled KTP recipients was 45.3 ± 10.9 years, and men represented 66.7% of the cases. ABO-incompatible KTPs constituted 14.3% and cadaver donors 42.9% of the cases. Steroids, mycophenolate mofetil, and tacrolimus were used as immunosuppressive treatment. There was no significant difference in dietary consumption between time points before and 6 months after KTP. Total cholesterol and low-density lipoprotein cholesterol levels were significantly higher at 6 months after KTP as compared with baseline. Erythrocyte membrane contents of polyunsaturated FA, ω-3 FA, ω-6 FA, and the ω-3 index were significantly higher, but erythrocyte membrane contents of total saturated FAs, total monounsaturated FAs, including oleic acid, total trans-FA, palmitoleic acid, and the ω-6-to-ω-3 ratio were significantly lower at 6 months after KTP. CONCLUSIONS Erythrocyte membrane FA contents significantly changed toward a more favorable cardiovascular profile after KTP. These changes in erythrocyte membrane FA contents may be related to improved renal function because of the absence of significant dietary changes.
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Affiliation(s)
- Y K Son
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - H Kwon
- Department of Internal Medicine, BHS Hanseo Hospital, Busan, Korea
| | - H W Lee
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - E G Jeong
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - S M Lee
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - S E Kim
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - Y Park
- Department of Food and Nutrition, Hanyang University, Seoul, Korea
| | - W S An
- Department of Internal Medicine, Dong-A University, Busan, Korea.
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Liu YL, Chin C, Catanese B, Lee SM, Zhan S, Kalinsky K, Connolly EP. Concurrent use of capecitabine with radiation therapy and survival in breast cancer (BC) after neoadjuvant chemotherapy. Clin Transl Oncol 2018; 20:1280-1288. [PMID: 29594944 DOI: 10.1007/s12094-018-1859-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 03/08/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE Capecitabine has been studied as a radiosensitizer, and our study seeks to examine the association of concurrent capecitabine/radiation therapy (RT) on event-free- (EFS) and overall survival (OS) in women with breast cancer (BC) with residual disease after neoadjuvant chemotherapy (NAC). METHODS/PATIENTS In a retrospective study of women with BC who received adriamycin/taxane-based NAC from 2004-2016, we identified 21 women administered concurrent capecitabine/RT. To assess differences in survival, we selected a clinical control cohort (n = 57) based on criteria used to select patients for capecitabine/RT. We also created a matched cohort (2:1), matching on tumor subtype, pathological stage and age (< 50 or 50+ years). Differences in EFS, using STEEP criteria, and OS, using all-cause mortality, between those who received capecitabine/RT and controls were assessed. RESULTS Of the 21 women who received capecitabine/RT, median age was 52 years. The majority were pathologic stage III (n = 15) and hormone receptor-positive/HER2-negative BC (n = 20). In those receiving capecitabine/RT, there were 9 events, compared with 14 events in clinical and 10 events in matched controls. Capecitabine/RT was associated with worse OS in clinical (HR 3.83 95% CI 1.12-13.11, p = 0.03) and matched controls (HR 3.71 95% CI 1.04-13.18, p = 0.04), after adjusting for clinical size, pathological stage and lymphovascular invasion. Capecitabine/RT was also associated with a trend towards worse EFS in clinical (HR 2.41 95% CI 0.86-6.74, p = 0.09) and matched controls (HR 2.68 95% CI 0.91-7.90, p = 0.07) after adjustment. CONCLUSION Concurrent capecitabine/RT after NAC is associated with worse survival and should be carefully considered in BC.
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Affiliation(s)
- Y L Liu
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - C Chin
- Department of Radiation Oncology, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA
| | - B Catanese
- Department of Radiation Oncology, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA
| | - S M Lee
- Department of Biostatistics, Columbia University School of Medicine, New York, NY, USA
| | - S Zhan
- Department of Biostatistics, Columbia University School of Medicine, New York, NY, USA
| | - K Kalinsky
- Department of Medical Oncology, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA
| | - E P Connolly
- Department of Radiation Oncology, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA.
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Abstract
We examined how individuals would respond to scarcity appeals when they felt low (vs. high) in personal control. We proposed that scarcity would be an effective way to compensate for loss of control because it symbolizes distinctiveness, stimulates urgency, and offers an opportunity
to obtain resources. Results from 2 experiments confirmed our prediction. In Study 1, participants (64 Korean college students) indicated a greater intention to purchase a limited-edition product when they perceived low (vs. high) control. In Study 2, participants (228 Korean college students)
who perceived low (vs. high) control chose a larger-sized product more often when the product used an only-time frame than when it did an any-time frame. Our findings contribute to the literature by introducing a compensatory paradigm to scarcity effects and identifying its promotional use
as a new mechanism for compensatory control.
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Daniel-Jambun D, Dwiyanto J, Lim YY, Tan JBL, Muhamad A, Yap SW, Lee SM. Investigation on the antimicrobial activities of gingers (Etlingera coccinea (Blume) S.Sakai & Nagam and Etlingera sessilanthera R.M.Sm.) endemic to Borneo. J Appl Microbiol 2017; 123:810-818. [PMID: 28708293 DOI: 10.1111/jam.13536] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 05/18/2017] [Revised: 06/24/2017] [Accepted: 07/04/2017] [Indexed: 11/27/2022]
Abstract
AIMS To investigate the antimicrobial properties of Etlingera coccinea and Etlingera sessilanthera and to isolate and identify the antimicrobial compounds. METHODS AND RESULTS Extracts were obtained via sequential solvent extraction method using hexane, dichloromethane, ethyl acetate, methanol and water. Antimicrobial activity testing was done using broth microdilution assay against 17 strains of bacteria. The leaf hexane extract of E. coccinea and rhizome hexane extract of E. sessilanthera showed best antimicrobial activities, with minimum inhibitory concentration (MIC) values ranging from 0·016 to 1 mg ml-1 against Gram-positive bacteria. From these active extracts, two antimicrobials were isolated and identified as trans-2-dodecenal and 8(17),12-labdadiene-15,16-dial with MIC values ranging from 4 to 8 μg ml-1 against Bacillus cereus, Bacillus subtilis and Staphylococcus aureus. CONCLUSION Etlingera coccinea and E. sessilanthera demonstrated good antimicrobial activities against clinically relevant bacteria strains. The antimicrobial compounds isolated showed low MIC values, hence suggesting their potential use as antimicrobial agents. SIGNIFICANCE AND IMPACT OF THE STUDY This study is the first to identify the potent antimicrobials from these gingers. The antimicrobials isolated could potentially be developed further for use in treatment of bacterial infections. Also, this study warrants further research into other Etlingera species in search for more antimicrobial compounds.
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Affiliation(s)
- D Daniel-Jambun
- School of Science, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - J Dwiyanto
- School of Science, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Y Y Lim
- School of Science, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - J B L Tan
- School of Science, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - A Muhamad
- Structural and Biophysics Facility, Malaysia Genome Institute, National Institutes of Biotechnology Malaysia (MOSTI), Kajang, Selangor, Malaysia
| | - S W Yap
- Conservation and Environmental Management Division, Kota Kinabalu, Sabah, Malaysia
| | - S M Lee
- Tropical Medicine and Biology, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
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Hur EY, Jin YJ, Jin TX, Lee SM. Development and evaluation of the automated risk assessment system for multidrug-resistant organisms (autoRAS-MDRO). J Hosp Infect 2017; 98:202-211. [PMID: 28807836 DOI: 10.1016/j.jhin.2017.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 08/06/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND A high proportion of infections acquired in hospitals are caused by multidrug-resistant organisms (MDROs). The priority in MDRO prevention is to detect high-risk patients and implement preventive intervention as soon as possible. AIM To develop an automated risk assessment system for MDROs (autoRAS-MDRO) to screen for patients at MDRO infection risk and evaluate the predictive validity of the autoRAS-MDRO. METHODS Data for 4200 variables were extracted from the electronic health records (EHRs) for constructing the MDRO risk-scoring algorithm, which was based on a logistic regression model. The autoRAS-MDRO was designed such that the MDRO risk classification (high, moderate, low risk) could be automatically displayed on the nursing Kardex screen in the EHRs system. For the development of the MDRO risk-scoring algorithm, 1000 patients with MDROs and 4000 patients without MDROs were selected; similarly, for the evaluation, 2173 and 8692 patients with and without MDROs, respectively, were selected. FINDINGS The predictive validity of the autoRAS-MDRO was as follows: (i) at the 6-month evaluation: sensitivity, 81%; specificity, 79%; positive predictive value (PPV), 49%; negative predictive value (NPV), 94%; and Youden index, 0.60; (ii) at the 12-month evaluation: sensitivity 79%, specificity 78%, PPV 47%, NPV 94%, and Youden index, 0.57. CONCLUSION The autoRAS-MDRO had moderate predictive validity. It could be useful in redirecting nurses' time and efforts required for MDRO risk assessment and implementation of infection control measures, and in reducing the incidence of MDRO infection in hospitals, thereby contributing to patient safety.
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Affiliation(s)
- E Y Hur
- College of Nursing, The Catholic University of Korea, Seoul, South Korea
| | - Y J Jin
- College of Nursing, The Catholic University of Korea, Seoul, South Korea
| | - T X Jin
- College of Nursing, The Catholic University of Korea, Seoul, South Korea
| | - S M Lee
- College of Nursing, The Catholic University of Korea, Seoul, South Korea.
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You SK, Lee JE, Lee SM, Cho HH. Metabolic bone disease in preterm infants: Relationship between radiologic grading in the wrist and serum biochemical markers. Diagn Interv Imaging 2017; 98:785-791. [PMID: 28734779 DOI: 10.1016/j.diii.2017.06.008] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 05/20/2017] [Accepted: 06/01/2017] [Indexed: 02/06/2023]
Abstract
PURPOSE To assess the relationship between radiographic findings of metabolic bone disease (MBD) and serum biochemical markers in preterm infants. MATERIALS AND METHODS A total of 159 preterm infants were included in this study. Two readers reviewed the wrist radiography for grading according to MBD severity. We recorded the levels of alkaline phosphatase (ALP) and phosphorous (P) immediately after birth, on the same day of the first wrist radiography (ALP-s, P-s), the highest/lowest ALP/P levels before the first wrist radiography (ALP-hb/P-lb) and during follow-up (ALP-h/P-l). For analysis, the patients were first subdivided into 4 groups according to MBD severity, and were then divided into 2 groups according to MBD presence or absence. RESULTS Of the 159 patients, 94, 39, 19, and 7 infants were classified into grades 0,1, 2, and 3. Analysis according to severity showed that ALP-s, ALP-hb, and ALP-h differed between grades 0-1 and 2-3 (all P<0.001); P-lb differed between grades 0 and 2 (P=0.001); and P-l differed between grades 0 and 2 or 3 (P<0.001 or P=0.001). Moreover, ALP-s, ALP-hb, ALP-h, P-s, P-lb, and P-l differed according to the presence or absence of MBD (P<0.001). ALP-h showed the largest area under the curve value (0.752, 95% confidence interval=0.676-0.828, P<0.001). The optimal cut-off value of ALP-h was 473.5U/L. The sensitivity and specificity were 81.5% and 47.9%. ALP-h was measured at 6.9±5.3 weeks after birth. CONCLUSION Taking the wrist radiography with reference to an ALP level measured at around 6.9 weeks after birth could be helpful for screening of MBD in preterm infants, unless a fracture is clinically suspected.
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Affiliation(s)
- S K You
- Department of Radiology, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Republic of Korea
| | - J E Lee
- Department of Radiology, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Republic of Korea.
| | - S M Lee
- Department of Radiology, Kyungpook National University Medical Center, 807 Hoguk-ro, Buk-gu, Daegu 41404, Republic of Korea
| | - H-H Cho
- Department of Radiology, Ewha Womans University Mokdong Hospital, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Republic of Korea
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Chun S, Kim H, Park CK, McDonald K, Sun Ha O, Kim DL, Lee SM. South Korean students' responses to English-medium instruction courses. soc behav pers 2017. [DOI: 10.2224/sbp.6049] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We explored the underlying mechanism for South Korean university students' negative responses to English-medium instruction (EMI) courses. Specifically, English language anxiety and confidence, and EMI course attitudes and avoidance were analyzed using survey data from 187 Korean university
students. Results showed that English language anxiety played a key role in both EMI course attitudes and avoidance, and also affected student achievement in EMI courses. Students' English language confidence and their perceptions of their instructors' English language competence were found
to be unrelated to EMI course attitudes and avoidance, but were negatively related to English language anxiety. In addition, students' EMI course content understanding and grades did not directly influence EMI course avoidance, but did indirectly influence course avoidance through EMI course
attitudes. Our results highlight the importance of addressing students' emotional challenges and attitudes to improve their motivation to take EMI courses.
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Lee SM, Cheon JE, Choi YH, Kim IO, Kim WS, Cho HH, Lee JY, Wang KC. Limited Dorsal Myeloschisis and Congenital Dermal Sinus: Comparison of Clinical and MR Imaging Features. AJNR Am J Neuroradiol 2017; 38:176-182. [PMID: 27765739 DOI: 10.3174/ajnr.a4958] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 08/15/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE While limited dorsal myeloschisis is a distinctive form of spinal dysraphism, it may be confused with congenital dermal sinus. The aim of this study was to describe clinical and MR imaging findings of limited dorsal myeloschisis that can distinguish it from congenital dermal sinus. MATERIALS AND METHODS We retrospectively reviewed the clinical and MR imaging findings of 12 patients with limited dorsal myeloschisis and 10 patients with congenital dermal sinus. Skin abnormalities, neurologic deficits, and infectious complication were evaluated on the basis of clinical information. We evaluated the following MR imaging features: visibility of the tract along the intrathecal course, attachment site of the tract, level of the conus medullaris, shape of the spinal cord, and presence of intradural lesions such as dermoid/epidermoid tumors. RESULTS A crater covered with pale epithelium was the most common skin lesion in limited dorsal myeloschisis (10/12, 83%). Infectious complications were common in congenital dermal sinus (6/10, 60%), whereas none were found in limited dorsal myeloschisis (P = .003). The following MR imaging findings were significantly different between the 2 groups (P < .05): 1) higher visibility of the intrathecal tract in limited dorsal myeloschisis (10/12, 83%) versus in congenital dermal sinus (1/10, 10%), 2) the tract attached to the cord in limited dorsal myeloschisis (12/12, 100%) versus various tract attachments in congenital dermal sinus, 3) dorsal tenting of the cord in limited dorsal myeloschisis (10/12, 83%) versus in congenital dermal sinus (1/10, 10%), and 4) the presence of dermoid/epidermoid tumors in congenital dermal sinus (6/10, 60%) versus none in limited dorsal myeloschisis. CONCLUSIONS Limited dorsal myeloschisis has distinct MR imaging features: a visible intrathecal tract with dorsal tenting of the cord at the tract-cord union. Limited dorsal myeloschisis was not associated with infection and dermoid/epidermoid tumors.
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Affiliation(s)
- S M Lee
- From the Departments of Radiology (S.M.L., J.-E.C., Y.H.C., I.-O.K., W.S.K., H.-H.C.)
- Department of Radiology (S.M.L.), Kyungpook National University Medical Center, Daegu, Korea
| | - J-E Cheon
- From the Departments of Radiology (S.M.L., J.-E.C., Y.H.C., I.-O.K., W.S.K., H.-H.C.)
| | - Y H Choi
- From the Departments of Radiology (S.M.L., J.-E.C., Y.H.C., I.-O.K., W.S.K., H.-H.C.)
| | - I-O Kim
- From the Departments of Radiology (S.M.L., J.-E.C., Y.H.C., I.-O.K., W.S.K., H.-H.C.)
| | - W S Kim
- From the Departments of Radiology (S.M.L., J.-E.C., Y.H.C., I.-O.K., W.S.K., H.-H.C.)
| | - H-H Cho
- From the Departments of Radiology (S.M.L., J.-E.C., Y.H.C., I.-O.K., W.S.K., H.-H.C.)
- Department of Radiology (H.-H.C.), Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
| | - J Y Lee
- Anatomy (J.Y.L.)
- Neurosurgery, Division of Pediatric Neurosurgery (J.Y.L., K.-C.W.), Seoul National University College of Medicine, Seoul, Republic of Korea
| | - K-C Wang
- Neurosurgery, Division of Pediatric Neurosurgery (J.Y.L., K.-C.W.), Seoul National University College of Medicine, Seoul, Republic of Korea
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Kim DW, Lee SM, Woo HS, Park JY, Ko BS, Heo JD, Ryu YB, Lee WS. Chemical constituents and anti-inflammatory activity of the aerial parts of Curcuma longa. J Funct Foods 2016. [DOI: 10.1016/j.jff.2016.08.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Lee JS, Lee SM, Jeong SW, Sung YG, Lee JH, Kim KW. Effects of age, replicative lifespan and growth rate of human nucleus pulposus cells on selecting age range for cell-based biological therapies for degenerative disc diseases. Biotech Histochem 2016; 91:377-85. [PMID: 27149303 DOI: 10.1080/10520295.2016.1179790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 01/04/2023] Open
Abstract
Autologous disc cell implantation, growth factors and gene therapy appear to be promising therapies for disc regeneration. Unfortunately, the replicative lifespan and growth kinetics of human nucleus pulposus (NP) cells related to host age are unclear. We investigated the potential relations among age, replicative lifespan and growth rate of NP cells, and determined the age range that is suitable for cell-based biological therapies for degenerative disc diseases. We used NP tissues classified by decade into five age groups: 30s, 40s, 50s, 60s and 70s. The mean cumulative population doubling level (PDL) and population doubling rate (PDR) of NP cells were assessed by decade. We also investigated correlations between cumulative PDL and age, and between PDR and age. The mean cumulative PDL and PDR decreased significantly in patients in their 60s. The mean cumulative PDL and PDR in the younger groups (30s, 40s and 50s) were significantly higher than those in the older groups (60s and 70s). There also were significant negative correlations between cumulative PDL and age, and between PDR and age. We found that the replicative lifespan and growth rate of human NP cells decreased with age. The replicative potential of NP cells decreased significantly in patients 60 years old and older. Young individuals less than 60 years old may be suitable candidates for NP cell-based biological therapies for treating degenerative disc diseases.
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Affiliation(s)
- J S Lee
- a Departments of Orthopedic Surgery , Seoul , Korea
| | - S M Lee
- a Departments of Orthopedic Surgery , Seoul , Korea
| | - S W Jeong
- b Orthopedic Research, Medical Research Institute , Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea , Seoul , Korea
| | - Y G Sung
- a Departments of Orthopedic Surgery , Seoul , Korea
| | - J H Lee
- a Departments of Orthopedic Surgery , Seoul , Korea
| | - K W Kim
- a Departments of Orthopedic Surgery , Seoul , Korea
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Shin J, Kim Y, Lee H, Lee J, Kim KS, Cho YJ, Jo YH, Rhu H, Kim KS, Lee SM, Min J, Park G, Yoon J, Park SI, Lee YJ. Transcultural adaptation and validation of familial satisfaction in the intensive care unit in Korea: preliminary study. Intensive Care Med Exp 2015. [PMCID: PMC4796308 DOI: 10.1186/2197-425x-3-s1-a654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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46
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Chang Y, Moon JY, Cho YJ, Lee SM, Jeon K, Kim SC, Kim YS, Chong YP, Kim YS, Hong SB. The current pathogens and treatment of hospital-acquired pneumonia/ventilator-associated pneumonia in medical intensive care units. Intensive Care Med Exp 2015. [PMCID: PMC4798512 DOI: 10.1186/2197-425x-3-s1-a707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Kwak WS, Kim YI, Lee SM, Lee YH, Choi DY. Effect of Feeding a Mixed Microbial Culture Fortified with Trace Minerals on the Performance and Carcass Characteristics of Late-fattening Hanwoo Steers: A Field Study. Asian-Australas J Anim Sci 2015; 28:1592-8. [PMID: 26580283 PMCID: PMC4647099 DOI: 10.5713/ajas.15.0101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 04/19/2015] [Accepted: 05/26/2015] [Indexed: 11/27/2022]
Abstract
This study was conducted to determine the effects of feeding a trace minerals-fortified microbial culture (TMC) on the performance and carcass characteristics of late-fattening Hanwoo steers. A mixture of microbes (0.6% [v/w] of Enterobacter sp., Bacillus sp., Lactobacillus sp., and Saccharomyces sp.) was cultured with 99% feedstuff for ensiling and 0.4% trace minerals (zinc, selenium, copper, and cobalt). Sixteen late-fattening steers (mean age, 21.8 months) were allocated to two diets: a control diet (concentrate mix and rice straw) and a treated diet (control diet+3.3% TMC). At a mean age of 31.1 months, all the steers were slaughtered. The addition of TMC to the diet did not affect the average daily weight gain of the late fattening steers, compared with that of control steers. Moreover, consuming the TMC-supplemented diet did not affect cold carcass weight, yield traits such as back fat thickness, longissimus muscle area, yield index or yield grade, or quality traits such as meat color, fat color, texture, maturity, marbling score, or quality grade. However, consumption of a TMC-supplemented diet increased the concentrations of zinc, selenium, and sulfur (p<0.05) in the longissimus muscle. With respect to amino acids, animals consuming TMC showed increased (p<0.05) concentrations of lysine, leucine, and valine among essential amino acids and a decreased (p<0.05) concentration of proline among non-essential amino acids. In conclusion, the consumption of a TMC-supplemented diet during the late-fattening period elevated the concentrations of certain trace minerals and essential amino acids in the longissimus muscle, without any deleterious effects on performance and other carcass characteristics of Hanwoo steers.
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Affiliation(s)
- W S Kwak
- Department of Animal Science, Kyungpook National University, Sangju 742-711, Korea
| | - Y I Kim
- Department of Animal Science, Kyungpook National University, Sangju 742-711, Korea
| | - S M Lee
- Department of Animal Science, Kyungpook National University, Sangju 742-711, Korea
| | - Y H Lee
- Department of Animal Science, Kyungpook National University, Sangju 742-711, Korea
| | - D Y Choi
- Department of Animal Science, Kyungpook National University, Sangju 742-711, Korea
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Park JK, Lee J, Kim K, Jo YH, Lee JH, Kim J, Lee SM, Song IA. Association of C-Reactive Protein and Outcome in Patients With Community-Acquired Pneumonia. Intensive Care Med Exp 2015. [PMCID: PMC4797359 DOI: 10.1186/2197-425x-3-s1-a523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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49
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Lee SM, Park JS, Norwitz ER, Oh S, Kim EJ, Kim SM, Lee J, Kim BJ, Park CW, Jun JK. Mid-trimester amniotic fluid pro-inflammatory biomarkers predict the risk of spontaneous preterm delivery in twins: a retrospective cohort study. J Perinatol 2015; 35:542-6. [PMID: 25856763 DOI: 10.1038/jp.2015.29] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 02/09/2015] [Accepted: 02/23/2015] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate the association between the concentrations of immune-related proteins in mid-trimester amniotic fluid (AF) and the subsequent risk of spontaneous preterm delivery in twins. STUDY DESIGN The study population consisted of consecutive women with a twin pregnancy who underwent clinically indicated genetic amniocentesis at 15 to 20 weeks, and had a subsequent spontaneous delivery in the early preterm period (<32 weeks (cases)) or at term (37 to 42 weeks (controls)). AF was analyzed for cytokines (interleukin (IL)-1ß, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, IL-13 and IL-15, interferon-γ, tumor necrosis factor-α), matrix metalloproteinases (MMP-1, MMP-2, MMP-3, MMP-8, MMP-9 and MMP-12), and chemokines (complement factor-D/Adipsin, Serpin E1/PAI-1, Adiponectin/Acrp30, C-Reactive Protein, CCL2/MCP-1, Leptin, Resistin) using multiplex immunoassay kits. The association between AF protein levels and subsequent early preterm birth were examined. RESULT A total of 96 sets of twins were enrolled, including 17 early preterm birth cases and 79 term controls. AF concentrations of IL-6, IL-8, MMP-3, MMP-8 and MMP-9, and CCL2/MCP-1 were significantly higher in cases than controls. Among these analytes, the combination of AF IL-8 and MMP-9 values had the highest predictive value for early preterm birth. The risk was 8% (10/132) for IL-8<1200 pg ml(-1) and MMP-9<1000 pg ml(-1), 30% (15/50) for IL-8>1200 pg ml(-1) or MMP-9>1000 pg ml(-1), and 90% (9/10) for IL-8>1200 pg ml(-1) and MMP-9>1000 pg ml(-1) (P<0.001). CONCLUSION High concentrations of IL-8 and MMP-9 in mid-trimester AF in twins predicted well the risk of early preterm birth.
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Affiliation(s)
- S M Lee
- 1] Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea [2] Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - J S Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - E R Norwitz
- Department of Obstetrics and Gynecology, Tufts University School of Medicine, Boston, MA, USA
| | - S Oh
- Department of Biostatistics, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - E J Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - S M Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - J Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - B J Kim
- 1] Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea [2] Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - C-W Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - J K Jun
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
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Shin WC, Lee SM, Lee KW, Cho HJ, Lee JS, Suh KT. The reliability and accuracy of measuring anteversion of the acetabular component on plain anteroposterior and lateral radiographs after total hip arthroplasty. Bone Joint J 2015; 97-B:611-6. [PMID: 25922453 DOI: 10.1302/0301-620x.97b5.34735] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
There is no single standardised method of measuring the orientation of the acetabular component on plain radiographs after total hip arthroplasty. We assessed the reliability and accuracy of three methods of assessing anteversion of the acetabular component for 551 THAs using the PolyWare software and the methods of Liaw et al, and of Woo and Morrey. All measurements of the three methods had excellent intra- and inter-observer reliability. The values of the PolyWare software, which determines version of the acetabular component by edge detection were regarded as the reference standard. Although the PolyWare software and the method of Liaw et al were similarly precise, the method of Woo and Morrey was significantly less accurate (p < 0.001). The method of Liaw et al seemed to be more accurate than that of Woo and Morrey when compared with the measurements using the PolyWare software. If the qualified lateral radiograph was selected, anteversion measured using the method of Woo and Morrey was considered to be relatively reliable.
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Affiliation(s)
- W C Shin
- Pusan National University School of Medicine, 20 Geumo-ro, Mulgeum-eup, Yangsan, Gyeongsangnam-do, 626-770, Korea
| | - S M Lee
- Pusan National University School of Medicine, 20 Geumo-ro, Mulgeum-eup, Yangsan, Gyeongsangnam-do, 626-770, Korea
| | - K W Lee
- Pusan National University School of Medicine, 20 Geumo-ro, Mulgeum-eup, Yangsan, Gyeongsangnam-do, 626-770, Korea
| | - H J Cho
- Pusan National University School of Medicine, 20 Geumo-ro, Mulgeum-eup, Yangsan, Gyeongsangnam-do, 626-770, Korea
| | - J S Lee
- Pusan National University School of Medicine, 20 Geumo-ro, Mulgeum-eup, Yangsan, Gyeongsangnam-do, 626-770, Korea
| | - K T Suh
- Pusan National University School of Medicine, 20 Geumo-ro, Mulgeum-eup, Yangsan, Gyeongsangnam-do, 626-770, Korea
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