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Kim EY, Lee KH, Yun JS, Park YL, Park CH, Jang SY, Ryu JM, Lee SK, Chae BJ, Lee JE, Kim SW, Nam SJ, Yu JH. Impact of residual microcalcifcations on prognosis after neoadjuvant chemotherapy in breast cancer patients. BMC Womens Health 2024; 24:187. [PMID: 38509531 PMCID: PMC10956337 DOI: 10.1186/s12905-024-02973-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 02/14/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Residual microcalcifications after neoadjuvant chemotherapy (NAC) are challenging for deciding extent of surgery and questionable for impact on prognosis. We investigated changes in the extent and patterns of microcalcifications before and after NAC and correlated them with pathologic response. We also compared prognosis of patients depending on presence of residual microcalcifications after NAC. METHODS A total of 323 patients with invasive breast carcinoma treated with neoadjuvant chemotherapy at Kangbuk Samsung Hospital and Samsung Medical center from March 2015 to September 2018 were included. Patients were divided into four groups according to pathologic response and residual microcalcifications. Non-pCRw/mic group was defined as breast non-pCR with residual microcalcifications. Non-pCRw/o mic group was breast non-pCR without residual microcalcifications. pCRw/mic group was breast pCR with residual microcalcifications. pCRw/o mic group was breast pCR without residual microcalcifications. The first aim of this study is to investigate changes in the extent and patterns of microcalcifications before and after NAC and to correlate them with pathologic response. The second aim is to evaluate oncologic outcomes of residual microcalcifications according to pathologic response after NAC. RESULTS There were no statistical differences in the extent, morphology, and distribution of microcalcifications according to pathologic response and subtype after NAC (all p > 0.05). With a median follow-up time of 71 months, compared to pCRw/o mic group, the hazard ratios (95% confidence intervals) for regional recurrence were 5.190 (1.160-23.190) in non-pCRw/mic group and 5.970 (1.840-19.380) in non-pCRw/o mic group. Compared to pCRw/o mic group, the hazard ratios (95% CI) for distant metastasis were 8.520 (2.130-34.090) in non-pCRw/mic group, 9.120 (2.850-29.200) in non-pCRw/o mic group. Compared to pCRw/o mic, the hazard ratio (95% CI) for distant metastasis in pCRw/mic group was 2.240 (0.230-21.500) without statistical significance (p = 0.486). CONCLUSIONS Regardless of residual microcalcifications, patients who achieved pCR showed favorable long term outcome compared to non-pCR group.
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Affiliation(s)
- Eun Young Kim
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kwan Ho Lee
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji-Sup Yun
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yong Lai Park
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chan Heun Park
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sung Yoon Jang
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea
| | - Jai Min Ryu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea
| | - Se Kyung Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea
| | - Byung-Joo Chae
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea
| | - Jeong Eon Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea
| | - Seok Won Kim
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea
| | - Seok Jin Nam
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea
| | - Jong Han Yu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea.
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Shin DS, Bang YJ, Choi JY, Jang SY, Lee H, Kwak Y, Chae BJ, Yu J, Lee JE, Kim SW, Nam SJ, Jeon BJ, Pyon JK, Mun GH, Lee KT, Ryu JM. Oncologic Outcomes of Immediate Breast Reconstruction in the Setting of Neoadjuvant Chemotherapy: A Long-term Follow-up Study of a Matched Cohort. J Breast Cancer 2024; 27:14-26. [PMID: 38233336 PMCID: PMC10912581 DOI: 10.4048/jbc.2023.0196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/08/2023] [Accepted: 12/10/2023] [Indexed: 01/19/2024] Open
Abstract
PURPOSE Despite the increasing use of immediate breast reconstruction (IBR), its oncologic safety in the setting of neoadjuvant chemotherapy (NACT) needs to be comprehensively clarified in breast cancer management. The objective of the present study was to analyze the oncologic safety of IBR following NACT. METHODS In total, 587 patients with breast cancer who underwent a total mastectomy (TM) with IBR after NACT between 2008 and 2017 at a single institution were retrospectively reviewed. The reviewed patients with IBR following skin-sparing mastectomy (SSM) or nipple-sparing mastectomy (NSM) were matched 1:3 to patients who underwent TM alone after NACT. Matching variables included age, clinical T and N stages before NACT, response to NACT, pathologic T and N stages, and molecular subtypes. RESULTS After propensity score matching, 95 patients who underwent IBR following SSM/NSM after NACT (IBR group) and 228 patients who underwent TM alone after NACT (TM group) were selected. The median follow-up period was 73 (range, 5-181) months after matching. After matching, there were no significant differences between the two groups in 5-year locoregional recurrence-free survival (88.8% vs. 91.2%, p = 0.516), disease-free survival (67.3% vs. 76.6%, p = 0.099), distant metastasis-free survival (71.9% vs. 81.9%, p = 0.057), or overall survival (84.1% vs. 91.5, p = 0.061) rates. In multivariate analyses, conducting IBR was not associated with increased risks for locoregional recurrence, any recurrence, distant metastasis, or overall death. CONCLUSION Our findings suggest that IBR following SSM/NSM elicits comparable long-term oncologic outcomes to those of TM alone in the setting of NACT.
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Affiliation(s)
- Dong Seung Shin
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Ju Bang
- Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Joon Young Choi
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Yoon Jang
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyunjun Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Youngji Kwak
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byung Joo Chae
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jonghan Yu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Eon Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seok Won Kim
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seok Jin Nam
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byung-Joon Jeon
- Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jai Kyong Pyon
- Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Goo-Hyun Mun
- Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyeong-Tae Lee
- Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Jai Min Ryu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Choi JY, Woen D, Jang SY, Lee H, Shin DS, Kwak Y, Lee H, Chae BJ, Yu J, Lee JE, Kim SW, Nam SJ, Ryu JM. Risk factors of breast cancer recurrence in pathologic complete response achieved by patients following neoadjuvant chemotherapy: a single-center retrospective study. Front Oncol 2023; 13:1230310. [PMID: 37849818 PMCID: PMC10577442 DOI: 10.3389/fonc.2023.1230310] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 09/14/2023] [Indexed: 10/19/2023] Open
Abstract
Objective Pathologic complete response (pCR) of breast cancer after neoadjuvant chemotherapy (NAC) is highly related to molecular subtypes. Patients who achieved tumor pCR after NAC have a better prognosis. However, despite of better prognosis, pCR patients have a potential for recurrence. There is little evidence of risk factors of recurrence in patients with pCR. We aim to analyze factors associated with tumor recurrence in patients who achieved pCR. Methods This study retrospectively reviewed the data of patients diagnosed with breast cancer who achieved pCR after receiving NAC between January 2009 and December 2018 in Samsung Medical Center. pCR was defined as no residual invasive cancer in the breast and axillary nodes even if there is residual ductal carcinoma in situ (ypT0 or ypTis with ypN0). Breast cancers are classified into 4 subtypes based on hormone receptors (HR) and human epithelial growth factor receptor 2 (HER2) status. Patients who had bilateral breast cancer, ipsilateral supraclavicular or internal mammary lymph node metastasis, inflammatory breast cancer, distant metastasis, unknown subtype, and histologically unique case were excluded from the study. Results In total 483 patients were included in this study except for patients who corresponded to the exclusion criteria. The median follow-up duration was 59.0 months (range, 0.5-153.3 months). Breast cancer recurred in 4.1% of patients (20 of 483). There was a significant difference in clinical T (P = 0.004) and clinical N (P = 0.034) stage in the Kaplan-Meier curve for disease-free survival. Molecular subtypes (P = 0.573), Ki67 (P = 1.000), and breast surgery type (P = 0.574) were not associated with tumor recurrence in patients who achieved pCR after NAC. In the clinical T stage and clinical N stage, there was a significant difference between recurrence and no-recurrence groups (clinical T stage; P = 0.045, clinical N stage; P = 0.002). Univariable Cox regression revealed statistical significance in the clinical T stage (P = 0.049) and clinical N stage (P = 0.010), while multivariable Cox regression demonstrated non-significance in the clinical T stage (P = 0.320) and clinical N stage (P = 0.073). Conclusion Results in this study showed that clinical T, clinical N stage, and molecular subtypes were not statistically significant predictors of recurrence in patients who achieved pCR after NAC. In spite of that, pCR after NAC may be more important than clinical staging and molecular subtype in early breast cancer. In addition, escalated treatments for patients with HER2 + or triple-negative tumors would be considered with a strict patient selection strategy to prevent over-treatment as well as achieve pCR.
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Affiliation(s)
- Joon Young Choi
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Doyoun Woen
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sung Yoon Jang
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyunjun Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong Seung Shin
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Youngji Kwak
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyunwoo Lee
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Byung Joo Chae
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jonghan Yu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jeong Eon Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seok Won Kim
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seok Jin Nam
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jai Min Ryu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Kwak Y, Jang SY, Choi JY, Lee H, Shin DS, Park YH, Kim JY, Ahn JS, Chae BJ, Yu J, Lee JE, Kim SW, Nam SJ, Ryu JM. Progesterone Receptor Expression Level Predicts Prognosis of Estrogen Receptor-Positive/HER2-Negative Young Breast Cancer: A Single-Center Prospective Cohort Study. Cancers (Basel) 2023; 15:3435. [PMID: 37444546 DOI: 10.3390/cancers15133435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Although estrogen receptor (ER) expression levels affect the prognosis of breast cancer, studies about progesterone receptor (PR) expression levels are insufficient, especially in young breast cancer (YBC). The purpose of this study was to compare clinical characteristics and prognosis according to PR expression levels in invasive breast cancer patients. METHODS A prospective cohort study was conducted to identify YBC patients with invasive carcinoma diagnosed at an age of less than 40 years old between 2013 and 2018. Clinicopathologic features and prognosis of ER-positive and human epidermal growth factor receptor 2 (HER2)-negative patients were investigated. Patients were stratified into strong PR (PR-positive cell proportion > 10%), low PR (PR-positive cell proportion = 1~10%), and PR-negative (PR-positive cell proportion < 1%). RESULTS Among 458 patients enrolled, 386 (84.3%), 26 (5.7%), and 46 (10.0%) were categorized into strong PR, low PR, and PR-negative groups, respectively. The median follow-up duration was 58.6 months. Compared with the strong PR group, low PR and PR-negative groups were more likely to have high Ki-67 and a high nuclear grade. Low R and PR-negative groups had significantly worse disease-free survival (DFS) and distant metastasis-free survival (DMFS) than the strong PR group (p = 0.0033, p = 0007). Low PR group had an even higher risk of distant metastasis than PR-negative patients. Low PR patients and PR-negative had significantly lower overall survival (OS) rates than strong PR. CONCLUSION Low PR might be a prognostic factor of ER-positive/HER2-negative in YBC.
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Affiliation(s)
- Youngji Kwak
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Sung Yoon Jang
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Joon Young Choi
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Hyunjun Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Dong Seung Shin
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Yeon Hee Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Ji-Yeon Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Jin-Seok Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Byung Joo Chae
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Jonghan Yu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Jeong Eon Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Seok Won Kim
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Seok Jin Nam
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Jai Min Ryu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea
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Abstract
OBJECTIVE To explore the association of frailty and its eight components with claims-based healthcare costs among South Korean older adults aged 66 from 2009 to 2012. DESIGN A cross-sectional design. SETTING Data were obtained from administrative claims, Regular Biennial General and Cancer Screening Examinations, and the 66-year Lifetime Transitional Period Health Examination. PARTICIPANTS South Korean older adults aged 66 (N = 818,337). MEASUREMENTS Frailty was measured using eight components (i.e., hospital admission, self-assessed health status, polypharmacy, weight loss, depressed mood, incontinence, visual and auditory problems, and performance on the Timed Up and Go test). Healthcare costs included those associated with inpatient and outpatient care and pharmaceuticals. Multiple Tobit regression was used to assess the association between frailty and healthcare costs before and after propensity score matching. RESULTS The mean annual total healthcare cost was $1,403.24 in robust participants, $2,364.78 in pre-frail participants, and $3,655.13 in frail participants. Among participants after propensity score matching, total healthcare costs were higher by $959.58 in the pre-frail (P < 0.001) and by $2,249.70 in the frail group (P < 0.001) compared to the robust group. The presence of each of the eight frailty components was significantly associated with higher total healthcare costs. CONCLUSION By comparing the variables of interest using claims data, our study showed that frailty and each of its eight symptoms was associated with increased healthcare costs. This provides evidence of the need for identifying and managing frailty to reduce healthcare costs among South Korean older adults.
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Affiliation(s)
- M J Kim
- In-Hwan Oh, Kyung Hee University College of Medicine, Kyung Hee University School of Medicine, Korea,
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Park YJ, Lee JH, Park BE, Kim HN, Jang SY, Bae MH, Yang DH, Park HS, Cho Y, Chae SC. P3617Systolic blood pressure, glycemic control and clinical outcome in diabetic patients with acute myocardial infarction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0475] [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
Recent blood pressure guidelines recommend intensive blood pressure control in diabetic patients with cardiovascular disease.
Purpose
We sought to investigate combined impact of intensive blood glucose lowering and blood pressure control on clinical outcome in diabetic patients with acute myocardial infarction (AMI) has not been fully investigated yet.
Method
Korean Acute Myocardial Infarction Registry (KAMIR) – National Institute of Health (NIH) database included 12,179 patients (9,046 men; mean age = 63.6±12.6 year-old) who were discharged alive. Among them, 3,430 (28.2%) had a diabetes mellitus (DM). MACCEs were defined as a composition of all cause death, non-fatal MI, repeat revascularizations including repeated percutaneous coronary intervention and coronary bypass grafting, cerebrovascular accident and rehospitalizations at 1 year. This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.
Result
We determined cut-off value of discharge systolic blood pressure (SBP) to predict 1-year MACCE in DM and non-DM patients. Discharge SBP of less than 130mmHg was associated with a lower MACCE at 1 year compared to SBP level of 130mmHg or greater (10.8% versus 15.4%; log-rank p=0.001) in DM patients, whereas discharge SBP cut-off level was 140mmHg to discriminate 1-year MACCE in non-DM patients (6.4% versus 8.5%, log-rank p=0.045). In DM patients, there were no significant difference in 1-year MACCEs between patients with HbA1c less than 7% versus 7% or greater (12.0% versus 10.7%; log-rank p=0.325). DM patients were categorized into 4 groups; discharge SBP <130mmHg and HbA1c <7% (Group 1); discharge SBP <130mmHg and HbA1c ≥7% (Group 2); discharge SBP ≥130mmHg and HbA1c <7% (Group 3); discharge SBP ≥130mmHg and HbA1c ≥7% (Group 4). Intensive BP control was associated lower 1-year MACCEs in patients with good glycemic control (Group 1 & 3; 10.7% versus 16.7%; log-rank p=0.009). However, in patients with poor glycemic control, intensive BP control did not improve 1-year MACCEs (Group 2 & 4; 10.6% versus 11.1%; log-rank p=0.761).
Conclusion
Strict BP control is more important than glycemic control to improve short-term clinical outcome in DM patients with AMI. However, in patients with poor glycemic control, strict BP control did not improve clinical outcome.
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Affiliation(s)
- Y J Park
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - J H Lee
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - B E Park
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - H N Kim
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - S Y Jang
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - M H Bae
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - D H Yang
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - H S Park
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - Y Cho
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - S C Chae
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
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Park YJ, Lee JH, Park BE, Kim HN, Jang SY, Bae MH, Yang DH, Park HS, Cho Y, Chae SC. P3583Optimal procedural strategy to improve clinical outcome in primary percutaneous coronary intervention. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0443] [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
Current guideline recommends potent antiplatelet agents and transradial intervention. However, it is uncertain whether routine use of IVUS, thrombus aspiration and glycoprotein IIB-IIIA inhibitor is beneficial for improving clinical outcome in patients with ST-segment elevation myocardial infarction (STEMI).
Purpose
The aim of this study was to investigate optimal procedural strategy to improve clinical outcome.
Methods
A total of 6,046 patients who underwent primary percutaneous coronary intervention (PCI) for STEMI were analyzed from the Korean Acute Myocardial Infarction Registry (KAMIR) – National Institute of Health (NIH) database. MACCEs were defined as a composition of all cause death, non-fatal MI, repeat revascularizations including repeated percutaneous coronary intervention and coronary bypass grafting, cerebrovascular accident and rehospitalizations. This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.
Results
During the primary PCI, potent antiplatelet agents such as prasugrel and ticagrelor were used in 2342 (38.4%). PCI was performed through transradial approach in 1490 (25.2%). Thrombus aspiration and intravascular ultrasound (IVUS) examination was done in 2204 (36.1%) and 1079 (18.1%), respectively. Glycoprotein IIB-IIIA inhibitor was administered in 1295 (21.7%). Among them, potent antiplatelet agents, transradial intervention, IVUS, and thrombus aspiration significantly reduced MACCEs at 1 year. Glycoprotein IIB-IIIA inhibitor was not effective to improved clinical outcome. In Cox-proportional hazards model, potent antiplatelet agents (hazard ratio 0.82, 95% confidence interval 0.67–0.99; p=0.045) and transradial intervention (hazard ratio 0.61, 95% confidence interval 0.47–0.78; p<0.001) was an independent predictor of MACCEs after adjusting for confounding variables. Combined use of potent antiplatelet agents and transradial intervention (hazard ratio 0.54; 95% confidence interval 0.37–0.80; p=0.002) substantially reduced MACCEs at 1 year.
Conclusion
Among evidence based procedures during the primary PCI, combined use of potent antiplatelet agents and transradial intervention was optimal procedural strategy to improve clinical outcome.
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Affiliation(s)
- Y J Park
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - J H Lee
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - B E Park
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - H N Kim
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - S Y Jang
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - M H Bae
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - D H Yang
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - H S Park
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - Y Cho
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - S C Chae
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
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Cho HJ, Yoon JY, Kim N, Jang SY, Bae MH, Lee JH, Yang DH, Park HS, Cho Y, Chae SC. Predictive value of a fragmented QRS complex in diagnosing patients with myocardial ischemia. Clin Cardiol 2019; 42:379-384. [PMID: 30597592 PMCID: PMC6712309 DOI: 10.1002/clc.23148] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 12/27/2018] [Indexed: 11/26/2022] Open
Abstract
Background A fragmented QRS complex (fQRS) is caused by conduction abnormalities of the ventricle secondary to myocardial ischemia and/or scar in patients with myocardial infarction. However, the implications of the fQRS in the development of coronary artery disease with myocardial ischemia in those without a scar remain unknown. Methods We studied electrocardiograms (ECGs) obtained from 150 patients (60.5 ± 8.5 years, 102 men) with myocardial ischemia, which was confirmed by performing both, a nuclear exercise stress test and coronary angiography. We also studied ECGs obtained from 601 patients (58.5 ± 10.0 years, 315 men) who showed a negative nuclear exercise stress test (control group). Patients in whom the nuclear exercise stress test showed a myocardial scar were excluded. Results An fQRS was more commonly observed in patients with myocardial ischemia (n = 48, 32.0%) than in the control group (n = 133, 22.1%) (P = 0.011). The sensitivity, specificity, positive, and negative predictive values of fQRS in diagnosing myocardial ischemia were 32.0, 77.9, 26.5, and 82.1%, respectively. The fQRS (odds ratio 1.580, 95% confidence interval 1.020‐2.446, P = 0.040) was an independent predictor of myocardial ischemia after adjusting for age, sex, current smoking habits, ST‐T changes on ECG, as well as histories of hypertension, diabetes, and dyslipidemia. Moreover, the fQRS showed an incremental prognostic value over conventional risk factors (χ2 = 5, P = 0.032) and over a combination of conventional factors and ST‐T changes (χ2 = 9, P = 0.014). Conclusions The fQRS is a moderately sensitive and independent predictor of myocardial ischemia.
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Affiliation(s)
- H J Cho
- Department of Cardiology, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - J Y Yoon
- Department of Cardiology, CHA Gumi Medical Center, CHA University, Gumi, Republic of Korea
| | - N Kim
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - S Y Jang
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - M H Bae
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - J H Lee
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - D H Yang
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - H S Park
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Y Cho
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - S C Chae
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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Lee JH, Park BE, Park YJ, Kim HN, Kim NK, Song JH, Jang SY, Bae MH, Yang DH, Park HS, Cho Y, Chae SC, Jeong MH. P5533Impact of thrombus aspiration and Glycoprotein IIb/IIIa inhibitor between new antiplatelet agents and clopidogrel in patients undergoing primary percutaneous coronary intervention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J H Lee
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - B E Park
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - Y J Park
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - H N Kim
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - N K Kim
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - J H Song
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - S Y Jang
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - M H Bae
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - D H Yang
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - H S Park
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - Y Cho
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - S C Chae
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - M H Jeong
- Kyungpook National University Hospital, Daegu, Korea Republic of
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Lee JH, Pakr BE, Park YJ, Kim HN, Song JH, Kim NK, Jang SY, Bae MH, Yang DH, Park HS, Cho Y, Chae SC, Jeong MH. P5575Practice-level variation in use of optimal medical treatment during hospitalization: a multi-level methodological approach. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5575] [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 H Lee
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - B E Pakr
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - Y J Park
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - H N Kim
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - J H Song
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - N K Kim
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - S Y Jang
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - M H Bae
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - D H Yang
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - H S Park
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - Y Cho
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - S C Chae
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - M H Jeong
- Kyungpook National University Hospital, Daegu, Korea Republic of
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Lee JH, Yoon JY, Park BE, Park YJ, Kim HN, Kim NK, Jang SY, Bae MH, Yang DH, Park HS, Cho Y, Chae SC. P3576Impact of intravascular ultrasound and final kissing balloon dilatation on 10-year clinical outcome in percutaneous revascularization with 1-stent strategy for left main coronary artery stenosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3576] [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 H Lee
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - J Y Yoon
- Gumi Cha Hospital, Internal Medicine, Gumi, Korea Republic of
| | - B E Park
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - Y J Park
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - H N Kim
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - N K Kim
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - S Y Jang
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - M H Bae
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - D H Yang
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - H S Park
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - Y Cho
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - S C Chae
- Kyungpook National University Hospital, Daegu, Korea Republic of
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Ko JS, Seo Y, Chae MK, Jang SY, Yoon JS. Effect of topical loteprednol etabonate with lid hygiene on tear cytokines and meibomian gland dysfunction in prosthetic eye wearers. Eye (Lond) 2017; 32:439-445. [PMID: 29052604 DOI: 10.1038/eye.2017.213] [Citation(s) in RCA: 5] [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: 11/30/2016] [Accepted: 08/21/2017] [Indexed: 02/04/2023] Open
Abstract
PurposeTo assess tear cytokine levels and clinical outcomes in meibomian gland dysfunction (MGD) in the blind eye of patients wearing an ocular prosthesis after 2 months of treatment with topical loteprednol etabonate and eyelid scrubs with warm compresses.Patients and methodsThis study included patients with MGD wearing a unilateral ocular prosthesis for more than 1 year. All patients topically received 0.5% loteprednol etabonate and were instructed to scrub their eyelids with warm compresses on the prosthetic eye for 2 months. We evaluated tear cytokine levels using Multiplex Bead Immunoassays, performed biomicroscopic examination of the lid margins and meibomian gland, conducted meibography imaging, and assessed MGD-related ocular symptoms using a questionnaire for the prosthetic eye before and 2 months after treatment.ResultsThirty consecutive patients were included. There were significant reductions in the levels of interleukin (IL)-6, interferon-γ, monocyte chemotactic protein-1, IL-8, tumor necrosis factor-α, and IL-1β (P<0.001 for each cytokine). Moreover, there were improvements in ocular symptoms (P=0.001), lid margin abnormalities (P<0.001), meibomian gland expressibility (P<0.001) and meibography findings (P=0.037).ConclusionTopical loteprednol etabonate in conjunction with eyelid scrubs and warm compresses were effective in treating MGD in prosthetic eye wearers. Furthermore, tear cytokine measurements may serve as an additional approach for evaluating the efficacy of anti-inflammatory treatment for MGD in prosthetic eye wearers.
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Affiliation(s)
- J S Ko
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Y Seo
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - M K Chae
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - S Y Jang
- Department of Ophthalmology, Soonchunhyang Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - J S Yoon
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
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Park SJ, Kim Y, Jang SY. The application of an acellular dermal allograft (AlloDerm) for patients with insufficient conjunctiva during evisceration and implantation surgery. Eye (Lond) 2017; 32:136-141. [PMID: 28799557 DOI: 10.1038/eye.2017.161] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 07/03/2017] [Indexed: 12/13/2022] Open
Abstract
PurposeTo describe the use of an acellular dermal allograft (AlloDerm) for patients with insufficient conjunctiva during evisceration and implantation surgery.Patients and methodsThe medical records of six patients with insufficient conjunctiva during evisceration surgery were reviewed. It was not possible to close the Tenon's capsule and conjunctiva without wound tension in these patients, so AlloDerm was placed over the sclera, and the edges were sutured with adjacent conjunctiva without tension. The size of the bare AlloDerm graft was measured in all patients. The clinical outcome was the incidence of complications, and the percentage of patients needing additional surgery was also recorded.ResultsThe cause of evisceration was end stage glaucoma (four patients) and endogenous endophthalmitis (two patients). All six eyes of six patients (100%) had a successful outcome showing no complications. Four cases achieved full conjunctivalisation over the bare AlloDerm graft. Two cases had a bare AlloDerm until the last follow-up, but showed no implant exposure. It took a median of 11 weeks for the slow advance of the conjunctival edge to entirely cover the AlloDerm graft.ConclusionsAlloDerm is a promising material for covering sclera and implants in a tension-free manner after evisceration surgery in patients with insufficient conjunctiva.
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Affiliation(s)
- S J Park
- College of medicine, Soonchunhyang University, Cheonan, Korea
| | - Y Kim
- Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - S Y Jang
- Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
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Park JG, Park SY, Tak WY, Kweon YO, Jang SY, Lee YR, Hur K, Lee HJ, Lee HW. Early complications after percutaneous radiofrequency ablation for hepatocellular carcinoma: an analysis of 1,843 ablations in 1,211 patients in a single centre: experience over 10 years. Clin Radiol 2017; 72:692.e9-692.e15. [PMID: 28364952 DOI: 10.1016/j.crad.2017.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 01/24/2017] [Accepted: 03/01/2017] [Indexed: 12/12/2022]
Abstract
AIM To evaluate the incidence of adverse events and associated factors after radiofrequency ablation (RFA) in patients with hepatocellular carcinoma within 30 days. MATERIALS AND METHODS The early complications that occurred within 30 days after RFA at a single institution from January 2000 to July 2010 were reviewed in order to evaluate the morbidity, mortality, and risk factors associated with the complications. In total, 1,211 patients (845 men, 70.5%) with a mean age of 68 years (range, 27-88 years) underwent 1,843 RFA procedures. RESULTS The overall incidence rate of complications was 6.8% (125 cases). Major complications (n=36, 2%) included liver abscess (n=15, 0.8%), intraperitoneal bleeding (n=8, 0.4%), liver failure (n=5, 0.3%), variceal bleeding (n=3, 0.2%), haemothorax (n=2, 0.1%), cholecystitis (n=2, 0.1%), and bowel perforation (n=1, 0.1%). Among the minor complications (n=89, 4.8%), the most common was the post RFA syndrome accompanied by pain and fever (n=75, 4.1%). Other minor complications included significant pleural effusion (n=7, 0.4%), skin wound infection (n=4, 0.2%), and thermal injuries to the skin (n=3, 0.2%). Procedural infections significantly increased with tumour size (OR=1.379; 95% confidence interval [CI], 1.191-1.579; p<0.001), and multiple overlapping ablations (OR=1.118; 95% CI, 1.019-1.227, p=0.018). Thrombocytopenia (<50,000/μl), prothrombin time, and serum albumin level were significantly associated with post-RFA bleeding episodes (p=0.041, p=0.021, and p=0.003, respectively). The overall mortality rate was 0.3% (three cases of hepatic failure, two case of sepsis, and one case of renal failure). CONCLUSIONS RFA is a safe and effective local treatment for hepatocellular carcinoma. Careful selection of patients and appropriate RFA planning could decrease procedural mortality and morbidity.
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Affiliation(s)
- J G Park
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - S Y Park
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
| | - W Y Tak
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
| | - Y O Kweon
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - S Y Jang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Y R Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - K Hur
- Department of Biochemistry and Cell Biology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - H J Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - H W Lee
- Department of Pathology, Dongsan Medical Center, School of Medicine, Keimyung University, Daegu, Republic of Korea
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Kim YS, Yoon JS, Jang SY. Comparison of two- and three-point sutures for advancing the levator aponeurosis in Asian eyelids. Eye (Lond) 2015; 29:1181-5. [PMID: 26113504 DOI: 10.1038/eye.2015.107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 04/30/2015] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To compare the functional and cosmetic outcomes of two- and three-point sutures for advancing the levator aponeurosis in blepharoptosis surgery on Asians. PATIENTS AND METHODS This retrospective study examined 60 Asian patients with blepharoptosis who had undergone advancement of the levator aponeurosis: 34 patients (46 eyelids) had ptosis correction using the two-point suture technique and 26 patients (41 eyelids) had ptosis correction using the three-point suture technique. The postoperative marginal reflex distance (MRD1), lid height difference, and eyelid contour were evaluated. RESULTS Twenty-seven (79.4%) of the 34 patients in the two-point group and 19 (73.1%) of 26 patients in the three-point group had a postoperative MRD1 of 2-4 mm, lids within 0.5 mm of each other, and a satisfactory eyelid contour; this difference was not significant. The rate of reoperation did not differ significantly between the two groups. CONCLUSION Two- and three-point sutures for advancing the levator aponeurosis were equally effective for correcting blepharoptosis in Asians.
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Affiliation(s)
- Y S Kim
- Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - J S Yoon
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - S Y Jang
- Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.,Yonsei University Graduate School of Medicine, Seoul, Korea
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Lim AY, Lee GY, Jang SY, Gwag HB, Choi SH, Jeon ES, Cha HS, Sung K, Kim YW, Kim SM, Choe YH, Kim DK. Gender differences in clinical and angiographic findings of patients with Takayasu arteritis. Clin Exp Rheumatol 2015; 33:S-132-7. [PMID: 26016764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 05/04/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Because Takayasu arteritis (TA) predominantly affects females, few data regarding gender differences have been reported. The aim of the present study is to describe clinical features and angiographic findings of patients with TA according to gender. METHODS According to the 1990 American College of Rheumatology criteria, 294 patients were diagnosed with TA between September 1994 and April 2014 at a single tertiary hospital. We reviewed clinical, laboratory, and radiologic data at the time of diagnosis. RESULTS Among the 294 patients studied, 257 (87.4%) were female (male:female ratio=1:6.9). Female patients had a higher tendency to exhibit blood pressure differences between arms (p=0.595) and a weak pulse at the brachial artery (p=0.063). In male patients, we observed higher serum creatinine levels (p=0.038) and hypertension more frequently (p=0.061) than in females. Females exhibited more common lesions in the thoracic aorta and its branches, while males had more frequent lesions in the abdominal aorta and its branches. An analysis of angiographic classification according to the International TA Conference in Tokyo 1994 classification revealed that male patients had a higher incidence of type IV and females showed a higher incidence of types I, IIa, and IIb. CONCLUSIONS Female patients with TA have more frequent involvement of the thoracic aorta and its branches, whereas involvement of the abdominal aorta and its branches is more common in males. Considering these gender-specific differences, adjustment of diagnostic criteria for TA according to gender may be necessary.
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Affiliation(s)
- A Y Lim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - G Y Lee
- Division of Cardiology, Department of Medicine, Vascular Center, Heart Center, Center for Cardiovascular and Stroke Imaging, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S Y Jang
- Division of Cardiology, Department of Medicine, Vascular Center, Heart Center, Center for Cardiovascular and Stroke Imaging, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - H B Gwag
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S H Choi
- Division of Cardiology, Department of Medicine, Vascular Center, Heart Center, Center for Cardiovascular and Stroke Imaging, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - E-S Jeon
- Division of Cardiology, Department of Medicine, Vascular Center, Heart Center, Center for Cardiovascular and Stroke Imaging, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - H-S Cha
- Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - K Sung
- Department of Thoracic and Cardiovascular Surgery, Vascular Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Y-W Kim
- Division of Vascular Surgery, Department of Surgery, Vascular Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S M Kim
- Department of Radiology and Center for Imaging Science, Center for Cardiovascular and Stroke Imaging, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Y H Choe
- Department of Radiology and Center for Imaging Science, Center for Cardiovascular and Stroke Imaging, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - D-K Kim
- Division of Cardiology, Department of Medicine, Vascular Center, Heart Center, Center for Cardiovascular and Stroke Imaging, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Han JW, Yoon JS, Jang SY. Short-term effects of topical cyclosporine A 0.05% (Restasis) in long-standing prosthetic eye wearers: a pilot study. Eye (Lond) 2014; 28:1212-7. [PMID: 25081289 DOI: 10.1038/eye.2014.174] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 05/20/2014] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Long-standing prosthetic eye wearing induces ocular surface inflammation. We investigated the short-term effects of topical cyclosporine A 0.05% (Restasis) in patients with ocular discomfort resulting from long-standing prosthetic eye wearing. METHODS This was a prospective, interventional case series. Patients who were unilateral prosthetic eye wearers over a period of 5 years were enrolled at a single institution from March to July 2013. The subjects were instructed to instill topical cyclosporine A 0.05% twice per day. Measurements were made pre-treatment and after 1 and 3 months of treatment. Outcome measures were the ocular symptom score, the lid margin abnormality score, the Schirmer test, and the tear meniscus amount, using Fourier-domain optical coherence tomography. RESULTS In total, 20 consecutive patients (mean age: 60.1 years, 8 males, 12 females) were included. Ocular symptoms were improved after treatment for 1 month in all patients (ocular symptom score pre-treatment 76.83 vs 46.75 after treatment; P<0.001). There was no statistically significant difference in lid margin abnormality score or tear meniscus amount. The Schirmer test results were improved after treatment for 3 months (pre- and after treatment, 6.70 vs 11.40; P<0.001). CONCLUSIONS Topical cyclosporine A 0.05% showed a satisfactory effect in long-standing prosthetic eye wearers. Ocular symptoms were markedly relieved in all subjects after treatment for 1 month.
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Affiliation(s)
- J W Han
- Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon,Korea
| | - J S Yoon
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - S Y Jang
- Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon,Korea
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Jang SY, Shin DY, Lee EJ, Lee SY, Yoon JS. Erratum: Relevance of TSH-receptor antibody levels in predicting disease course in Graves’ orbitopathy: comparison of the third-generation TBII assay and Mc4-TSI bioassay. Eye (Lond) 2013. [DOI: 10.1038/eye.2013.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Park JY, Jang SY, Shin YK, Koh H, Suh DJ, Shinji T, Araki T, Park HT. Mitochondrial swelling and microtubule depolymerization are associated with energy depletion in axon degeneration. Neuroscience 2013; 238:258-69. [PMID: 23485808 DOI: 10.1016/j.neuroscience.2013.02.033] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 01/17/2013] [Accepted: 02/15/2013] [Indexed: 01/03/2023]
Abstract
Although mitochondrial dysfunction is intimately related to axonal degeneration following nerve injury, the molecular mechanisms of mitochondrial swelling and its mechanistic relation to axonal degeneration are largely unknown. Previous studies have demonstrated that axonal degeneration in the injured peripheral nerves shows two morphologically distinct phases: (1) A latency period (∼24h), in which the morphology of axonal cytoskeletons seems unchanged, followed by (2) an execution period (36-48h), which shows a catastrophic granular degeneration of most axonal structures in rodent axons. In the present study, we found that, in the sciatic nerve axotomy model, energy failure and microtubule depolymerization occurred during the latency period whereas mitochondrial swelling and neurofilament degradation started in the execution period. The energy repletion with NAD or an NAD/pyruvate mixture inhibited microtubule depolymerization, mitochondrial swelling and axonal degeneration in transected sciatic nerve axons. In addition, microtubule perturbing agents enhanced axonal degeneration and mitochondrial swelling. Extracellular calcium chelation did not affect energy failure, microtubule depolymerization or mitochondrial swelling, but it did prevent neurofilament degradation. These findings suggest that an early disturbance in energy dynamics regardless of mitochondrial swelling might be a key trigger for the initiation of axonal degeneration and that extracellular calcium influx is a late effector for neurofilament degradation.
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Affiliation(s)
- J Y Park
- Department of Physiology, Mitochondria Hub Regulation Center, College of Medicine, Dong-A University, Busan, Republic of Korea
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Lee D, Yoon A, Jang SY, Yoon JG, Chung JS, Kim M, Scott JF, Noh TW. Giant flexoelectric effect in ferroelectric epitaxial thin films. Phys Rev Lett 2011; 107:057602. [PMID: 21867099 DOI: 10.1103/physrevlett.107.057602] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Indexed: 05/31/2023]
Abstract
We report on nanoscale strain gradients in ferroelectric HoMnO(3) epitaxial thin films, resulting in a giant flexoelectric effect. Using grazing-incidence in-plane x-ray diffraction, we measured strain gradients in the films, which were 6 or 7 orders of magnitude larger than typical values reported for bulk oxides. The combination of transmission electron microscopy, electrical measurements, and electrostatic calculations showed that flexoelectricity provides a means of tuning the physical properties of ferroelectric epitaxial thin films, such as domain configurations and hysteresis curves.
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Affiliation(s)
- D Lee
- ReCFI, Department of Physics and Astronomy, Seoul National University, Seoul 151-747, Korea
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21
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Jang SY, Kim H, Moon SJ, Choi WS, Jeon BC, Yu J, Noh TW. The electronic structure of epitaxially stabilized 5d perovskite Ca(1-x)Sr(x)IrO3 (x = 0, 0.5, and 1) thin films: the role of strong spin-orbit coupling. J Phys Condens Matter 2010; 22:485602. [PMID: 21406751 DOI: 10.1088/0953-8984/22/48/485602] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We have investigated the electronic structure of meta-stable perovskite Ca(1 - x)Sr(x)IrO(3)(x = 0, 0.5, and 1) thin films using transport measurements, optical spectroscopy, and first-principles calculations. We artificially fabricated the perovskite phase of Ca(1 - x)Sr(x)IrO(3), which has a hexagonal or post-perovskite crystal structure in bulk form, by growing epitaxial thin films on perovskite GdScO(3) substrates using an epi-stabilization technique. The transport properties of the perovskite Ca(1 - x)Sr(x)IrO(3) films systematically change from nearly insulating (or semi-metallic) for x = 0 to weakly metallic for x = 1. Due to the extended wavefunctions, 5d electrons are usually delocalized. However, the strong spin-orbit coupling in Ca(1 - x)Sr(x)IrO(3) results in the formation of effective total angular momentum J(eff) = 1/2 and 3/2 states, which puts Ca(1 - x)Sr(x)IrO(3) in the vicinity of a metal-insulator phase boundary. As a result, the electrical properties of the Ca(1 - x)Sr(x)IrO(3) films are found to be sensitive to x and strain.
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Affiliation(s)
- S Y Jang
- ReCFI, Department of Physics and Astronomy, Seoul National University, Seoul, Republic of Korea
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Shim I, Javaid JI, Wirtshafter D, Jang SY, Shin KH, Lee HJ, Chung YC, Chun BG. Nicotine-induced behavioral sensitization is associated with extracellular dopamine release and expression of c-Fos in the striatum and nucleus accumbens of the rat. Behav Brain Res 2001; 121:137-47. [PMID: 11275291 DOI: 10.1016/s0166-4328(01)00161-9] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
It is well known that repeated injections of nicotine produce progressively larger increases in locomotor activity, an effect referred to as behavioral sensitization. This study was carried out to investigate the neural mechanisms underlying nicotine-induced behavioral sensitization using in vivo microdialysis and Fos-like immunohistochemistry (FLI). Rats were given repeated injections of saline or nicotine (0.4 mg/kg s.c., twice daily for 7 days) followed by one challenge injection on the 4th day after the last daily injection. Systemic challenge with nicotine produced a much larger increase in locomotor activity in nicotine-pretreated rats (659.1+/-94.9 counts/2 h) than in saline-pretreated rats (218.1+/-61 counts/2 h). A direct local challenge of nicotine (1 or 5 mM) via a microdialysis probe in the nucleus accumbens or striatum induced a much greater dose-dependent increase of dopamine (DA) output in nicotine-pretreated rats than in saline-pretreated rats. Furthermore, in parallel with the behavioral and biochemical data, systemic challenge with nicotine produced marked Fos-like immunohistochemistry in the nucleus accumbens and the striatum in the nicotine-pretreated rats. Taken together, this study demonstrates that behavioral sensitization is clearly associated with an increase in DA release and activation of Fos-like immunoreactive cells in the striatum and the nucleus accumbens produced by repeated nicotine treatment. Our results strongly suggest that the striatum and the nucleus accumbens may play a major role in nicotine-induced behavioral sensitization. The present results are discussed in terms of the development and expression of nicotine-induced behavioral sensitization.
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Affiliation(s)
- I Shim
- Graduate School of East-West Medical Science, Kyung Hee University, Seoul, South Korea
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Johnson WJ, Jang SY, Bernard DW. Hormone sensitive lipase mRNA in both monocyte and macrophage forms of the human THP-1 cell line. Comp Biochem Physiol B Biochem Mol Biol 2000; 126:543-52. [PMID: 11026666 DOI: 10.1016/s0305-0491(00)00220-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [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] [Indexed: 12/01/2022]
Abstract
The identity of the neutral cholesteryl ester hydrolase (CEH) in human monocyte/macrophages is uncertain. Prior studies indicate that hormone sensitive lipase (HSL) is a major CEH in mouse macrophages, and that HSL mRNA is present in human THP-1 monocytes. In the present study, HSL mRNA expression was examined in THP-1 cells as a function of differentiation status and cholesterol enrichment. By RT-PCR with primer pairs that span exon boundaries, HSL mRNA was demonstrated in THP-1 monocytes and phorbol-ester differentiated THP-1 macrophages. cDNA identities were confirmed by sequencing. By Northern blotting, with HSL cDNA as probe, THP-1 monocytes were found to contain HSL mRNA of approximately 3 and 3.9 kb. In THP-1 macrophages, the 3 kb mRNA was greatly diminished, while the level of the 3.9 kb mRNA was maintained. mRNA of approximately 3 and 3.9 kb are those expected of the 86-kDa (adipocyte) and 117-kDa (testicular) HSL isoforms, respectively. The presence of the testicular isoform mRNA was confirmed in THP-1 cells by amplification and sequencing of an isoform-specific cDNA. Additionally, Northern-blot comparisons showed that the 3 and 3.9 kb mRNA in THP-1 comigrated with the HSL mRNA in 3T3-L1 adipocytes and rat testis, respectively. The level of the 3.9 kb mRNA did not vary greatly with cholesterol enrichment. Thus, the HSL gene is transcribed in THP-1 cells both before and after differentiation into macrophages; after differentiation, the predominant mRNA is that for the 117-kDa isoform. This isoform is a CEH, and may mediate some CE turnover in THP-1 cells.
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Affiliation(s)
- W J Johnson
- Abramson Research Center, Joseph Stokes, Jr, Research Institute, Children's Hospital of Philadelphia, PA 19104, USA.
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Shin SY, Kang JH, Jang SY, Kim Y, Kim KL, Hahm KS. Effects of the hinge region of cecropin A(1-8)-magainin 2(1-12), a synthetic antimicrobial peptide, on liposomes, bacterial and tumor cells. Biochim Biophys Acta 2000; 1463:209-18. [PMID: 10675500 DOI: 10.1016/s0005-2736(99)00210-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
A 20-residue hybrid peptide (CA(1-8)-MA(1-12): KWKLFKKIGIGKFLHSAKKF-NH(2)) incorporating 1-8 residues of cecropin A (CA) and 1-12 residues of magainin 2 (MA) has potent antibiotic activity without hemolytic activity. In order to investigate the effects of the flexible hinge sequence, Gly-Ile-Gly of CA(1-8)-MA(1-12) (CA-MA) on antibiotic activity, CA-MA and its three analogues, CA-MA1, CA-MA2 and CA-MA3 were synthesized. The Gly-Ile-Gly sequence of CA-MA was deleted in CA-MA1 and replaced with Pro and Gly-Pro-Gly in CA-MA2 and CA-MA3, respectively. CA-MA1 and CA-MA3 caused a significant decrease in the bactericidal rate against Escherichia coli and Bacillus subtilis and the tumoricidal activity against four different tumor cells, and the PC/PS (4:1, w/w) vesicle-aggregating and disrupting activities. However, CA-MA2 showed a similar bactericidal rate and antitumor, vesicle-aggregating and disrupting activities, as compared with CA-MA. These results suggested that the flexibility or beta-turn induced by Gly-Ile-Gly or Pro in the central part of CA-MA may be important in the electrostatic interaction of the cationic short alpha-helical region in the N-terminus with the cell membrane surface and the hydrophobic interaction of amphipathic alpha-helical region in the C-terminus with the hydrophobic acyl chains in the cell membrane. CA-MA3 exhibited lower activity in antibacterial, antitumor, and vesicle-aggregating and disrupting activities than CA-MA and CA-MA2. This result suggested that the excessive beta-turn structure by Gly-Pro-Gly in CA-MA3 seems to interrupt the ion channel/pore formation on the lipid bilayer. It was concluded that the appropriate flexibility or beta-turn structure provided by the central hinge is responsible for the effective antibiotic activity of the antimicrobial peptides with the helix-hinge-helix structure.
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Affiliation(s)
- S Y Shin
- Peptide Engineering Research Unit, Korea Research Institute of Bioscience and Biotechnology, P.O. Box 115, Yusong, Taejon, South Korea
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Kang JH, Shin SY, Jang SY, Kim KL, Hahm KS. Effects of tryptophan residues of porcine myeloid antibacterial peptide PMAP-23 on antibiotic activity. Biochem Biophys Res Commun 1999; 264:281-6. [PMID: 10527878 DOI: 10.1006/bbrc.1999.1510] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PMAP-23 is a 23-residue antimicrobial peptide from porcine myeloid cells. In order to determine the effects of two Trp residues in positions 7 and 21 of PMAP-23 on antibacterial activity and phospholipid vesicle interacting property, two analogues in which Ala is substituted for Trp residue in position 7 or 21 were synthesized. A(21)-PMAP-23 exhibited reduced antibacterial activity and phospholipid vesicle disrupting activity when compared to those of PMAP-23 and A(7)-PMAP-23. PMAP-23 readily interacted with model lipid membrane and induced membrane destabilization. Therefore antibacterial activity induced by PMAP-23 is due to the interaction of cell membrane with peptide followed by membrane perturbation. A significant structural change on the SDS micelle was not found by Ala substitution of the Trp residue of PMAP-23. Also, there is a good correlation between hydrophobic interaction on RP-HPLC, expressed as retention time on RP-HPLC, and antibacterial activity. The vesicle titration experiment indicated that Trp residues located at near C-terminus are accessible to hydrophobic tail of phospholipid vesicle. This result suggests that the C-terminal end of PMAP-23 penetrates into the lipid bilayer in the course of the interaction with phospholipid membranes and is important for its antibacterial activity.
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Affiliation(s)
- J H Kang
- Peptide Engineering Research Unit, Korea Research Institute of Bioscience and Biotechnology, Taejon, 305-600, Korea
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26
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Jacobson KA, Hoffmann C, Kim YC, Camaioni E, Nandanan E, Jang SY, Guo DP, Ji XD, von Kügelgen I, Moro S, Ziganshin AU, Rychkov A, King BF, Brown SG, Wildman SS, Burnstock G, Boyer JL, Mohanram A, Harden TK. Molecular recognition in P2 receptors: ligand development aided by molecular modeling and mutagenesis. Prog Brain Res 1999; 120:119-32. [PMID: 10550992 PMCID: PMC4321826 DOI: 10.1016/s0079-6123(08)63550-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- K A Jacobson
- Molecular Recognition Section, LBC, NIDDK, NIH, Bethesda, MD 20892, USA.
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27
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Kang JH, Shin SY, Jang SY, Lee MK, Hahm KS. Release of aqueous contents from phospholipid vesicles induced by cecropin A (1-8)-magainin 2 (1-12) hybrid and its analogues. J Pept Res 1998; 52:45-50. [PMID: 9716250 DOI: 10.1111/j.1399-3011.1998.tb00651.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The membrane-disrupting properties of cecropin A (1-8)-magainin 2 (1-12) hybrid peptide, which has higher antitumor with less hemolytic activities than cecropin A (1-8)-melittin (1-12), and its analogues were assessed by measuring the induced release of vesicle-entrapped fluorescence probes. A model membrane was made of zwitterionic phospholipid (phosphatidylcholine) or the mixture of negatively and zwitterionic phospholipids (phosphatidylcholine and phosphatidylserine). The extent of leakage of the aqueous content of the phospholipid vesicles was found to have remarkable discrepancies according to the amphipathic nature of each analogue peptide. The entrapped high molecular weight solute (fluorescein-labeled immunoglobulin G, 55 kDa) also was released by the analogue which had the largest hydrophobic region and the highest amphipathic score among peptides tested. As the result of the determination of the relationships between the membrane-disrupting properties and the hydrophobicity values of peptides, it was found that the membrane-disrupting activity increased according to increasing the hydrophobicity of the peptide. The tryptophan fluorescence emission spectra and CD spectra showed that on interaction with the phospholipid vesicle, the peptide acquired the ordered structure and alpha-helical conformation by moving a tryptophan residue into the nonpolar environment of the phospholipid vesicle. These results suggest that the breakdown of the lipid bilayer was mediated by the alpha-helical amphipathic structure of the peptide interacting with the lipid bilayers as well as the by the hydrophobicity of the peptide.
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Affiliation(s)
- J H Kang
- Peptide Engineering Research Unit, Korea, Research Institute of Bioscience and Biotechnology, Yusong, Taejon
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Shin SY, Lee MK, Kim SY, Jang SY, Hahm KS. The use of multiple antigenic peptide (MAP) in the immunodiagnosis of human immunodeficiency virus infection. Biochem Mol Biol Int 1997; 43:713-21. [PMID: 9385431 DOI: 10.1080/15216549700204521] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In order to develop an ELISA system for the antibody detection of HIV-1 or HIV-2 infections, MAPs for HIV-1 gp41(584-618) and HIV-2 gp36(574-602) corresponding to the immunodominant regions of HIV-1 gp41 and HIV-2 gp36 were used as coating antigens in the ELISA. The MAPs were synthesized by the solid phase method using Fmoc-Lys(Fmoc)-OH and their molecular weights were confirmed by tricine gel electrophoresis. The MAPs reacted with all HIV positive sera (64 samples), but did not react with HIV negative sera (48 samples) obtained from healthy blood donors. The MAPs showed high sensitivity and specificity in anti-HIV 1/2 combo panel and anti-HIV-1 seroconversion panels. The results indicated that the ELISA system using synthetic MAPs of gp41(584-618) and gp36(574-602) as coating antigens can be used as an analytical system for the immunodiagnosis of HIV-1 or HIV-2 infections.
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Affiliation(s)
- S Y Shin
- Peptide Engineering Research Unit, Korea Research Institute of Bioscience and Biotechnology, KIST, Taejon, Korea
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Chou YC, Perng JC, Juan CC, Jang SY, Kwok CF, Chen WL, Fong JC, Ho LT. Endothelin-1 inhibits insulin-stimulated glucose uptake in isolated rat adipocytes. Biochem Biophys Res Commun 1994; 202:688-93. [PMID: 8048938 DOI: 10.1006/bbrc.1994.1985] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A single class of high affinity endothelin-1 (ET-1) binding sites with an apparent Kd of 350 pM and a binding capacity of 69,000 sites/cell was found in isolated rat adipocytes. Whereas ET-1 had no effect on basal glucose uptake, it inhibited insulin-stimulated glucose uptake in both a dose- and time-dependent manner. Insulin binding, however, was not altered. Thus, the present study demonstrates the presence of ET-1 receptor in isolated rat adipocytes and the inhibition of insulin-stimulated glucose uptake by ET-1 via a post-receptor mechanism.
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Affiliation(s)
- Y C Chou
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC
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Kim IC, Cha JH, Kim JR, Jang SY, Seo BC, Cheong TK, Lee DS, Choi YD, Park KH. Catalytic properties of the cloned amylase from Bacillus licheniformis. J Biol Chem 1992; 267:22108-14. [PMID: 1385394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
A gene encoding a new amylolytic enzyme of Bacillus licheniformis (BLMA) has been cloned, and we characterized the enzyme expressed in Escherichia coli. The genomic DNA of B. licheniformis was double-digested with EcoRI and BamHI and ligated the pBR322. The transformed E. coli was selected by its amylolytic activity, which carries the recombinant plasmid pIJ322 containing a 3.5-kilobase fragment of B. licheniformis DNA. The purified enzyme encoded by pIJ322 was capable of hydrolyzing pullulan and cyclodextrin as well as starch. It was active over a pH range of 6-8 and its optimum temperature was 50 degrees C. The molecular weight of the enzyme was 64,000, and the isoelectric point was 5.4. It degraded soluble starch by cleaving maltose units preferentially but did not attack alpha-1,6-linkage. The enzyme also hydrolyzed pullulan to panose units exclusively. In the presence of glucose, however, it transferred the panosyl moiety to glucose with the formation of alpha-1,6-linkage. The specificity of transferring activity is evident from the result of the maltosyl-transferring reaction which produces isopanose from maltotriose and glucose. The molecular structure of the enzyme deduced from the nucleotide sequence of the clone maintains limited similarity in the conserved regions to the other amylolytic enzymes.
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Affiliation(s)
- I C Kim
- Research Center for New Biomaterials in Agriculture, Seoul National University, Suwon, Korea
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