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Ballard DW, Huang J, Sharp AL, Mark DG, Nguyen THP, Young BR, Vinson DR, Van Winkle P, Kene MV, Rauchwerger AS, Zhang JY, Park SJ, Reed ME, Greenhow TL. An all-inclusive model for predicting invasive bacterial infection in febrile infants age 7-60 days. Pediatr Res 2024:10.1038/s41390-024-03141-3. [PMID: 38575694 DOI: 10.1038/s41390-024-03141-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Invasive bacterial infections (IBIs) in febrile infants are rare but potentially devastating. We aimed to derive and validate a predictive model for IBI among febrile infants age 7-60 days. METHODS Data were abstracted retrospectively from electronic records of 37 emergency departments (EDs) for infants with a measured temperature >=100.4 F who underwent an ED evaluation with blood and urine cultures. Models to predict IBI were developed and validated respectively using a random 80/20 dataset split, including 10-fold cross-validation. We used precision recall curves as the classification metric. RESULTS Of 4411 eligible infants with a mean age of 37 days, 29% had characteristics that would likely have excluded them from existing risk stratification protocols. There were 196 patients with IBI (4.4%), including 43 (1.0%) with bacterial meningitis. Analytic approaches varied in performance characteristics (precision recall range 0.04-0.29, area under the curve range 0.5-0.84), with the XGBoost model demonstrating the best performance (0.29, 0.84). The five most important variables were serum white blood count, maximum temperature, absolute neutrophil count, absolute band count, and age in days. CONCLUSION A machine learning model (XGBoost) demonstrated the best performance in predicting a rare outcome among febrile infants, including those excluded from existing algorithms. IMPACT Several models for the risk stratification of febrile infants have been developed. There is a need for a preferred comprehensive model free from limitations and algorithm exclusions that accurately predicts IBIs. This is the first study to derive an all-inclusive predictive model for febrile infants aged 7-60 days in a community ED sample with IBI as a primary outcome. This machine learning model demonstrates potential for clinical utility in predicting IBI.
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Affiliation(s)
- Dustin W Ballard
- The Permanente Medical Group, Oakland, CA, USA.
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
| | - Jie Huang
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Adam L Sharp
- Kaiser Permanente Bernard J. Tyson School of Medicine, Health Systems Science Department, Pasadena, CA, USA
| | - Dustin G Mark
- The Permanente Medical Group, Oakland, CA, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Tran H P Nguyen
- Department of Hospital Pediatrics, Kaiser Permanente Northern California, Roseville, CA, USA
| | - Beverly R Young
- Department of Hospital Pediatrics, Kaiser Permanente Northern California, Roseville, CA, USA
| | - David R Vinson
- The Permanente Medical Group, Oakland, CA, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Patrick Van Winkle
- Department of Pediatrics, Kaiser Permanente Southern California, Anaheim, CA, USA
| | | | - Adina S Rauchwerger
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Jennifer Y Zhang
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Stacy J Park
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Mary E Reed
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Tara L Greenhow
- The Permanente Medical Group, Oakland, CA, USA
- Division of Infectious Diseases, Department of Pediatrics, Kaiser Permanente Northern California, San Francisco, CA, USA
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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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Liu EY, Lin EY, Lee A, Venkat PS, Shiao JC, Wong A, Yu A, Hagio MA, Park SJ, Demanes J, Chang AJ. High-Dose Rate Brachytherapy Alone for Treatment of Unfavorable Intermediate Risk Prostate Cancer: A Propensity-Score Matched Analysis. Int J Radiat Oncol Biol Phys 2023; 117:e408-e409. [PMID: 37785355 DOI: 10.1016/j.ijrobp.2023.06.1551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To demonstrate the feasibility of high-dose rate brachytherapy (HDR BT) as monotherapy for unfavorable intermediate risk (UIR) prostate cancer by comparing survival outcomes of HDR BT alone against external beam radiation therapy (EBRT) + HDR BT boost, +/- androgen deprivation therapy (ADT) using propensity-score matched (PSM) data. MATERIALS/METHODS This retrospective study queried two data registries collecting patient data from 1991 to present. 633 patients with UIR prostate cancer treated with HDR BT alone, HDR BT+EBRT or HDR+EBRT+ADT were included. HDR BT patients received 42-45Gy/6 fractions (fx) or 27 Gy/2 fx. For HDR BT+EBRT, the HDR dose was 20-24 Gy/2 fx, 24 Gy/4 fx, or 15 Gy/1 fx. EBRT patients received 45 Gy/25 fx to the prostate +/- pelvic nodes. GU/GI toxicities were graded according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Time-to-event analyses were carried out to evaluate the relationship between treatments and five primary endpoints of interest: freedom from biochemical recurrence (FFBC), freedom from distant metastasis (FFDM), freedom from local failure (FFLF), cancer specific survival (CSS), and overall survival (OS) at 5 years. PSM was performed with one-to-n matching. Logistic regression was used to estimate the respective propensity scores. The five potential confounders identified were T-stage, Gleason score, pre-treatment PSA, age, and percent positive cores. Balance was checked using the standardized mean difference of covariates. Univariate and multivariate analyses were conducted on the matched data. Toxicity analysis was performed via association between a change in pre- and post-treatment GU/GI toxicity status and the treatment group, as well as incidence of post-treatment severe GI/GU toxicity (grade 3 or higher) and the treatment group. RESULTS Univariate analysis with Kaplan-Meier method and log rank test comparison between the three cohorts demonstrated no significant difference in all survival outcomes FFBC, FFDM, FFLF, CSS, OS (p = 0.15, 0.19, 0.29, 0.57, 0.28, respectively). Multivariate analysis with Cox proportional hazard regression showed no differences in HR for FFBC and OS (p = 0.95, 0.11) with addition of EBRT, or with EBRT+ADT (p = 0.17, 0.24); no fit was obtainable for FFDM, CSS, FFLF. Toxicities between the three cohorts were not significantly different when comparing post-treatment and baseline GI/GU symptoms (p = 0.53/1). No Grade 2 or 3 GI toxicities were identified, while 8%/1% HDR patients, 10%/1% HDR+EBRT patients, and 12%/2% HDR+EBRT+ADT patients experienced Grade 2/3 GU toxicities. The incidence of grade 3 or higher GU toxicities between the three groups was not significantly different (p = 0.91). CONCLUSION This propensity-score matched study demonstrates the feasibility of HDR BT alone for effective treatment of UIR prostate cancer when compared to HDR+EBRT or HDR+EBRT+ADT, while potentially minimizing the added toxicities of EBRT and the undesirable side effect profile of ADT.
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Affiliation(s)
- E Y Liu
- Department of Radiation Oncology, UCLA David Geffen School of Medicine, Los Angeles, CA
| | - E Y Lin
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - A Lee
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - P S Venkat
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - J C Shiao
- The University of Kansas Cancer Center, Kansas City, KS
| | - A Wong
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - A Yu
- University of California, Los Angeles, Los Angeles, CA
| | - M A Hagio
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - S J Park
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - J Demanes
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - A J Chang
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
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Salehi-Rad R, Lim RJ, Du Y, Tran LM, Li R, Ong SL, Ling Huang Z, Dumitras C, Zhang T, Park SJ, Crosson W, Kahangi B, Abascal J, Seet C, Oh M, Shabihkhani M, Paul M, Krysan K, Lisberg AE, Garon EB, Liu B, Dubinett SM. CCL21-DC in situ vaccination in murine NSCLC overcomes resistance to immunotherapy and generates systemic tumor-specific immunity. J Immunother Cancer 2023; 11:e006896. [PMID: 37730274 PMCID: PMC10510892 DOI: 10.1136/jitc-2023-006896] [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] [Accepted: 07/16/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Despite recent advances in immunotherapy, many patients with non-small cell lung cancer (NSCLC) do not respond to immune checkpoint inhibitors (ICI). Resistance to ICI may be driven by suboptimal priming of antitumor T lymphocytes due to poor antigen presentation as well as their exclusion and impairment by the immunosuppressive tumor microenvironment (TME). In a recent phase I trial in patients with NSCLC, in situ vaccination (ISV) with dendritic cells engineered to secrete CCL21 (CCL21-DC), a chemokine that facilitates the recruitment of T cells and DC, promoted T lymphocyte tumor infiltration and PD-L1 upregulation. METHODS Murine models of NSCLC with distinct driver mutations (KrasG12D/P53+/-/Lkb1-/- (KPL); KrasG12D/P53+/- (KP); and KrasG12D (K)) and varying tumor mutational burden were used to evaluate the efficacy of combination therapy with CCL21-DC ISV plus ICI. Comprehensive analyses of longitudinal preclinical samples by flow cytometry, single cell RNA-sequencing (scRNA-seq) and whole-exome sequencing were performed to assess mechanisms of combination therapy. RESULTS ISV with CCL21-DC sensitized immune-resistant murine NSCLCs to ICI and led to the establishment of tumor-specific immune memory. Immunophenotyping revealed that CCL21-DC obliterated tumor-promoting neutrophils, promoted sustained infiltration of CD8 cytolytic and CD4 Th1 lymphocytes and enriched progenitor T cells in the TME. Addition of ICI to CCL21-DC further enhanced the expansion and effector function of T cells both locally and systemically. Longitudinal evaluation of tumor mutation profiles revealed that CCL21-DC plus ICI induced immunoediting of tumor subclones, consistent with the broadening of tumor-specific T cell responses. CONCLUSIONS CCL21-DC ISV synergizes with anti-PD-1 to eradicate murine NSCLC. Our data support the clinical application of CCL21-DC ISV in combination with checkpoint inhibition for patients with NSCLC.
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Affiliation(s)
- Ramin Salehi-Rad
- Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Raymond J Lim
- Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Yushen Du
- Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China
| | - Linh M Tran
- Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Rui Li
- Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Stephanie L Ong
- Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Zi Ling Huang
- Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Camelia Dumitras
- Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Tianhao Zhang
- Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Stacy J Park
- Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - William Crosson
- Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Bitta Kahangi
- Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Jensen Abascal
- Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Christopher Seet
- Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Michael Oh
- Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Maryam Shabihkhani
- Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Manash Paul
- Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Kostyantyn Krysan
- Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Aaron E Lisberg
- Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Edward B Garon
- Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Bin Liu
- Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Steven M Dubinett
- Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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Park SJ, Kim H, Piao M, Kang HJ, Fassah DM, Jung DJS, Kim SY, Na SW, Beak SH, Jeong IH, Yoo SP, Hong SJ, Lee DH, Lee SH, Haque MN, Shin DJ, Kwon JA, Jo C, Baik M. Effects of genomic estimated breeding value and dietary energy to protein ratio on growth performance, carcass trait, and lipogenic gene expression in Hanwoo steer. Animal 2023; 17:100728. [PMID: 36870258 DOI: 10.1016/j.animal.2023.100728] [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: 12/01/2021] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/12/2023] Open
Abstract
"Genome-based precision feeding" is a concept that involves the application of customised diets to different genetic groups of cattle. We investigated the effects of the genomic estimated breeding value (gEBV) and dietary energy to protein ratio (DEP) on growth performance, carcass traits, and lipogenic gene expression in Hanwoo (Korean cattle) steers. Forty-four Hanwoo steers (BW = 636 kg, age = 26.9 months) were genotyped using the Illumina Bovine 50 K BeadChip. The gEBV was calculated using genomic best linear unbiased prediction. Animals were separated into high gEBV of marbling score or low-gMS groups based on the upper and lower 50% groupings of the reference population, respectively. Animals were assigned to one of four groups in a 2 × 2 factorial arrangement: high gMS/high DEP (0.084 MJ/g), high gMS/low DEP (0.079 MJ/g), low gMS/high DEP, and low gMS/low DEP. Steers were fed concentrate with a high or low DEP for 31 weeks. The BW tended to be higher (0.05 < P < 0.1) in the high-gMS groups compared to the low-gMS groups at 0, 4, 8, 12, and 20 weeks. The average daily gain (ADG) tended to be lower (P = 0.08) in the high-gMS group than in the low-gMS group. Final BW and measured carcass weight (CW) were positively correlated with the gEBV of carcass weight (gCW). The DEP did not affect ADG. Neither the gMS nor the DEP affected the MS and beef quality grade. The intramuscular fat (IMF) content in the longissimus thoracis (LT) tended to be higher (P = 0.08) in the high-gMS groups than in the low-gMS groups. The mRNA levels of lipogenic acetyl-CoA carboxylase and fatty acid binding protein 4 genes in the LT were higher (P < 0.05) in the high-gMS group than in the low-gMS group. Overall, the IMF content tended to be affected by the gMS, and the genetic potential (i.e., gMS) was associated with the functional activity of lipogenic gene expression. The gCW was associated with the measured BW and CW. The results demonstrated that the gMS and the gCW may be used as early prediction indexes for meat quality and growth potential of beef cattle.
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Affiliation(s)
- S J Park
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - H Kim
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - M Piao
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - H J Kang
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - D M Fassah
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - D J S Jung
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - S Y Kim
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - S W Na
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - S-H Beak
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - I H Jeong
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - S P Yoo
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - S J Hong
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - D H Lee
- Division of Animal and Dairy Science, Chungnam National University, Daejeon 34134, Republic of Korea
| | - S H Lee
- Division of Animal and Dairy Science, Chungnam National University, Daejeon 34134, Republic of Korea
| | - M N Haque
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - D-J Shin
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - J A Kwon
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - C Jo
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea; Institutes of Green Bio Science Technology, Pyeongchang-daero, Daehwa-myeon, Pyeongchang-gun, Gangwon 25354, Republic of Korea
| | - M Baik
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea; Institutes of Green Bio Science Technology, Pyeongchang-daero, Daehwa-myeon, Pyeongchang-gun, Gangwon 25354, Republic of Korea.
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Lee YH, Kim SM, Kim EK, Park SJ, Lee SC, Park SW, Jeong DS, Chang SA. Pattern of pericardial calcification determines the mid-term postoperative outcome after pericardiectomy in chronic constrictive pericarditis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1797] [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: 11/15/2022] Open
Abstract
Abstract
Background/Introduction
Although pericardiectomy is an effective treatment of constrictive pericarditis (CP), clinical outcome is not always successful. Pericardial calcification is a unique finding in CP. However, the amount and localization of calcification vary. Computer tomography (CT) can visualize the pericardial calcification with high sensitivity and provide the anatomical assessment.
Purpose
We investigated that how the pattern and amount of pericardial calcification affect the mid-term postoperative outcome after pericardiectomy in CP.
Methods
All of the patients who underwent total pericardiectomy in our hospital from 2010 to 2020 were derived from electrical medical records (n=105). Among them, preoperative CT scans (non-gated non-contrast) of 98 patients were available and, thus, 98 consecutive patients were finally analyzed. Medical records were reviewed in a retrospective manner. Cardiovascular event is defined as cardiovascular death or hospitalization associated with a heart failure symptom and all cause event is defined as all events that require admission. CT scan was analyzed by Aquarius Workstation, and the volume and localization pattern of pericalcification were derived. Pericardium calcium score was given as an Agatston score.
Results
Of 98 patients, 25 (25.5%) patients were hospitalized with heart failure symptom after pericardiectomy. Median follow up duration of patients is 172 weeks. A group with cardiovascular event had higher NYHA grade (P<0.001), lower calcium volume (P=0.004), and lower calcium score (P=0.01). Multivariate cox proportional analysis showed that high ln(calcium score) before pericardiectomy was dependent predictor of cardiovascular event (hazard ratio, 0.90; P=0.04) and all cause event (hazard ratio, 0.91, P=0.04) after pericardiectomy. When we set the cut off value at 7.22, based on ROC curve, there was a significant difference in cardiovascular event between the groups divided by this cutoff value in Kaplan-Meier curve (P=0.002) and multivariate cox proportional analysis (P=0.04). In the subgroup analysis, myocardium invasion and circumferential calcification were more common in the high calcium score group. Idiopathic & tuberculosis pericarditis were more associated with high calcium score group and post-operative pericarditis, other reasons (infection, radiation, etc) were more associated with low calcium group.
Conclusion
Low burden of pericardial calcification was associated high rate of mid-term clinical event after pericardiectomy CP. Preoperative evaluation of pericardial calcification pattern can be used as predictor of postoperative outcomes.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- Y H Lee
- Sungkyunkwan University School of Medicine , Seoul , Korea (Republic of)
| | - S M Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Radiology , Seoul , Korea (Republic of)
| | - E K Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - S J Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - S C Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - S W Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - D S Jeong
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Thoracic and Cardiovascular Surgery , Seoul , Korea (Republic of)
| | - S A Chang
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
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Lee HJ, Park CS, Lee S, Park JB, Kim HK, Park SJ, Kim YJ, Lee SP. Systemic proinflammatory-profibrotic response in aortic stenosis patients with diabetes and its relationship with myocardial remodeling and clinical outcome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1621] [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: 11/12/2022] Open
Abstract
Abstract
Background
It is unclear whether and how diabetes mellitus may aggravate myocardial fibrosis and remodeling in the pressure-overloaded heart. We investigated the impact of diabetes on the prognosis of aortic stenosis (AS) patients and its underlying mechanisms using comprehensive noninvasive imaging studies and plasma proteomics.
Methods
Severe AS patients undergoing both echocardiography and cardiovascular magnetic resonance (CMR) (n=253 of which 66 had diabetes) comprised the imaging cohort. The degree of replacement and diffuse interstitial fibrosis by late gadolinium enhancement (LGE) and extracellular volume fraction (ECV) was quantified using CMR. Plasma samples were analyzed with the multiplex proximity extension assay for 92 proteomic biomarkers in a separate biomarker cohort of severe AS patients (n=100 of which 27 had diabetes).
Results
In the imaging cohort, diabetic patients were older (70.4±6.8 vs. 66.7±10.1 years) and had a higher prevalence of ischemic heart disease (28.8% vs. 9.1%), with more advanced ventricular diastolic dysfunction. On CMR, diabetic patients had increased replacement and diffuse interstitial fibrosis (LGE% 0.3 [0.0–1.6] versus 0.0 [0.0–0.5], p=0.009; ECV% 27.9 [25.7–30.1] versus 26.7 [24.9–28.5], p=0.025) (Figure 1).
Plasma proteomics analysis of the biomarker cohort revealed that 9 proteins (E-selectin, interleukin-1 receptor type 1, interleukin-1 receptor type 2, galectin-4, intercellular adhesion molecule 2, integrin beta-2, galectin-3, growth differentiation factor 15, and cathepsin D) are significantly elevated in diabetic AS patients (Figure 2). Pathway over-representation analyses of the plasma proteomics with Gene Ontology terms indicated that pathways related to inflammatory response and extracellular matrix components were enriched, suggesting that diabetes is associated with systemic effects that evoke proinflammatory and profibrotic response to the pressure-overloaded myocardium.
During follow-up (median 6.3 years [IQR 5.2–7.2]) of the imaging cohort, 232 patients received aortic valve replacement (AVR) with 53 unexpected heart failure admissions or death. Diabetes was a significant predictor of heart failure and death, independent of clinical covariates and AVR (hazard ratio 1.88, 95% confidence interval 1.06–3.31, p=0.030).
Conclusion
Plasma proteomic analyses indicate that diabetes potentiates the systemic proinflammatory and profibrotic milieu in AS patients. These systemic biological changes underlie the increase of myocardial fibrosis, diastolic dysfunction, and worse clinical outcomes in severe AS patients with concomitant diabetes.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): National Research Foundation of Korea
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Affiliation(s)
- H J Lee
- Seoul National University Hospital, Internal Medicine , Seoul , Korea (Republic of)
| | - C S Park
- Seoul National University Hospital, Internal Medicine , Seoul , Korea (Republic of)
| | - S Lee
- Asan Medical Center, Internal Medicine , Seoul , Korea (Republic of)
| | - J B Park
- Seoul National University Hospital, Internal Medicine , Seoul , Korea (Republic of)
| | - H K Kim
- Seoul National University Hospital, Internal Medicine , Seoul , Korea (Republic of)
| | - S J Park
- Samsung Medical Center, Cardiovascular Imaging Center , Seoul , Korea (Republic of)
| | - Y J Kim
- Seoul National University Hospital, Internal Medicine , Seoul , Korea (Republic of)
| | - S P Lee
- Seoul National University Hospital, Internal Medicine , Seoul , Korea (Republic of)
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8
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Kim MS, Jeon KN, Lee SC, Yang JH, Kim EK, Park SJ, Park SW, Chang SA. Role of combined exercise stress echocardiography and cardiopulmonary exercise test in chronic thromboembolic disease. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1879] [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
Chronic thromboembolic pulmonary disease (CTEPD) without pulmonary hypertension could cause significant exercise limitations. However, interventional or surgical treatments for CTEPD with mild pulmonary hypertension or normal pressure are on controversy.
Purpose
We aimed to evaluate cardiopulmonary function through cardiopulmonary exercise test (CPET) with stress echocardiography and to determine whether exercise pulmonary hypertension can explain exercise limitations in CTEPD patients with mPAP <30mmHg.
Methods
Patients diagnosed as CTEPD with mPAP less than 30mmHg was derived from our pulmonary hypertension center registry from April 2014 to October 2021.Transthoracic echocardiography (TTE) was performed at baseline (resting state) and immediately after CPET. TTE derived parameters and CPET parameters were compared with hemodynamic parameters measured by right catheterization.
Results
Total 37 patients were enrolled. Of these, Thirty-five patients had previously been diagnosed with CTEPH and had undergone PEA, BPA, or both. Most of the patients complained dyspnea of WHO functional class II or III. Pulmonary vascular resistance (PVR) was slightly higher than normal (185.0±102.2 dyne sec cm–5). Also VO2max was decreased in CPET (23.1±6.5 mL/kg/min). In correlation analysis, the higher the mPAP and PVR at rest, the lower VO2max during exercise. Meanwhile basal right ventricular (RV) function was normal, an increase in RVSP was notably observed during exercise (RVSP: pre-exercise 36.2±11.9, post-exercise 60.7±19.3, p value <0.001). Furthermore RV function deteriorated during exercise (TAPSE: pre-exercise 16.1±4.8, post-exercise 12.9±5.0, p value <0.001).
Conclusions
CTEPD patients with mild or normal PAP showed limited exercise capacity with exercise induced hypertension. Even in the mPAP less than 30mmHg, PVR and mPAP was significantly associated with exercise capacity. CPET with stress echocardiography could help to identify the main cause of exercise limitation in CTEPD patients and possibly provide the guideline for treatment plan.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M S Kim
- Samsung Changwon Hospital , Changwon , Korea (Republic of)
| | - K N Jeon
- Samsung Medical Center, Cardiology , Seoul , Korea (Republic of)
| | - S C Lee
- Samsung Medical Center, Cardiology , Seoul , Korea (Republic of)
| | - J H Yang
- Samsung Medical Center, Cardiology , Seoul , Korea (Republic of)
| | - E K Kim
- Samsung Medical Center, Cardiology , Seoul , Korea (Republic of)
| | - S J Park
- Samsung Medical Center, Cardiology , Seoul , Korea (Republic of)
| | - S W Park
- Samsung Medical Center, Cardiology , Seoul , Korea (Republic of)
| | - S A Chang
- Samsung Medical Center, Cardiology , Seoul , Korea (Republic of)
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9
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Bak M, Choi KH, Kim JH, Park TK, Kim EK, Kim SM, Choi SH, Park SJ. Risk factors and clinical effects of late leaflet thrombosis after transcatheter aortic valve replacement. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1569] [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
As the indications for trans-catheter aortic valve replacement (TAVR) expand, it is expected that the number of TAVR patients would increase and the follow-up duration would be longer. It is known that the incidence of leaflet thrombosis is higher in TAVR than in surgical aortic valve replacement (SAVR), but not much is known about the risk factors of late leaflet thrombosis in TAVR.
Aim
Therefore, in this study, the incidence and risk factors of late leaflet thrombosis at late term after TAVR and the effect on clinical course of late leaflet thrombosis would be investigated.
Method
There were 176 patients undergone TAVR from January 2015 to October 2020 in one tertiary hospital of south korea. 94 patients had follow-up cardiovascular computed tomography (CT) between 3 months and 2 years after TAVR. Among 94 patients, late leaflet thrombosis was discovered at 20 patients, and risk factors were analyzed by comparing clinical factors, echocardiographic and cardiovascular CT information, and angiographic data between the group with and without late leaflet thrombosis. And the difference in aortic valve hemodynamics between the group with and without leaflet thrombosis was examined and clinical outcomes were compared. Clinical outcome was defined as the composite of all-cause death, stroke, heart failure (HF) admission, redo-aortic valve (AV) replacement and major bleeding after detection of late leaflet thrombosis.
Results
Indexed mean sinus of Valsalva diameter, AV calcium score and post procedure estimated orifice area (EOA) had predictability of late leaflet thrombosis with AUC value of 0.670 (95% CI [0.546–0.795], p value = 0.020), AUC value of 0.698 (95% CI [0.544–0.851], p value = 0.012) and AUC value of 0.665 (95 percent CI [0.548–0.782], p value = 0.031), respectively (Figure 1).
In echocardiography performed at the time of follow-up CT, AV max velocity and AV mean pressure gradient were higher in thrombosis group and EOA and Doppler velocity index were lower in thrombosis group than in no thrombosis group within normal range (Figure 2). Clinical outcome was not significant different between the two groups (log rank p value = 0.560).
Conclusion
Larger indexed sinus of Valsalva diameter, higher AV calcium score and smaller post procedure AV EOA were risk factors for late leaflet thrombosis after TAVR. Subclinical late leaflet thrombosis have a benign course when properly managed.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Bak
- Samsung Medical Center, Division of Cardiology, Cardiovascular Imaging Center, Heart Vascular Stroke Institute , Seoul , Korea (Republic of)
| | - K H Choi
- Samsung Medical Center , Seoul , Korea (Republic of)
| | - J H Kim
- Samsung Medical Center, Division of Cardiology, Cardiovascular Imaging Center, Heart Vascular Stroke Institute , Seoul , Korea (Republic of)
| | - T K Park
- Samsung Medical Center , Seoul , Korea (Republic of)
| | - E K Kim
- Samsung Medical Center, Division of Cardiology, Cardiovascular Imaging Center, Heart Vascular Stroke Institute , Seoul , Korea (Republic of)
| | - S M Kim
- Samsung Medical Center, Department of Radiology, Cardiovascular Imaging Center, Heart Vascular Stroke Institute , Seoul , Korea (Republic of)
| | - S H Choi
- Samsung Medical Center , Seoul , Korea (Republic of)
| | - S J Park
- Samsung Medical Center, Division of Cardiology, Cardiovascular Imaging Center, Heart Vascular Stroke Institute , Seoul , Korea (Republic of)
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10
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Jin U, Park SJ, Park SM. Critical roles of Parkin and PINK1 in antiviral immunity and protection from cell death in Enterovirus-induced viral myocarditis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1067] [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
Myocarditis is an inflammatory disease of the heart muscle often resulting in cardiac dysfunction and death. One of the most common causes is a cardiac infection with viruses, especially with enteroviruses of the Coxsackievirus B (CVB) family. CVB3-induced viral myocarditis is a well-established model to elucidate viral myocarditis in mice. It is assumed that mitochondrial damage control and mitochondria-associated innate immunity is essential for defence against viral infection of the heart muscle. And Parkinson's disease genes Parkin and PINK1 are well known for their critical function in mitochondrial homeostasis and damage control. We investigated the roles of Parkin and PINK1 in CVB3-induced viral myocarditis mouse model.
Material and methods
Male C57BL/6J WT, Parkin KO and PINK1 KO mice were used in an age of 8 to 12 weeks. The animals were injected intraperitoneally with 1x104 plaque forming units of CVB3 diluted in phosphate-buffered saline. Control and survived virus-infected mice were sacrificed for tissue sampling at day 7 to investigate imaging and molecular workup.
Result
After virus inoculation, the Parkin KO and PINK1 KO groups showed a significantly lower 28-day survival rate compared with the WT group (p<0.001 in Parkin KO; p<0.001 in PINK1 KO). Evans-Blue Dye (EBD) staining image of day 7 after virus-infection showed that the hearts of Parkin KO and PINK1 KO mice were more severely damaged than the hearts of WT mice (3.2-fold, p<0.01 in Parkin KO; 2.6-fold, p<0.05 in PINK1 KO). H&E staining showed that severe inflammatory reaction occurred in the hearts of WT mice, although the inflammatory reaction was much lower compared to WT in the hearts of Parkin KO and PINK1 KO mice (p<0.001 in Parkin KO; p<0.001 in PINK1 KO). In immunohistochemistry, EBD staining positive area colocalized well with CVB3 in Parkin KO and PINK1 KO mice hearts, although EBD staining positive area was rare and didn't colocalized well CVB3 in WT mice hearts. mRNA levels of cell markers (CD3, natural cytotoxicity receptors, F4/80), inflammatory cytokines (IL-1β, IL-6, TNF-α), type II interferon, macrophage-derived protective factors, and CXCL10 family cytokines were lower in virus-infected Parkin/PINK1 KO mice than WT mice. Western blots showed that phospho-p65 increased less than WT in the heart of Parkin KO (0.7-fold, p<0.05) and PINK1 KO mice (0.58-fold, p<0.05).
Conclusion
The Parkin KO and PINK1 KO mice showed a higher mortality rate and more severe cardiomyocyte damage than the WT mice in the viral myocarditis mouse model. Parkin and PINK1 is critical to the type II IFN pathway that inhibits virus replication. And Parkin and PINK1 play an important role in the recruitment of IFN-γ-producing lymphocytes through NF-κB pathway and CXCL10 family chemokines.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- U Jin
- Ajou University Hospital, Department of Cardiology , Suwon , Korea (Republic of)
| | - S J Park
- Asan Medical Center, Department of Thoracic and Cardiovascular Surgery , Seoul , Korea (Republic of)
| | - S M Park
- Ajou University School of Medicine, Department of Pharmacology , Suwon , Korea (Republic of)
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11
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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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12
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Lee HJ, Jeong GH, Li H, Kim MS, Kim JS, Park SJ, Han YJ, Lee KH, Kronbichler A, Hong SH, Ghayda RA, Luchini C, Nottegar A, Koyanagi A, Smith L, Jacob L, Dragioti E, Radua J, Cargnin S, Terrazzino S, Thompson T, Yon DK, Lee SW, Yang JM, Wasuwanich P, Shin JI, Gamerith G. Efficacy and safety of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) monotherapy for advanced EGFR-mutated non-small cell lung cancer: systematic review and meta-analysis. Eur Rev Med Pharmacol Sci 2021; 25:6232-6244. [PMID: 34730203 DOI: 10.26355/eurrev_202110_26993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE It is controversial whether there is efficacy or safety benefit of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in advanced EGFR-mutated non-small cell lung cancer (NSCLC) compared to standard chemotherapy. We aim to assess the efficacy and safety of EGFR-TKIs compared to other chemotherapeutics in EGFR-mutated NSCLC. MATERIALS AND METHODS Up to April 27th, 2020, PubMed, Embase, Medline, Scopus, Cochrane library, and ClinicalTrials.gov were searched for articles or trials meeting the inclusion criteria. After filtering, 230 eligible studies were initially identified. Data extraction followed PRISMA and included outcomes were progression-free survival (PFS), overall survival (OS), and severe adverse events (SAEs). Direct and indirect meta-analyses were generated in the context of log-linear mixed-effects models, with fixed effects for each relative comparison and random effects for each study. RESULTS The results showed that EGFR-TKI therapy had improved PFS with a hazard ratio (HR) of 0.40 (95% CI: 0.36-0.44, p<0.001) compared to standard chemotherapy. Nevertheless, the EGFR-TKIs showed no benefit on OS (HR: 0.96, 95% CI: 0.83-1.10, p=0.556). In the analysis of adverse events, EGFR-TKIs had fewer SAEs than standard chemotherapy (HR: 0.29, 95% CI: 0.26-0.33, p<0.001). CONCLUSIONS Our systemic review indicates that EGFR-TKI therapy has improved PFS, and reduced SAEs compared to standard chemotherapy in advanced EGFR-mutated NSCLC.
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Affiliation(s)
- H J Lee
- Yonsei University College of Medicine, Seoul, Republic of Korea.
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13
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Han KH, Lee KH, Park SJ, Yu R, Kim SH, Lee IR, Han SY, Kim HS, Kronbichler A, Li H, Koyanagi A, Jacob L, Shin JI, Kim JH, Smith L. Hypocomplementemia (C3) as an independent predictor for children with acute post-streptococcal glomerulonephritis: a long-term observation. Eur Rev Med Pharmacol Sci 2021; 25:5674-5683. [PMID: 34604959 DOI: 10.26355/eurrev_202109_26786] [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] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim of this study was to examine the altering patterns in clinical characteristics and severity of acute post-streptococcal glomerulonephritis (APSGN) in children. PATIENTS AND METHODS We analyzed the medical records of 119 children who were diagnosed with APSGN from 1987 to 2018, retrospectively. The patients were divided into two groups: Group I (n=72, before 1998) and Group II (n=47, after 1998). Clinical, radiologic, and laboratory findings were compared between the two groups. RESULTS The clinical manifestations, including vomiting (20.8% vs. 4.3%, p=0.014), oliguria (40.3% vs. 19.1%, p=0.016), and generalized edema (86.1% vs. 63.8%, p=0.005), were statistically less frequent since 1998. Pulmonary edema on chest X-ray (22.7% vs. 4.4%, p=0.014) was less frequent in Group II than in Group I. The level of BUN (23.3±19.3 vs. 18.8±11.2, p=0.009) was lower in Group II than in Group I, while that of creatinine was not significantly different between the two groups. C3 level was an independent factor for predicting the development of edema (odds ratio [OR]: 1.034, 95% CI: 1.010-1.060, p=0.006) and acute nephritic symptoms (≥2) (OR: 0.974, 95% CI: 0.952-0996, p=0.020). It was also negatively correlated with an increasing number of acute nephritic symptoms, including oliguria and edema, in patients with APSGN (R=-0.182, p=0.048). CONCLUSIONS This study demonstrated that APSGN had favorable clinical manifestations and severity over the past 30 years. The monitoring of C3 levels can be used to assess the disease severity and risk of complications, including edema and oliguria, which are decreasing in South Korean children.
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Affiliation(s)
- K H Han
- Department of Pediatrics, Jeju National University School of Medicine, Jeju, Republic of Korea.
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14
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Park SJ, Han HS, Shin SH, Yoo KH, Li K, Kim BJ, Seo SJ, Park KY. Adverse skin reactions due to use of face masks: a prospective survey during the COVID-19 pandemic in Korea. J Eur Acad Dermatol Venereol 2021; 35:e628-e630. [PMID: 34131961 PMCID: PMC8447351 DOI: 10.1111/jdv.17447] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S J Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - H S Han
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - S H Shin
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - K H Yoo
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - K Li
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - B J Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - S J Seo
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - K Y Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
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15
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Li R, Salehi-Rad R, Crosson W, Momcilovic M, Lim RJ, Ong SL, Huang ZL, Zhang T, Abascal J, Dumitras C, Jing Z, Park SJ, Krysan K, Shackelford DB, Tran LM, Liu B, Dubinett SM. Inhibition of Granulocytic Myeloid-Derived Suppressor Cells Overcomes Resistance to Immune Checkpoint Inhibition in LKB1-Deficient Non-Small Cell Lung Cancer. Cancer Res 2021; 81:3295-3308. [PMID: 33853830 PMCID: PMC8776246 DOI: 10.1158/0008-5472.can-20-3564] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [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: 10/26/2020] [Revised: 03/08/2021] [Accepted: 04/12/2021] [Indexed: 01/19/2023]
Abstract
LKB1 inactivating mutations are commonly observed in patients with KRAS-mutant non-small cell lung cancer (NSCLC). Although treatment of NSCLC with immune checkpoint inhibitors (ICI) has resulted in improved overall survival in a subset of patients, studies have revealed that co-occurring KRAS/LKB1 mutations drive primary resistance to ICIs in NSCLC. Effective therapeutic options that overcome ICI resistance in LKB1-mutant NSCLC are limited. Here, we report that loss of LKB1 results in increased secretion of the C-X-C motif (CXC) chemokines with an NH2-terminal Glu-Leu-Arg (ELR) motif in premalignant and cancerous cells, as well as in genetically engineered murine models (GEMM) of NSCLC. Heightened levels of ELR+ CXC chemokines in LKB1-deficient murine models of NSCLC positively correlated with increased abundance of granulocytic myeloid-derived suppressor cells (G-MDSC) locally within the tumor microenvironment and systemically in peripheral blood and spleen. Depletion of G-MDSCs with antibody or functional inhibition via all-trans-retinoic acid (ATRA) led to enhanced antitumor T-cell responses and sensitized LKB1-deficent murine tumors to PD-1 blockade. Combination therapy with anti-PD-1 and ATRA improved local and systemic T-cell proliferation and generated tumor-specific immunity. Our findings implicate ELR+ CXC chemokine-mediated enrichment of G-MDSCs as a potential mediator of immunosuppression in LKB1-deficient NSCLC and provide a rationale for using ATRA in combination with anti-PD-1 therapy in patients with LKB1-deficient NSCLC refractory to ICIs. SIGNIFICANCE: These findings show that accumulation of myeloid-derived suppressor cells in LKB1-deficient non-small cell lung cancer can be overcome via treatment with all-trans-retinoic acid, sensitizing tumors to immunotherapy.
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Affiliation(s)
- Rui Li
- Department of Medicine, Division of Pulmonary and Critical Care, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-229 CHS, Los Angeles, CA 90095-1690, USA
| | - Ramin Salehi-Rad
- Department of Medicine, Division of Pulmonary and Critical Care, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-229 CHS, Los Angeles, CA 90095-1690, USA,Department of Medicine, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA
| | - William Crosson
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, 650 Charles E. Young Drive South, 23-120 CHS, Box 951735, Los Angeles, CA 90095-1735, USA
| | - Milica Momcilovic
- Department of Medicine, Division of Pulmonary and Critical Care, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-229 CHS, Los Angeles, CA 90095-1690, USA
| | - Raymond J. Lim
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, 650 Charles E. Young Drive South, 23-120 CHS, Box 951735, Los Angeles, CA 90095-1735, USA
| | - Stephanie L. Ong
- Department of Medicine, Division of Pulmonary and Critical Care, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-229 CHS, Los Angeles, CA 90095-1690, USA
| | - Zi Ling Huang
- Department of Medicine, Division of Pulmonary and Critical Care, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-229 CHS, Los Angeles, CA 90095-1690, USA
| | - Tianhao Zhang
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, 650 Charles E. Young Drive South, 23-120 CHS, Box 951735, Los Angeles, CA 90095-1735, USA
| | - Jensen Abascal
- Department of Medicine, Division of Pulmonary and Critical Care, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-229 CHS, Los Angeles, CA 90095-1690, USA
| | - Camelia Dumitras
- Department of Medicine, Division of Pulmonary and Critical Care, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-229 CHS, Los Angeles, CA 90095-1690, USA
| | - Zhe Jing
- Department of Medicine, Division of Pulmonary and Critical Care, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-229 CHS, Los Angeles, CA 90095-1690, USA
| | - Stacy J. Park
- Department of Medicine, Division of Pulmonary and Critical Care, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-229 CHS, Los Angeles, CA 90095-1690, USA
| | - Kostyantyn Krysan
- Department of Medicine, Division of Pulmonary and Critical Care, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-229 CHS, Los Angeles, CA 90095-1690, USA
| | - David B. Shackelford
- Department of Medicine, Division of Pulmonary and Critical Care, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-229 CHS, Los Angeles, CA 90095-1690, USA,Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, 650 Charles E. Young Drive South, 23-120 CHS, Box 951735, Los Angeles, CA 90095-1735, USA
| | - Linh M. Tran
- Department of Medicine, Division of Pulmonary and Critical Care, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-229 CHS, Los Angeles, CA 90095-1690, USA
| | - Bin Liu
- Department of Medicine, Division of Pulmonary and Critical Care, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-229 CHS, Los Angeles, CA 90095-1690, USA,Corresponding authors: Bin Liu and Steven M. Dubinett. David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-229 CHS, Los Angeles, CA 90095-1690, USA. Phone: 310-267-2725; ;
| | - Steven M. Dubinett
- Department of Medicine, Division of Pulmonary and Critical Care, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-229 CHS, Los Angeles, CA 90095-1690, USA,Department of Medicine, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA,Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, 650 Charles E. Young Drive South, 23-120 CHS, Box 951735, Los Angeles, CA 90095-1735, USA,Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Los Angeles, CA 90095, USA,Jonsson Comprehensive Cancer Center, UCLA, 8-684 Factor Building, Box 951781, Los Angeles, CA 90095-1781, USA,Corresponding authors: Bin Liu and Steven M. Dubinett. David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-229 CHS, Los Angeles, CA 90095-1690, USA. Phone: 310-267-2725; ;
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Park SJ, Park YH. Simplified technique of in-office secondary tracheoesophageal puncture with immediate voice prosthesis placement under transnasal esophagoscope guidance. Eur Ann Otorhinolaryngol Head Neck Dis 2021; 138 Suppl 2:53-54. [PMID: 34116948 DOI: 10.1016/j.anorl.2021.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/17/2021] [Accepted: 04/20/2021] [Indexed: 10/21/2022]
Affiliation(s)
- S J Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10 63-ro, Yeongdeungpo-gu, Seoul, 07345, Korea
| | - Y H Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10 63-ro, Yeongdeungpo-gu, Seoul, 07345, Korea.
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17
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Park SJ, Park JW, Ahn GR, Choi SY, Yoo KH, Li K, Kim BJ. A study of the microbiological profile of filler-induced skin necrosis. Clin Exp Dermatol 2021; 46:901-905. [PMID: 33763910 DOI: 10.1111/ced.14653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/08/2021] [Accepted: 03/19/2021] [Indexed: 11/28/2022]
Abstract
Skin necrosis is one of the most severe complications following filler injections, and can result in permanent aesthetic defects. Although an increasing number of studies have addressed the management of dermal filler complications, no study has described the spectrum of microbial pathogens. The aim of this study was to delineate the bacterial profile and prognostic factors of filler-related skin necrosis by reviewing the clinical and microbiological features of these patients. A retrospective medical record review of patients undergoing treatment for skin necrosis induced by fillers was conducted. In total, 10 cases were identified, with injection sites being the nasolabial fold (70%; n = 7), nasal dorsum (20%; n = 2) and nasal tip (10%; n = 1). Reviewing the culture results, the true culture-positive rate was found to be 50% after cases of contamination were excluded. To avoid permanent sequelae, all physicians should be aware of possible secondary infections when treating filler-induced skin necrosis.
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Affiliation(s)
- S J Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - J W Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - G R Ahn
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - S Y Choi
- Department of Dermatology, Seoul Paik Hospital, Inje University, Seoul, South Korea
| | - K H Yoo
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - K Li
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - B J Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
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Kang SH, Park SJ, Park JW, Kim WS, Seo SJ. Paradoxical darkening following picosecond laser and successful treatment. Clin Exp Dermatol 2021; 46:1128-1129. [PMID: 33774841 DOI: 10.1111/ced.14661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 11/28/2022]
Affiliation(s)
- S H Kang
- Departments of Plastic Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - S J Park
- Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - J W Park
- Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - W S Kim
- Departments of Plastic Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - S J Seo
- Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
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19
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Park SJ, Zonetti S, Parker-Jervis RS, Wu J, Wood CD, Li LH, Davies AG, Linfield EH, Sydoruk O, Cunningham JE. Terahertz magnetoplasmon resonances in coupled cavities formed in a gated two-dimensional electron gas. Opt Express 2021; 29:12958-12966. [PMID: 33985041 DOI: 10.1364/oe.414178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/11/2021] [Indexed: 06/12/2023]
Abstract
We report on both experiments and theory of low-terahertz frequency range (up to 400 GHz) magnetoplasmons in a gated two-dimensional electron gas at low (<4K) temperatures. The evolution of magnetoplasmon resonances was observed as a function of magnetic field at frequencies up to ∼400 GHz. Full-wave 3D simulations of the system predicted the spatial distribution of plasmon modes in the 2D channel, along with their frequency response, allowing us to distinguish those resonances caused by bulk and edge magnetoplasmons in the experiments. Our methodology is anticipated to be applicable to the low temperature (<4K) on-chip terahertz measurements of a wide range of other low-dimensional mesoscopic systems.
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Preciado SM, Sharp AL, Sun BC, Baecker A, Wu YL, Lee MS, Shen E, Ferencik M, Natsui S, Kawatkar AA, Park SJ, Redberg RF. Evaluating Sex Disparities in the Emergency Department Management of Patients With Suspected Acute Coronary Syndrome. Ann Emerg Med 2021; 77:416-424. [PMID: 33358395 PMCID: PMC8005458 DOI: 10.1016/j.annemergmed.2020.10.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 10/02/2020] [Accepted: 10/28/2020] [Indexed: 02/06/2023]
Abstract
STUDY OBJECTIVE We compare clinical management and outcomes of emergency department (ED) encounters by sex after implementation of a clinical care pathway in 15 community EDs that standardized recommendations based on patient risk, using the History, ECG, Age, Risk Factors, and Troponin (HEART) score. METHODS This was a retrospective analysis of adult ED encounters evaluated for suspected acute coronary syndrome with a documented HEART score from May 20, 2016, to December 1, 2017. The primary outcomes were hospitalization or 30-day stress testing. Secondary outcomes included 30-day acute myocardial infarction or all-cause death (major adverse cardiac event). A generalized estimating equation regression model was used to compare the odds of hospitalization or stress testing by sex; we report HEART scores (0 to 10) stratified by sex and describing major adverse cardiac events. RESULTS A total of 34,715 adult ED encounters met the inclusion criteria (56.0% women). A higher proportion of women were classified as low risk (60.5% versus 52.4%; odds ratio [OR] 1.39; 95% confidence interval [CI] 1.33 to 1.45). Women were hospitalized or received stress testing less frequently than men for low HEART scores (18.8% versus 22.8%; OR 0.79; 95% CI 0.73 to 0.84) and intermediate ones (46.7% versus 49.7%; OR 0.88; 95% CI 0.83 to 0.95), but similarly for high-risk ones (74.1% versus 74.4%; OR 0.99; 95% CI 0.77 to 1.28). Women had 18% lower odds of hospitalization or noninvasive cardiac testing (OR 0.82; 95% CI 0.78 to 0.86), even after adjusting for HEART score and comorbidities. Men had higher risks of major adverse cardiac events than women for all HEART score categories but the risk for men was significantly higher among low-risk HEART scores (0.4% versus 0.1%). CONCLUSION Women with low-risk HEART scores are hospitalized or stress tested less than men, which is likely appropriate, and women have better outcomes than men. Use of the HEART score has the potential to reduce sex disparities in acute coronary syndrome care.
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Affiliation(s)
- Salena M Preciado
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Adam L Sharp
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Benjamin C Sun
- Department of Emergency Medicine, University of Pennsylvania, Leonard Davis Institute, Philadelphia, PA
| | - Aileen Baecker
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Yi-Lin Wu
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Ming-Sum Lee
- Division of Cardiology, Kaiser Permanente Southern California, Los Angeles Medical Center, Los Angeles, CA
| | - Ernest Shen
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Maros Ferencik
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR
| | - Shaw Natsui
- New York City Health + Hospitals, New York, NY
| | - Aniket A Kawatkar
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Stacy J Park
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Rita F Redberg
- Division of Cardiology, University of California-San Francisco, San Francisco, CA.
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Yoo KH, Park SJ, Han HS, Won CH, Lee YW, Kim BJ. Randomized, double-blind, active-controlled, multicentre, phase III clinical trial with two stages to assess the safety and efficacy of letibotulinum toxin a vs. onabotulinum toxin a for subjects with moderate to severe crow's feet. J Eur Acad Dermatol Venereol 2021; 35:1587-1594. [PMID: 33721365 DOI: 10.1111/jdv.17217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/24/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Letibotulinum toxin A (LeBA) was approved by the Ministry of Food and Drug Safety (known as the Korea Food & Drug Administration) for cosmetic indications in 2012. However, the efficacy and safety of this newly introduced LeBA have not been investigated in crow's feet lines (CFL) treatment and standardization before its universal use. OBJECTIVE The aim of this multicentre, double-blind, randomized, parallel, active-controlled Phase III clinical trial with two stages (ClinicalTrials.gov identifier: NCT03408236) was to investigate the non-inferiority of LeBA vs. the existing onabotulinum toxin A (OnBA) for the treatment of CFL. METHODS A total of 240 subjects were randomized to either the test (LeBA) or control (OnBA) group. At the baseline and at weeks 4 while maximum smiling (primary efficacy assessment), 8, 12 and 16, investigator's on-site evaluation, independent evaluator, evaluation by the subjects, subjects' satisfaction assessment and safety assessment were performed. RESULTS At week 4, the response rate of primary efficacy assessment was 69.75% and 68.33% in the test (LeBA) and control (OnBA) groups, respectively, without a significant difference. Other minor secondary evaluation results showed significant differences suggesting that LeBA offered better improvement than OnBA, but the overall results did not show significant differences between the two groups. CONCLUSION This study showed that LeBA was as effective and safe as OnBA for the treatment of CFL at the same doses.
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Affiliation(s)
- K H Yoo
- Department of Dermatology, College of Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - S J Park
- Department of Dermatology, College of Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - H S Han
- Department of Dermatology, College of Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - C H Won
- Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Y W Lee
- Department of Dermatology, College of Medicine, Konkuk University Hospital, Seoul, Korea
| | - B J Kim
- Department of Dermatology, College of Medicine, Chung-Ang University Hospital, Seoul, Korea
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22
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Ghobadi A, Lin B, Musigdilok VV, Park SJ, Palmer‐Toy DE, Gould MK, Vinson DR, Hutchison DM, Sharp AL. Effect of Using an Age-adjusted D-dimer to Assess for Pulmonary Embolism in Community Emergency Departments. Acad Emerg Med 2021; 28:60-69. [PMID: 33206443 DOI: 10.1111/acem.14175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/20/2020] [Accepted: 11/14/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The objective of this study was to evaluate the effect of changing the laboratory-reported D-dimer reference intervals to age-adjusted reference intervals on the use of advanced chest imaging and 30-day adverse events among emergency department (ED) encounters. METHODS A retrospective interrupted time-series analysis of ED encounters for patients > 50 years evaluated for suspected pulmonary embolism (PE) from April 2014 to April 2016. The primary outcome was use of advanced diagnostic imaging, and the secondary outcome was 30-day mortality or PE diagnosis. Secondary analyses also quantified delayed PE diagnoses pre- and postintervention. A generalized estimating equation segmented logistic regression model, adjusting for patient and facility characteristics, was used to determine changes in odds of diagnostic imaging and 30-day mortality or PE diagnoses. RESULTS A total of 10,534 (5,153 pre- and 5,381 postimplementation) ED encounters were included. Advanced imaging was obtained in 35.9% of pre- versus 33% of postimplementation encounters. Age-adjusted D-dimer (AADD) showed a small and nonsignificant decrease in month-to-month trends of advanced chest imaging postimplementation (odds ratio [OR] = 0.98, 95% confidence interval [CI] = 0.96 to 1.00). Use of advanced imaging in patients with D-dimer values lower than 500 ng/mL fibrinogen-equivalent units (FEU) was similar in the preintervention (5.8%) and postintervention (6.8%) periods. However, imaging was obtained in 30% of patients postintervention with a D-dimer result less than AADD reference interval , but more than the historical 500 ng/mL FEU reference interval. Implementing an AADD threshold demonstrated no change in the rate of 30-day adverse events (missed PE or mortality). CONCLUSION Changing the laboratory-reported D-dimer reference intervals for evaluation of PE was not associated with reduction in advanced chest imaging and did not increase 30-day adverse events. However, there was substantial noncompliance with the age-adjusted reference intervals in the postintervention period likely blunting the impact of this intervention.
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Affiliation(s)
- Ali Ghobadi
- From the Department of Clinical Science Kaiser Permanente Bernard J. Tyson School of Medicine PasadenaCAUSA
- the Anaheim Medical Center Kaiser Permanente Southern California Anaheim CAUSA
| | - Bryan Lin
- the Department of Research and Evaluation Kaiser Permanente PasadenaCAUSA
| | | | - Stacy J. Park
- the Department of Research and Evaluation Kaiser Permanente PasadenaCAUSA
| | - Darryl E. Palmer‐Toy
- the Southern California Permanente Medical Group Regional Reference Laboratories North Hollywood and Chino Hills CAUSA
| | - Michael K. Gould
- the Department of Research and Evaluation Kaiser Permanente PasadenaCAUSA
- the Department of Health Systems Science Kaiser Permanente Bernard J. Tyson School of Medicine Pasadena CAUSA
| | - David R. Vinson
- the Department of Research, and The Permanente Medical Group Kaiser Permanente Northern California Oakland CAUSA
- the Kaiser Permanente Roseville Medical Center Roseville CAUSA
| | | | - Adam L. Sharp
- the Department of Research and Evaluation Kaiser Permanente PasadenaCAUSA
- the Department of Health Systems Science Kaiser Permanente Bernard J. Tyson School of Medicine Pasadena CAUSA
- and the Los Angeles Medical Center Kaiser Permanente Southern California Los Angeles CA USA
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23
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Ioannides KL, Sun BC, Baecker AS, Redberg RF, Lee M, Ferencik M, Wu Y, Shen E, Zheng C, Musigdilok V, Park SJ, Sharp AL. Not all HEART scores are created equal: identifying "low-risk" patients at higher risk. J Am Coll Emerg Physicians Open 2020; 1:1161-1167. [PMID: 33392519 PMCID: PMC7771830 DOI: 10.1002/emp2.12315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE We sought to identify sub-groups of "low-risk" HEART score patients (history, ECG, age, risk factors, and troponin) at elevated risk of acute myocardial infarction or death within 30 days. METHODS We performed a secondary analysis of prospective emergency department (ED) encounters for suspected acute coronary syndrome in a large health system with low-risk HEART scores (0-5 points). Logistic regression using the 5 components of the HEART score analyzed the increase risk attributable to points from each of the 5 score components. RESULTS Of 30,971 encounters among 28,992 unique patients, 135 (0.44%, 95% confidence interval [CI] = 0.37-0.51) experienced acute myocardial infarction or death. Risk increased for each component of the HEART score from 0 to 1 to 2 points (history, 0.4% to 0.5% to 0.6%; ECG, 0.3% to 0.7% to 0.7%; age, 0.2% to 0.3% to 0.7%; risk factors, 0.1% to 0.4% to 0.8%), except troponin, which had the highest risk with 1 point (troponin, 0.4% to 2.7% to 0.9%). Odds ratios from our regression, which adjusts for other components, showed a similar pattern (from 1 vs 0 and 2 vs 0 points, respectively: history, 1.0 and 1.8; ECG, 2.2 and 3.5; age, 1.2 and 2.1; risk factors, 2.4 and 4.2; and troponin, 6.0 and 3.6). CONCLUSION Among "low-risk" suspected acute coronary syndrome encounters, increasing points within each of the 5 categories demonstrated small increases in risk of death or acute myocardial infarction, with the troponin and ECG components representing the largest risk increases.
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Affiliation(s)
- Kimon L.H. Ioannides
- NationalClinician Scholars ProgramDepartment of Emergency MedicineUniversity of California, Los AngelesLos AngelesCaliforniaUSA
| | - Benjamin C. Sun
- Department of Emergency Medicine and the Leonard Davis Institute of Health EconomicsUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Aileen S. Baecker
- Research and Evaluation DepartmentKaiser Permanente Southern CaliforniaPasadenaCaliforniaUSA
| | - Rita F. Redberg
- Division of CardiologyUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Ming‐Sum Lee
- Division of CardiologyLos Angeles Medical CenterKaiser Permanente Southern CaliforniaLos AngelesCaliforniaUSA
| | - Maros Ferencik
- Knight Cardiovascular InstituteOregon Health and Science UniversityPortlandOregonUSA
| | - Yi‐Lin Wu
- Research and Evaluation DepartmentKaiser Permanente Southern CaliforniaPasadenaCaliforniaUSA
| | - Ernest Shen
- Research and Evaluation DepartmentKaiser Permanente Southern CaliforniaPasadenaCaliforniaUSA
| | - Chengyi Zheng
- Research and Evaluation DepartmentKaiser Permanente Southern CaliforniaPasadenaCaliforniaUSA
| | - Visanee Musigdilok
- Research and Evaluation DepartmentKaiser Permanente Southern CaliforniaPasadenaCaliforniaUSA
| | - Stacy J. Park
- Research and Evaluation DepartmentKaiser Permanente Southern CaliforniaPasadenaCaliforniaUSA
| | - Adam L. Sharp
- Research and Evaluation DepartmentKaiser Permanente Southern CaliforniaPasadenaCaliforniaUSA
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Park SJ, Park JW, Park KY, Li K, Seo SJ, Kim BJ, Yoo KH. Systemic contact dermatitis induced by Rhus allergens in Korea: exercising caution in the consumption of this nutritious food. Clin Exp Dermatol 2020; 46:324-327. [PMID: 32974941 DOI: 10.1111/ced.14458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/11/2020] [Accepted: 09/16/2020] [Indexed: 11/29/2022]
Abstract
Systemic contact dermatitis (SCD) develops when a person who was previously sensitized to an allergen is exposed to the same allergen via the systemic route. In East Asia, the use of lacquer for polishing furniture is common and a part of the traditional culture. Contact exposure to tableware polished with Rhus lacquer may lead to sensitization. In Korea, SCD is commonly observed after systemic exposure to Rhus, a nutritious food item consumed because of the common belief of it improving the immune system. In this study, we reviewed the medical records of 21 Korean patients with SCD caused by Rhus ingestion. We found that the most significant epidemiological factor for SCD was the season of the year. Furthermore, 66.67% of the patients presented with leucocytosis and 23.81% showed increased liver enzyme levels. It is important to educate people on the risks associated with the systemic ingestion of Rhus.
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Affiliation(s)
- S J Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - J W Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - K Y Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - K Li
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - S J Seo
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - B J Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - K H Yoo
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
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Gwag HB, Park SJ, Park KM, On YK, Kim JS. 847Interim analysis of the device-detected cardiac tachyarrhythmic events and sleep-disordered breathing (DEDiCATES)" study; focused on baseline characteristics. Europace 2020. [DOI: 10.1093/europace/euaa162.352] [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: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
This work is supported by Boston Scientific.
Background/introduction: Sleep-disordered breathing (SDB) is one of the common comorbidities in cardiac implantable electronic devices (CIED) patients. It’s feasible to detect SDB using specialized diagnostic function of CIEDs showing comparable performance in diagnostic accuracy of SDB to conventional polysomnography. To date, few studies have investigated the prognostic value of CIED-detected SDB in cardiovascular risk.
Purpose
In the Device-Detected CArdiac Tachyarrhythmic events and Sleep-disordered breathing (DEDiCATES) study, we aim to determine whether device-detected sleep-disordered breathing (SDB) events are associated with increased risk of cardiac arrhythmias or other cardiovascular (CV) outcomes. Here, we present interim baseline data of the study population to investigate the baseline prevalence and severity of device-detected SDB in CIED patients.
Methods
The study was designed as a prospective, multicenter, and observational study to include 600 patients. Eligible patients have dual chamber CIEDs with SDB detection function which reports the average number of sleep disturbance events per hour per night in the form of a Respiratory Disturbance Index (RDI). The daily RDI values were collected to measure the severity and burden of SDB. The baseline severity of SDB was determined according to RDI data recorded during the first 1 week, 1 month, and 3 ± 1 months after CIED implantation; patients with RDI≥ 30/h for at least one night are classified into the severe SDB group.
Results
A total of 313 patients who completed the first device interrogation at 3 ± 1 months were included for analysis. The mean age and CHA2DS2VASc score were 69 and 3.1, respectively. Forty-nine percent of patients were men, and 35.5% were classified as high risk for SDB by Berlin questionnaire. The rate of severe SDB increased with longer monitoring period (83.8% at 1week, 91.6% at 1 month, and 96.4% at 3 ± 1 months). There was no baseline demographic difference between the severe and non-severe SDB groups, except that baseline body mass index (BMI) was higher in the severe group (24.5% vs. 21.5%, p = 0.01). The mean RDI was 36.3, 34.2, and 33.0 per night during the first 1 week, 1 month, and 3 ± 1 months, respectively. Considering the limitation of the categorical criteria of baseline severity, we arbitrarily reclassified the patients according to median mean RDI value. Men were more frequent and BMI was higher in the above-mean RDI group compared to the below-mean RDI group. Using logistic regression analysis, we identified that BMI and male gender were associated with patients with above-mean RDI.
Conclusions
Conventional categorical classification of SDB severity seems to be limited in its ability to discriminate high risk patients. Thus, more suitable RDI-related variables need to be identified in future outcome analysis.
Abstract Figure. Prevalence of baseline severe SDB
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Affiliation(s)
- H B Gwag
- Samsung Changwon Hospital, Changwon, Korea (Republic of)
| | - S J Park
- Samsung Medical Center, Cardiology, Seoul, Korea (Republic of)
| | - K M Park
- Samsung Medical Center, Cardiology, Seoul, Korea (Republic of)
| | - Y K On
- Samsung Medical Center, Cardiology, Seoul, Korea (Republic of)
| | - J S Kim
- Samsung Medical Center, Cardiology, Seoul, Korea (Republic of)
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26
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Ahn D, Song JD, Kang SS, Lim JY, Yang SH, Ko S, Park SH, Park SJ, Kim DS, Chang HJ, Chang J. Intrinsically p-type cuprous iodide semiconductor for hybrid light-emitting diodes. Sci Rep 2020; 10:3995. [PMID: 32132624 PMCID: PMC7055318 DOI: 10.1038/s41598-020-61021-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 01/17/2020] [Indexed: 11/25/2022] Open
Abstract
Cuprous halides, characterized by a direct wide band-gap and a good lattice matching with Si, is an intrinsic p-type I-VII compound semiconductor. It shows remarkable optoelectronic properties, including a large exciton binding energy at room temperature and a very small piezoelectric coefficient. The major obstacle to its application is the difficulty in growing a single-crystal epitaxial film of cuprous halides. We first demonstrate the single crystal epitaxy of high quality cuprous iodide (CuI) film grown on Si and sapphire substrates by molecular beam epitaxy. Enhanced photoluminescence on the order of magnitude larger than that of GaN and continuous-wave optically pumped lasing were found in MBE grown CuI film. The intrinsic p-type characteristics of CuI were confirmed using an n-AlGaN/p-CuI junction that emits blue light. The discovery will provide an alternative way towards highly efficient optoelectronic devices compatible with both Si and III-nitride technologies.
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Affiliation(s)
- D Ahn
- Peta Lux Inc., 3F TLi Building, 12 Yanghyeon-ro, 405 beon-gil, Jungwon-gu, Seongnam-si, Gyeonggi-do, 13438, Republic of Korea. .,Department of Electrical and Computer Engineering and Center for Quantum Information Processing, University of Seoul, 163 Seoulsiripdae-ro, Dongdaemun-gu, Seoul, 02504, Republic of Korea. .,Physics Department, Charles E. Schmidt College of Science, Florida Atlantic University, 777 Glades Road, Boca Raton, FL, 33431-0991, USA.
| | - J D Song
- Post-Silicon Semiconductor Institute, Korea Institute of Science and Technology Hwarang-ro 14 gil, Seoungbuk-ku, Seoul, 02792, Republic of Korea.
| | - S S Kang
- Post-Silicon Semiconductor Institute, Korea Institute of Science and Technology Hwarang-ro 14 gil, Seoungbuk-ku, Seoul, 02792, Republic of Korea.,Department of Physics, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - J Y Lim
- Peta Lux Inc., 3F TLi Building, 12 Yanghyeon-ro, 405 beon-gil, Jungwon-gu, Seongnam-si, Gyeonggi-do, 13438, Republic of Korea
| | - S H Yang
- Peta Lux Inc., 3F TLi Building, 12 Yanghyeon-ro, 405 beon-gil, Jungwon-gu, Seongnam-si, Gyeonggi-do, 13438, Republic of Korea
| | - S Ko
- Peta Lux Inc., 3F TLi Building, 12 Yanghyeon-ro, 405 beon-gil, Jungwon-gu, Seongnam-si, Gyeonggi-do, 13438, Republic of Korea
| | - S H Park
- Electronics Department, Catholic University of Daegu, 13 Hayang-Ro, Hayang-Eup, Gyeongsan-si, Gyeongbuk, 38430, Republic of Korea
| | - S J Park
- WONIK IPS, 75 Jinwisandan-ro, Jinwi-myeon, Pyeingtaek-si, Gyeonggi-do, 17709, Republic of Korea
| | - D S Kim
- TLi Inc., 10 F TLi Building, 12 Yanghyeon-ro, 405 beon-gil, Jungwon-gu, Seongnam-si, Gyeonggi-do, 13438, Republic of Korea
| | - H J Chang
- Post-Silicon Semiconductor Institute, Korea Institute of Science and Technology Hwarang-ro 14 gil, Seoungbuk-ku, Seoul, 02792, Republic of Korea
| | - Joonyeon Chang
- Post-Silicon Semiconductor Institute, Korea Institute of Science and Technology Hwarang-ro 14 gil, Seoungbuk-ku, Seoul, 02792, Republic of Korea. .,Department of Materials Science & Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. .,Yonsei-KIST Convergence Research Institute, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Choi M, Byun SJ, Lee DH, Kim KH, Park KH, Park SJ. The Association with rhegmatogenous retinal detachment and paediatric atopic dermatitis: a 12-year Nationwide Cohort Study. Eye (Lond) 2020; 34:1909-1915. [PMID: 32080352 PMCID: PMC7608199 DOI: 10.1038/s41433-020-0816-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 10/23/2019] [Accepted: 12/17/2019] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Historically, atopic dermatitis (AD) is associated with an increased risk of rhegmatogenous retinal detachment (RRD). However, uncertainty remained regarding the effect of AD itself and comorbidities (e.g., allergic diseases, cataract surgery) on RRD occurrence in a large, population-based paediatric population. PATIENTS AND METHODS We analysed the 12-year National Health Insurance Service database (2002-2013) covering the entire Korean population to estimate the association between AD and RRD in people aged under 20 years. RESULTS We identified 3142 RRD patients, and matched 18,852 controls (six controls to each RRD patient); therefore, we included 21,994 peoples under aged 20 years in the analyses. AD was more prevalent in the RRD group (329 patients, 10.47%) than the control group (1043 patients, 5.53%; P < 0.001), and so were severe AD (153 patients [4.87%] and 223 patients [1.18%], respectively; P < 0.001). In conditional logistic regression analysis, AD was associated with RRD (OR, 1.61; 95% CI, 1.93-1.87) even after adjusting for allergic conditions, connective tissue disease, uveitis, and cataract surgery. In addition, severity of AD was associated with an increased risk of RRD (OR for non-severe AD and severe AD, 1.26 [95% CI, 1.05-1.51] and 2.88 [95% CI, 2.25-3.68]). CONCLUSION This study suggests that AD itself is a risk factor of RRD in children by showing the association between AD and RRD occurrence and the biologic gradient even after adjustment for known confounders including allergic conditions, uveitis, and cataract surgery.
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Affiliation(s)
- M Choi
- Department of Dermatology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - S J Byun
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - D H Lee
- Department of Dermatology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - K H Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - K H Park
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - S J Park
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
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Lee MH, Yanagawa J, Tran L, Walser TC, Bisht B, Fung E, Park SJ, Zeng G, Krysan K, Wallace WD, Paul MK, Girard L, Gao B, Minna JD, Dubinett SM, Lee JM. FRA1 contributes to MEK-ERK pathway-dependent PD-L1 upregulation by KRAS mutation in premalignant human bronchial epithelial cells. Am J Transl Res 2020; 12:409-427. [PMID: 32194893 PMCID: PMC7061839] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 12/14/2019] [Indexed: 06/10/2023]
Abstract
Oncogenic KRAS mutations are frequently found in non-small cell lung carcinoma (NSCLC) and cause constitutive activation of the MEK-ERK pathway. Many cancer types have been shown to overexpress PD-L1 to escape immune surveillance. FRA1 is a MEK/ERK-dependent oncogenic transcription factor and a member of the AP-1 transcriptional factor superfamily. This study assesses the hypothesis that KRAS mutation directly regulates PD-L1 expression through the MEK-ERK pathway mediated by FRA1. Premalignant human bronchial epithelial cell (HBEC) lines harboring the KRAS mutationV12, EGFR mutation, p53 knock-down, or both KRAS mutation and p53 knock-down were tested for levels of PD-L1, FRA1, and ERK activation (pERK). Our results showed that KRAS mutation alone, but not other genetic alterations, induced significantly higher expression of PD-L1 compared to its vector counterparts. The increased PD-L1 expression in the KRAS mutated cells was dramatically reduced by inhibition of ERK activation. Furthermore, the MEK-ERK pathway-dependent PD-L1 expression was markedly reduced by FRA1 silencing. Interestingly, FRA1 silencing led to inhibition of ERK activation, indicating that FRA1 plays a role in PD-L1 regulation via positive feedback of ERK activation. Correlation of PD-L1 and FRA1 mRNA expression was validated using human lung cancer specimens from The Cancer Genome Atlas (TCGA) and established NSCLC cell lines from Cancer Cell Line Encyclopedia (CCLE). FRA1 expression was significantly associated with PD-L1 expression, and high FRA1 expression was correlated with poor overall survival. Our findings suggest that oncogenic KRAS-driven PD-L1 expression is dependent on MEK-ERK and FRA1 in high risk, premalignant HBEC.
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Affiliation(s)
- Mi-Heon Lee
- Lung Cancer Research Program, Jonsson Comprehensive Cancer CenterLos Angeles, CA, USA
- Division of Thoracic Surgery, University of CaliforniaLos Angeles, CA, USA
- Current address: Department of Radiation Oncology, David Geffen School of Medicine at UCLALos Angeles, CA 90095, USA
| | - Jane Yanagawa
- Lung Cancer Research Program, Jonsson Comprehensive Cancer CenterLos Angeles, CA, USA
- Division of Thoracic Surgery, University of CaliforniaLos Angeles, CA, USA
| | - Linh Tran
- Lung Cancer Research Program, Jonsson Comprehensive Cancer CenterLos Angeles, CA, USA
- Division of Pulmonary and Critical Care Medicine, University of CaliforniaLos Angeles, CA, USA
| | - Tonya C Walser
- Lung Cancer Research Program, Jonsson Comprehensive Cancer CenterLos Angeles, CA, USA
- Division of Pulmonary and Critical Care Medicine, University of CaliforniaLos Angeles, CA, USA
| | - Bharti Bisht
- Lung Cancer Research Program, Jonsson Comprehensive Cancer CenterLos Angeles, CA, USA
- Division of Thoracic Surgery, University of CaliforniaLos Angeles, CA, USA
| | - Eileen Fung
- Lung Cancer Research Program, Jonsson Comprehensive Cancer CenterLos Angeles, CA, USA
- Division of Thoracic Surgery, University of CaliforniaLos Angeles, CA, USA
| | - Stacy J Park
- Lung Cancer Research Program, Jonsson Comprehensive Cancer CenterLos Angeles, CA, USA
| | - Gang Zeng
- Department of Urology, University of CaliforniaLos Angeles, CA, USA
| | - Kostyantyn Krysan
- Lung Cancer Research Program, Jonsson Comprehensive Cancer CenterLos Angeles, CA, USA
- Division of Pulmonary and Critical Care Medicine, University of CaliforniaLos Angeles, CA, USA
| | - William D Wallace
- Department of Pathology and Laboratory Medicine at The David Geffen School of Medicine, University of CaliforniaLos Angeles, CA, USA
| | - Manash K Paul
- Lung Cancer Research Program, Jonsson Comprehensive Cancer CenterLos Angeles, CA, USA
- Division of Pulmonary and Critical Care Medicine, University of CaliforniaLos Angeles, CA, USA
| | - Luc Girard
- Department of Internal Medicine and Pharmacology, Hamon Center for Therapeutic Oncology Research The University of Texas Southwestern Medical CenterDallas, TX, USA
| | - Boning Gao
- Department of Internal Medicine and Pharmacology, Hamon Center for Therapeutic Oncology Research The University of Texas Southwestern Medical CenterDallas, TX, USA
| | - John D Minna
- Department of Internal Medicine and Pharmacology, Hamon Center for Therapeutic Oncology Research The University of Texas Southwestern Medical CenterDallas, TX, USA
| | - Steven M Dubinett
- Lung Cancer Research Program, Jonsson Comprehensive Cancer CenterLos Angeles, CA, USA
- Division of Pulmonary and Critical Care Medicine, University of CaliforniaLos Angeles, CA, USA
- Molecular Gene Medicine Laboratory, Veterans Affair Greater Los Angeles Healthcare SystemLos Angeles, CA, USA
| | - Jay M Lee
- Lung Cancer Research Program, Jonsson Comprehensive Cancer CenterLos Angeles, CA, USA
- Division of Thoracic Surgery, University of CaliforniaLos Angeles, CA, USA
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Amano M, Izumi C, Kim YJ, Park SJ, Park SW, Tanaka H, Hozumi T, Ling LH, Yu CM, Fukuda S, Otsuji Y, Song JK, Sohn DW. P914 Changes of echocardiographic parameters in primary mitral regurgitation and determinants of symptom: an assessment from the Asian valve registry data. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.550] [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]Clinicians often have a difficulty in determining the presence of mitral regurgitation (MR)-relatedsymptoms because of subjectivity.However, there are few actual measurement data for echocardiographic left ventricular (LV) and left atrial (LA) size related to the severity of MR and the relationship between MR-related symptoms and these echocardiographic parameters.
[Purpose] The purpose of this study was to clarify actual values for echocardiographic parameters related to severity of MR and determinant factors of MR-related symptoms.
[Methods] Among patients enrolled in the Asian Valve Registry, we investigated 778 consecutive patients with primary MR showing sinus rhythm. Symptoms were determined by NYHA (≤ II or ≥ III).
[Results]MR severity was mild in 106, moderate in 285, and severe in 387 patients. LA volume index, LV end-diastolic diameter, and LV mass index increased with increasing MR grade [LA volume index: 47.9 (mild), 56.2 (moderate), and 64.9 ml/m2(severe) (p < 0.001), LV end-diastolic diameter: 51.2, 54.5, 58.1 mm (p < 0.001), and LV mass index: 101, 109, 123 g/m2(p < 0.001)]. Regarding moderate and severe MR, 70 patients (10.4%) were symptomatic. Table shows multivariable analysis for being symptomatic in moderate and severe MR patients. LV mass index (p = 0.040), ejection fraction (p < 0.001), female gender (p = 0.004), and heart rate (p = 0.007) were independent factors for MR-related symptoms.
[Conclusions] LV and LA parameters on echocardiography worsened as MR severity progressed. Larger LV mass index and lower ejection fraction were independent determinant factors for MR-related symptoms. We should also pay attention to LV hypertrophy in patients with primary MR.
Determinant factors for mitral regurgita Model 1 Model 2 OR (95% CI) P-value OR (95% CI) P-value Age, per 1-y increment 1.03 (1.00-1.05) 0.035 1.02 (0.99-1.05) 0.053 Sex (female) 2.23 (1.20-4.16) 0.011 2.28 (1.31-3.98) 0.004 Hear rate, per 1 bpm increment 1.03 (1.00-1.05) 0.025 1.03 (1.01-1.05) 0.007 LVDs index, per 1 mm increment 0.99 (0.90-1.09) 0.90 EF, per 1% increment 0.95 (0.92-0.99) 0.019 0.96 (0.93-0.98) <0.001 LV mass index, per 10 g/m2increment 1.12 (1.01-1.25) 0.033 1.09 (1.005-1.18) 0.040 LA volume index, per 10 mL/m2increment 0.96 (0.90-1.03) 0.23 E wave, per 1cm/s increment 1.81 (0.70-4.66) 0.23 TR pressure gradient >40 mmHg 2.11 (0.97-4.57) 0.057 Hypertention 1.40 (0.75-2.63) 0.29
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Affiliation(s)
- M Amano
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - C Izumi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - Y J Kim
- Seoul National University Hospital, Cardiology, Seoul, Korea (Republic of)
| | - S J Park
- Samsung Medical Center, Cardiology, Seoul, Korea (Republic of)
| | - S W Park
- Samsung Medical Center, Cardiology, Seoul, Korea (Republic of)
| | - H Tanaka
- Kobe University, Cardiovascular Medicine, Kobe, Japan
| | - T Hozumi
- Wakayama Medical University, Cardiovascular Medicine, Wakayama, Japan
| | - L H Ling
- National Heart Centre Singapore, Singapore, Singapore
| | - C M Yu
- The University of Hong Kong, Medicine and Therapeutics, Hong Kong, Hong Kong
| | - S Fukuda
- University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Y Otsuji
- University of Occupational and Environmental Health, Kitakyushu, Japan
| | - J K Song
- Asan Medical Center, Seoul, Korea (Republic of)
| | - D W Sohn
- Seoul National University Hospital, Cardiology, Seoul, Korea (Republic of)
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Hwang I, Lee JM, Park JB, Yoon YE, Lee SP, Kim HK, Kim YJ, Cho GY, Park SJ, Kim KH, Hong GR. P1368 Effect of angiotensin receptor blocker in patients with moderate or severe aortic stenosis: a randomized controlled trial. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.803] [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: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
This study was supported by grants from Boryung Pharmacy Research Fund.
Background/Introduction: Pathophysiology of aortic stenosis (AS) and several previous studies suggested the potential role of angiotensin receptor blocker (ARB) in patients with AS.
Purpose
We aimed to investigate the effects of Fimasartan, an ARB, on exercise capacity and progression of AS in patients with moderate to severe AS.
Methods
We conducted a prospective, randomized, double-blind, placebo-controlled trial in 32 normotensive or controlled-hypertensive patients with moderate or severe AS. Study participants were randomized to Fimasartan 30 mg to 60 mg daily (n = 14) or placebo (n = 18) for 1 year, and underwent cardiopulmonary exercise test, 6-minute walk test, and echocardiography at 0, 6, and 12 months, with follow-up data available in 29 subjects.
Results
Significant reductions in blood pressures were observed in the Fimasartan group but not in the placebo group. Two of the 14 patients in the Fimasartan group withdrew the study due to mild symptoms probably related with the decreased blood pressure, and one patient decline the study protocol. After the 12-month treatment, the peak oxygen consumption (VO2; the primary outcome) in the Fimasartan group was significantly decreased (from 28.3 ± 5.9 to 25.4 ± 3.8 mL/min/kg, P = 0.021) but not in the placebo group (P for interaction = 0.046) (Figure 1A). The severity of AS showed a gradual progression in both groups, without inter-group differences (mean transaortic pressure; Fimasartan group, +4.0 ± 3.8 mmHg/year; placebo group, +5.3 ± 6.2 mmHg/year; P for interaction = 0.429) (Figure 1B). Parameters of left ventricular systolic and diastolic function did not change in both groups.
Conclusions
The use of ARB impaired exercise capacity in patients with moderate or severe AS, and did not prevent the progression of AS. However, due to the small number of participants, further studies are required to confirm these findings.
Abstract P1368 Figure.
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Affiliation(s)
- I Hwang
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - J M Lee
- Samsung Medical Center, Cardiovascular Center, Seoul, Korea (Republic of)
| | - J B Park
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - Y E Yoon
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - S P Lee
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - H K Kim
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - Y J Kim
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - G Y Cho
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - S J Park
- Samsung Medical Center, Cardiovascular Center, Seoul, Korea (Republic of)
| | - K H Kim
- Chonnam National University Hospital, Gwangju, Korea (Republic of)
| | - G R Hong
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
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31
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Yoon SA, Cha SH, Jun SW, Park SJ, Park JY, Lee S, Kim HS, Ahn YH. Identifying different types of microorganisms with terahertz spectroscopy. Biomed Opt Express 2020; 11:406-416. [PMID: 32010524 PMCID: PMC6968764 DOI: 10.1364/boe.376584] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 05/08/2023]
Abstract
Most microbial detection techniques require pretreatment, such as fluorescent labeling and cultivation processes. Here, we propose novel tools for classifying and identifying microorganisms such as molds, yeasts, and bacteria based on their intrinsic dielectric constants in the THz frequency range. We first measured the dielectric constant of films that consisted of a wide range of microbial species, and extracted the values for the individual microbes using the effective medium theory. The dielectric constant of the molds was 1.24-1.85, which was lower than that of bacteria ranging from 2.75-4.11. The yeasts exhibited particularly high dielectric constants reaching 5.63-5.97, which were even higher than that of water. These values were consistent with the results of low-density measurements in an aqueous environment using microfluidic metamaterials. In particular, a blue shift in the metamaterial resonance occurred for molds and bacteria, whereas the molds have higher contrast relative to bacteria in the aqueous environment. By contrast, the deposition of the yeasts induced a red shift because their dielectric constant was higher than that of water. Finally, we measured the dielectric constants of peptidoglycan and polysaccharides such as chitin, α-glucan, and β-glucans (with short and long branches), and confirmed that cell wall composition was the main cause of the observed differences in dielectric constants for different types of microorganisms.
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Affiliation(s)
- S A Yoon
- Department of Physics and Department of Energy Systems Research, Ajou University, Suwon 16499, South Korea
- Co-first authors with equal contribution
| | - S H Cha
- Department of Physics and Department of Energy Systems Research, Ajou University, Suwon 16499, South Korea
- Co-first authors with equal contribution
| | - S W Jun
- Department of Physics and Department of Energy Systems Research, Ajou University, Suwon 16499, South Korea
| | - S J Park
- Department of Physics and Department of Energy Systems Research, Ajou University, Suwon 16499, South Korea
| | - J-Y Park
- Department of Physics and Department of Energy Systems Research, Ajou University, Suwon 16499, South Korea
| | - S Lee
- Department of Physics and Department of Energy Systems Research, Ajou University, Suwon 16499, South Korea
| | - H S Kim
- Department of Biological Science, Ajou University, Suwon 16499, South Korea
| | - Y H Ahn
- Department of Physics and Department of Energy Systems Research, Ajou University, Suwon 16499, South Korea
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32
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Meng K, Park SJ, Li LH, Bacon DR, Chen L, Chae K, Park JY, Burnett AD, Linfield EH, Davies AG, Cunningham JE. Tunable broadband terahertz polarizer using graphene-metal hybrid metasurface. Opt Express 2019; 27:33768-33778. [PMID: 31878438 DOI: 10.1364/oe.27.033768] [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] [Received: 09/06/2019] [Accepted: 10/14/2019] [Indexed: 06/10/2023]
Abstract
We demonstrate an electrically tunable polarizer for terahertz (THz) frequency electromagnetic waves formed from a hybrid graphene-metal metasurface. Broadband (>3 THz) polarization-dependent modulation of THz transmission is demonstrated as a function of the graphene conductivity for various wire grid geometries, each tuned by gating using an overlaid ion gel. We show a strong enhancement of modulation (up to ∼17 times) compared to graphene wire grids in the frequency range of 0.2-2.5 THz upon introduction of the metallic elements. Theoretical calculations, considering both plasmonic coupling and Drude absorption, are in good agreement with our experimental findings.
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Kim MS, Kim SM, Kim EK, Park SJ, Lee SC, Park SW, Choe YH, Chang SA. P5279Pericardial inflammation basced on cardiac magnetic resonance imaging in patients with tuberculous pericarditis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
While constrictive pericarditis has been traditionally considered a disabling disease, reversible constrictive pericarditis has been described in previous studies. But there are limited studies on cardiac imaging of tuberculous pericarditis. In particular, no studies on cardiac magnetic resonance imaging (CMR) have been reported. We aimed to investigate CMR findings including pericardial late gadolinium enhancement (LGE) and T2 fat suppression and black blood sequences in patients with tuberculous pericarditis.
Methods
We retrospectively analyzed medical records of patients with tuberculous pericarditis between January 2010 and January 2017 in Samsung Medical Center. Definite diagnosis of tuberculous pericarditis is based on the identification of Mycobacterium tuberculosis in pericardial fluid or tissue; probable diagnosis was made when there was other evidence of tuberculosis elsewhere in patients with unexplained pericarditis. We performed CMR at initial diagnosis. Treatment consists of the standard 4-drug antituberculosis regimen for 6 months with or without steroids. Echocardiography was also conducted at initial diagnosis and 6 months later.
Results
Total 39 cases with tuberculous pericarditis in immunocompetent patients were enrolled. Ten patients were diagnosed as definite tuberculous pericarditis. CMR finding at initial diagnosis divided into five groups: 1) pericardial effusion only (n=20, 51.3%), 2) effusive constrictive pericarditis (n=5, 12.8%), 3) constrictive pericarditis (n=11, 28.2%), 4) pericardial abscess formation (n=4, 10.3%) and 5) absence of pericardial effusion and constrictive physiology (n=1, 2.6%). One of the 4 patients with pericardial abscess formation was together with pericardial effusion and the other was accompanied by effusive constrictive pericarditis. Pericardial thickness increased to more than 4mm in 25 patients (64.1%) and the mean pericardial thickness was 10.0±6.9mm. Delayed enhancement of pericardium was noticed in 29 patients (74.4%). In T2 fat suppression and black blood sequences, 30 patients showed increased T2 signal intensity indicating inflammation with extensive edema. Pericardial thickening (>4mm) with constriction (n=15) was not statistically significant in the delayed enhancement and increased T2 signal intensity compared with pericardial thickening without constrictive pericarditis (n=10) (delayed enhancement 93.8% vs. 77.8% p=0.287; increased T2 signal intensity 88.9% vs. 87.5%, p=0.713). After 6 months, only 3 patients still had constrictive pericarditis in echocardiography.
Effusive constrictive pericarditis
Conclusions
Pericardial thickening is associated with delayed enhancement and increased T2 signal intensity in patients with tuberculous pericarditis regardless of constrictive pericarditis. Even though there were hemodynamic feature of constrictive pericarditis and pericardial inflammation with extensive edema in CMR at initial diagnosis, 80% of the patients were improved from constrictive pericarditis.
Acknowledgement/Funding
None
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Affiliation(s)
- M S Kim
- Gangnam CHA General Hospital, Cardiology, Seoul, Korea (Republic of)
| | - S M Kim
- Samsung Medical Center, Radiology, Cardiovascular Imaging Center, Seoul, Korea (Republic of)
| | - E K Kim
- Samsung Medical Center, Cardiology, Seoul, Korea (Republic of)
| | - S J Park
- Samsung Medical Center, Cardiology, Seoul, Korea (Republic of)
| | - S C Lee
- Samsung Medical Center, Cardiology, Seoul, Korea (Republic of)
| | - S W Park
- Samsung Medical Center, Cardiology, Seoul, Korea (Republic of)
| | - Y H Choe
- Samsung Medical Center, Radiology, Cardiovascular Imaging Center, Seoul, Korea (Republic of)
| | - S A Chang
- Samsung Medical Center, Cardiology, Seoul, Korea (Republic of)
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Park SJ, Park J, Lee MJ, Seo JS, Ahn JY, Cho JW. Time series analysis of delta neutrophil index as the predictor of sepsis in patients with acute poisoning. Hum Exp Toxicol 2019; 39:86-94. [PMID: 31558056 DOI: 10.1177/0960327119878244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Delta neutrophil index (DNI), which reflects the fraction of immature granulocytes, is used to detect infection and sepsis from noninfectious conditions, but few studies have evaluated in the early stage of acute poisoning. This retrospective observational study was performed on acute poisoning patients who visited to the emergency department (ED) and were consecutively admitted in intensive care units over 18-month period. The serial DNI, conventional inflammatory biomarkers, and culture results were obtained in the ED and after admission. The outcomes were the identification of sepsis, bacteremia, and 30-day mortality. Of 166 patients (mean age, 56.0 years) in this cohort, 59 (35.5%) had sepsis and 29 (17.5%) had bacteremia. Initial and peak DNI fractions 24 h after ED admission were strong independent predictors of sepsis development. Analysis of the area under the curve according to multiple receiver operating characteristics showed that DNI had a higher capability to predict sepsis than other parameters (0.815 for DNI, 0.700 for procalcitonin, 0.681 for C-reactive protein, and 0.741 for white blood cell). Using multivariable logistic regression analysis, it was found that DNI was an independent predictor of sepsis (95% confidence interval (CI) of odds: 1.03-1.18) and bacteremia (95% CI: 1.01-1.14). Therefore, initial and serial measurement of DNI may serve as useful risk predictor for development of sepsis or bacteremia in acute poisoning.
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Affiliation(s)
- S J Park
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - J Park
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - M J Lee
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - J S Seo
- Department of Emergency Medicine, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Seoul, Republic of Korea
| | - J Y Ahn
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - J W Cho
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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Meng K, Park SJ, Burnett AD, Gill T, Wood CD, Rosamond M, Li LH, Chen L, Bacon DR, Freeman JR, Dean P, Ahn YH, Linfield EH, Davies AG, Cunningham JE. Increasing the sensitivity of terahertz split ring resonator metamaterials for dielectric sensing by localized substrate etching. Opt Express 2019; 27:23164-23172. [PMID: 31510599 DOI: 10.1364/oe.27.023164] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 06/11/2019] [Indexed: 05/18/2023]
Abstract
We demonstrate a significant enhancement in the sensitivity of split ring resonator terahertz metamaterial dielectric sensors by the introduction of etched trenches into their inductive-capacitive gap area, both through finite element simulations and in experiments performed using terahertz time-domain spectroscopy. The enhanced sensitivity is demonstrated by observation of an increased frequency shift in response to overlaid dielectric material of thicknesses up to 18 µm deposited on to the sensor surface. We show that sensitivity to the dielectric is enhanced by a factor of up to ∼2.7 times by the incorporation of locally etched trenches with a depth of ∼3.4 µm, for example, and discuss the effect of the etching on the electrical properties of the sensors. Our experimental findings are in good agreement with simulations of the sensors obtained using finite element methods.
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Nguyen HQ, Moy ML, Liu ILA, Fan VS, Gould MK, Desai SA, Towner WJ, Yuen G, Lee JS, Park SJ, Xiang AH. Effect of Physical Activity Coaching on Acute Care and Survival Among Patients With Chronic Obstructive Pulmonary Disease: A Pragmatic Randomized Clinical Trial. JAMA Netw Open 2019; 2:e199657. [PMID: 31418811 PMCID: PMC6704745 DOI: 10.1001/jamanetworkopen.2019.9657] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE While observational studies show that physical inactivity is associated with worse outcomes in chronic obstructive pulmonary disease (COPD), there are no population-based trials to date testing the effectiveness of physical activity (PA) interventions to reduce acute care use or improve survival. OBJECTIVE To evaluate the long-term effectiveness of a community-based PA coaching intervention in patients with COPD. DESIGN, SETTING, AND PARTICIPANTS Pragmatic randomized clinical trial with preconsent randomization to the 12-month Walk On! (WO) intervention or standard care (SC). Enrollment occurred from July 1, 2015, to July 31, 2017; follow-up ended in July 2018. The setting was Kaiser Permanente Southern California sites. Participants were patients 40 years or older who had any COPD-related acute care use in the previous 12 months; only patients assigned to WO were approached for consent to participate in intervention activities. INTERVENTIONS The WO intervention included collaborative monitoring of PA step counts, semiautomated step goal recommendations, individualized reinforcement, and peer/family support. Standard COPD care could include referrals to pulmonary rehabilitation. MAIN OUTCOMES AND MEASURES The primary outcome was a composite binary measure of all-cause hospitalizations, observation stays, emergency department visits, and death using adjusted logistic regression in the 12 months after randomization. Secondary outcomes included self-reported PA, COPD-related acute care use, symptoms, quality of life, and cardiometabolic markers. RESULTS All 2707 eligible patients (baseline mean [SD] age, 72 [10] years; 53.7% female; 74.3% of white race/ethnicity; and baseline mean [SD] percent forced expiratory volume in the first second of expiration predicted, 61.0 [22.5]) were randomly assigned to WO (n = 1358) or SC (n = 1349). The intent-to-treat analysis showed no differences between WO and SC on the primary all-cause composite outcome (odds ratio [OR], 1.09; 95% CI, 0.92-1.28; P = .33) or in the individual outcomes. Prespecified, as-treated analyses compared outcomes between all SC and 321 WO patients who participated in any intervention activities (23.6% [321 of 1358] uptake). The as-treated, propensity score-weighted model showed nonsignificant positive estimates in favor of WO participants compared with SC on all-cause hospitalizations (OR, 0.84; 95% CI, 0.65-1.10; P = .21) and death (OR, 0.62; 95% CI, 0.35-1.11; P = .11). More WO participants reported engaging in PA compared with SC (47.4% [152 of 321] vs 30.7% [414 of 1349]; P < .001) and had improvements in the Patient-Reported Outcomes Measurement Information System 10 physical health domain at 6 months. There were no group differences in other secondary outcomes. CONCLUSIONS AND RELEVANCE Participation in a PA coaching program by patients with a history of COPD exacerbations was insufficient to effect improvements in acute care use or survival in the primary analysis. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02478359.
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Affiliation(s)
- Huong Q. Nguyen
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Marilyn L. Moy
- Harvard Medical School, Boston, Massachusetts
- VA Boston Healthcare System, Boston, Massachusetts
| | - In-Lu Amy Liu
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Vincent S. Fan
- University of Washington, Seattle
- VA Puget Sound Health Care System, Seattle, Washington
| | - Michael K. Gould
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | | | - William J. Towner
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - George Yuen
- Kaiser Permanente Southern California, Orange County, Anaheim
| | - Janet S. Lee
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Stacy J. Park
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Anny H. Xiang
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
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Kim BJ, Yoo HJ, Park SJ, Kwak MK, Lee SH, Kim SJ, Hamrick MW, Isales CM, Ahn SH, Koh JM. Association of blood n-3 fatty acid with bone mass and bone marrow TRAP-5b in the elderly with and without hip fracture. Osteoporos Int 2019; 30:1071-1078. [PMID: 30719549 DOI: 10.1007/s00198-019-04881-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 01/27/2019] [Indexed: 10/27/2022]
Abstract
UNLABELLED The plasma n-3 fatty acid level was 26.2% lower in patients with osteoporotic hip fracture than in those with osteoarthritis. In all patients, n-3 fatty acid was positively associated with bone mineral density and inversely associated with tartrate-resistant acid phosphatase-5b level in bone marrow aspirates, reflecting the bone microenvironment. INTRODUCTION Despite the potential beneficial role of n-3 fatty acid (FA) on bone metabolism, the specific mechanisms underlying these effects in humans remain unclear. Here, we assessed whether the plasma n-3 level, as an objective indicator of its status, is associated with osteoporosis-related phenotypes and bone-related markers in human bone marrow (BM) samples. METHODS This was a case-control and cross-sectional study conducted in a clinical unit. n-3 FA in the blood and bone biochemical markers in the BM aspirates were measured by gas chromatography/mass spectrometry and immunoassay, respectively. BM fluids were collected from 72 patients who underwent hip surgery because of either osteoporotic hip fracture (HF; n = 28) or osteoarthritis (n = 44). RESULTS After adjusting for confounders, patients with HF had 26.2% lower plasma n-3 levels than those with osteoarthritis (P = 0.006), and each standard deviation increment in plasma n-3 was associated with a multivariate-adjusted odds ratio of 0.40 for osteoporotic HF (P = 0.010). In multivariate analyses including all patients, a higher plasma n-3 level was associated with higher bone mass at the lumbar spine (β = 0.615, P = 0.002) and total femur (β = 0.244, P = 0.045). Interestingly, the plasma n-3 level was inversely associated with the tartrate-resistant acid phosphatase-5b level (β = - 0.633, P = 0.023), but not with the bone-specific alkaline phosphatase level, in BM aspirates. CONCLUSIONS These findings provide clinical evidence that n-3 FA is a potential inhibitor of osteoclastogenesis that favors human bone health.
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Affiliation(s)
- B-J Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
| | - H J Yoo
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - S J Park
- Asan Institute for Life Sciences, Seoul, South Korea
| | - M K Kwak
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - S H Lee
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - S J Kim
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - M W Hamrick
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - C M Isales
- Department of Orthopedic Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - S H Ahn
- Department of Endocrinology, Inha University School of Medicine, Incheon, South Korea
| | - J-M Koh
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
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Jung SY, Han JH, Park SJ, Lee EG, Lee MH, Lee ES, Kang HS, Lee KS, Park IH, Sim SH, Jeong HJ, Kwon Y, Lee DE, Joo J, Kim SK, Lee S. Abstract P3-03-05: Not presented. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-03-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was not presented at the conference.
Citation Format: Jung S-Y, Han JH, Park SJ, Lee E-G, Lee MH, Lee ES, Kang H-S, Lee KS, Park IH, Sim SH, Jeong HJ, Kwon Y, Lee D-E, Joo J, Kim S-K, Lee S. Not presented [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-03-05.
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Affiliation(s)
- S-Y Jung
- National Cancer Center, Goyang, Republic of Korea; Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea
| | - JH Han
- National Cancer Center, Goyang, Republic of Korea; Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea
| | - SJ Park
- National Cancer Center, Goyang, Republic of Korea; Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea
| | - E-G Lee
- National Cancer Center, Goyang, Republic of Korea; Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea
| | - MH Lee
- National Cancer Center, Goyang, Republic of Korea; Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea
| | - ES Lee
- National Cancer Center, Goyang, Republic of Korea; Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea
| | - H-S Kang
- National Cancer Center, Goyang, Republic of Korea; Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea
| | - KS Lee
- National Cancer Center, Goyang, Republic of Korea; Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea
| | - IH Park
- National Cancer Center, Goyang, Republic of Korea; Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea
| | - SH Sim
- National Cancer Center, Goyang, Republic of Korea; Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea
| | - HJ Jeong
- National Cancer Center, Goyang, Republic of Korea; Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Y Kwon
- National Cancer Center, Goyang, Republic of Korea; Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea
| | - D-E Lee
- National Cancer Center, Goyang, Republic of Korea; Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea
| | - J Joo
- National Cancer Center, Goyang, Republic of Korea; Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea
| | - S-K Kim
- National Cancer Center, Goyang, Republic of Korea; Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea
| | - S Lee
- National Cancer Center, Goyang, Republic of Korea; Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea
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Kim SH, Lee EC, Park SJ. Living-donor Liver Retransplantation Using the Vessels of the Previous Allograft by Means of Intragraft Dissection. Transplant Proc 2018; 50:3562-3563. [PMID: 30577238 DOI: 10.1016/j.transproceed.2018.09.021] [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: 04/13/2018] [Revised: 08/27/2018] [Accepted: 09/11/2018] [Indexed: 11/16/2022]
Abstract
Retransplantation with the use of a living-donor graft can be the only therapeutic option for patients with irreversible graft failure, especially in regions with limited access to deceased donors, but it can be technically demanding because of severe adhesion around the hepatic hilum and inferior vena cava. We introduce an effective and safe technique to overcome this challenge for right-lobe living-donor liver retransplantation by using the vessels of the previous right liver allograft with the use of intragraft dissection. The technique was used in 2 critically ill patients undergoing the graft failure. The operative times were 360 and 410 minutes. The recipients were discharged on days 18 and 25 with normal liver function. One postoperative complication occurred 3 months after retransplantation: biliary leakage, corrected with the use of percutaneous transhepatic biliary drainage. Both patients were alive with a functioning allograft at last follow-up of >3 years. Intragraft dissection to use the vessels of the previous right-liver allograft can be a useful technique and should be considered for right-lobe living-donor liver retransplantation.
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Affiliation(s)
- S H Kim
- National Cancer Center, Goyang-si, Gyeonggi-do, Korea.
| | - E C Lee
- National Cancer Center, Goyang-si, Gyeonggi-do, Korea
| | - S J Park
- National Cancer Center, Goyang-si, Gyeonggi-do, Korea
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Kim MS, Kim EK, Park SJ, Park SW, Lee SC, Oh JK, Chang SA. P691The clinical course of tuberculous pericarditis in immunocompetent hosts based on serial echocardiography. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M S Kim
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
| | - E K Kim
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
| | - S J Park
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
| | - S W Park
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
| | - S C Lee
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
| | - J K Oh
- Mayo Clinic, Division of Cardiovascular Diseases, Rochester, United States of America
| | - S A Chang
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
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On YK, Lee DH, Park SJ, Park KM, Kim JS. P2892Clinical outcomes of atrial fibrillation development or progression in patients with permanent pacemakers. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Y.-K On
- Samsung Medical Center, Sungkyunkwan University, Cardiovascular Center, Seoul, Korea Republic of
| | - D H Lee
- Samsung Medical Center, Sungkyunkwan University, Cardiovascular Center, Seoul, Korea Republic of
| | - S J Park
- Samsung Medical Center, Sungkyunkwan University, Cardiovascular Center, Seoul, Korea Republic of
| | - K M Park
- Samsung Medical Center, Sungkyunkwan University, Cardiovascular Center, Seoul, Korea Republic of
| | - J S Kim
- Samsung Medical Center, Sungkyunkwan University, Cardiovascular Center, Seoul, Korea Republic of
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Won J, Jeong HK, Hong YJ, Jeong MH, Kim YJ, Chae SC, Hong TJ, Seong IW, Chae JK, Kim CJ, Cho MC, Rha SW, Bae JH, Seung KB, Park SJ. P6438Comparative efficacy of angiotensin converting enzyme inhibitor and angiotensin receptor blocker for patients with acute myocardial infarction and renal dysfunction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J Won
- Chonnam National University Hospital, Division of Cardiology, Gwangju, Korea Republic of
| | - H K Jeong
- Chonnam National University Hospital, Division of Cardiology, Gwangju, Korea Republic of
| | - Y J Hong
- Chonnam National University Hospital, Division of Cardiology, Gwangju, Korea Republic of
| | - M H Jeong
- Chonnam National University Hospital, Division of Cardiology, Gwangju, Korea Republic of
| | - Y J Kim
- Yeungnam University Hospital, Division of Cardiology, Daegu, Korea Republic of
| | - S C Chae
- Kyungpook National University Hospital, Division of Cardiology, Daegu, Korea Republic of
| | - T J Hong
- Pusan National University Hospital, Division of Cardiology, Pusan, Korea Republic of
| | - I W Seong
- Chungnam National University Hospital, Division of Cardiology, Daejeon, Korea Republic of
| | - J K Chae
- Chonbuk National University Hospital, Division of Cardiology, Jeonju, Korea Republic of
| | - C J Kim
- Kyung Hee University Hospital at Gangdong, Division of Cardiology, Seoul, Korea Republic of
| | - M C Cho
- Chungbuk National University Hospital, Division of Cardiology, Cheongju, Korea Republic of
| | - S W Rha
- Korea University Guro Hospital, Division of Cardiology, Seoul, Korea Republic of
| | - J H Bae
- Konyang University hospital, Division of Cardiology, Daejeon, Korea Republic of
| | - K B Seung
- Seoul St. Mary's Hospital, Division of Cardiology, Seoul, Korea Republic of
| | - S J Park
- Asan Medical Center, Division of Cardiology, Seoul, Korea Republic of
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Chun KJ, Gwag HB, Park SJ, Park KM, On YK, Kim JS. P6650Comparision of transjugular versus transfemoral approach for temporary pacemaker implantation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K J Chun
- Kangnam Sacred Heart Hospital, Seoul, Korea Republic of
| | - H B Gwag
- Samsung Medical Center, Seoul, Korea Republic of
| | - S J Park
- Samsung Medical Center, Seoul, Korea Republic of
| | - K M Park
- Samsung Medical Center, Seoul, Korea Republic of
| | - Y K On
- Samsung Medical Center, Seoul, Korea Republic of
| | - J S Kim
- Samsung Medical Center, Seoul, Korea Republic of
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Gwag HB, Jeong DS, Hwang JK, Chun KJ, Park SJ, On YK, Kim JS, Park KM. P846Characteristics and outcomes of recurrent atrial tachyarrhythmia after totally thoracoscopic ablation for persistent atrial fibrillation. Europace 2018. [DOI: 10.1093/europace/euy015.449] [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: 11/12/2022] Open
Affiliation(s)
- H B Gwag
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
| | - D S Jeong
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
| | - J K Hwang
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
| | - K J Chun
- Kangnam Sacred Heart Hospital, Seoul, Korea Republic of
| | - S J Park
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
| | - Y K On
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
| | - J S Kim
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
| | - K M Park
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
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Gwag HB, Hwang JK, Jeong DS, Park SJ, Kim JS, Park KM, On YK. P845Benefits of concurrent cavotricuspid isthmus ablation after totally thoracoscopic ablation for persistent atrial fibrillation. Europace 2018. [DOI: 10.1093/europace/euy015.448] [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: 11/14/2022] Open
Affiliation(s)
- H B Gwag
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
| | - J K Hwang
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
| | - D S Jeong
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
| | - S J Park
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
| | - J S Kim
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
| | - K M Park
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
| | - Y K On
- Samsung Medical Center, Cardiology, Seoul, Korea Republic of
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Lee EG, Kang H, Park SJ, Han JH, Jung SY, Lee S, Kang HS, Park B, Kong SY, Lim MC, Park SY, Lee ES. Abstract P4-06-12: Different patterns of risk reducing decisions in affected or unaffected BRCA mutation carriers. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p4-06-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND
Risk-reducing (RR) management decreases the risk of breast cancer and BRCA related gynecologic cancer. However, there are fewer reports on the RR management in Asia compared to Western countries.The aim of this study is to identify risk reducing management patterns with BRCA1 or BRCA2 mutation carriers.
METHODS
The study group consisted of all consecutive 1104 breast cancer, ovarian patients and their families of high-risk patients who underwent BRCA gene testing in National Cancer Center, Korea from 2008 to 2016. A total 220 BRCA mutations (19.9%) were detected with 125(11.3%) of BRCA1 gene and 95 (8.6%) of BRCA2 gene.
RESULTS
Out of 220 BRCA mutations carriers, they were consisted of 83 breast cancers, 10 ovarian cancers, 7 both cancers, and 120 unaffected carriers. Among them, 42 were men and 178 were women. About 90 % (198/ 220) had the familial history of breast, ovarian or both malignancies (113 in BRCA1 and 85 in BRCA2 mutation (p=0.821)).
All 42 men chose surveillance. Among 178 female BRCA mutation carriers, 98(55.1%) underwent risk reducing management including 18(10.1%) of chemoprevention, and 80(49.9%) had risk-reducing surgeries (RRSs) (1 case of risk-reducing mastectomy, 76 of risk reducing bilateral salphingo-oophorectomy (RRSO), and 3 of both) and 80 (54.9%) chose only intensive surveillance for both of breast and ovary cancer.
In affected carriers with breast cancer, 59 (71.1%) underwent RR management (1 case of risk reducing mastectomy, 53 of RRSO, 3 of both surgery, and 2 of chemoprevention). There was no risk reducing management in affected carrier with ovarian cancer patients. In 78 unaffected women carriers, 39(50.0%) women received RR management (23(29.5%) cases of RRSO and 16(20.5%) cases of chemoprevention). The rates of RRSs have increased annually since the 2013 year, (prior to 2013 vs. since 2013, RRSs 28.6% (6 cases/21 carriers) vs. 37.2% (74/199), p<0.01).
CONCLUSION
This study was conducted on the largest numbers of BRCA mutation carriers in Asian countries. RRSO is the more preferred management for affected carriers with breast cancer or unaffected carriers. The results might be explained by the severity of the illness and that RRSO was only reimbursed RR strategy from the Korean Government Insurance. Tailored genetic counseling and insurance policy may enhance overall levels of RR management.
Citation Format: Lee EG, Kang H, Park SJ, Han JH, Jung S-Y, Lee S, Kang H-S, Park B, Kong S-Y, Lim MC, Park S-Y, Lee ES. Different patterns of risk reducing decisions in affected or unaffected BRCA mutation carriers [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-06-12.
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Affiliation(s)
- EG Lee
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea; Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Korea; Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - H Kang
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea; Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Korea; Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - SJ Park
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea; Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Korea; Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - JH Han
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea; Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Korea; Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - S-Y Jung
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea; Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Korea; Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - S Lee
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea; Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Korea; Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - H-S Kang
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea; Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Korea; Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - B Park
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea; Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Korea; Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - S-Y Kong
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea; Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Korea; Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - MC Lim
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea; Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Korea; Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - S-Y Park
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea; Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Korea; Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - ES Lee
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea; Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Korea; Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea
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47
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Kim YH, Jeon SY, Park JH, Choe JH, Lee SH, Park SJ, Kim KH, Kim JS. Faucial Pillar Perforation by Glidescope Intubation with Incorrectly Placed Stylet. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791201900112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Glidescope GVL® is frequently used in intubation of difficult airway. We report a case of right side of faucial pillar perforation during intubation with Glidescope®. A rigid stylet can facilitate placing of endotracheal tube quickly but it may also penetrate the soft tissue to cause injuries.
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Affiliation(s)
| | | | | | | | | | - SJ Park
- Haeundae Paik Hospital, Department of Surgery, Inje University, Busan, South Korea
| | - KH Kim
- Haeundae Paik Hospital, Department of Surgery, Inje University, Busan, South Korea
| | - JS Kim
- Haeundae Paik Hospital, Department of Surgery, Inje University, Busan, South Korea
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48
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Baik M, Kang HJ, Park SJ, Na SW, Piao M, Kim SY, Fassah DM, Moon YS. TRIENNIAL GROWTH AND DEVELOPMENT SYMPOSIUM: Molecular mechanisms related to bovine intramuscular fat deposition in the longissimus muscle. J Anim Sci 2017; 95:2284-2303. [PMID: 28727015 DOI: 10.2527/jas.2016.1160] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The intramuscular fat (IMF) content of the LM, also known as marbling, is particularly important in determining the price of beef in Korea, Japan, and the United States. Deposition of IMF is influenced by both genetic (e.g., breed, gender, and genotype) and nongenetic factors (e.g., castration, nutrition, stressors, animal weight, and age). Castration of bulls markedly increases deposition of IMF, resulting in improved beef quality. Here, we present a comparative gene expression approach between bulls and steers. Transcriptomic and proteomic studies have demonstrated that the combined effects of increases in lipogenesis, fatty acid uptake, and fatty acid esterification and decreased lipolysis are associated with increased IMF deposition in the LM. Several peripheral tissues (LM, adipose tissues, and the liver) are involved in lipid metabolism. Therefore, understanding the significance of the tissue network in lipid metabolism is important. Here, we demonstrate that lipid metabolism in LM tissues is crucial for IMF deposition, whereas lipid metabolism in the liver plays only a minor role. Metabolism of body fat and IMF deposition in bovine species has similarities with these processes in metabolic diseases, such as obesity in humans and rodents. Extensive studies on metabolic diseases using epigenome modification (DNA methylation, histone modification, and microRNA), microbial metagenomics, and metabolomics have been performed in humans and rodents, and new findings have been reported using these technologies. The importance of applying "omics" fields (epigenomics, metagenomics, and metabolomics) to the study of IMF deposition in cattle is described. New information on the molecular mechanisms of IMF deposition may be used to design nutritional or genetic methods to manipulate IMF deposition and to modify fatty acid composition in beef cattle. Applying nutrigenomics could maximize the expression of genetic potential of economically important traits (e.g., marbling) in animals.
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49
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Park SJ, Bostwick JB, De Andrade V, Je JH. Self-spreading of the wetting ridge during stick-slip on a viscoelastic surface. Soft Matter 2017; 13:8331-8336. [PMID: 29058731 DOI: 10.1039/c7sm01408b] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Dynamic wetting behaviors on soft solids are important to interpret complex biological processes from cell-substrate interactions. Despite intensive research studies over the past half-century, the underlying mechanisms of spreading behaviors are not clearly understood. The most interesting feature of wetting on soft matter is the formation of a "wetting ridge", a surface deformation by a competition between elasticity and capillarity. Dynamics of the wetting ridge formed at the three-phase contact line underlies the dynamic wetting behaviors, but remains largely unexplored mostly due to limitations in indirect observation. Here, we directly visualize wetting ridge dynamics during continuous- and stick-slip motions on a viscoelastic surface using X-ray microscopy. Strikingly, we discover that the ridge spreads spontaneously during stick and triggers contact line depinning (stick-to-slip transition) by changing the ridge geometry which weakens the contact line pinning. Finally, we clarify 'viscoelastic-braking', 'stick-slipping', and 'stick-breaking' spreading behaviors through the ridge dynamics. In stick-breaking, no ridge-spreading occurs and contact line pinning (hysteresis) is enhanced by cusp-bending while preserving a microscopic equilibrium at the ridge tip. We have furthered the understanding of spreading behaviors on soft solids and demonstrated the value of X-ray microscopy in elucidating various dynamic wetting behaviors on soft solids as well as puzzling biological issues.
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Affiliation(s)
- S J Park
- X-ray Imaging Center, Department of Materials Science and Engineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-Gu, Pohang 37673, South Korea.
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50
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VanBik D, Lee SH, Seo MG, Jeon BR, Goo YK, Park SJ, Rhee MH, Kwon OD, Kim TH, Geraldino PJL, Kwak D. Borrelia Species Detected in Ticks Feeding on Wild Korean Water Deer (Hydropotes inermis) Using Molecular and Genotypic Analyses. J Med Entomol 2017; 54:1397-1402. [PMID: 28549151 DOI: 10.1093/jme/tjx106] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Indexed: 06/07/2023]
Abstract
Lyme borreliosis is a vector-borne disease transmitted through the bite of ticks infected by Borrelia burgdorferi sensu lato group, including B. burgdorferi sensu stricto, B. afzelii, and B. garinii. The goal of the present study was to detect Borrelia species in ticks infesting wild Korean water deer (KWD; Hydropotes inermis Swinhoe), using molecular and genotypic analyses. In total, 48 ticks were collected from KWD, all of which were morphologically identified as Haemaphysalis longicornis Neumann that is dominant in Korea. Nested PCR was performed to detect the Borrelia-specific 5S (rrf)-23S (rrl) intergenic spacer region and the outer surface protein A (ospA) genes in ticks. Both rrf-rrl and ospA were amplified from one of the 48 ticks (2.1%) and were identified as B. afzelii. To our knowledge, this study constitutes the first molecular detection of B. afzelii in Haemaphysalis ticks in Korea. Because B. afzelii is a zoonotic tick-borne pathogen, understanding the molecular characteristics of this bacterium is important for preventing the transmission of Borrelia from ticks to other animals and humans.
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Affiliation(s)
- D VanBik
- College of Veterinary Medicine, Kyungpook National University, Daegu, Korea
| | - S H Lee
- College of Veterinary Medicine, Kyungpook National University, Daegu, Korea
- Animal and Plant Quarantine Agency, Gimcheon, Gyeongbuk, Korea
| | - M G Seo
- College of Veterinary Medicine, Kyungpook National University, Daegu, Korea
- Animal and Plant Quarantine Agency, Gimcheon, Gyeongbuk, Korea
| | - B R Jeon
- College of Veterinary Medicine, Kyungpook National University, Daegu, Korea
| | - Y K Goo
- Department of Parasitology and Tropical Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - S J Park
- College of Veterinary Medicine, Kyungpook National University, Daegu, Korea
| | - M H Rhee
- College of Veterinary Medicine, Kyungpook National University, Daegu, Korea
| | - O D Kwon
- College of Veterinary Medicine, Kyungpook National University, Daegu, Korea
| | - T H Kim
- College of Veterinary Medicine, Kyungpook National University, Daegu, Korea
| | - P J L Geraldino
- Department of Biology, College of Arts and Sciences, University of San Carlos, Cebu, Philippines
| | - D Kwak
- College of Veterinary Medicine, Kyungpook National University, Daegu, Korea
- Cardiovascular Research Institute, Kyungpook National University, Daegu, Korea
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