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Yun SY, Suh CH, Byun JH, Jo SY, Chung SJ, Lim JS, Lee JH, Kim MJ, Kim HS, Kim SJ. Efficacy and safety of shunt surgery in patients with idiopathic normal-pressure hydrocephalus: can we predict shunt response by preoperative magnetic resonance imaging (MRI)? Clin Radiol 2024:S0009-9260(24)00142-9. [PMID: 38622045 DOI: 10.1016/j.crad.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/28/2024] [Accepted: 03/05/2024] [Indexed: 04/17/2024]
Abstract
AIM The aim of this study was to identify preoperative magnetic resonance imaging (MRI) findings that can predict the shunt responsiveness in idiopathic normal-pressure hydrocephalus (iNPH) patients and to investigate postoperative outcome and complications. MATERIALS AND METHODS A total of 192 patients with iNPH who underwent shunt at our hospital between 2000 and 2021 were included to investigate complications. Of these, after exclusion, 127 (1-month postoperative follow-up) and 77 (1-year postoperative follow-up) patients were evaluated. The preoperative MRI features (the presence of tightness of the high-convexity subarachnoid space, Sylvian fissure enlargement, Evans' index, and callosal angle) of the shunt-response and nonresponse groups were compared, and a systematic review was conducted to evaluate whether preoperative MRI findings could predict shunt response. RESULTS Postoperative complications within one month after surgery were observed in 6.8% (13/192), and the most common complication was hemorrhage. Changes in corpus callosum were observed in 4.2% (8/192). The shunt-response rates were 83.5% (106/127) in the 1-month follow-up group and 70.1% (54/77) in 1-year follow-up group. In the logistic regression analysis, only Evans' index measuring >0.4 had a significant negative relationship with shunt response at 1-month follow-up; however, no significant relationship was observed at 1-year follow-up. According to our systematic review, it is still controversial whether preoperative MRI findings could predict shunt response. CONCLUSION Evans' index measure of >0.4 had a significant relationship with the shunt response in the 1-month follow-up group. In systematic reviews, there is ongoing debate about whether preoperative MRI findings can accurately predict responses to shunt surgery. Postoperative corpus callosal change was observed in 4.2% of iNPH patients.
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Affiliation(s)
- S Y Yun
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - C H Suh
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - J H Byun
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S Y Jo
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S J Chung
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J-S Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J-H Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - M J Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - H S Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S J Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Kim SJ, Jo Y, Park SJ, Ji E, Lee JY, Choi E, Baek JY, Jang IY, Jung HW, Kim K, Ryu D, Yoo HJ, Kim BJ. Metabolomic profiles of ovariectomized mice and their associations with body composition and frailty-related parameters in postmenopausal women. J Endocrinol Invest 2024:10.1007/s40618-024-02338-x. [PMID: 38493245 DOI: 10.1007/s40618-024-02338-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/12/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Menopause, a dramatical estrogen-deficient condition, is considered the most significant milestone in women's health. PURPOSE To investigate the metabolite changes attributed to estrogen deficiency using random forest (RF)-based machine learning (ML) modeling strategy in ovariectomized (OVX) mice as well as determine the clinical relevance of selected metabolites in older women. METHODS AND RESULTS Untargeted and targeted metabolomic analyses revealed that metabolites related to TCA cycle, sphingolipids, phospholipids, fatty acids, and amino acids, were significantly changed in the plasma and/or muscle of OVX mice. Subsequent ML classifiers based on RF algorithm selected alpha-ketoglutarate (AKG), arginine, carnosine, ceramide C24, phosphatidylcholine (PC) aa C36:6, and PC ae C42:3 in plasma as well as PC aa 34:1, PC aa C34:3, PC aa C36:5, PC aa C32:1, PC aa C36:2, and sphingosine in muscle as top featured metabolites that differentiate the OVX mice from the sham-operated group. When circulating levels of AKG, arginine, and carnosine, which showed the most significant changes in OVX mice blood, were measured in postmenopausal women, higher plasma AKG levels were associated with lower bone mass, weak grip strength, poor physical performance, and increased frailty risk. CONCLUSIONS Metabolomics- and ML-based methods identified the key metabolites of blood and muscle that were significantly changed after ovariectomy in mice, and the clinical implication of several metabolites was investigated by looking at their correlation with body composition and frailty-related parameters in postmenopausal women. These findings provide crucial context for understanding the diverse physiological alterations caused by estrogen deficiency in women.
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Affiliation(s)
- S J Kim
- Department of Convergence Medicine, Asan Institute for Life Sciences, Asan Medical Center,, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea
| | - Y Jo
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005, South Korea
| | - S J Park
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - E Ji
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - J Y Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - E Choi
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - J-Y Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - I Y Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - H-W Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - K Kim
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - D Ryu
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005, South Korea.
| | - H J Yoo
- Department of Convergence Medicine, Asan Institute for Life Sciences, Asan Medical Center,, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea.
| | - B-J Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea.
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Cho SW, Malick H, Kim SJ, Grattoni A. Advances in Skin-on-a-Chip Technologies for Dermatological Disease Modeling. J Invest Dermatol 2024:S0022-202X(24)00115-5. [PMID: 38493383 DOI: 10.1016/j.jid.2024.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/19/2024] [Accepted: 01/29/2024] [Indexed: 03/18/2024]
Abstract
Skin-on-a-chip (SoC) technologies are emerging as a paradigm shift in dermatology research by replicating human physiology in a dynamic manner not achievable by current animal models. Although animal models have contributed to successful clinical trials, their ability to predict human outcomes remains questionable, owing to inherent differences in skin anatomy and immune response. Covering areas including infectious diseases, autoimmune skin conditions, wound healing, drug toxicity, aging, and antiaging, SoC aims to circumvent the inherent disparities created by traditional models. In this paper, we review current SoC technologies, highlighting their potential as an alternative to animal models for a deeper understanding of complex skin conditions.
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Affiliation(s)
- Seo Won Cho
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas, USA; Texas A&M University School of Medicine, College Station, Texas, USA
| | - Hamza Malick
- Texas A&M University School of Medicine, College Station, Texas, USA
| | - Soo Jung Kim
- Department of Dermatology, Baylor College of Medicine, Houston, Texas, USA
| | - Alessandro Grattoni
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas, USA; Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA; Department of Radiation Oncology, Houston Methodist Hospital, Houston, Texas, USA.
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Dai A, Kim SJ. Systemic calcineurin inhibitors tacrolimus and voclosporin: A review of off-label dermatologic uses. J Am Acad Dermatol 2024; 90:358-367. [PMID: 37307993 DOI: 10.1016/j.jaad.2023.05.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 05/08/2023] [Accepted: 05/18/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Systemic calcineurin inhibitors, cyclosporine, tacrolimus, and voclosporin, have been utilized in various dermatologic conditions. Although there have been numerous off-label dermatologic indications with published guidelines for cyclosporine, there is no established strong consensus for tacrolimus and voclosporin. OBJECTIVE To conduct a review of off-label use of systemic tacrolimus and voclosporin in various dermatoses to better inform treatment methods. METHODS A literature search was conducted using PubMed and Google Scholar. Relevant clinical trials, observational studies, case series, and reports regarding off-label dermatologic uses of systemic tacrolimus and voclosporin were included. RESULTS Tacrolimus shows promise for numerous dermatologic conditions, including psoriasis, atopic dermatitis/eczema, pyoderma gangrenosum, chronic urticaria, and Behcet's disease. Randomized controlled trial data are only available for voclosporin in psoriasis, which showed efficacy but did not meet noninferiority to cyclosporine. LIMITATIONS Data were limited and extracted from published papers. Studies differed in methodology, and nonstandardized outcomes limited the conclusions drawn. CONCLUSIONS In comparison to cyclosporine, tacrolimus can be considered for treatment-refractory disease or in patients with cardiovascular risk factors or inflammatory bowel disease. Voclosporin has only been utilized in psoriasis currently, and clinical trials in psoriasis show voclosporin's efficacy. Voclosporin can be considered for patients with lupus nephritis.
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Affiliation(s)
- Annie Dai
- Department of Dermatology, Baylor College of Medicine, Houston, Texas
| | - Soo Jung Kim
- Department of Dermatology, Baylor College of Medicine, Houston, Texas.
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Kim SJ, Park BY. Changes in smoking patterns and characteristics of Koreans using the Korea National Health and Nutrition Examination Survey 2013-2021 data. Public Health 2024; 227:259-266. [PMID: 38301303 DOI: 10.1016/j.puhe.2023.12.017] [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: 09/07/2023] [Revised: 11/30/2023] [Accepted: 12/08/2023] [Indexed: 02/03/2024]
Abstract
OBJECTIVES This study explored factors related to Korean adults' smoking patterns and also the reasons for using new types of tobacco products. STUDY DESIGN Cross-sectional survey. METHODS Data from the Korea National Health and Nutrition Examination Survey from 2013 to 2021 were used. The prevalence of the use of electronic cigarettes (e-cigarettes) or heated tobacco products (HTPs) alone or in combination with conventional cigarettes (CC) and the reasons for using new tobacco products are presented. Factors associated with using new types of tobacco products alone or in combination with CC compared to exclusive CC users were identified using multinomial logistic regression analysis. RESULTS The prevalence of current smoking was 25.54% in 2013 and 23.05% in 2021, with no significant change. The prevalence of CC decreased from 23.39% in 2013 to 15.77% in 2021. The prevalence of new tobacco use in combination with CC did not show a definite trend. The prevalence of exclusive use of new tobacco was <1% until 2018 and has rapidly increased thereafter. Of the HTPs users, 46.68% responded with 'no cigarette smell' as the main reason for HTPs use, followed by 'It seems less harmful than cigarette' (19.19%), and 'It seems to be helpful for quitting smoking' (15.04%). Of the e-cigarette users, 45.19% responded 'It seems to be helpful for quitting smoking' as the main reason for e-cigarette use, followed by 'It is less harmful than cigarettes' (19.98%). Compared to CC users, new tobacco users were younger, had a higher household income or education, and used more nutritional supplements. CONCLUSION Regulations for newer tobacco products are more lenient than for traditional cigarettes, leading to misunderstandings, especially among women and young people. To increase awareness of the risks of these products, specific policies such as disclosure of ingredients, ban on online sales, and increase in consumption tax, are needed.
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Affiliation(s)
- S J Kim
- Department of Health Sciences, Graduate School of Public Health, Hanyang University, Seoul, Republic of Korea
| | - B Y Park
- Department of Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea; Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Republic of Korea.
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Lee DH, Heo H, Suh CH, Shim WH, Kim E, Jo S, Chung SJ, Lee CS, Kim HS, Kim SJ. Improved diagnostic performance of susceptibility-weighted imaging with compressed sensing-sensitivity encoding and neuromelanin-sensitive MRI for Parkinson's disease and atypical Parkinsonism. Clin Radiol 2024; 79:e102-e111. [PMID: 37863747 DOI: 10.1016/j.crad.2023.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 08/08/2023] [Accepted: 09/18/2023] [Indexed: 10/22/2023]
Abstract
AIM To verify the diagnostic performance of the loss of nigrosome-1 on susceptibility-weighted imaging (SWI) with compressed sensing-sensitivity encoding (CS-SENSE) and neuromelanin on neuromelanin-sensitive (NM) magnetic resonance imaging (MRI) for the diagnosis of Parkinson's disease (PD) and atypical Parkinsonism. MATERIALS AND METHODS A total of 195 patients who underwent MRI between October 2019 and February 2020, including SWI, with or without CS-SENSE, and NM-MRI, were reviewed retrospectively. Two neuroradiologists assessed the loss of nigrosome-1 on SWI and neuromelanin on the NM-MRI. The result of N-3-fluoropropyl-2-beta-carbomethoxy-3-beta-(4-iodophenyl) nortropane positron-emission tomography (PET) was set as the reference standard. RESULTS When CS-SENSE was applied for nigrosome-1 imaging on SWI, the non-diagnostic scan rate was lowered significantly from 19.3% (17/88) to 5.6% (6/107; p=0.004). Diagnosis of PD and atypical Parkinsonism based on the loss of nigrosome-1 on SWI and based on NM-MRI showed good diagnostic value (area under the curve [AUC] 0.821, 95% confidence interval [CI] = 0.755-0.875: AUC 0.832, 95% CI = 0.771-0.882, respectively) with a substantial inter-reader agreement (κ = 0.791 and 0.681, respectively). Combined SWI and neuromelanin had a similar discriminatory ability (AUC 0.830, 95% CI = 0.770-0.880). Similarly, the diagnosis of PD was excellent. CONCLUSIONS CS-SENSE may add value to the diagnostic capability of nigrosome-1 on SWI to reduce the nondiagnostic scan rates. Furthermore, loss of nigrosome-1 on SWI or volume loss of neuromelanin on NM-MRI may be helpful for diagnosing PD.
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Affiliation(s)
- D H Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea; Department of Radiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - H Heo
- Department of Convergence Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - C H Suh
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
| | - W H Shim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - E Kim
- Philips Healthcare Korea, Seoul, Republic of Korea
| | - S Jo
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - S J Chung
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - C S Lee
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - H S Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - S J Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Jeong Y, Park S, Kwon E, Hur YM, You YA, Kim SM, Lee G, Lee KA, Kim SJ, Cho GJ, Oh MJ, Na SH, Lee SJ, Bae JG, Kim YH, Lee SJ, Kim YH, Kim YJ. Personal exposure of PM 2.5 and metabolic syndrome markers of pregnant women in South Korea: APPO study. Environ Sci Pollut Res Int 2023; 30:123893-123906. [PMID: 37996573 PMCID: PMC10746774 DOI: 10.1007/s11356-023-30921-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 11/02/2023] [Indexed: 11/25/2023]
Abstract
We examined the association between exposure to PM2.5, focused on individual exposure level, and metabolic dysfunction during pregnancy. APPO study (Air Pollution on Pregnancy Outcome) was a prospective, multicenter, observational cohort study conducted from January 2021 to March 2023. Individual PM2.5 concentrations were calculated using a time-weighted average model. Metabolic dysfunction during pregnancy was assessed based on a modified definition of metabolic syndrome and its components, accounting for pregnancy-specific criteria. Exposure to PM2.5 during pregnancy was associated with worsened metabolic parameters especially glucose metabolism. In comparison to participants exposed to the low PM2.5 group, those exposed to high PM2.5 levels exhibited increased odds of gestational diabetes mellitus (GDM) after adjusting for confounding variables in different adjusted models. Specifically, in model 1, the adjusted odds ratio (aOR) was 3.117 with a 95% confidence interval (CI) of 1.234-7.870; in model 2, the aOR was 3.855 with a 95% CI of 1.255-11.844; in model 3, the aOR was 3.404 with a 95% CI of 1.206-9.607; and in model 4, the aOR was 2.741 with a 95% CI of 0.712-10.547. Exposure to higher levels of PM2.5 during pregnancy was associated with a tendency to worsen metabolic dysfunction markers specifically in glucose homeostasis. Further research is needed to investigate the mechanisms underlying the effects of ambient PM2.5 on metabolic dysfunction during pregnancy.
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Affiliation(s)
- Yeonseong Jeong
- Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sunwha Park
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Eunjin Kwon
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Young Min Hur
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Young-Ah You
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Soo Min Kim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University Mokdong Hospital, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea
| | - Gain Lee
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University Mokdong Hospital, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea
| | - Kyung A Lee
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University Seoul Hospital, Seoul, Korea
| | - Soo Jung Kim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University Seoul Hospital, Seoul, Korea
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, College of Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Min-Jeong Oh
- Department of Obstetrics and Gynecology, College of Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Sung Hun Na
- Department of Obstetrics and Gynecology, College of Medicine, Kangwon National University Hospital, Chuncheon, Korea
| | - Se Jin Lee
- Department of Obstetrics and Gynecology, College of Medicine, Kangwon National University Hospital, Chuncheon, Korea
| | - Jin-Gon Bae
- Department of Obstetrics and Gynecology, College of Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Yu-Hwan Kim
- Department of Obstetrics and Gynecology, College of Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Soo-Jeong Lee
- Department of Obstetrics and Gynecology, Ulsan university hospital, University of Ulsan College of Medicine Ulsan, Ulsan, Korea
| | - Young-Han Kim
- Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University Mokdong Hospital, Seoul, Korea.
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea.
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Ansari S, Zamil DH, Rodriguez E, Dunn C, Kim SJ. Differentiating Desquamating Skin Lesions: A Case of Methotrexate Epidermal Necrosis. Cureus 2023; 15:e50050. [PMID: 38186488 PMCID: PMC10767466 DOI: 10.7759/cureus.50050] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2023] [Indexed: 01/09/2024] Open
Abstract
Desquamating skin lesions are a non-specific finding that requires urgent evaluation given the life-threatening severity of one of the potential causes, Stevens-Johnson syndrome (SJS). Methotrexate toxicity, also known in its cutaneous form as methotrexate epidermal necrosis (MEN), is another entity that presents similarly to SJS and is described here in a patient with increased risk due to his age, chronic kidney disease, and increased dose of methotrexate. His diagnosis was complicated by other historical risk factors, including antibiotic use, but was eventually elucidated when he was noted to have bone marrow suppression. Given the pathophysiology of SJS, a T-cell mediated reaction, the patient's leukopenia increased the likelihood of MEN as his ultimate diagnosis. However, in light of his aggressive treatment and non-specific histopathology, the clinical suspicion of MEN could not be confirmed.
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Affiliation(s)
| | - Dina H Zamil
- Dermatology, Baylor College of Medicine, Houston, USA
| | | | - Carly Dunn
- Dermatology, Baylor College of Medicine, Houston, USA
| | - Soo Jung Kim
- Dermatology, Baylor College of Medicine, Houston, USA
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Kim SJ, Park MH, Lee JH. Comparison of operative and fertility outcomes of single-incision robotic myomectomy: a retrospective single-center analysis of 286 cases. J Robot Surg 2023; 17:2945-2953. [PMID: 37856060 DOI: 10.1007/s11701-023-01743-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/06/2023] [Indexed: 10/20/2023]
Abstract
To assess the short-term operative and fertility outcomes of single-incision robotic myomectomy. We performed this retrospective cohort study of 286 women who underwent robotic single-site myomectomy using the da Vinci® Xi surgical system (RSSM group, n = 70) or robotic single-port myomectomy using the da Vinci® SP surgical system (RSPM group, n = 216). Data were collected through chart reviews and telephone interviews. Except operating time (94.6 ± 30.1 min in RSSM vs. 81.7 ± 20.1 min in RSPM) and location of the removed fibroids, there were no significant differences in the operative outcomes or characteristics of the removed fibroids between both groups. The proportion of fibroids in the lateral wall in RSPM (13.4%) was approximately twice that in RSSM (6.3%). There was no conversion to laparotomy or multiport access, and none of the women required readmission in either group. No significant difference in the complication rate was noted between groups, and all complications were resolved with conservative treatment. During the approximately 20-month follow-up period, in the RSSM and RSPM groups, the pregnancy rates were 54.5% and 67.4%, respectively, and the abortion rates were 33.3% and 22.6%, respectively. In terms of operative and fertility outcomes, single-site robotic myomectomy appears to be feasible and safe in women with symptomatic fibroids. The da Vinci® SP system is thought to be helpful in reducing operation time and surgically difficult myomectomy.
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Affiliation(s)
- Soo Jung Kim
- The Department of Obstetrics and Gynecology, School of Medicine, Ewha Womans University Seoul Hospital, Ewha Womans University, Seoul, Republic of Korea
| | - Mi-Hye Park
- The Department of Obstetrics and Gynecology, School of Medicine, Ewha Womans University Seoul Hospital, Ewha Womans University, Seoul, Republic of Korea
| | - Jung Hun Lee
- The Department of Obstetrics and Gynecology, School of Medicine, Ewha Womans University Seoul Hospital, Ewha Womans University, Seoul, Republic of Korea.
- The Comprehensive Gynecologic Cancer Center, CHA Bundang Medical Center, College of Medicine, CHA University, Seongnam-si, 13496, Republic of Korea.
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Noh HJ, Song JH, Ham SY, Park Y, Won HK, Kim SJ, Chung KB, Kim CK, Ahn YM, Lee BJ, Kang HR. Clinical outcomes of mild to moderate coronavirus disease 2019 patients treated with Regdanvimab in delta-variant outbreak: Retrospective cohort study. Medicine (Baltimore) 2023; 102:e35987. [PMID: 37960790 PMCID: PMC10637437 DOI: 10.1097/md.0000000000035987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/16/2023] [Indexed: 11/15/2023] Open
Abstract
Regdanvimab is a novel neutralizing antibody agent used for the treatment of coronavirus disease 2019 (COVID-19). However, the effectiveness of regdanvimab in delta-variant patients has rarely been investigated. We examined the clinical outcomes and adverse events in COVID 19 patients treated with regdanvimab in the delta-variant era. Data were collected from laboratory-confirmed COVID-19 hospitalized patients who received regdanvimab in 2021 and categorized into pre-delta and delta variant groups. The primary outcome was the need for oxygen therapy. Rescue therapy, clinical improvement, and adverse events were analyzed. Among 101 patients treated with regdanvimab, 31 (30.7%) were delta patients and 49 (48.5) were pre-delta patients. 64.4% were male, the mean age was 60.3 years, and 70 patients (69%) had at least one underlying disease. The median interval from symptom onset to injection was 4 days. Twenty-three patients (23%) needed oxygen therapy, including 9 (29%) in the delta and 8 (16.3%) in the pre-delta group. (P = .176) The risk of early oxygen supplement was higher in the delta group (adjusted hazard ratio (aHR), 6.75; 95% confidence interval(CI), 1.53-29.8). The in-hospital survival rate was 100%, and no patients were admitted to the intensive care unit. Adverse events occurred in 43% of patients:13 (42%) delta patients and 23 (47%) pre-delta patients had any adverse events (P = .661). Patients treated with regdanvimab 4 days after symptom onset showed a favorable prognosis (aHR, 0.26; 95% CI, 0.26-0.91). We found that the high-risk mild to moderate COVID-19 patients treated with regdanvimab showed similar disease progression in delta-variant patients and pre-delta variants; however, we need to be more closely observed delta-variant patients than those in the pre-delta group despite regdanvimab treatment due to rapid disease aggravation.
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Affiliation(s)
- Hyeong-Jun Noh
- Division of Pulmonary and Allergy Medicine, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Jin Hwa Song
- Division of Pulmonary and Allergy Medicine, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Sin Young Ham
- Division of Infectious Disease, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Yeonkyung Park
- Division of Pulmonary and Allergy Medicine, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Ha-Kyeong Won
- Division of Pulmonary and Allergy Medicine, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Soo Jung Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Keun Bum Chung
- Division of Pulmonary and Allergy Medicine, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Choon Kwan Kim
- Division of Infectious Disease, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Young Mee Ahn
- Division of Pulmonary and Allergy Medicine, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Byoung-Jun Lee
- Division of Pulmonary and Allergy Medicine, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Hye-Rin Kang
- Division of Pulmonary and Allergy Medicine, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Republic of Korea
- Department of Internal Medicine, Graduate School of Medicine, Seoul National University, Seoul, Republic of Korea
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11
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Joshi TP, Bancroft A, DeLeon D, Garcia D, Kunisetty B, Truong P, Kim SJ. Association of atopic dermatitis with substance use disorders: A case-control study in the All of Us research program. J Am Acad Dermatol 2023; 89:e237-e238. [PMID: 37454697 DOI: 10.1016/j.jaad.2023.06.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Tejas P Joshi
- School of Medicine, Baylor College of Medicine, Houston, Texas.
| | - Ashley Bancroft
- School of Medicine, Baylor College of Medicine, Houston, Texas
| | - Danielle DeLeon
- Wiess School of Natural Sciences, Rice University, Houston, Texas
| | - Danielle Garcia
- School of Medicine, Baylor College of Medicine, Houston, Texas
| | | | - Paulina Truong
- School of Medicine, Baylor College of Medicine, Houston, Texas
| | - Soo Jung Kim
- Department of Dermatology, Baylor College of Medicine, Houston, Texas
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12
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Joshi TP, Dunn C, Huttenbach YT, Kim SJ. Onychomatricoma in a patient with skin of color. JAAD Case Rep 2023; 41:44-45. [PMID: 37842151 PMCID: PMC10568227 DOI: 10.1016/j.jdcr.2023.08.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Affiliation(s)
- Tejas P. Joshi
- School of Medicine, Baylor College of Medicine, Houston, Texas
| | - Carly Dunn
- Department of Dermatology, Baylor College of Medicine, Houston, Texas
| | - Yve T. Huttenbach
- Department of Dermatology, Baylor College of Medicine, Houston, Texas
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas
| | - Soo Jung Kim
- Department of Dermatology, Baylor College of Medicine, Houston, Texas
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13
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Hong SY, Kim SJ, Park MH, Lee KA. Nonfamilial VACTERL-H Syndrome in a Dizygotic Twin: Prenatal Ultrasound and Postnatal 3D CT Findings. Medicina (Kaunas) 2023; 59:1387. [PMID: 37629676 PMCID: PMC10456747 DOI: 10.3390/medicina59081387] [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] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023]
Abstract
Background: VACTERL association is a widely known congenital malformation that includes vertebral, anal, cardiac, tracheoesophageal, renal, and limb anomalies. Patients with VACTERL and hydrocephalus appear to form a distinct group, both genetically and phenotypically, and their condition has been called VACTERL-H syndrome. Most cases of VACTERL-H have been reported postnatally, as VACTER-H syndrome is difficult to diagnose prenatally. Case Presentation: Here, we report a case of VACTERL-H syndrome in a dichorionic and diamniotic twin diagnosed prenatally by ultrasonography and confirmed postnatally by three-dimensional computed tomography (3D CT). A 34-year-old multiparous female was referred to our institution at 31 + 3 weeks gestation for suspected fetal ventriculomegaly. Detailed examinations using two-dimensional and Doppler ultrasounds revealed hydrocephalus, bilateral dysplastic upper arms, radial aplasia, unilateral pulmonary agenesis, dextrocardia with right atrial enlargement, a unilateral hypoplastic ectopic kidney, a single umbilical artery, a tracheoesophageal fistula with a small stomach, polyhydramnios, and anal atresia. Findings from the postnatal 3D CT aligned with the prenatal diagnosis, showing upper-limb agenesis, dextrocardia with pulmonary hypoplasia, tracheoesophageal fistula, imperforate anus, and colon dilatation. The affected 1390-g male twin had an unaffected 1890-g female twin sister and a healthy 6-year-old brother. Conclusions: Upon encountering fetuses with multiple anomalies, including ventriculomegaly, a small stomach with polyhydramnios, an abnormally positioned heart, and upper-limb abnormalities, clinicians should perform systematic ultrasonographic examinations to detect associated anomalies and be aware of VACTERL-H syndrome.
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Affiliation(s)
| | | | | | - Kyung A. Lee
- Department of Obstetrics and Gynecology, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea; (S.Y.H.); (S.J.K.); (M.-H.P.)
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14
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Kim SJ, Aye YM, Panyarachun D, Hong SA, Chang YS. Social support for postpartum women and associated factors including online support to reduce stress and depression amidst COVID-19: Results of an online survey in Thailand. PLoS One 2023; 18:e0289250. [PMID: 37498895 PMCID: PMC10374076 DOI: 10.1371/journal.pone.0289250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Social support for postpartum women helps mothers to recover from childbirth and fosters healthy infant development. However, the impacts of reduced interpersonal interactions inflicted by the COVID-19 outbreak on available social support for postpartum women have received little attention. Therefore, this study aimed to examine the levels of social support provided to postpartum women and associated factors in Thailand during the COVID-19 pandemic. METHODS A cross-sectional study was conducted from July to October 2021 using an anonymous online questionnaire. The responses of 840 eligible women up to six months postpartum in Thailand were obtained. The maternity social support scale was used to measure social support. Multivariate logistic regression was used to analyse the factors associated with social support among postpartum women. RESULTS About 57% of women reported to receive high support. Women in the high social support group were more likely to be married (aOR:2.70; 95% CI:1.57-4.66), have a university education or above (1.88; 1.35-2.64), have an intended pregnancy (2.06; 1.34-3.16), good health (2.01; 1.44-2.81), good sleep quality (1.62; 1.14-2.31), receive counsel from peers or family (1.56; 1.13-2.16), and use internet or social media to reduce stress and depression (1.51; 1.08-2.11). Meanwhile, women in the high social support group were significantly less likely to feed complementary foods to infants within 24 hours of completing the survey (0.28; 0.15-0.52). CONCLUSIONS The results of this study indicated that more than half of the women reported high support and illustrated the important role played by family, peers, and professionals as well as online and remote channels in providing postpartum informational and emotional support during the pandemic. Online platforms and remote support may be considered to provide social support to postpartum women during a pandemic such as COVID-19.
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Affiliation(s)
- Soo Jung Kim
- Department of Public Health Sciences, Seoul National University, Seoul, Republic of Korea
| | - Yin Min Aye
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand
| | - Danipa Panyarachun
- Faculty of Medical Technology, Mahidol University, Nakhon Pathom, Thailand
| | - Seo Ah Hong
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand
- Institute for Health and Society, Hanyang University, Seoul, Republic of Korea
| | - Yan-Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom
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15
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Lin RJ, Kim SJ, Brown S, Elko TA, Ruiz JD, Hanley DM, Lia Palomba M, Perales MA, Shah GL, Dahi PB, Scordo M, Sauter CS, Batlevi CL, Tomas AA, Shouval R, Lee N, Pavkovic EA, Engstler DE, Park JH, Salles GA, Devlin SM, Korc-Grodzicki B, Hamlin PA, Giralt SA. Prospective geriatric assessment and geriatric consultation in CAR T-cell therapy for older patients with lymphoma. Blood Adv 2023; 7:3501-3505. [PMID: 37078703 PMCID: PMC10362256 DOI: 10.1182/bloodadvances.2023010003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 02/15/2023] [Revised: 03/27/2023] [Accepted: 04/12/2023] [Indexed: 04/21/2023] Open
Affiliation(s)
- Richard J. Lin
- Adult Blood and Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Weill Cornell Medical College, New York, NY
| | - Soo Jung Kim
- Geriatrics Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Samantha Brown
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Theresa A. Elko
- Adult Blood and Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Josel D. Ruiz
- Adult Blood and Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Danielle M. Hanley
- Adult Blood and Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - M. Lia Palomba
- Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Weill Cornell Medical College, New York, NY
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Miguel-Angel Perales
- Adult Blood and Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Weill Cornell Medical College, New York, NY
| | - Gunjan L. Shah
- Adult Blood and Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Weill Cornell Medical College, New York, NY
| | - Parastoo B. Dahi
- Adult Blood and Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Weill Cornell Medical College, New York, NY
| | - Michael Scordo
- Adult Blood and Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Weill Cornell Medical College, New York, NY
| | - Craig S. Sauter
- Adult Blood and Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Weill Cornell Medical College, New York, NY
| | - Connie L. Batlevi
- Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Weill Cornell Medical College, New York, NY
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ana Alarcon Tomas
- Adult Blood and Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Roni Shouval
- Adult Blood and Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Weill Cornell Medical College, New York, NY
| | - Nicole Lee
- Adult Blood and Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Emma A. Pavkovic
- Adult Blood and Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Danielle E. Engstler
- Adult Blood and Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jae H. Park
- Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Weill Cornell Medical College, New York, NY
| | - Gilles A. Salles
- Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Weill Cornell Medical College, New York, NY
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sean M. Devlin
- Weill Cornell Medical College, New York, NY
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Beatriz Korc-Grodzicki
- Weill Cornell Medical College, New York, NY
- Geriatrics Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Paul A. Hamlin
- Weill Cornell Medical College, New York, NY
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sergio A. Giralt
- Adult Blood and Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Weill Cornell Medical College, New York, NY
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16
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Soh Y, Yoo EA, Kim ES, Kim SJ. MRI Features of Multiple Cranial Neuropathies in Guillain-Barré Syndrome Occurring after COVID-19 Vaccination: A Case Report. J Korean Soc Radiol 2023; 84:964-969. [PMID: 37559813 PMCID: PMC10407074 DOI: 10.3348/jksr.2022.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 11/02/2022] [Accepted: 11/13/2022] [Indexed: 08/11/2023]
Abstract
Guillain-Barré syndrome (GBS) is an immune-mediated demyelinating polyneuropathy characterized by progressive, ascending, and symmetrical paralysis. It is known to be triggered by an antecedent infection or vaccination. Recently, GBS development following coronavirus disease 2019 (COVID-19) vaccination has been reported. Cranial neuropathies in typical GBS patients usually involve the facial and the lower cranial nerves (from IX to XII). We report a rare case of multiple cranial neuropathies involving trigeminal, abducens, and facial nerves in a patient who developed GBS following COVID-19 vaccination on the basis of obvious MRI features.
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17
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Zhu H, Huang A, Zhou K, Bhatnagar A, Sorensen R, Cordova K, Calderara GA, Dasari N, Kirby RP, Kim SJ. Association of demographic factors and medical school research productivity with dermatology residency tier placement: A national cohort study. J Am Acad Dermatol 2023; 89:186-188. [PMID: 36924932 DOI: 10.1016/j.jaad.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 02/27/2023] [Accepted: 03/03/2023] [Indexed: 03/18/2023]
Affiliation(s)
- Harrison Zhu
- School of Medicine, Baylor College of Medicine, Houston, Texas.
| | - Austin Huang
- School of Medicine, Baylor College of Medicine, Houston, Texas
| | - Kelvin Zhou
- School of Medicine, Baylor College of Medicine, Houston, Texas
| | | | - Ryan Sorensen
- School of Medicine, Baylor College of Medicine, Houston, Texas
| | - Kathryn Cordova
- School of Medicine, Baylor College of Medicine, Houston, Texas
| | | | - Nina Dasari
- School of Medicine, Baylor College of Medicine, Houston, Texas
| | | | - Soo Jung Kim
- Department of Dermatology, Baylor College of Medicine, Houston, Texas
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18
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Kim SJ, Jeon HD, Shim SY, Kim YS, Park MH, Lee KA. What Is the Optimal Digoxin Level? Challenging Case of Fetal Atrial Flutter Treatment in a Monochorionic Diamniotic Twin. Medicina (Kaunas) 2023; 59:1198. [PMID: 37512010 PMCID: PMC10384027 DOI: 10.3390/medicina59071198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/15/2023] [Accepted: 06/22/2023] [Indexed: 07/30/2023]
Abstract
Background: Atrial flutter is an infrequent yet potentially fatal arrhythmia. Digoxin is the preferred first-line treatment for fetal atrial flutter due to its efficacy and favorable safety profile. The optimal digoxin serum target level for neonatal atrial flutter management remains uncertain, with the standard target level ranging from 1.0 to 2.0 ng/mL due to potential toxicity concerns above this threshold. Case Presentation: We present a case of atrial flutter in a fetus within a monochorionic diamniotic (MCDA) twin pregnancy that was successfully managed using a higher-than-standard target level of digoxin. A 34-year-old nulliparous woman was referred to our institution at 31 + 3 weeks of gestation due to fetal distress in an MCDA twin pregnancy. Fetal echocardiography revealed a ventricular rate of 214 bpm in twin A, while twin B exhibited no abnormal findings. Conclusions: Our case highlights a distinct correlation between the serum digoxin level and its impact on atrial flutter. A higher target serum level of digoxin may be necessary to achieve sinus conversion due to the unique maternal and fetal circulatory characteristics in MCDA pregnancies.
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Affiliation(s)
- Soo Jung Kim
- Department of Obstetrics and Gynecology, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea
| | - Hee Do Jeon
- Department of Cardiology, Loma Linda University Medical Center, Loma Linda, CA 92354, USA
| | - So-Yeon Shim
- Department of Pediatrics, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea
| | - Yi-Seul Kim
- Department of Pediatrics, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea
| | - Mi-Hye Park
- Department of Obstetrics and Gynecology, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea
| | - Kyung A Lee
- Department of Obstetrics and Gynecology, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea
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19
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Kim T, Kim SJ, Choi H, Shin TR, Sim YS. Diagnostic Utility and Tendency of Bronchial and Serum Soluble Receptor for Advanced Glycation EndProducts (sRAGE) in Lung Cancer. Cancers (Basel) 2023; 15:2819. [PMID: 37345156 DOI: 10.3390/cancers15102819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 06/23/2023] Open
Abstract
The receptor for advanced glycation end-products (RAGE) may serve as a diagnostic and prognostic biomarker of lung cancer and lung injury. We explored whether the serum and bronchial levels of soluble RAGE (sRAGE) distinguished infectious lung diseases from lung cancer. We collected serum and bronchial washing fluids (BWFs) from patients diagnosed with pneumonia, tuberculosis, or preoperative lung cancer from April 2016 to March 2022. sRAGE levels were measured using an enzyme-linked immunosorbent assay and we drew receiver operating characteristic (1) curves to determine the cut-off values affording the best diagnostic sensitivities. We enrolled 81 patients including 20 with tuberculosis, 30 with pneumonia, and 31 with lung cancer. Of the 81, 61% were males and the median age was 66 years. The median serum level of sRAGE was 822 (678-1168 pg/mL) and did not differ significantly between the three groups. The median bronchial sRAGE level was 167 (83-529 pg/mL) but 231 (108-649 pg/mL) for tuberculosis, 366 (106-706 pg/mL) for pneumonia, and 103 (32-254 pg/mL) for lung cancer patients (p = 0.018). The ROC curve for the bronchial sRAGE values of lung cancer patients revealed that the optimal cut-off was 118.9 pg/mL. This afforded a sensitivity of 76%, a specificity of 58%, and an area under the ROC curve of 0.695 (p = 0.005). The level of bronchial sRAGE differed significantly between patients with lung cancer and other respiratory diseases; that level may serve as an auxiliary diagnostic biomarker.
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Affiliation(s)
- Taehee Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul 07440, Republic of Korea
- Lung Research Institute, Hallym University College of Medicine, Chuncheon 24253, Republic of Korea
| | - Soo Jung Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul 07440, Republic of Korea
- Lung Research Institute, Hallym University College of Medicine, Chuncheon 24253, Republic of Korea
| | - Hayoung Choi
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul 07440, Republic of Korea
- Lung Research Institute, Hallym University College of Medicine, Chuncheon 24253, Republic of Korea
| | - Tae Rim Shin
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul 07440, Republic of Korea
- Lung Research Institute, Hallym University College of Medicine, Chuncheon 24253, Republic of Korea
| | - Yun Su Sim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul 07440, Republic of Korea
- Lung Research Institute, Hallym University College of Medicine, Chuncheon 24253, Republic of Korea
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Abstract
Vasculitic skin findings may present with annular morphologies. This group of conditions consists of capillaritis, such as pigmented purpuric dermatoses, and vasculitis, which is often classified by the affected vessel size. Annular vasculitic lesions may be the presenting sign of systemic disease, thus requiring thorough exploration to reach an accurate diagnosis and guide proper disease management. Herein we review the clinical presentation, histopathology, and treatments for cutaneous vasculitic disease that may present with annular lesions.
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Affiliation(s)
| | | | - Soo Jung Kim
- Department of Dermatology, Baylor College of Medicine, Houston, Texas, USA.
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21
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Kim SJ, Shim SY, Cho HH, Park MH, Lee KA. Prenatal Diagnosis of Fetal Obstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA) Syndrome. Medicina (B Aires) 2023; 59:medicina59040703. [PMID: 37109661 PMCID: PMC10146732 DOI: 10.3390/medicina59040703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/26/2023] [Accepted: 04/02/2023] [Indexed: 04/07/2023] Open
Abstract
Background: Obstructed hemivagina and ipsilateral renal agenesis (OHVIRA) syndrome, also known as Herlyn-Werner-Wunderlich syndrome, is a rare syndrome characterized by the triad of uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. Most cases of OHVIRA have been reported in adolescents or adults. Gartner duct cysts, including those manifesting as vaginal wall cysts, are also rare. Fetal OHVIRA syndrome and Gartner duct cysts are difficult to diagnose. Case Presentation: Here, the authors report a case of combined OHVIRA and Gartner duct cyst diagnosed prenatally by ultrasonography, along with a brief review of the relevant published reports. A 30-year-old nulliparous female was referred to our institution at 32 weeks’ gestation for fetal right kidney agenesis. Detailed ultrasonographic examinations using 2D, 3D, and Doppler ultrasounds revealed hydrocolpometra, and uterus didelphys, with a normal anus and right kidney agenesis. Conclusions: When encountering female fetuses with ipsilateral renal agenesis or vaginal cysts, clinicians should be aware of OHVIRA syndrome and Gartner duct cysts and perform systematic ultrasonographic examinations for other genitourinary anomalies.
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Affiliation(s)
- Soo Jung Kim
- Department of Obstetrics and Gynecology, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea
| | - So-Yeon Shim
- Department of Pediatrics, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea
| | - Hyun-Hae Cho
- Department of Radiology, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea
| | - Mi-Hye Park
- Department of Obstetrics and Gynecology, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea
| | - Kyung A. Lee
- Department of Obstetrics and Gynecology, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea
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22
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Huang A, Huang KY, Kim SJ. Retractions in Dermatology Literature Between 1982 and 2022: Cross-sectional Study. JMIR Dermatol 2023; 6:e39021. [PMID: 37632934 PMCID: PMC10335146 DOI: 10.2196/39021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 12/27/2022] [Accepted: 02/24/2023] [Indexed: 03/29/2023] Open
Affiliation(s)
- Austin Huang
- Department of Dermatology, Baylor College of Medicine, Houston, TX, United States
| | - Kevin Y Huang
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX, United States
| | - Soo Jung Kim
- Department of Dermatology, Baylor College of Medicine, Houston, TX, United States
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23
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Hur YM, Park S, Kwon E, You YA, Ansari A, Kim SM, Lee G, Park MH, Lee KA, Kim SJ, Kim YH, Jung YS, Cho GJ, Oh MJ, Na SH, Lee SJ, An TG, Bae JG, Kim YH, Lee SJ, Kim NK, Ha EH, Kim YJ. The introduction to air pollution on pregnancy outcome (APPO) study: a multicenter cohort study. Obstet Gynecol Sci 2023; 66:169-180. [PMID: 36973177 DOI: 10.5468/ogs.22278] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/15/2023] [Indexed: 03/29/2023] Open
Abstract
The air pollution on pregnancy outcome, (APPO) study is a prospective hospital-based cohort study designed to investigate the maternal and fetal effects of particulate matter with an aerodynamic diameter <10 μm (PM10) and particulate matter with an aerodynamic diameter below 10 μm <2.5 μm (PM2.5) exposure. Specifically, approximately 1,200 pregnant women will be recruited for 3 years to collect data on exposure to fine dust, and the methods for measuring exposure to fine particles for each pregnant woman and estimating output will be established. This study aims to analyze the relationship between particulate matter and adverse pregnancy outcomes, identify related biomarkers, and develop management guidelines. We recruited early pregnant women without underlying diseases and collected biological samples using 5 mL of maternal venous blood and 15 mL of urine in each trimester of pregnancy; in addition, 5 mL of umbilical cord blood and 2×2×2 cm of placental tissue were collected after delivery. By applying PM10 and PM2.5 and time-activity patterns from the time-weighted average model, the individual predicted exposure to air pollution for the pregnant women was obtained. The APPO study can identify the degree of exposure to air pollution in pregnant women and use it as basic data for estimating individual exposure to particulate matter. The results of this APPO study will facilitate the development of health management strategies for pregnant women against air pollution.
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Affiliation(s)
- Young Min Hur
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Sunwha Park
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Eunjin Kwon
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Young-Ah You
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - AbuZar Ansari
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Soo Min Kim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Gain Lee
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Mi Hye Park
- Ewha Womans University Seoul Hospital, Seoul, Korea
| | - Kyung A Lee
- Ewha Womans University Seoul Hospital, Seoul, Korea
| | - Soo Jung Kim
- Ewha Womans University Seoul Hospital, Seoul, Korea
| | | | - Yeon-Sung Jung
- Yonsei University Gangnam Severance Hospital, Seoul, Korea
| | | | | | - Sung Hun Na
- Kangwon National University Hospital, Chuncheon, Korea
| | - Se Jin Lee
- Kangwon National University Hospital, Chuncheon, Korea
| | - Tae Gyu An
- Kangwon National University Hospital, Chuncheon, Korea
| | - Jin-Gon Bae
- Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Yu-Hwan Kim
- Keimyung University Dongsan Medical Center, Daegu, Korea
| | | | - Na Kyung Kim
- Department of Environmental Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Eun-Hee Ha
- Department of Preventive Medicine, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University Mokdong Hospital, Seoul, Korea
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24
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Kim SJ, Lee DW. A retrospective analysis of nonresponse to denosumab after hip fractures. Acta Orthop Belg 2023; 89:71-76. [PMID: 37294988 DOI: 10.52628/89.1.9808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Denosumab is an effective antiresorptive drug commonly prescribed for the treatment of osteoporosis. However, some patients do not respond well to denosumab treatment. The aim of this study was to evaluate the factors underlying treatment nonresponses to denosumab in elderly patients following hip fracture. This retrospective study included 130 patients treated with denosumab after osteoporotic hip fracture between March 2017 and March 2020. The patients were categorized as denosumab nonresponders if they had a T-score <-3 that persisted between dual-energy X-ray absorptiometry scans, a >3% decrease in bone mineral density (BMD), or an incident fracture on denosumab therapy. We examined the baseline characteristics associated with blunted BMD responses and compared the groups following denosumab treatment for 12 months. Of 130 patients with baseline data, 105 patients (80.8%) were considered responders. No difference in baseline vitamin D, calcium, BMI, age, gender, prior fracture history, or bisphosphonate use was observed between responders and nonresponders. A longer interval between denosumab injections was associated with suboptimal BMD response at both spine and total hip (p<0.001 and p=0.04, respectively). The overall L-BMD and H-BMD were significantly increased compared with pretreatment levels after denosumab treatment (5.7% and 2.5%, respectively). This study revealed that nonresponse was not strongly associated with certain baseline variables and it appears that the reponders and nonresponders were reasonably comparable in this study population. The results of our study highlight the importance of timely denosumab administration when using this drug for osteoporosis management. Physicians should keep these results in mind in clinical practice so that they can improve utilization of 6-month denosumab.
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25
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Zhu H, Huang A, Zhou K, Bhatnagar A, Sorensen R, Cordova K, Calderara GA, Dasari N, Parker Kirby R, Kim SJ. Demographic and applicant-specific predictors of medical school research productivity in a national cohort of dermatology residents. Clin Dermatol 2023; 41:291-295. [PMID: 37271241 DOI: 10.1016/j.clindermatol.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Research is a crucial aspect of medical advancement, and applicants applying to dermatology often have high research outputs. With United States Medical Licensing Examination (USMLE) Step 1 becoming pass/fail, research productivity may be more emphasized. We primarily sought to assess predictors of medical school research productivity. Class of 2023 dermatology residents publicly listed on Accreditation Council for Graduate Medical Education-accredited programs were included. Their medical school bibliography and demographics were assessed using PubMed and other platforms (eg, Doximity, LinkedIn). By multivariable analysis, students who attended a top 25 medical school (ranked by US News and World Report) or were PhD graduates had significantly higher H-indices, average impact factors, and total years of research activity (P < .01). Top 25 medical school graduates also had significantly higher total peer-reviewed publications, first authorships, and clinical research papers (P < .01). PhD graduates had significantly more clinical research and fewer dermatology-related papers (P < .03). Graduates of osteopathic medical schools had significantly fewer review papers (P = .02). Gender and graduation from an international medical school had no relationship with research productivity. Our study demonstrates a correlation between applicant-specific factors and research productivity. Because the emphasis on research productivity may increase, understanding the mechanisms behind these relationships may guide future dermatology applicants or their mentors.
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Affiliation(s)
- Harrison Zhu
- School of Medicine, Baylor College of Medicine, Houston, Texas, USA.
| | - Austin Huang
- Department of Dermatology, Baylor College of Medicine, Houston, Texas, USA
| | - Kelvin Zhou
- School of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Anshul Bhatnagar
- School of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Ryan Sorensen
- School of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Kathryn Cordova
- School of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | | | - Nina Dasari
- School of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - R Parker Kirby
- School of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Soo Jung Kim
- Department of Dermatology, Baylor College of Medicine, Houston, Texas, USA
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26
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Brown A, Kim SJ. Detecting Elder Abuse in Dermatology: A Clinical and Practical Review. J Am Acad Dermatol 2023:S0190-9622(23)00176-7. [PMID: 36775102 DOI: 10.1016/j.jaad.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/12/2023]
Abstract
The pace of aging in our population is dramatically increasing, raising concern for rising prevalence of elder abuse. Given the visual nature of the occupation, dermatologists can play a crucial role in identifying certain types of elder mistreatment, especially physical abuse, sexual abuse, and neglect. Nonetheless, many dermatologists report insufficient training in the diagnosis of elder abuse as well as appropriate interventions. This review article aims to synthesize and assess recent clinical, screening, and practical developments surrounding elder abuse. Implementation of some of these screening methods and recommendations in clinical practice and in dermatology residency curriculums could lead to increased awareness among physicians and improved patient outcomes. Like all other clinicians, dermatologists have a legal, moral, and ethical obligation to report suspicion of mistreatment and help suffering patients. Elder abuse is and will continue to be, an important issue that will require efforts from physicians across all fields to ensure the health and safety of patients.
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Affiliation(s)
| | - Soo Jung Kim
- Baylor College of Medicine, Department of Dermatology, Houston, TX
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27
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Kim TH, Woo SG, Kim SK, Yoo BH, Shin J, Rha E, Kim SJ, Kwon KK, Lee H, Kim H, Kim HT, Sung BH, Lee SG, Lee DH. A Genetically Encoded Biosensor for the Detection of Levulinic Acid. J Microbiol Biotechnol 2023; 33:552-558. [PMID: 36775859 PMCID: PMC10164729 DOI: 10.4014/jmb.2301.01021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 01/20/2023] [Accepted: 01/20/2023] [Indexed: 02/14/2023]
Abstract
Levulinic acid (LA) is a valuable chemical used in fuel additives, fragrances, and polymers. In this study, we proposed possible biosynthetic pathways for LA production from lignin and poly(ethylene terephthalate). We also created a genetically encoded biosensor responsive to LA, which can be used for screening and evolving the LA biosynthesis pathway genes, by employing an LvaR transcriptional regulator of Pseudomonas putida KT2440 to express a fluorescent reporter gene. The LvaR regulator senses LA as a cognate ligand. The LA biosensor was first examined in an Escherichia coli strain and was found to be non-functional. When the host of the LA biosensor was switched from E. coli to P. putida KT2440, the LA biosensor showed a linear correlation between fluorescence intensity and LA concentration in the range of 0.156-10 mM LA. In addition, we determined that 0.156 mM LA was the limit of LA detection in P. putida KT2440 harboring an LA-responsive biosensor. The maximal fluorescence increase was 12.3-fold in the presence of 10 mM LA compared to that in the absence of LA. The individual cell responses to LA concentrations reflected the populationaveraged responses, which enabled high-throughput screening of enzymes and metabolic pathways involved in LA biosynthesis and sustainable production of LA in engineered microbes.
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Affiliation(s)
- Tae Hyun Kim
- Synthetic Biology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon 34141, Republic of Korea.,Department of Biosystems and Bioengineering, KRIBB School of Biotechnology, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - Seung-Gyun Woo
- Synthetic Biology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon 34141, Republic of Korea
| | - Seong Keun Kim
- Synthetic Biology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon 34141, Republic of Korea
| | - Byeong Hyeon Yoo
- Synthetic Biology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon 34141, Republic of Korea.,Department of Biosystems and Bioengineering, KRIBB School of Biotechnology, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - Jonghyeok Shin
- Synthetic Biology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon 34141, Republic of Korea
| | - Eugene Rha
- Synthetic Biology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon 34141, Republic of Korea
| | - Soo Jung Kim
- Department of Integrative Food, Bioscience and Biotechnology, Chonnam National University, Gwangju 61186, Republic of Korea
| | - Kil Koang Kwon
- Synthetic Biology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon 34141, Republic of Korea
| | - Hyewon Lee
- Synthetic Biology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon 34141, Republic of Korea
| | - Haseong Kim
- Synthetic Biology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon 34141, Republic of Korea.,Department of Biosystems and Bioengineering, KRIBB School of Biotechnology, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - Hee-Taek Kim
- Department of Food Science and Technology, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Bong-Hyun Sung
- Synthetic Biology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon 34141, Republic of Korea.,Department of Biosystems and Bioengineering, KRIBB School of Biotechnology, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - Seung-Goo Lee
- Synthetic Biology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon 34141, Republic of Korea.,Department of Biosystems and Bioengineering, KRIBB School of Biotechnology, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - Dae-Hee Lee
- Synthetic Biology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon 34141, Republic of Korea.,Department of Biosystems and Bioengineering, KRIBB School of Biotechnology, University of Science and Technology (UST), Daejeon 34113, Republic of Korea.,Department of Integrative Biotechnology, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon 16419, Republic of Korea
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28
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Lee GK, Perrault DP, Bouz A, Pourmoussa AJ, Yu R, Kim SJ, Gardner D, Johnson M, Park SY, Park EK, Seong YJN, Lee S, Jung E, Choi D, Hong YK, Wong AK. Prolymphangiogenic Effects of 9- cis Retinoic Acid Are Enhanced at Sites of Lymphatic Injury and Dependent on Treatment Duration in Experimental Postsurgical Lymphedema. Lymphat Res Biol 2022; 20:640-650. [PMID: 35584281 PMCID: PMC9810351 DOI: 10.1089/lrb.2021.0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background: Patients undergoing surgical treatment for solid tumors are at risk for development of secondary lymphedema due to intraoperative lymphatic vessel injury. The damaged lymphatic vessels fail to adequately regenerate and lymphatic obstruction leads to fluid and protein accumulation in the interstitial space and chronic lymphedema develops as a result. There are currently no effective pharmacological agents that reduce the risk of developing lymphedema or treat pre-existing lymphedema, and management is largely palliative. The present study investigated the efficacy of various 9-cis retinoic acid (9-cis RA) dosing strategies in reducing postsurgical lymphedema by utilizing a well-established mouse tail lymphedema model. Methods and Results: Short-duration treatment with 9-cis RA did not demonstrate a significant reduction in postoperative tail volume, nor an improvement in lymphatic clearance. However, long-term treatment with 9-cis RA resulted in decreased overall tail volume, dermal thickness, and epidermal thickness, with an associated increase in functional lymphatic clearance and lymphatic vessel density, assessed by LYVE-1 immunostaining, compared with control. These effects were seen at the site of lymphatic injury, with no significant changes observed in uninjured sites such as ear skin and the diaphragm. Conclusions: Given the reported results indicating that 9-cis RA is a potent promoter of lymphangiogenesis and improved lymphatic clearance at sites of lymphatic injury, investigation of postoperative 9-cis RA administration to patients at high risk of developing lymphedema may demonstrate positive efficacy and reduced rates of postsurgical lymphedema.
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Affiliation(s)
- Gene K. Lee
- Division of Plastic and Reconstructive Surgery and Keck School of Medicine of USC, Los Angeles, California, USA
- Department of Surgery, Keck School of Medicine of USC, Los Angeles, California, USA
| | - David P. Perrault
- Division of Plastic and Reconstructive Surgery and Keck School of Medicine of USC, Los Angeles, California, USA
| | - Antoun Bouz
- Division of Plastic and Reconstructive Surgery and Keck School of Medicine of USC, Los Angeles, California, USA
| | - Austin J. Pourmoussa
- Division of Plastic and Reconstructive Surgery and Keck School of Medicine of USC, Los Angeles, California, USA
| | - Roy Yu
- Division of Plastic and Reconstructive Surgery and Keck School of Medicine of USC, Los Angeles, California, USA
| | - Soo Jung Kim
- Division of Plastic and Reconstructive Surgery and Keck School of Medicine of USC, Los Angeles, California, USA
- Department of Surgery, Keck School of Medicine of USC, Los Angeles, California, USA
- Division of Plastic Surgery, City of Hope National Medical Center, Duarte, California, USA
| | - Daniel Gardner
- Division of Plastic and Reconstructive Surgery and Keck School of Medicine of USC, Los Angeles, California, USA
| | - Maxwell Johnson
- Division of Plastic and Reconstructive Surgery and Keck School of Medicine of USC, Los Angeles, California, USA
| | - Sun Young Park
- Division of Plastic and Reconstructive Surgery and Keck School of Medicine of USC, Los Angeles, California, USA
| | - Eun Kyung Park
- Department of Surgery, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Young Jin N. Seong
- Department of Surgery, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Sunju Lee
- Department of Surgery, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Eunson Jung
- Division of Plastic and Reconstructive Surgery and Keck School of Medicine of USC, Los Angeles, California, USA
| | - Dongwon Choi
- Department of Surgery, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Young-Kwon Hong
- Division of Plastic and Reconstructive Surgery and Keck School of Medicine of USC, Los Angeles, California, USA
- Department of Surgery, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Alex K. Wong
- Division of Plastic and Reconstructive Surgery and Keck School of Medicine of USC, Los Angeles, California, USA
- Department of Surgery, Keck School of Medicine of USC, Los Angeles, California, USA
- Division of Plastic Surgery, City of Hope National Medical Center, Duarte, California, USA
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29
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Lee SJ, Kim D, Suh CH, Shim WH, Heo H, Jo S, Chung SJ, Kim HS, Kim SJ. Detection rate of MR myelography without intrathecal gadolinium in patients with newly diagnosed spontaneous intracranial hypotension. Clin Radiol 2022; 77:848-854. [PMID: 35985843 DOI: 10.1016/j.crad.2022.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/16/2022] [Accepted: 06/28/2022] [Indexed: 11/26/2022]
Abstract
AIM To evaluate the detection rate of magnetic resonance (MR) myelography without intrathecal gadolinium for cerebrospinal fluid (CSF) leakage in patients with newly diagnosed spontaneous intracranial hypotension (SIH) and to validate a published scoring system for predicting CSF leakage. MATERIALS AND METHODS This retrospective, observational, single-institution study included patients with newly diagnosed SIH between March 2015 and April 2021. Patients were included if they (a) had newly diagnosed SIH and (b) underwent initial brain MR imaging and preprocedural MR myelography with two- and three-dimensional turbo spin-echo sequences. Patients who underwent spine surgery or procedures including epidural injection and acupuncture were excluded. The detection rate was defined as the proportion of patients with a true-positive MR myelography result among all patients with confirmed CSF leakage. The interobserver agreement for the MR myelography results between two radiologists was analysed using weighted kappa statistics. RESULTS A total of 136 patients (mean age, 48 years; 70 women) with suspected SIH were included. Of these patients, 120 (88%, 120/136) were confirmed to have CSF leakage. Of the patients with confirmed CSF leakage, 90 (75%, 90/120) had epidural fluid collection. The detection rate of MR myelography for CSF leakage was 88% (105/120). The interobserver agreement between the two readers for detecting CSF leakage (κ = 0.76) or epidural fluid collection (κ = 0.76) on MR myelography was high. Among 24 patients with normal brain MR imaging results, 16 had CSF leakage (67%, 16/24). CONCLUSIONS Non-invasive MR myelography without intrathecal gadolinium should be considered to detect CSF leakage in patients with suspected SIH.
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Affiliation(s)
- S J Lee
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - D Kim
- University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - C H Suh
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - W H Shim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - H Heo
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S Jo
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S J Chung
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - H S Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S J Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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30
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Seo SM, Kim SJ, Kwon O, Brilakis ES, Yoon YH, Lee KS, Kim TO, Lee PH, Kang SJ, Kim YH, Lee CW, Park SW, Lee SW. Intravascular ultrasound-guided optimization for chronic total occlusion-percutaneous coronary intervention with multiple drug-eluting stents. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2071] [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
Multiple stenting in the chronic total occlusion (CTO) lesions is frequently required, however associated with poorer clinical outcomes. It is demonstrated that intravascular ultrasound (IVUS)-guided CTO-percutaneous coronary intervention (PCI) is related to a lower risk of adverse clinical events.
Purpose
We aimed to evaluate the clinical impact of stent optimization under IVUS guidance for multiple stenting, comparing with single stenting.
Methods
A total of 916 patients receiving drug-eluting stent (DES) under IVUS guidance were classified into two groups (stent optimization and non-optimization) according to optimization criteria (an absolute expansion criteria; minimal stent area ≥4.9 mm2 and a relative expansion criteria; 80% of mean reference lumen area). Of total population, 314 patients (34.3%) were treated with single stent and 575 patients (62.7%) were treated with multiple stents, respectively. Ischemic-driven target-lesion revascularization (TLR)/reocclusion was evaluated.
Results
Under IVUS guidance, 316 patients (34.5%) met IVUS criteria for stent optimization The achieving rates were 53% in the single stent group and 24% in the multiple stents group, respectively, (p<0.001). During a median of 4.7 years, the multiple stent group showed a significantly higher TLR/reocclusion rate, compared with the single stent group (12.8% vs. 5.2%, adjusted hazard ratio [HR] 2.51, 95% confidence interval [CI] 1.20–5.25, p=0.01). (Figure 1) Meeting both the absolute and relative expansion criteria was associated with a significantly low rate of TLR/reocclusion rate (12.5% vs. 5.2%, adjusted HR 0.34, 95% CI: 0.15–0.79, p=0.01). Under IVUS-guidance, there was no significant difference between multiple stenting and single stenting in case of achieving the optimization criteria (6.5% vs. 4.2%, p=0.11), whereas non-optimization group in the patients with multiple stenting showed a significantly higher rate of TLR/reocclusion, compared with IVUS-optimization group in the patients with single stenting (14.5% vs. 4.2%, p=0.002). (Figure 2)
Conclusions
In CTO-PCI with DES, multiple stenting significantly increased the risk of TLR/reocclusion. IVUS-guided optimization for multiple stenting showed a comparable long-term risk of TLR/reocclusion to single stenting with IVUS optimization. Hence, achieving IVUS expansion criteria may help to reduce the risk of TLR/reocclusion in CTO-PCI with multiple DES overlapping.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S M Seo
- Eunpyeoung St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - S J Kim
- Eunpyeoung St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - O Kwon
- Eunpyeoung St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - E S Brilakis
- Minneapolis Heart Institute Foundation , Minneapolis , United States of America
| | - Y H Yoon
- Sejong Chungnam National University Hospital , Sejong , Korea (Republic of)
| | - K S Lee
- Daejeon St. Mary's Hospital , Daejeon , Korea (Republic of)
| | - T O Kim
- Asan Medical Center , Seoul , Korea (Republic of)
| | - P H Lee
- Asan Medical Center , Seoul , Korea (Republic of)
| | - S J Kang
- Asan Medical Center , Seoul , Korea (Republic of)
| | - Y H Kim
- Asan Medical Center , Seoul , Korea (Republic of)
| | - C W Lee
- Asan Medical Center , Seoul , Korea (Republic of)
| | - S W Park
- Asan Medical Center , Seoul , Korea (Republic of)
| | - S W Lee
- Asan Medical Center , Seoul , Korea (Republic of)
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Namgoong H, Kim SJ, Choi SW. Functional analysis of novel SCN5A mutations related to Brugada syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.364] [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
Brugada syndrome (BrS) is an arrhythmogenic disorder that has been linked to mutations in SCN5A, the gene encoding for the pore-forming α-subunit of the cardiac Na+ channel. Recently, novel SCN5A missense mutations (A385T and R504T) were identified in a BrS patient. Since the mutations are in the loop connecting transmembrane segments 5 and 6 in domain 1 (S5-S6 in DI) and segments 6 and 1 between domain 1 and 2 (DI-DII linker), it can lead to dysfunctional property of the Na+ channel. Here we aimed to characterize the electrophysiological properties of A385T and R504T. The wild-type (WT) and mutant SCN5A were transiently transfected in HEK293 cells, and the Na+ channel was analyzed using the whole-cell patch-clamp technique. WT, A385T, R504T, and double mutant (A385T/R504T) showed no significant differences in the current density and the voltage-dependent activation. Unexpectedly, a rightward shift of the voltage-dependent inactivation was identified in the three groups of mutation. Besides, the recovery from inactivation of double mutant was faster than that of WT. These results suggest that, contrary to the expected mechanism of BrS, the mutations cause a gain-of-function of NaV1.5. However, the current densities of R504T and double mutant transfected with β-subunit SCN1B were significantly suppressed but A385T was not different from WT. The voltage dependent activation and inactivation of all mutants were not significantly different from WT. The recovery from inactivation of all mutants were slower than that of WT. These results suggest that R504T mutation of α-subunit SCN5A interacting with β-subunit SCN1B is responsible to pathophysiological function of novel BrS.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- H Namgoong
- Seoul National University College of Medicine , Seoul , Korea (Republic of)
| | - S J Kim
- Seoul National University College of Medicine , Seoul , Korea (Republic of)
| | - S W Choi
- Dongguk university College of medicine , Gyeongju , Korea (Republic of)
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Byun IH, Koo HK, Kim SJ, Kim HJ, Lee SW. Double Triangle Suture Technique for Inverted Nipple Correction While Preserving the Lactiferous Ducts. J Cutan Aesthet Surg 2022; 15:371-374. [PMID: 37035585 PMCID: PMC10081458 DOI: 10.4103/jcas.jcas_85_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
Background Inverted nipple is a relatively common symptom to encounter, and numerous surgical techniques have been developed for correction. Aim The aim of this study is to provide a simple and effective procedure with long-term results. Materials and Methods A total of 209 nipples of 108 patients received inverted nipple correction via double triangle suture technique. Results Of the 108 patients, 7 patients had unilateral inverted nipple and 101 patients had bilateral. Of the 209 nipples operated, 28 were grade 1, 117 were grade 2, and 64 were grade 3. The mean follow-up period was 13.16 ± 6.77 months. There were minimal complications. Conclusion Double triangle suture technique is a safe and reliable inverted nipple correction method. It requires two small incisions, few sutures, and minimal operation time. We especially recommend this procedure for young women with potential breastfeeding in the future and who concern for minimal scars.
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Affiliation(s)
- Il Hwan Byun
- Department of Plastic and Reconstructive Surgery, Seoul, Korea
| | - Hyun Kook Koo
- Department of Plastic and Reconstructive Surgery, Seoul, Korea
| | - Soo Jung Kim
- Department of Plastic and Reconstructive Surgery, Seoul, Korea
| | - Hye Jin Kim
- Department of General Surgery, DA Plastic Surgery, Seoul, Korea
| | - Sang Woo Lee
- Department of Plastic and Reconstructive Surgery, Seoul, Korea
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Wang HY, Jacob JS, Dunn C, Muhammad M, Kim SJ. Hyaluronidase for Skin Necrosis Induced by Amiodarone. Cutis 2022; 110:E33-E35. [PMID: 36446094 DOI: 10.12788/cutis.0655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Hannah Y Wang
- Baylor College of Medicine, Houston, Texas. Drs. Dunn, Muhammad, and Kim are from the Department of Dermatology
| | - Joanne S Jacob
- Baylor College of Medicine, Houston, Texas. Drs. Dunn, Muhammad, and Kim are from the Department of Dermatology
| | - Carly Dunn
- Baylor College of Medicine, Houston, Texas. Drs. Dunn, Muhammad, and Kim are from the Department of Dermatology
| | - Muneeza Muhammad
- Baylor College of Medicine, Houston, Texas. Drs. Dunn, Muhammad, and Kim are from the Department of Dermatology
| | - Soo Jung Kim
- Baylor College of Medicine, Houston, Texas. Drs. Dunn, Muhammad, and Kim are from the Department of Dermatology
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Gupta R, Robson D, Khalfe Y, Lowe N, Kim SJ. Bleeding risk after skin biopsy in patients with underlying bleeding diathesis: A retrospective review. Australas J Dermatol 2022; 63:e362-e365. [DOI: 10.1111/ajd.13927] [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] [Received: 06/11/2022] [Revised: 08/10/2022] [Accepted: 09/08/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Rohit Gupta
- School of Medicine Baylor College of Medicine Houston Texas USA
| | - Denise Robson
- School of Medicine Baylor College of Medicine Houston Texas USA
| | - Yasmin Khalfe
- Department of Medicine Tulane University School of Medicine New Orleans Louisiana USA
| | - Nicholas Lowe
- Dermatology Intermountain Healthcare Medical Group Salt Lake City Utah USA
| | - Soo Jung Kim
- Department of Dermatology Baylor College of Medicine Houston Texas USA
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Huang A, Zhu H, Zhou K, Kirby RP, Dasari N, Calderara GA, Cordova K, Sorensen R, Bhatnagar A, Kim SJ. Social Media Impact of Articles Published by Dermatology Residents During Medical School: Cross-sectional Study. JMIR Dermatol 2022; 5:e39201. [PMID: 37632895 PMCID: PMC10334923 DOI: 10.2196/39201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The Altmetric score (AS) is a novel measure of publication impact that is calculated by the number of mentions across various social media websites. This method may have advantages over traditional bibliometrics in the context of research by medical students. OBJECTIVE This study aimed to determine whether dermatology matriculants who graduated from higher-ranked medical schools published more articles with greater impact (ie, a higher AS) than those from lower-ranked institutions. METHODS A PubMed search for articles published by dermatology residents who started medical school in 2020 was conducted. Demographic information and Altmetric data were collected, and medical schools were sorted according to US News' top-25 and non-top-25 categories. RESULTS Residents who completed their medical training at a top-25 institution published more papers (mean 4.93, SD 4.18 vs mean 3.11, SD 3.32; P<.001) and accrued a significantly higher total AS (mean 67.9, SD 160 vs mean 22.9, SD 75.9; P<.001) and average AS (mean 13.1, SD 23.7 vs mean 6.71, SD 32.3; P<.001) per article than those who graduated from non-top-25 schools. CONCLUSIONS Our results indicate that students in top-25 schools may have greater access to research resources and opportunities. With a pass/fail United States Medical Licensing Examination Step 1 exam that may increasingly shift focus toward scholarly output from medical students, further discussion on how to create a more equitable dermatology match is essential.
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Affiliation(s)
- Austin Huang
- Department of Dermatology, Baylor College of Medicine, Houston, TX, United States
| | - Harrison Zhu
- Department of Dermatology, Baylor College of Medicine, Houston, TX, United States
| | - Kelvin Zhou
- Department of Dermatology, Baylor College of Medicine, Houston, TX, United States
| | - R Parker Kirby
- Department of Dermatology, Baylor College of Medicine, Houston, TX, United States
| | - Nina Dasari
- Department of Dermatology, Baylor College of Medicine, Houston, TX, United States
| | | | - Kathryn Cordova
- Department of Dermatology, Baylor College of Medicine, Houston, TX, United States
| | - Ryan Sorensen
- Department of Dermatology, Baylor College of Medicine, Houston, TX, United States
| | - Anshul Bhatnagar
- Department of Dermatology, Baylor College of Medicine, Houston, TX, United States
| | - Soo Jung Kim
- Department of Dermatology, Baylor College of Medicine, Houston, TX, United States
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Soh Y, Kim SJ, Yoo EA. Large Dolichoectasia Concurrently Involving Both Anterior and Posterior Cerebral Circulation: A Case Report. J Korean Soc Radiol 2022; 83:1153-1159. [PMID: 36276223 PMCID: PMC9574282 DOI: 10.3348/jksr.2021.0184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/28/2022] [Accepted: 04/14/2022] [Indexed: 11/30/2022]
Abstract
Dolichoectasia is an uncommon disorder characterized by the presence of a dilated, elongated, and tortuous cerebral artery. Its main pathologic mechanism is the disruption of the internal elastic lamina. Risk factors for dolichoectasia are advanced age, chronic hypertension, and metabolic disease. It mainly involves the vertebrobasilar vasculature (or "posterior circulation"), but dolichoectasia can also be seen in the anterior circulation, particularly the anterior cerebral artery. There are no reported cases of dolichoectasia involving both anterior and posterior circulation in South Korea. Here we report an unusual case of dolichoectasia involving both anterior and posterior circulation in a young female without any underlying disease on the basis of prominent imaging findings.
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Shahrokni A, Tin AL, Downey RJ, Bochner BH, Nash GM, Kim SJ, Afonso A, Korc-Grodzicki B, Vickers A. Development of memorial Sloan Kettering (MSK) surgery stress score for older adults with cancer. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e24014] [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: 11/20/2022] Open
Abstract
e24014 Background: The stress from oncologic surgeries for older adults may lead to poor surgical outcomes. In this study, we aim to develop a MSK Surgery Stress Score to measure the complexity of surgery for these patients. The score could then be used for future analyses using datasets where patients undergoing a variety of procedures. Methods: This is a retrospective analysis of adults aged 75 and older who underwent elective cancer surgery in our institution with hospital length of stay of at least one day in 2015 to 2020. Based on surgery stress score developed by Haga et al., we explored various models including at least one or some of these variables as linear or non-linear terms: operation time, weight (kg), blood loss (cc), type of surgery, body mass index, and incision score. The primary outcome of interest evaluated was defined as the composite outcome of death within 90-day of surgery, readmission or emergency room visit or major complications (grade 3-5) within 30 days of surgery. We additionally explored models for a secondary outcome, where minor complications (grade 1-2) were included in the definition, and lastly, we looked at major complications alone as a tertiary outcome. For each of the model and outcomes, we used a logistic regression. We then used the logit transformation of the predicted probability to represent the proposed surgery stress score. Using this score, we evaluated the area under the curve (AUC) for each outcome. Results: In total, 1573 patients were included in the study. The median age was 80 (quartiles 77, 83) and just under half (49%) were male. The median (quartile) operation time was 181 minutes (115, 259), weight was 71 kg (62, 84), blood loss was 100 mL (50, 300), and just over (51%) of patient underwent an abdominopelvic procedure. The rate of 90-day mortality was 3.8%, while the rate of 30-day major complication, readmission and emergency room visit was 7.4%, 10% and 13%, respectively Furthermore, 21%, and 35% experienced primary, and secondary outcomes, respectively. Overall, 18 predictive models for each of the outcomes were developed and assessed. AUC for our different models ranged from 0.59 to 0.73 for the different definitions of our outcomes. Among the various models, the one defined using whether patients underwent an abdominopelvic procedure, incision score, operation time, weight, and blood loss (the latter two both included as non-linear terms) appeared to the front runner. Conclusions: We explored potential models to be used as the MSK Surgery Stress Score. Currently the model is being optimized by additional work. Following optimization of the model, future studies should validate this score in other cohorts of older surgical patients with cancer.
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Affiliation(s)
| | - Amy L. Tin
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | | | - Soo Jung Kim
- Memorial Sloan Kettering Cancer Center, New York, NY
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Aye YM, Kim SJ, Suriyawongpaisal W, Hong SA, Chang YS. Utilization of Postnatal Care Services among Thai Women during the COVID-19 Pandemic: Results of a Web-Based Survey. Int J Environ Res Public Health 2022; 19:ijerph19116536. [PMID: 35682122 PMCID: PMC9179996 DOI: 10.3390/ijerph19116536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022]
Abstract
The postnatal period is an underserved aspect of maternity care, potentially worsened by the COVID-19 pandemic. This study aims to identify postnatal care (PNC) use by health personnel within the 42 days of childbirth among postpartum mothers in Thailand. This web-based, cross-sectional study was conducted from July to October 2021 (n = 840). Multiple binary and ordinal logistic regressions were conducted to predict three outcome variables (≥2 times, ≥3 times, or level of PNC use). Women who received PNC were in low numbers (≥2: 30.7% and (≥3: 12.9%), while 54.4% of women reported no barriers to access PNC, and 31.9% reported barriers, including worries over COVID-19 infection, followed by movement restrictions imposed by the government (11.7%) and the closure of healthcare centers (10%). Women working in a self-employed capacity, living in urban areas, and undergoing a Caesarean section with no/less worry about COVID-19 infection were more likely to utilize postnatal care (≥2 or number of PNC). This study provides timely information, revealing that a relatively low percentage of postpartum women received PNC, particularly among the socially deprived group. Since the fear of COVID infection is listed as a major barrier, the provision of PNC services, including a telehealth program should be considered.
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Affiliation(s)
- Yin Min Aye
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom 73170, Thailand; (Y.M.A.); (W.S.)
| | - Soo Jung Kim
- Department of Health Sciences, Hamburg University of Applied Sciences, 20099 Hamburg, Germany;
| | - Wichukorn Suriyawongpaisal
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom 73170, Thailand; (Y.M.A.); (W.S.)
| | - Seo Ah Hong
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom 73170, Thailand; (Y.M.A.); (W.S.)
- Correspondence: ; Tel.: +66-2441-9040
| | - Yan-Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London SE1 8WA, UK;
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Lee KH, Li H, Lee MH, Park SJ, Kim JS, Han YJ, Cho K, Ha B, Kim SJ, Jacob L, Koyanagi A, Shin JI, Kim JH, Smith L. Clinical characteristics and treatments of multi-system inflammatory syndrome in children: a systematic review. Eur Rev Med Pharmacol Sci 2022; 26:3342-3350. [PMID: 35587087 DOI: 10.26355/eurrev_202205_28754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Multisystem inflammatory syndrome in children (MIS-C) can occur in association with coronavirus disease 2019 (COVID-19). It is not easy to differentiate MIS-C from severe COVID-19 or Kawasaki disease based on symptoms. The aim of this study was to describe the clinical and laboratory characteristics of MIS-C. PATIENTS AND METHODS We searched PubMed/Medline for case series and reports of MIS-C published until June 20, 2020. From a total of nine articles involving 45 cases, various clinical and laboratory data were extracted. Each target case was evaluated by using different diagnostic criteria. RESULTS The average age at onset of MIS-C was 8.6 years. In 80% of cases, the age of patients ranged from 5 to 15 years. Fever (100%) and shock (82%) were the most common presenting symptoms. Sixty percent of cases met the diagnostic criteria for typical or atypical Kawasaki disease. Biomarkers indicative of inflammation, coagulopathy, or cardiac injury were characteristically elevated as follows: ferritin (mean: 1,061 ng/mL), CRP (217 mg/L), ESR (69 mm/hr), IL-6 (214.8 pg/mL), TNFα (63.4 pg/mL), D-dimer (3,220 ng/mL), PT (15.5 s), troponin I (1,006 ng/L), and BNP (12,150 pg/mL). Intravenous immunoglobulin was administered in all target cases, and inotropic agents were commonly used as well. No case of death was observed. CONCLUSIONS This study demonstrated that MIS-C is a serious condition that presents with fever, rash, as well as cardiovascular and gastrointestinal symptoms. Although it is challenging to differentiate MIS-C from Kawasaki disease or severe COVID-19, initiation of appropriate treatments through early diagnosis is warranted.
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Affiliation(s)
- K H Lee
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Kim SJ, Fessele KL, Tin AL, Malling C, Litchfield H, Korc-Grodzicki B, Shahrokni A. The association between Memorial Sloan Kettering Frailty Index with 30-day survival among patients aged ≥ 75 with cancer and COVID-19. J Geriatr Oncol 2022; 13:416-419. [PMID: 34955444 PMCID: PMC8687748 DOI: 10.1016/j.jgo.2021.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/01/2021] [Accepted: 12/17/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Advanced age and multiple comorbidities have been established as a risk factor for more severe disease and increased mortality among patients with COVID-19, yet the impact of frailty in patients with cancer 75 years and older who are admitted, remains unclear. METHODS To better understand the clinical presentation and course of illness for this population, we conducted a chart review of patients with cancer age 75 and older who were admitted to a comprehensive cancer center within 72 h of a confirmed COVID-19 diagnosis over a three-month period (March 1, 2020-May 31, 2020). Frequency and proportion of characteristics were reported. We additionally assessed the association between frailty and 30-day mortality using univariable logistic regression. RESULTS Our cohort consisted of 70 patients. We found evidence that increased frailty based on MSK-FI was associated with increased risk of 30-day mortality (OR 1.37, 95% CI 1.00, 1.87; p-value = 0.051), though this did not meet conventional levels of significance. CONCLUSION Our analysis showed evidence of some association between degree of frailty and 30-day survival among older patients with cancer aged ≥75 who were admitted with COVID-19 infection. This finding illustrates the importance of frailty screening in the care management of older patients with cancer and COVID-19.
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Affiliation(s)
- Soo Jung Kim
- Geriatric Service, Division of Subspecialty Medicine, Memorial Sloan Kettering Cancer Center, USA,Corresponding author at: Geriatrics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Box 205 1275, York Ave., New York, NY 10065, USA
| | | | - Amy L. Tin
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, USA
| | - Charlotte Malling
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, USA
| | - Hayley Litchfield
- Division of Sub-Specialty Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065, USA
| | - Beatriz Korc-Grodzicki
- Geriatric Service, Division of Subspecialty Medicine, Memorial Sloan Kettering Cancer Center, USA
| | - Armin Shahrokni
- Geriatric Service, Division of Subspecialty Medicine, Memorial Sloan Kettering Cancer Center, USA
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Elkrief A, Hennessy C, Kuderer NM, Rubinstein SM, Wulff-Burchfield E, Rosovsky RP, Vega-Luna K, Thompson MA, Panagiotou OA, Desai A, Rivera DR, Khaki AR, Tachiki L, Lynch RC, Stratton C, Elias R, Batist G, Kasi A, Shah DP, Bakouny Z, Cabal A, Clement J, Crowell J, Dixon B, Friese CR, Fry SL, Grover P, Gulati S, Gupta S, Hwang C, Khan H, Kim SJ, Klein EJ, Labaki C, McKay RR, Nizam A, Pennell NA, Puc M, Schmidt AL, Shahrokni A, Shaya JA, Su CT, Wall S, Williams N, Wise-Draper TM, Mishra S, Grivas P, French B, Warner JL, Wildes TM. Geriatric risk factors for serious COVID-19 outcomes among older adults with cancer: a cohort study from the COVID-19 and Cancer Consortium. Lancet Healthy Longev 2022; 3:e143-e152. [PMID: 35187516 PMCID: PMC8843069 DOI: 10.1016/s2666-7568(22)00009-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Older age is associated with poorer outcomes of SARS-CoV-2 infection, although the heterogeneity of ageing results in some older adults being at greater risk than others. The objective of this study was to quantify the association of a novel geriatric risk index, comprising age, modified Charlson comorbidity index, and Eastern Cooperative Oncology Group performance status, with COVID-19 severity and 30-day mortality among older adults with cancer. METHODS In this cohort study, we enrolled patients aged 60 years and older with a current or previous cancer diagnosis (excluding those with non-invasive cancers and premalignant or non-malignant conditions) and a current or previous laboratory-confirmed COVID-19 diagnosis who reported to the COVID-19 and Cancer Consortium (CCC19) multinational, multicentre, registry between March 17, 2020, and June 6, 2021. Patients were also excluded for unknown age, missing data resulting in unknown geriatric risk measure, inadequate data quality, or incomplete follow-up resulting in unknown COVID-19 severity. The exposure of interest was the CCC19 geriatric risk index. The primary outcome was COVID-19 severity and the secondary outcome was 30-day all-cause mortality; both were assessed in the full dataset. Adjusted odds ratios (ORs) and 95% CIs were estimated from ordinal and binary logistic regression models. FINDINGS 5671 patients with cancer and COVID-19 were included in the analysis. Median follow-up time was 56 days (IQR 22-120), and median age was 72 years (IQR 66-79). The CCC19 geriatric risk index identified 2365 (41·7%) patients as standard risk, 2217 (39·1%) patients as intermediate risk, and 1089 (19·2%) as high risk. 36 (0·6%) patients were excluded due to non-calculable geriatric risk index. Compared with standard-risk patients, high-risk patients had significantly higher COVID-19 severity (adjusted OR 7·24; 95% CI 6·20-8·45). 920 (16·2%) of 5671 patients died within 30 days of a COVID-19 diagnosis, including 161 (6·8%) of 2365 standard-risk patients, 409 (18·5%) of 2217 intermediate-risk patients, and 350 (32·1%) of 1089 high-risk patients. High-risk patients had higher adjusted odds of 30-day mortality (adjusted OR 10·7; 95% CI 8·54-13·5) than standard-risk patients. INTERPRETATION The CCC19 geriatric risk index was strongly associated with COVID-19 severity and 30-day mortality. Our CCC19 geriatric risk index, based on readily available clinical factors, might provide clinicians with an easy-to-use risk stratification method to identify older adults most at risk for severe COVID-19 as well as mortality. FUNDING US National Institutes of Health National Cancer Institute Cancer Center.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Orestis A Panagiotou
- Department of Health Services Policy and Practice, Brown University School of Public Health, Providence, RI, USA
| | | | | | | | - Lisa Tachiki
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Ryan C Lynch
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Catherine Stratton
- Yale Cancer Center at Yale University School of Medicine, New Haven, CT, USA
| | - Rawad Elias
- Hartford Healthcare Cancer Institute, Hartford, CT, USA
| | - Gerald Batist
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Anup Kasi
- The University of Kansas Medical Center, Kansas City, KS, USA
| | - Dimpy P Shah
- Mays Cancer Center at UT Health San Antonio MD Anderson Cancer Center, San Antonio, TX, USA
| | | | - Angelo Cabal
- Moores Comprehensive Cancer Center at the University of California, San Diego (UCSD), San Diego, CA, USA
| | | | | | | | | | - Stacy L Fry
- University of Michigan Rogel Cancer Center, Ann Arbor, MI, USA
| | - Punita Grover
- University of Cincinnati Cancer Center, Cincinnati, OH, USA
| | - Shuchi Gulati
- University of Cincinnati Cancer Center, Cincinnati, OH, USA
| | - Shilpa Gupta
- Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - Clara Hwang
- Henry Ford Cancer Institute, Henry Ford Hospital, Detroit, MI, USA
| | - Hina Khan
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Soo Jung Kim
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Elizabeth J Klein
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Rana R McKay
- Moores Comprehensive Cancer Center at the University of California, San Diego (UCSD), San Diego, CA, USA
| | - Amanda Nizam
- Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | | | | | | | | | - Justin A Shaya
- Moores Comprehensive Cancer Center at the University of California, San Diego (UCSD), San Diego, CA, USA
| | | | - Sarah Wall
- The Ohio State University, Columbus, OH, USA
| | | | | | - Sanjay Mishra
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Petros Grivas
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA
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Koo Y, Kim SJ, Song JH. The moderating effect of communication on congruence and incongruence of openness to change: is communication always beneficial for learning organization culture and knowledge sharing? TLO 2022. [DOI: 10.1108/tlo-02-2021-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this study was to explore the moderating role of communication in the relationship between person-organization fit (P-O fit) of openness to change, learning organization and knowledge sharing.
Design/methodology/approach
A total of 1,015 faculty and staff participants from three private universities in South Korea was included in the analysis. Individual and organizational aspects of openness to change were examined based on the P-O fit theory. Moderated polynomial regression and response surface methodology were used for data analysis.
Findings
At a higher level of communication, the congruence of openness to change between the individual and organization showed a positive fit effect on learning organization. The incongruence of openness to change between individual and organization, in which the organizations’ openness to change was higher than that of individuals, decreased the level of knowledge sharing when the level of communication was higher.
Originality/value
The results of this study support the theory and practice that consideration of P-O fit on openness to change and a strategic approach of communication are needed to succeed in organizational change.
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Trinidad J, Gabel CK, Bonomo L, Cartron A, Chand S, Coburn W, Daveluy S, Davis M, DeNiro KL, Guggina LM, Han JJ, Hennessy K, Hoffman M, Katz K, Keller JJ, Kim SJ, Konda S, Lake E, Lincoln FN, Lo JA, Markova A, Marvin EK, Micheletti RG, Newman S, Nutan F, Nguyen CV, Pahalyants V, Patel J, Rahnama-Moghadam S, Rambhatla PV, Riegert M, Reingold RE, Robinson DB, Rrapi R, Sartori-Valinotti JC, Seminario-Vidal L, Sharif-Sidi Z, Smogorzewski J, Spaccarelli N, Stewart JR, Tuttle SD, Ulrich MN, Wanat KA, Xia FD, Kaffenberger B, Kroshinsky D. Telemedicine and Dermatology Hospital Consultations During The COVID-19 Pandemic: A Multi-Center Observational Study on Resource Utilization and Conversion to In-Person Consultations During the COVID-19 Pandemic. J Eur Acad Dermatol Venereol 2021; 36:e323-e325. [PMID: 34932237 DOI: 10.1111/jdv.17898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/25/2021] [Accepted: 12/15/2021] [Indexed: 11/28/2022]
Affiliation(s)
- John Trinidad
- The Ohio State University College of Medicine, Columbus.,Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
| | - Colleen K Gabel
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Lauren Bonomo
- Division of Dermatology, Department of Medicine, University of Washington School of Medicine, Seattle
| | - Alexander Cartron
- Department of Dermatology, University of Maryland School of Medicine, Baltimore
| | - Sidharth Chand
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - William Coburn
- Department of Dermatology, University of Colorado School of Medicine, Aurora
| | | | - Mark Davis
- Department of Dermatology, Mayo Clinic, Rochester
| | - Katherine L DeNiro
- Division of Dermatology, Department of Medicine, University of Washington School of Medicine, Seattle
| | - Lauren M Guggina
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston
| | - Jane J Han
- Division of Dermatology, Loyola University Medical Center, Maywood
| | - Kerry Hennessy
- Department of Dermatology and Cutaneous Surgery, University of South Florida Morsani College of Medicine, Tampa
| | - Melissa Hoffman
- Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia
| | - Kimberly Katz
- Department of Dermatology, Medical College of Wisconsin, Milwaukee
| | - Jesse J Keller
- Department of Dermatology, Oregon Health and Science University, Portland
| | - Soo Jung Kim
- Department of Dermatology, Baylor College of Medicine, Houston
| | | | - Eden Lake
- Division of Dermatology, Loyola University Medical Center, Maywood
| | - Flossy N Lincoln
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago
| | - Jennifer A Lo
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Alina Markova
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York.,Department of Dermatology, Weill Cornell Medical College, New York
| | | | - Robert G Micheletti
- Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia
| | - Sabrina Newman
- Department of Dermatology, University of Colorado School of Medicine, Aurora
| | - Fnu Nutan
- Department of Dermatology, Virginia Commonwealth University, Richmond
| | - Cuong V Nguyen
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago
| | - Vartan Pahalyants
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Jay Patel
- Department of Dermatology, Baylor College of Medicine, Houston
| | | | | | - Maureen Riegert
- Division of Dermatology, Loyola University Medical Center, Maywood
| | - Rachel E Reingold
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York.,Albert Einstein College of Medicine, Bronx
| | | | - Renajd Rrapi
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston
| | | | - Lucia Seminario-Vidal
- Department of Dermatology and Cutaneous Surgery, University of South Florida Morsani College of Medicine, Tampa
| | | | | | | | | | | | | | - Karolyn A Wanat
- Department of Dermatology, Medical College of Wisconsin, Milwaukee
| | - Fan Di Xia
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Benjamin Kaffenberger
- The Ohio State University College of Medicine, Columbus.,Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
| | - Daniela Kroshinsky
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston
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Lee JH, Jeon B, Park M, Ha J, Kim SJ, Son MK, Wang S, Lee JH, Jeong YK. Synergistic radiosensitizing effect of BR101801, a specific DNA-dependent protein kinase inhibitor, in various human solid cancer cells and xenografts. Am J Cancer Res 2021; 11:5440-5451. [PMID: 34873471 PMCID: PMC8640799] [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] [Received: 07/20/2021] [Accepted: 10/07/2021] [Indexed: 06/13/2023] Open
Abstract
DNA-dependent protein kinase (DNA-PK), an essential component of the non-homologous end-joining (NHEJ) repair pathway, plays an important role in DNA damage repair (DDR). Therefore, DNA-PK inhibition is a promising approach for overcoming radiotherapy or chemotherapy resistance in cancers. In this study, we demonstrated that BR101801, a potent DNA-PK inhibitor, acted as an effective radiosensitizer in various human solid cancer cells and an in vivo xenograft model. Overall, BR101801 strongly elevated ionizing radiation (IR)-induced genomic instability via induction of cell cycle G2/M arrest, autophagic cell death, and impairment of DDR pathway in human solid cancer cells. Interestingly, BR101801 inhibited not only phosphorylation of DNA-PK catalytic subunit in NHEJ factors but also BRCA2 protein level in homologous recombination (HR) factors. In addition, combination BR101801 and IR suppressed tumor growth compared with IR alone by reducing phosphorylation of DNA-PK in human solid cancer xenografts. Our findings suggested that BR101801 is a selective DNA-PK inhibitor with a synergistic radiosensitizing effect in human solid cancers, providing evidence for clinical applications.
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Affiliation(s)
- Jae Hee Lee
- Radiological and Medical Support Center, Korea Institute of Radiological and Medical SciencesSeoul 01812, Republic of Korea
| | - Byeongwook Jeon
- Boryung Pharmaceutical, R&D CenterAnsan 15425, Republic of Korea
| | - Mijeong Park
- Radiological and Medical Support Center, Korea Institute of Radiological and Medical SciencesSeoul 01812, Republic of Korea
| | - Jimin Ha
- Radiological and Medical Support Center, Korea Institute of Radiological and Medical SciencesSeoul 01812, Republic of Korea
| | - Soo Jung Kim
- Boryung Pharmaceutical, R&D CenterAnsan 15425, Republic of Korea
| | - Mi Kwon Son
- Boryung Pharmaceutical, R&D CenterAnsan 15425, Republic of Korea
| | - Seungho Wang
- Boryung Pharmaceutical, R&D CenterAnsan 15425, Republic of Korea
| | - Joo Han Lee
- Boryung Pharmaceutical, R&D CenterAnsan 15425, Republic of Korea
| | - Youn Kyoung Jeong
- Radiological and Medical Support Center, Korea Institute of Radiological and Medical SciencesSeoul 01812, Republic of Korea
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Sattar S, Haase KR, Milisen K, Campbell D, Kim SJ, Chalchal H, Kenis C. Oncology clinic nurses' attitudes and perceptions regarding implementation of routine fall assessment and fall risk screening: A survey study. Can Oncol Nurs J 2021; 31:367-375. [PMID: 34786454 PMCID: PMC8565430 DOI: 10.5737/23688076314367375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Falls in older adults with cancer are often under-recognized and under-reported. The objective of this study was to explore oncology clinic nurses' willingness and perceived barriers to implement routine falls assessment and falls screening in their practice. Nurses working in outpatient oncology clinics were invited to complete an online survey. Data were analyzed using descriptive statistics and sorted into thematic categories. The majority of respondents indicated willingness to routinely ask older patients about falls (85.7%) and screen for fall risks (73.5%). The main reasons for unwillingness included: belief that patients report falls on their own, lack of time, and lack of support staff. Findings from this study show many oncology nurses believe in the importance of routine fall assessment and screening and are willing to implement them routinely, although falls are not routinely asked about or assessed. Future work should explore strategies to address barriers nurses face given the implications of falls amongst this vulnerable population.
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Affiliation(s)
| | - Kristen R Haase
- School of Nursing, University of British Columbia, Vancouver, BC
| | - Koen Milisen
- Department of Geriatrics, University Hospitals Leuven, Leuven, Belgium & Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Diane Campbell
- College of Nursing, University of Saskatchewan, Saskatoon, SK
| | - Soo Jung Kim
- Geriatrics Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Haji Chalchal
- College of Medicine, University of Saskatchewan; Saskatchewan Cancer Agency, Regina, SK
| | - Cindy Kenis
- University Hospitals Leuven, Leuven, Belgium
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Wang S, Yoon YN, Son MK, Kim SJ, Lee BR, Yang EH, Jeon B, Lee SH, Kim TJ, Kim JS, Lee JH. 600 BR101801 stimulates anti-tumor immunity and enhances the efficacy of radiation in a syngeneic model. J Immunother Cancer 2021. [DOI: 10.1136/jitc-2021-sitc2021.600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BackgroundBR101801 is an inhibitor of PI3K γ/δ and DNA-PK. It has received clinical approval from the U.S. FDA as an anticancer drug candidate, and phase 1a/1b is ongoing in the U.S. and South Korea. According to the prior studies PI3K γ/δ inhibition exhibits anticancer immune effects by changing the tumor microenvironment [1]. In addition, ionizing radiation (IR) activates the immune response by causing the destroyed cells to act as antigens [2]. Therefore, the combination of BR101801 and IR can induce cancer cell death and amplify anticancer immune effects. This study aims to demonstrate efficacy of the BR101801 as a potent cancer immunotherapy.MethodsThe enzymatic potency of PI3K isotype and DNA-PK was analyzed by Eurofins. The effects of BR101801 on cell viability were evaluated in 4T1 (breast cancer) and CT-26 (colon cancer) cells for 72 h using WST-8 assay. For in vivo studies, the tumor (4T1 or CT-26)-bearing syngeneic mice were treated with BR101801. To evaluate the synergistic effect, CT-26 tumor-bearing syngeneic mice were treated with vehicle, BR101801, IR (2 Gy or 7.5 Gy), and BR101801 + IR. Immune cells from the spleen or tumor were quantified by flow cytometry.ResultsIn vitro selectivity and target potency of BR101801 on different PI3K isotypes and DNA-PK were studied in a cell-free system. The biochemical IC50 values of BR101801 for PI3K -γ, -δ, and DNA-PK were 15 nM, 2 nM, and 6 nM, respectively. In vitro 50% of maximal inhibition of cell proliferation (GI50) in 4T1 and CT26 cell lines were both above 10 μM. In 4T1 and CT-26 syngeneic models, BR101801 showed the highest tumor inhibitor efficacy (Figure 1). In particular, regulatory T cells (Tregs) & Myeloid derived suppressor cells (MDSC) were decreased and CD8+ T cells were increased in the spleens isolated from the tumor-bearing mice. Compared with other PI3K inhibitors, BR101801 had the highest efficacy, confirming that it changes the immune microenvironment. Moreover, BR101801 was synergistic in combination with 2 Gy or 7.5 Gy of IR in the syngeneic model. Notably, Tregs & Macrophage2 were decreased and CD8+ T cells were increased in the tumor tissue, confirming that the anticancer efficacy.Abstract 600 Figure 1Synergistic effect with ionizing radiation In VivoThe combination of BR101801 and ionising radiation showed synergistic effects in the CT-26 Syngeneic model. BR101801 increases anti-cancer immune cells, CD8 + T cells, and decreases immune suppressor cells Tregs and macrophages through a combination of radiation, resulting in immuno-cancer effects.ConclusionsBR101801 demonstrated an anticancer immune effect by changing the tumor microenvironment and showed synergistic effects with radiation combination therapy. We will confirm the anticancer immunity effect in ongoing clinical trials.ReferencesOkkenhaug K, Graupera M, Vanhaesebroeck B. Targeting PI3K in Cancer: Impact on Tumor Cells, Their Protective Stroma, Angiogenesis, and Immunotherapy. Cancer Discov. 2016; 10: 1090–1105.McKelvey K, Hudson A, Back M, Eade T, Diakos C. Radiation, inflammation and the immune response in cancer. Mammalian Genome. 2018;9:843–865Ethics ApprovalThe protocol and any amendment(s) or procedures involving the care and use of animals in this study were reviewed and approved by the Institutional animal Car and Use Committee (IACUC) of BoRyung Pharm. prior to conduct.[Approval number:BR18130]
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Sattar S, Haase KR, Milisen K, Campbell D, Kim SJ, Chalchal H, Kenis C. Évaluation systématique des chutes et du risque de chutes : Sondage sur l’attitude et les perceptions des infirmières cliniques en oncologie. Can Oncol Nurs J 2021; 31:376-385. [PMID: 34786455 PMCID: PMC8565442 DOI: 10.5737/23688076314376385] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Chez les personnes âgées atteintes de cancer, les chutes sont un problème souvent sous-estimé et peu rapporté. La présente étude visait à explorer la volonté des infirmières cliniques en oncologie à évaluer et à dépister systématiquement les chutes dans leur pratique; l’étude examinait également les obstacles perçus à l’évaluation et au dépistage systématique. Les infirmières ont donc été invitées à remplir un sondage en ligne. Les données ont été analysées à l’aide de statistiques descriptives. La majorité des infirmières ayant répondu ont dit qu’elles accepteraient de poser systématiquement des questions sur les chutes (85,7 %) et de dépister les risques de chutes (73,5 %) chez les personnes âgées. Voici les principales raisons des réticences : conviction que les patients signalent les chutes d’euxmêmes, manque de temps, pénurie de personnel de soutien. Selon les résultats de l’étude, beaucoup d’infirmières en oncologie trouvent important d’évaluer et de dépister systématiquement les chutes, et sont d’accord pour l’intégrer à leur pratique bien que, d’habitude, les chutes ne fassent pas automatiquement l’objet de questions ou d’une évaluation. Étant donné les conséquences des chutes sur ces patients vulnérables, la recherche à venir devra explorer les stratégies permettant de surmonter les obstacles auxquels se butent les infirmières.
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Affiliation(s)
- Schroder Sattar
- Collège des sciences infirmières, Université de la Saskatchewan, Regina, SK
| | - Kristen R Haase
- École des sciences infirmières, Université de la Colombie-Britannique, Vancouver, BC
| | - Koen Milisen
- Département de gériatrie, Hôpital universitaire de Louvain, Louvain, Belgique, et Département de santé publique et de soins primaires, Centre universitaire de sciences infirmières et de pratique sagefemme, KU Leuven, Louvain, Belgique
| | - Diane Campbell
- Collège des sciences infirmières, Université de la Saskatchewan, Regina, SK
| | - Soo Jung Kim
- Service de gériatrie, Centre de cancérologie Memorial Sloan Kettering, New York, États-Unis
| | - Haji Chalchal
- Collège de médecine, Université de la Saskatchewan, Agence du cancer de la Saskatchewan, Regina, SK
| | - Cindy Kenis
- Hôpital universitaire de Louvain, Louvain, Belgique
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McMillan S, Kim SJ, Tin AL, Downey RJ, Vickers AJ, Korc-Grodzicki B, Shahrokni A. Association of frailty with 90-day postoperative mortality & geriatric comanagement among older adults with cancer. Eur J Surg Oncol 2021; 48:903-908. [PMID: 34756761 DOI: 10.1016/j.ejso.2021.10.019] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Geriatric medical comanagement of older surgical patients with cancer is associated with lower 90-day postoperative mortality. Here, we investigate the hypothesis that this association varies on the basis of the degree of a patient's frailty. METHODS Frailty was assessed using the Memorial Sloan Kettering Frailty Index. Our hypothesis was evaluated using two approaches, both adjusted for age, sex, American Society of Anesthesiologists Physical Status, preoperative albumin, operating room duration, and estimated blood loss. A logistic regression was performed with 90-day mortality as the outcome and geriatric comanagement, continuous Memorial Sloan Kettering Frailty Index, and an interaction term between these two variables as the primary predictors. We then categorized frailty into four levels and, within each level, performed logistic regression with geriatric comanagement as the primary predictor and 90-day mortality as the outcome. Finally, we extracted the effect size and used a meta-analytic approach to test for heterogeneity. RESULTS Of 1687 patients aged ≥75 years who underwent elective cancer surgery with a length of stay of ≥1 day, 931 (55%) received comanagement; 31 patients (3.3%) who received comanagement died within 90 days, compared with 72 (9.5%) who did not. Ninety-day mortality was not statistically significantly different by degree of frailty in either analysis (interaction P = 0.4; test of heterogeneity P = 0.8). CONCLUSION Geriatric comanagement is valuable for all older surgical patients, not just the frail, and should be provided to as large a portion of the older surgical population as possible. Further research should examine predictors of response to geriatric comanagement.
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Affiliation(s)
- Sincere McMillan
- Geriatrics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Soo Jung Kim
- Geriatrics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Amy L Tin
- Department of Biostatistics and Epidemiology, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Robert J Downey
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Andrew J Vickers
- Department of Biostatistics and Epidemiology, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Beatriz Korc-Grodzicki
- Geriatrics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Armin Shahrokni
- Geriatrics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, NY, USA.
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Yan HH, Jung KH, Lee JE, Son MK, Fang Z, Park JH, Kim SJ, Kim JY, Lim JH, Hong SS. ANGPTL4 accelerates KRAS G12D-Induced acinar to ductal metaplasia and pancreatic carcinogenesis. Cancer Lett 2021; 519:185-198. [PMID: 34311032 DOI: 10.1016/j.canlet.2021.07.036] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 12/13/2022]
Abstract
Oncogenic KRASG12D induces neoplastic transformation of pancreatic acinar cells through acinar-to-ductal metaplasia (ADM) and pancreatic intraepithelial neoplasia (PanIN), and drives pancreatic ductal adenocarcinoma (PDAC). Angiopoietin-like 4 (ANGPTL4) is known to be involved in the regulation of cancer growth and metastasis. However, whether ANGPTL4 affects KRASG12D-mediated ADM and early PDAC intervention remains unknown. In the current study, we investigated the role of ANGPTL4 in KRASG12D-induced ADM, PanIN formation, and PDAC maintenance. We found that ANGPTL4 was highly expressed in human and mouse ADM lesions and contributed to the promotion of KRASG12D-driven ADM in mice. Consistently, ANGPTL4 rapidly induced ADM in three-dimensional culture of acinar cells with KRAS mutation and formed ductal cysts that silenced acinar genes and activated ductal genes, which are characteristic of in vivo ADM/PanIN lesions. We also found that periostin works as a downstream regulator of ANGPTL4-mediated ADM/PDAC. Genetic ablation of periostin diminished the ADM/PanIN phenotype induced by ANGPTL4. A high correlation between ANGPTL4 and periostin was confirmed in human samples. These results demonstrate that ANGPTL4 is critical for ADM/PanIN initiation and PDAC progression through the regulation of periostin. Thus, the ANGPTL4/periostin axis is considered a potential target for ADM-derived PDAC.
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Affiliation(s)
- Hong Hua Yan
- Department of Medicine, College of Medicine, and Program in Biomedical Sciences & Engineering, Inha University, 366, Seohae-daero, Jung-gu, Incheon, 22332, Republic of Korea
| | - Kyung Hee Jung
- Department of Medicine, College of Medicine, and Program in Biomedical Sciences & Engineering, Inha University, 366, Seohae-daero, Jung-gu, Incheon, 22332, Republic of Korea
| | - Ji Eun Lee
- Department of Medicine, College of Medicine, and Program in Biomedical Sciences & Engineering, Inha University, 366, Seohae-daero, Jung-gu, Incheon, 22332, Republic of Korea
| | - Mi Kwon Son
- Department of Medicine, College of Medicine, and Program in Biomedical Sciences & Engineering, Inha University, 366, Seohae-daero, Jung-gu, Incheon, 22332, Republic of Korea
| | - Zhenghuan Fang
- Department of Medicine, College of Medicine, and Program in Biomedical Sciences & Engineering, Inha University, 366, Seohae-daero, Jung-gu, Incheon, 22332, Republic of Korea
| | - Jung Hee Park
- Department of Medicine, College of Medicine, and Program in Biomedical Sciences & Engineering, Inha University, 366, Seohae-daero, Jung-gu, Incheon, 22332, Republic of Korea
| | - Soo Jung Kim
- Department of Medicine, College of Medicine, and Program in Biomedical Sciences & Engineering, Inha University, 366, Seohae-daero, Jung-gu, Incheon, 22332, Republic of Korea
| | - Ju Young Kim
- Department of Medicine, College of Medicine, and Program in Biomedical Sciences & Engineering, Inha University, 366, Seohae-daero, Jung-gu, Incheon, 22332, Republic of Korea
| | - Ju Han Lim
- Department of Medicine, College of Medicine, and Program in Biomedical Sciences & Engineering, Inha University, 366, Seohae-daero, Jung-gu, Incheon, 22332, Republic of Korea
| | - Soon-Sun Hong
- Department of Medicine, College of Medicine, and Program in Biomedical Sciences & Engineering, Inha University, 366, Seohae-daero, Jung-gu, Incheon, 22332, Republic of Korea.
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Lee JH, Kim SJ. Characteristics and outcomes of emergency department patients with a foreign body that entered through the ear, nose or mouth: a 10-year retrospective analysis. J Laryngol Otol 2021; 135:1-7. [PMID: 34674776 DOI: 10.1017/s0022215121002747] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Foreign bodies in the ear, nose and throat commonly necessitate emergency department visits. METHOD This retrospective study was conducted on emergency department visits from January 2010 to December 2019 to determine characteristics and clinical prognoses of ENT patients. Patients were divided into three groups according to foreign-body entry route; patient characteristics and clinical findings were compared between groups. RESULTS Of 676 142 emergency department visits, 10 454 were because of ENT-related foreign bodies. The mean (± standard deviation) age of subjects was 24.0 (± 23.4) years, and 5176 patients were male (49.5 per cent). The most common entry route was the mouth (74.5 per cent). Most patients (97.1 per cent) were discharged after emergency treatment. Intensive care and in-hospital mortality occurred only in the mouth group. CONCLUSION Clinical findings differ depending on foreign-body entry route. After emergency treatment, most patients were discharged; some cases presented serious complications.
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Affiliation(s)
- J H Lee
- Department of Emergency Medicine, Seoul, Republic of Korea
| | - S J Kim
- Department of Otorhinolaryngology - Head and Neck Surgery, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
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