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Yoon SH, Vandal A, Rivera-Rodriguez C. Weight calibration in the joint modelling of medical cost and mortality. Stat Methods Med Res 2024; 33:728-742. [PMID: 38444359 DOI: 10.1177/09622802241236935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Joint modelling of longitudinal and time-to-event data is a method that recognizes the dependency between the two data types, and combines the two outcomes into a single model, which leads to more precise estimates. These models are applicable when individuals are followed over a period of time, generally to monitor the progression of a disease or a medical condition, and also when longitudinal covariates are available. Medical cost datasets are often also available in longitudinal scenarios, but these datasets usually arise from a complex sampling design rather than simple random sampling and such complex sampling design needs to be accounted for in the statistical analysis. Ignoring the sampling mechanism can lead to misleading conclusions. This article proposes a novel approach to the joint modelling of complex data by combining survey calibration with standard joint modelling. This is achieved by incorporating a new set of equations to calibrate the sampling weights for the survival model in a joint model setting. The proposed method is applied to data on anti-dementia medication costs and mortality in people with diagnosed dementia in New Zealand.
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Affiliation(s)
- Seong Hoon Yoon
- Department of Statistics, The University of Auckland, Auckland, New Zealand
| | - Alain Vandal
- Department of Statistics, The University of Auckland, Auckland, New Zealand
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Choi MG, Kim YJ, Lee JC, Ji W, Oh IJ, Lee SY, Yoon SH, Lee SY, Lee JE, Kim EY, Choi CM. The Real-World Outcome of First Line Atezolizumab in Extensive-Stage Small Cell Lung Cancer: A Multicenter Prospective Cohort Study. Cancer Res Treat 2024; 56:422-429. [PMID: 37871898 PMCID: PMC11016637 DOI: 10.4143/crt.2023.913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 10/21/2023] [Indexed: 10/25/2023] Open
Abstract
PURPOSE The addition of immune checkpoint inhibitors to chemotherapy has improved survival outcomes in patients with extensive-stage small cell lung cancer (ES-SCLC). However, their real-world effectiveness remains unknown. Therefore, we investigated the effectiveness of atezolizumab plus chemotherapy in ES-SCLC in actual clinical settings. MATERIALS AND METHODS In this multicenter prospective cohort study, patients with ES-SCLC receiving or scheduled to receive atezolizumab in combination with etoposide and carboplatin were enrolled between June 2021 and August 2022. The primary outcomes were progression-free survival (PFS) and the 1-year overall survival (OS) rate. RESULTS A total of 100 patients with ES-SCLC were enrolled from seven centers. Median age was 69 years, and 6% had an Eastern Cooperative Oncology Group performance status (ECOG PS) ≥ 2. The median PFS was 6.0 months, the 1-year OS rate was 62.2%, and the median OS was 13.5 months. An ECOG PS of 2-3 and progressive disease as the best response were poor prognostic factors for PFS, while an ECOG PS of 2-3 and brain metastasis were associated with poor prognosis for OS. In addition, consolidative thoracic radiotherapy was found to be an independent favorable prognostic factor for OS (hazard ratio, 0.336; p=0.021). Grade ≥ 3 treatment-related adverse events were observed in 7% of patients, with treatment-related deaths occurring in 2% of patients. CONCLUSION We provided evidence of the favorable real-world effectiveness and safety of atezolizumab plus chemotherapy in ES-SCLC patients, including in the elderly and those with poor ECOG PS. Additional consolidative thoracic radiotherapy may also benefit ES-SCLC patients.
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Affiliation(s)
- Myeong Geun Choi
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Yeon Joo Kim
- Department of pulmonology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Jae Cheol Lee
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Wonjun Ji
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - In-Jae Oh
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Sung Yong Lee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seong Hoon Yoon
- Division of Pulmonology, Allergy, and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Shin Yup Lee
- Department of Internal Medicine, Kyungpook National University, School of Medicine, Daegu, Korea
| | - Jeong Eun Lee
- Division of Pulmonology, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Eun Young Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Chang-Min Choi
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Jeon DS, Park C, Kim SJ, Park CK, Chang YS, Jung CY, Lee SY, Lee S, Ryu J, Lee JE, Lee KY, Jang TW, Jang SH, Yoon SH, Lee SH, Choi C, Kim HR, Kim YJ. Real-world outcome of crizotinib for anaplastic lymphoma kinase-positive lung cancer: Multicenter retrospective analysis in South Korea. Thorac Cancer 2024; 15:448-457. [PMID: 38171544 PMCID: PMC10883859 DOI: 10.1111/1759-7714.15213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND About 3%-5% of non-small cell lung cancer (NSCLC) presents positive anaplastic lymphoma kinase (ALK). Recently, several target agents have been approved as a treatment for ALK-positive NSCLC. This study aimed to analyze the real-world efficacy and outcome when administered crizotinib, the first approved target agent for ALK-positive NSCLC, according to first- or late-line treatment. METHODS A total of 290 patients with ALK-positive advanced NSCLC who were treated with crizotinib in 15 institutions in South Korea from January 2009 to December 2018 were enrolled. RESULTS The median age of patients was 57.0 years, and 50.3% were male. The median follow-up duration was 29.3 months. Among them, 113 patients received crizotinib as first-line therapy. The objective response rate (ORR) was 60.1% (57.0% for first-line recipients, 61.8% for second-/later-line). Median (95% CI) progression-free survival (PFS) was 13.7 (11.6-17.0) months. For first-line recipients, overall survival (OS) was 26.3 (17.6-35.0) months. No significant difference in ORR, PFS and OS, according to the setting of crizotinib initiation, was observed. In a multivariate Cox regression analysis, old age, male gender, initially metastatic, and number of metastatic organs were associated with poor PFS and OS. The most common adverse events were nausea and vomiting, and severe adverse event leading to dose adjustment was hepatotoxicity. CONCLUSIONS ORR, PFS, OS, and adverse event profiles were comparable to previous clinical trials. Our findings could aid in the efficient management of ALK-positive lung cancer patients.
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Affiliation(s)
- Da Som Jeon
- Department of Pulmonary and Critical Care MedicineNowon Eulji Medical Center, University of EuljiSeoulSouth Korea
| | - Cheol‐kyu Park
- Department of Pulmonary and Critical Care MedicineChonnam National University Hwasun hospital, Chonnam National UniversityJeollanam‐doRepublic of Korea
| | - Seung Joon Kim
- Department of Internal MedicinePostech‐Catholic Biomedical Engineering Institute, College of Medicine, The Catholic University of KoreaSeoulRepublic of Korea
| | - Chan Kwon Park
- Department of Pulmonary and Critical Care MedicineCatholic University of Korean Yeouido Saint Mary's HospitalSeoulKorea
| | - Yoon Soo Chang
- Department of Internal MedicineYonsei University College of Medicine, 8th Floor Annex Building, Yongdong Severance HospitalSeoulRepublic of Korea
| | - Chi Young Jung
- Department of Internal MedicineDaegu Catholic University School of MedicineDaeguKorea
| | - Sung Yong Lee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of MedicineSeoulKorea
| | - Shin‐Yup Lee
- Division of Pulmonary and Critical Care MedicineKyungpook National University Chilgok HospitalDaeguKorea
| | - Jeong‐Seon Ryu
- Department of Pulmonary and Critical Care MedicineInha University HospitalIncheonRepublic of Korea
| | - Jeong Eun Lee
- Department of Internal MedicineChungnam National University HospitalDaejeonRepublic of Korea
| | - Kye Young Lee
- Department of Pulmonary MedicineKonkuk University School of MedicineSeoulRepublic of Korea
| | - Tae Won Jang
- Department of Internal MedicineKosin University Medical CollegePusanKorea
| | - Seung Hun Jang
- Department of PulmonaryAllergy and Critical Care Medicine, Hallym University Sacred Heart HospitalAnyangRepublic of Korea
| | - Seong Hoon Yoon
- Department of Internal MedicineSchool of Medicine, Pusan National UniversityYangsanRepublic of Korea
| | - Sang Hoon Lee
- Division of Pulmonology, Institute of Chest Disease, Department of Internal MedicineYonsei University College of MedicineSeoulRepublic of Korea
| | - Chang‐min Choi
- Department of Pulmonary and Critical Care MedicineAsan Medical Centre, University of Ulsan College of MedicineSeoulRepublic of Korea
- Department of OncologyAsan Medical Centre, University of Ulsan College of MedicineSeoulRepublic of Korea
| | - Hyeong Ryul Kim
- Department of Pulmonary and Critical Care MedicineAsan Medical Centre, University of Ulsan College of MedicineSeoulRepublic of Korea
| | - Yeon Joo Kim
- Department of Pulmonary and Critical Care MedicineNowon Eulji Medical Center, University of EuljiSeoulSouth Korea
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Kim HH, Lee JC, Oh IJ, Kim EY, Yoon SH, Lee SY, Lee MK, Lee JE, Park CK, Lee KY, Lee SY, Kim SJ, Lim JH, Choi CM. Real-World Outcomes of Crizotinib in ROS1-Rearranged Advanced Non-Small-Cell Lung Cancer. Cancers (Basel) 2024; 16:528. [PMID: 38339278 PMCID: PMC10854608 DOI: 10.3390/cancers16030528] [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: 12/31/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Real-world data on the use and outcomes of crizotinib in ROS1-rearranged non-small-cell lung cancer (NSCLC) are limited. This study aims to analyze the real-world efficacy of crizotinib in South Korea and explore the utilization of liquid biopsies that implement next-generation sequencing (NGS) using cell-free total nucleic acids. In this prospective multicenter cohort study, 40 patients with ROS1-rearranged NSCLC, either starting or already on crizotinib, were enrolled. Patients had a median age of 61 years, with 32.5% presenting brain/central nervous system (CNS) metastases at treatment initiation. At the data cutoff, 48.0% were still in treatment; four continued with it even after disease progression due to the clinical benefits. The objective response rate was 70.0%, with a median duration of response of 27.8 months. The median progression-free survival was 24.1 months, while the median overall survival was not reached. Adverse events occurred in 90.0% of patients, primarily with elevated transaminases, yet these were mostly manageable. The NGS assay detected a CD74-ROS1 fusion in 2 of the 14 patients at treatment initiation and identified emerging mutations, such as ROS1 G2032R, ROS1 D2033N, and KRAS G12D, during disease progression. These findings confirm crizotinib's sustained clinical efficacy and safety in a real-world context, which was characterized by a higher elderly population and higher rates of brain/CNS metastases. The study highlights the clinical relevance of liquid biopsy for detecting resistance mechanisms, suggesting its value in personalized treatment strategies.
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Affiliation(s)
- Hyeon Hwa Kim
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea;
| | - Jae Cheol Lee
- Department of Oncology, Asan Medical Centre, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea;
| | - In-Jae Oh
- Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Gwangju 58128, Republic of Korea;
| | - Eun Young Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Seong Hoon Yoon
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea;
| | - Shin Yup Lee
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu 41404, Republic of Korea
| | - Min Ki Lee
- Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Hospital, Busan 49241, Republic of Korea;
| | - Jeong Eun Lee
- Division of Pulmonology, Department of Internal Medicine, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Chan Kwon Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea;
| | - Kye Young Lee
- Departments of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Republic of Korea;
| | - Sung Yong Lee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Republic of Korea
| | - Seung Joon Kim
- Division of Pulmonology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea;
| | - Jun Hyeok Lim
- Department of Internal Medicine, Inha University Hospital, Incheon 22332, Republic of Korea
| | - Chang-min Choi
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea;
- Department of Oncology, Asan Medical Centre, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea;
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Lee S, Yeo HJ, Yoon SH, Lee SE, Cho WH, Jeon DS, Kim YS, Son BS, Kim DH. Erratum: Correction of Affiliations in the Article "Validity of Outcome Prediction Scoring Systems in Korean Patients with Severe Adult Respiratory Distress Syndrome Receiving Extracorporeal Membrane Oxygenation Therapy". J Korean Med Sci 2023; 38:e380. [PMID: 37904662 PMCID: PMC10615636 DOI: 10.3346/jkms.2023.38.e380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 10/21/2023] [Indexed: 11/01/2023] Open
Abstract
This corrects the article on p. 932 in vol. 31, PMID: 27247503.
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Affiliation(s)
- Seunghyun Lee
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Hye Ju Yeo
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Seong Hoon Yoon
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Seung Eun Lee
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Woo Hyun Cho
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.
| | - Doo Soo Jeon
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Yun Seong Kim
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Bong Soo Son
- Department of Cardiovascular and Thoracic Surgery, Pusan National University Yangsan Hospital, Pusan National University, Yangsan, Korea
| | - Do Hyung Kim
- Department of Cardiovascular and Thoracic Surgery, Pusan National University Yangsan Hospital, Pusan National University, Yangsan, Korea
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Kim T, Jang TW, Choi CM, Kim MH, Lee SY, Chang YS, Lee KY, Kim SJ, Yang SH, Ryu JS, Lee JE, Lee SY, Park CK, Lee SH, Jang SH, Yoon SH, Oh HJ. Final Report on Real-World Effectiveness of Sequential Afatinib and Osimertinib in EGFR-Positive Advanced Non-Small Cell Lung Cancer: Updated Analysis of the RESET Study. Cancer Res Treat 2023; 55:1152-1170. [PMID: 37218139 PMCID: PMC10582551 DOI: 10.4143/crt.2023.493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 05/18/2023] [Indexed: 05/24/2023] Open
Abstract
PURPOSE This study aimed to report the final analysis of time-on-treatment (TOT) and overall survival (OS) in patients with advanced-stage epidermal growth factor receptor (EGFR)+ non-small cell lung cancer (NSCLC) who received sequential afatinib and osimertinib and to compare the outcomes with other second-line regimens (comparator group). MATERIALS AND METHODS In this updated report, the existing medical records were reviewed and rechecked. TOT and OS were updated and analyzed according to clinical features using the Kaplan-Meier method and log-rank test. TOT and OS were compared with those of the comparator group, in which most patients received pemetrexed-based treatments. A multivariable Cox proportional hazard model was used to evaluate features that could affect survival outcomes. RESULTS The median observation time was 31.0 months. The follow-up period was extended to 20 months. A total of 401 patients who received first-line afatinib were analyzed (166 with T790M+ and second-line osimertinib, and 235 with unproven T790M and other second-line agents). Median TOTs on afatinib and osimertinib were 15.0 months (95% confidence interval [CI], 14.0 to 16.1) and 11.9 months (95% CI, 8.9 to 14.6), respectively. The median OS in the osimertinib group was 54.3 months (95% CI, 46.7 to 61.9), much longer than that in the comparator group. In patients who received osimertinib, the OS was longest with Del19+ (median, 59.1; 95% CI, 48.7 to 69.5). CONCLUSION This is one of the largest real-world studies reporting the encouraging activity of sequential afatinib and osimertinib in Asian patients with EGFR+ NSCLC who acquired the T790M mutation, particularly Del19+.
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Affiliation(s)
- Taeyun Kim
- Department of Internal Medicine, Samsung Medical Center, Seoul,
Korea
| | - Tae Won Jang
- Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan,
Korea
| | - Chang Min Choi
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Mi-Hyun Kim
- Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan,
Korea
| | - Sung Yong Lee
- Division of Pulmonology, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul,
Korea
| | - Yoon Soo Chang
- Department of Internal Medicine, Yonsei University Gangnam Severance Hospital, Seoul,
Korea
| | - Kye Young Lee
- Department of Internal Medicine, Konkuk University Medical Center, Seoul,
Korea
| | - Seung Joon Kim
- Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Sei Hoon Yang
- Department of Internal Medicine, Wonkwang University Hospital, Iksan,
Korea
| | - Jeong Seon Ryu
- Department of Internal Medicine, Inha University Hospital, Incheon,
Korea
| | - Jeong Eun Lee
- Department of Internal Medicine, Chungnam National University Hospital, Daejeon,
Korea
| | - Shin Yup Lee
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu,
Korea
| | - Chan Kwon Park
- Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Sang Hoon Lee
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
| | - Seung Hun Jang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang,
Korea
| | - Seong Hoon Yoon
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan,
Korea
| | - Hyung-Joo Oh
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun,
Korea
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Park CK, Oh HJ, Kim YC, Kim YH, Ahn SJ, Jeong WG, Lee JY, Lee JC, Choi CM, Ji W, Song SY, Choi J, Lee SY, Kim H, Lee SY, Park J, Yoon SH, Joo JH, Oh IJ. Korean Real-World Data on Patients With Unresectable Stage III NSCLC Treated With Durvalumab After Chemoradiotherapy: PACIFIC-KR. J Thorac Oncol 2023; 18:1042-1054. [PMID: 37085032 DOI: 10.1016/j.jtho.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 04/23/2023]
Abstract
INTRODUCTION This study aimed to investigate real-world evidence for efficacy and safety of durvalumab consolidation (DC) after chemoradiotherapy (CRT) in patients with unresectable stage III NSCLC. METHODS Patients with stage III NSCLC who started DC after CRT between September 2018 and December 2020 and were treated at five tertiary hospitals in the Republic of Korea were included. The primary end point was real-world progression-free survival (rwPFS). Secondary end points were overall survival, objective response rate, and adverse events including radiation pneumonitis (RP) and immune-related adverse events (irAEs). RESULTS A total of 157 patients were enrolled. At the median follow-up of 19.1 months, median rwPFS of DC was 25.9 months (95% confidence interval: 16.5-35.4) and the 1-, 2-, and 3-year rwPFS rates were 59.4%, 51.8%, and 43.5%, respectively. The median overall survival was not mature, and objective response rate of DC was 51.0%. High programmed death-ligand 1 expression (≥50%) and development of RP requiring steroid treatment were significantly associated with longer (p = 0.043) and shorter rwPFS (p = 0.036), respectively. RP, RP requiring steroid treatment, and irAEs developed in 57 (36.3%), 42 (26.8%), and 53 (33.8%) patients, respectively. Among peripheral blood cell counts at the initiation of DC, a high derived monocyte-to-lymphocyte ratio was the most significant risk factor for the development of RP requiring steroid treatment (OR 44.76, 95% CI: 8.89-225.43, p < 0.001) and irAEs (OR 2.85, 95% CI: 1.27-6.41, p = 0.011). CONCLUSIONS Compared with the outcome of the PACIFIC trial, these real-world data revealed favorable survival benefits of DC after CRT in patients with unresectable stage III NSCLC. Blood-based biomarkers could predict higher-grade RP and irAEs before the initiation of DC.
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Affiliation(s)
- Cheol-Kyu Park
- Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Jeonnam, Republic of Korea
| | - Hyung-Joo Oh
- Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Jeonnam, Republic of Korea
| | - Young-Chul Kim
- Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Jeonnam, Republic of Korea
| | - Yong-Hyub Kim
- Department of Radiation Oncology, Chonnam National University Medical School and Hwasun Hospital, Jeonnam, Republic of Korea
| | - Sung-Ja Ahn
- Department of Radiation Oncology, Chonnam National University Medical School and Hwasun Hospital, Jeonnam, Republic of Korea
| | - Won Gi Jeong
- Department of Radiology, Chonnam National University Medical School and Hwasun Hospital, Jeonnam, Republic of Korea
| | - Jeong Yeop Lee
- Department of Radiology, Chonnam National University Medical School and Hwasun Hospital, Jeonnam, Republic of Korea
| | - Jae Cheol Lee
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Chang Min Choi
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Wonjun Ji
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Si Yeol Song
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Juwhan Choi
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sung Yong Lee
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hakyoung Kim
- Department of Radiation Oncology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Shin Yup Lee
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Jongmoo Park
- Department of Radiation Oncology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Seong Hoon Yoon
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan Hospital, Gyeongnam, Republic of Korea
| | - Ji Hyeon Joo
- Department of Radiation Oncology, Pusan National University School of Medicine, Yangsan Hospital, Gyeongnam, Republic of Korea
| | - In-Jae Oh
- Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Jeonnam, Republic of Korea.
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Jang JH, Shin KH, Lee HR, Son E, Lee SE, Seol HY, Yoon SH, Kim T, Cho WH, Jeon D, Kim YS, Yeo HJ. Initial Tumor Necrosis Factor-Alpha and Endothelial Activation Are Associated with Hemorrhagic Complications during Extracorporeal Membrane Oxygenation. J Clin Med 2023; 12:4520. [PMID: 37445555 DOI: 10.3390/jcm12134520] [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: 05/12/2023] [Revised: 06/22/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
Studies on inflammatory markers, endothelial activation, and bleeding during extracorporeal membrane oxygenation (ECMO) are lacking. Blood samples were prospectively collected after ECMO initiation from 150 adult patients who underwent ECMO for respiratory failure between 2018 and 2021. After excluding patients who died early (within 48 h), 132 patients were finally included. Their tumor necrosis factor-alpha (TNF-α), tissue factor (TF), soluble thrombomodulin (sTM), and E-selectin levels were measured. A Cox proportional hazards regression model was used to estimate the hazard ratio for hemorrhagic complications during ECMO. The 132 patients were divided into hemorrhagic (n = 23, H group) and non-complication (n = 109, N group) groups. The sequential organ failure assessment score, hemoglobin level, and ECMO type were included as covariates in all Cox models to exclude the effects of clinical factors. After adjusting for these factors, initial TNF-α, TF, sTM, E-selectin, and activated protein C levels were significantly associated with hemorrhagic complications (all p < 0.001). TNF-α, TF, and E-selectin better predicted hemorrhagic complications than the model that included only the aforementioned clinical factors (clinical factors only (area under the curve [AUC]: 0.804), reference; TNF-α (AUC: 0.914); TF (AUC: 0.915); E-selectin (AUC: 0.869)). Conclusions: TNF-α levels were significantly predictive of hemorrhagic complications during ECMO.
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Affiliation(s)
- Jin Ho Jang
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Transplantation Research Center and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
| | - Kyung-Hwa Shin
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan 49241, Republic of Korea
| | - Hye Rin Lee
- Transplantation Research Center and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
| | - Eunjeong Son
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Transplantation Research Center and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
| | - Seung Eun Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Transplantation Research Center and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
| | - Hee Yun Seol
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Transplantation Research Center and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
| | - Seong Hoon Yoon
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Transplantation Research Center and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
| | - Taehwa Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Transplantation Research Center and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
| | - Woo Hyun Cho
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Transplantation Research Center and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
| | - Doosoo Jeon
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Transplantation Research Center and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
| | - Yun Seong Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Transplantation Research Center and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
| | - Hye Ju Yeo
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Transplantation Research Center and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
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9
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Kim J, Jang TW, Choi CM, Kim MH, Lee SY, Park CK, Chang YS, Lee KY, Kim SJ, Yang SH, Ryu JS, Lee JE, Lee SY, Park CK, Lee SH, Jang SH, Yoon SH. Real-world analysis of first-line afatinib in patients with EGFR-mutant non-small cell lung cancer and brain metastasis: survival and prognostic factors. Transl Lung Cancer Res 2023; 12:1197-1209. [PMID: 37425421 PMCID: PMC10326794 DOI: 10.21037/tlcr-22-832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/17/2023] [Indexed: 07/11/2023]
Abstract
Background Overall survival (OS) in patients with non-small cell lung cancer (NSCLC) and brain metastases (BMs) is poor. We aimed to identify prognostic factors and ascertain treatment outcomes of first-line afatinib for patients with epidermal growth factor receptor (EGFR)-mutant NSCLC with BM in a real-world setting. Methods This retrospective observational study reviewed electronic records of patients with EGFR-mutant NSCLC who received first-line afatinib treatment between October 2014 and October 2019 in 16 hospitals across South Korea. The Kaplan-Meier method estimated time on treatment (TOT) and OS; multivariate analyses were performed using Cox proportional hazards (PH) models. Results Among 703 patients who received first-line afatinib, 262 (37.3%) had baseline BM. Of 441 patients without baseline BM, 92 (20.9%) developed central nervous system (CNS) failure. Compared with patients without CNS failure, those with CNS failure during afatinib treatment were younger (P=0.012), had a higher Eastern Cooperative Oncology Group (ECOG) performance status (PS) (P<0.001), increased metastatic site involvement (P<0.001), advanced stage disease (P<0.001), with liver metastasis (P=0.008) and/or bone metastasis (P<0.001) at baseline. Cumulative incidence of CNS failure in years 1, 2 and 3 was 10.1%, 21.5% and 30.0%, respectively. In multivariate analysis, cumulative incidence was significantly higher in patients with ECOG PS ≥2 (P<0.001), uncommon EGFR mutations (P=0.001), and no baseline pleural metastasis (P=0.017). Median TOT was 16.0 months (95% CI: 14.8-17.2) and, in patients with CNS failure, without CNS failure, and with baseline BM was 12.2, 18.9, and 14.1 months, respectively (P<0.001). Median OS was 52.9 months (95% CI: 45.4-60.3) and, in patients with CNS failure, without CNS failure, and with baseline BM was 29.1, 67.3 and 48.5 months, respectively (P<0.001). Conclusions First-line afatinib in the real-world setting showed clinically meaningful effectiveness in patients with EGFR-mutant NSCLC and BM. CNS failure was a poor prognostic factor for TOT and OS correlating with younger age, poor ECOG PS, higher metastatic number, advanced disease stage, uncommon EGFR mutations, and baseline liver and/or bone metastases.
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Affiliation(s)
- Jehun Kim
- Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Tae Won Jang
- Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Chang Min Choi
- Department of Internal Medicine, Ulsan University Asan Medical Center, Seoul, Republic of Korea
| | - Mi Hyun Kim
- Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Pusan, Republic of Korea
| | - Sung Yong Lee
- Division of Pulmonology, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Cheol Kyu Park
- Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeonnam, Republic of Korea
| | - Yoon Soo Chang
- Department of Internal Medicine, Yonsei University Gangnam Severance Hospital, Seoul, Republic of Korea
| | - Kye Young Lee
- Department of Internal Medicine, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Seung Joon Kim
- Department of Internal Medicine, Catholic University Seoul St. Mary’s Hospital, Seoul, Republic of Korea
| | - Sei Hoon Yang
- Department of Internal Medicine, Wonkwang University Hospital, Iksan, Republic of Korea
| | - Jeong Seon Ryu
- Department of Internal Medicine, Inha University Hospital, Incheon, Republic of Korea
| | - Jeong Eun Lee
- Department of Internal Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Shin Yup Lee
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Chan Kwon Park
- Department of Internal Medicine, Catholic University Yeoudo St. Mary’s Hospital, Seoul, Republic of Korea
| | - Sang Hoon Lee
- Department of Internal Medicine, Yonsei University Severance Hospital, Seoul, Republic of Korea
| | - Seung Hun Jang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Seong Hoon Yoon
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
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10
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Park CK, Jun HR, Oh HJ, Lee JY, Cho HJ, Kim YC, Lee JE, Yoon SH, Choi CM, Lee JC, Lee SY, Lee SY, Chun SM, Oh IJ. Evaluation of Blood Tumor Mutation Burden for the Efficacy of Second-Line Atezolizumab Treatment in Non-Small Cell Lung Cancer: BUDDY Trial. Cells 2023; 12:cells12091246. [PMID: 37174645 PMCID: PMC10177441 DOI: 10.3390/cells12091246] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/17/2023] [Accepted: 04/23/2023] [Indexed: 05/15/2023] Open
Abstract
This study aimed to investigate the feasibility of blood-based biomarkers, including blood tumor mutation burden (bTMB), to predict atezolizumab efficacy in relapsed and advanced non-small cell lung cancer (NSCLC). Stage IV NSCLC patients who had previously received platinum-doublet chemotherapy were recruited and received 1200 mg of atezolizumab every three weeks. Blood was collected to obtain plasma cell-free DNA (cfDNA) before the first cycle (C0) and at the fourth cycle (C4). bTMB was measured by CT-ULTRA in patients with cfDNA over 10 ng. The objective response rate (ORR) of the enrolled 100 patients was 10%, and there was no difference in ORR according to bTMB (cutoff: 11.5 muts/Mb) at C0 (high bTMB: 8.1% vs. low bTMB: 11.1%). However, the C4/C0 bTMB ratio was significantly lower in the durable clinical benefit (DCB) patients. The cfDNA concentration at C0, the C4/C0 ratio of the cfDNA concentration, the highest variant allele frequency (hVAF), and the VAF standard deviation (VAFSD) were significantly lower in the DCB patients. In the multivariate analysis, a high cfDNA concentration at C0 (cutoff: 8.6 ng/mL) and a C4/C0 bTMB ratio greater than 1 were significantly associated with progression-free survival. These results suggest that baseline levels and dynamic changes of blood-based biomarkers (bTMB, cfDNA concentration, and VAFSD) could predict atezolizumab efficacy in previously treated NSCLC patients.
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Affiliation(s)
- Cheol-Kyu Park
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju 58128, Republic of Korea
| | - Ha Ra Jun
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Hyung-Joo Oh
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju 58128, Republic of Korea
| | - Ji-Young Lee
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Hyun-Ju Cho
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju 58128, Republic of Korea
| | - Young-Chul Kim
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju 58128, Republic of Korea
| | - Jeong Eun Lee
- Department of Internal Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea
| | - Seong Hoon Yoon
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan 50612, Republic of Korea
| | - Chang Min Choi
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Jae Cheol Lee
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Sung Yong Lee
- Department of Internal Medicine, Korea University Guro Hospital, Seoul 08308, Republic of Korea
| | - Shin Yup Lee
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Sung-Min Chun
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - In-Jae Oh
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju 58128, Republic of Korea
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11
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Yoon SH, Han CH, Eun S. Impact of the COVID-19 pandemic on the incidence of intussusception: a systematic review. Eur Rev Med Pharmacol Sci 2022; 26:9040-9049. [PMID: 36524523 DOI: 10.26355/eurrev_202212_30579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE We aimed to assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on the incidence of intussusception. MATERIALS AND METHODS Literature search of the PubMed and EMBASE databases was conducted for articles published in English until August 5, 2022. RESULTS Overall, 127 articles were retrieved, and five studies from South Korea (n=4) and the United States of America (n=1) containing clinical data from single-center medical records to nationwide databases were ultimately included in the systematic review. All the included studies reported that the incidence of intussusception decreased significantly during the pandemic period compared with the pre-pandemic period. The communicable disease incidence tended to decrease even as the incidence of non-communicable diseases did not significantly change. There was no significant difference in the time to diagnosis between the pre-pandemic and pandemic periods; however, the time to radiologic reduction was significantly longer or not depending on the study. CONCLUSIONS The COVID-19 pandemic significantly reduced the incidence of intussusception in children, supporting the hypothesis that infection plays a major role in the etiology of intussusception. Future studies in the late pandemic or post-pandemic era, which would represent the level of implementation of non-pharmaceutical interventions and social distancing as well as additional data from various countries will be needed.
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Affiliation(s)
- S H Yoon
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
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12
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Chung JH, Choi HJ, Kang YJ, Kim YS, Lee SY, Kwon RJ, Jeong HS, Park SJ, Jeong Y, Kang D, Ko J, Noh S, Chung HY, Moon HR, Yoon SH. MHY4571, a novel diarylcyclohexanone derivative, exerts anti-cancer activity by regulating the PKA-cAMP-response element-binding protein pathway in squamous cell lung cancer. Exp Hematol Oncol 2022; 11:68. [PMID: 36209131 PMCID: PMC9547450 DOI: 10.1186/s40164-022-00324-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background The protein kinase A (PKA)/cAMP response element-binding protein (CREB) has been suggested to be related to the inhibition of the proliferation of non-small cell lung cancer (NSCLC) cells. This study aimed to investigate the efficacy of a novel diarylcyclohexanone derivative, MHY4571, in regulating the PKA-CREB pathway and to study its anti-tumor role in squamous NSCLC. Methods We designed MHY4571 as a novel PKA inhibitor with acceptable in silico ADME properties and tested it in vitro in lung cancer cell lines and in vivo in xenograft and orthotopic mouse models of squamous cell lung carcinoma. Results MHY4571 inhibited PKA activity (> 70% inhibition) and suppressed the expression of p-PKA and p-CREB dose-dependently. MHY4571 treatment reduced lung cancer cell viability and promoted caspase 3-dependent apoptotic cell death. Orally administered MHY4571 significantly suppressed lung tumor growth in xenograft and orthotopic mouse models. PKA catalytic subunit alpha-silencing by siRNA (siPKA) strongly attenuated CREB phosphorylation; siCREB did not alter PKA protein levels or its phosphorylation, suggesting that PKA is an upstream regulator of CREB activity. MHY4571 acted synergistically with cisplatin (on co-treatment) to induce apoptotic cell death in lung cancer cells. Conclusions Our results imply that MHY4571 may be a potential drug candidate for squamous cell lung cancer treatment. Supplementary Information The online version contains supplementary material available at 10.1186/s40164-022-00324-8.
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Affiliation(s)
- Jae Heun Chung
- Department of Internal Medicine, Pusan National University, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan, 50612, South Korea. .,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, 50612, Republic of Korea.
| | - Ho Jung Choi
- Department of Internal Medicine, Pusan National University, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan, 50612, South Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, 50612, Republic of Korea
| | - Yong Jung Kang
- Department of Internal Medicine, Pusan National University, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan, 50612, South Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, 50612, Republic of Korea
| | - Yun Seong Kim
- Department of Internal Medicine, Pusan National University, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan, 50612, South Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, 50612, Republic of Korea
| | - Sang-Yull Lee
- Department of Biochemistry, School of Medicine, Pusan National University, Beomeo-ri, Mulgeum-eup, Yangsan, 50612, Republic of Korea
| | - Ryuk Jun Kwon
- Department of Family Medicine, Pusan National University, Pusan National University Yangsan Hospital, Yangsan, 50612, Republic of Korea
| | - Han-Sol Jeong
- School of Korean Medicine, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Su-Jung Park
- School of Korean Medicine, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Yeongmu Jeong
- Department of Manufacturing Pharmacy, College of Pharmacy, Pusan National University, Geumjeong-gu, Busan, 46241, Republic of Korea
| | - Dongwan Kang
- Department of Manufacturing Pharmacy, College of Pharmacy, Pusan National University, Geumjeong-gu, Busan, 46241, Republic of Korea
| | - Jeongin Ko
- Department of Manufacturing Pharmacy, College of Pharmacy, Pusan National University, Geumjeong-gu, Busan, 46241, Republic of Korea
| | - SangGyun Noh
- Department of Manufacturing Pharmacy, College of Pharmacy, Pusan National University, Geumjeong-gu, Busan, 46241, Republic of Korea
| | - Hae Young Chung
- Department of Manufacturing Pharmacy, College of Pharmacy, Pusan National University, Geumjeong-gu, Busan, 46241, Republic of Korea
| | - Hyung Ryong Moon
- Department of Manufacturing Pharmacy, College of Pharmacy, Pusan National University, Geumjeong-gu, Busan, 46241, Republic of Korea.
| | - Seong Hoon Yoon
- Department of Internal Medicine, Pusan National University, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan, 50612, South Korea. .,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, 50612, Republic of Korea.
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13
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Kim BG, Yuk JS, Kim GS, Seo JK, Jin MN, Lee HY, Seo YS, Kim MH, Yang SW, Yoon SH, Byun YS, Kim BO. Effect of early hysterectomy on a risk of incident cardiovascular disease in women: a nationwide population-based cohort study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Aim
Women who inevitably underwent surgical hysterectomy before natural menopause may have an earlier increase in hematocrit and storage iron than women who continue menstruation, thereby increasing the risk of cardiovascular disease (CVD) early. We aimed to evaluate the association of women with hysterectomy vs. without hysterectomy before their 50s with the risk of incident CVD.
Methods
This was a retrospective-cohort study, 135,575 women aged 40 to 50 years in 2011–2014 were extracted from the Korean Health Insurance Review and Assessment Service data and after propensity score matching, 55,539 pairs were included in hysterectomy and non-hysterectomy group respectively. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of cardiovascular death, myocardial infarction (MI), stroke, and coronary artery revascularization.
Results
After adjustment for confounding factors, hysterectomy group had an increased risk of MACCE compared with non-hysterectomy group (hazard ratio [HR], 1.25; 95% confidence interval [CI], 1.09–1.44). Regarding individual outcomes, cardiovascular death, MI, and coronary revascularization were comparable between the groups, whereas, the risk of stroke was significantly higher in hysterectomy group than non-hysterectomy group (HR, 1.31; 95% CI, 1.12–1.53). Even after excluding women who underwent oophorectomy, hysterectomy group had a higher risk of MACCE than non-hysterectomy group (HR, 1.24; 95% CI 1.06–1.44).
Conclusions
Early surgical menopause due to hysterectomy, not hormonal menopause, was associated with an increased risk for a composite of CVD, especially stroke. This suggest that the role of “uterus” as well as sex hormones may be important for the sharp increase in the risk of CVD in women after menopause.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- B G Kim
- Inje University Sanggye Paik Hospital, Cardiology , Seoul , Korea (Republic of)
| | - J S Yuk
- Sanggye Paik Hospital, Obstetrics and Gynecology , Seoul , Korea (Republic of)
| | - G S Kim
- Inje University Sanggye Paik Hospital, Cardiology , Seoul , Korea (Republic of)
| | - J K Seo
- Inje University Sanggye Paik Hospital, Cardiology , Seoul , Korea (Republic of)
| | - M N Jin
- Inje University Sanggye Paik Hospital, Cardiology , Seoul , Korea (Republic of)
| | - H Y Lee
- Inje University Sanggye Paik Hospital, Cardiology , Seoul , Korea (Republic of)
| | - Y S Seo
- Sanggye Paik Hospital, Obstetrics and Gynecology , Seoul , Korea (Republic of)
| | - M H Kim
- Sanggye Paik Hospital, Obstetrics and Gynecology , Seoul , Korea (Republic of)
| | - S W Yang
- Sanggye Paik Hospital, Obstetrics and Gynecology , Seoul , Korea (Republic of)
| | - S H Yoon
- Sanggye Paik Hospital, Obstetrics and Gynecology , Seoul , Korea (Republic of)
| | - Y S Byun
- Inje University Sanggye Paik Hospital, Cardiology , Seoul , Korea (Republic of)
| | - B O Kim
- Inje University Sanggye Paik Hospital, Cardiology , Seoul , Korea (Republic of)
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14
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Yoon SH, Kim H, Lim SM, Kang JM. Nosocomial outbreak of Achromobacter spp. bacteremia due to germicide contamination: a systematic review. Eur Rev Med Pharmacol Sci 2022; 26:6374-6381. [PMID: 36111940 DOI: 10.26355/eurrev_202209_29664] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Achromobacter spp. are aerobic, non-fermentative Gram-negative bacilli that can be widely found in aquatic environments. Nosocomial outbreaks and pseudo-outbreaks of Achromobacter spp. bacteremia have been recognized for decades. Notably, commonly used germicides in hospital settings constitute important sources for these outbreaks. This review aims at summarizing the latest studies and presents the characteristics of nosocomial outbreaks of Achromobacter spp. bacteremia caused by germicide contamination. MATERIALS AND METHODS A systematic search of the PubMed and EMBASE databases was conducted for articles published in English between January 1, 2000, and June 10, 2022. RESULTS Overall, 170 articles were retrieved, and 7 studies were finally included in the systematic review. Whether true or pseudo-bacteremia, positive blood culture results were most commonly reported in immunosuppressed patients or those with indwelling catheters. The most commonly reported contaminated germicide was chlorhexidine solution used as both an antiseptic and disinfectant. Atomizers, dispensers, and various product containers were identified as reservoirs. The prognoses of the affected patients were generally favorable. CONCLUSIONS Awareness about the high survival ability of Achromobacter spp. in germicides and the possible hospital reservoirs of these microbes will help to improve infection control and prevent nosocomial outbreaks or pseudo-outbreaks caused by Achromobacter spp.
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Affiliation(s)
- S H Yoon
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
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15
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Kim J, Kim T, Jang TW, Kang H, Kim MH, Yoon SH, Son CH, Lee HK, Kim HK, Lee SY, Shin KC, Han JY, Kang EJ. Clinical outcomes of hyperprogression based on volumetry in non-small cell lung cancer after immune checkpoint inhibitor treatment. Thorac Cancer 2022; 13:2170-2179. [PMID: 35785522 PMCID: PMC9346184 DOI: 10.1111/1759-7714.14539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Hyperprogressive disease (HPD) is a novel pattern of the treatment course after immune checkpoint inhibitor (ICI) therapy in patients with non-small cell lung cancer (NSCLC). This study aimed to investigate the clinical characteristics, outcomes, and associated factors of HPD using a semiautomatic volume measurement. METHODS This retrospective study enrolled patients with recurrent and/or metastatic NSCLC treated with ICIs between January 2015 and August 2019 at eight tertiary centers in Korea. HPD was defined according to the tumor growth kinetics and time to treatment failure. Tumor volume was measured using a semiautomatic software. RESULTS A total of 219 NSCLC patients with 35 HPD by volumetric measurement (HPDv) (15.9%) were enrolled. The median duration of overall survival (OS) and OS after ICI treatment (ICI-OS) were 34.5 and 18.4 months, respectively. HPDv patients had significantly worse progression-free survival (PFS) than progressive disease patients without HPDv (1.16 vs. 1.82 months, p-value <0.001). ICI-OS did not significantly differ between patients with HPDv and those without HPDv (2.66 vs. 5.4 months, p = 0.105). PD-L1 expression lower than 50%, more than three metastatic sites, neutrophil-to-lymphocyte ratio equal to or higher than 3.3, and hemoglobin level lower than 10 were found to be associated with HPDv. CONCLUSIONS There is no standardized definition of HPD. However, defining HPD in NSCLC patients treated with ICI using a semiautomatic volume measurement software is feasible.
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Affiliation(s)
- Jehun Kim
- Division of Pulmonology, Department of Internal Medicine, Kosin University College of Medicine, Kosin University Gospel Hospital, Busan, South Korea
| | - Taeyun Kim
- Department of Internal Medicine, The Armed Forces Goyang Hospital, Goyang-si, South Korea
| | - Tae Won Jang
- Division of Pulmonology, Department of Internal Medicine, Kosin University College of Medicine, Kosin University Gospel Hospital, Busan, South Korea
| | - Hee Kang
- Department of Radiology, Kosin University College of Medicine, Kosin University Gospel Hospital, Busan, South Korea
| | - Mi Hyun Kim
- Division of Pulmonology, Department of Internal Medicine, Pusan National University Hospital, Pusan, South Korea
| | - Seong Hoon Yoon
- Division of Pulmonology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Choon-Hee Son
- Division of Pulmonology, Department of Internal Medicine, Gwanghye General Hospital, Pusan, South Korea
| | - Hyun-Kyung Lee
- Division of Pulmonology, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, South Korea
| | - Hyun-Kuk Kim
- Division of Pulmonology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, South Korea
| | - Shin Yup Lee
- Division of Pulmonology, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Kyeong Choel Shin
- Division of Pulmonology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, South Korea
| | - Ji-Yeon Han
- Department of Radiology, Inje University Busan Paik Hospital, Busan, South Korea
| | - Eun-Ju Kang
- Department of Radiology, Dong-A University College of Medicine, Busan, South Korea
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Chung JH, Yoon SH, Jeon D, Choi HJ, Moon K, Kwon S, Saputra HA, Kim YS, Shim YB. The feasibility of granzyme B levels using an amperometric immunosensor for lung cancer detection. Ann Transl Med 2022; 10:622. [PMID: 35813317 PMCID: PMC9263765 DOI: 10.21037/atm-22-470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/28/2022] [Indexed: 11/22/2022]
Abstract
Background Low-dose computed tomography (LDCT) has improved the early detection of lung cancer. However, LDCT scans present several disadvantages, including the abundance of false-positive results, which lead to a high socioeconomic cost, psychological burden, and repeated exposure to radiation. Therefore, the identification of complementary biomarkers is needed to select high-risk individuals for LDCT. Here, we showed that granzyme B testing with the novel immunosensor has diagnostic value for identifying patients with lung cancer. Methods We enrolled 44 patients with lung cancer and 51 health controls at Pusan National University Yangsan Hospital in Korea between March 2018 and September 2019. The immunosensor analyzed serum granzyme B levels, and their association with lung cancer detection was evaluated with machine learning models. Results Serum granzyme B levels were assessed in samples from patients with lung cancer and healthy individuals. Granzyme B testing showed 100% sensitivity, 80% specificity, and an area under the curve of 0.938 for lung cancer detection. After combining granzyme B testing with clinical predictors such as age, smoking status, or pack-years, results from the five-fold cross-validation with random forest model improved diagnostic accuracy of 92.1%, with a sensitivity, specificity, and area under the curve of 92.0%, 92.1%, and 0.977, respectively. Conclusions This feasibility study suggested that granzyme B may be utilized to detect lung cancer.
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Affiliation(s)
- Jae Heun Chung
- Department of Internal Medicine, School of Medicine, Pusan National University, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Seong Hoon Yoon
- Department of Internal Medicine, School of Medicine, Pusan National University, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Doosoo Jeon
- Department of Internal Medicine, School of Medicine, Pusan National University, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Ho Jung Choi
- Department of Internal Medicine, School of Medicine, Pusan National University, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Kisung Moon
- School of Biomedical Convergence Engineering, College of Information and Biomedical Engineering, Pusan National University, Yangsan, Republic of Korea
| | - Sunyoung Kwon
- School of Biomedical Convergence Engineering, College of Information and Biomedical Engineering, Pusan National University, Yangsan, Republic of Korea
| | - Heru Agung Saputra
- Department of Chemistry and Institute of BioPhysio Sensor Technology (IBST), Pusan National University, Busan, Republic of Korea
| | - Yun Seong Kim
- Department of Internal Medicine, School of Medicine, Pusan National University, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Yoon-Bo Shim
- Department of Chemistry and Institute of BioPhysio Sensor Technology (IBST), Pusan National University, Busan, Republic of Korea
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Shin KH, Lee SM, Park K, Choi H, Kim IS, Yoon SH, Oh SH. Effects of Different Centrifugation Protocols on the Detection of EGFR Mutations in Plasma Cell-Free DNA. Am J Clin Pathol 2022; 158:206-211. [PMID: 35285877 PMCID: PMC9350828 DOI: 10.1093/ajcp/aqac024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/27/2022] [Indexed: 01/04/2023] Open
Abstract
Objectives Various preanalytical factors, including the collection tube, storage conditions, and centrifugation, affect the detection results of plasma cell-free DNA (cfDNA). We compared the effect of different centrifugation protocols on the detection of EGFR mutations in cfDNA. Methods We analyzed 117 plasma specimens from 110 patients with non–small cell lung cancer using the cobas EGFR Mutation Test v2 (Roche Diagnostics). We compared the identified EGFR mutations and semiquantitative index values from the 1- and 2-step centrifugation groups and confirmed the clinical impact of differences in the results after further high-speed centrifugation. Results We detected EGFR mutations in 44 (37.6%) and 47 (40.2%) samples that were centrifuged once and twice, respectively; the 2 groups showed an 89.7% (105/117) concordance and a strong correlation in their semiquantitative index values (r = 0.929). Among the 12 inconsistent result pairs, 9 samples of 2-step centrifugation (75%) were consistent with the results of a recent tissue biopsy. Conclusions Additional high-speed centrifugation has been shown to increase the sensitivity of EGFR mutation detection in a commercial in vitro diagnostic real-time polymerase chain reaction device and is an optimal preanalytical factor for detecting low-allele frequency gene mutations using low concentrations of cfDNA.
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Affiliation(s)
- Kyung-Hwa Shin
- Department of Laboratory Medicine, Busan, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
- Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, South Korea
| | - Sun Min Lee
- Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, South Korea
- Department of Laboratory Medicine, Yangsan, South Korea
- Research Institute for Convergence of Biomedical Science and Technology, Yangsan, South Korea
| | | | - Hyunji Choi
- Department of Laboratory Medicine, Yangsan, South Korea
- Research Institute for Convergence of Biomedical Science and Technology, Yangsan, South Korea
| | - In-suk Kim
- Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, South Korea
- Department of Laboratory Medicine, Yangsan, South Korea
- Research Institute for Convergence of Biomedical Science and Technology, Yangsan, South Korea
| | - Seong Hoon Yoon
- Lung Cancer Clinic, Pulmonary Medicine Center, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Seung Hwan Oh
- Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, South Korea
- Department of Laboratory Medicine, Yangsan, South Korea
- Research Institute for Convergence of Biomedical Science and Technology, Yangsan, South Korea
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Yoon SH, Choi B, Eun S, Bae GE, Koo CM, Kim MK. Using the lactate-to-albumin ratio to predict mortality in patients with sepsis or septic shock: a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci 2022; 26:1743-1752. [PMID: 35302224 DOI: 10.26355/eurrev_202203_28244] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This study aimed to investigate whether the lactate-to-albumin ratio (LAR) can predict mortality in patients with sepsis or septic shock. PATIENTS AND METHODS A systematic search of the PubMed, EMBASE, Web of Science, and Google Scholar databases was conducted on December 16, 2021, for relevant articles that provided the predictive performance of LAR for mortality in patients with sepsis or septic shock. RESULTS Eight studies encompassing a total of 4,723 patients were included in this paper. The pooled sensitivity, specificity, and diagnostic odds ratio of the LAR for predicting mortality were 0.71 (95% confidence interval [CI]: 0.54-0.84), 0.68 (95% CI: 0.58-0.76) and 5.23 (95% CI: 2.62-10.45), respectively. The area under the summary receiver operating characteristic curve was 0.74 (95% CI: 0.70-0.78). CONCLUSIONS The current evidence suggests that LAR is moderately predictive of mortality among patients with sepsis or septic shock and may be beneficial to identify high-risk patients.
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Affiliation(s)
- S H Yoon
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
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Saputra HA, Chung JH, Yoon SH, Seo KD, Park DS, Shim YB. Disposable amperometric immunosensor with a dual monomers-based bioconjugate for granzyme B detection in blood and cancer progress monitoring of patients. Biosens Bioelectron 2022; 198:113846. [PMID: 34871833 DOI: 10.1016/j.bios.2021.113846] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/10/2021] [Accepted: 11/25/2021] [Indexed: 12/27/2022]
Abstract
A disposable amperometric biosensor with a dual monomers-based bioconjugate was developed for granzyme B (GzmB) detection and for monitoring of the cancer progression of patients before and after immunotherapy. The biosensor was fabricated by immobilizing a GzmB monoclonal antibody (Ab1) on a poly3'-(2-aminopyrimidyl)-2,2':5',2''-terthiophene/gold nanoparticle (pPATT/AuNP) layer. The bioconjugate nanoparticles were synthesized through self-assembly of a monomer mixture of 2,2:5,2-terthiophene-3-(p-benzoic acid) (TBA) and PATT onto AuNPs, followed by chemical binding of brilliant cresyl blue (BCB) on TBA and GzmB polyclonal antibody (Ab2) on the PATT layer. Each sensing layer was investigated by surface analysis and electrochemical experiments. The sensor performance was assessed with selectivity, stability, reproducibility, detection limit, and real sample analysis. Under the optimized conditions, the dynamic range of GzmB was in two slopes from 3.0 to 50.0 pg/ml and from 50.0 to 1000.0 pg/ml with a detection limit of 1.75 ± 0.14 pg/ml (RSD ≤5.2%). GzmB monitoring was performed for the patient's serum samples, where a low level of GzmB was observed for lung cancer patients before immunotherapy (10.51 ± 0.99 pg/ml, RSD ≤6.2%), and the level was increased after therapy (17.19 ± 2.22 pg/ml, RSD ≤2.6%). Moreover, a significantly higher level was present in healthy persons (34.40 ± 3.92 pg/ml, RSD ≤1.4%). The cancer progression of patients before and after therapy was evaluated by monitoring GzmB levels in human serum using the proposed sensor.
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Affiliation(s)
- Heru Agung Saputra
- Institute of BioPhysio Sensor Technology (IBST) and Department of Chemistry, Pusan National University, Busan, 46241, Republic of Korea
| | - Jae Heun Chung
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan-si, 626-770, Republic of Korea
| | - Seong Hoon Yoon
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan-si, 626-770, Republic of Korea
| | - Kyeong-Deok Seo
- Institute of BioPhysio Sensor Technology (IBST) and Department of Chemistry, Pusan National University, Busan, 46241, Republic of Korea
| | - Deog-Su Park
- Institute of BioPhysio Sensor Technology (IBST) and Department of Chemistry, Pusan National University, Busan, 46241, Republic of Korea
| | - Yoon-Bo Shim
- Institute of BioPhysio Sensor Technology (IBST) and Department of Chemistry, Pusan National University, Busan, 46241, Republic of Korea.
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Eun S, Ho IG, Bae GE, Kim H, Koo CM, Kim MK, Yoon SH. Neutrophil-to-lymphocyte ratio for the diagnosis of pediatric acute appendicitis: a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci 2021; 25:7097-7107. [PMID: 34859875 DOI: 10.26355/eurrev_202111_27263] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Acute appendicitis (AA) is one of the most common surgical emergencies and causes of acute abdominal pain in the pediatric population. However, it can be difficult to diagnose in children. We aimed to provide updated evidence on the diagnostic utility of the neutrophil-to-lymphocyte ratio (NLR) for AA, along with other conventional biomarkers, in pediatric patients. MATERIALS AND METHODS We searched the PubMed, Embase, Cochrane Library, and Web of Science databases for eligible articles published up to May 16, 2021. RESULTS We included 19 studies comprising a total of 5,974 pediatric cases. The overall sensitivity and specificity of the NLR were 0.82 (95% confidence interval [CI]: 0.79-0.85) and 0.76 (95% CI: 0.69-0.81), respectively. The overall diagnostic odds ratio was 14.34 (95% CI: 9.05-22.73). The area under the summary receiver operating characteristic curve was 0.86 (95% CI: 0.83-0.89). The pooled sensitivity and specificity of other biomarkers were as follows: 0.79 (95% CI: 0.71-0.86) and 0.66 (95% CI: 0.54-0.77) for the white blood cell count, 0.73 (95% CI: 0.69-0.77) and 0.68 (95% CI: 0.55-0.79) for the C-reactive protein level, 0.75 (95% CI: 0.65-0.82) and 0.78 (95% CI: 0.72-0.83) for the absolute neutrophil count, and 0.83 (95% CI: 0.79-0.87) and 0.68 (95% CI: 0.53-0.80) for the neutrophil percentage, respectively. CONCLUSIONS The NLR has moderate predictive power for AA and can be used as a simple, auxiliary tool for diagnosis. NLR can also help clinicians decide whether to perform imaging testing when the clinical symptoms or physical examination findings are vague.
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Affiliation(s)
- S Eun
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
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21
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Lee SY, Choi CM, Chang YS, Lee KY, Kim SJ, Yang SH, Ryu JS, Lee JE, Lee SY, Park JY, Kim YC, Oh IJ, Jung CY, Lee SH, Yoon SH, Choi J, Jang TW. Real-world experience of afatinib as first-line therapy for advanced EGFR mutation-positive non-small cell lung cancer in Korea. Transl Lung Cancer Res 2021; 10:4353-4367. [PMID: 35070746 PMCID: PMC8743522 DOI: 10.21037/tlcr-21-501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 11/11/2021] [Indexed: 11/12/2022]
Abstract
Background We investigated the clinical characteristics and treatment outcomes of Korean patients receiving first-line afatinib for advanced epidermal growth factor receptor mutation-positive (EGFRm+) non-small cell lung cancer (NSCLC) in a real-world setting. Methods Electronic case reports were retrospectively reviewed from patients across 15 sites in South Korea. Outcome measures included baseline characteristics, overall response rate (ORR), time-to-treatment discontinuation (TTD), and overall survival (OS). Subgroups were: presence/absence of brain metastases at baseline, dose reductions, and baseline EGFR mutation category. Results Among 422 patients, 39.8% had brain metastases and 59.0%/25.1%/10.0%/5.0% had Del19/L858R/compound/uncommon EGFR mutations at baseline. ORR was 62.6% overall; responses were observed across all EGFR mutation categories, including against compound mutations. Median TTD was 17.8 months; median OS was not reached (NR). Median TTD and OS were longer in patients without versus with brain metastases (TTD: 22.9 vs. 14.8 months, P=0.001; OS: NR vs. 40.3 months, P=0.0009) and patients with versus without dose reductions (TTD: 22.2 vs. 14.2 months, P=0.0004; OS: NR vs. 40.3 months, P=0.0117). Median OS was 30.5/37.7 months in patients receiving chemotherapy/osimertinib as subsequent therapy. The most common treatment-related adverse events (TRAEs; any grade/grade ≥3) were diarrhea (31.3%/8.5%) and rash (23.0%/8.1%). Overall, 34 patients (8.1%) discontinued afatinib due to AEs. Conclusions Afatinib was well tolerated with no new safety signals, and efficacy was encouraging in Korean patients with EGFRm+ NSCLC, including those with baseline brain metastases and/or uncommon EGFR mutations. AE management with dose reductions facilitated a long TTD, prolonging the chemotherapy-free period for many patients.
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Affiliation(s)
| | - Chang-Min Choi
- Ulsan University Asan Medical Center, Seoul, South Korea
| | - Yoon Soo Chang
- Yonsei University Gangnam Severance Hospital, Seoul, South Korea
| | - Kye Young Lee
- Konkuk University Medical Center, Seoul, South Korea
| | - Seung Joon Kim
- Catholic University Seoul St. Mary’s Hospital, Seoul, South Korea
| | | | | | | | - Shin Yup Lee
- Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Ji Young Park
- Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Young-Chul Kim
- Chonnam National University Medical School and Hwasun Hospital, Hwasun, South Korea
| | - In-Jae Oh
- Chonnam National University Medical School and Hwasun Hospital, Hwasun, South Korea
| | - Chi Young Jung
- Daegu Catholic University Medical Center, Daegu, South Korea
| | - Sang Hoon Lee
- Yonsei University Severance Hospital, Seoul, South Korea
| | - Seong Hoon Yoon
- Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Juwhan Choi
- Korea University Guro Hospital, Seoul, South Korea
| | - Tae Won Jang
- Kosin University Gospel Hospital, Busan, South Korea
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Son E, Jang J, Kim T, Jang JH, Chung JH, Seol HY, Yeo HJ, Yoon SH, Lee SE, Cho WH, Kim YS, Jeon D. Head-to-head comparison of Xpert MTB/RIF with real-time polymerase chain reaction assay in bronchial washing specimens. Tuberc Respir Dis (Seoul) 2021; 85:89-95. [PMID: 34727491 PMCID: PMC8743642 DOI: 10.4046/trd.2021.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/02/2021] [Indexed: 11/24/2022] Open
Abstract
Background With the introduction of Xpert MTB/RIF assay (Xpert), its incorporation into tuberculosis (TB) diagnostic algorithm has become an important issue. The aim of this study was to evaluate the performance of the Xpert assay in comparison with a commercial polymerase chain reaction (PCR) assay. Methods Medical records of patients having results of both Xpert and AdvanSure TB/NTM real-time PCR (AdvanSure) assays using the same bronchial washing specimens were retrospectively reviewed. Results Of the 1,297 patients included in this study, 205 (15.8%) were diagnosed with pulmonary TB. Using mycobacterial culture as the reference method, sensitivity of the Xpert assay using smear-positive specimens was 97.5%, which was comparable to that of the AdvanSure assay (96.3%, p=0.193). However, the sensitivity of the Xpert assay using smear-negative specimens was 70.6%, which was significantly higher than that of the AdvanSure assay (52.9%, p=0.018). Usng phenotypic drug susceptibility testing as the reference method, sensitivity and specificity for detecting rifampicin resistance were 100% and 99.1%, respectively. Moreover, a median turnaround time of the Xpert assay was 1 day, which was significantly shorter than 3 days of the AdvanSure assay (p<0.001). Conclusion In comparison with the AdvanSure assay, the Xpert assay had a higher sensitivity using smear-negative specimens, a shorter turnaround time, and could reliably predict rifampin resistance. Therefore, the Xpert assay might be preferentially recommended over TB-PCR in Korean TB diagnostic algorithm.
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Affiliation(s)
- Eunjeong Son
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Jinook Jang
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Taehwa Kim
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Jin Ho Jang
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Jae Heun Chung
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Hee Yun Seol
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Hye Ju Yeo
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Seong Hoon Yoon
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Seung Eun Lee
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Woo Hyun Cho
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Yun Seong Kim
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Doosoo Jeon
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
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Kim YS, Chung JH, Yoon SH, Seol HY. High fold-changes in peripheral blood PD-1+ CD8+ T cells expressing Granzyme B predicts the response to immunotherapy in NSCLC. Lung Cancer 2021. [DOI: 10.1183/13993003.congress-2021.pa1130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Lambert FN, Gracy HR, Gracy AJ, Yoon SH, Scott RW, Rincon DM, Vulpe CD. Effects of ultraviolet-filters on Daphnia magna development and endocrine-related gene expression. Aquat Toxicol 2021; 238:105915. [PMID: 34329859 DOI: 10.1016/j.aquatox.2021.105915] [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] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 06/23/2021] [Accepted: 07/14/2021] [Indexed: 06/13/2023]
Abstract
Ultraviolet (UV) filters are emerging contaminants of concern that are widely spread throughout the aquatic environment. Many organic UV filters are endocrine disrupting compounds (EDCs) in vertebrates. However, few studies have assessed their effects on invertebrates. Molting, or the shedding of the exoskeleton, may be affected by exposure to these compounds in Arthropods (the largest phylum of invertebrates). Molting is necessary for growth and development and is regulated by an arthropod specific endocrine system, the ecdysteroid pathway. Alterations of this process by EDCs can result in improper development, reduced growth, and even death. We investigated the sublethal effects of chronic exposure to three organic UV filters (4-methylbenzylidene camphor (4MBC), octylmethoxycinnamate (OMC), and benzophenone-3 (BP3) in a crustacean, Daphnia magna, with particular emphasis on molting and development. We demonstrate that 4MBC, OMC, and BP3 affect development and long-term health in neonates of exposed parents at concentrations of 130 µg/L, 75 µg/L, and 166 µg/L, respectively. Additionally, the expression of endocrine-related genes (including ultraspiracle protein, usp) are significantly altered by 4MBC and BP3 exposure, which may relate to their developmental toxicity.
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Affiliation(s)
- F N Lambert
- Center for Environmental and Human Toxicology, University of Florida.
| | - H R Gracy
- Center for Environmental and Human Toxicology, University of Florida
| | - A J Gracy
- Center for Environmental and Human Toxicology, University of Florida
| | - S H Yoon
- Center for Environmental and Human Toxicology, University of Florida
| | - R W Scott
- Center for Environmental and Human Toxicology, University of Florida
| | - D M Rincon
- Center for Environmental and Human Toxicology, University of Florida
| | - C D Vulpe
- Center for Environmental and Human Toxicology, University of Florida
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Kim T, Jang TW, Choi CM, Kim MH, Lee SY, Park CK, Chang YS, Lee KY, Kim SJ, Yang SH, Ryu JS, Lee JE, Lee SY, Park CK, Lee SH, Jang SH, Yoon SH. Sequential treatment of afatinib and osimertinib or other regimens in patients with advanced non-small-cell lung cancer harboring EGFR mutations: Results from a real-world study in South Korea. Cancer Med 2021; 10:5809-5822. [PMID: 34258882 PMCID: PMC8419762 DOI: 10.1002/cam4.4127] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/25/2021] [Accepted: 06/23/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES The optimal sequence for the administration of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) for treating non-small cell lung cancer (NSCLC) is still unclear. This study aimed to evaluate the efficacy of sequential afatinib and osimertinib treatment in patients with NSCLC harboring EGFR mutations. MATERIALS AND METHODS Electronic records of patients with EGFR-mutated NSCLC, who were administered afatinib and osimertinib (group A) or other chemotherapy (group B) between October 2014 and 2019, across 16 hospitals in South Korea were reviewed. The primary outcome, time on treatment (TOT), secondary outcome, and overall survival (OS) were estimated using the Kaplan-Meier method and log-rank test. Multivariate analyses were performed using the Cox proportional hazards model. RESULTS Of the 737 patients who received frontline afatinib treatment, 324 with complete records were selected (group A: 126, group B: 198). All patients in group A were T790M positive after afatinib, while patients in group B were all negative or unknown. The median TOT was 35.4 months (95% confidence interval [CI]: 27.7-45.6) in group A and 20.8 months (95% CI: 19.4-24.0) in group B. The median TOT with afatinib was 13.0 months (95% CI: 12.0-13.9) overall and 15.7 months (95% CI: 13.9-17.3) in group A. The 2- and 3-year survival rates were 86.0 and 69.3% in group A and 75.9 and 55.3% in group B, respectively. CONCLUSION Sequential afatinib and osimertinib treatment resulted in better survival rates than treatment with afatinib followed by other chemotherapies.
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Affiliation(s)
- Taeyun Kim
- Department of Internal Medicine, The Armed Forces Goyang Hospital, Goyang-si, Korea
| | - Tae Won Jang
- Department of Internal Medicine, Kosin University College of Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Chang Min Choi
- Department of Internal Medicine, Ulsan University Asan Medical Center, Seoul, Korea
| | - Mi-Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Pusan, Korea
| | - Sung Yong Lee
- Division of Pulmonology, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Cheol-Kyu Park
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Yoon Soo Chang
- Department of Internal Medicine, Yonsei University Gangnam Severance Hospital, Seoul, Korea
| | - Kye Young Lee
- Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea
| | - Seung Joon Kim
- Department of Internal Medicine, Catholic University Seoul St. Mary's Hospital, Seoul, Korea
| | - Sei Hoon Yang
- Department of Internal Medicine, Wonkwang University Hospital, Iksan, Korea
| | - Jeong Seon Ryu
- Department of Internal Medicine, Inha University Hospital, Incheon, Korea
| | - Jeong Eun Lee
- Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Shin Yup Lee
- Department of Internal Medicine, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Chan Kwon Park
- Department of Internal Medicine, Catholic University Yeouido St. Mary's Hospital, Seoul, Korea
| | - Sang Hoon Lee
- Department of Internal Medicine, Yonsei University Severance Hospital, Seoul, Korea
| | - Seung Hun Jang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Seong Hoon Yoon
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
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Yoon SH, Gao J, Xu L, Yu Z, Jiang T, Kang BK, Zhang R, Cao D. Effect of additive-assisted fat transplantation on fat graft survival rate: A preliminary experimental study based on a rabbit animal model. ANN CHIR PLAST ESTH 2021; 66:440-446. [PMID: 33966905 DOI: 10.1016/j.anplas.2021.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Improving the survival rate of fat grafts is yet a difficult problem in the field of autologous fat transplantation. Prevailing methods such as making nanofat and SVF are time-consuming. Hence, the role of additives application in the improvement of fat graft survival during fat transplantation was considered and preliminarily evaluated in a rabbit animal model. METHODS A rabbit animal model was established where rabbit ears were injected with a mixture of 1.5mL of adipose tissue and 1mL of saline (group A), 1.5mL of adipose tissue and 1mL of botulinum toxin A (BoNTA) (group B), 1.5mL of adipose tissue and 1mL of prostaglandin E2 (groupC), 1.5mL of adipose tissue and 1mL of PDRN (group D) respectively. Then, the extents of neovascularization and inflammation were evaluated on the 7th, 14th, 28th, 42nd, 56th and 70th day after injection by ELISA assays and H&E and immunofluorescence staining. RESULTS The results showed that pre-treatment with BoNTA, prostaglandin E2 and PDRN improved graft volume and weight. The H&E and immunofluorescence staining revealed that BoNTA, prostaglandin E2 and PDRN improved the graft angiogenesis. Simultaneously, TNF-α expression level detected by ELISA was the lowest in the PDRN group. CONCLUSION Henceforth, the present preliminary study suggests that pre-transplantation treatment with BoNTA, prostaglandin E2 and PDRN can improve the fat graft angiogenesis and graft integrity, whereby the effect of adding PDRN may be significant.
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Affiliation(s)
- S H Yoon
- Department of plastic and reconstructive surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University school of medicine, 639, Zhizaoju road, 200011 Shanghai, China
| | - J Gao
- Department of plastic and reconstructive surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University school of medicine, 639, Zhizaoju road, 200011 Shanghai, China
| | - L Xu
- Department of plastic and reconstructive surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University school of medicine, 639, Zhizaoju road, 200011 Shanghai, China
| | - Z Yu
- Department of plastic and reconstructive surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University school of medicine, 639, Zhizaoju road, 200011 Shanghai, China
| | - T Jiang
- Department of plastic and reconstructive surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University school of medicine, 639, Zhizaoju road, 200011 Shanghai, China
| | - B K Kang
- Department of plastic and reconstructive surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University school of medicine, 639, Zhizaoju road, 200011 Shanghai, China
| | - R Zhang
- Department of plastic and reconstructive surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University school of medicine, 639, Zhizaoju road, 200011 Shanghai, China.
| | - D Cao
- Department of plastic and reconstructive surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University school of medicine, 639, Zhizaoju road, 200011 Shanghai, China.
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Hong G, Kim YI, Park SJ, Lee SY, Kim JW, Yoon SH, Lee KS, Byun MK, Kim HR, Chung J. Effects of a Mixture of Ivy Leaf Extract and Coptidis rhizome on Patients with Chronic Bronchitis and Bronchiectasis. Int J Environ Res Public Health 2021; 18:4024. [PMID: 33921227 PMCID: PMC8069972 DOI: 10.3390/ijerph18084024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/26/2021] [Accepted: 04/09/2021] [Indexed: 12/05/2022]
Abstract
BACKGROUND Hederacoside C from ivy leaf dry extracts (HH) and berberine from Coptidis rhizome dry extracts (CR) can be combined (HHCR) as a herbal product. Previous studies have demonstrated that HHCR has antitussive and expectorant effects in animal models of respiratory disease. However, the therapeutic effects of HHCR on respiratory diseases in humans have not been well-studied. Therefore, we aimed to clarify the effectiveness of HHCR in patients with chronic bronchitis and bronchiectasis. METHODS This was a multicenter (10 university teaching hospitals), open-label, prospective, single-arm, observational study. Consecutive patients with chronic bronchitis and bronchiectasis were included. Patients were orally treated with HHCR daily for 12 weeks. St. George's Respiratory Questionnaire (SGRQ) scores and bronchitis severity scores (BSS) were measured at baseline and at the end of the 12-week study. RESULTS In total, 376 patients were enrolled, of which 304 were finally included in the study, including 236 males and 68 females with a median age of 69 years (range: 37-88 years). After 12 weeks of HHCR treatment, there was a significant improvement in SGRQ score (baseline, 32.52 ± 16.93 vs. end of study, 29.08 ± 15.16; p < 0.0001) and a significant reduction in BSS (baseline, 7.16 ± 2.63 vs. end of study, 4.72 ± 2.45; p < 0.0001). During the study, 14 patients concomitantly used an inhaled corticosteroid and 83 patients used an inhaled bronchodilator. HHCR also had significant positive effects on these patients in terms of SGRQ score and BSS. No serious adverse drug reactions occurred during HHCR treatment. CONCLUSIONS treatment with HHCR improved the SGRQ score and BSS in patients with chronic bronchitis and bronchiectasis. HHCR may be a new therapeutic option for chronic bronchitis and bronchiectasis. Large-scale, randomized, double-blind, placebo-controlled clinical trials are warranted.
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Affiliation(s)
- Goohyeon Hong
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan 31116, Korea;
| | - Yu-Il Kim
- Department of Internal Medicine, Division of Pulmonology, Chonnam National University Hospital, Chonnam 61469, Korea;
| | - Seoung Ju Park
- Department of Internal Medicine, Division of Pulmonology, Allergy and Critical Care Medicine, Jeonbuk National University Medical School, Cheonbuk 54907, Korea;
| | - Sung Yong Lee
- Department of Internal Medicine, Division of Pulmonology, Allergy and Critical Care Medicine, Korea University Guro Hospital, Seoul 08308, Korea;
| | - Jin Woo Kim
- Department of Internal Medicine, Division of Pulmonology, College of Medicine, The Catholic University, Uijeongbu 11765, Korea;
| | - Seong Hoon Yoon
- Department of Internal Medicine, Division of Pulmonology, Pusan National University Yangsan Hospital, Pusan 49241, Korea;
| | - Keu Sung Lee
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Ajou University Hospital, Suwon 16499, Korea;
| | - Min Kwang Byun
- Department of Internal Medicine, Division of Respiratory Medicine, Gangnam Severance Hospital, Seoul 06273, Korea;
| | - Hak-Ryul Kim
- Department of Internal Medicine, Division of Respiratory Medicine, Wonkwang University Hospital, Iksan 54538, Korea;
| | - Jaeho Chung
- Department of Internal Medicine, Division of Respiratory Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon 22711, Korea
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Yoon SH, Yang S, Cho H, Eun S, Koo CM, Kim MK. Point-of-care testing for the detection of SARS-CoV-2: a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci 2021; 25:503-517. [PMID: 33506942 DOI: 10.26355/eurrev_202101_24422] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To evaluate the diagnostic accuracy of the Food and Drug Administration Emergency Use Authorization (FDA-EUA) authorized point-of-care tests (POCTs) for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). MATERIALS AND METHODS A systematic literature search was conducted using the PubMed, Embase, and Web of Science databases for articles published till August 10, 2020. We included studies providing information regarding diagnostic test accuracy of FDA-EUA POCTs for SARS-CoV-2 detection. The methodologic quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. The review protocol is registered in the International Prospective Register of Systematic Reviews (protocol number CRD42020202248). RESULTS We included 26 studies describing a total of 3242 samples. The summary sensitivity and specificity were 0.94 [95% confidence interval (CI): 0.88-0.97] and 1.00 (95% CI: 0.99-1.00), respectively. The area under the summary receiver operating characteristic curve was 1.00 (95% CI: 0.99-1.00). A pooled analysis based on the index test revealed a summary sensitivity and specificity of Cepheid Xpert Xpress SARS-CoV-2 [0.99 (95% CI: 0.97-1.00) and 0.99 (95% CI: 0.94-1.00, respectively)] and ID NOW COVID-19 [0.78 (95% CI: 0.74-0.82) and 1.00 (95% CI: 0.98-1.00), respectively]. CONCLUSIONS FDA-EUA POCTs, especially molecular assays, have high sensitivity, specificity, and overall diagnostic accuracy for detecting SARS-CoV-2. If approved, FDA-EUA POCTs can provide a rapid and practical way to identify infected individuals early on and help to limit the strain on the healthcare system. However, more high-quality clinical data are required to support our results.
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Affiliation(s)
- S H Yoon
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea.
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Nam Y, Kim HC, Kim YC, Jang SH, Lee KY, Lee SY, Lee SH, Lee SY, Yoon SH, Ryu JS, Jang TW, Chang YS, Kim SJ, Park CK, Lee JE, Jung CY, Choi CM. Clinical impact of rebiopsy among patients with epidermal growth factor receptor-mutant lung adenocarcinoma in a real-world clinical setting. Thorac Cancer 2021; 12:890-898. [PMID: 33529490 PMCID: PMC7952806 DOI: 10.1111/1759-7714.13857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/08/2021] [Accepted: 01/08/2021] [Indexed: 12/11/2022] Open
Abstract
Background In this study, we investigated the risk factors of acquired T790M mutation among patients with lung adenocarcinoma with epidermal growth factor receptor (EGFR) tyrosine mutation who were treated with EGFR‐tyrosine kinase inhibitors (TKIs). The aim was to identify the clinical impact of rebiopsy. Methods This multicenter, retrospective cohort study was conducted in South Korea from January 2007 to June 2017. Patients with adenocarcinoma with EGFR mutation who underwent rebiopsy and were treated with EGFR‐TKIs were included. Results Of a total of 352 patients, T790M mutation was identified in 156 (41.9%) at the time of rebiopsy. The median duration from initial biopsy to rebiopsy was 17 months. Univariate logistic regression analysis revealed associations of exon 19 deletion (odds ratio [OR], 1.643; p = 0.026), absence of L858R (OR, 0.627; p = 0.042), and previous EGFR‐TKI treatment duration (OR, 1.039; p < 0.001) with T790M mutation. Previous EGFR‐TKI treatment duration (OR, 3.580; p < 0.001) was independently associated with T790M mutation. A multivariate Cox proportional hazard model revealed that brain metastasis at initial diagnosis (hazard ratio, 1.390; p = 0.050) tended to be associated with T790M mutation. Among the patients with T790M mutation at rebiopsy, the osimertinib user group (n = 90) had a better one‐year survival (68.7 vs. 58.3%, p = 0.048) than the osimertinib nonuser group (n = 66). Conclusions Rebiopsy might affect the clinical course of patients with EGFR‐mutant adenocarcinoma who receive EGFR‐TKIs.
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Affiliation(s)
- Yunha Nam
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ho Cheol Kim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Young-Chul Kim
- Department of Internal Medicine, Chonnam National University Medical School, and Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - Seung Hun Jang
- Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Kye Young Lee
- Department of Pulmonary Medicine, Konkuk University School of Medicine, Seoul, South Korea
| | - Shin Yup Lee
- Department of Internal Medicine, Kyungpook National University, School of Medicine, Daegu, South Korea
| | - Sang Hoon Lee
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung Yong Lee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Seong Hoon Yoon
- Department of Pulmonology and Allergy, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Jeong-Seon Ryu
- Department of Internal Medicine, Inha University Hospital, Incheon, South Korea
| | - Tae Won Jang
- Department of Internal Medicine, Kosin University Medical College, Pusan, South Korea
| | - Yoon Soo Chang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung Joon Kim
- Division of Pulmonology, Department of Internal Medicine, The Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Chan Kwon Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jeong Eun Lee
- Division of Pulmonology, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon, South Korea
| | - Chi Young Jung
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, South Korea
| | - Chang-Min Choi
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.,Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Chung JH, Ha JS, Choi J, Kwon SM, Yun MS, Kim T, Jeon D, Yoon SH, Kim YS. Granzyme B for predicting the durable clinical benefit of anti- PD-1/PD-L1 immunotherapy in patients with non-small cell lung cancer. Transl Cancer Res 2021; 11:316-326. [PMID: 35281415 PMCID: PMC8904957 DOI: 10.21037/tcr-21-2506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/19/2022] [Indexed: 11/06/2022]
Abstract
Background To identify immunotherapy biomarkers, we examined granzyme B levels in peripheral blood PD-1+ CD8+ T cells and their relationship with treatment outcomes in patients with non-small cell lung cancer (NSCLC). Methods To evaluate the association of granzyme B with response to immunotherapy, we tested blood samples obtained from 16 patients with stage IIIC to IV NSCLC receiving immune-checkpoint inhibitor treatment. We used flow cytometry to measure the change in the percentage of PD1+ CD8+ T cells expressing granzyme B before (t0) and after (t1) immunotherapy, and we evaluated for an association with tumor response to therapy, progression-free survival (PFS) and overall survival (OS). Additionally, we measured immune markers correlated with immunotherapy response by enzyme-linked immunosorbent assay. Results We found that the sequential change of granzyme B+ T cells after immunotherapy (t1/t0) significantly predicted durable clinical benefit (DCB) compared to no clinical benefit (NCB) (P=0.048), and prolonged PFS (P=0.025). Patients who demonstrated a PD-L1 tumor proportion score (TPS) >50% showed NCB if patients had low granzyme B t1/t0 levels (<0.805). Additionally, all patients with 1% PD-L1 TPS (or higher) and high granzyme B t1/t0 (≥0.805) showed DCB. Therefore, granzyme B t1/t0 may be an adjunctive marker with available PD-L1 TPS. Conclusions Our findings revealed that sequential change in granzyme B might be utilized as a predictive biomarker of immune checkpoint inhibitor monotherapy.
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Affiliation(s)
- Jae Heun Chung
- Department of Internal Medicine, College of Medicine, Pusan National University, Pusan National University Yangsan Hospital, Yangsan, South Korea
- Research Institute of Convergence Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Jong Seong Ha
- Laboratory of Regenerative Medicine and Stem Cell Biology, Department of Physiology, Medical Research Institute, School of Medicine, Pusan National University, Yangsan, South Korea
- BK21 GRAND Convergence Medical Science Eduation Rsearch Center, Pusan National University, Yangsan, South Korea
| | - Jaewoo Choi
- Laboratory of Regenerative Medicine and Stem Cell Biology, Department of Physiology, Medical Research Institute, School of Medicine, Pusan National University, Yangsan, South Korea
| | - Sang Mo Kwon
- Laboratory of Regenerative Medicine and Stem Cell Biology, Department of Physiology, Medical Research Institute, School of Medicine, Pusan National University, Yangsan, South Korea
- BK21 GRAND Convergence Medical Science Eduation Rsearch Center, Pusan National University, Yangsan, South Korea
| | - Mi Sook Yun
- Research Institute of Convergence Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Taehwa Kim
- Department of Internal Medicine, College of Medicine, Pusan National University, Pusan National University Yangsan Hospital, Yangsan, South Korea
- Research Institute of Convergence Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Doosoo Jeon
- Department of Internal Medicine, College of Medicine, Pusan National University, Pusan National University Yangsan Hospital, Yangsan, South Korea
- Research Institute of Convergence Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Seong Hoon Yoon
- Department of Internal Medicine, College of Medicine, Pusan National University, Pusan National University Yangsan Hospital, Yangsan, South Korea
- Research Institute of Convergence Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Yun Seong Kim
- Department of Internal Medicine, College of Medicine, Pusan National University, Pusan National University Yangsan Hospital, Yangsan, South Korea
- Research Institute of Convergence Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
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Song SY, Ha SJ, Park JH, Park SJ, Shin SH, Oak C, Choi JY, Yoon SW, Kim JA, Yoon SH, Son JW, Kim SJ, Yoo HS. A randomized, multi-center, open-label study to compare the safety and efficacy between afatinib monotherapy and combination therapy of afatinib and HAD-B1 for the locally advanced or metastatic NSCLC patients with EGFR mutations. Medicine (Baltimore) 2020; 99:e23455. [PMID: 33285743 PMCID: PMC7717758 DOI: 10.1097/md.0000000000023455] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 11/02/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Afatinib is an epidermal growth factor receptor - tyrosine kinase inhibitor (EGFR-TKI) with proven efficacy for treating patients with advanced or metastatic non-small cell lung cancer (NSCLC). Unfortunately, responses are limited by acquired resistance. Because traditional Korean medicine may have synergistic effects when combined with chemotherapy or radiotherapy, the aim of our study is to elucidate the efficacy and safety of afatinib plus HangAmDan-B1 (HAD-B1) combination therapy in the treatment of patients with NSCLC, as well as EGFR mutations, who need afatinib therapy. METHODS/DESIGN This study is a randomized, multi-center, open clinical trial. A total of 178 eligible subjects, recruited at 8 centers, are randomly assigned to take Afatinib (20-40 mg) ± HAD-B1 (0.972 g/day) for 48 weeks. In the test group, HAD-B1 and afatinib will be used in combination. The primary outcome is a comparison of progression-free survival (PFS) between afatinib monotherapy and afatinib plus HAD-B1 combination therapy in patients with local advanced or metastatic (Stage IIIA, B, C/IV) NSCLC. Secondary outcomes are the overall survival rates, clinical responses, tumor size reductions, health-related qualities of life, and safety. DISCUSSION The result of this clinical trial will provide evidence for the efficacy and safety of using HAD-B1 in the treatment of EGFR-positive patients with locally advanced or metastatic NSCLC who require afatinib therapy. TRIAL REGISTRATION Clinical Research Information Service (CRIS), Republic of Korea (ID: KCT0005414), on September 23, 2020.
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Affiliation(s)
- Si-Yeon Song
- East West Cancer Center, Daejeon Korean Medicine Hospital of Daejeon University, Daejeon
| | - Su-Jeong Ha
- East West Cancer Center, Daejeon Korean Medicine Hospital of Daejeon University, Daejeon
| | - Ji-Hye Park
- East West Cancer Center, Seoul Korean Medicine Hospital of Daejeon University, Seoul
| | - So-Jung Park
- East West Cancer Center, Daejeon Korean Medicine Hospital of Daejeon University, Daejeon
| | - Seong Hoon Shin
- Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Pusan
| | - Chulho Oak
- Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Pusan
| | - Jun-Yong Choi
- Department of Internal Medicine, School of Korean Medicine & Korean Medicine Hospital of Pusan National University, Yangsan
| | - Seong Woo Yoon
- Korean Medicine Cancer Center, Kyung Hee University Hospital at Gangdong
| | - Jung-A Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Kyung Hee University Gangdong Hospital, Seoul
| | - Seong Hoon Yoon
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan
| | - Ji Woong Son
- Department of Internal Medicine, Konyang University Hospital, Daejeon
| | - Seung Joon Kim
- Department of Internal Medicine, Seoul St. Mary's Hospital, Postech-Catholic Biomedical Engineering Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hwa-Seung Yoo
- East West Cancer Center, Seoul Korean Medicine Hospital of Daejeon University, Seoul
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Sung P, Yoon SH, Kim J, Hong JH, Park S, Goo JM. Bronchovascular bundle thickening on CT as a predictor of survival and brain metastasis in patients with stage IA peripheral small cell lung cancer. Clin Radiol 2020; 76:76.e37-76.e46. [PMID: 32948314 DOI: 10.1016/j.crad.2020.08.018] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/19/2020] [Indexed: 01/03/2023]
Abstract
AIM To determine if bronchovascular bundle (BVB) thickening on pretreatment computed tomography (CT) images helps predict survival in patients with peripheral small cell lung cancer (pSCLC) ≤3 cm. MATERIALS AND METHODS The pretreatment CT examinations of 79 histopathologically proven pSCLC ≤3 cm (TNM stage I, 21; II, 13; III, 22; IV, 23) were reviewed retrospectively. The CT characteristics of the nodule and associated findings, including BVB thickening, were evaluated. Progression-free survival (PFS), overall survival (OS), and brain metastasis-free survival were compared with the presence of BVB thickening using Kaplan-Meier and Cox regression analysis. RESULTS Among the 79 patients, 34 (43%) had BVB thickening. BVB thickening was prevalent in patients with mediastinal lymph node metastasis (50.9% versus 22.7%; p=0.024) and distant metastasis (60.9% versus 35.7%; p=0.049). Out of the 21 patients with TNM stage IA disease, the 16 patients (76.2%) without BVB thickening showed better PFS, OS, and brain metastasis-free survival (mean, 1,762 versus 483 days; p=0.019: 2,243 versus 1,328 days; p=0.038: 2,274 versus 1,287 days; p=0.038, respectively). Multivariate Cox regression analysis showed that the absence of BVB thickening (hazard ratio [HR], 7.806; 95% CI, 1.241-49.091; p=0.029) and surgery (HR, 0.075; 95% CI, 0.008-0.746; p=0.027) were independent and useful prognostic factors for PFS. CONCLUSIONS BVB thickening was found more frequently in patients with advanced-stage pSCLC ≤3 cm, and the PFS was more favourable in patients without BVB thickening, with a similar tendency to that of OS and brain metastasis-free survival, in stage IA pSCLC.
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Affiliation(s)
- P Sung
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
| | - S H Yoon
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea; Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 030804, South Korea.
| | - J Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam, Gyeonggi-do, 13620, South Korea
| | - J H Hong
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
| | - S Park
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - J M Goo
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea; Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 030804, South Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
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Yoon SH, Kang JM, Ahn JG. Clinical outcomes of 201 neonates born to mothers with COVID-19: a systematic review. Eur Rev Med Pharmacol Sci 2020; 24:7804-7815. [PMID: 32744708 DOI: 10.26355/eurrev_202007_22285] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To evaluate the clinical manifestations and outcomes of neonates born to women who had Coronavirus Disease 2019 (COVID-19) during pregnancy. MATERIALS AND METHODS A systematic literature search was conducted on PubMed and Embase till April 15, 2020, by combining the terms (COVID-19, Severe Acute Respiratory Syndrome Coronavirus 2, SARS-CoV-2, Novel Coronavirus, 2019-nCov, Wuhan pneumonia) and (pregnancy, pregnant women, mother, fetus, neonate, newborn, infant). RESULTS We included 16 case series and 12 case reports describing a total of 223 pregnant women and 201 infants. Four newborns born to mothers affected by COVID-19 were reported to have laboratory-confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection within 48 hours after birth. However, Reverse Transcription-Polymerase Chain Reaction tests of the breast milk, placenta, amniotic fluids, and cord blood and maternal vaginal secretions were all negative for SARS-CoV-2 in the reported cases. Fetal death was reported in two cases, and 48 of 185 newborns (25.9%) were born prematurely. Infants born small for gestational age and low birth weight (< 2,500 g) accounted for 8.3% and 15.6% of reported cases, respectively. Birth asphyxia and respiratory distress syndrome were observed in 1.8% and 6.4% of neonates, respectively. There was one neonatal death due to intractable gastric bleeding among the SARS-CoV-2-negative infants. CONCLUSIONS Current evidence suggests that COVID-19 during pregnancy rarely affects fetal and neonatal mortality, but can be associated with adverse neonatal morbidities. Vertical transmission has not been observed in the majority of the reported cases. The infants born to mothers with COVID-19 are carefully monitored for accompanying complication, and quarantine of infected mothers is warranted.
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Affiliation(s)
- S H Yoon
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
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Kang LH, Hwang CS, Yoon SH. Primary pleural liposarcoma combined spindle cell lipoma of the lung. Thorac Cancer 2020; 11:2059-2062. [PMID: 32438529 PMCID: PMC7327671 DOI: 10.1111/1759-7714.13495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/01/2020] [Accepted: 05/02/2020] [Indexed: 11/26/2022] Open
Abstract
Liposarcoma is a malignant adipose tissue tumor which mainly originates from the extremities and retroperitoneum. Primary pleural liposarcoma is very rare. Spindle cell lipoma is a rare benign adipose tissue tumor. A 66‐year‐old male was referred to our hospital for the evaluation of a mass‐like opacity visible on chest X‐ray. Computed tomography (CT) scan revealed a well‐defined soft tissue mass with internal low attenuations and adjacent multiple nodules in the upper lobe of the left lung, and surgical excision was subsequently performed. Histopathological findings revealed adipose tissue with lipoblasts and spindle cells and immunohistochemical staining (IHC) revealed the tumor cells were strongly positive for CDK4 and MDM2. Histopathological examination of the small lung nodules showed spindle cell proliferation and adipose tissue without positivity for MDM2. Here, we report a rare case of primary pleural liposarcoma combined adjacent spindle cell lipoma of the lung.
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Affiliation(s)
- Lae Hyung Kang
- Department of Internal Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Chung Su Hwang
- Department of Pathology, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Seong Hoon Yoon
- Department of Internal Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
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Han S, Yoon SH, Goo JM, Yim JJ. Radiological features and progression of incipient active pulmonary tuberculosis according to risk factors. Int J Tuberc Lung Dis 2020; 23:698-706. [PMID: 31315702 DOI: 10.5588/ijtld.18.0541] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
<sec> <title>OBJECTIVES</title> To examine the radiological features of incipient active pulmonary tuberculosis (PTB) in humans and evaluate radiological progression according to risk factors. </sec> <sec> <title>DESIGN</title> We retrospectively included 66 non-human immunodeficiency virus patients with bacteriologically proven PTB who had diagnostic and incidental pre-diagnostic computed tomography (CT) scans. CT scans were reviewed using a scoring system that included typical and atypical abnormalities associated with PTB. Risk factors for progression were assessed and, based on these, the CT features and progression of TB were compared using regression analyses. </sec> <sec> <title>RESULTS</title> The most prevalent CT finding in incipient PTB was a well-defined solid nodule in upper lobes and lower lobe superior segments. The non-risk and at-risk groups did not differ in terms of the proportion of individuals with nodules and segmental location. The at-risk group had a higher incidence of progression (adjusted odds ratio 8.59), greater increment in the CT score (adjusted regression coefficient [aRC] 9.19) and a higher proportion of atypical CT abnormalities on diagnostic CT scans (aRC 13.15). </sec> <sec> <title>CONCLUSION</title> Incipient active PTB primarily manifested as a small nodule in humans regardless of risk factors. With risk factors, it progressed more frequently and rapidly into active disease, with a higher prevalence of atypical radiological manifestations. </sec>.
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Affiliation(s)
- S Han
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul
| | - S H Yoon
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul
| | - J M Goo
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Institute of Radiation Medicine, Seoul National University Medical Research Center
| | - J-J Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
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Ock HS, Kang LH, Yeo HJ, Yoon SH, Cho WH, Jeon DS, Kim YS, Lee SE. Utilization of extracorporeal membrane oxygenation for refractory status asthmaticus during pregnancy: A case report. Allergy Asthma Respir Dis 2020. [DOI: 10.4168/aard.2020.8.2.92] [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: 11/20/2022]
Affiliation(s)
- Hye Sung Ock
- Department of Pulmonology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Lae Hyung Kang
- Department of Pulmonology, Good Moonhwa Hospital, Busan, Korea
| | - Hye Ju Yeo
- Department of Pulmonology and Allergy, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seong Hoon Yoon
- Department of Pulmonology and Allergy, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Woo Hyun Cho
- Department of Pulmonology and Allergy, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Doo Soo Jeon
- Department of Pulmonology and Allergy, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yun Seong Kim
- Department of Pulmonology and Allergy, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seung Eun Lee
- Department of Pulmonology and Allergy, Pusan National University Yangsan Hospital, Yangsan, Korea
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Yeo HJ, Byun KS, Han J, Kim JH, Lee SE, Yoon SH, Jeon D, Kim YS, Cho WH. Prognostic significance of malnutrition for long-term mortality in community-acquired pneumonia: a propensity score matched analysis. Korean J Intern Med 2019; 34:841-849. [PMID: 30685962 PMCID: PMC6610202 DOI: 10.3904/kjim.2018.037] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 06/13/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND/AIMS The impact of malnutrition on the outcome of hospitalized adults with community-acquired pneumonia (CAP) has not been fully investigated. This study evaluated the prevalence and prognostic significance of malnutrition in a Korean population with CAP. METHODS In total, 198 patients with CAP from November 2014 to September 2015 were analyzed retrospectively. We assessed the prevalence of malnutrition and the risk factors for 2-year mortality. Furthermore, we divided the patients into two groups: elderly (age ≥ 65 years, n = 131) and non-elderly (age < 65 years, n = 67). Subgroup analyses were performed in the elderly group through propensity score matching. RESULTS The prevalence of malnutrition was 39.4%, and the proportion of patients with malnutrition was significantly higher (53.4% vs. 11.9%, p < 0.001) in the elderly group than in the non-elderly group. In-hospital mortality, 1-year mortality, and 2-year mortality rates were 4.5%, 19.2%, and 26.8%, respectively. Multivariate Cox regression analyses revealed that malnutrition (odds ratio [OR], 2.52; 95% confidence interval [CI], 1.39 to 4.60; p = 0.002) and the Charlson comorbidity index score (OR, 1.30; 95% CI, 1.17 to 1.45; p < 0.001) were associated with 2-year mortality. CONCLUSION Malnutrition was common and associated with a poor long-term outcome in patients with CAP, particularly the elderly. A routine nutritional assessment at admission is mandatory as a first step for appropriate nutritional therapy.
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Affiliation(s)
- Hye Ju Yeo
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ki Sup Byun
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Junhee Han
- Department of Statistics, Hallym University, Chuncheon, Korea
| | - June Hyun Kim
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seung Eun Lee
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seong Hoon Yoon
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Doosoo Jeon
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yun Seong Kim
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Woo Hyun Cho
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
- Correspondence to Woo Hyun Cho, M.D. Department of Pulmonology and Critical Care Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea Tel: +82-55-360-2120 Fax: +82-55-360-2157 E-mail:
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Chung JH, Yoon SH, Kang YJ, Kim YS, Son BS, Kwon RJ, Han JH, Kim DH. Receptor-interacting protein kinase 3 as a predictive adjuvant chemotherapy marker after lung adenocarcinoma resection. Ann Transl Med 2019; 7:42. [PMID: 30906746 DOI: 10.21037/atm.2018.12.65] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background This study assessed the predictive value of receptor-interacting protein kinase 3 (RIPK3) expression and its correlation with clinicopathological characteristics, disease-free survival, and overall survival of patients with cisplatin-based adjuvant chemotherapy after lung adenocarcinoma resection. Methods This study included 50 patients who underwent cisplatin-based adjuvant chemotherapy after lung adenocarcinoma (stage IB-IIIA) resection. Immunohistochemical analysis was performed by probing tumor tissue microarrays with anti-RIPK3 antibody. Results High RIPK3 expression was detected in 24 (48.0%) of the 50 patients. Moreover, high RIPK3 expression was associated with a prolonged disease-free survival (P=0.015) but not with a prolonged overall survival (P=0.109) of the patients who underwent cisplatin doublet therapy after lung adenocarcinoma resection. We also examined whether RIPK3 expression was associated with prognosis based on chemotherapeutic response and found that patients with low RIPK3 expression showed a higher tendency of developing a progressive disease [14/26 (53.8%) patients] than patients with high RIPK3 expression [6/24 (25.0%) patients] (P=0.03). Results of Cox univariate proportional hazards regression model showed that age, N stage, and high RIPK3 expression (P=0.04) were associated with the prolonged disease-free survival of the patients who underwent cisplatin-based adjuvant chemotherapy after lung adenocarcinoma resection. Conclusions These results suggest that RIPK3 overexpression is a potential biomarker to identify patients with lung adenocarcinoma who can benefit the most from cisplatin-based adjuvant chemotherapy after complete adenocarcinoma resection.
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Affiliation(s)
- Jae Heun Chung
- Department of Pulmonology, Allergy and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seong Hoon Yoon
- Department of Pulmonology, Allergy and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yong Jung Kang
- Department of Pulmonology, Allergy and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yun Seong Kim
- Department of Pulmonology, Allergy and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Bong Soo Son
- Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ryuk Jun Kwon
- Department of Family Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jun Hee Han
- Department of Statistics, Hallym University, Chucheon, Kangwon, Korea
| | - Do Hyung Kim
- Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
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Lee SY, Kang DY, Kim JY, Yoon SH, Choi YH, Lee W, Cho SH, Kang HR. Incidence and Risk Factors of Immediate Hypersensitivity Reactions Associated With Low-Osmolar Iodinated Contrast Media: A Longitudinal Study Based on a Real-Time Monitoring System. J Investig Allergol Clin Immunol 2019; 29:444-450. [PMID: 30676320 DOI: 10.18176/jiaci.0374] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES We investigated the incidence of immediate hypersensitivity reaction (HSR) caused by different types of low-osmolar contrast media (LOCM) and cumulative exposure to LOCM. METHODS This cohort study included all consecutive patients who underwent LOCM-enhanced computed tomography from 2012 through 2014. We assessed 5 LOCM (iobitridol, iohexol, iomeprol, iopamidol, and iopromide). All patients were monitored for adverse events, and new symptoms and signs were recorded in real time using the Contrast Safety Monitoring and Management System (CoSM2oS). RESULTS The overall incidence of immediate HSR to LOCM was 0.97% (2004 events resulting from 205 726 exposures). Incidence differed significantly depending on whether the patient had a previous history of HSR to LOCM (0.80% in patients with no history and 16.99% in patients with a positive history of HSR to LOCM, P=.001). The incidence of HSR to individual LOCM ranged from 0.72% (iohexol) to 1.34% (iomeprol), although there were no significant differences across the 5 LOCM. A longitudinal analysis demonstrated that the incidence of HSR increased gradually with more frequent previous exposure to LOCM (HR=2.006 [95%CI, 1.517-2.653], P<.001). However, this cumulative increase in risk was observed in patients who had experienced HSR to LOCM, but not in those who had not. CONCLUSION The incidence of HSR did not differ significantly across the 5 LOCM assessed in the study. Repeated exposure to LOCM did not increase the risk of HSR among patients who had never experienced HSR to LOCM.
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Affiliation(s)
- S Y Lee
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.,Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - D Y Kang
- Drug Safety Monitoring Center, Seoul National University Hospital, Seoul, Korea
| | - J Y Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - S H Yoon
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Y H Choi
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - W Lee
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - S H Cho
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.,Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Drug Safety Monitoring Center, Seoul National University Hospital, Seoul, Korea
| | - H R Kang
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.,Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Drug Safety Monitoring Center, Seoul National University Hospital, Seoul, Korea
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40
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Chung JH, Kim DH, Kim YS, Son BS, Kim D, Hwang C, Shin D, Noh SG, Han JH, Kim DK, Kim JH, Koo JS, Chung HY, Yoon SH. Upregulation of P21-Activated Kinase 1 (PAK1)/CREB Axis in Squamous Non-Small Cell Lung Carcinoma. Cell Physiol Biochem 2018; 50:304-316. [PMID: 30282071 DOI: 10.1159/000494007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 09/25/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS p21-activated Ser/Thr kinase 1 (PAK1) is essential for the genesis and development of many cancers. The purpose of this study was to investigate the role of the PAK1-cyclic AMP response element-binding (CREB) axis in non-small cell lung cancer (NSCLC) tumorigenesis and its related mechanisms. METHODS Western blot assay and immunohistochemical staining were employed to investigate the PAK1 and CREB expression in the tissue microarray of human squamous NSCLC. Co-immunoprecipitation and immunofluorescence confocal assays were performed to determine the link between PAK1 and CREB. NSCLC xenograft models were used to study oncogenic function of PAK1 in vivo. RESULTS We observed that PAK1 and CREB expression levels were significantly elevated in human squamous NSCLC-tissue specimens, compared with those in adjacent normal bronchial or bronchiolar epithelial-tissue specimens, as well as their phosphorylated forms, based on western blotting. We showed in vitro that PAK1 knockdown by small-interfering RNA (siRNA) blocked CREB phosphorylation, whereas plasmid-based PAK1 overexpression resulted in CREB phosphorylation at Ser133, based on western blotting. In addition, PAK1 interacted with CREB in co-immunoprecipitation assays. Additionally, our in vitro findings detected by flow cytometry revealed that PAK1 silencing attenuated cell cycle progression, inducing apoptosis. Inhibition of PAK1 expression reduced tumor sizes and masses by modulating CREB expression and activation in xenograft models. CONCLUSION These results suggest a novel mechanism whereby the PAK1-CREB axis drives carcinogenesis of squamous-cell carcinomas, and have important implications in the development of targeted therapeutics for squamous-cell lung cancer.
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Affiliation(s)
- Jae Heun Chung
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Dae Hyun Kim
- Molecular Inflammation Research Center for Aging intervention (MRCA), College of Pharmacy, Pusan National University, Busan, Republic of Korea
| | - Yun Seong Kim
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Bong Soo Son
- Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Dohyung Kim
- Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Chungsu Hwang
- Department of Pathology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Donghoon Shin
- Department of Pathology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Sang Gyun Noh
- Molecular Inflammation Research Center for Aging intervention (MRCA), College of Pharmacy, Pusan National University, Busan, Republic of Korea
| | - Jun Hee Han
- Department of Statistics, Hallym University, Chuncheon, Republic of Korea
| | - Dae Kyung Kim
- Department of Physiology, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Jae Ho Kim
- Department of Physiology, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Ja Seok Koo
- Section of Medical Oncology, Department of Internal Medicine, Yale Comprehensive Cancer Center, Yale School of Medicine, New Haven, Connecticut, USA
| | - Hae Young Chung
- Molecular Inflammation Research Center for Aging intervention (MRCA), College of Pharmacy, Pusan National University, Busan, Republic of Korea
| | - Seong Hoon Yoon
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
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Kim YS, Kim TH, Jeon DS, Lee SE, Yoon SH, Yeo HJ. Diagnostic performance of interferon-gamma release assay for tuberculous pericarditis: A systematic review and meta-analysis. Tuberculosis (Edinb) 2018. [DOI: 10.1183/13993003.congress-2018.pa2761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Yeo HJ, Lee S, Yoon SH, Lee SE, Cho WH, Jeon D, Kim YS, Kim D. Extracorporeal Life Support as a Bridge to Lung Transplantation in Patients With Acute Respiratory Failure. Transplant Proc 2018; 49:1430-1435. [PMID: 28736018 DOI: 10.1016/j.transproceed.2017.02.064] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 02/10/2017] [Accepted: 02/23/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Extracorporeal membrane oxygenation (ECMO) is being used more often as a bridge to transplantation (BTT) in patients with acutely decompensated end-stage lung disease in Korea. ECMO as a BTT may be the only rescue strategy for severe acute respiratory failure, but many centers still consider it to be a relative contraindication to lung transplantation because of its poor outcome. Because there are not enough lung donors, it is important to determine their optimal use. We reviewed and analyzed our experiences with the use of ECMO as a BTT in patients with acute respiratory failure. METHODS This was a retrospective analysis of all patients with acutely decompensated end-stage lung disease treated with ECMO as a bridge to lung transplantation between March 2012 and February 2016. RESULTS Of the 194 patients who underwent respiratory ECMO over a 4-year period, a BTT strategy was used for 19 patients (median age, 58 years) on our institution's lung transplantation waiting list (15 veno-venous, 3 veno-veno-arterial, 1 veno-arterial). Fourteen patients (73.7%) were successfully bridged to transplantation; however, 3 died while on the waiting list and 2 returned to their baseline functions without transplantation. The overall in-hospital survival rate was 57.9% (11 of 19), including the 9 (64.3%) patients who underwent transplantation. CONCLUSIONS Our findings support the view that well-selected candidates with acutely decompensated end-stage lung disease may be safely bridged until a suitable donor is identified. ECMO is not able to reverse the course of patients; however, it could be a life-saving option for patients with acute respiratory failure requiring lung transplantation.
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Affiliation(s)
- H J Yeo
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - S Lee
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - S H Yoon
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - S E Lee
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - W H Cho
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - D Jeon
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Y S Kim
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - D Kim
- Department of Thoracic and Cardiovascular Surgery, Pusan National University, Yangsan Hospital, Yangsan, Republic of Korea.
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Sol IS, Kim YH, Park YA, Lee KE, Hong JY, Kim MN, Kim YS, Oh MS, Yoon SH, Kim MJ, Kim KW, Sohn MH, Kim KE. Relationship between sputum clusterin levels and childhood asthma. Clin Exp Allergy 2017; 46:688-95. [PMID: 26661728 DOI: 10.1111/cea.12686] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 11/27/2015] [Accepted: 12/05/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND Clusterin is a sensitive cellular biosensor of oxidative stress and has been studied as a biomarker for inflammation-associated diseases. Clusterin levels in childhood asthma have not been evaluated. OBJECTIVES (1) To evaluate sputum clusterin levels in children with asthma compared to a control group. (2) To assess the relationships between sputum clusterin levels and airway inflammation, pulmonary function, and bronchial hyperresponsiveness. METHODS This study included 170 children aged 5-18 years with stable asthma (n = 91), asthma exacerbation (n = 29), or no asthma (healthy controls; n = 50). Induced sputum, pulmonary function, and methacholine challenge tests were performed. Stable asthma was classified into two groups according to the severity. Clusterin levels in sputum were measured using an enzyme-linked immunosorbent assay. RESULTS Children with stable asthma had a higher clusterin level than healthy controls [4540 (3872-5651) pg/mL vs. 3857 (1054-4369) pg/mL, P < 0.001]. The clusterin level was also more elevated in eosinophil-dominant sputum than in non-eosinophilic sputum in stable asthma [5094 (4243-6257) pg/mL vs. 4110 (1871-4839) pg/mL, P = 0.0017]. Clusterin levels were associated with asthma severity. Paradoxically, clusterin levels were lower during asthma exacerbation than in stable asthma [1838 (350-4790] pg/mL vs. 4540 (3872-5651) pg/mL, P < 0.001]. Clusterin levels were strongly correlated with the methacholine concentration that caused a 20% decrease in the forced expiratory volume in 1 s (r = -0.617, P < 0.001); there was no significant correlation between clusterin levels and other pulmonary function parameters. CONCLUSIONS AND CLINICAL RELEVANCE Clusterin levels were altered in children with stable asthma and asthma exacerbation because of its antioxidant and anti-inflammatory effects. Clusterin may be a marker that reflects airway inflammation and severity of symptoms, and it can be used in the assessment and management of childhood asthma.
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Affiliation(s)
- I S Sol
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Y H Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Y A Park
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - K E Lee
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - J Y Hong
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - M N Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Y S Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - M S Oh
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - S H Yoon
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - M J Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - K W Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - M H Sohn
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - K E Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
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Abstract
Lung transplantation is the only effective treatment option for patients with end-stage lung disease. However, donor organ shortage makes timely transplant not possible for all patients, especially in Korea. We investigated the number and utilization of donor lungs by retrospectively reviewing all donor organs registered in the Korea Network for Organ Sharing database from March 2012 to March 2016. The donors were stratified into 4 groups by donor acceptability criteria. A total of 1,304 donors were included. Of those, 295 brain-dead donors (22.6%) consented to lung donation. Among these consented donors, 168 donors (12.9%) were retrieved for lung transplant. Retrieval rate was very low compared with that of the kidney (93.9%), liver (86.3%), and heart (27.3%). The characteristics of utilized donor lungs were: mean age, 40.5 years (range: 18 to 63 years); mean partial pressure of oxygen, 356.5 mmHg; mean smoking history, 5.9 pack-years; and mean body mass index, 22.6 kg/m². The proportion of donors with acceptable condition of the transplanted lungs was only 39.3% (ideal 19, standard 47, marginal 70, unusable 32). Among brain-dead patients who denied to donate lungs (n = 1,009), 82 were potentially acceptable donors (ideal 19, standard 63), which was equal to half of actually transplanted lung donations. Many potential donor lungs, which are currently excluded, may be successfully used in lung transplantation in Korea. The available lung donors must be actively selected and managed to maximize the utilization of this precious resource.
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Affiliation(s)
- Hye Ju Yeo
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seong Hoon Yoon
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seung Eun Lee
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Doosoo Jeon
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yun Seong Kim
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Woo Hyun Cho
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Do Hyung Kim
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea.
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45
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Abstract
BACKGROUND Many people experience the common cold, but there is currently no special treatment. For this reason, complementary and alternative medicine (CAM) therapies are used to improve the symptoms of the common cold. Blood-letting therapy (BL) is a CAM therapy that has been used for over 2000 years to treat various diseases. However, few studies have provided evidence for the efficacy and safety of BL for the common cold. This study aims to assess the effectiveness and safety of BL for the common cold. METHODS AND ANALYSIS A total of 11 databases will be searched for studies conducted through June 2017. We will include randomized controlled trials assessing BL for the common cold. All randomized controlled trials on BL or related interventions will be included. Risk of bias will be assessed using the Cochrane Risk of Bias Assessment Tool, while confidence in the accumulated evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation instrument. ETHICS AND DISSEMINATION This systematic review will be published in a peer-reviewed journal and will also be disseminated electronically and in print. The review will be updated to inform and guide healthcare practices.
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Affiliation(s)
- Ju Ah Lee
- Department of Korean Internal Medicine, College of Korean Medicine, Gachon University
| | - Minna Hong
- The Graduate School of Pusan National University, Busan
- Department of Internal Medicine, Korean Medicine Hospital of Pusan National University, Yangsan
| | - Myeong Soo Lee
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon
| | - Seong Hoon Yoon
- Lung Cancer Clinic, Pulmonary Medicine Center, Pusan National University Yangsan Hospital
| | - Jun-Yong Choi
- Department of Internal Medicine, Korean Medicine Hospital of Pusan National University, Yangsan
- School of Korean Medicine, Pusan National University, Yangsan, Republic of South Korea
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Bae YS, Yoon SH, Han JY, Woo J, Cho YS, Kwon SK, Bae YC, Kim D, Kim E, Kim MH. Deficiency of aminopeptidase P1 causes behavioral hyperactivity, cognitive deficits, and hippocampal neurodegeneration. Genes Brain Behav 2017; 17:126-138. [PMID: 28834604 DOI: 10.1111/gbb.12419] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 08/14/2017] [Accepted: 08/21/2017] [Indexed: 12/14/2022]
Abstract
Metabolic diseases affect various organs including the brain. Accumulation or depletion of substrates frequently leads to brain injury and dysfunction. Deficiency of aminopeptidase P1, a cytosolic proline-specific peptidase encoded by the Xpnpep1 gene, causes an inborn error of metabolism (IEM) characterized by peptiduria in humans. We previously reported that knockout of aminopeptidase P1 in mice causes neurodevelopmental disorders and peptiduria. However, little is known about the pathophysiological role of aminopeptidase P1 in the brain. Here, we show that loss of aminopeptidase P1 causes behavioral and neurological deficits in mice. Mice deficient in aminopeptidase P1 (Xpnpep1-/- ) display abnormally enhanced locomotor activities in both the home cage and open-field box. The aminopeptidase P1 deficiency in mice also resulted in severe impairments in novel-object recognition, the Morris water maze task, and contextual, but not cued, fear memory. These behavioral dysfunctions were accompanied by epileptiform electroencephalogram activity and neurodegeneration in the hippocampus. However, mice with a heterozygous mutation for aminopeptidase P1 (Xpnpep1+/- ) exhibited normal behaviors and brain structure. These results suggest that loss of aminopeptidase P1 leads to behavioral, cognitive and neurological deficits. This study may provide insight into new pathogenic mechanisms for brain dysfunction related to IEMs.
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Affiliation(s)
- Y-S Bae
- Department of Physiology and Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
| | - S H Yoon
- Department of Physiology and Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
| | - J Y Han
- Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul, Korea
| | - J Woo
- Department of Biological Sciences, KAIST, Daejeon, Korea
| | - Y S Cho
- Department of Anatomy and Neurobiology, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - S-K Kwon
- Department of Biological Sciences, KAIST, Daejeon, Korea.,Center for Synaptic Brain Dysfunctions, Institute for Basic Science (IBS), Daejeon, Korea
| | - Y C Bae
- Department of Anatomy and Neurobiology, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - D Kim
- Department of Biological Sciences, KAIST, Daejeon, Korea
| | - E Kim
- Department of Biological Sciences, KAIST, Daejeon, Korea.,Center for Synaptic Brain Dysfunctions, Institute for Basic Science (IBS), Daejeon, Korea
| | - M-H Kim
- Department of Physiology and Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea.,Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul, Korea.,Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea
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47
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Kim YS, Yoon SH, Son BS, Kim DH, Kim KY, Kim SJ. Usefulness of F-18 FDG PET/CT to identify metastatic mediastinal lymph node in NSCLC patients with bilateral benign mediastinal lymph node hyperplasia. Lung Cancer 2017. [DOI: 10.1183/1393003.congress-2017.pa4278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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48
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Yi S, Lee H, Jang SB, Byun HM, Yoon SH, Cho JY, Jang IJ, Yu KS. A novel K+ competitive acid blocker, YH4808, sustains inhibition of gastric acid secretion with a faster onset than esomeprazole: randomised clinical study in healthy volunteers. Aliment Pharmacol Ther 2017; 46:337-346. [PMID: 28543183 DOI: 10.1111/apt.14148] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 06/06/2016] [Accepted: 04/25/2017] [Indexed: 12/26/2022]
Abstract
BACKGROUND YH4808, a K+ -competitive acid blocker, is under clinical development for the treatment of acid-related disorders, such as gastroesophageal reflux disease. AIMS To determine the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of YH4808, compared to placebo and esomeprazole. METHODS This double-blind, randomised, placebo- and active comparator (esomeprazole)-controlled study was conducted with 123 healthy male volunteers. We evaluated YH4808 (30-800 mg) properties, administered in single (N=55) and multiple (N=24) oral doses, and recorded the effects on 24-hour intragastric acidity. Results were compared to placebo (N=20) and esomeprazole 40 mg (N=24). RESULTS Plasma YH4808 exposure increased dose-proportionally and declined in a multi-phasic manner. YH4808 ≥200 mg/d maintained intragastric acidity at pH >4 for longer times than esomeprazole during both day and night (%Time at pH >4: >70% vs 58% of a 24-hour period, respectively; and >50% vs 33% of a 9-hour night respectively). A twice-daily regimen of YH4808 more effectively controlled intragastric pH at night than a once-daily regimen. In evaluating the mean areas under the intragastric pH-time curves in 15-minute intervals for 2 hours after dosing, we found that YH4808 had a faster onset than esomeprazole. Moreover, unlike esomeprazole, YH4808 PK and PD were not significantly affected by the CYP2C19 genotype of the subjects. YH4808 was well-tolerated at all doses administered. CONCLUSION This study showed that YH4808 produced a rapid, sustained suppression of gastric secretion with good tolerability. The results at YH4808 ≥200 mg/d provide a rationale for further clinical investigations in populations with acid-related diseases.
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Affiliation(s)
- S Yi
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - H Lee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea.,Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
| | - S B Jang
- Department of Research and Development, Yuhan Co. Ltd., Seoul, Republic of Korea
| | - H M Byun
- Department of Research and Development, Yuhan Co. Ltd., Seoul, Republic of Korea
| | - S H Yoon
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - J-Y Cho
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - I-J Jang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - K-S Yu
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
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49
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Ryu MY, Lee MA, Ahn YH, Kim KS, Yoon SH, Snyder EY, Cho KG, Kim SU. Brain Transplantation of Neural Stem Cells Cotransduced with Tyrosine Hydroxylase and GTP Cyclohydrolase 1 in Parkinsonian Rats. Cell Transplant 2017; 14:193-202. [PMID: 15929554 DOI: 10.3727/000000005783983133] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Neural stem cells (NSCs) of the central nervous system (CNS) recently have attracted a great deal of interest not only because of their importance in basic research on neural development, but also in terms of their therapeutic potential in neurological diseases, such as Parkinson's disease (PD). To examine if genetically modified NSCs are a suitable source for the cell and gene therapy of PD, an immortalized mouse NSC line, C17.2, was transduced with tyrosine hydroxylase (TH) gene and with GTP cyclohydrolase 1 (GTPCH1) gene, which are important enzymes in dopamine biosynthesis. The expression of TH in transduced C17.2-THGC cells was confirmed by RT-PCR, Western blot analysis, and immunocytochemistry, and expression of GTPCH1 by RT-PCR. The level of L-DOPA released by C17.2-THGC cells, as determined by HPLC assay, was 3793 pmol/106 cells, which is 760-fold higher than that produced by C17.2-TH cells, indicating that GTPCH1 expression is important for L-DOPA production by transduced C17.2 cells. Following the implantation of C17.2-THGcC NSCs into the striata of parkinsonian rats, a marked improvement in amphetamine-induced turning behavior was observed in parkinsonian rats grafted with C17.2-THGC cells but not in the control rats grafted with C17.2 cells. These results indicate that genetically modified NSCs grafted into the brain of the parkinsonian rats are capable of survival, migration, and neuronal differentiation. Collectively, these results suggest that NSCs have great potential as a source of cells for cell therapy and an effective vehicle for therapeutic gene transfer in Parkinson's disease.
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Affiliation(s)
- M Y Ryu
- Department of Neurosurgery, Ajou University School of Medicine, Suwon, Korea
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50
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Yeo HJ, Yoon SH, Lee SE, Jeon D, Kim YS, Cho WH, Kim D. Safety of Surgical Tracheostomy during Extracorporeal Membrane Oxygenation. Korean J Crit Care Med 2017; 32:197-204. [PMID: 31723634 PMCID: PMC6786719 DOI: 10.4266/kjccm.2017.00059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 03/21/2017] [Accepted: 03/21/2017] [Indexed: 12/04/2022] Open
Abstract
Background The risk of bleeding during extracorporeal membrane oxygenation (ECMO) is a potential deterrent in performing tracheostomy at many centers. To evaluate the safety of surgical tracheostomy (ST) in critically ill patients supported by ECMO, we reviewed the clinical correlation between preoperative coagulation status and bleeding complication-related ST during ECMO. Methods From April 1, 2012 to March 31, 2016, ST was performed on 38 patients supported by ECMO. We retrospectively reviewed and analyzed the medical records including complications related to ST. Results Heparin was administered to 23 patients (60.5%) for anticoagulation during ECMO, but 15 patients (39.5%) underwent ECMO without anticoagulation. Of the 23 patients administered anticoagulation therapy, heparin infusion was briefly paused in 13 prior to ST. The median platelet count, international normalized ratio, and activated partial thromboplastin time before ST were 126 × 109/L (range, 46 to 434 × 109/L), 1.2 (range, 1 to 2.3) and 62 seconds (27 to 114.2 seconds), respectively. No peri-procedural clotting complications related to ECMO were observed. Two patients (5.3%) suffering from ST-related major bleeding required surgical hemostasis. Minor bleeding after ST occurred in two cases (5.3%). No significant difference was found according to anticoagulation management (P = 0.723). No fatality was attributable to ST. Conclusions The complication rates of ST in the patients supported by ECMO were low. Therefore, ST performed by an experienced operator, and with careful optimization of coagulation status, is a relatively safe procedure; the use of ST with ECMO should thus not be dismissed on account of the potential for bleeding caused by the administration of anticoagulants.
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Affiliation(s)
- Hye Ju Yeo
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology, Yangsan, Korea
| | - Seong Hoon Yoon
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology, Yangsan, Korea
| | - Seung Eun Lee
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology, Yangsan, Korea
| | - Doosoo Jeon
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology, Yangsan, Korea
| | - Yun Seong Kim
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology, Yangsan, Korea
| | - Woo Hyun Cho
- Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology, Yangsan, Korea
| | - Dohyung Kim
- Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology, Yangsan, Korea
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