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Basak I, Wicky HE, McDonald KO, Xu JB, Palmer JE, Best HL, Lefrancois S, Lee SY, Schoderboeck L, Hughes SM. Correction: A lysosomal enigma CLN5 and its significance in understanding neuronal ceroid lipofuscinosis. Cell Mol Life Sci 2024; 81:45. [PMID: 38236309 PMCID: PMC10796411 DOI: 10.1007/s00018-023-05047-5] [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] [Accepted: 11/10/2023] [Indexed: 01/19/2024]
Affiliation(s)
- I Basak
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - H E Wicky
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - K O McDonald
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - J B Xu
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - J E Palmer
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - H L Best
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
- School of Biosciences, Cardiff University, Sir Martin Evans Building, Museum Avenue, CF10 3AX, Wales, UK
| | - S Lefrancois
- Centre INRS-Institut Armand-Frappier, INRS, H7V 1B7, Laval, Canada
- Department of Anatomy and Cell Biology, McGill University, H3A 2B2, Montreal, Canada
| | - S Y Lee
- Department of Biochemistry and Molecular Biology, University of Kansas Medical Center, 66160, Kansas City, KS, USA
| | - L Schoderboeck
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - S M Hughes
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand.
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Kim JC, Choi MG, Park JS, Lee SY, Park CW, Chung BY, Misery L, Kim HO. Sensitive skin is associated with contact sensitization and decreased nociceptive threshold. J Eur Acad Dermatol Venereol 2024; 38:e125-e127. [PMID: 37556672 DOI: 10.1111/jdv.19398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 08/03/2023] [Indexed: 08/11/2023]
Affiliation(s)
- J C Kim
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - M G Choi
- Department of Computer Science, Kwangwoon University, Seoul, South Korea
| | - J S Park
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - S Y Lee
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - C W Park
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - B Y Chung
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - L Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
| | - H O Kim
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
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Lee M, Thomas AS, Lee SY, Cho YJ, Jung HS, Yun WG, Han Y, Jang JY, Kluger MD, Kwon W. Reconsidering the absence of extrapancreatic extension in T staging for pancreatic adenocarcinoma in the AJCC (8 th ed) Staging Manual using the National Cancer Database. J Gastrointest Surg 2023; 27:2484-2492. [PMID: 37848688 DOI: 10.1007/s11605-023-05850-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/16/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE Although the concept of extrapancreatic extension (EPEx) was removed in the eighth edition of the American Joint Committee on Cancer pancreatic cancer staging system, several studies have supported the prognostic significance of EPEx. This study aimed to investigate the significance of EPEx in pancreatic ductal adenocarcinoma (PDAC) using the National Cancer Database (NCDB). METHODS Data of patients who underwent resection for PDAC between 2006 and 2016 were extracted and analyzed from the NCDB. Cases arising from premalignant lesions, those with metastases, and those treated with neoadjuvant therapy were excluded. RESULTS Among 37,634 patients, the median overall survival was 23 months and the 5-year survival rate was 22.7%. The EPEx prevalence was the lowest for T1 stage (63.2%) and increased with each T-stage (T2:83.4%, T3:85.8%). The overall survival was better in EPEx-negative patients than in EPEx-positive patients (median 33.7 vs. 21.5 months; p<0.001). When the T-stages were stratified by EPEx, EPEx-positive patients showed worse survival in all T-stages than EPEx-negative patients. Survival was comparable between T1 EPEx-positive and T2 or T3 EPEx-negative patients (p=0.088 and p=0.178, respectively). Furthermore, T2 and T3 EPEx-negative patients had similar survival to each other (p=0.877), and distinctly superior survival compared to T2 and T3 EPEx-positive patients (p<0.001). CONCLUSIONS EPEx was an important prognostic factor in the overall cohort and in differentiating between T stages. This study strongly suggests that staging systems should reinstate EPEx and apply it to all T-stages, especially in T1, where EPEx was absent in 36% of patients.
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Affiliation(s)
- Mirang Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Chongno-gu, Seoul, 03080, South Korea
| | - Alexander S Thomas
- Division of GI/Endocrine Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York, USA
| | - Seung Yeoun Lee
- Department of Mathematics and Statistics, Sejong University College of Natural Sciences, Seoul, Republic of Korea
| | - Young Jae Cho
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Chongno-gu, Seoul, 03080, South Korea
| | - Hye-Sol Jung
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Chongno-gu, Seoul, 03080, South Korea
| | - Won-Gun Yun
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Chongno-gu, Seoul, 03080, South Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Chongno-gu, Seoul, 03080, South Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Chongno-gu, Seoul, 03080, South Korea
| | - Michael D Kluger
- Division of GI/Endocrine Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York, USA
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Chongno-gu, Seoul, 03080, South Korea.
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Pyo JH, Lee SY, Lee IJ, Kim SM, Kim JW. Beneficial Role of Multi-Disciplinary Treatment for Anaplastic Thyroid Cancer with Initial Distant Metastasis. Int J Radiat Oncol Biol Phys 2023; 117:e616-e617. [PMID: 37785850 DOI: 10.1016/j.ijrobp.2023.06.1996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Anaplastic thyroid cancer (ATC) is a rare, highly aggressive tumor, with median survival around 5 months. Approximately half of the ATC patients presents with distant metastases at diagnosis, showing even more devastating prognosis, yet no outcome analysis had been reported. In this study, we aim to evaluate the clinical outcome of M1 ATC patients, and to define the group of patients who would benefit from local treatment based on multi-disciplinary approach. MATERIALS/METHODS A total of 133 histology-confirmed ATC patients underwent protocol-based multidisciplinary treatment including surgery and chemoradiotherapy (CRT) between May 2016 and January 2022. Patients received intensity-modulated radiotherapy of 30 fractions concurrently with paclitaxel on days 1, 8 and 15 every 4 weeks, and lenvatinib was added upon progression. After 18 fractions of CRT, interim response analysis using modified RECIST was conducted for adaptive treatment planning. We reviewed 58 patients with distant metastasis at diagnosis (stage IVC). Overall survival (OS) and progression-free survival (PFS) were measured from the day of diagnosis. RESULTS Most common metastatic site was lung (91.4%), followed by bone (31.0%) and brain (5.2%). Lenvatinib was added for 35 patients after any sign of progression. Fourteen patients received upfront surgery (16 debulking and 5 total) followed by adjuvant CRT in 16 patients. Thirty-one patients received upfront CRT with 2 patients receiving total resection after sufficient down-staging. Six (10%) patients could not complete radiotherapy but continued receiving systemic treatment. The median follow-up was 5.9 months. The median and 1-year OS were 6.2 months and 20.5%, and PFS were 3.7 months and 3.5%. Total RT dose over 60 Gy significantly improved median OS (7.5 vs 4.1 months, p = 0.012) and median PFS (4.4 vs 3.0, p = 0.010). Patients with less than 10 initial metastatic tumors showed better median OS (9.1 vs 4.6 months, p = 0.002) but not PFS (5.1 vs 3.6, p = 0.485). At interim analysis, early response (CR, PR and SD) of primary tumor was not associated with survival, while progression of distant metastases showed significantly worse median OS (9.8 vs 4.6 months, p = 0.001). More than 10 metastatic tumors (HR 2.73, 95% CI 1.32-5.66) and stable metastasis at interim analysis (HR 2.39, 95% CI 1.04-5.48) remained as significant factor in the multivariable cox regression analysis. Median OS and PFS of patients with less than 10 metastases showing no progression at interim analysis were 9.1 months, and 5.1 months. CONCLUSION Local treatment combined with chemotherapy for M1 ATC patients showed outcome comparable to those of non-metastatic ATC results. Active local treatment should be considered especially for patients with less than 10 metastases, and patients without distant progression in early response evaluation.
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Affiliation(s)
- J H Pyo
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - S Y Lee
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - I J Lee
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - S M Kim
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - J W Kim
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
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Kwon W, Heo JS, Han IW, Kang CM, Hwang HK, Kim SC, Park SJ, Yoon YS, Kim YH, Lim CS, Lee SY, Park T, Takami H, Watanabe N, Shimizu Y, Okuno M, Yamaue H, Kawai M, Seiko H, Nagakawa Y, Osakabe H, Sugiura T, Toyama H, Ohtsuka M, Unno M, Endo I, Kitago M, Jang JY. Features of T1 pancreatic cancer and validation of the eighth edition AJCC staging system definition using a Korean-Japanese joint cohort and the SEER database. J Hepatobiliary Pancreat Sci 2023; 30:1129-1140. [PMID: 36734142 DOI: 10.1002/jhbp.1316] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/23/2022] [Accepted: 01/20/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND/PURPOSE Little is known about the features of T1 pancreatic ductal adenocarcinoma (PDAC) and its definition in the eighth edition of the American Joint Committee on Cancer (AJCC) staging system needs validation. The aims were to analyze the clinicopathologic features of T1 PDAC and investigate the validity of its definition. METHOD Data from 1506 patients with confirmed T1 PDAC between 2000 and 2019 were collected and analyzed. The results were validated using 3092 T1 PDAC patients from the Surveillance, Epidemiology, and End Results (SEER) database. RESULTS The median survival duration of patients was 50 months, and the 5-year survival rate was 45.1%. R0 resection was unachievable in 10.0% of patients, the nodal metastasis rate was 40.0%, and recurrence occurred in 55.2%. The current T1 subcategorization was not feasible for PDAC, tumors with extrapancreatic extension (72.8%) had worse outcomes than those without extrapancreatic extension (median survival 107 vs. 39 months, p < .001). Extrapancreatic extension was an independent prognostic factor whereas the current T1 subcategorization was not. The results of this study were reproducible with data from the SEER database. CONCLUSION Despite its small size, T1 PDAC displayed aggressive behavior warranting active local and systemic treatment. The subcategorization by the eighth edition of the AJCC staging system was not adequate for PDAC, and better subcategorization methods need to be explored. In addition, the role of extrapancreatic extension in the staging system should be reconsidered.
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Affiliation(s)
- Wooil Kwon
- Department of Surgery, College of Medicine, Seoul National University, Seoul, South Korea
| | - Jin Seok Heo
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - In Woong Han
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Chang Moo Kang
- Department of Hepatobiliary and Pancreatic Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Ho Kyoung Hwang
- Department of Hepatobiliary and Pancreatic Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Song Cheol Kim
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Sang-Jae Park
- Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, South Korea
| | - Yoo-Seok Yoon
- Department of Surgery, Seoul National University Bundang Hospital, Sungnam, South Korea
| | - Yong Hoon Kim
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Keimyung University Dongsan Hospital, Daegu, South Korea
| | - Chang-Sup Lim
- Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Seung Yeoun Lee
- Department of Mathematics and Statistics, Sejong University College of Natural Sciences, Seoul, South Korea
| | - Taesung Park
- Department of Statistics and Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, South Korea
| | - Hideki Takami
- Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Watanabe
- Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhiro Shimizu
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Masataka Okuno
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hiroki Yamaue
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Manabu Kawai
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hirono Seiko
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Yuichi Nagakawa
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Hiroaki Osakabe
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Teiichi Sugiura
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Japan, Shizuoka, Japan
| | - Hirochika Toyama
- Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masayuki Ohtsuka
- Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Michiaki Unno
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Itaru Endo
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Minoru Kitago
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Jin-Young Jang
- Department of Surgery, College of Medicine, Seoul National University, Seoul, South Korea
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Choi JI, Kweon HY, Lee YL, Lee JH, Lee SY. Efficacy of Silkworm Pupae Extract on Muscle Strength and Mass in Middle-Aged and Older Individuals: A Randomized, Double-Blind, Placebo-Controlled Trial. J Nutr Health Aging 2023; 27:578-585. [PMID: 37498105 DOI: 10.1007/s12603-023-1942-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 06/06/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVES We investigated the efficacy and safety of silkworm pupae extract (SWP) consumption for 12 weeks on muscle mass and strength in middle-aged and older individuals with relatively low skeletal muscle mass who do regular low-intensity exercise. DESIGN A randomized double-blinded placebo-controlled trial. PARTICIPANTS The study was conducted with 54 participants with relatively low skeletal muscle mass (SMM) (64.4 ± 6.1 years; body mass index, 23.8 ± 2.4 kg/m2). INTERVENTION AND MEASUREMENTS Participants were randomly assigned to one of two groups: 1000 mg of SWP/day plus regular exercise (SWP group, n=27) or placebo plus regular exercise (placebo group, n=27). All participants were required to engage in 30-60 minutes/day of walking for ≥3 days/week for 12 weeks. The primary outcome was knee extension/flexion strength (Nm), measured at the velocity of 60°/s. Secondary outcomes included body composition, biomarkers (creatine kinase and creatinine), handgrip strength, and quality of life questionnaire. RESULTS Both the intention-to-treat (ITT) and per-protocol (PP) analyses revealed no significant impact of SWP on knee strength compared to the placebo group over 12 weeks. On the other hand, the SWP group had significantly greater increases in right-handgrip strength by 1.94 kg (95% CI: 0.08-3.79; p = 0.041) and left-handgrip strength by 1.83 kg (0.25-3.41; p = 0.024) compared to the placebo group in the ITT population, after 12 weeks. Moreover, in the PP population, the SWP group revealed an even greater increase in right-handgrip strength by 2.07 kg (0.15-3. 98; p = 0.035) and left-handgrip strength by 2.21 kg (0.60-3.83; p = 0.008) for the 12-week period. However, this study resulted in a failure to detect significant differences in the body composition, biomarkers, quality of life questionnaire, physical activity, and caloric intake between the groups. None of the participants in the SWP group experienced any significant adverse events. In the placebo group, two participants experienced urticaria and allergic side effects, leading to their withdrawal from the study and two exhibited elevated levels of liver enzyme and increased diastolic blood pressure, respectively at 12 weeks. CONCLUSION SWP, in addition to low-intensity exercise, may enhance handgrip strengths in middle-aged and older adults with relatively lower SMM. Future studies need to use a large sample size over longer periods to validate our findings. This trial was registered at clinicaltrials.gov as NCT04994054.
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Affiliation(s)
- J I Choi
- Sang Yeoup Lee, Family Medicine Clinic, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea, Telephone: +82-55-390-1442, E-mail: , Fax: +82-51-510-8125
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Kang SY, Choi MG, Wei ET, Selescu T, Lee SY, Kim JC, Chung BY, Park CW, Kim HO. TRPM8 agonist (cryosim-1) gel for scalp itch: A randomized, vehicle controlled clinical trial. J Eur Acad Dermatol Venereol 2022; 36:e588-e589. [PMID: 35293031 DOI: 10.1111/jdv.18080] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S Y Kang
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea
| | - M G Choi
- Department of Computer Science and Engineering, Kwangwoon University, Seoul, Korea
| | - E T Wei
- School of Public Health, University of California, Berkeley, CA, 94720, USA
| | - T Selescu
- Department of Anatomy, Physiology and Biophysics, Faculty of Biology, University of Bucharest, Bucuresti, Romania
| | - S Y Lee
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea
| | - J C Kim
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea
| | - B Y Chung
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea
| | - C W Park
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea
| | - H O Kim
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea
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Kim JC, Lee SY, Kang SY, Kim HO, Park CW, Chung BY. Erythema annulare centrifugum induced by COVID-19 vaccination. Clin Exp Dermatol 2021; 47:591-592. [PMID: 34731529 PMCID: PMC8652630 DOI: 10.1111/ced.15002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/27/2021] [Accepted: 11/01/2021] [Indexed: 12/19/2022]
Affiliation(s)
- J C Kim
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - S Y Lee
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - S Y Kang
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - H O Kim
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - C W Park
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - B Y Chung
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
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Basak I, Wicky HE, McDonald KO, Xu JB, Palmer JE, Best HL, Lefrancois S, Lee SY, Schoderboeck L, Hughes SM. A lysosomal enigma CLN5 and its significance in understanding neuronal ceroid lipofuscinosis. Cell Mol Life Sci 2021; 78:4735-4763. [PMID: 33792748 PMCID: PMC8195759 DOI: 10.1007/s00018-021-03813-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 01/09/2023]
Abstract
Neuronal Ceroid Lipofuscinosis (NCL), also known as Batten disease, is an incurable childhood brain disease. The thirteen forms of NCL are caused by mutations in thirteen CLN genes. Mutations in one CLN gene, CLN5, cause variant late-infantile NCL, with an age of onset between 4 and 7 years. The CLN5 protein is ubiquitously expressed in the majority of tissues studied and in the brain, CLN5 shows both neuronal and glial cell expression. Mutations in CLN5 are associated with the accumulation of autofluorescent storage material in lysosomes, the recycling units of the cell, in the brain and peripheral tissues. CLN5 resides in the lysosome and its function is still elusive. Initial studies suggested CLN5 was a transmembrane protein, which was later revealed to be processed into a soluble form. Multiple glycosylation sites have been reported, which may dictate its localisation and function. CLN5 interacts with several CLN proteins, and other lysosomal proteins, making it an important candidate to understand lysosomal biology. The existing knowledge on CLN5 biology stems from studies using several model organisms, including mice, sheep, cattle, dogs, social amoeba and cell cultures. Each model organism has its advantages and limitations, making it crucial to adopt a combinatorial approach, using both human cells and model organisms, to understand CLN5 pathologies and design drug therapies. In this comprehensive review, we have summarised and critiqued existing literature on CLN5 and have discussed the missing pieces of the puzzle that need to be addressed to develop an efficient therapy for CLN5 Batten disease.
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Affiliation(s)
- I Basak
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - H E Wicky
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - K O McDonald
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - J B Xu
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - J E Palmer
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - H L Best
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
- School of Biosciences, Cardiff University, Sir Martin Evans Building, Museum Avenue, Wales, CF10 3AX, United Kingdom
| | - S Lefrancois
- Centre INRS-Institut Armand-Frappier, INRS, Laval, H7V 1B7, Canada
- Department of Anatomy and Cell Biology, McGill University, Montreal, H3A 2B2, Canada
| | - S Y Lee
- Department of Biochemistry and Molecular Biology, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - L Schoderboeck
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand
| | - S M Hughes
- Neurodegenerative and Lysosomal Disease Laboratory, Department of Biochemistry, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, 710 Cumberland Street, Dunedin, 9016, New Zealand.
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Rhie YH, Lee SY, Walck JL, Hidayati SN. Seed dormancy and germination of Asarum sieboldii, a disjunct relict species in East Asia. Plant Biol (Stuttg) 2021; 23:300-306. [PMID: 33289269 DOI: 10.1111/plb.13224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 11/09/2020] [Indexed: 06/12/2023]
Abstract
Disjunct species in the same genus are a common feature of the flora in the temperate forests of East Asia and eastern North America. This study aimed to evaluate whether the kind of seed dormancy was maintained after species in the genus Asarum (Aristolochiaceae) were separated from their common ancestor. We classified the seed dormancy of Asarum sieboldii, an East Asian species, based on a phenology study and experiments in controlled temperature conditions, and then compared it to that of the previously studied A. canadense, an eastern North American species. The underdeveloped embryo of A. sieboldii grew and germinated (radicle emergence) in autumn but shoot emergence did not occur until the following spring. The seeds of A. sieboldii had deep simple epicotyl morphophysiological dormancy because the seeds with emerged radicle required a relatively long period of cold stratification to break epicotyl dormancy and produce a shoot. Although the seed of A. sieboldii had weaker radicle dormancy and stronger epicotyl dormancy compared to A. canadense, the kind of seed dormancy was the same for the two species. The trait of seed dormancy was inherited from a shared common ancestor and maintained in populations well after the two species (or their ancestors) separated. However, quantitative differences in temperature requirements for radicle and shoot emergence suggest the possibility of adaptation to the environment.
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Affiliation(s)
- Y H Rhie
- Department of Horticulture and Forestry, Pai Chai University, Daejeon, Korea
| | - S Y Lee
- Division of Horticulture & Medicinal Plant, Andong National University, Andong, Korea
| | - J L Walck
- Department of Biology, Middle Tennessee State University, Murfreesboro, TN, USA
| | - S N Hidayati
- Department of Biology, Middle Tennessee State University, Murfreesboro, TN, USA
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11
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Ju YJ, Lee JE, Lee SY. Associations between Chewing Difficulty, Subjective Cognitive Decline, and Related Functional Difficulties among Older People without Dementia: Focus on Body Mass Index. J Nutr Health Aging 2021; 25:347-355. [PMID: 33575727 DOI: 10.1007/s12603-020-1521-2] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This study aimed to determine whether chewing difficulty is associated with subjective cognitive decline (SCD) and related functional difficulties by body mass index. DESIGN A population-based cross-sectional study. SETTING AND PARTICIPANTS A nationwide sample of 54,004 individuals aged ≥65 years from the 2018 Korea Community Health Survey. MEASUREMENTS SCD and SCD-related functional difficulties were measured using the cognitive decline module of the Behavioral Risk Factor Surveillance System. Chewing difficulty was assessed based on a self-report questionnaire from an oral health-related behaviors interview survey. BMI was calculated from objective values by measuring height and weight through a physical meter. RESULTS Among the 54,004 individuals, the prevalence of SCD in underweight, overweight, and obesity group was 33.6% (n = 806), 30.3% (n = 9,691), and 28.7% (n=5,632) respectively. Chewing difficulty was associated with SCD and SCD-related functional difficulties. This association was more pronounced in underweight (BMI: <18.5 kg/m2) people [underweight: (odds ratio [OR] = 1.68, 95% confidence interval [CI] 1.48-1.92); normal weight: OR = 1.13, 95% CI 1.04-1.22; obese: OR = 1.15, 95% CI 1.05-1.27]. Similar trends were demonstrated for SCD-related functional difficulties (underweight: OR = 1.53, 95% CI 1.17-2.01; normal weight: OR = 1.36, 95% CI 1.15-1.63; obese: OR = 1.50, 95% CI 1.22-1.86). CONCLUSIONS Chewing difficulty was associated with SCD and SCD-related functional difficulties in older people. Our results suggest that underweight status may play roles in the associations between chewing difficulty and SCD and SCD-related functional difficulties.
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Affiliation(s)
- Y J Ju
- Soon Young Lee, MD, PhD, Department of Preventive Medicine and Public Health, Ajou University School of Medicine 206 World cup-ro, Yeongtong-gu, Suwon-si Gyeonggi-do 16499, Republic of Korea, T: 82-31-219-5301, F: 82-31-219-5084, E:
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12
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Lee CT, Chen MZ, Yip CYC, Yap ES, Lee SY, Merchant RA. Prevalence of Anemia and Its Association with Frailty, Physical Function and Cognition in Community-Dwelling Older Adults: Findings from the HOPE Study. J Nutr Health Aging 2021; 25:679-687. [PMID: 33949637 DOI: 10.1007/s12603-021-1625-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 12/29/2022]
Abstract
OBJECTIVES The prevalence of anemia and its impact on frailty and physical function amongst the multiethnic older populations in the Southeast Asian (SEA) countries are often not well studied. Singapore, a nation comprised of multiethnic communities, is one of the most rapidly aging population globally. We aim to evaluate the prevalence of anemia and its impact on frailty, and physical function in Healthy Older People Everyday (HOPE)- an epidemiologic population-based study on community-dwelling older adults in Singapore. DESIGN Cross-sectional study. SETTING Community. PARTICIPANTS 480 adults ≥ 65 years old. MEASUREMENTS Data were collected from interviewers-administered questionnaires on socio-demographics, FRAIL scale, Mini-Mental State Examination, EQ-5D, Barthel Index, and Lawton index. Hemoglobin concentration and physical assessments, including anthropometry, grip strength, timed up-and-go (TUG) were measured. RESULTS The overall prevalence of anemia was 15.2% (73 out of 480). The Indian ethnic group had the highest prevalence of anemia (32%, OR=3.02; 95%CI= 1.23-7.41) with the lowest hemoglobin concentration compared to the overall population (13.0±1.3g/L and 13.5±1.4g/L, p=0.02). Hemoglobin levels and anemia were significantly associated with frailty (OR=2.28; 95% CI=1.02-5.10), low grip strength (OR=1.79; 95% CI=1.01-3.03), ≥ one IADL impairment (OR=2.35; 95% CI=1.39-3.97). Each 1 g/dL increase in hemoglobin was associated with a 6% decrease in frailty odds after adjusting for potential covariates (OR = 0.94, 95% CI: 0.90-0.99). There was a significant difference in the mean TUG between the non-anemic (11.0±3.4 seconds) and anemic (12.3±6.0 seconds, p=0.01) counterparts, but no difference in the number of falls. CONCLUSION In our multiethnic Asian population, anemia was adversely associated with frailty, decreased muscle strength, and IADL impairment. Health policies on anemia screening should be employed to avoid or potentially delay or reverse these adverse outcomes associated with anemia. Recognition, evaluation, and treatment of anemia amongst this vulnerable population is warranted.
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Affiliation(s)
- C-T Lee
- Chun-Tsu Lee, MBBS(Mal.), M.Med (S'pore), MRCP(UK), FRCPath (UK), FAMS, Fast and Chronic Program, Alexandra Hospital, National University Health System, 378 Alexandra Road, Singapore 159964. Telephone: +65 64722000.
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13
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Chan NH, Lee SY, Cheng NHY, Wong HY, Lo WK, Lung DC. Hospital infection control best practice: Five essential elements to successfully minimize healthcare-associated COVID-19. Infect Prev Pract 2020; 3:100110. [PMID: 34316572 PMCID: PMC7837126 DOI: 10.1016/j.infpip.2020.100110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/10/2020] [Indexed: 01/22/2023] Open
Affiliation(s)
- N H Chan
- Infection Control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - S Y Lee
- Infection Control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - N H Y Cheng
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - H Y Wong
- Infection Control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - W K Lo
- Infection Control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - D C Lung
- Infection Control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region.,Department of Pathology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
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14
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Wong SCY, Kwong RTS, Wu TC, Chan JWM, Chu MY, Lee SY, Wong HY, Lung DC. Risk of nosocomial transmission of coronavirus disease 2019: an experience in a general ward setting in Hong Kong. J Hosp Infect 2020; 105:119-127. [PMID: 32259546 PMCID: PMC7128692 DOI: 10.1016/j.jhin.2020.03.036] [Citation(s) in RCA: 156] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 03/27/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) was first reported in Wuhan in December 2019 and has rapidly spread across different cities within and outside China. Hong Kong started to prepare for COVID-19 on 31st December 2019 and infection control measures in public hospitals were tightened to limit nosocomial transmission within healthcare facilities. However, the recommendations on the transmission-based precautions required for COVID-19 in hospital settings vary from droplet and contact precautions, to contact and airborne precautions with placement of patients in airborne infection isolation rooms. AIM To describe an outbreak investigation of a patient with COVID-19 who was nursed in an open cubicle of a general ward before the diagnosis was made. METHOD Contacts were identified and risk categorized as 'close' or 'casual' for decisions on quarantine and/or medical surveillance. Respiratory specimens were collected from contacts who developed fever, and/or respiratory symptoms during the surveillance period and were tested for SARS-CoV-2. FINDINGS A total of 71 staff and 49 patients were identified from contact tracing, seven staff and 10 patients fulfilled the criteria of 'close contact'. At the end of 28-day surveillance, 76 tests were performed on 52 contacts and all were negative, including all patient close contacts and six of the seven staff close contacts. The remaining contacts were asymptomatic throughout the surveillance period. CONCLUSION Our findings suggest that SARS-CoV-2 is not spread by an airborne route, and nosocomial transmissions can be prevented through vigilant basic infection control measures, including wearing of surgical masks, hand and environmental hygiene.
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Affiliation(s)
- S C Y Wong
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - R T-S Kwong
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - T C Wu
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - J W M Chan
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - M Y Chu
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - S Y Lee
- Infection control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - H Y Wong
- Infection control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - D C Lung
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region; Infection control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region.
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15
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Lee SY, Yeom SS, Kim CH, Kim YJ, Kim HR. A new aortoiliac calcification scoring system to predict grade C anastomotic leak following rectal cancer surgery. Tech Coloproctol 2020; 24:843-849. [PMID: 32468245 DOI: 10.1007/s10151-020-02246-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/19/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Aortoiliac calcification may be a surrogate marker of decreased visceral perfusion causing anastomotic leak (AL). The aim of this study was to evaluate the predictive role of aortoiliac calcification for AL after rectal cancer surgery. METHODS We enrolled patients with primary rectal cancer who had restorative resection at our institution between January 2013 and December 2015. An aortoiliac calcification score was calculated as the sum of calcification scores at the infrarenal aorta (0: no, 1: ≤ 3 cm, 2: > 3 cm) and the common iliac arteries (0: no, 1: unilateral, 2: bilateral). AL was classified into three grades: grade A, requiring no intervention; grade B, requiring therapeutic intervention without re-laparotomy; and grade C, requiring re-laparotomy. Clinicopathological characteristics were analyzed to identify risk factors for AL. RESULTS There were 583 patients. Three-hundred forty-five (59.2%) had an aortoiliac calcification score ≥ 3, and 37 (6.3%) patients experienced AL, in 30 cases (5.1%) grade C AL. Patients with an aortoiliac calcification score ≥ 3 had a higher incidence of grade C AL (6.7% vs. 2.9%, p = 0.045). Multivariate logistic regression analysis revealed that an aortoiliac calcification score ≥ 3 was an independent risk factor for grade C AL (odds ratio = 2.669, 95% confidence interval 1.066-6.686, p = 0.036). CONCLUSIONS Aortoiliac calcification may be considered a risk factor for grade C AL after rectal cancer surgery.
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Affiliation(s)
- S Y Lee
- Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun, Jeonnam, 58128, South Korea
| | - S-S Yeom
- Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun, Jeonnam, 58128, South Korea
| | - C H Kim
- Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun, Jeonnam, 58128, South Korea
| | - Y J Kim
- Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun, Jeonnam, 58128, South Korea
| | - H R Kim
- Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun, Jeonnam, 58128, South Korea.
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16
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Kim KW, Chung S, Lee SY, Yoon SS, Kang HR. Successful Infusion of Obinutuzumab by Desensitization: A Case of Anaphylactic Shock During Desensitization. J Investig Allergol Clin Immunol 2020; 30:457-459. [PMID: 32376522 DOI: 10.18176/jiaci.0581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- K W Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - S Chung
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - S Y Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.,Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
| | - S S Yoon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - H R Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.,Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.,Drug Safety Monitoring Center, Seoul National University Hospital, Seoul, Korea
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17
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Kim YJ, Jeong YJ, Kim SH, Kim YJ, Lee SY, Kim TY, Choi MS, Ahn JH. Preparedness for COVID-19 infection prevention in Korea: a single-centre experience. J Hosp Infect 2020; 105:370-372. [PMID: 32302723 PMCID: PMC7194524 DOI: 10.1016/j.jhin.2020.04.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 04/09/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Y J Kim
- Division of Infectious Disease, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea; Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea.
| | - Y J Jeong
- Division of Infectious Disease, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea; Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - S H Kim
- Division of Infectious Disease, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea; Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - Y J Kim
- Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - S Y Lee
- Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - T Y Kim
- Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - M S Choi
- Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - J H Ahn
- Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea; Division of Pulmonology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Kwon W, Park T, He J, Higuchi R, Son D, Lee SY, Kim J, Byun Y, Kim H, Kim SW, Wolfgang CL, Yamamoto M, Jang JY. Is the New T1 Category as Defined in the Eighth Edition of the AJCC Pancreatic Cancer Staging System an Improvement? J Gastrointest Surg 2020; 24:262-269. [PMID: 31823321 DOI: 10.1007/s11605-019-04464-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 10/30/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND The new T1 pancreatic cancer by the eighth edition of the AJCC staging system discards the concept of "extension beyond the pancreas" and focuses on size only. Furthermore, the new T1 is divided into T1a, T1b, and T1c based on size. The evidence pertaining to these changes has not been evaluated. This is to evaluate the feasibility of the new T1 definition in the pancreas head cancer cohort. METHODS Data from 540 patients with T1 pancreatic ductal adenocarcinoma as defined by the eighth edition were collected from Korea, Japan, and the USA. Invasive IPMNs were excluded. Survival analyses were performed. RESULTS Of the 540 patients, 181 patients were T1 according to the seventh edition and 359 were down-staged to T1 from the former T3 because the concept of "extension beyond the pancreas" was discarded. The 5-year survival rate and the median survival of T1 patients were 30.6% and 27 months, respectively. Comparing tumors that extend beyond the pancreas (new T1) and those confined within the pancreas (original T1), the latter showed significantly longer median survival (43 vs. 24 months, p < 0.001). In terms of T1a/b/c, there were no significant differences in survival. Using MaxStat, subdividing into two groups using 1.1 cm as the cut-off value, yielded significantly discrete prognostic groups (p < 0.001). CONCLUSION The new T1 definition may be more practical, but the implications of the concept of "extension beyond the pancreas" should be re-investigated. Further, the subcategorization of T1a/b/c may not be adequate and may require revision or deletion.
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Affiliation(s)
- Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Taesung Park
- Department of Bioinformatics, Seoul National University College of Natural Sciences, Seoul, Korea
| | - Jin He
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ryota Higuchi
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Donghee Son
- Department of Mathematics and Statistics, Sejong University College of Natural Sciences, Seoul, Korea
| | - Seung Yeoun Lee
- Department of Mathematics and Statistics, Sejong University College of Natural Sciences, Seoul, Korea
| | - Jaeri Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Yoonhyeong Byun
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Sun-Whe Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | | | - Masakazu Yamamoto
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
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Woo W, Jeong JS, Kim DK, Lee CM, Choi SH, Suh JY, Lee SY, Harjo S, Kawasaki T. Stacking Fault Energy Analyses of Additively Manufactured Stainless Steel 316L and CrCoNi Medium Entropy Alloy Using In Situ Neutron Diffraction. Sci Rep 2020; 10:1350. [PMID: 31992801 PMCID: PMC6987211 DOI: 10.1038/s41598-020-58273-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [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: 09/11/2019] [Accepted: 01/10/2020] [Indexed: 11/08/2022] Open
Abstract
Stacking fault energies (SFE) were determined in additively manufactured (AM) stainless steel (SS 316 L) and equiatomic CrCoNi medium-entropy alloys. AM specimens were fabricated via directed energy deposition and tensile loaded at room temperature. In situ neutron diffraction was performed to obtain a number of faulting-embedded diffraction peaks simultaneously from a set of (hkl) grains during deformation. The peak profiles diffracted from imperfect crystal structures were analyzed to correlate stacking fault probabilities and mean-square lattice strains to the SFE. The result shows that averaged SFEs are 32.8 mJ/m2 for the AM SS 316 L and 15.1 mJ/m2 for the AM CrCoNi alloys. Meanwhile, during deformation, the SFE varies from 46 to 21 mJ/m2 (AM SS 316 L) and 24 to 11 mJ/m2 (AM CrCoNi) from initial to stabilized stages, respectively. The transient SFEs are attributed to the deformation activity changes from dislocation slip to twinning as straining. The twinning deformation substructure and atomic stacking faults were confirmed by electron backscatter diffraction (EBSD) and transmission electron microscopy (TEM). The significant variance of the SFE suggests the critical twinning stress as 830 ± 25 MPa for the AM SS 316 L and 790 ± 40 MPa for AM CrCoNi, respectively.
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Affiliation(s)
- W Woo
- Neutron Science Center, Korea Atomic Energy Research Institute, Daejeon, 34057, Korea.
| | - J S Jeong
- Materials Technology Development Team, Doosan heavy industries, Changwon, 44610, Korea
| | - D-K Kim
- School of Mechanical Engineering, University of Ulsan, Ulsan, 44610, Korea
| | - C M Lee
- Neutron Science Center, Korea Atomic Energy Research Institute, Daejeon, 34057, Korea
| | - S-H Choi
- Department of Printed Electronics Engineering, Sunchon National University, Sunchon, 57922, Korea
| | - J-Y Suh
- High Temperature Energy Materials Research Center, Korea Institute of Science and Technology, Seoul, 02792, Korea
| | - S Y Lee
- Department of Materials Science and Engineering, Chungnam National University, Daejeon, 34134, Korea
| | - S Harjo
- J-PARC Center, Japan Atomic Energy Agency, 2-4 Shirakata, Tokai, Naka, Ibaraki, 319-1195, Japan
| | - T Kawasaki
- J-PARC Center, Japan Atomic Energy Agency, 2-4 Shirakata, Tokai, Naka, Ibaraki, 319-1195, Japan
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Lee SY, Lee SH, Park YH. P799 The echocardiographic and clinical characteristics of Fabry patients without overt left ventricular hypertrophy but progressing despite on enzyme replacement therapy. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Fabry disease (FD) is X-linked genetic disorder caused by the deficiency or absent activity of lysosomal α- galactosidase. When the heart is involved, progressive left ventricular hypertrophy (LVH) is the key feature. Although, LVH is not present in all subjects, some of them progress with LVH despite enzyme replacement therapy (ERT). The present study aimed to evaluate the characteristics of patient of FD without overt LVH, but progresses with their left ventricular mass index (LVMI).
Method : This study includes subjects carrying genetic mutations for FD without LVH (n = 12) in a single tertiary center. ‘Decreasing LVMI group (Group1)’ was defined when pre-ERT LVMI minus last LVMI value obtained by echocardiography was positive, and when negative, defined as ‘Increasing LVMI group (Group 2)’. The baseline characteristics and echocardiographic parameters including global strain was analyzed.
Result : Total 6 patients were classified as Group 1 and 2 each. The median age at diagnosis for male was 21 vs 27 for each group, and 21 vs 31 for female. The median follow-up duration was 4.0 vs 5.7 yr. The antibody formation for replaced enzyme was 3 for Group 2 and any family member who developed overt LVH was much 1 vs 3 for group 1 vs 2. Initial 3 plane GLS was worse and showed trend to drop in Group 2.
Conclusion : In the Fabry patients get worse with their LVMI but still not developed overt LVH despite enzyme replacement therapy, there are some clinical and echo-parameter difference. These findings could suggest insufficient enzyme replacement therapy.
Group 1 (n = 6) Group 2 (n = 6) Female/Male 4/2 3/3 Age of at Dx (Female) (median) 21 28 Age of at Dx (Male) (median) 21 31 F/U duration (median) 4.0 yrs 5.7 yrs Antibody formation 0 3 Any Overt LVH family Genotype c.56T > C c.40-11T > A, 782_delG, c.658C > T Initial LVMI (Median) 98.2g/m2 70.9g/m2 Initial GLS (3P) -19 -17.8 Continuously elevated LysoGb3 2 4 Proteinuria >300mg 1 3 (1 preparing HD)
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Affiliation(s)
- S Y Lee
- Pusan National University Yangsan Hospital, Yangsan-si, Korea (Republic of)
| | - S H Lee
- Pusan National University Yangsan Hospital, Yangsan-si, Korea (Republic of)
| | - Y H Park
- Pusan National University Yangsan Hospital, Yangsan-si, Korea (Republic of)
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Wang Y, Hays RD, Marcus M, Maida CA, Shen J, Xiong D, Coulter ID, Lee SY, Spolsky VW, Crall JJ, Liu H. Developing Children's Oral Health Assessment Toolkits Using Machine Learning Algorithm. JDR Clin Trans Res 2019; 5:233-243. [PMID: 31710817 DOI: 10.1177/2380084419885612] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Evaluating children's oral health status and treatment needs is challenging. We aim to build oral health assessment toolkits to predict Children's Oral Health Status Index (COHSI) score and referral for treatment needs (RFTN) of oral health. Parent and Child toolkits consist of short-form survey items (12 for children and 8 for parents) with and without children's demographic information (7 questions) to predict the child's oral health status and need for treatment. METHODS Data were collected from 12 dental practices in Los Angeles County from 2015 to 2016. We predicted COHSI score and RFTN using random Bootstrap samples with manually introduced Gaussian noise together with machine learning algorithms, such as Extreme Gradient Boosting and Naive Bayesian algorithms (using R). The toolkits predicted the probability of treatment needs and the COHSI score with percentile (ranking). The performance of the toolkits was evaluated internally and externally by residual mean square error (RMSE), correlation, sensitivity and specificity. RESULTS The toolkits were developed based on survey responses from 545 families with children aged 2 to 17 y. The sensitivity and specificity for predicting RFTN were 93% and 49% respectively with the external data. The correlation(s) between predicted and clinically determined COHSI was 0.88 (and 0.91 for its percentile). The RMSEs of the COHSI toolkit were 4.2 for COHSI (and 1.3 for its percentile). CONCLUSIONS Survey responses from children and their parents/guardians are predictive for clinical outcomes. The toolkits can be used by oral health programs at baseline among school populations. The toolkits can also be used to quantify differences between pre- and post-dental care program implementation. The toolkits' predicted oral health scores can be used to stratify samples in oral health research. KNOWLEDGE TRANSFER STATEMENT This study creates the oral health toolkits that combine self- and proxy- reported short forms with children's demographic characteristics to predict children's oral health and treatment needs using Machine Learning algorithms. The toolkits can be used by oral health programs at baseline among school populations to quantify differences between pre and post dental care program implementation. The toolkits can also be used to stratify samples according to the treatment needs and oral health status.
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Affiliation(s)
- Y Wang
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA.,Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - R D Hays
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, CA, USA.,Department of Medicine, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,RAND Corporation, Santa Monica, CA, USA
| | - M Marcus
- Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - C A Maida
- Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,Division of Oral Biology and Medicine, School of Dentistry, University of California, Los Angeles, CA, USA
| | - J Shen
- Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - D Xiong
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA.,Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - I D Coulter
- Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,RAND Corporation, Santa Monica, CA, USA
| | - S Y Lee
- Division of Constitutive & Regenerative Sciences, Section of Restorative Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - V W Spolsky
- Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - J J Crall
- Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - H Liu
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA.,Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,Department of Medicine, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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Lee SY, Chau JPC, Choi KC, Lo SHS. Feasibility of a guided participation discharge program for very preterm infants in a neonatal intensive care unit: a randomized controlled trial. BMC Pediatr 2019; 19:402. [PMID: 31684903 PMCID: PMC6827218 DOI: 10.1186/s12887-019-1794-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 10/21/2019] [Indexed: 11/26/2022] Open
Abstract
Background Previous studies showed that parents of very preterm infants expressed feelings of incompetence and experienced high levels of stress upon the discharge of their infants. We conducted a systematic review of seven studies and observed potential benefits for parental outcomes when using discharge interventions that adopted guided participation (GP). More evidence is needed on the effective doses of discharge interventions underpinned by the principles of GP. Aim To investigate the feasibility and preliminarily estimate the effects on parental competence and stress outcomes of a newly developed, nurse-led, GP discharge program for mothers of very preterm infants. Methods A two-arm randomized controlled trial was conducted in a neonatal intensive care unit (NICU). Mothers of infants with gestational ages of ≤32 weeks who had no congenital malformations and did not need to undergo major surgeries were recruited. All mothers were the primary caregivers to their infants. The intervention group received a nurse-led GP discharge intervention (three structured 30- to 60-min GP sessions and one follow-up phone call). The control group received usual care. The parental outcomes were measured using the Parenting Sense of Competence Scale (C-PSOC) and Perceived Stress Scale (C-PSS) at baseline (T0), on the day of discharge (T1), after the follow-up phone call (within 72 h after discharge) (T2), and 1 month after discharge (T3). The outcomes were analyzed using generalized estimating equations based on intention-to-treat principles. Results Thirty infant–mother dyads were recruited. Greater improvements in the C-PSOC score were observed in the intervention group than in the control group at T1 and T2, although these differences were statistically insignificant. The intervention group exhibited greater improvements than the control group in the C-PSS scores at T1, T2, and T3, although these differences were also not statistically significant. Conclusions The findings suggest that a GP discharge intervention could improve parenting competence and stress among mothers with very preterm infants. The absence of adverse events suggests that the GP discharge intervention could be feasibly implemented in NICU settings. This feasibility study was not powered to determine the effectiveness of the intervention but is anticipated to lay the foundation for a future full-scale study. Trial registration ClinicalTrials.gov Identifier: NCT03668912. Date of registration: 13 September 2018 (retrospectively registered).
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Affiliation(s)
- S Y Lee
- Department of Pediatrics, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, N.T., Hong Kong SAR
| | - J P C Chau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR.
| | - K C Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR
| | - S H S Lo
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR
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23
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Hong D, Choi KH, Youn T, Lee SY, Bak M, M KM, Cho YH, Yang JH. P1711The association of multidisciplinary team approach with clinical outcomes in patients with acute myocardial infarction underwent veno-arterial extracorporeal membrane oxygenation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0466] [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: 11/13/2022] Open
Abstract
Abstract
Background
Multidisciplinary team approach is necessary for the management of critically-ill patients. However, limited data are available on the impact of specialized extracorporeal membrane oxygenation (ECMO) team on clinical outcomes in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock.
Objectives
This study aimed to identify whether specialized ECMO team is associated with improved in-hospital mortality in AMI patients underwent venoarterial ECMO.
Methods
A total of 255 AMI patients underwent venoarterial ECMO from May 2004 to July 2018 were enrolled. In January 2014, multidisciplinary ECMO team was founded at our institution. Eligible patients were classified into pre-ECMO team group (n=131) and post-ECMO team group (n=124). The primary outcome was in-hospital mortality.
Results
In-hospital mortality (54.2% vs. 33.9%, p=0.002) and cardiac intensive care unit mortality (45.0% vs. 25.0%, p=0.001) were significantly lower after the implantation of multidisciplinary ECMO team (pre ECMO team vs. post-ECMO team). On binary logistic regression model, the multidisciplinary ECMO team approach was associated with lower risk of in-hospital mortality (odds ratio 0.36, 95% confidence interval 0.19–0.67, p=0.001). Incidence of all-cause mortality (58.3% vs. 35.2%, p<0.001) and rehospitalization due to heart failure (28.2% vs. 6.4%, p=0.001) at 6-months follow-up were also significantly lower in the post-ECMO team group than in the pre-ECMO team group.
Clinical outcomes Variables Total (N=255) Pre-ECMO team (N=131) Post-ECMO team (N=124) P value In-hospital mortality 113 (44.3) 71 (54.2) 42 (33.9) 0.002 Cardiovascular death 90 (35.3) 59 (45.0) 31 (25.0) 0.001 Noncardiovascular death 23 (9.0) 12 (9.2) 11 (8.9) >0.99 Cardiac intensive care unit mortality 106 (41.6) 68 (51.9) 38 (30.6) 0.001 Successful weaning of ECMO 169 (66.3) 75 (57.3) 94 (75.8) 0.002 Data are presented as n (%). Abbreviations: ECMO, extracorporeal membrane oxygenation.
Incidence of death, readmission for HF
Conclusions
The multidisciplinary ECMO team approach was associated with improved clinical outcomes in AMI patients complicated by cardiogenic shock. Our data support that specialized ECMO team is indispensable to improve outcomes in patients with AMI with refractory cardiogenic shock.
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Affiliation(s)
- D Hong
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - K H Choi
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - T Youn
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - S Y Lee
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - M Bak
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - K M M
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - Y H Cho
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - J H Yang
- Samsung Medical Center, Seoul, Korea (Republic of)
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Rhee MY, Kim JH, Namgung J, Lee SY, Cho DK, Choi TY, Kim SY. P800Proposal of an algorithm for the diagnosis of hypertension by using out-of-office blood pressure measurements. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0399] [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: 11/13/2022] Open
Abstract
Abstract
Background and purpose
Based on the data of patients who measured office BP (OBP) in controlled condition, home BP (HBP), and 24-hour ambulatory BP (24hABP) for diagnosis of hypertension, we developed and validated a diagnostic algorithm for hypertension.
Methods
Patients who have high BP (≥140/90 mmHg) at the outpatient clinic were referred to measure OBP in controlled condition, HBP and 24hABP. The OBP was measured three times at each visit for 3 days in controlled condition by using a validated oscillometric device. HBP was measured for 7 days in triplicates every morning and evening. The 24hABP was measured on the 8th day. Same study protocol was used for development and validation population.
Results
In the development of algorithm, 319 patients were recruited and data of 256 patients (51.8±9.7 years, 119 men) with valid HBP and 24hABP measurements were analyzed. In the validation of algorithm, 300 patients were recruited and data of 257 patients (52.4±9.8 years, 126 men) with valid HBP and 24hABP measurements were analyzed. In the development population, the prevalence of masked hypertension was 19.5% (n=50) and most of them (n=47, 94%) was in the range of 130–139/80–89 mmHg. The BP in the range of 130–144/80–94 mmHg was defined as the grey zone of OBP, because prevalence of white-coat hypertension was lowered to 1.6% from 4.3% with threshold of 145/95 mmHg. The diagnostic sensitivity, specificity, positive and negative predictive value of OBP was improved to 97.4%, 76.5, 96.5% and 81.3% after excluding the grey zone of OBP (n=125). The diagnostic agreement between 24hABP and HBP in the grey zone of OBP was 64%. The diagnostic sensitivity, specificity, positive and negative predictive value of HBP were 88.8%, 74.7, 93.5% and 61.5% after excluding the grey zone of HBP (130–134/80–84 mmHg, n=28). Based upon these results, we developed a diagnostic algorithm for hypertension by using on out-of-office BP measurements to improved diagnostic accuracy of hypertension (Figure). In the validation population, the developed algorithm showed similar diagnostic accuracy.
Diagnostic algorithm for hypertension
Conclusion
For accurate diagnosis of hypertension, OBP measurement according to guidelines and 24hABP measurement to grey zone of OBP is preferred. To improve diagnostic accuracy of HBP measurement, 24hABP measurement to grey zone of HBP is required.
Acknowledgement/Funding
Part of this study was supported by a grand from Dong-A ST Co. Ltd., Seoul, Korea.
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Affiliation(s)
- M Y Rhee
- Dongguk University Ilsan Hospital, Goyang-si, Korea (Republic of)
| | - J H Kim
- Dongguk University Ilsan Hospital, Goyang-si, Korea (Republic of)
| | - J Namgung
- Inje University Ilsan Paik Hospital, Goyang, Korea (Republic of)
| | - S Y Lee
- Inje University Ilsan Paik Hospital, Goyang, Korea (Republic of)
| | - D K Cho
- Hospital Myongji, Goyang, Korea (Republic of)
| | - T Y Choi
- Seoul Red Cross Hospital, Seoul, Korea (Republic of)
| | - S Y Kim
- Seoul Medical Center, Seoul, Korea (Republic of)
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Sung J, Ahn KT, Cho BR, Lee SY, Kim BJ, Kim DK, Park JI, Lee WS. 1423Adherence to triple component antihypertensive regimen is higher in single-pill combination than two-pill regimen: data from a randomized controlled trial using medication event monitoring system. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Simplicity of regimen is known to be an important determinant of medication adherence and using single-pill combination (SPC) in hypertension treatment resulted in better adherence and persistence than free-equivalent combination. However, this finding has been studied only in dual-component antihypertensive treatments and in observational studies using medication possession ratio as an index of adherence. Medication event monitoring system (MEMS) is considered to be the gold standard in estimating medication adherence.
Purpose
To investigate the superiority in adherence of triple-component SPC compared to equivalent two-pill regimen using MEMS
Methods
This is a multi-center open-label randomized controlled trial. Inclusion criteria were hypertensive patients whose clinic blood pressure is not adequately controlled (systolic >140 mmHg or diastolic >90 mmHg) with combination antihypertensive regimen comprising two of three classes (angiotensin receptor blocker, calcium channel blocker and thiazide diuretics) for at least 4 weeks. Eligible patients were randomized either to single-pill (triple-component SPC, olmesartan/amlodipine/ hydrochlorothiazide 20/5/12.5 mg) or two-pill (dual-component SPC + one free pill, olmesartan/hydrochlorothiazide 20/12.5 mg + amlodipine 5 mg) groups and maintained for 12 weeks. Medications were dispensed in MEMS. Primary outcomes were the difference of percentage of dose taken (PDT) and percentage of days with prescribed dose taken correctly (PDTc) between single- and two-pill therapy, calculated from MEMS data.
Results
From 8 hospitals, 146 hypertensive patients were randomized into single- and two-pill groups. Final analysis was done in 65 and 66 patients in each group from which adherence index could be obtained. Baseline clinical characteristics of the two groups were not different. The single-pill group had significantly higher PDT and PDTc compared to the two-pill group. (median (25–75 percentile) (%), PDT 95.1 (87.9 - 100.0) vs 91.2 (79.8 - 96.5); PDTc 93.1 (79.8 - 96.5) vs 91.3 (70.7 - 96.4), p = both 0.04, by Wilcoxon rank sum test)
Percent dose taken
Conclusion
Single-pill combination of triple-component antihypertensive regimen showed superior adherence compared to equivalent two-pill therapy. Reducing pill burden by using SPC is a relevant strategy to enhance the adherence to multi-drug antihypertensive therapy.
Acknowledgement/Funding
Daiichi-Sankyo
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Affiliation(s)
- J Sung
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (Republic of)
| | - K T Ahn
- Chungnam National University Hospital, Daejeon, Korea (Republic of)
| | - B R Cho
- Kangwon National University Hospital, Chooncheon, Korea (Republic of)
| | - S Y Lee
- Ilsan Paik Hospital, Goyang, Korea (Republic of)
| | - B J Kim
- Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea (Republic of)
| | - D K Kim
- Busan Paik Hospital, Busan, Korea (Republic of)
| | - J I Park
- VHS Medical Center, Seoul, Korea (Republic of)
| | - W S Lee
- Chung-Ang University Hospital, Seoul, Korea (Republic of)
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Marcus M, Maida CA, Wang Y, Xiong D, Hays RD, Coulter ID, Lee SY, Spolsky VW, Shen J, Crall JJ, Liu H. Child and Parent Demographic Characteristics and Oral Health Perceptions Associated with Clinically Measured Oral Health. JDR Clin Trans Res 2019; 3:302-313. [PMID: 30938594 DOI: 10.1177/2380084418774549] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine child and parent reports about the child's oral health and assess the associations of these reports with clinical assessments of oral health status by dental examiners. METHODS Surveys with 139 items for children and 133 items for parents were administered by Audio Computer-Assisted Self-Interview Software. In addition, the Children's Oral Health Status Index (COHSI) was computed from a dental examination. RESULTS A total of 334 families with children ages 8 to 17 y participated at 12 dental practices in Los Angeles County. Ordinary least squares regression models were estimated separately for child and parent surveys to identify items uniquely associated with the COHSI. Ten of 139 items the children reported regarding their oral health were associated with the COHSI. The strongest associations were found for child's age, aesthetic factors (straight teeth and pleased with teeth), and cognitive factors related to perception of dental appearance (pleased/happy with the look of the child's mouth, teeth, and jaws). Nine of 133 parent items about the child's oral health were associated with the COHSI in the parent model, notably being a single parent, parent's gender, parent born in the United States, pleased or happy with the look of their child's teeth, and accessing the Internet. CONCLUSION These child and parent survey items have potential to be used to assess oral health status for groups of children in programs and practices in lieu of dental screenings. KNOWLEDGE TRANSLATION STATEMENT The paper's results inform the development of a toolkit that can be used by schools, public health agencies, and dental programs to identify children with low oral health status based on parents' and children's responses to survey items across demographic, physical, mental, and social domains. These survey items can be used to inform parents of the desirability of proactively addressing inadequacies in their child's oral health status, enabling them to more rationally address dental needs.
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Affiliation(s)
- M Marcus
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - C A Maida
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,2 Division of Oral Biology and Medicine, School of Dentistry, University of California, Los Angeles, CA, USA
| | - Y Wang
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,3 Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - D Xiong
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,3 Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - R D Hays
- 4 Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, CA, USA.,5 Department of Medicine, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,6 RAND Corporation, Santa Monica, CA, USA
| | - I D Coulter
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,6 RAND Corporation, Santa Monica, CA, USA
| | - S Y Lee
- 7 Division of Constitutive & Regenerative Sciences, Section of Restorative Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - V W Spolsky
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - J Shen
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - J J Crall
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - H Liu
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,3 Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA.,5 Department of Medicine, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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Kim K, Jeong Y, Shin KH, Kim JH, Ahn SD, Kim SS, Suh CO, Kim YB, Choi DH, Park W, Cha J, Chun M, Lee DS, Lee SY, Kim JH, Park HJ. Abstract P3-12-12: Impact of regional nodal irradiation for breast cancer patients with supraclavicular and/or internal mammary lymph node involvement: A multicenter, retrospective study (KROG 16-14). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-12-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: To evaluate the treatment outcomes of radiotherapy (RT) for breast cancer with ipsilateral supraclavicular (SCL) and/or internal mammary (IMN) lymph node involvement.
Methods: A total of 353 patients from 11 institutions were included. One hundred and thirty-six patients had SCL involvement, 148 had IMN involvement, and 69 had both. All patients received neoadjvant systemic therapy followed by breast conserving surgery or mastectomy, and postoperative RT to whole breast/chest wall. As for regional lymph node irradiation, SCL RT was given to 344 patients, and IMN RT to 236 patients. The median RT dose was 50.4 Gy.
Results: The median follow-up duration was 61 months (range, 7-173). In-field progression was present in SCL (n=20) and/or IMN (n=7). The 5-year disease-free survival (DFS) and overall survival rates were 57.8% and 75.1%, respectively. On multivariate analysis, both SCL/IMN involvement, number of axillary lymph node ≥4, triple negative subtype, and mastectomy were significant adverse prognosticators for DFS (p = 0.022, 0.001, 0.001, and 0.004, respectively). Regarding the impact of regional nodal irradiation, SCL RT dose ≥54 Gy was not associated with DFS (5-yr rate, 52.9% vs. 50.9%, p = 0.696) in SCL-involved patients, and the receipt of IMN RT was not associated with DFS (5-yr rate, 56.1% vs. 78.1%, p = 0.099) in IMN-involved patients.
Conclusion: Neoadjuvant chemotherapy followed by surgery and postoperative RT achieved an acceptable in-field regional control rate in patients with SCL and/or IMN involvement. However, a higher RT dose to SCL or IMN RT was not associated with the improved DFS in these patients.
Citation Format: Kim K, Jeong Y, Shin KH, Kim JH, Ahn SD, Kim SS, Suh C-O, Kim YB, Choi DH, Park W, Cha J, Chun M, Lee DS, Lee SY, Kim JH, Park HJ. Impact of regional nodal irradiation for breast cancer patients with supraclavicular and/or internal mammary lymph node involvement: A multicenter, retrospective study (KROG 16-14) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-12-12.
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Affiliation(s)
- K Kim
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - Y Jeong
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - KH Shin
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - JH Kim
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - SD Ahn
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - SS Kim
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - C-O Suh
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - YB Kim
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - DH Choi
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - W Park
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - J Cha
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - M Chun
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - DS Lee
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - SY Lee
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - JH Kim
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - HJ Park
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, 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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29
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Critchley LAH, Ho AMH, Ho M, Lee SY. Right Upper Lobe Collapse Secondary to an Anomalous Bronchus after Endotracheal Intubation for Routine Surgery. Anaesth Intensive Care 2019; 35:274-7. [PMID: 17444320 DOI: 10.1177/0310057x0703500219] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Perioperative hypoxaemia is a common but serious problem with well recognised causes. However, an anomalous bronchus causing lobar collapse as a cause is seldom mentioned. A healthy young male patient was anaesthetised for a knee operation. He required reintubation immediately postoperatively for hypoxia. He was found to have right upper lobe collapse. Fibreoptic examination of the trachea demonstrated an anomalous bronchus as the cause. Intra-operatively, the endotracheal tube had been inserted too deeply and the bronchial orifice had been obstructed by the tip. It took several hours for the lung to re-expand. Greater awareness of this potential complication is needed.
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Affiliation(s)
- L A H Critchley
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
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30
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Kwon W, He J, Higuchi R, Son D, Lee SY, Kim J, Kim H, Kim SW, Wolfgang CL, Cameron JL, Yamamoto M, Jang JY. Multinational validation of the American Joint Committee on Cancer 8th edition pancreatic cancer staging system in a pancreas head cancer cohort. J Hepatobiliary Pancreat Sci 2019; 25:418-427. [PMID: 30118171 DOI: 10.1002/jhbp.577] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The aim of the present study was to compare the 7th and 8th editions of the American Joint Committee on Cancer (AJCC) staging system for pancreas head cancer and to validate the 8th edition using three multinational tertiary center data. METHODS Data of 2,864 patients with pancreas head cancer were collected from Korea (571), Japan (824), and the USA (1,469). Survival analysis was performed to compare the 7th and 8th editions. Validation was performed by log-rank tests and test for trend repeated 1,000 times with random sets. RESULTS In the 7th edition, 4.1%, 3.1%, 18.6%, 67.5%, 3.6%, and 3.1% were stage IA, IB, IIA, IIB, III, and IV. In the 8th edition, 8.8%, 13.9%, 3.1%, 38.2%, 32.9%, and 3.1% were stage IA, IB, IIA, IIB, III, and IV, respectively. The change in T category downstaged 459 patients from IIA to the new IA and IB. The new N2 category upstaged 856 patients from the former IIB to III. The 7th edition reversely stratified IA and IB. The 8th edition corrected this mis-stratification of the 7th edition, but lacked discriminatory power between IB and IIA (P = 0.271). Validation using the log-rank showed that the 8th edition provided better discrimination in 6.387 test sets among 10 tests. The test for trend validated the 8th edition to stratify stages in correct order more often (7.815/10). CONCLUSION The 8th edition provides more even distribution with more powerful discrimination compared to the 7th edition.
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Affiliation(s)
- Wooil Kwon
- Department of Surgery, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jin He
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ryota Higuchi
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Donghee Son
- Department of Mathematics and Statistics, Sejong University College of Natural Sciences, Seoul, Korea
| | - Seung Yeoun Lee
- Department of Mathematics and Statistics, Sejong University College of Natural Sciences, Seoul, Korea
| | - Jaeri Kim
- Department of Surgery, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Sun-Whe Kim
- Department of Surgery, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | | | - John L Cameron
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Masakazu Yamamoto
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Jin-Young Jang
- Department of Surgery, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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31
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Lee JR, Lin EP, Hofacer RD, Upton B, Lee SY, Ewing L, Joseph B, Loepke AW. Alternative technique or mitigating strategy for sevoflurane-induced neurodegeneration: a randomized controlled dose-escalation study of dexmedetomidine in neonatal rats. Br J Anaesth 2019; 119:492-505. [PMID: 28969315 DOI: 10.1093/bja/aex219] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2017] [Indexed: 12/26/2022] Open
Abstract
Background Brain injury in newborn animals from prolonged anaesthetic exposure has raised concerns for millions of children undergoing anaesthesia every yr. Alternative anaesthetic techniques or mitigating strategies are urgently needed to ameliorate potentially harmful effects. We tested dexmedetomidine, both as a single agent alternative technique and as a mitigating adjuvant for sevoflurane anaesthesia. Methods Neonatal rats were randomized to three injections of dexmedetomidine (5, 25, 50, or 100 µg kg -1 every 2 h), or 6 h of 2.5% sevoflurane as a single agent without or with dexmedetomidine (1, 5, 10, or 20 µg kg -1 every 2 h). Heart rate, oxygen saturation, level of consciousness, and response to pain were assessed. Cell death was quantified in several brain regions. Results Dexmedetomidine provided lower levels of sedation and pain control than sevoflurane. Exposure to either sevoflurane or dexmedetomidine alone did not cause mortality, but the combination of 2.5% sevoflurane and dexmedetomidine in doses exceeding 1 µg kg -1 did. Sevoflurane increased apoptosis in all brain regions; supplementation with dexmedetomidine exacerbated neuronal injury, potentially as a result of ventilatory or haemodynamic compromise. Dexmedetomidine by itself increased apoptosis only in CA2/3 and the ventral posterior nucleus, but not in prefrontal cortex, retrosplenial cortex, somatosensory cortex, subiculum, lateral dorsal thalamic nucleaus, or hippocampal CA1. Conclusions We confirm previous findings of sevoflurane-induced neuronal injury. Dexmedetomidine, even in the highest dose, did not cause similar injury, but provided lesser degrees of anaesthesia and pain control. No mitigation of sevoflurane-induced injury was observed with dexmedetomidine supplementation, suggesting that future studies should focus on anaesthetic-sparing effects of dexmedetomidine, rather than injury-preventing effects.
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Affiliation(s)
- J-R Lee
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul 120-752, Korea
| | - E P Lin
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - R D Hofacer
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Program in Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - B Upton
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Medical Scientist Training Program, University of Cincinnati, Cincinnati, OH, USA
| | - S Y Lee
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - L Ewing
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - B Joseph
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - A W Loepke
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Program in Neuroscience, University of Cincinnati, Cincinnati, OH, USA.,Departments of Anesthesiology and Pediatrics, University of Cincinnati, Cincinnati, OH, USA.,Department of Anesthesiology and Critical Care Medicine, Division of Cardiac Anesthesiology, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Lim SK, Beom J, Lee SY, Lim JY. Functional Outcomes of Fragility Fracture Integrated Rehabilitation Management in Sarcopenic Patients after Hip Fracture Surgery and Predictors of Independent Ambulation. J Nutr Health Aging 2019; 23:1034-1042. [PMID: 31781735 DOI: 10.1007/s12603-019-1289-4] [Citation(s) in RCA: 5] [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] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To compare the changes in the functional level of patients with versus without sarcopenia who received by fragility fracture integrated rehabilitation management (FIRM) after hip fracture (HF) surgery over a 6-month follow-up period and to identify variables influencing independent ambulation (IA) at 6 months after HF. DESIGN Prospective observational study. SETTING Three in-hospital rehabilitation setting. PARTICIPANTS Patients older than 65 years of age (N=80) categorized by the presence of sarcopenia. INTERVENTION The FIRM program during the-2 week hospital stay after surgery. MEASUREMENTS Main outcomes for ambulatory function (Koval score, Functional Ambulatory Category) and other secondary outcomes were measured at rehabilitation admission, at discharge, at 3 months and 6 months after surgery. Other secondary outcomes were measured. The possibility of IA at 6 months after surgery were also investigated. RESULTS Sarcopenia and non-sarcopenia patients did not differ significantly in terms of changes in ambulation or other functions over a 6-month follow-up (p < 0.001 or p = 0.001). The two groups did not differ significantly in terms of final functional status (6 months). The IA ratios of the two groups did not significantly differ at 6 months after surgery (sarcopenia [54.3%] and non-sarcopenia [64.5%]). IA before fracture (p = 0.039) and age (≥80 years) (p = 0.03) were independent predictors and sarcopenia was not a predictor for the possibility of IA at 6-months after surgery. CONCLUSIONS The FIRM program was effective for promoting functional recovery in older patients with fragility HF, either with or without sarcopenia. The present findings provide evidence of the pressing need for integrated rehabilitation management in fragility fracture care to improve functional recovery in patients with sarcopenia.
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Affiliation(s)
- S-K Lim
- Jae-Young Lim, MD, PhD. Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Rep. of Korea 13620, Telephone: 82- 031-787-7732, Fax: 82-031-787-4051, E-mail:
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Kim J, Kim SW, Lee SY, Kim TH, Jung JH. Bone mineral density in osteoporotic patients with pyogenic vertebral osteomyelitis: effect of early versus late treatment for osteoporosis. Osteoporos Int 2018; 29:2761-2770. [PMID: 30225674 DOI: 10.1007/s00198-018-4695-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 09/03/2018] [Indexed: 12/19/2022]
Abstract
UNLABELLED Patients with pyogenic vertebral osteomyelitis (PVO) are at greater risk of bone loss. However, treatment guidelines for bone loss have been lacking. Early bisphosphonate treatment within 6 weeks after PVO diagnosis was significantly associated with superior outcome in femoral BMD at 2-year follow-up, compared to that with late treatment. INTRODUCTION Due to absence of concern and proper guidelines, management of bone loss or osteoporosis in PVO is often neglected or delayed. A retrospective cohort study was planned to investigate differences in bone mineral density (BMD) in PVO patients with osteoporosis according to the timing of osteoporosis treatment. METHODS The PVO cohort consisted of 192 patients with osteoporosis who visited our institution between January 2003 and March 2015 and received bisphosphonate treatment for osteoporosis. According to the interval between PVO diagnosis and initiation of bisphosphonate, the patients were divided into three groups: group A (within 6 weeks after PVO diagnosis), group B (between 6 weeks and 3 months after diagnosis), and group C (more than 3 months after PVO diagnosis). RESULTS The percent increase in total femoral BMD in group A was significantly larger than that in group B at 2-year follow-up (p = 0.036). Similarly, the percent increase in trochanteric (p = 0.008) and total femoral (p = 0009) BMD in group A was significantly larger than that in group C at 2-year follow-up. Even after multivariate adjustment, total femoral BMD changes were significantly associated with the treatment group. Group B (odds ratio = 2.824, p = 0.013) and group C (odds ratio = 3.591, p = 0.001) were more significantly associated with total femoral BMD decreases at 2-year follow-up compared with group A. CONCLUSIONS Early bisphosphonate treatment within 6 weeks after PVO diagnosis (group A) was significantly associated with superior outcome in femoral BMD at 2-year follow-up, compared to that with late treatment (groups B and C).
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Affiliation(s)
- J Kim
- Division of Infection, Department of Pediatrics, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - S W Kim
- Spine Center, Department of Orthopedics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - S Y Lee
- Spine Center, Department of Orthopedics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - T-H Kim
- Spine Center, Department of Orthopedics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.
| | - J-H Jung
- Spine Center, Department of Orthopedics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
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Bak Y, Jang HJ, Shin JW, Kim SJ, Chun HW, Seo JH, No SH, Chae JI, Son DH, Lee SY, Hong J, Yoon DY. Alternative Carcinogenicity Screening Assay Using Colon Cancer Stem Cells: A Quantitative PCR (qPCR)-Based Prediction System for Colon Carcinogenesis. J Microbiol Biotechnol 2018. [PMID: 29539880 DOI: 10.4014/jmb.1712.12043] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The carcinogenicity of chemicals in the environment is a major concern. Recently, numerous studies have attempted to develop methods for predicting carcinogenicity, including rodent and cell-based approaches. However, rodent carcinogenicity tests for evaluating the carcinogenic potential of a chemical to humans are time-consuming and costly. This study focused on the development of an alternative method for predicting carcinogenicity using quantitative PCR (qPCR) and colon cancer stem cells. A toxicogenomic method, mRNA profiling, is useful for predicting carcinogenicity. Using microarray analysis, we optimized 16 predictive gene sets from five carcinogens (azoxymethane, 3,2'-dimethyl-4-aminobiphenyl, N-ethyl-n-nitrosourea, metronidazole, 4-(n-methyl-n-nitrosamino)-1-(3-pyridyl)-1-butanone) used to treat colon cancer stem cell samples. The 16 genes were evaluated by qPCR using 23 positive and negative carcinogens in colon cancer stem cells. Among them, six genes could differentiate between positive and negative carcinogens with a p-value of < or =0.05. Our qPCR-based prediction system for colon carcinogenesis using colon cancer stem cells is cost- and time-efficient. Thus, this qPCR-based prediction system is an alternative to in vivo carcinogenicity screening assays.
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Affiliation(s)
- Yesol Bak
- Department of Bioscience and Biotechnology, Konkuk University, Seoul 05209, Republic of Korea
| | - Hui-Joo Jang
- Department of Bioscience and Biotechnology, Konkuk University, Seoul 05209, Republic of Korea
| | - Jong-Woon Shin
- Department of Bioscience and Biotechnology, Konkuk University, Seoul 05209, Republic of Korea
| | - Soo-Jin Kim
- Department of Bioscience and Biotechnology, Konkuk University, Seoul 05209, Republic of Korea
| | - Hyun Woo Chun
- Department of Bioscience and Biotechnology, Konkuk University, Seoul 05209, Republic of Korea
| | - Ji-Hye Seo
- Department of Dental Pharmacology, School of Dentistry and Institute of Oral Bioscience, BK21 Plus, Chonbuk National University, Jeonju 54896, Republic of Korea
| | - Su-Hyun No
- Department of Dental Pharmacology, School of Dentistry and Institute of Oral Bioscience, BK21 Plus, Chonbuk National University, Jeonju 54896, Republic of Korea
| | - Jung-Il Chae
- Department of Dental Pharmacology, School of Dentistry and Institute of Oral Bioscience, BK21 Plus, Chonbuk National University, Jeonju 54896, Republic of Korea
| | - Dong Hee Son
- Department of Applied Statistics, College of Natural Sciences, Sejong University, Seoul 05209, Republic of Korea
| | - Seung Yeoun Lee
- Department of Applied Statistics, College of Natural Sciences, Sejong University, Seoul 05209, Republic of Korea
| | - Jintae Hong
- College of Pharmacy and Medical Research Center, Chungbuk National University, Cheongju 28644, Republic of Korea
| | - Do-Young Yoon
- Department of Bioscience and Biotechnology, Konkuk University, Seoul 05209, Republic of Korea
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Tan EK, Goh BKP, Lee SY, Krishnamoorthy TL, Tan CK, Jeyaraj PR. Liver Transplant Waitlist Outcomes and the Allocation of Hepatocellular Carcinoma Model for End-Stage Liver Disease Exception Points at a Low-Volume Center. Transplant Proc 2018; 50:3564-3570. [PMID: 30577239 DOI: 10.1016/j.transproceed.2018.08.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 08/29/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Organ scarcity continues to be the main problem limiting the number of liver transplants performed. Outcomes of patients waitlisted for an organ in an Asian country with low organ donation rate have not been well evaluated. Our current policy of allocating 15 exception points to patients with hepatocellular carcinoma (HCC) to render them competitive for a transplant also requires review. METHODS The waiting list registry and the organ transplant registry of a single institution in Asia were reviewed from December 2005 to June 2016 for all patients who underwent liver transplantation. Patient characteristics and outcomes of waitlist dropouts were evaluated. Statistical analyses were performed using SPSS version 20.0. RESULTS One hundred seventy-three patients were waitlisted for a deceased donor liver-only transplant. The most common etiology of liver disease was hepatitis B, followed by cholestatic diseases. Approximately half of the patients had HCC (45.6%). Priority listing for transplant comprised 15.6% of cases. Median Model for End-Stage Liver Disease (MELD) at listing was 15, and median waiting time to transplant was 17 weeks (interquartile range = 6.5-43.5). Overall, 89 (51.4%) patients underwent liver transplantation and 68 (39.3%) dropped out. For patients with HCC, the most common cause of dropout was progression beyond University of California San Francisco transplant criteria (62.5%). The cumulative incidence of dropout at 3 months among patients with HCC who received exception MELD scores was 11%. This was higher than those listed with physiologic MELD of 14-16 points (7%) but lower than those with 17-19 points (16%). CONCLUSIONS Hepatitis B-related liver disease and HCC comprise the majority of patients listed for liver transplant. Dropout rates are high and this is due to the lack of donor organs. The current policy of allocating 15 exception MELD points to patients with HCC within transplant criteria may underestimate the dropout risk of patients with HCC in our population.
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Affiliation(s)
- E K Tan
- Department of Hepato-pancreato-biliary and Transplant Surgery, Singapore General Hospital, Bukit Merah, Singapore.
| | - B K P Goh
- Department of Hepato-pancreato-biliary and Transplant Surgery, Singapore General Hospital, Bukit Merah, Singapore
| | - S Y Lee
- Department of Hepato-pancreato-biliary and Transplant Surgery, Singapore General Hospital, Bukit Merah, Singapore
| | - T L Krishnamoorthy
- Department of Gastroenterology & Hepatology, Singapore General Hospital, Bukit Merah, Singapore
| | - C K Tan
- Department of Gastroenterology & Hepatology, Singapore General Hospital, Bukit Merah, Singapore
| | - P R Jeyaraj
- Department of Hepato-pancreato-biliary and Transplant Surgery, Singapore General Hospital, Bukit Merah, Singapore
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Hwang KW, Choi JH, Jung SM, Kim YS, Lee SY, Chon MK, Lee SH, Kim JS, Park YH, Kim JH, Chun KJ, Je HG, Lee SK, Choi HO. P1520Defining the blanking period after maze procedure for atrial fibrillation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K W Hwang
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - J H Choi
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - S M Jung
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - Y S Kim
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - S Y Lee
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - M K Chon
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - S H Lee
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - J S Kim
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - Y H Park
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - J H Kim
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - K J Chun
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - H G Je
- Pusan National University Yangsan Hospital, Department of Cardiovascular and Thoracic Surgery, Yansan, Korea Republic of
| | - S K Lee
- Pusan National University Yangsan Hospital, Department of Cardiovascular and Thoracic Surgery, Yansan, Korea Republic of
| | - H O Choi
- Soonchunhyang University Hospital, Cardiology, Bucheon, Korea Republic of
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Kim YS, Hwang KW, Choi HO, Jung SM, Choi JH, Lee SY, Chun MK, Lee SH, Kim JS, Je HG, Park YH, Kim JH, Lee SK, Chun KJ. P4815Incidence of incomplete surgical left atrial appendage closure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Y S Kim
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - K W Hwang
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - H O Choi
- Soonchunhyang University Hospital, Department of internal medicine, Bucheon, Korea Republic of
| | - S M Jung
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - J H Choi
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - S Y Lee
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - M K Chun
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - S H Lee
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - J S Kim
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - H G Je
- Pusan National University, Department of Cardiovascular and Thoracic Surgery, Yangsan, Korea Republic of
| | - Y H Park
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - J H Kim
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - S K Lee
- Pusan National University, Department of Cardiovascular and Thoracic Surgery, Yangsan, Korea Republic of
| | - K J Chun
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
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Lee SY, Jeon KH, Kim MJ, Kim JB, Jang HJ, Kim JS, Lee HJ, Kim TH, Park JS, Choi YJ, Lee MM, Choi RK. P4660The impact of complication of extracorporeal life support for acute myocardial infarction with refractory cardiogenic shock or cardiac arrest. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Y Lee
- Sejong General Hospital, Department of Cardiology, Bucheon, Korea Republic of
| | - K H Jeon
- Sejong General Hospital, Department of Cardiology, Bucheon, Korea Republic of
| | - M J Kim
- Sejong General Hospital, Department of Cardiology, Bucheon, Korea Republic of
| | - J B Kim
- Sejong General Hospital, Department of Cardiology, Bucheon, Korea Republic of
| | - H J Jang
- Sejong General Hospital, Department of Cardiology, Bucheon, Korea Republic of
| | - J S Kim
- Sejong General Hospital, Department of Cardiology, Bucheon, Korea Republic of
| | - H J Lee
- Sejong General Hospital, Department of Cardiology, Bucheon, Korea Republic of
| | - T H Kim
- Sejong General Hospital, Department of Cardiology, Bucheon, Korea Republic of
| | - J S Park
- Sejong General Hospital, Department of Cardiology, Bucheon, Korea Republic of
| | - Y J Choi
- Sejong General Hospital, Department of Cardiology, Bucheon, Korea Republic of
| | - M M Lee
- Sejong General Hospital, Department of Cardiology, Bucheon, Korea Republic of
| | - R K Choi
- Sejong General Hospital, Department of Cardiology, Bucheon, Korea Republic of
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Kim DH, Park SW, Lee SY, Park JS. P6648Right ventricular septal pacing with narrow QRS less than 125ms is beneficial for preventing pacing induced cardiomyopathy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- D H Kim
- Sejong General Hospital, Arrhythmia division, Cardiology department, Bucheon, Korea Republic of
| | - S W Park
- Sejong General Hospital, Arrhythmia division, Cardiology department, Bucheon, Korea Republic of
| | - S Y Lee
- Sejong General Hospital, Arrhythmia division, Cardiology department, Bucheon, Korea Republic of
| | - J S Park
- Sejong General Hospital, Arrhythmia division, Cardiology department, Bucheon, Korea Republic of
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Chen H, Au KM, Hsu KE, Lai CK, Myint J, Mak YF, Lee SY, Wong TY, Tsang NC. Multidrug-resistant organism carriage among residents from residential care homes for the elderly in Hong Kong: a prevalence survey with stratified cluster sampling. Hong Kong Med J 2018; 24:350-360. [PMID: 30065121 DOI: 10.12809/hkmj176949] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION A point prevalence survey was conducted to study the epidemiology of and risk factors associated with multidrug-resistant organism carriage among residents in residential care homes for the elderly (RCHEs). METHODS A total of 20 RCHEs in Hong Kong were selected by stratified single-stage cluster sampling. All consenting residents aged ≥65 years from the selected RCHEs were surveyed by collection of nasal swab, axillary swab, rectal swab or stool on one single day for each home. Specimens were cultured and analysed for methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant Acinetobacter (MDRA, defined as concomitant resistant to fluoroquinolones, carbapenems, aminoglycosides, cephalosporins and beta-lactam with or without beta-lactamase inhibitors), vancomycin-resistant Enterococcus (VRE), and carbapenemase-producing Enterobacteriaceae (CPE). One third of the MRSA-positive samples were selected at random for molecular typing; all positive MDRA, VRE and CPE samples were tested for molecular typing. Demographic and health information of residents including medical history, history of hospitalisation, antimicrobial usage, and use of indwelling catheters were collected to determine any associated risk factors. RESULTS Samples of 1028 residents from 20 RCHEs were collected. Prevalence of MRSA was estimated as 30.1% (95% confidence interval [CI]=25.1%-35.6%) and MDRA 0.6% (95% CI=0.1%-4.1%). No residents carried VRE nor CPE. Residents living in privately run RCHEs were associated with MRSA carriage. Non-Chinese residents were associated with MRSA carriage with borderline significance. CONCLUSIONS This survey provided information about multidrug-resistant organism carriage among RCHE residents. This information will enable us to formulate targeted surveillance and control strategies for multidrug-resistant organisms.
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Affiliation(s)
- H Chen
- Infection Control Branch, Centre for Health Protection, Department of Health, Hong Kong
| | - K M Au
- Infection Control Branch, Centre for Health Protection, Department of Health, Hong Kong
| | - K E Hsu
- Infection Control Branch, Centre for Health Protection, Department of Health, Hong Kong
| | - C K Lai
- Department of Pathology, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - J Myint
- Department of Rehabilitation, Kowloon Hospital, Homantin, Hong Kong
| | - Y F Mak
- Department of Medicine, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - S Y Lee
- Infection Control Team, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - T Y Wong
- Infection Control Team, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - N C Tsang
- Department of Pathology, Queen Elizabeth Hospital, Jordan, Hong Kong
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Choi DW, Park JH, Lee SY, An SH. Effect of hypothermia treatment on gentamicin pharmacokinetics in neonates with hypoxic-ischaemic encephalopathy: A systematic review and meta-analysis. J Clin Pharm Ther 2018; 43:484-492. [PMID: 29781085 DOI: 10.1111/jcpt.12711] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 04/16/2018] [Indexed: 12/22/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Hypothermia is the current standard therapy for asphyxiated neonates with hypoxic-ischaemic encephalopathy (HIE). Gentamicin is used for the empirical treatment of early-onset neonatal sepsis. We investigated the influence of hypothermia treatment on gentamicin pharmacokinetics and suggested the appropriate dosing recommendations for gentamicin in neonates with HIE receiving hypothermia treatment. METHODS We searched studies published until February 2017 in MEDLINE using PubMed, EMBASE and the Cochrane Library. Three independent reviewers screened the literature and extracted data from each study. All of the studies that reported the blood concentrations or pharmacokinetic parameters of gentamicin in hypothermic neonates with HIE were included in this review. Articles were excluded if they were not original research. RESULT AND DISCUSSION A total of 8 observational studies met the inclusion criteria. Meta-analyses were performed in which the mean difference of gentamicin for the trough concentration and clearance between hypothermic and normothermic neonates were 0.81 mg/L (95% confidence interval [-0.07, 1.69]) and -0.21 mL/kg/min (95% confidence interval [-0.31, -0.12]), respectively. The factors affecting gentamicin clearance in hypothermic neonates with HIE were gestational age, birthweight and serum creatinine. WHAT IS NEW AND CONCLUSION Gentamicin clearance is decreased in neonates with HIE receiving hypothermia treatment compared to those not receiving hypothermia treatment. Modified gentamicin dosing regimens are required to avoid potential toxicity related to higher concentrations during hypothermia treatment.
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Affiliation(s)
- D W Choi
- College of Pharmacy, Wonkwang University, Iksan, Korea
| | - J H Park
- College of Pharmacy, Wonkwang University, Iksan, Korea
| | - S Y Lee
- College of Pharmacy, Wonkwang University, Iksan, Korea
| | - S H An
- College of Pharmacy, Wonkwang University, Iksan, Korea
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Abstract
OBJECTIVES To examine how Twitter is used as a place where people seek others to make suicide pacts. STUDY DESIGN This is an exploratory quantitative study. METHODS We used Twitter application programming interfaces to collect all Korean tweets containing the term 'suicide pact' between October 16, 2017 and November 30, 2017. A Python program and human coders were employed to further identify tweets that aimed to seek others to make a suicide pact and analyze the content of each tweet. Poisson regression analysis was used to examine the characteristics of the tweets that attracted more replies. RESULTS During the data collection period comprising 43 days, 1702 tweets posted by 551 users were aimed to find others to make suicide pacts. Many of the tweets contained detailed information such as the name of city, gender and age of the user, preferred contact method, and preferred gender of a partner. The number of replies to a tweet seeking a suicide pact varied according to the types of the information contained in the tweet. CONCLUSIONS The results of this study indicate that Twitter might be an attractive place where people try to meet others to make a suicide pact. Thus, the government should try to prevent cases of suicides caused by suicide pacts made via Twitter.
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Affiliation(s)
- S Y Lee
- Department of Communication, Yonsei University, 50 Yonsei-ro, Billingsley Hall #109, Seodaemun-gu, Seoul, 03722, South Korea.
| | - Y Kwon
- BK21plus Research Team, Graduate School of Communication & Arts, Yonsei University, 50 Yonsei-ro, Bilingsley Hall #208, Seodaemun-gu, Seoul, South Korea.
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Lian YK, Hsieh AMC, Tsai MS, Jiang HR, Yen CY, Hsia YJ, Lee SY. Treatment efficiency and stability of skeletal Class III malocclusion with a surgery-first approach. Orthod Craniofac Res 2018; 21:90-95. [PMID: 29493904 DOI: 10.1111/ocr.12221] [Citation(s) in RCA: 4] [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] [Accepted: 01/30/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To compare treatment duration in skeletal Class III malocclusion patients managed with a 2-step treatment (surgery-first approach, SFA) and conventional 3-step treatment, and to compare stability of surgical outcomes between segmentation and non-segmentation in the 2-step treatment group. SETTING AND SAMPLE POPULATION The sample population consisted of 37 patients who completed orthognathic surgery (OGS) and orthodontic correction at the Charm Aesthetic Surgery Clinic (Taipei, Taiwan) between 2012 and 2015. Of these, 26 received 2-step treatment and 11 received 3-step treatment. MATERIALS AND METHODS To compare treatment efficiency and stability, three time points were analysed: T0 , before treatment (before OGS in the 2-step group and before orthodontic treatment in the 3-step group); T1 , after OGS but before orthodontic correction (cone beam computed tomography (CBCT) was obtained within 2 weeks of OGS); and T2 , after orthodontic correction (CBCT was obtained on the day of bracket removal). The post-OGS (T1 ) CBCT items were individually superimposed on the pre-treatment (T0 ) CBCT items to determine the distance of B point migration. RESULTS A significant difference was found in treatment times between 2-step treatment and conventional 3-step treatment. In addition, no significant difference was found when comparing B-X (mm) and B-Y (mm) at T2 -T1 for the segmentation and non-segmentation groups. CONCLUSIONS Using SFA for skeletal Class III malocclusions saves approximately 6 months of treatment time over 3-step treatment; the stability of the segmentation group was comparable to that of the non-segmentation group, a result that is possibly associated with the fixation of 2 miniplates.
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Affiliation(s)
- Y K Lian
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Orthodontics, Department of Dentistry, Wan-Fang Medical Center, Taipei, Taiwan
| | - A M C Hsieh
- Charm Aesthetic Surgery Clinic, Taipei, Taiwan
| | - M S Tsai
- Division of Orthodontics, Department of Dentistry, Wan-Fang Medical Center, Taipei, Taiwan.,Charm Aesthetic Surgery Clinic, Taipei, Taiwan
| | - H R Jiang
- Division of Orthodontics, Department of Dentistry, Wan-Fang Medical Center, Taipei, Taiwan.,Charm Aesthetic Surgery Clinic, Taipei, Taiwan
| | - C Y Yen
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Dentistry, National Defense Medical Center, Taipei, Taiwan.,Oral and Maxillofacial Surgery Section, Chi Mei Medical Center, Tainan, Taiwan
| | - Y J Hsia
- Department of Dentistry, National Defense Medical Center, Taipei, Taiwan.,Oral and Maxillofacial Surgery Section, Tzu Chi Hospital, Taipei, Taiwan
| | - S Y Lee
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Orthodontics, Department of Dentistry, Wan-Fang Medical Center, Taipei, Taiwan.,Research Center for Tooth Bank and Dental Stem Cell Technology, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
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Esteva FJ, Chung HC, Royce ME, Lee SY, Lee SJ, Stebbing J. Abstract P5-20-14: Cardiotoxicity in 1 year of treatment with reference trastuzumab and its biosimilar candidate CT-P6 in HER2 positive early stage breast cancer (EBC) patients. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-20-14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background CT-P6 is a proposed biosimilar to reference trastuzumab. This trial (NCT02162667) evaluated the similarity of CT-P6 and reference trastuzumab for both efficacy and safety in HER2 positive EBC patients. The primary endpoint, pathological complete response (pCR) rate was entirely within the pre-defined equivalence margin (Stebbing et al., Lancet Oncology 2017). Efficacy and safety were similar between the two treatment groups. We aimed to investigate the cardiotoxicity in the 1 year treatment and follow-up period.
Methods A total of 549 patients with HER2 positive EBC were randomized to receive CT-P6 (n=271) or reference trastuzumab (n=278) in combination with docetaxel (Cycles 1-4) and 5-fluorouracil, epirubicin and cyclophosphamide (FEC, Cycles 5-8) in the neoadjuvant setting. CT-P6 or reference trastuzumab was administered at 8 mg/kg (Cycle 1 only) followed by 6 mg/kg every 3 weeks. After surgery, patients received monotherapy of CT-P6 or reference trastuzumab up to 10 cycles in the adjuvant setting. Left ventricular ejection fraction (LVEF) was evaluated by ECHO or MUGA at baseline, every 3 or 4 cycles during treatment and every 6 months thereafter. If LVEF decreased by ≥10 points from baseline and <50%, a reassessment was performed within 3 weeks and the patient was withdrawn from the study treatment if the cardiac toxicity was confirmed.
Results Median follow-up period was 19 months. In total, 96% of patients completed 8 cycles of taxane and anthracycline combination therapy during the neoadjuvant period and 90% of patients in each group received 1-year treatment of CT-P6 or reference trastuzumab.
The relative dose intensity of study drug was similar, indicating good tolerability of CT-P6 and reference trastuzumab (97.5% and 97.3% during the neoadjuvant period; 98.5% and 98.8% during the adjuvant period). Docetaxel and FEC combination therapies were administered approximately 96% of dose intensity in the two groups.
All patients had normal LVEF (≥55%) at baseline. Mean LVEF value was maintained more than 60% during 1-year treatment and follow-up period. Heart failure cases with LVEF decrease (≥10 points from baseline and <50%) were reported to be similar between two groups. Three patients in each group were withdrawn due to LVEF decrease. Adverse events of cardiac disorders were reported to be similar between two groups. All cases were mild or moderate except two cases.
Table 1. Summary of heart failure with LVEF decrease and cardiotoxicity CT-P6 (N=271)Reference Trastuzumab (N=278)LVEF decrease ≥ 10 points and below 50%9 (3.3%)7 (2.5%)- Asymptomatic9 (3.3%)6 (2.1%)- Symptomatic01 (0.4%)- Confirmed2 (0.7%)4 (1.4%)- Withdrawn3 (1.1%)3 (1.1%)Cardiac disorder by AEs31 (11.4%)38 (13.7%)- Grade 1 to 230 (11.0%)37 (13.3%)- Grade 3 to 51 (0.4%)11 (0.4%)21 Grade 3 of Adams-Strokes syndrome occurring 5 months after the completion of 1-year treatment; 2 Grade 5 of acute myocardial infarction occurring 10 days after Cycle 1 of the neoadjuvant therapy
Conclusions Combination therapy of CT-P6 with taxane/anthracycline and monotherapy of CT-P6 over 1 year period were well tolerated and cardiotoxicity was similar to reference trastuzumab.
Citation Format: Esteva FJ, Chung HC, Royce ME, Lee SY, Lee SJ, Stebbing J. Cardiotoxicity in 1 year of treatment with reference trastuzumab and its biosimilar candidate CT-P6 in HER2 positive early stage breast cancer (EBC) patients [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-20-14.
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Affiliation(s)
- FJ Esteva
- New York University Langone Medical Center; Yonsei Cancer Center, Yonsei University College of Medicine; Clinical Trialist and Breast Cancer Oncologist; Celltrion, Inc.; Imperial College/Imperial Healthcare NHS Trust
| | - HC Chung
- New York University Langone Medical Center; Yonsei Cancer Center, Yonsei University College of Medicine; Clinical Trialist and Breast Cancer Oncologist; Celltrion, Inc.; Imperial College/Imperial Healthcare NHS Trust
| | - ME Royce
- New York University Langone Medical Center; Yonsei Cancer Center, Yonsei University College of Medicine; Clinical Trialist and Breast Cancer Oncologist; Celltrion, Inc.; Imperial College/Imperial Healthcare NHS Trust
| | - SY Lee
- New York University Langone Medical Center; Yonsei Cancer Center, Yonsei University College of Medicine; Clinical Trialist and Breast Cancer Oncologist; Celltrion, Inc.; Imperial College/Imperial Healthcare NHS Trust
| | - SJ Lee
- New York University Langone Medical Center; Yonsei Cancer Center, Yonsei University College of Medicine; Clinical Trialist and Breast Cancer Oncologist; Celltrion, Inc.; Imperial College/Imperial Healthcare NHS Trust
| | - J Stebbing
- New York University Langone Medical Center; Yonsei Cancer Center, Yonsei University College of Medicine; Clinical Trialist and Breast Cancer Oncologist; Celltrion, Inc.; Imperial College/Imperial Healthcare NHS Trust
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Takahara S, Lee SY, Iwakura T, Oe K, Fukui T, Okumachi E, Waki T, Arakura M, Sakai Y, Nishida K, Kuroda R, Niikura T. Altered expression of microRNA during fracture healing in diabetic rats. Bone Joint Res 2018; 7:139-147. [PMID: 29437637 PMCID: PMC5895942 DOI: 10.1302/2046-3758.72.bjr-2017-0082.r1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Diabetes mellitus (DM) is known to impair fracture healing. Increasing evidence suggests that some microRNA (miRNA) is involved in the pathophysiology of diabetes and its complications. We hypothesized that the functions of miRNA and changes to their patterns of expression may be implicated in the pathogenesis of impaired fracture healing in DM. METHODS Closed transverse fractures were created in the femurs of 116 rats, with half assigned to the DM group and half assigned to the control group. Rats with DM were induced by a single intraperitoneal injection of streptozotocin. At post-fracture days five, seven, 11, 14, 21, and 28, miRNA was extracted from the newly generated tissue at the fracture site. Microarray analysis was performed with miRNA samples from each group on post-fracture days five and 11. For further analysis, real-time polymerase chain reaction (PCR) analysis was performed at each timepoint. RESULTS Microarray analysis showed that there were 14 miRNAs at day five and 17 miRNAs at day 11, with a greater than twofold change in the DM group compared with the control group. Among these types of miRNA, five were selected based on a comparative and extended literature review. Real-time PCR analysis revealed that five types of miRNA (miR-140-3p, miR-140-5p, miR-181a-1-3p, miR-210-3p, and miR-222-3p) were differentially expressed with changing patterns of expression during fracture healing in diabetic rats compared with controls. CONCLUSIONS Our findings provide information to further understand the pathology of impaired fracture healing in a diabetic rat model. These results may allow the potential development of molecular therapy using miRNA for the treatment of impaired fracture healing in patients with DM.Cite this article: S. Takahara, S. Y. Lee, T. Iwakura, K. Oe, T. Fukui, E. Okumachi, T. Waki, M. Arakura, Y. Sakai, K. Nishida, R. Kuroda, T. Niikura. Altered expression of microRNA during fracture healing in diabetic rats. Bone Joint Res 2018;7:139-147. DOI: 10.1302/2046-3758.72.BJR-2017-0082.R1.
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Affiliation(s)
- S Takahara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 650-0017 Kobe, Japan
| | - S Y Lee
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine and Showa University School of Medicine,650-0017 Kobe, Japan and 142-8666 Tokyo, Japan
| | - T Iwakura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 650-0017 Kobe, Japan
| | - K Oe
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 650-0017 Kobe, Japan
| | - T Fukui
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 650-0017 Kobe, Japan
| | - E Okumachi
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 650-0017 Kobe, Japan
| | - T Waki
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 650-0017 Kobe, Japan
| | - M Arakura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 650-0017 Kobe, Japan
| | - Y Sakai
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, 650-0017 Kobe, Japan
| | - K Nishida
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 650-0017 Kobe, Japan
| | - R Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 650-0017 Kobe, Japan
| | - T Niikura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 650-0017 Kobe, Japan
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Fullerton AH, Torgersen CE, Lawler JJ, Steel EA, Ebersole JL, Lee SY. Longitudinal thermal heterogeneity in rivers and refugia for coldwater species: effects of scale and climate change. Aquat Sci 2018; 80:1-15. [PMID: 29556118 PMCID: PMC5854952 DOI: 10.1007/s00027-017-0557-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 11/14/2017] [Indexed: 05/23/2023]
Abstract
Climate-change driven increases in water temperature pose challenges for aquatic organisms. Predictions of impacts typically do not account for fine-grained spatiotemporal thermal patterns in rivers. Patches of cooler water could serve as refuges for anadromous species like salmon that migrate during summer. We used high-resolution remotely sensed water temperature data to characterize summer thermal heterogeneity patterns for 11,308 km of 2nd- to 7th-order rivers throughout the Pacific Northwest and northern California (USA). We evaluated (1) water temperature patterns at different spatial resolutions, (2) the frequency, size, and spacing of cool thermal patches suitable for Pacific salmon (i.e., contiguous stretches ≥0.25 km, ≤15°C and ≥2°C cooler than adjacent water), and (3) potential influences of climate change on availability of cool patches. Thermal heterogeneity was nonlinearly related to the spatial resolution of water temperature data, and heterogeneity at fine resolution (<1 km) would have been difficult to quantify without spatially continuous data. Cool patches were generally >2.7 and <13.0 km long, and spacing among patches was generally >5.7 and <49.4 km. Thermal heterogeneity varied among rivers, some of which had long uninterrupted stretches of warm water ≥20°C, and others had many smaller cool patches. Our models predicted little change in future thermal heterogeneity among rivers, but within-river patterns sometimes changed markedly compared to contemporary patterns. These results can inform long-term monitoring programs as well as near-term climate-adaptation strategies.
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Affiliation(s)
- A H Fullerton
- Fish Ecology Division, Northwest Fisheries Science Center, National Marine Fisheries Service, NOAA, 2725 Montlake Blvd E, Seattle WA, 98112, USA; phone: 206-302-2415; fax: 206-860-3267
| | - C E Torgersen
- U.S. Geological Survey, Forest and Rangeland Ecosystem Science Center, Cascadia Field Station, University of Washington, Seattle, WA, USA
| | - J J Lawler
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA, USA
| | - E A Steel
- Pacific Northwest Research Station, USDA Forest Service, Seattle, WA, USA
| | - J L Ebersole
- National Health and Environmental Effects Research Laboratory, Western Ecology Division, U.S. Environmental Protection Agency, Corvallis, OR, USA
| | - S Y Lee
- Climate Impacts Group, University of Washington, Seattle, WA, USA
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Kim SW, Kim JH, Park CK, Kim TJ, Lee SY, Kim YK, Kwon SS, Rhee CK, Yoon HK. Effect of roflumilast on airway remodelling in a murine model of chronic asthma. Clin Exp Allergy 2017; 46:754-63. [PMID: 26542330 DOI: 10.1111/cea.12670] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 09/16/2015] [Accepted: 10/17/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Airway remodelling is associated with irreversible, or partially reversible, airflow obstruction and ultimately unresponsiveness to asthma therapies such as corticosteroids. Roflumilast is a selective phosphodiesterase-4 inhibitor that has an anti-inflammatory effect in chronic obstructive pulmonary disease (COPD). OBJECTIVE The objective of this study was to study the effect of roflumilast on airway inflammation and remodelling in a murine model of chronic asthma. METHODS BALB/c mice sensitized to ovalbumin (OVA) were chronically exposed to intranasal OVA administration twice a week for additional 3 months. Roflumilast was administered orally during the intranasal OVA challenge. A lung fibroblast cell line was used in the proliferation assay. RESULTS Compared with control mice, mice chronically exposed to OVA developed eosinophilic airway inflammation, airway hyper-responsiveness (AHR), and exhibited features of airway remodelling. Administration of roflumilast significantly inhibited airway inflammation and AHR. Roflumilast also significantly decreased goblet cell hyperplasia and pulmonary fibrosis, which are parameters of airway remodelling. The levels of interleukin (IL)-4, IL-5, and IL-13 in the bronchoalveolar lavage (BAL) fluids were significantly lower in the roflumilast group. In vitro, roflumilast significantly inhibited stem cell factor (SCF)-induced cell proliferation of fibroblasts. The SCF concentration and mRNA expression in a murine model also significantly decreased with roflumilast treatment. CONCLUSIONS These results suggest that the administration of roflumilast regulates airway inflammation, AHR, and airway remodelling in a model of chronic asthma. The beneficial effects from roflumilast may be related to the SCF/c-kit pathway.
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Affiliation(s)
- S W Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - J H Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - C K Park
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - T J Kim
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - S Y Lee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Y K Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - S S Kwon
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - C K Rhee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - H K Yoon
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Lee YB, Lee SY, Choi JY, Lee JH, Chae HS, Kim JW, Han KD, Park YG, Yu DS. Incidence, prevalence, and mortality of Adamantiades-Behçet's disease in Korea: a nationwide, population-based study (2006-2015). J Eur Acad Dermatol Venereol 2017; 32:999-1003. [PMID: 28940547 DOI: 10.1111/jdv.14601] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 09/05/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND The epidemiology of Adamantiades-Behçet's disease varies among ethnic populations worldwide. Trends in the incidence of Adamantiades-Behçet's disease have not been investigated based on the Korean National Health Insurance database. OBJECTIVES This study investigated the incidence and mortality of Adamantiades-Behçet's disease by age using nationwide population data in Korea. METHODS A nationwide population-based cohort study was performed using the Korean National Health Insurance Claims Database from 2006 to 2015. The incidence of Adamantiades-Behçet's disease was calculated by age, sex, calendar year and habitat. And comorbid metabolic diseases were also analysed in patients with Adamantiades-Behçet's disease. RESULTS The annual incidence of Adamantiades-Behçet's disease per 100 000 person-years was 3.976 (2.587 for males and 5.373 for females) from 2006 to 2015. The incidence of Adamantiades-Behçet's disease peaked among people in their 40s (6.561 per 100 000 person-years). Incidence was significantly higher in subjects with comorbid metabolic conditions, such as diabetes mellitus, hypertension and dyslipidemia. The mortality rate per 1000 person-years increased with age in patients with Adamantiades-Behçet's disease. CONCLUSIONS This study showed the incidence, prevalence and mortality of Adamantiades-Behçet's disease. Metabolic conditions increased the risk of Adamantiades-Behçet's disease among Koreans.
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Affiliation(s)
- Y B Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - S Y Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - J Y Choi
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - J H Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - H S Chae
- Department of Internal Medicine, The Catholic University of Korea, Seoul, South Korea
| | - J W Kim
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - K D Han
- Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Y G Park
- Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - D S Yu
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Park HJ, Lee SY, Choi SH, Hong HP, Choi YJ, Kim MS. Reduced metallic artefacts in 3 T knee MRI using fast spin-echo multi-point Dixon compared to fast spin-echo T2-weighted sequences. Clin Radiol 2017; 72:996.e1-996.e6. [PMID: 28807564 DOI: 10.1016/j.crad.2017.07.012] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 06/18/2017] [Accepted: 07/06/2017] [Indexed: 10/19/2022]
Abstract
AIM To compare multi-point Dixon magnetic resonance imaging (MRI) and fast spin-echo (FSE) T2-weighted imaging (WI) with regard to the size of metallic artefacts when imaging the knee joint. MATERIALS AND METHODS A total of 42 patients who underwent anterior cruciate ligament (ACL) reconstruction and follow-up imaging with 3 T MRI using the multi-point Dixon technique was included in this retrospective study. The maximal distance of the image distortion area around the metallic artefact was measured (interference screw of femoral tunnel area) on sagittal images of both FSE T2WI (T2WI and fat-suppressed [FS] T2WI) and multi-point Dixon (water only image and in-phase image) sequences. The maximal distance of the image distortion were compared using paired t-tests across the image sequences (multi-point Dixon water only image versus FS T2WI and multi-point Dixon in-phase image versus T2WI). RESULTS The mean distance of the image distortion from metallic artefacts regardless of the image sequence ranged from 16.6 mm to 24.5 mm (Table 2). The mean distances measured by two readers on multi-point Dixon (water only image) sequences were significantly shorter than those in FS T2WI sequences (p<0.001). In contrast, the mean distances measured by two readers on multi-point Dixon (in-phase image) sequences did not differ from those of T2WI (p>0.05) sequences. CONCLUSION The water-only image of multi-point Dixon technique reduces the amount of metallic artefacts compared to that in FS FSE T2WI sequences; however, the metallic artefacts were not significantly different between in-phase images of multi-point Dixon and FSE T2WI.
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Affiliation(s)
- H J Park
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S Y Lee
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S H Choi
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - H P Hong
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Y J Choi
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - M S Kim
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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50
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He J, Kim JR, Lee SY, Oh J, Park T, Kang MJ, Kwon W, Kim H, Kim SW, Cameron JL, Wolfgang CL, Jang JY. Proposed new staging system for ampulla of Vater cancer with greater discriminatory ability: multinational study from eastern and western centers. J Hepatobiliary Pancreat Sci 2017; 24:475-484. [PMID: 28660632 DOI: 10.1002/jhbp.486] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND We built a multinational retrospective database of patients with ampulla of Vater cancer to develop a reliable new staging system. METHOD This study included 841 patients with ampulla of Vater cancer after curative surgery at Seoul National University Hospital (n = 440) and Johns Hopkins University medical institutions (n = 401) between 1985 and 2013. RESULTS The 5-year overall survival (OS) rates of patients staged according to the 7th American Joint Committee on Cancer staging system were 80.3%, 60.9%, 58.1%, 36.6%, 17.9%, and 25.0% for Stages IA (n = 140), IB (n = 194), IIA (n = 115), IIB (n = 348), III (n = 33), and IV (n = 4), respectively. Five-year OS rates were similar in patients with Stage IB (T2N0M0) and IIA (T3N0M0) tumors (P = 0.556), but differed significantly between other pairs of groups. The number of positive lymph nodes (PLN) enhanced prognosis when stratified as 0, 1-2 and ≥3 (P < 0.001). The revised staging system consisted of Stages I (T1, PLN 0), IIA (T2-T3, PLN 0), IIB (T1-T3, PLN 1-2), III (PLN ≥3 or any T4), and IV (any M1), with 5-year OS rates differing significantly in each pair of groups, including Stages I and IIA (P < 0.001). CONCLUSION This new staging system has better discriminatory ability in stratifying 5-year OS rates based on a large multinational database.
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Affiliation(s)
- Jin He
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jae Ri Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Yeoun Lee
- Department of Mathematics and Statistics, Sejong University College of Natural Sciences, Seoul, Korea
| | - Jinseok Oh
- Department of Mathematics and Statistics, Sejong University College of Natural Sciences, Seoul, Korea
| | - Taesung Park
- Department of Statistics, Seoul National University College of Natural Sciences, Seoul, Korea
| | - Mee Joo Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Sun-Whe Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - John L Cameron
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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